Wikipedia talk:Identifying reliable sources (medicine)/Archive 28

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Should we warn new users before they edit medical pages?

It can't be a very good user experience for newish users to spend time collating good sources that meet WP:RS in the rest of Wikipedia and then have all their work thrown away because an editor believes it fails a strange guideline called WP:MEDRS that they've never heard of before, especially since MEDRS is a good policy but it certainly isn't just a formalization of "common sense" (like "don't use a random blog as a source") that we can expect the average editor to anticipate. In addition, on more obscure pages non-MEDRS info might end up remaining indefinitely. In short, it's obviously better if users are aware of MEDRS before they attempt to add content to medical articles so that they're less likely to attempt to insert content that fails MEDRS.

I would propose that the first time a logged-in user starts to edit a page within the subcategory of Category:Medicine or Category:Health, they get a one-time tip informing them "Tip: on Wikipedia, all biomedical or health content must should conform to stringent WP:MEDRS policy guidelines." (I suspect the Wikipedia software doesn't currently have the ability to do this, but I would argue it's reasonable here to at least ask the software team for such a feature; it's good UI practice to try to inform users of new information as they likely need it, rather than rely on a giant manual nobody's going to read up front.) This wouldn't be perfect, for example it would miss IP users, but it would be better than nothing IMHO.

Rolf H Nelson (talk) 05:03, 10 April 2018 (UTC)

1. How are we going to know a newbie is about to edit a new article? In the example above, Czechboy1 has made a single edit. (I am disregarding the suggestion at Category linkage might work.) 2. If it could work, what about WP:BITE? 3. Why hasn't Czechboy1 received a Welcome message? I think the best person to do so is the reverting editor. – S. Rich (talk) 05:32, 10 April 2018 (UTC)

1. If the user is creating a new medical article, obviously we can't catch that. If the user is editing an existing article within the tree of the given categories, on the classic interface, the tip could show when above the edit box as a small note, same as when you edit "Syria civil war" you get a small "article is semi-protected" note (and a large community sanctions warning; the proposed tip would use a small rather than a large font). I'm reasonably confident some heuristic can be found that identifies a large portion of medical-related articles; because the tip is phrased as a generic tip, it won't confuse users when it occasionally shows up on a non-medical page. In the unlikely event no decent heuristic can be found, we can consider the proposal void. Rolf H Nelson (talk) 06:37, 11 April 2018 (UTC)

@Rolf h nelson: The Syria Civil War article gets a popup warning because an Admin has placed a protective template on the particular article. – S. Rich (talk) 06:50, 11 April 2018 (UTC)

2. The intention is to give a helpful tip up-front, feel free to propose better wording. Rolf H Nelson (talk) 06:37, 11 April 2018 (UTC)

3. Great idea, I'll start doing that from now on when reverting new users. Rolf H Nelson (talk) 06:37, 11 April 2018 (UTC)

I had a look at the edits Rolf H Nelson reverted. They appear to be very well accepted facts these days. So, you reverted information that was likely correct, that you haven't actually contested, purely because you believe the sources fail MEDRS. You also, incorrectly, state MEDRS is a "higher standard" and above claim it is "policy". These are not true. MEDRS is a guideline and as such, the application of policy (WP:V and WP:OR -- especially WP:WEIGHT) to the medical domain. That is all. There is no way that MEDRS would have been accepted as a guideline on WP if it was judged to be a higher or different standard to policy. Please don't make such claims, as it will only encourage folk to seek its removal.

I am very tempted to revert you Rolf, but I'm not a reverty sort of editor. Your job, as an experienced wikipedian, is to welcome this user (their talk page is still a red link) and guide them towards making better edits. One way would be for you to search for better sources yourself -- I'm absolutely sure they'll exist -- and substitute them, explaining to the newbie why they are better. If you don't have access to such sources, you can make a request for others to search at WP:MED. In the mean time, I wonder if you would self-revert please. Reverts are seen by normal people as a slap in the face and by newbies as a "go away". That editor may have struggled for a while to locate the sources and cite them. All their work is now erased. I really, really, wish WP:MED folk would learn not to use revert as a solution to all, and not to take such a dogmatic approach to MEDRS. It is merely a guideline. The only time WP:V requires you to remove text that is unsourced or badly sourced, is BLP. Otherwise a better approach is to source it yourself, or add a tag, or open a discussion on the talk page. Removing text that is likely to be able to be sourced to MEDRS standards is basically a POINTy edit, and disruptive as you've removed encyclopaedic information. We're here to collaborate with others to build a great encyclopaedia, and reverting new users is nether collaborative nor building.

If there's anywhere that needs a warning, it is MEDRS: something about "Reverting per MEDRS is the least helpful thing you can do". -- Colin°^Talk 07:10, 10 April 2018 (UTC)

I've just had another look at the article. There are several other sources that are primary research studies. So this newbie will be doubly confused that you kept those. MEDRS helps you choose better sources and use sources that establish WP:WEIGHT. We should remove information that you know to be wrong or that wouldn't be claimed by those better sources or that fail to have weight/consensus in the literature, or because the added information is already in the article, etc. The lead of that article mentions a study but provides no citation. -- Colin°^Talk 07:29, 10 April 2018 (UTC)

Thanks for correcting me; it is indeed a guideline rather than a policy. Re "Removing text that is likely to be able to be sourced to MEDRS standards is basically a POINTy edit": The added content is unlikely to be sourceable to the MEDRS standards as the MEDRS standards are currently written. Also, I and many other editors believe that often dubious material should be deleted rather than tagged, and current policy allows editors to choose to do either approach. Sorry we don't see eye-to-eye on the revert, now can we get back to the original question I asked? Rolf H Nelson (talk) 06:37, 11 April 2018 (UTC)

The problem is that you haven't actually established that the article text is "dubious". Only that you find the sources to be less than ideal per some guideline. Are you really telling me that "Other problems arising from lack of sleep include poor academic or work performance, lower or slower cognition, and trouble concentrating." cannot be sourced to MEDRS standards? And the statement "Some researchers believe that girls are more prone to the impacts on sleep from electronic media due to their on average higher usage of social media, leading them to stay up longer and be engaged with electronic media up until bedtime." is a totally verifiable fact: some researchers do believe this and here's the published paper. The only question with the last statement is whether per WP:WEIGHT that observation/opinion is accepted to the degree that warrants mention in this article. So, wrt the original question, definitely not per Wikipedia:Please do not bite the newcomers. We cannot expect newbies to get it all right first time. Sorry, but your post on the guy's talk page " if you want to rework the material and try again with stronger sources." is totally wrong on a collaborative editing project. Please read Wikipedia:About. We aren't here to ensure every fact is 100% correct and well stated and sourced to an RCT at all times. The evidence of that is the poor quality of much of the rest of that article, which you seem happy to ignore. Wikipedia is a work in progress and always will be. That means experienced editors at WP:MED help inexperienced editors, and lead by example. Reverting is the least constructive, by its very definition, thing you can do on Wikipedia, and reverting without immediately starting a discussion to achieve consensus for new/modified material, is the least collaborative thing you can do on Wikipedia. -- Colin°^Talk 20:36, 11 April 2018 (UTC)

Seems like all of this should be on the relevant article's talk page rather than here, it being a separate discussion from whether or not there should be some sort of additional reference to this guideline when someone attempts to edit a medical article.--tronvillain (talk) 21:04, 11 April 2018 (UTC)

New article on review articles

With respect to WP:MEDASSESS, editors may find this new article by Trish Greenhalgh et al. interesting on what reviews when are useful: "Time to challenge the spurious hierarchy of systematic over narrative reviews?", doi:10.1111/eci.12931. Bondegezou (talk) 12:32, 18 April 2018 (UTC)

Canine medicine

Does WP:MEDRS apply to canine medicine? I am concerned about the last two paragraphs of Hip_dysplasia_(canine)#Diet_supplementation, which describe the benefits of treatments, usng primary sources. Maproom (talk) 07:18, 3 May 2018 (UTC)

The veterinary medicine project would be a better place to ask. I don't think MEDRS explicitly applies, but MEDMOS does and MEDRS is referred to in MEDMOS. Bondegezou (talk) 12:57, 16 May 2018 (UTC)

PCORI (Patient Centered Outcomes Research Institute): Evidence update for clinicians and patients

Hello, I am interested in obtaining community feedback as to whether these evidence updates are appropriate to use as references in medical articles under MEDRS. According to PCORI, they have been created by an independent panel consisting of patients, clinicians, and researchers who have been trained to assess the primary research. I believe they are also reviewed by a major medical society (The American Urological Society in this example):

https://www.pcori.org/sites/default/files/PCORI-Evidence-Update-for-Clinicians-Prostate-Cancer.pdf

These updates can be found here: https://www.pcori.org/research-results/putting-evidence-work/evidence-decisions

Thank you!

JenOttawa (talk) 01:37, 15 May 2018 (UTC)

• As these are supported by a major medical organization, in this case the American Urological Association, I think they are suitable per MEDRS. Doc James (talk · contribs · email) 19:14, 15 May 2018 (UTC)
• This is a bit complicated. The document on prostate cancer one linked to, focuses very tightly on 2 recent primary sources describing studies funded by the organization. This is almost like a press release about those two studies but gussied up a bit. I struggle with that. There is a column on the left side of the 2nd page that summarizes guidelines that is good. But the rest of the document feels agendy to me. Do you see what I mean User:Doc James? Jytdog (talk) 02:48, 22 May 2018 (UTC)
  • "agendy" User:Jytdog?
  • Yah a bit concerned that they do not review all literature on the topic to put the two studies they funded into context.
  • They are a government sponsored organization whose goal is simply to study various treatments. Doc James (talk · contribs · email) 04:13, 22 May 2018 (UTC)

• Based on a quick overview, I think I would probably count these as tertiary sources, akin to a textbook. That is, they can be used, but high-quality secondary sources are preferable. Looie496 (talk) 13:09, 22 May 2018 (UTC)

agree w/ Looie496--Ozzie10aaaa (talk) 00:28, 23 May 2018 (UTC)

• From 2012-14 I shared information from a Consumer Reports educational campaign called Choosing Wisely. The similarity of that with this case is that PCORI and Consumer Reports both have expertise in determining what technical medical information to lay audiences need and how to make that information easy to understand. Most of the focus in health communication is at United States 4th grade educational level; PCORI and CR have a history of aiming for 8th grade level while showcasing some evidence at the undergraduate college level. This is true even for guides like this targeted to clinicians. Clinicians like anyone else prefer well-written, easy to understand writing when they can trust it and it is available.

Wiki community consensus was that the sources were tertiary as Looie is saying. However, even though these documents say they are for clinicians, they are actually very readable for interested layman audiences. I advise to dual cite with sources like these even when a statement also cites the authoritative academic source because Wikipedia promotes accessibility of information alongside the technical sources. I do not advocate this for all layman sources, but when there is some prominent patient advocate like PCORI or Consumer Reports taking a position that a certain topic needs a special media campaign to communicate it, that is supporting evidence that they as experts have identified an accessibility issue in the available sources. Wikipedia is both readable and correct, and it is okay to draw on correct readable sources to guide the level of precision which Wikipedia presents.

As an aside, I have some documentation about sharing information from this campaign at Wikipedia:Choosing Wisely, but it can be hard to follow because I made that before the advent of automated reports in meta:Pageviews Analysis. If you need support in tracking or reporting what you do to the wiki community or external organizations then ping me. We need whatever precedent we can establish to get more expert organizations engaged with Wikimedia projects. Blue Rasberry (talk) 16:20, 22 May 2018 (UTC)

"Scientific publishing is totally broken".

This Is The Sickening Amount Pharmaceutical Companies Pay Top Journal Editors. Scientific publishing is totally broken. By Fiona MacDonald. 12 Apr 2018.

Following along the lines of this discussion:

• Wikipedia talk:Identifying reliable sources (medicine)/Archive 27#WP:MEDRS is based on a sham. --Timeshifter (talk) 00:46, 13 April 2018 (UTC)

Some sloppy blog, who cares? Grabbing whatever shit is at hand and throwing it at the wall is not impressive - lumping in the finding about German IRBs was completely irrelevant and the scare quotes around "research" are just funny.Jytdog (talk) 00:52, 13 April 2018 (UTC)

The article links to many sources. Feel free to ignore whatever you disagree with. --Timeshifter (talk) 00:56, 13 April 2018 (UTC)

I am sure that sciencealert.com is grateful for the eyeballs you are winning for them. That is the whole point of people posting this kind of alarmist garbage on the internet.Jytdog (talk) 01:01, 13 April 2018 (UTC)

(unindent) Jytdog. You sound like the one slinging crap against the prison cell of your mind, not me. I am slinging reliable sources. From the article:

A paper published last year in the British Medical Journal examined how much money editors of the world's most influential medical journals were taking from industry sources. Of the journals that could be assessed, 50.6 percent of editors were receiving money from the pharmaceutical industry - in some cases, hundreds of thousands of dollars. ... Worst on that list is the Journal of the American College of Cardiology (JACC), where 19 of its editors received, on average, US$475,072 personally and another US$119,407 for 'research'. ... "The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research," said the late Arnold Relman, a former editor-in-chief of the New England Journal of Medicine (NEJM) in 2002. He passed away in 2014. "The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. I think it's disgraceful." ... There's also a push to get organisations to publish all valid results, even if they're negative.

Read the article for more info. and more links to reliable sources. --Timeshifter (talk) 07:12, 13 April 2018 (UTC)

Let's see... "For the 713 editors, the median general payment was $11 (interquartile range $0-2923) and the median payment for research was $0 ($0-0)." Gosh. --tronvillain (talk) 18:18, 13 April 2018 (UTC)

Follow the money. |

• NIH suspends study on benefits of alcohol after questions about industry involvement. By Jessie Hellmann - 05/17/18. Washington Post. From the article:

The advocacy group Public Citizen has criticized the NIH review of the alcohol study, saying it should be handled by the inspector general of the Department of Health and Human Services. Collins “is basically investigating himself,” said Michael Carome, director of Public Citizen’s Health Research Group. Carome added that the funding of the alcohol study damaged NIH’s reputation, and the halting of the study “is a small step toward restoring that reputation.”

And (emphasis added):

Sen. Patty Murray (D-Wash.) asked whether what happened at NIAAA with the alcohol study might have happened at other institutes in the sprawling NIH operation. Collins answered, “I'm very concerned this might be the tip of a larger iceberg,” adding that his investigators are looking for other examples at NIH.

--Timeshifter (talk) 07:05, 18 May 2018 (UTC)

Follow the lack of money and interest for unbiased or less biased government studies versus (more biased overall) Big Pharma studies. Bias based on choice of what to study. Followup studies on unproven, possibly harmful, adjuvant therapy, versus new drug studies which are much more profitable.

• Doctors Scrutinize Overtreatment, As Cancer Death Rates Decline. June 5, 2018. Heard on All Things Considered on the American network National Public Radio (NPR). Article quotes with emphasis and wikilinks added:

Why are doctors giving patients challenging and unnecessary treatments? ... Over the years, doctors started using it for less advanced cases, and eventually as a treatment to prevent cancer from coming back (known as "adjuvant therapy.") ... There may be many other cancer treatments that are unneeded and possibly even harmful. Many long-time medical practices are based on tradition and thin evidence. But Johnson worries the federal government has been losing interest in this kind of expensive and time-consuming research. He notes that over the past decade, the number of studies presented at the ASCO meeting that have been funded by the U.S. government has dropped from 575 to 143. "It's cut in one-fourth!" he laments. "And one of the things that we think is critically important is a robust clinical infrastructure supported by our government." Indeed, European researchers presented many of the big studies at this year's meeting. ... care about research that will save government health services the costs of unneeded treatment.

--Timeshifter (talk) 22:07, 5 June 2018 (UTC)

So...why is Timeshifter using the top thread on this talk page to maintain an ongoing blog? TenOfAllTrades(talk) 22:13, 5 June 2018 (UTC)

The talk page archiving software has archived threads above it. I keep adding related info as I find it. This thread is all about the effect of money (or lack of it in some cases) on reliable sources used in medical-related Wikipedia articles. It is important info helpful for deciding which reliable sources to use. And what importance to assign to each. It is on topic. --Timeshifter (talk) 04:51, 8 June 2018 (UTC)

MEDRS for all sources?

Does every source in an article need to meet MEDRS requirements even when no medical claims are being cited? It is widely accepted (New York Times NewYorker Wired Smithsonian Financial Times) that Silicon Valley has some fascination with life extension. My inclusion of this text at young blood transfusion has been reverted citing MEDRS: Young blood transfusions have been called a "current trend" in regenerative medicine, with significant Silicon Valley investment in "life extension". Jeff Bercovici wrote for Inc. that it is "a popular obsession" and that there are rumours of wealthy technology bosses "spending tens of thousands of dollars for the procedures and young-person-blood". I doubt that I could find that backed up in any medical journal but I think it is making relevant non-medical claims sourced from reputable non-medical sources. violet/riga _^[talk] 11:24, 29 May 2018 (UTC)

To answer the more general question about sources posted here. This kind of source is opinion, and as long as the source is reliable as well as the writer, and as long as health claims are not being made, is acceptable. Its probably a good idea as the example here shows, to reference the writer by name rather than post in Wikipedia's voice. If we are going to remove this kind of content and I'd say again the publication and writer for the publication have to be reliable then we can get rid of the same kind of opinion in other articles. A good example is the content added and sourced to David Gorski on his blog/blogs. Do we want to get rid of that content. General consensus seems to be we don't.(Littleolive oil (talk) 15:11, 29 May 2018 (UTC))

I'd add that I have edited a little on this article.(Littleolive oil (talk) 15:11, 29 May 2018 (UTC))

I think Littleolive oil puts it well — it is a good idea to qualify this with who said it, or that it was from the New Yorker — if for no other reason than that this strengthens the message as opposed to "some claim". MEDRS applies only to medical claims, so to answer your question if MEDRS applies to everything in an article: No.

However, "popularity" or "prevalence of use" is a medical claim and most often falls under MEDRS. The popularity of "alternative medicine" is subject to epidemiological research, and it is often heavily overstated by practitioners — so there MEDRS applies. Your topic violetriga, is an edge case and it would be a stretch to suggest that such research exists to cover young blood transfusions. I would be comfortable using the New Yorker to claim a "trend". At the very least one could use it to claim a trend in media-coverage, if it does not specifically suggest that the prevalence is going up. If there are 5 people, up from 2 doing this thing it isn't worth mentioning that prevalence is up, but if media coverage is up it could certainly be. Carl Fredrik ^talk 07:31, 8 June 2018 (UTC)

"Primary source" definition is too broad

The project page defines a "primary source" as "one in which the authors directly participated in the research or documented their personal experiences. They examined the patients, injected the rats, filled the test tubes, or at least supervised those who did. Many, but not all, papers published in medical journals are primary sources for facts about the research and discoveries made." This is overly simplistic. More accurately, a primary source is the data set, interview transcripts, etc., from which the findings are derived. If the current definition of primary source was used consistently on Wikipedia then many if not most of the citations on medical articles would have to be removed as primary research. This definition seems to be applied selectively editors which results in edits being reverted because of this definition of a primary source. There are literally thousands of valid citations on Wikipedia that fall afoul of the very broad definition used here. For example. Actually, about 1/2 of the citations on that article which are perfectly fine could potentially be removed as primary sources. AugusteBlanqui (talk) 21:53, 30 June 2018 (UTC)

So you're saying that the primary source is the data itself that is generated by researchers? I've never heard that definition before. The definition we use is the common construct of what a primary source in the biomedical sciences is. Natureium (talk) 22:36, 30 June 2018 (UTC)

@Natureium: The University of Minnesota Bio-Med library has an accurate definition which includes both journal articles and the data: "Primary sources are original materials/information on which other research is based. It includes journal articles of original research, conference papers, dissertations, technical reports, and patents.Primary sources are also sets of data, such as health statistics, which have been tabulated, but not interpreted." AugusteBlanqui (talk) 23:38, 30 June 2018 (UTC)

Ok, but that definition you just quoted also includes what you're wanting to take out of the MEDRS guidelines. Natureium (talk) 01:39, 1 July 2018 (UTC)

We understand that "primary source" is a technical term here in WP. It means what it means here. That is why we take pains to define it. We understand completely that the term is used differently elsewhere. And yes, we constantly need to maintain articles, removing primary sources where they are used inappropriately. Jytdog (talk) 22:39, 30 June 2018 (UTC)

Wikipedia:Frequently misinterpreted sourcing policy

Some here may want to weigh in on this at Wikipedia talk:Frequently misinterpreted sourcing policy. Flyer22 Reborn (talk) 06:01, 1 July 2018 (UTC)

It says in bold "Even WP:MEDRS has a blatant error in this regard,...". Is it required reading for those who don't follow MEDRS? It looks like a humour essay! QuackGuru (talk) 06:16, 1 July 2018 (UTC)

The title "Frequently misinterpreted sourcing policy" is not what the page is about. It claims "This is a list of key points of frequently misinterpreted sourcing policy, guidelines, and community norms at Wikipedia."[1] It is not about that. It is a disagreement with sourcing policy. It is not about misinterpreting policy. If it was about misinterpreting policy then it would be providing specific information on what is being misinterpreting. It is about "Frequent disagreements with sourcing policy". The title should be changed to reflect what the page is about. QuackGuru (talk) 22:31, 2 July 2018 (UTC)

different medical dictionaries are used in Wikipedia articles. Is there a list of reliable ones?

Which medical dictionaries are considered reliable sources? I'm looking around but I don't see a list anywhere. Some Wikiprojects list all reliable sources in one area, making it easier to search for things. Dream Focus 23:05, 14 July 2018 (UTC)

FASEB unreliable?

Someone has claimed at Talk:Marie Antoinette syndrome that Federation of American Societies for Experimental Biology is categorically unreliable. I don't know enough about the organization to know if this is true. I did not that our article on them reads like a brochure (i.e., like WP:COI editing, possibly copy-pasted from their official "about us" info).  — SMcCandlish ☏ ¢ 😼  14:03, 16 July 2018 (UTC)

FASEB is a professional organization of all branches of experimental biology, commonly joined by American and Canadian academic and industrial biological scientists. It publishes the FASEB Journal, having an impact factor of 5.6 (moderate strength) containing diverse articles on the biological sciences. The Talk page comment by the unsigned editor, "The source "FASEB" has been shunned by virtually all scientific communities for inventing evidence and falsifying studies for political reasons" is opposite to the truth. The issue for WP:MEDRS is whether the source provided is appropriate by MEDRS standards as a systematic review. This ref is just an observation and commentary, and is not a MEDRS-quality source for the topic. --Zefr (talk) 14:28, 16 July 2018 (UTC)

References

Assessing journal reputability

Hmm. So, there don't seem to be any comprehensive impact factor tools. Even Clarivate's (which seems to be a paid-subscription site) only covers about 10% of journals. I've run into dubious citations from Advances in Aging Research (basic journal info here) and Journal of Stem Cells (basic journal info here). Neither are listed at the predatory journals site, but that's always a work in progress. Just the nature of the material cited and the authors' affiliations makes me think these are probably predatory journals or basically pseudo-journals, but it's not my field.  — SMcCandlish ☏ ¢ 😼  09:52, 20 July 2018 (UTC)

Citations and proper attribution for medical-related content

• {{PD-notice}}
• {{CC-notice}}
• WP:CFAQ
• WP:COMPLIC

The sources below include the proper attribution in citations to avoid a copyright violation or to indicate the content from the source is in the public domain:

References

When an editor copies content from a source they also need to include the proper attribution inside the citation. For example, the following slanted content was copied. See The understanding of trypophobia is still limited and the number of peer-reviewed articles is low, as of 2018. The citation includes the part This article incorporates text by Juan Carlos Martínez-Aguay, Renzo C. Lanfranco, Marcelo Arancibia, Elisa Sepúlveda and Eva Madrid available under the CC BY 4.0 license.

References

The proper attribution was added to the citation. MEDRS does not address how to format a citation in order to copy content from a source to avoid adding a copyright violation to a medical article. Without proper attribution it is a copyright violation if the content was added to an article or even the talk page of any medical article. There are sources that allow content to be copied but they require proper attribution in order to use the content. Proper attribution is required for copying licensed content that is not in the public domain. See WP:Compatible license. Editors should not remove the required attribution inside the citation or quote the source in the article or on the talk page without a link to a source for content that is not in the public domain. Unattributed copying in a medical-related article or the talk page is a copyright violation. We do use copy-pasted material from a source without quoting it, when it's permissible under copyright law. Many organisations have content on their website that are in the public domain such as content on the FDA website. The CDC website has a lot of medical-related content that is in the public domain. For content that is in the public domain I use the correct template for public domain content. See Template:PD-notice.

I propose we create a new section for MEDRS in order to explain how to properly use sources that have a WP:Compatible license. QuackGuru (talk) 04:53, 21 July 2018 (UTC)

While we should always encourage editors to properly cite content – including attribution of reused public domain and compatibly-licensed material – the copyright status and proper citation method for a particular source don't really have anything to do with assessing the reliability of that source. There may be a better place for this sort of guidance; it strikes me as out of scope here. TenOfAllTrades(talk) 05:25, 21 July 2018 (UTC)

The issue is that editors are adding content to medical-related articles without the proper attribution. I have seen on a medical-related article the required attribution was removed from citation that caused a copyright violation. Editors can easily add more content to a medical-related article if they knew the content can be copied. I'm not sure where is the best place to explain all of this for medical-related content. QuackGuru (talk) 05:34, 21 July 2018 (UTC)

Ah, okay. I hadn't delved into the dispute at Talk:Trypophobia.

My (admittedly cursory) reading of the situation there is that the dispute is less about methods of citation, and more about when and whether – as a matter of good editorial practice – we ought to copy compatibly-licensed (i.e. public domain or compatible free-licensed) blocks of text into our articles without setting them off with quotation marks. That's a much more complex and nuanced discussion—but it's still not really a MEDRS-specific issue. (In circumstances where MEDRS is engaged, I would as a rule of thumb discourage the use of quotation-mark-free copying, even where licensing/copyright status might allow it. When we present medical information in Wikipedia's voice – that is, without quotation marks – it should be the writing of Wikipedia editors, not the writing of outside authors dropped in en bloc.) TenOfAllTrades(talk) 00:14, 22 July 2018 (UTC)

Predatory journals: add DOAJ list of members?

Should we add the DOAJ list of publisher members[2] as an additional source to check what open access journals are reliable sources? --Signimu (talk) 20:56, 27 July 2018 (UTC)

Use up-to-date evidence: a more recent review not citing an old material makes it automatically dubious?

In the section "Use up-to-date evidence", we can find the following:

«If recent reviews do not mention an older primary source, the older source is dubious.»

I think the "is dubious" might be a bit too strong, as there can be many reasons why a recent review does not mention an older primary source (eg, simply did not find it, bias of opposite view with the review authors, redondant with newer material, etc). I propose to change this part of the sentence into "the older source might be dubious". --Signimu (talk) 18:24, 28 July 2018 (UTC)

Don't take this like law. That probably arose because people attached to out-dated ideas raised arguments when those ideas where no longer current and not reflected in newer sources.

The spirit of this guideline find high quality sources and summarize what they say. Part of "high quality" is "relatively recent". If you just find high quality sources and summarize them (them, dealing with any tensions among them), it is hard to go wrong with respect to this guideline. Jytdog (talk) 18:37, 28 July 2018 (UTC)

Quick MEDRS question

From MEDRS: "Ideal sources for biomedical material include..." (emphasis added).

Here's my question: Does MEDRS apply to "biomedical" articles only? I often recommend WP:MED to other psychologists as an example of a smart, well-organized Wikiproject that produces high-quality medical articles. And I generally believe articles about psychosocial topics that might not fall under the "biomedical" umbrella (or at least the entire article is not focused on biomedical concerns) often benefit from following guidance or policies developed by this Wikiproject such as MEDRS. Is there an essay or policy which describes the difference between "biomedical" and, for lack of a better term, "definitely not biomedical"?   - Mark D Worthen PsyD (talk) 21:02, 6 August 2018 (UTC)

There is pretty much broad consensus that this means "health". Carl Fredrik ^talk 22:39, 6 August 2018 (UTC)

So far, we have Wikipedia:Biomedical information for what biomedical material is and isn't. Flyer22 Reborn (talk) 15:30, 7 August 2018 (UTC)

Thanks y'all! :0)   - Mark D Worthen PsyD (talk) 02:43, 12 August 2018 (UTC)

Thank you and hello

Hello - I wanted to follow up on the helpful post from JenOttawa's post about PCORI's evidence updates for patients and clinicians. Thank you for everyone's help. I work for PCORI (the Patient-Centered Outcomes Research Institute) and I'm slowly learning the ropes about how to share vetted, reliable sources about results from the studies we've funded. Again, thank you for your feedback so far and help in the future. Link to original post: PCORI's Evidence Update for clinicians and patients Nytodc (talk) 12:21, 15 August 2018 (UTC)

RfC

Please see Wikipedia:Reliable_sources/Noticeboard#RfC:Genetics_references Jytdog (talk) 17:03, 9 September 2018 (UTC)

European funders seek to end reign of paywalled journals

European funders seek to end reign of paywalled journals. By Martin Enserink. Science. 07 Sep 2018: Vol. 361, Issue 6406, pp. 957-958. DOI: 10.1126/science.361.6406.957. --Timeshifter (talk) 01:29, 12 September 2018 (UTC)

This policy is effectively BROKEN

The problem with primary vs. secondary sources in medicine, is that first, it is impossible to applicably quote a secondary source without first having quoted a primary source. Secondly, Primary Sources must pass scientific peer review in order to be published, and therefore are quite reliable despite what this policy attempts to allude to. Secondly, there is the issue of articles for which nearly all of the information is primary sourced. (such as Cannabidiol Which has extremely sparse research, and virtually no reliable secondary sources that aren't clearly politically inundated.) Therefore, I find this policy to be inappropriate and misguided, especially in the context of the most modern subject matters that are most likely to be relevant to readers on this kind of platform. 71.91.178.54 (talk) 07:37, 20 August 2018 (UTC)

Although I might not phrase the concern as harshly, I agree with the gist of <Anonymous_IP>'s argument, i.e., we should not automatically assume secondary sources are better. In practice, I think the active editors in this WikiProject evaluate the quality of secondary sources. However, it would help new editors, and some experienced editors, to describe when and how secondary sources should be used, and when primary sources would be better. (If there is already something that does what I'm suggesting, please let me know! Many thanks   - Mark D Worthen PsyD (talk) 08:09, 20 August 2018 (UTC)

Primary vs. secondary isn't really the key issue for medical articles (nor indeed for most scientific articles). The main issues are quality and, for medical articles, one-off studies vs. reviews of multiple studies. Peter coxhead (talk) 10:02, 20 August 2018 (UTC)

What differentiates "primary" from "one-off studies" and "secondary" from "reviews of multiple studies"?   - Mark D Worthen PsyD (talk) 13:02, 20 August 2018 (UTC)

Well, it depends on your definition of "primary" and "secondary". I am fine with equating "one-off studies" to "primary" and "reviews of multiple studies" to "secondary". But the problem for scientific articles is that the definitions of "primary" and "secondary" are taken from WP:PSTS, which is policy, so can't be lightly ignored. It was written by and for historians and the like, not scientists. Many of us regularly encounter the view that journal articles are automatically "primary" regardless of their nature. Peter coxhead (talk) 13:18, 20 August 2018 (UTC)

Primary sources should refer to a dataset or some other type of evidence. Referring to peer-reviewed journals as primary sources by default is a bad policy that limits the use of peer-reviewed material on Wikipedia. Very few peer-reviewed journal articles are review articles. AugusteBlanqui (talk) 09:16, 13 September 2018 (UTC)

@AugusteBlanqui: I agree wholeheartedly. But the problem remains the way that WP:PSTS, which is policy, is regularly interpreted. Peter coxhead (talk) 13:28, 13 September 2018 (UTC)

Responding to the OP and AugusteBlanqui. Here in WP, terms like "primary" and "secondary" are technical terms. They have a relationship with the use of the terms in historiography, from where they were cadged, but they mean things here. Wanting it to be different, is like complaining about the concept of grammatical gender in languages that use it. It's how it is.

Probably more important, the policy and guideline system here isn't broken. Some parts of it seem bizarre or arbitrary at first, but it all hangs together and makes sense, once you understand how this place works and why it works that way. Please have a read of User:Jytdog/How which tries to explain that.Jytdog (talk) 15:16, 13 September 2018 (UTC)

Jytdog wrote: "Here in WP, terms like "primary" and "secondary" are technical terms. They have a relationship with the use of the terms in historiography, from where they were cadged, but they mean things here." I wasn't sure where exactly "primary" and "secondary" are defined for biomedical articles, so I looked around. For other Wikipedians who aren't sure what Jytdog was referencing, the terms are defined for biomedical articles here: Identifying reliable sources (medicine)#Definitions. I also found two other bits of helpful info.

First, the second paragraph in No original research#Primary, secondary and tertiary sources: "Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary, secondary or tertiary sources are appropriate in any given instance is a matter of good editorial judgment and common sense, and should be discussed on article talk pages. A source may be considered primary for one statement but secondary for a different one, and sources can contain both primary and secondary source material for the same statement."

Second, although it's an explanatory supplement (information page), i.e., a helpful explication, but not official policy, I liked Identifying and using primary sources#Secondary does not mean "good", which includes a subsection, Primary does not mean "bad".   - Mark D Worthen PsyD (talk) 07:34, 15 September 2018 (UTC)

Time to play the fake secondary source game

Quite often, if a disease is rare and/or the human trials were expensive, it will be some time before trial results are independently duplicated. In the meantime, we will have effectively only one good primary source, and everybody else writing later, will be padding it out in a "review" which looks at the natural history of the disease, treatments of other manifestations of it, and the ONE good randomized prospective blinded multicenter placebo controlled human trial published in (say) NEJM. But padding out a NEJM primary clinical trial does not make a "real" secondary source. Even worse, as a second matter, the fears of primary sources addressed in MEDRS are not even germane. We read "Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early in vitro results which don't hold in later clinical trials." Yes, yes. But what if this WAS a clinical trial? What if it was the best one you can think of? What if it was a superb one, good enough for the NEJM? Is that trial reference strong enough to support ANY statement in WP? It may be good enough to support a glowing editorial by non-study authors in the same edition. It may serve as the centerpiece in a bunch of later "stone soup" reviews which cite only it, plus a bunch of background articles. Does it then get to slip in the back door? Yes, often it does.

This week the NEJM published a blinded placebo-controlled multicenter trial of the drug tafamidis, a putative small molecule treatment for ATTR cardiomyopathy. The trial found the drug cut mortality rates (p<.001) and hospitalizations and improved clinical outcomes. It is inductively supported by some work with tafamidis in the neuropathy of ATTR and also by basic biochemical studies showing how the drug works to stabilize ATTR so amyloid does not form from it. But there are not yet any confirming studies, and won't be for some years. So I put in a paragraph saying what the trial had found, but I didn't add what you can read in an NEJM editorial: Given the dearth of acceptable treatments for this disorder, these robust efficacy results, combined with a benign safety profile, suggest an important role for tafamidis in the treatment of transthyretin cardiomyopathy. (NEJM Sept 13, 2018, p. 1084).

Now, I care nothing about tafamidis. I have no horse in this race. But I'm interested in amyloids, so I added the study for what it found, and nothing more. My addition was then completely reverted by user:Jytdog here with the somewhat rude comment that we avoid primary sources, along with a comment on my talk page that I had formatted the references wrong.

Why should I work to get them right, if somebody is just going to remove rather than improve? That's why I stay away from the medical content of Wikipedia. From what I know of ATTR (including familial amyloid polyneuropathy) I would be willing to bet a large sum that this drug is active. I would also be willing to bet a lesser sum that, given the important nature of this study, somebody will succeed in adding some review of ATTR treatment that contains this study as centerpiece (but nothing more that confirms it), as a "secondary source" in WP, and it will "stick." Or more likely, the FDA will use the same study (or the same multicenter data) as basis to approve the drug for this use. THEN, WP will mention it. But the FDA's endorsement (with no more data) adds nothing epistemologically, either. NONE of it is better than just the primary source and editorial, no matter who else signs-on. The evidence is just as good (or bad) as it ever was. Meanwhile, you're just fooling yourselves. But you on WP will do that. Wait and see.

The problem with WP:MEDRS is that nobody actually follows it as stringently as is suggested by these actions, or else WP's reporting of many medical matters would be many years behind the times. Instead, what happens with a single very good trial, is that "stone soup" reviews that use it as a jewel in their setting, then get used as "secondary sources", even though they add nothing but editorial endorsement by another bunch of authors. Big deal. But if it makes you all feel better, then I guess it does. I'm just not going to contribute my time to the "single jewel in a nice setting" game. I'll go back to chemistry and physics articles and continue to let medical articles be edited by non-physicians, and WP:OWNed by a few doctors who seems to have taken over the standards and enforce them haphazardly, and with no real relationship to what the rest of us (including the FDA) take as likely reality. Enjoy yourselves. SBHarris 01:32, 13 September 2018 (UTC)

I am sorry that you found the {{RSPlease}} template upsetting, and to be about formatting citations. The heart of that message is meant to be the kind of sources that we use. It was changed recently to add a bunch of detail about how to format refs; it used to do just have this message.

To your point, our mission is to summarize accepted knowledge. A primary source in the biomedical literature is not "accepted knowledge".

Yes, that sometimes puts us "years behind the times". (although that is an exaggeration - reviews come out pretty regularly on most things, and good ones actually look at the primary sources and don't just regurgitate them).

But it is OK to be "behind the times". We are not a newspaper, and Wikipedia overall is lagging indicator of notability (that is about N, not what is noteworthy, but the same idea applies.)

With respect to clinical trials published in the NEJM, I was just talking to a muckracking medical journalist on the phone the other day and mentioned NEJM, and she about ripped my head off, and said "industry sponsored clinical trials in the NEJM are infamous for being corrupt and skewing the data" or something like that. (She is not alone in that perception - see here for example)

More generally, there are lots of reasons why we rely on secondary sources for content about health. You might find WP:Why MEDRS? helpful in that regard.

Sorry you were upset. But no. I and many other experienced medical editors will remove edits like that, most every time. (about the "inconsistency" thing, well this is "the encyclopedia that anyone can edit". Any bit of content will only be as good (or bad) as the last editor who touched it, left it. As you should know). Jytdog (talk) 01:49, 13 September 2018 (UTC)

First of all, who told you that WP’s purpose was ONLY to summarize “accepted knowledge”? We do that, but we also summarize the accepted state of debates and the accepted state of preliminary hypotheses and the unknown. If somebody else writes about it in a RS, even if they write about Dark energy, we summarize it. We reliably know almost nothing about (say) dark energy and in fact most astronomical topics. In most of medicine and biology we have theories and we’re in the dark about most mechanisms. We summarize idiopathic diseases.

We summarize academic disagreements. We even summarize legal and journalistic disagreements that get significant RS coverage, like the one you mention regarding rivaroxaban. Let’s take that one. The muckraking journalist you talked to can probably be fairly described as just that (and you can thank some really stinky past journalist editors of WP for the fact that WP considers muckracking in “newspapers of record” to be RS, but that’s an old WP:ILIKEIT debate). In 2016 a lot of plaintiffs, going after a huge pile of money, attacked Bayer and rivaroxaban in tort suits, and especially a 2011 NEJM study ROCKET AF (which put the drug on market in the U.S.), claiming use of a faulty home INR machine might have jeopardized that NEJM study’s conclusions (an interesting hypothesis, but in need of proof). And there is Wikipedia, citing newspaper articles about all this, at the end of a drug article. And you citing them. Ah, but did the opposition prove its case? No. Has further study of the drug in separate trials shown that rivaroxaban does anything but what it was originally designed and advertised to do? No. It’s still a best-selling drug, though the warfarin INR machine is gone. Ah, the BMJ got a chance to razz the NEJM over that. Damn Yankees and their home machines. However, warfarin itself is also going, going, going…, even in Great Britain. Rivaroxaban actually was started as a WP article in 2009, after being approved in the EU and Canada for post-surgery clot prevention, BEFORE the US. You can see that article edited by user: Doc James then, and full of references to primary studies. Ouch.

Okay, just about every sentence in the previous paragraph speaks against your arguments. You are not doing well. In fact, I’m going to revert your reversion. I would suggest you follow Doc James for awhile and make such changes to HIS articles.

Now, of course there is nothing I can say to your suggestion that WP is inconsistent and I have no argument based on the state of how things are. We always excuse WP’s crap that way, as well as when it does things we don’t like. But I do have an argument based on your own editing. You recently edited Gene therapy of the human retina. You collapsed three primary studies into a review—that’s fine, since we use the best sources we have. But you left the rest of the article a wastebasket of studies of a few patients, mostly non-blinded retinal studies (that’s a joke, son). And at the end of the clinical section, a monkey study. One supposes a ‘’clinical’’ monkey study. ;’p. But you went from there to attacking my editing five days later. Why not finish off the monkeys in this article about human retina therapy? You have work to do. Go do it on somebody else.SBHarris 04:46, 13 September 2018 (UTC)

Which primary sources are you saying I have added? Or are you just saying that primary sources exist within some of the articles I have edited? If the first happy to have it brought to my attention. If the latter happy to see the primary sources replaced by secondary ones. Best Doc James (talk · contribs · email) 05:12, 13 September 2018 (UTC)

I'll be glad to. In cases where genuine secondary sources do not exist (just a review of a primary, but no-meta analysis or additional info) would you like to know about it so you can delete it entirely, as was one to me? I'll be glad to show you many of these. The point of WP:MEDRS is we use the best sources we can get. But if only one really good study exists for a given drug, we don't ignore it until there are TWO. Even the FDA doesn't do THAT. You recently looked at nitrofurantoin. How many primary articles do you count in the references? Remove them! SBHarris 05:59, 13 September 2018 (UTC)

Who says its "good". I wonder. Papers get retracted even from Nature. We look to reviews not only for meta-analyses (which I guess is what you are getting at, with the "TWO" business); a good review will also let us know how the clinical trial paper has been received by the field. That is how we know it is "good". That is the epistemology here. Sources are experts. Not you. Not me. Jytdog (talk) 18:58, 13 September 2018 (UTC)

Sbharris, please thread your posts.

I fully understand where you are coming from. It is not what we do here. MEDRS has broad and deep consensus. I get it that you don't agree with it. Jytdog (talk) 05:22, 13 September 2018 (UTC)

And I get it that you don't really understand it. You'd have to delete 90% of the content of all biomedical articles on Wikipedia. SBHarris 05:59, 13 September 2018 (UTC)

90%. Hm. Jytdog (talk) 14:26, 13 September 2018 (UTC)

For Jytdog and SBharris to consider

IMHO both of you had valid points, and both of you could communicate in a more collegial manner. So here's a challenge for you both, if you choose to accept it. Do one or more of the following:

(a) For the next four weeks, show appreciation for another editor each week, e.g., give an editor a barnstar.

(b) If you don't already belong, join WikiProject Editor Retention and nominate someone as Editor of the Week until your person is selected.

(c) Give an olive branch to an editor with whom you have had a dispute.

(d) Tell me to go to Hades for daring to imply that you might benefit from greater civility!

Sincerely   - Mark D Worthen PsyD (talk) 08:35, 15 September 2018 (UTC)

Thank you, Mark. If I had a way of showing you my notice list (I know of none) I could show you my list of "thank you s" gotten for my edits, and those I've given to others. And the barnstars and other things I've given to other editors who've helped me. For example: [3]

The problem here is that I am procedurally right, if the procedure you worship is WP:MEDRS. As I just wrote on WP:AN3, WP:MEDRS actually has a section at the beginning (which I once absorbed but had forgotten the source of) which addresses just this kind of problem:

Findings are often touted in the popular press as soon as original, primary research is reported, before the scientific community has analyzed and commented on the results. Therefore, such sources should generally be entirely omitted (see recentism). Determining weight of studies generally requires reliable secondary sources (not press releases or newspaper articles based on such sources). If conclusions are worth mentioning (such as large randomized clinical trials with surprising results), they should be described appropriately as from a single study: (example given) Given time a review will be published, and the primary sources should preferably be replaced with the review. Using secondary sources then allows facts to be stated with greater reliability: (example given) If no reviews on the subject are published in a reasonable amount of time, then the content and primary source should be removed. bold added by sbharris

We have exactly that kind of study here. Cardiologists have been praising it in several places on the internet, including its unusual but powerful structure-- but since the study came out in print only last week, and since this is a rare disease which is very expensive to study in this way, we do not have time yet for any sort of published "review" to appear. Certainly no "reasonable" amount of time has passed, yet two editors overrode me and removed my information on the new study immediately anyway, citing WP:MEDRS. Which actually says it's appropriate to wait, in a good study with conclusions "worth mentioning."

Now, Jytdog is in violation of this policy, and so is the editor who agreed with him and removed my contribution for the THIRD time (instead of finding a better place for it as an "recently-advanced experimental therapy"-- which I myself would have done except I was, and am, being scrutinized). Doc James was silent. Nobody else said anything except drop-bys on AN3, and they clearly hadn't read the policy, either. But they had an opinion against me anyway.

As I said, my own editing on WP is full of places where I thank other editors and they thank me, and where I back down when shown to be wrong, and basically I'm usually pretty collegial. But in this case I'm right and my opponents are wrong, and the problem is they can't admit it, and can't back down, and so I wound up on WP:AN3. I won't put up with that, any more than being punched in a bar fight. If people want to WP:LAWYER me, I'm going to make them own it. And I'm not going to make it pleasant when somebody puts their foot in it, in the process of wikilawyering. Why should I? If anybody had thought about this for more than a minute, they'd have done some more reading, instead of coming at *me.* This is not something that can be fixed with a bit of couples-therapy. The WP system is, in many ways, broken. I’m angry about it. I'm tried of coming here as a subject matter expert, and having to spend time beating down people editing from Mom's basement, and that's why they have so many edits, or have risen to the rank of administrator, or whatever. That's what happens in an anonymous system.

WP:MEDRS has many problems, and we can begin with what "a reasonable amount of time" to wait for a review is. Who is to judge? Not the literature, because it's not going to say. WP editors who know nothing of the subject or the medical publication world? Editors who don't have any medical publications themselves, or any experience with the process? WP editors usually (but not always) lack exactly what a review (absent any new evidence) brings to the table! You see the problem. In any case, whatever you decide, a week is not long enough, and certainly a day is not. The devil is in the details.

I’m sorry if that isn’t all puppies and kittens. It’s never going to be. You might as well ask a black guy who has just been subject to an unjustified traffic stop, to write down three ways in which they appreciate Highway Patrolmen, and then draw a rainbow. That’s not going to work. SBHarris 02:26, 17 September 2018 (UTC)

So, what is your suggested solution? Carl Fredrik ^talk 06:07, 17 September 2018 (UTC)

News articles as secondary sources

Hi all - I work for the Patient-Centered Outcomes Research Institue and I'm still getting up to speed on what counts as an acceptable secondary source for highlighting our research. I know that systematic reviews in journals, work with the stamp of approval by advocacy organizations, and textbooks count as secondary sources. Do news articles covering journal articles that highlight the results of a study we fund count as a secondary source? An example: We fund a study on prostate cancer. The results are published in JAMA. The New York Times writes a story that references the results published in JAMA. Is this kosher to use as a resource when updating the page on prostate cancer? Thanks! Nytodc (talk) 12:31, 18 September 2018 (UTC)

Thanks for your question. "work with the stamp of approval by advocacy organizations" are not OK per MEDRS.

No, news organizations are not OK for WP:Biomedical information. They often get the news wrong in typical ways, like sensationalizing them, failing to state how far from the clinical the work actually is, etc. I commend to you https://www.healthnewsreview.org/ which does a very good job of critiquing mainstream news coverage driven by press releases promoting scientific papers. Jytdog (talk) 23:36, 19 September 2018 (UTC)

Thank you so much for the feedback! So helpful to know about the news articles. For the advocacy organizations, this seems to conflict with some information I received here previously. This document, which we call "Evidence Updates," is what I'm referring to: Evidence Update for Clinicians You can see another one, written for patients here Again, thanks so much for your help Nytodc (talk) 13:22, 20 September 2018 (UTC)

"Advocacy organization" is very broad and would include groups like ILADS and oh, groups that advocate for Electromagnetic hypersensitivity to be treated as a real thing. Right? We discussed PCORI here and there was some consensus to use their guides, in places where they are trying to summarize accepted knowledge. We actually discussed the prostate cancer one in that discussion, and I found that one useful for the guideline-summarizing and somewhat alarming for its emphasis on the recent clinical trial results... and Doc James sort of acknowledged that. Jytdog (talk) 14:36, 20 September 2018 (UTC)

Again, thank you. I really appreciate you holding my hand through this. Nytodc (talk) 15:31, 20 September 2018 (UTC)

Should the validity and reliability of psychological studies be downgraded in Wikipedia medical rules?

It is recognized that the methodology, validity and reliability of psychological studies is poor in comparison to biomedical studies, and that from the scientific perspective, psychology is the poor cousin of biomedical science. Academic psychologist Professor Brian Hughes has just published a book "Psychology in Crisis" about the way flawed research prospers so freely in modern psychology.

Thus this leads to considerations regarding a change of the rules for Wikipedia medical: when a psychological study and a biomedical study present differing or contradictory theories on the etiology of a disease or medical circumstance, at present these two studies are considered of equal validity; but one needs to question whether in these cases the biomedical research should be give precedence over the psychological study, just as secondary sources are given precedence over primary sources.

Until such time in the future that psychology and psychiatry get their act together and become rigorous sciences with a validity and reliability comparable to that of biomedical research, to me it makes sense that psychological studies in Wikipedia should not be given the same weight as biomedical papers. Wikipedia medical always rigorously adopts the highest standards of scientific evidence, so for that reason, Wikipedia should not give undue weight to psychological papers, whose methodology is often flawed and unreliable. It does not matter whether the psychological source is secondary or tertiary, because the primary studies themselves are often poor and unreliable.

Thus my suggestion is to consider a new Wikipedia medical rule that would state something along the lines of:

No psychological source, even if it is secondary or tertiary, should be able to "trump" a biomedical study. When a psychological study and a biomedical study provide differing views, the biomedical perspective should be given precedence. Hip-IV (talk) 04:26, 10 September 2018 (UTC)

No. (That's my answer to your question.) // You need to cite many more sources, including some that examine problems with biomedical research publications, before I would even begin to consider your proposal. // One of the things I like about WP:MED is members' respect for, and support of, Wikipedians from non-medical (but related) disciplines such as clinical psychology. It would be a shame if this WikiProject engaged in pointless, juvenile, inane condescension toward other academic disciplines deemed inferior to biomedical sciences.   - Mark D Worthen PsyD (talk) 06:34, 15 September 2018 (UTC)

It's not a case of condescension, it's a case of the harm that flawed psychological research does. A good example is the damage that the psychological theory that myalgic encephalomyelitis / chronic fatigue syndrome is an "all in the mind" disease caused by the patient's own belief system (ie, psychogenic/somatoform theory of ME/CFS). This theory has no basis in empirical fact, yet it is widely used to treat ME/CFS, and causes a lot of harm for various reasons, not the least of which is the reporting of parents of children with ME/CFS to the authorities for encouraging their child to believe that he or she has ME/CFS, which then, according to these crazy psychologists, maintains the disease condition. Hip-IV (talk) 22:50, 19 September 2018 (UTC)

Here is good recent article by psychologist Prof David F. Marks on how psychology merely apes proper science, and also details the harm done when psychological theories of disease are given precedence over biomedical theories:Psychology – Science or Delusion? Psychology is a subject I love, and the fact that is does not often meet the criteria for being a science is part of its virtue: great novels and literature are not a science either, but that does not mean you cannot learn a great deal about life and you own self from reading novels. So I have no qualms with psychology in general, just concern about the situation when when psychology runs up against biomedical understandings of physical and mental diseases, where I suggest biomedical understandings should be given priority in Wikipedia. Hip-IV (talk) 12:01, 23 September 2018 (UTC)

Determining which medical bodies or associations meet MEDRS: Canadian Association for Genetic Counsellors

I am interested in getting feedback on https://www.cagc-accg.ca/?page=110 as a source for background info. It has been recommended by a clinician in the field, but there do not appear to be references in their information articles (link above). Thank you!! JenOttawa (talk) 00:05, 5 October 2018 (UTC)

As a thought: A source is reliable per Wikipedia and specifically per MEDRS dependent on what specific content needs the support of a reference. So whether the source is reliable depends very much on the content you want to source.(Littleolive oil (talk) 03:57, 6 October 2018 (UTC))

Draft:TAPSE: Tricuspid Annular Plane of Systolic Excursion

Hi, I came across this draft while going through the WP:AFC queue. I'm not sure if this qualifies as an article, or if the sources are reliable. If a member of the project could have a look and advise, I would appreciate it. --K.e.coffman (talk) 23:17, 22 October 2018 (UTC)

Assessing pertinence based on the number of patients?

I had a disagreement with another contributor on the pertinence of some sources. The sources are systematic reviews on clinical trials (on humans), published by notable publishers. For this, no disagreement. But the disagreement comes from the fact that these reviews are made on not enough patients (we talk here about hundreds when doing the total over all reviewed trials). The context is that this is pertaining to "innovative" fields, in the sense that there is not as much interest (and thus funding or patients) as in others like Alzheimer. In my opinion, this context should be taken into account, and if all other reliability factors are greenlight, the source is admissible. But the other contributor has the opposite view . I checked MEDRS and found no mention of accounting for the number of patients. Here is an example source where we disagreed: [4]. Also, to add a bit more context, the goal was to say that "to date, this compound has shown no significantly beneficial effect", which is a non extraordinary claim (negative result). So, should the number of patients be accounted? Thank you in advance for your advices/thoughts! --Signimu (talk) 21:54, 2 November 2018 (UTC)

You can have strong evidence of an effect from a small numbe of patients if the effect size is large. The harder thing to do is to interpret negative results based on a small number of trials/patients. It makes sense to me to be guided by the wording in the systematic review being referenced. Bondegezou (talk) 23:53, 2 November 2018 (UTC)

@Bondegezou: Thank you very much for your reply! How would you define "small number of trials/patients" in the case of negative results? Or should I just use the systematic review wording, in order to avoid any personal interpretation of "small"? --Signimu (talk) 02:42, 4 November 2018 (UTC)

Generally safest to stick to the systematic review's own wording, so as to avoid WP:OR. Bondegezou (talk) 13:27, 4 November 2018 (UTC)

What is medical content ?

I would like the meaning of medical content, (bio)medical information, non-(bio)medical information to be clarified in WP:MEDRS. I would like the article to begin with a definition of these 3 terms, and possibly the article WP:MEDRS to be reviewed according to the definition of each term.

2 different kinds of information can be confused:

1. a non medical information on a medical subject (e.g. "Germany allows the medical use of cannabis", "cannabis use for MS is approved in ten countries")
2. a medical information on a medical subject (e.g. "cannabis is not proven to be effective in relieving chronic pain", "when cannabis is inhaled, blood levels of cannabinoids rise faster than when oral products are used")

According to what is written at the beginning of WP:MEDRS ("non-medical information in medicine-articles – is covered by the general guideline"), the first kind is covered by WP:RS and the second kind by WP:MEDRS; and both kinds can figure in medicine-articles.

Riffstilde (talk) 15:35, 24 September 2018 (UTC)

Your number 1 just needs RS as it is primarily about regulation ("society and culture" stuff). Your #2 needs MEDRS, as it is biomedical information. See WP:Biomedical information. There is a link to it in this guideline. Jytdog (talk) 15:40, 24 September 2018 (UTC)

Thanks. I just added the link to WP:Biomedical information after reading your reply. Riffstilde (talk) 16:41, 24 September 2018 (UTC)

It was already there. Please slow down and read more carefully. You are wasting everyone's time, including your own. Jytdog (talk) 16:46, 24 September 2018 (UTC)

Hello Jytdog, I am sure you are right and the link is somewhere on the page. I could not find it and I still cannot find it. This is why I added it where I feel it belongs to, which is where I looked for the information when I read and reread the page. I believe it will save people time to have the info where they need it. I believe it would be good if you side stepped a little and let a day or 2 pass before you jump on any modifications : people take time to think and prepare their edits (In my case I had studied this for a couple hours). They need to feel respected , and they may not be as wrong as it may seem at first. So, I will put this stuff back on, and please take some time to consider it. It tries to solve an issue. Maybe you have a better way to solve the issue. The issue is that what is and what is not biomedical info can only be found in another page, but this is not indicated in this page introduction. That's why I feel it needs to be part of the introduction. Riffstilde (talk) 17:08, 24 September 2018 (UTC)

It there in the lead already, in the second sentence. Please read more carefully. Jytdog (talk) 17:34, 24 September 2018 (UTC)

Thanks. You are right, but I still think it needs to be in the text because that's where it belongs to (when reading the paragraph, you can ask yourself how to define medical content, and you will not figure out that the answer is actually in another page about biomedical info, not about medical info):

"Wikipedia's articles are not medical advice, but are widely used as a source for health information.[1] For this reason, all biomedical information must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge. This guideline supports the general sourcing policy with specific attention to what is appropriate for medical content in any Wikipedia article, including those on alternative medicine. Sourcing for all other types of content – including non-medical information in medicine-articles – is covered by the general guideline on identifying reliable sources. In case of doubt about whether an information is to be treated as (bio)medical, check WP:biomedical information." Riffstilde (talk) 18:22, 24 September 2018 (UTC)

We use "biomedical" in relation to Wikipedia:Biomedical information. We've discussed "biomedical" extensively at this talk page. See Wikipedia talk:Identifying reliable sources (medicine)/Archive 21#Clarifying "biomedical" and Wikipedia talk:Identifying reliable sources (medicine)/Archive 25#Biomedical and health. Especially see that latter discussion, which closed with WP:RfC consensus for "biomedical" over "biomedical and health." Stop WP:Edit warring over long-standing content at this guideline, and seek WP:Consensus. Flyer22 Reborn (talk) 19:44, 25 September 2018 (UTC)

Regarding this and this, I thought you had removed "biomedical." But regarding replacing "medical" with "biomedical," I feel that this could be used as a WP:Gaming the system tactic, where some editors will claim that, in their view, certain content is not biomedical and therefore doesn't fall under this guideline. As seen by the aforementioned debates, that likely needs further discussion. After all, we aren't going to remove every mention of "medical" from the guideline or replace every mention with "biomedical." Flyer22 Reborn (talk) 20:04, 25 September 2018 (UTC)

It is "in the text". The changes were not helpful. Please stop changing this and try to understand it first, instead. Thanks. Jytdog (talk) 20:29, 25 September 2018 (UTC)

I still find the beginning of the article confusing: I would like the meaning of medical content, medical information, non-medical information to be defined, or the wording simplified. I think my edits were rightly simplifying, but it was not in the purpose of replacing medical with biomedical. It was a purpose of simplifying to make the text unambiguous by eliminating medical content which I found excessively confusing. I also replaced medical by biomedical for another reason: I believed the 2 words had the same signification in the article. If you still keep biomedical information, medical content and medical information, it makes it not understandable what must and must not follow biomedical guidelines. How can you keep 2 different words: medical and biomedical and ask to refer to biomedical guidelines for both of them? What about medical content? What is it? Will you refer me to biomedical guidelines, as the article does? Riffstilde (talk) 12:45, 28 September 2018 (UTC)

The reason for this, is discussed in the archives of this page. Jytdog (talk) 12:48, 28 September 2018 (UTC)

Hello Jytdog, (1) I am not seeing how your reply addresses my remark about removing ambiguity and poor wording. Whatever the policy expressed in the article, it must be stated clearly. (2) If you want to refer me to the archive, please indicate a precise reference. Thanks. Riffstilde (talk) 17:21, 9 October 2018 (UTC) ↓

→ Two points from my perspective: (1) This kind of language, particularly early in a discussion, is disrespectful: "Please slow down and read more carefully. You are wasting everyone's time, including your own." At a time when Wikipedia needs more good editors, tact, courtesy, and respect are much more important than being right.

(2) I agree with Riffstilde, who is simply trying to improve understanding for the average Wikipedia customer (visitor, consumer, reader). Those of you who have used (and helped improve) WP:MEDRS for years seem to (at times) forget that you know these issues inside and out, whereas the average Wikipedia reader (and editor) is encountering them for only the first or second time. Therefore, making it relatively easy for the average reader/editor to discover how we define "biomedical information" improves their understanding, makes them a better editor, and forestalls questions about the term on this Talk page and elsewhere.

I support Riffstilde's proposed edit:

Wikipedia's articles are not medical advice, but are widely used as a source for health information.[1] For this reason, all biomedical information must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge. This guideline supports the general sourcing policy with specific attention to what is appropriate for medical content in any Wikipedia article, including those on alternative medicine. Sourcing for all other types of content – including non-medical information in medicine-articles – is covered by the general guideline on identifying reliable sources. In case of doubt about whether an information is to be treated as (bio)medical, check WP:biomedical information.

  - Mark D Worthen PsyD (talk) 17:40, 8 November 2018 (UTC)

P.S. When I write that I "support" Riffstilde's proposed edit, I do not mean to imply that I support their exact wording only, i.e., we might want to hash out precise wording that we agree on (consensus).   - Mark D Worthen PsyD (talk) 20:17, 8 November 2018 (UTC)

Template:CC-notice

Moonriddengirl, regarding this and this, should we include the "Removing the CC-notice for copyrighted content will result in a copyright violation." sentence in this guideline? After all, Template:CC-notice states, in part, "This template should not be used when you cite a source, but still write all the article content in your own words." Flyer22 Reborn (talk) 06:33, 11 November 2018 (UTC)

"Copying content under a compatible license requires a template under the correct license. Removing it for copied content under a compatible license will result in a copyright violation." When the content is written in your own words is not relevant to this discussion. This is for content that is not written in your own words for copied content under one of the various compatible licenses. It is also a good idea to add a template for content in the public domain. QuackGuru (talk) 09:44, 11 November 2018 (UTC)

It is an ongoing problem. Numerous editors think if the content is under an appropriate license they can copy the content without using one of the templates.

This is happening across numerous topics. Even for content in the public domain it is required to use a template to avoid plagiarism. QuackGuru (talk) 16:26, 11 November 2018 (UTC)

Hi. Just because I was pinged by Flyer22 Reborn, popping in to say that I don't have any real strong opinion over whether this information is included in this guideline or not. It's included in several relevant policies, guidelines, and protocol pages, so I don't regard it as essential. Not all pages can or should include all information.

If it is included, I prefer the text as presented by [User:QuackGuru|QuackGuru]] just above - the starker "Removing the CC-notice for copyrighted content will result in a copyright violation." is misleading, at least by itself. The content remains copyrighted whether it is copied or properly paraphrased. When properly paraphrased, citation is necessary to avoid plagiarism, but the CC-notice is not. The language "Copying content under a compatible license requires a template under the correct license. Removing it for copied content under a compatible license will result in a copyright violation" is clearer. That said, again, I don't have a strong opinion. Perhaps some of the editors who work on these particular suite of guidance pages might be better at guiding consensus here. --Moonriddengirl ^(talk) 02:50, 12 November 2018 (UTC)

Thank you, Moonriddengirl. Flyer22 Reborn (talk) 02:52, 12 November 2018 (UTC)

And just to be clear, I was asking about the accuracy of the "Removing the CC-notice for copyrighted content will result in a copyright violation." statement (even though my question above was about inclusion). You answered that. Flyer22 Reborn (talk) 02:59, 12 November 2018 (UTC)

The content is accurate but doesn't belong here -- WP:OFFTOPIC. This guideline is WP:Not the kitchen sink... Jytdog (talk) 09:37, 13 November 2018 (UTC)

Draft:Development and Wellbeing Assessment

Would like to reach out to the project members here in re: this draft:

• Draft:Development and Wellbeing Assessment

I'm not sure if this is a suitable draft on a notable topic, or perhaps a form of advocacy. --K.e.coffman (talk) 05:30, 8 December 2018 (UTC)

Not bad for a newbie - I can see why you might think that it is advocacy but I think it is okay. Mentioned as a clinical tool with low bias in various NICE reports. CV9933 (talk) 11:30, 8 December 2018 (UTC)

Title change

Steel1943, regarding the title format change, is it the standard title format in cases like this?

If you reply, please don't ping me since this page is on my watchlist. Flyer22 Reborn (talk) 12:11, 28 December 2018 (UTC)

• It's a type of standard format that allows easier navigation to Wikipedia:Identifying reliable sources, the assumed de facto parent page for this page. At least in the case of some web browsers, since subpages have links to heir parent pages in the top left corner, it makes locating the page easier to do. In addition, this format, in the event that Wikipedia:Identifying reliable sources is ever renamed, since this page is now a subpage of the aforementioned page, if the aforementioned page is ever moved, administrators and page movers will be able to move this page at the same time, better preventing page name mismatches. This move is similar to what occurred with the subpages of "Wikipedia:Contact us" as a result of a recent move discussion. Steel1943 (talk) 17:14, 28 December 2018 (UTC)

Steel1943, thanks for explaining. Flyer22 Reborn (talk) 21:29, 28 December 2018 (UTC)

The reason I asked is because formats with the parentheses still exist for guideline subpages; one current example is Wikipedia:Notability (people). But then again, Wikipedia:Manual of Style/Biography uses the format you changed the WP:MEDRS guideline to. Flyer22 Reborn (talk) 21:32, 28 December 2018 (UTC)

@Flyer22 Reborn: I’ve been giving this some thought, and I’m going to revert my move of this page. The reason being that the result of this RfD discussion may affect the title of this page if it is a subpage of Wikipedia:Reliable sources, and I’m certain that would need broader discussion than the RfD. And yes, I later realized that many guidelines use the "Wikipedia:DE FACTO PARENT PAGE (SUBPAGE)" naming convention, so it is a bit different that this would be one-off situation. Steel1943 (talk) 14:50, 31 December 2018 (UTC)

MedicineNet and the likes

There are quite a few refs to WebMD, MedicineNet, etc. Many of them are nothing but clickbaits. But the major problem with these is that information there lacks depth and further refs. They claim it was written bu=y experts, but there are no names and hence no way to verify the expertise. Are there any RS-guidelines with respect of these "medical info aggregators"? Staszek Lem (talk) 01:01, 16 January 2019 (UTC)

We've had discussions on such sources. See, for example, this, this, this, and this. And we have the "Other sources" section in the guideline. Flyer22 Reborn (talk) 23:04, 16 January 2019 (UTC)

Sponsored supplements and symposia

Discussing content on supplements in WP:MEDINDY (and WP:SPONSORED) here as suggested by Flyer22 Reborn and Kingofaces43. Flyer22, your "usually unreliable" is perfectly fair, in my experience, but I don't have a citable source for that. I think it's fairly obvious that something like the paper which initially prompted this content is not independent and thus not RS (a foundation funded by industry groups paid for the supplement; the foundation's director, the supplement editor, and the lead author on the paper are all the same person). Supplement sponsorship by some organization which has a neutral-sounding public-health-like name, but which is basically an industry advocacy group, is fairly common (examples); it might be useful to explicitly warn about this. "Shill" denotes someone pretending to be an independent peer of the audience members when they are not (wiktionary:shill#Noun), which is why I called native advertising in the form of academic articles "shill academic articles"; I'm happy to discuss whether this is a good term. There are also fake journals, such as Australasian Journal of Bone & Joint Medicine; don't know if those should be mentioned. HLHJ (talk) 21:19, 13 January 2019 (UTC)

The edited version basically gets the meat of it across without getting into the weeds over the term shill, which isn't necessarily going to apply in all instances either. I guess I'm not seeing anything that would really improving the current text yet.

I should also point out that I've removed the "reference" to [[Wikipedia talk:WikiProject Medicine/Archive 109#Sponsored supplement? twice now. Normally, talk page discussions aren't used as references or even linked in policies or guidelines except in rare cases. Instead, you have a talk page discussion that informs the creation of standalone guideline/policy text. In this case, it's at Wikiproject Med, not here, so it really has no direct bearing on guideline creation. It looks like the current version sums up the caution from that talk discussion though, but if there's more to add from there, it should be discussed for creating more standalone text here rather than a blanket link a larger discussion. Kingofaces43 (talk) 06:08, 14 January 2019 (UTC)

Regarding this, something about "unacceptable sources" should be there. Regarding "usually unreliable," as seen here with a followup note here, it was just a wording mistake in my edit summary. Definitely wasn't a suggestion. Flyer22 Reborn (talk) 08:44, 15 January 2019 (UTC)

Apologies, Kingofaces43, I wasn't trying to edit-war; from your edit comment ("Last sentence isn't really needed since it's not really giving further guidance") I thought you might have just removed the archive link with the sentence it was attached to the end of, without objection to it in and of itself. It does support the "Suppl." statement, but you are right that it isn't really a reference; more of a footnote, really. Perhaps I could have used {{refn|group=lower-alpha|Note: See [[Wikipedia talk:WikiProject Medicine/Archive 109#Sponsored supplement?|this discussion]] of how to identify shill academic articles cited in Wikipedia.}}</ref> or some such?

Flyer22, I realized that it was just a wording mistake, and I am not suggesting putting this opinion of mine in the article, just joking about inadvertent accuracy. I think it's pretty obvious from the context about third-party, independent sources that some supplements are unacceptable sources, but am not the best judge. Do people feel that we need a warning to look up the funding and affiliations of organizations that fund supplements? They sometimes have very innocuous names: Council for Responsible Nutrition, British Nutrition Foundation, Rippe Health, or something like that. HLHJ (talk) 05:37, 16 January 2019 (UTC)

Missed these comments on my watchlist somehow, so sorry about that. HLHJ, the main issue is that we normally don't link to talk discussions, but instead generate content that sums up that discussion adequately enough so a link isn't needed (barring where you draw the line on things like instruction creep).

Flyer22, I know the community tends to be cautious about the terms unacceptable, never use, etc. except in extreme circumstances (the Daily Mail RfC as a good example). Saying usually unreliable gets the message across by saying they are usually not independent. I'm not sure if examples exist of reputable scientific organizations or other groups doing a supplement, so that's why I'm careful about wording. Basically, the caution in the guideline should be to check who sponsored the supplement and the editorial control process. As long as that is being said, it would be difficult for someone to try to wikilawyer a bad source in it seems. Kingofaces43 (talk) 23:11, 28 January 2019 (UTC)

Kingofaces43, "usually unreliable" was not wording that was used. As noted above, it was a mistake in my edit summary. The wording that was used was "are often (but not always) unacceptable sources." And that wording is clearer than "usually not independent." It's been shown time and time again that our editors, especially newbies, don't know what "independent sources" means. Newbies and less experienced editors also usually have to be informed on what we mean by reliable sources, but they quickly learn of the WP:Reliable sources guideline. The text in question doesn't state "usually not independent," though. It states, "They may lack independent editorial oversight and peer review with no supervision of content by the parent journal." Flyer22 Reborn (talk) 20:21, 7 February 2019 (UTC)

How to tell what's subject to MEDRS

How do I determine from an article if it's subject to MEDRS or not? For example, what about CSRP3? Mathglot (talk) 08:54, 6 February 2019 (UTC)

Is a medical claim (e.g., treatment) being made? CSRP3#Clinical_significance is definitely within the scope of WP:MEDRS. The rest of the article IMHO is more within the scope of WP:SCIRS. Boghog (talk) 09:56, 6 February 2019 (UTC)

We have the Wikipedia:Biomedical information page, which is mentioned and linked in the guideline, for explaining what is covered by WP:MEDRS. And it states, in part, "Biomedical information is information that relates to (or could reasonably be perceived as relating to) human health." I would look at more than than the Clinical significance section of the CSRP3 article and other articles when it comes to weighing what is covered by WP:MEDRS. Flyer22 Reborn (talk) 20:21, 7 February 2019 (UTC)

New Trials Paper

Page-watchers here may be interested in this fantastic paper led by Ben Goldacre about problems with published clinical trials and abuse heaped upon the team by gatekeeping journal editors. [5]

jps (talk) 11:55, 15 February 2019 (UTC)

New research results about increased cancer risk of herbicide were not authorized

I learned of a new research saying that glyphosate (a common herbicide) increases risk of cancer. I added a couple of lines to the Wikipedia article, as follows: "In February 2019, a new research from the University of Washington found that exposure to glyphosate increases risk of some cancers by more than 40 percent." However, my lines were immediately deleted, with comment "We need a better source than that; it's only a press release". My questions: 1) What's wrong with a university press release. Does Wikipedia suspect the objectivity and correctness of university press releases? 2) The press release contains a link to the original article. If the problem was with not linking to the original article, why did the editor delete my addition instead of correcting the link? 3) In the discussion page the editor raised another issue, saying that the research needs to reach "scientific consensus" before publication. Why isn't an academically reviewed paper enough to indicate scientific consensus? 4) Who decides what the consensus is - WHO? NIH? and if so - why don't they review the papers in the first place? -- thanks, Ronnie — Preceding unsigned comment added by 84.109.189.248 (talk) 20:47, 16 February 2019 (UTC)

References

The original discussion is at Talk:Glyphosate#New meta-analysis out today says "raises risk of non-Hodgkin lymphoma by 41%". --Tryptofish (talk) 21:18, 16 February 2019 (UTC)

System Still Broken

From seven months ago on this TALK page (now archived) [6]

This week the NEJM published a blinded placebo-controlled multicenter trial of the drug tafamidis, a putative small molecule treatment for ATTR cardiomyopathy. The trial found the drug cut mortality rates (p<.001) and hospitalizations and improved clinical outcomes. It is inductively supported by some work with tafamidis in the neuropathy of ATTR and also by basic biochemical studies showing how the drug works to stabilize ATTR so amyloid does not form from it. But there are not yet any confirming studies, and won't be for some years. So I put in a paragraph saying what the trial had found, but I didn't add what you can read in an NEJM editorial: Given the dearth of acceptable treatments for this disorder, these robust efficacy results, combined with a benign safety profile, suggest an important role for tafamidis in the treatment of transthyretin cardiomyopathy. (NEJM Sept 13, 2018, p. 1084).

Now, I care nothing about tafamidis. I have no horse in this race. But I'm interested in amyloids, so I added the study for what it found, and nothing more. My addition was then completely reverted by user:Jytdog here with the somewhat rude comment that we avoid primary sources, along with a comment on my talk page that I had formatted the references wrong.

Why should I work to get them right, if somebody is just going to remove rather than improve? That's why I stay away from the medical content of Wikipedia. From what I know of ATTR (including familial amyloid polyneuropathy) I would be willing to bet a large sum that this drug is active. I would also be willing to bet a lesser sum that, given the important nature of this study, somebody will succeed in adding some review of ATTR treatment that contains this study as centerpiece (but nothing more that confirms it), as a "secondary source" in WP, and it will "stick." Or more likely, the FDA will use the same study (or the same multicenter data) as basis to approve the drug for this use. THEN, WP will mention it. But the FDA's endorsement (with no more data) adds nothing epistemologically, either. NONE of it is better than just the primary source and editorial, no matter who else signs-on. The evidence is just as good (or bad) as it ever was. Meanwhile, you're just fooling yourselves. But you on WP will do that. Wait and see.

(Sept 2018)

Fast forward to yesterday May 6, 2019 The FDA approved tafamidis for ATT-CR (cardiomyopathy) based on the single NEJM study above, and no other data. (Projected cost for patients is $225,000 a year. Two cheers)

Apparently I am clairvoyant, as this is exactly what I predicted would happen last September (see above). Alas, nobody took me up on my bet.

However, I was not allowed to enter the study upon which this drug was approved, into the article on amyloid polyneuropathy. Although it was in the NEJM, it was seen as a primary study, and thus not include-able in WP, despite being the best clinical study available (and thus actually not in violation of WP:MEDRS until there was some statement of it being an accepted treatment-- it would have to put as "experimental treatment." But I wasn't given that option either.) A fight in the WP:AN3 erupted with me being reported by user:Jytdog [7]. This did nobody any good. A long discussion on this TALK page featured Jytdog giving a dissertation on how medical journals are corrupt and even NATURE has to withdraw articles, and THEREFORE this NEJM article could not be mentioned on WP. See the above reference-- I do not want to repeat it all here, but go and read. And it featured me saying this whole argument was ridiculous (see above) because the FDA was going to approve the drug anyway, based on this single study that we refuse to mention on WP. Which is just what happened.

Now that the drug is approved, the study I wanted to include has been made notable by the fact that the FDA used it as data to approve the drug. However, the study itself is still a primary source. Mentions in secondary reviews do not change that, as a review of one paper is not a review, but simply a mention by somebody else, with nothing to add. No new knowledge or reliability is added.

At the end of the discussion referenced above, I was asked what my solution was. I had none. I still have none. Against stupidity, the gods themselves contend in vain. WP's MEDRS edit-warring is really stupid. Common sense do I not see. Although I am able to predict the future, so there's that. SBHarris 01:29, 8 May 2019 (UTC)

Well, I just found out that the editor Jytdog who blocked my inclusion of the NEJM article cite last September, and then took me to the 3RR noticeboard over it, was actually banned last December, a few months later, for some completely unrelated WP infraction, but which also involved total intractability over editing. Where there is smoke, there is fire. Where is my apology??? for the crap this editor and WP put me through on this single citation for this single drug-- the wikilawyering, and the bad faith, and the perverted process, and (finally) the poorer encyclopedia that came out of the process because not one of you stood up for my side of what was happening? 03:31, 23 July 2019 (UTC)

References

The use of blogs

Can a blog be used to proof a point in an article, even if this is from a relative reputed scientist? KFvdL (talk) 20:28, 1 August 2019 (UTC)

As it says at the top, this page is "for discussing improvements to the Identifying reliable sources (medicine) page", not for general queries. If your question is whether blog posts can be reliable sources, the answer is yes. It depends on the precise use. The question should be asked at the article's talk page or (with a specific example as stipulated there) at WP:RS/N. Alexbrn (talk) 13:28, 2 August 2019 (UTC)

Thank you, I will bring it up there. KFvdL (talk) 22:17, 3 August 2019 (UTC)

Wikipedia and the systematic obfuscation and denial of Homeopathy

Hello I see the fundraising button on wiki. I would gladly donate but I have a few issues.

1. I am a homeopath and the homeopathy page you have does not reflect the true nature of homeopathy
2. I am a homeopath and your medical reference sections do not list anything about herbology or homeopathy, only allopathic treatment options
3. I am a book writer and medical researcher and your human biology sections do not include anything about the wealth of information on herbal and homeopathic drugs that treat any of these conditions.
4. I am a practitioner that works with children who have vaccine damage and no content about vaccines on Wiki talks about the damages that vaccines do.
5. Because I am a homeopath and work with vaccine damage not only are my medical or research needs not met by wikipedia, I am cast out as a charlatan, liar, practicing pseudo- science, and criminally negligent for not being pro-vaccine. I remember when the internet was developed. The vision was for a vast vault of knowledge for a better world or free information. It appears that that is not possible when there is an agenda to censor and manipulate the information being presented. Homeopathy has been around for over 2000 years and Herbology is ancient. There needs to be more complete information on the internet to reflect and fulfill the quest humans have to know. A medically driven myopic view of the world is not helping anyone.

When wikipedia is able to support something other than the pharmaceutical driven medical agenda I would be happy to contribute.

Plus also the homeopathy page has been taken over by anit-homeopathy people. It is locked and there is not talk page. Until Wikipedia and all the volunteers who work the platform allow representative from the profession who understand the 200 year old practice of homeopathy, and are willing to discuss it in a descriptive rather than opinion based context I will stand by my 'I would donate but..' I can't support an organization that actively denies the reality of my life, practice and the patients who I see every day that are helped with homeopathy.

If you would please forward this on to people who might review this. There is money to be had in this world and money to shared for the good of humanity. I know I will not be sharing any of my money with wikipedia and it volunteer editors when they/it is bent on trying to destroy not only my financial livelihood, but that of 500,000's or more other homeopathic practitioners around the world and the 200 million people who utilize homeopathy worldwide and the multi-million dollar industry of homeopathic remedies. The action by wikipedia and its editors such as the likes of Ben Goldacre, taken against one sector of the GDP and the international practice and trade of homeopathic remedies and knowledge. Homeopathy would never had gotten to this level of econimic growth if it did not work.

This action taken by the editors on Wikipedia is worthy of antitrust legal action. I will need to be taking with my people on how to take steps along these lines.

• https://www.hri-research.org/resources/essentialevidence/use-of-homeopathy-across-the-world/
• https://www.fda.gov/regulatory-information/search-fda-guidance-documents/cpg-sec-400400-conditions-under-which-homeopathic-drugs-may-be-marketed.
• https://en.wikipedia.org/wiki/United_States_antitrust_law

Thank you for your careful consideration into this matter. Please forward to the people who need to know. — Preceding unsigned comment added by Katebhom (talk • contribs) 00:19, 12 July 2019 (UTC)

@Katebhom: To be perfectly blunt, homeopathy is considered to be a WP:FRINGE theory and therefore not worthy of any coverage in any capacity but that.--Jasper Deng (talk) 00:32, 12 July 2019 (UTC)

There is little to respond here except to point at WP:QUACKS. Headbomb {t · c · p · b} 18:40, 7 August 2019 (UTC)

Also, we do not take legal threats lightly; you may be blocked or banned if you continue to claim legal action. --Masem (t) 18:59, 7 August 2019 (UTC)

Yes, do stop with the legal threats. Flyer22 Reborn (talk) 00:19, 8 August 2019 (UTC)

Homeopathy would never had gotten to this level of econimic [sic] growth if it did not work. So the huge size of the gambling industry shows that gambling works for those who engage in it? It's a ridiculous argument. Snake oil may have been discredited, but snake oil products abound, sadly. Peter coxhead (talk) 07:42, 9 August 2019 (UTC)

Scope of MEDRS and applicability to articles?

What is the scope of MEDRS, in the sense of which articles are subject to it, and which parts of those articles?

This doesn't seem to be clearly stated here. Despite its obvious necessity, MEDRS is often used as a WP:BLUDGEON in places where it ought not to be.

One question is, "Which articles are subject to MEDRS?" Another is, "For a MEDRS-subject article, is any {RS, non-MEDRS} sourcing acceptable?" Practice at present seems to be to land-grab articles as being "under MEDRS", then to insist on MEDRS sourcing throughout that article. I do not see policy (and MEDRS and RS are anyway both guidelines, not policy) to support that.

The lead contains this (emphasis mine):

For this reason, all biomedical information must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge. This guideline supports the general sourcing policy with specific attention to what is appropriate for medical content in any Wikipedia article, including those on alternative medicine. Sourcing for all other types of content – including non-medical information in medicine-articles – is covered by the general guideline on identifying reliable sources.

Note that this does not identify "MEDRS-requiring" articles, or impose any global standard within such articles, but rather refers to biomedical content within any articles. It is also specific that non-medical content within that same article must meet RS, but not necessarily MEDRS.

As an example, I believe that an article on Dr Foster's Magic Purple Pills could contain the following:

• Dr Foster's pills cure everything (Strong MEDRS sourcing required)
• Dr Foster's pills were invented by Dr Archibald Foster and released onto the market in 2015 (RS sourcing)
• The pills are purple and triangular, packaged one to a box (RS sourcing) as no-one ever manages to swallow a second one (MEDRS!)

My point is this: even within an article that is clearly on a biomedical topic, where significant claims are made which obviously require MEDRS, there are also areas that do not require it. That is legitimate. Andy Dingley (talk) 08:33, 27 September 2019 (UTC)

Yup, it applies to WP:Biomedical information. This seems perfectly clear. Could you give an example or two where this "land grab" is happening? Alexbrn (talk) 09:16, 27 September 2019 (UTC)

A question of applicability of MEDRS

Due to several articles coming out in mainstream sources, I am looking to have a better article to cover the issues of "violence and video games" which is presently buried among the article Video game controversies. I am initially tackling this from a history standpoint, focusing only on when various govt actions and other key statements and actions were made. Not a MEDRS question yet.

However, I do feel that at some point we will need to include some cross section of studies - of which there have been numerous - that claim there's no connection between video games and violence, with a few that do make that assertion. This is where I ask: would MEDRS cover this side of the issue, if the nature of these studies that will be used should meet MEDRS? This does have to do with psychiatry and mental health, so I think it will just slip into MEDRS coverage for that.

Assuming this is the case, I suspect that I as I dig into politician responses, they are going to cite studies that do fail MEDRS. Assuming the politician's statement is appropriate and not UNDUE, is linking to the non-MEDRS study appropriate or not? Do we call this out as a bad source (I don't thnk we can).

(I do recognize there are other facts on the current Video game controversies page where there are medical claims being made - eg playing video games releasing endorphins-type stuff and that's going to need a better cleanup for MEDRS compliance, but I'm voicing on if a study suggesting video games lead to violence has to be handled by MEDRS sources?) --Masem (t) 23:08, 9 August 2019 (UTC)

@Masem: That's debatable, so I'm not sure (and not experienced enough) to voice an opinion on this, but IMO such content should at a minimum follow WP:SCIRS, although unfortunately this is not (yet?) a recommendation but only an essay. --Signimu (talk) 20:43, 14 October 2019 (UTC)

If you're still looking for sources, then you might try PMID 30275306, PMID 29093050, PMID 28221065 (interesting for differentiating between "violent thoughts" and "there's nobody in my video game room to hit"), and maybe PMID 28212816 for a somewhat different perspective. Also, you might get faster responses if you take questions like this to WT:MED. WhatamIdoing (talk) 02:20, 15 October 2019 (UTC)

Wikipedia_talk:Why_MEDRS?#Review_required_for_this_edit.

The detail is in the link above. --Envisaging tier (talk) 09:54, 25 December 2019 (UTC)

new or incurable diseases: exploratory research vs causal research

Exploratory research is part of scientific research. See exploratory research if you're not sure what that means :). For newly discovered or so-far-incurable diseases, shouldn't it be acceptable to present encyclopedic information on exploratory research, provided that it is clearly distinguished from causal research (which is not casual research; it's causal, not casual)? The guideline here almost entirely focuses on causal research, for justifiable reasons, especially because of readers' misunderstanding of the different components and phases of scientific research (e.g. confusion such as: "science = truth", but "science can be wrong", thus "science = nonsense"). But should exploratory research be completely rejected as "unreliable"? The cases of new diseases (such as that induced by Novel coronavirus (2019-nCoV)) or so-far-incurable diseases (cancer in general) differ here. For new diseases, it seems to me that informing readers of Wikipedia that exploratory research is ongoing is reasonable, provided that it's appropriately described as such and properly dated to avoid violating WP:RELTIME for future readers if the text remains non-updated (e.g. "In exploratory research in mm yyyy, scientists at X University found that foo seemed to have an effect against bar" would be OK). When the disease is no longer new, the emphasis would shift to towards the present main theme of the guidline. In the case of so-far-incurable diseases, the argument seems less clear to me. If exploratory research is accepted in a Wikipedia article in this case, then the prose content on that could risk accumulating over many years, so dating it with {{as of}} rather than with mm yyyy dates might be a minimum requirement to encourage old exploratory research to be removed. Or developing some new tags such as {{exploratory research}} might be enough, where the template could hide the text if older then 2 years, for example - the text would need to be a parameter of the template. Boud (talk) 21:37, 1 February 2020 (UTC)

Regarding diagnosispro

Is it an ok source to use in biomedical articles ?Walidou47 (talk) 21:24, 5 February 2020 (UTC)

Favipiravir

This article is a little crumby, and could possibly use some eyes in light of the whole COVID thing. NickCT (talk) 01:23, 19 March 2020 (UTC)

":Report something when there's a trial result - the mere fact of a trial should not be reported"

My apologies if this is a repeat, I've seen some editors remove things based on: "report something when there's a trial result - the mere fact of a trial should not be reported" Is this really the absolute case no exception? In particular, a page I was working on includes this content (https://en.wikipedia.org/wiki/COVID-19_drug_repurposing_research) and that information (in my opinion) is of significant note. ProbablyAndrewKuznetsov (talk) 23:02, 22 March 2020 (UTC)

If it's noteworthy, then secondary MEDRS sources will report on it that should be sourced. Remember that WP:ISNOT is policy, and of of those things is that we are not a newspaper for late-breaking news (newspapers are for that). We're supposed to be behind the ball and not document events as they unfold. Kingofaces43 (talk) 00:09, 23 March 2020 (UTC)

In this particular case, I would venture to disagree. Your reasoning contains some leaps of logic that arrive at an invalid conclusion. Firstly, regarding what Wikipedia is not, your argument based on that policy is not relevant in this context; it could be used to argue that there should not BE any Wikipedia article(s) COVID-19, but as there clearly already ARE, it can't be used as a reason to delete content within the article -- because, that would necessarily include ALL content within the article, and would thus undermine the article itself. The same is true regarding whether content is not noteworthy unless it is published in a secondary sourced medical journal. That is a standard that would be impossible to meet for ANY content that could be included in the article(s) in question.

Now, regarding @ProbablyAndrewKuzetsov's original question, whether that guideline is absolutely the case, no exceptions: absolutely not. See WP:IGNORE. Furthermore, it is in my opinion that articles on this subject matter should not be treated as strictly medical-related articles, so I don't think strict application of guidelines for medical articles should be used....regarding the noteworthiness of the content and whether it should be included, that should be discussed, and the solution should reflect consensus. I believe the proper cycle is remove, revert, discuss ( in order to avoid edit warring.

Cheers, hope this was helpful :) Firejuggler86 (talk) 20:37, 1 April 2020 (UTC)

Thank you that was very useful. ProbablyAndrewKuznetsov (talk) 02:45, 23 March 2020 (UTC)

Promotion of TCM herbal medicines for SARS and COVID-19

I just reverted this content, but there is a quote from Nature, and I'd like others to check if I did the right thing. -- BullRangifer (talk) 16:02, 21 March 2020 (UTC)

MEDRS applies. I don't think the Nature ref meets that criteria. --Hipal/Ronz (talk) 16:11, 21 March 2020 (UTC)

Whether or not the nature ref meets the criteria would depend on whether or not the ultimate source of the information cited meets the criteria, and not necessarily on whether nature itself does. I don't know if it does or not, but if this is an issue to anyone, they might want to look into that... Regarding herbal medicine: perhaps an alternative to removing any mention of its existence would be to reword it in such a way that reflects reality; that is, that it *is* being used by people in hope of it being beneficial in the absence of any known effective medicine, the effectiveness of which cannot be known. (The last part of that sentence i think is patently obvious enough that it needs no citation: see WP:BLUESKY). In short, it is my opinion that factual information that is relevent, *so long as diligent care be taken so to not present it in such a way that may be misleading*, with *due weight*, is usually preferable to no information at all.

Firejuggler86 (talk) 21:17, 1 April 2020 (UTC)

If we can put it in proper context, maybe, but the problem in cases like this is usually that there's little to draw from other than promotion. The content in question is opportunistic, irresponsible, promotion. --Hipal/Ronz (talk) 22:15, 1 April 2020 (UTC)

Agree with User:Hipal an editorial is not sufficient for the content in question. Doc James (talk · contribs · email) 23:47, 1 April 2020 (UTC)

UpToDate

Hoping someone can add some additional context to the line about UpToDate. It jumps out as unusual to me, since the reason it's to be avoided seems based on the accessibility of specific versions. Ideally a source would keep individual versions accessible, but with archival tools so easily accessible (and even, in many cases, automated), it seems like there's no need for that to be a deal-breaker. Is there more to it? --Ryan (Wiki Ed) (talk) 19:39, 13 April 2020 (UTC)

“in vitro” and “in vivo” are mainly just confusing

“in vitro” — in glass

“in vivo” — in (the) living

http://www.chem.ucla.edu/~harding/IGOC/I/in_vitro.html

Maybe if we’re using both terms as part of a contrast and a compare, or maybe if we’re using it as part of a more common phrase such as “in vitro fertilization.” Other than that, I think we’re mainly just showing off, I’m sorry, and not focusing on clear communication with our reader.

Now, our reader’s just as smart as we are. We don’t need to talk down to him or her, for that’s almost always a mistake. But neither do we need to throw in a technical term merely for the sake of having a technical term. FriendlyRiverOtter (talk) 00:00, 16 May 2020 (UTC)

What's this got to do with identifying reliable sources? Are you looking for MOS:MED perhaps? Headbomb {t · c · p · b} 00:09, 16 May 2020 (UTC)

The editor made this change to a long-standing piece. Flyer22 Frozen (talk) 03:04, 16 May 2020 (UTC)

I can decipher no reason for this revert; it is simply better grammar and sound logic (cannot be known in advance). I do not understand the revert, Flyer? SandyGeorgia (Talk) 03:17, 16 May 2020 (UTC)

Crossroads explained very clearly below. Supposed bad grammar was the last thing on my mind when reverting the piece. Flyer22 Frozen (talk) 21:44, 16 May 2020 (UTC)

We’re merely agnostic toward early lab results, right?

Our second paragraph currently includes:

” . . . Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early lab results which don't hold in later clinical trials.”

What we do is to merely suspend belief. The fact is, these lab results might pan out in clinical trials, or they might not. So, to reflect this not knowing and also for the sake of reading flow, I’d prefer:

” . . . for example early lab results which may or may not hold in later clinical trials.”

@Flyer22 Frozen: I’d appreciate having your views regarding this. FriendlyRiverOtter (talk) 20:57, 16 May 2020 (UTC)

I said the same thing in the section above, where I questioned the revert. I can see no reason that the grammatical improvement was reverted. SandyGeorgia (Talk) 21:01, 16 May 2020 (UTC)

I prefer the pre-existing text which she reverted to. It is saying that such sources often include...early lab results which don't hold in later clinical trials". (Emphasis added.) This is the truth. It is not saying that early results never hold in later clinical trials, but that often they do not. How often? Too often such that early lab results in primary sources should not be used to, say, tout this or that as a remedy. I see no reason to water this down with a "may or may not". We are not here encyclopedically talking about how clinical trials work; we are warning against improper use of primary sources. Crossroads ^-talk- 21:08, 16 May 2020 (UTC)

@SandyGeorgia: it’s not only grammatical. Per @Crossroads: there’s also a difference in emphasis. I can only say it stumbled me the first time I read it. I had to go back to read it and realize, okay, it’s not saying all early results fail. It’s saying that because some fail, all are unreliable. But I still think we can improve upon it. FriendlyRiverOtter (talk) 21:16, 16 May 2020 (UTC)

I don't know why we need the make the page so hard to read; what Flyer reverted to makes no sense. We can't know in advance. SandyGeorgia (Talk) 21:28, 16 May 2020 (UTC)

I agree with Crossroads. Find some other way to state the same thing if "don't" is supposedly so hard to read, but do not water it down. And just to be clear, I will not be debating this. Flyer22 Frozen (talk) 21:44, 16 May 2020 (UTC)

Flyer, I suggest that when you have reverted someone, "not debating this" is not an option; discussion is how we develop consensus and improve things on Wikipedia. SandyGeorgia (Talk) 21:51, 16 May 2020 (UTC)

Um, no. I do not need a lecture on how Wikipedia works, and you know that. I gave my opinion. I am free to comment and move on if I want to. Others are free to comment and move on if they want to. Consensus can form without me. Editors are not obligated to debate a thing. That is how Wikipedia works. Editors are very much aware of the fact that I discuss issues. They know that I debate issues. But discussing issues is not necessarily the same thing as debating issues. You also know that. I choose what I comment on or debate. After I have commented on a matter, including a revert I made, and explained my viewpoint, I do not need to keep commenting unless I choose to do so. As an example, I chose not to debate all of that drug price drama; I chose to ignore the related ArbCom circus you tried to drag me to.

Your "make an enemy of Flyer because she occasionally agreed with Doc James about drug pricing and/or on other things I personally disagree with" mindset, after we have gotten along for years, is quite distasteful and very disappointing. And, other than this post, I'm not spending any more time on it. Reply however you want. Flyer22 Frozen (talk) 22:14, 16 May 2020 (UTC)

This is WT:MEDRS; please take personalization elsewhere. Best, SandyGeorgia (Talk) 02:07, 17 May 2020 (UTC)

@SandyGeorgia: thank you for standing up in favor of my proposed edit. Let’s see if we can perhaps get Crossroads on board and maybe tweak the edit a little. FriendlyRiverOtter (talk) 01:47, 17 May 2020 (UTC)

Yes, let's :) What is here now is:

Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early lab results which don't hold in later clinical trials.

I see multiple problems.

1. This is out of sync with WP:PSTS. Yes, we rarely use primary sources, but in fact, they do have a place even in medical articles. For example, when discussing a seminal study (as mentioned by secondary sources), we may actually cite the primary study. So, by saying "should generally not be used", we are really giving the editor nothing useful.
2. We simply do not know that they include "unreliable" information: in fact, that is circular reasoning. We deem them unreliable in Wikipedia terms, but the information in them, although preliminary, could turn out to be accurate and reliable. So, we've messed up here by calling preliminary information "unreliable", and not really explained to new or experienced editors what we mean.
3. "Ditto for "early lab results which don't hold in later"; we are going in circles.

The whole thing needs some wordsmithing. Things have gotten well out of whack on this page. If you go back quite a few years, you find a reasonable explanation of primary sources in medicine, which offers some starting places for repair. Besides being confusing to read, the current text has gotten out of sync with Wikipedia-wide policy. SandyGeorgia (Talk) 02:05, 17 May 2020 (UTC)

@SandyGeorgia: because the first header already says “ . . best treated with common sense, and occasional exceptions may apply. . , ” I tend to feel that we don’t need to spell out in the article that it’s sometimes fine to include a primary source. And I agree that a seminal study would be a great example of such, along of course with a solid review article or two citing it.
Try as I may, I think I’m back to “may or may not” as a good, straightforward way of communicating the fact that we simply do not know.
I like the idea of comparing our current version to one several years ago, or even 10 years ago. It’s a big project. Maybe we can start with spot-checking, such as what you’re talking about here of how strongly we wave people off from primary sources. FriendlyRiverOtter (talk) 00:24, 18 May 2020 (UTC)

I'm open to purely stylistic tweaks, but I oppose anything that would water down our discouragement of primary sources. We do not need to make it easier for people to cluelessly add random studies they hear about in the media, or even to WP:CPUSH for things like "alternative" medicine, or for any such material to be preserved. Your example of citing a seminal primary source together with a secondary source is already specifically permitted under the WP:MEDPRI section: "Primary sources may be presented together with secondary sources." As for WP:PSTS, that states, "Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary, secondary, or tertiary sources are appropriate in any given instance is a matter of good editorial judgment and common sense, and should be discussed on article talk pages." In other words, there is leeway for deciding what is appropriate, and it makes perfect sense that MEDRS would be stricter about primary sources than other areas of the encyclopedia like, say, highways or TV episodes. As for the idea that the current wording makes it sound like primary research is always wrong or unreliable, I have nothing to add to what I said above. Both that and the idea that it is confusing are subjective; to me it has always been perfectly clear. We'll see what others say if and when they weigh in. Crossroads ^-talk- 03:09, 17 May 2020 (UTC)

@Crossroads: I’ve heard that only a low percentage of cures for cancer in genetically identical mice end up working in humans. Other areas of medicine, maybe a higher percentage. If we could run across even a couple of these statistics, it would enrich our article, as well as showing different ranges of not working and thereby providing our fellow editors another example of the uncertainty involved. Other than that, I think we have to use something similar to “may or may not.”
By the way, when you mention highways, if you’re talking about building highways, I personally think engineering is about a generation ahead of medicine. But then, medicine is trying to understand and change things which are quite literally . . . biologically complex. FriendlyRiverOtter (talk) 02:31, 18 May 2020 (UTC)

You said it would "enrich our article", but this isn't an article. With highways, I didn't mean engineering, I literally meant the numerous articles we have about this or that highway, which usually lack secondary sources (or even any inline sources) for route descriptions and the like. Same for TV episodes and plot descriptions. The medical field is far too complex and important to allow that sort of thing. Crossroads ^-talk- 04:16, 18 May 2020 (UTC)

You’re right. It’s a project page. Some crucial differences. I still think it would help giving some specific examples, as long as we don’t go overboard.
I’ll tell you one thing. I did not know what a “review article” was well into my adult years. And I’m guessing it’s the same for a lot of other people. So, again not going overboard, I think we could lift people’s game if we had a good succinct explanation of what one is relatively early in the project page. FriendlyRiverOtter (talk) 23:36, 18 May 2020 (UTC)

I'm on team don't water down. As mentioned above, this isn't an article about how clinical trial works, this is saying don't cite early lab results those because they often don't pan out and therefore aren't reliable sources. Headbomb {t · c · p · b} 13:43, 18 May 2020 (UTC)

What water down? When I read “often include unreliable . . . for example early lab results which don't hold in later clinical trials,” my reaction was merely confusion. Uh? I think the entire thing without my ellipses is more confusing. I’ve pared it down. And I had to read it several times before I was satisfied, okay, they’re saying that all are unreliable because some don’t pan out. It really is a complex sentence. And we shouldn’t have to parse it this closely. FriendlyRiverOtter (talk) 23:48, 18 May 2020 (UTC)

Preprints

Preprints are not considered MEDRS and thus shall not be used for sourcing Wikipedia. They have even become dangerous to use because one can become sanctioned (see Talk:Coronavirus_disease_2019#Discretionary_sanctions_on_the_use_of_preprints).

However, I want to propose an exception to the guideline of banning preprints, because of this recent news report stating that the chinese government is "tightening its grip" on covid research. This has been a controversial measure, that could censor any research that suggests negligence of the chinese regarding the origin of the spread of the virus. Although I appreciate the spirit of excluding preprints as MEDRS, I suggest that we relax it regarding preprints from chinese scientists in the eventual case that RS report that they were censored by the chinese government, in which case their information can not physically proceed to the peer review stage despite any merit. According to Nature the regular channels of science publication in China are distorted by government interference and preprints may be the only escape valve for them.Forich (talk) 14:24, 29 May 2020 (UTC)

Forich, the Covid19 articles on WP exist in their own little bubble of IAR right now. They don't really represent typical medicine articles where were are not concerned with new developments in the last 24 hours or are relying so much on tertiary sources like government or WHO websites aimed at a lay audience. We aren't here to right-great-wrongs and if there is medical information that deserves to be on Wikipedia then I'm sure it will be published in the secondary literature. If it isn't, then it isn't our job to decide what research the public need to hear about, and we just have to accept that. -- Colin°^Talk 15:44, 29 May 2020 (UTC)

verywell

Someon is really rather keen to get the Verywell sites removed from the blacklist. The most likely use, according to what little data we have from logs, is on medical articles (which is kind of obvious). Does this sound like something that would be acceptable? Not necessarily for biomedical claims but for overviews of diseases, for example. Guy (help!) 21:07, 23 May 2020 (UTC)

See also Wikipedia:Reliable sources/Noticeboard/Archive 292#Verywell and MediaWiki talk:Spam-blacklist#Verywell, 2. WhatamIdoing (talk) 05:30, 18 June 2020 (UTC)

Reliable sources for medicine, nutrition and toxicology should state dose

Moved from Wikipedia talk:Reliable sources § Reliable sources for medicine, nutrition and toxicology should state dose

 – ​— Newslinger talk 01:39, 22 May 2020 (UTC)

To wait for secondary sources which state dose in events such as chloroquine poisoning may be thought to delay distribution of safety concerns. (What part should Wikipedia be playing in distributing safety information?) But to allow sources which do not specify dose may enable editors to create a perception about a formulation.Soundhill (talk) 00:16, 22 May 2020 (UTC)

@Newslinger I am thinking about such things as "Large amounts of swallowed toothpaste can be toxic." but no mention of what is a large amount for a young child. Whether on an ongoing basis or one-off.

I refer to perception-manipulation, which could be in this case such as in a TV advertisement showing a brush being covered in toothpaste, which might be different from instructions on some toothpaste packages. I haven't found it easy to find perception-manipulation on Wikipedia, either.

This year the world has been rapidly progressing through the covid-19 pandemic. Research is developing but by the time it gets to secondary sources people may have gone into intensive care which could have been prevented. One person died of using a formulation of a malaria drug also used for treating fish/tanks it was reported but not the dose they took. That has been used to warn people off something without dose mention and I can't tell if leaving off that dose data means people who primary research has said could be helped will be denied. Soundhill (talk) 02:56, 22 May 2020 (UTC)

References

Hi Soundhill, I've moved the discussion here since this page (the talk page of WP:MEDRS) receives more attention from editors who focus on medicine-related topics. I'm not familiar enough with the subject to be of much help here, but hopefully others are. — Newslinger talk 20:26, 22 May 2020 (UTC)

@Soundhill dosage guidelines are notated often as bodyweight:mg/measurement unit. Pediatric application is thus covered by this method in general.

Toxic levels are notated this way also.

Personally I find that peer reviewed research journals are going to need their own RS page soon. Jdabs (talk) 18:43, 18 June 2020 (UTC)

Finding journals that comply with WP:MEDRS standards

I did a bunch of searching on the National Library of Medicine site to discern the best ways to determine if a journal meets WP:MEDRS standards, e.g., "Is it indexed by MEDLINE?" and "Is it listed in the Index Medicus?" Based on what I found, I created a list of guides, FAQS, tutorials, etc. at User:Markworthen/PubMed-Help, including specific help for Finding journals that comply with WP:MEDRS standards. If I have repeated help that's already available somewhere else on Wikipedia, please let me know! Otherwise, I'm posting this info in case it's helpful to other editors.   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 06:27, 31 May 2020 (UTC)

I'm finding https://www.scopus.com/sources to be quicker. The comparison with other journals in the same field(s) is particularly handy. Other research suggests that the lowest ~20% of journals have more problems (e.g., blatant copyvios), and no editor with any sense will argue that only the top handful of journals in any field are acceptable (unless we're grasping at straws to support some serious POV pushing, but No True™ Wikipedia Editor would ever stoop to that, right? ;-) ), so it's convenient to be able to look up a journal, see that it's in the middle quintile, and stop wondering whether the bad one is the one called J Vague Abbr or the one called Int J Vague Abbr. WhatamIdoing (talk) 05:45, 18 June 2020 (UTC)

Great tip WhatamIdoing! Thank you.   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 16:22, 21 June 2020 (UTC)

One of my concerns about WP:MEDRS is that some subjects are covered in good journals that are not indexed in MEDLINE because they are not biomedical journals. My experience is primarily with psychology topics. I searched the Scopus subject index (at the link WhatamIdoing posted) and found Medicine > Psychiatry and Mental Health, and I was pleased to see that it lists several clinical psychology journals. In fact the top two are clinical psych journals (Annual Review of Clinical Psychology and Clinical Psychology Review). Nice. :)   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 16:38, 21 June 2020 (UTC)

Probably a good idea to mention WP:CITEWATCH and WP:UPSD to detect sources which aren't reliable too. Headbomb {t · c · p · b} 16:27, 21 June 2020 (UTC)

Henceforth, I will check both WP:CITEWATCH and Scopus for psychiatry & psychology journals. WP:CITEWATCH (and Headbomb's very helpful script, the Unreliable/Predatory Source Detector (UPSD)), provides excellent general (and moderately specific) information about journals. For example, WP:CITEWATCH and UPSD provide cautionary information about journals published by Frontiers Media. Regarding a specific journal, Frontiers in Psychiatry, our Wikipedia article offers cautionary information, and, at the same time, the journal ranks in the top 20% of Psychiatry and Mental Health journals per Scopus. My take is that Frontiers in Psychiatry contains many well-written, well-referenced, good articles, but it also contains some mediocre articles that do not pass muster.   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 16:58, 21 June 2020 (UTC)

UPSD's one-size-fits-none treatment of Frontiers is one of the reasons that I wouldn't recommend it to anyone. The directions say to use it merely as a simple guide and to double-check it, but basically nobody does. Some of them are rather dogmatic about its results: We joke that we'd take a self-published blog post from Albert Einstein on physics, but if he published an article in one of the journals highlighted by USPD, some editors don't care whether he's an expert. If that script evaluated every journal separately, or if it removed the publishers who are in the 50–50 range (including Frontiers), then it would be less susceptible to misuse, but I don't see any way around the problem of editors trusting the script (and therefore distrusting the publisher) more than independent evaluations or the judgment of experienced editors. WhatamIdoing (talk) 17:07, 21 June 2020 (UTC)

I find the script to be helpful, but then I also investigate further. I agree that many editors do not appreciate the importance of a detailed, nuanced evaluation of individual articles and journals. I will continue to challenge rigid, simplistic conclusions about references, but my impression is that there are more "rigid editors" who spend more time and energy on Wikipedia than "careful editors". Maybe something about this problem could be added to WP:MEDRS?   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 17:23, 21 June 2020 (UTC)

Frontiers is a garbage publisher, which happens to publish acceptable research occasionally/semi-frequently. It varies greatly by journal and it varies even more from paper to paper, but their journals will accept nearly everything and editorial boards get sacked when they emphasize quality over quantity. As a researcher, I wouldn't cite a Frontiers paper unless absolutely necessary, or that I vetted every line of the paper myself. On Wikipedia, I wouldn't cite them unless it was for completely routine information, or absolutely necessary. Certainly wouldn't cite them for the conclusions found in the papers unless, again, it was absolutely necessary. Some might pass MEDRS, but I would be extremely uneasy to cite anything MEDRS to a Frontiers paper. Headbomb {t · c · p · b} 21:00, 21 June 2020 (UTC)

And since Zefr (talk · contribs) thanked me for the above, I'll take the opportunity to distance myself from their one-size-fits-all approach to Frontiers and their continuous misapplication of "per WP:CITEWATCH" as an argument to remove sources. Headbomb {t · c · p · b} 21:10, 21 June 2020 (UTC)

A topical example of the pitfalls of a one-size-fits-all approach to Frontiers might be PMID 32984206, which publishes a statement by the pediatric section/s of the European Society for Emergency Medicine and European Academy of Pediatrics (a relevant potential MEDRS). More subjectively perhaps, I would feel uncomfortable not being able to cite PMID 30619331 – an uncommonly useful review by subject experts that sets out to cover a key topic. 86.161.190.118 (talk) 09:47, 30 September 2020 (UTC)

At the same time, I also feel a personal need to caution against excessive reliance on impact factors, given the ethically troubling practices of certain 'non-predatory' journals to game the system, with editorial boards that more or less subtlety exert direct or indirect pressure on authors to selectively cite their journal. I've seen egregious deployment of such practices, including targeted creation by professionally affiliated or 'friendly' authors of largely redundant reviews specifically designed to self-cite the journal, and how they can propel a journal into the leading bunch within a highly competitive sector. I wouldn't go as far as to suggest that the content of that particular journal is necessarily unreliable, but I can easily empathize with some of the strongly felt opinions expressed above about co-ercing quantity over quality. Imo, a significant concern here is to avoid rejecting pertinent medrs content (maybe regarding rare diseases, or non-Western populations) that is otherwise acceptable, just based on a lowish impact factor which may actually reflect a greater degree of editorial integrity than the numerical score might suggest. Here again, I think we need to be wary of one-size-fits-all approaches. 86.190.128.121 (talk) 10:23, 1 October 2020 (UTC)

• Hear, hear! Exceptionally well said. Mark D Worthen PsyD (talk) [he/his/him] 03:35, 3 October 2020 (UTC)

Suggestion ref. primary sources

Apologies but it seems the medical rules for wiki are different from the rest of wiki; if consensus sources only are acceptable, then the content becomes much more backward-looking than the rest of wiki (where a comment sourced by a primary sources is acceptable). I wonder if each medical article could have a link to a 'primary research' addendum article - or an appendix discussing primary sources. Then readers would be ale to see some of the more recent research directions and thinking. It just seems odd that there is this difference in medical articles on wiki c.f. other articles.JCJC777 (talk) 06:04, 3 August 2020 (UTC)

Actually the whole of Wikipedia, not just WP:MED prefers secondary sources (see WP:SECONDARY). Secondary sources are especially important in biomedical sciences because of the Replication crisis. In short, an astonishing high percentage of scientific experiments simply cannot be repeated. It is therefore essential that these results are reviewed and integrated with other studies before concluding the results are reliable. Furthermore how many times have you heard that coffee causes disease X and then a new study published in the next month claims that coffee cures disease X. Independent studies often come to different conclusions. Which study should be cited? Again, the only way to arrive at a reliable conclusion is to rely on secondary sources. Boghog (talk) 12:31, 1 October 2020 (UTC)

Wikipedia simply is not the place to report primary research results. That's what journals are for. Headbomb {t · c · p · b} 14:07, 1 October 2020 (UTC)

@JCJC777: I have had similar concerns in the past, but over time I have come to appreciate the policy on reliable sources generally and primary sources specifically, although it has been a bumpy journey. Discussions like this one have definitely helped me gain a deeper understanding, but probably the most helpful thing I've done is to read this content guideline—Wikipedia:Identifying reliable sources (medicine)—over and over again. It is a carefully written guideline that I would rate A-class + good article + featured article, if we had such quality indicators for Wikipedia guidelines. In other words, it's a top-notch, best-in-its-class guideline. (IMHO, of course.) ¶ Note that the "primary source rule" is not a rigid, "never ever" rule. The guideline itself notes exceptions. The leading coronavirus and COVID-19 articles on Wikipedia serve as exemplars for understanding this guideline, including judicious, careful, conservative citations to a select few primary sources. Mark D Worthen PsyD (talk) [he/his/him] 03:51, 3 October 2020 (UTC)

P.S. Despite this excellent guideline, many primary sources sneak into medical articles, often in the Risks/Genetics and Pathophysiology sections (among others), I think partly because such research is inherently fascinating and we want to tell people about it! But we really shouldn't until several replications support the original research and good meta-analytic and systematic review articles have been published in reliable sources (journals). I frequently find primary source articles cited as evidence for conclusory statements in an article. For example, in Post-traumatic stress disorder#Genetics, "There is evidence that those with a smaller hippocampus are more likely to develop PTSD following a traumatic event" based on a primary source (very preliminary study) - see my edit (diff) and "Heightened startle responses and a smaller hippocampal volume have been identified as biomarkers for the risk of developing PTSD", again based on a primary source reporting on a very small sample, very preliminary study (diff). Mark D Worthen PsyD (talk) [he/his/him] 04:24, 3 October 2020 (UTC)

many thanks. much appreciated. will read the guide. JCJC777 (talk) 06:57, 3 October 2020 (UTC)

VPI regarding non-review sources

Watchers of this page may be interested in Wikipedia:Village pump (idea lab) § Biomedical Sciences: An idea to identify acceptable primary research for citations (in addition to citing reviews). Izno (talk) 13:26, 5 October 2020 (UTC)

I would encourage you to read this too. It seems a good way to assess the importance of primary research publications which need recognition and inclusion, alongside or before any secondary reviews. Jrfw51 (talk) 17:44, 5 October 2020 (UTC)

Proposed copy edit for Definitions section

I suggest modifying these two sentences in the definitions section:

Text that relies on primary sources should usually have minimal weight, only be used to describe conclusions made by the source, and must describe these findings clearly so that all editors even those without specialist knowledge can check sources. Primary sources should never be cited in support of a conclusion that is not clearly made by the authors (see WP:Synthesis).

Here is my suggested copy edit:

Text that relies on primary sources should be given due weight; that is, statements, paragraphs, and sections supported by reliable secondary or tertiary sources should contain greater depth of detail, more text, and superior prominence of placement compared to primary-source-supported statements. Text that relies on primary sources should clearly indicate that any conclusions made by the source are just that since the conclusions may or may not receive support in subsequent research by others. Primary-source-supported statements must describe research findings clearly so that all editors even those without specialist knowledge can check sources. Primary sources should never be cited in support of conclusory statements in "wikivoice". Conclusory statements must be supported by good secondary or tertiary sources such as meta-analytic or systematic reviews and clinical guidelines.

I am sure my suggested copy edit will benefit from additional refinements by other editors. But what do you think about the gist of my changes as reflected in the above? Mark D Worthen PsyD (talk) [he/his/him] 20:00, 5 October 2020 (UTC)

Have you brought this up because of this discussion? I oppose the change. We can use a primary source to make a conclusive statement in Wikipedia's voice (which is why the section question currently states what it states), but context matters. If the topic is barely researched, mainly only has primary sources, and the statement is obviously non-controversial, I see no problem with stating the matter in Wikipedia's voice. There is not always a need to state "A [so and so] study reported [so and so]." And per Wikipedia:Manual of Style/Medicine-related articles#Citing sources, it is best to avoid something like "An uncontrolled survey involving 132 experienced long-distance backpackers on the Appalachian trail in 1997 concluded that washing hands after defecating reduces the incidence of diarrhea in the wilderness." unless necessary. I'm of the opinion that attributing a mater to the source via text is necessary when it's a controversial statement or a statement that very likely conflicts with other research on the topic. But when that's not the case or when that's not the case and what is being reported on the matter is all that is known about the topic regarding that aspect? I don't see the problem. Flyer22 Frozen (talk) 03:37, 6 October 2020 (UTC)

We (WikiProject Medicine) sometimes exhibit astounding hypocrisy when it comes to WP:MEDRS. If another editor cites a primary source we don't like, we launch an aggressive "colon attack"—with WP:MEDRS the first missile we launch at the benighted offender. But when we think an area of inquiry merits discussion in an article, we know how to artfully include conclusory statements based on preliminary findings that cite primary sources. If anyone challenges our wise additions, we point with indignation and a practiced superciliousness to WP:MEDDEF. ¶ "How clever you are, my dear! You never mean a single word you say." Mark D Worthen PsyD (talk) [he/his/him] 00:17, 7 October 2020 (UTC)

I certainly wouldn't say I've seen "astounding hypocrisy". Even your proposed version still allows for primary sources, yet we will still have editors removing primary sources in many cases because of concerns about weight. On the flip side, if there are cases where undue weight is being put on what primary sources say, or WP:In-text attribution is needed, that can be addressed under current guidelines. Crossroads ^-talk- 03:26, 7 October 2020 (UTC)

We never perceive ourselves as being hypocritical. We perceive ourselves as "defending the wiki" (that's when I remove your content) and "improving articles" (that's when I cite the kind of source that I won't let you cite).

However, I don't think that we win any prizes here. I think the prize goes to the people who have trouble remembering that Wikipedia:Secondary does not mean independent, and who will insist that their article, cited exclusively to breaking news, is 100% sourced to "secondary" sources, because the reporter isn't an active participant in the story. At least when we cite original experimental results in medical articles, we're citing something a a little stronger than a TV news reporter standing in front of a burning house and saying that a house is on fire ("It's news because we can stick a camera in front of it"). WhatamIdoing (talk) 05:41, 7 October 2020 (UTC)

Yeah, I don't see that we should make it that specific and detailed. I think the more concise existing version works. It's also important to emphasize that synthesis is improper. Crossroads ^-talk- 19:08, 6 October 2020 (UTC)

Markworthen, this reminds me of WP:Based upon. All articles should be "based upon" secondary sources, but no article is absolutely required to eschew all primary sources. WhatamIdoing (talk) 22:05, 6 October 2020 (UTC)

Interesting essay - thanks for alerting me to it. And I agree with what you wrote. :) Mark D Worthen PsyD (talk) [he/his/him] 00:18, 7 October 2020 (UTC)

I got tired of repeating myself (mostly at WT:V), so I eventually wrote it down in one place. See also WP:LIKELY and WP:Published for similar pages. WhatamIdoing (talk) 05:36, 7 October 2020 (UTC)

Perhaps it would be useful to give an example, either an existing well-written one or one you propose might require primary sources and use them wisely. After all, the guideline should demonstrate best-practice. Also beware that although we casually describe a research paper as a primary source, it may contain weak secondary source material (background section) and not everything we may use it for is from the conclusions. For example, some things may just be bare facts about the study itself like where the research was conducted, how large it was, that some patients died, or identifying a researcher involved. Oh, and to clarify, those things are unlikely to appear in the treatment section of a disease or indications sections of a drug, but could perhaps appear in a history section or in text about the research institution or researcher. Most likely WP:WEIGHT would require secondary sources to be writing about those things, though as noted above, weight can be difficult to judge if very few people are writing about a worthy article topic at all. -- Colin°^Talk 07:31, 7 October 2020 (UTC)

@Crossroads - You're right. "Astounding" was a tad hyperbolic. Mark D Worthen PsyD (talk) [he/his/him] 18:25, 7 October 2020 (UTC)

@Colin - Great suggestion. Everything else you wrote makes good sense to me. Mark D Worthen PsyD (talk) [he/his/him] 18:25, 7 October 2020 (UTC)

@WhatamIdoing - Is there anything other than "breaking news" these days? :^O ... PBS Newshour rocks! ;-) Mark D Worthen PsyD (talk) [he/his/him] 18:28, 7 October 2020 (UTC)

I've been surprised at how much longform reporting is available. Once the writers aren't constrained to a certain number off column–inches, and the reader isn't constrained to the local newspaper, things like longreads.com became viable. WhatamIdoing (talk) 05:58, 9 October 2020 (UTC)

If you need help finding examples, then you might try User:MastCell's early editing. It would only be fitting, since the section on preferring secondary sources was largely his idea. WhatamIdoing (talk) 06:00, 9 October 2020 (UTC)

References

Change guidance about indexing in bibliographic databases to be open to non-MEDLINE indexed journals?

Any thoughts on this edit (which I reverted) by new account Meansell?

I ask because although I don't cite "non-MEDLINE" as a reason to reject journals, I know that a number of editors have and still do today. And that includes Tgeorgescu, who likely wants to comment on Meansell's edit.

What non-MEDLINE indexed journal should we be open to?

Meansell, hi. Welcome. Although your account is new, you don't appear to be new to editing Wikipedia. By this, I mean that it's very unusual for the very first edits by a brand new account to be to their user page (unless it's a student editor) and/or to a policy or guideline page. You did both. So I wondered what brought you here. I do see that you state on your user page that you edit Wikipedia infrequently, which I take to mean "as an IP." Did the Wikipedia + Libraries asynchronous Moodle course offered by the Network of the National Library of Medicine, which you mention on your user page, bring you here? If so, how did that come about? Why did you make the MEDLINE edit? Flyer22 Frozen (talk) 23:58, 7 October 2020 (UTC)

Hi Flyer22 Frozen,

Yes, I'm a 'student' editor insofar as I'm taking a continuing education course through the NNLM, and have made some edits on random pages in the past that I could've sworn I made while logged in, but apparently wasn't based on my contributions history. I edited the policy/guideline page because as a medical librarian I'm pretty familiar with predatory publishing and what counts as a reputable source, and can claim with some authority that excluding sources based on simply whether they are indexed in MEDLINE or not is rather problematic, as it excludes quite a bit of quality health science literature that is indexed in other reputable databases such as CINAHL (which focuses on nursing) and Embase (which originally specialized in pharma/drug lit). While I definitely agree that MEDLINE is top tier and a core biomedical literature database, it can't be the only indicator upon which sources are included/excluded. Meansell (talk) 03:09, 8 October 2020 (UTC)

But there is already the exception Determining the reliability of any individual journal article may also take into account whether the article has garnered significant positive citations in sources of undisputed reliability, suggesting wider acceptance in the medical literature despite any red flags suggested here. So, I guess, that trumps lack of MEDLINE indexation.

Yeah, if it is an important discovery, it doesn't matter where it was published. The tricky part is however: convince us that it is an important discovery. (No, it is not impossible to do it, it is just hard.) Tgeorgescu (talk) 17:40, 8 October 2020 (UTC)

Meansell, you stated that you thought you were signed in. Although I wondered if you had only just created the Meansell account on October 5th and therefore wondered what account you would have signed into before this one, I see that you created your account at 21:17 on June 5, 2017 (3 years ago).

As for the edit in question, we need a standard. As you know, we obviously just can't allow any journal to be used. "MEDLINE-indexed" gives us a standard. Maybe we should have a few examples listed. I will alert WP:Med to this discussion for further input. Please don't ping me if you reply. Flyer22 Frozen (talk) 00:58, 9 October 2020 (UTC)

I understand there is an exception, but, as Tgeorgescu mentions, this places an additional ("not impossible, but hard") burden of proof on articles from non-MEDLINE journals to demonstrate themselves worthy of an exception, one which is unnecessary if the journal is indexed in a reputable non-MEDLINE database, of which there are several. I agree that having several examples of reputable databases that meet MEDLINE-level standards is a good idea - I'm happy to contribute suggestions of core biomedical databases of high quality. Meansell (talk) 05:22, 9 October 2020 (UTC)

MEDLINE indexes Medical Hypotheses, which should give any editor a good reason not to take MEDLINE as the sole arbiter.

MEDLINE also rejects most non-English journals – which means that middling English-language journals are being preferred over some high-quality French, German, etc., journals – and journals that are on the edges of medicine but which still have relevant biomedical information (e.g., chemistry). The language problem is not a small one, especially in psychiatry and psychology, as different languages/cultures have different approaches to some conditions. To give just two examples, I expect that most of you are aware of the differences between American and French pediatric psychiatrists when it comes to ADHD, and Haltlose personality disorder, which was mentioned at WT:MED the other day, is almost never diagnosed outside of Europe. It's not because these things don't exist around the world, but because the conventional medical establishment has different ideas.

I think that, in general, we need to reconsider how we're teaching editors to evaluate journals. There are no magic numbers and no magic lists. You really need to look at multiple indicators. WhatamIdoing (talk) 06:10, 9 October 2020 (UTC)

Being in MEDLINE/PubMed is a basic minimum, in the sense that not being in MEDLINE is a huge redflag. Being in MEDLINE doesn't mean it's good enough though, it has plenty of predatory and low-quality journals in it, just that it at least has a chance of being good enough. If you want to skew the odds in your favour, go with coverage in Index Medicus. Again, not a garantee of anything (e.g. it includes the Journal of Alternative and Complementary Medicine for example), but there's a much higher treshold of quality for inclusion. Headbomb {t · c · p · b} 11:44, 9 October 2020 (UTC)

Side note, Q8 in the CiteWatch FAQ will have some relevant advice which could potentially be adapted for here. Headbomb {t · c · p · b} 11:51, 9 October 2020 (UTC)

@Headbomb: Overall, I absoulutely get where you're coming from here. My question/s would be: Do you think the non-MEDLINE red flag is also valid for fields such as psychiatry or clinical psychology (cf WAID's point above), where PsycINFO, for example, is a key resource? Also *perhaps*: In cases of geographically circumscribed content (and/or some rare conditions maybe), could there be a case to waive this sort of general restriction if broadly MEDRS-compliant content appears in a smaller (maybe local/regional), non-predatory journal that isn't actually MEDLINE-indexed? (And on a sidenote, I think the potential for contribution by medical librarians here is good :). 86.186.94.204 (talk) 15:45, 9 October 2020 (UTC)

I'm no doctor or librarian, and have no real qualified opinion about the state of psychology representation in medline. However, local/regional considerations are a no-go for me. An unknown journal from the small country of Foobar does not get to dodge WP:MEDRS because of "but it's a small Foobari journal, coverage in MEDLINE enforces Western Bias!!!" types of arguments, because those types of arguments ignore that the scientific standards in the small country of Foobar often leave much to be desired. India has the Ministry of AYUSH for example, and a plethora of garbage publishers like the OMICS Publishing Group. It's not all Indian medical journals that are crap, of course, but going 'but it's an Indian journal, we shouldn't expect it to be in MEDLINE!' is a great way to add all sorts of nonsense. The Journal of the Indian Medical Association is in the Index Medicus for example. There's no reason the other Indian journals should have to play by different rules. Headbomb {t · c · p · b} 15:59, 9 October 2020 (UTC)

I'm agreed with Headbomb. Additionally, English is the lingua franca of academia, so if something does not appear at all in English journals, that is a red flag. That another culture has another approach to things is not an argument for including that as valid; we are not to be cultural relativists. WAID uses the example of the differences between American and French pediatric psychiatrists when it comes to ADHD, but this is just the sort of thing we should be very skeptical of, because France is unusual in being still enamored with Freudian psychoanalysis, which has been discredited elsewhere. [8] As for because the conventional medical establishment has different ideas, well, that's just the point. Wikipedia is a WP:MAINSTREAM encyclopedia and is to say what the conventional medical and scientific establishments say. This is not the site to make the case for non-mainstream ideas. Crossroads ^-talk- 16:26, 9 October 2020 (UTC)

agree w/ HEADBOMB and Crossroads--Ozzie10aaaa (talk) 19:21, 12 October 2020 (UTC)

(hum... just to point out that my second query was a tentative one, and I had absolutely no intention of entering into "...MEDLINE enforces Western BIAS!!!" polemic. I have no direct experince of PsycINFO, but am aware of its potential relevance (including in systematic retrieval of guidance/instruments), though not necessarily regarding MEDRS - ping @User:Markworthen for a (possible :) informed opinion .) 86.186.94.204 (talk) 17:05, 9 October 2020 (UTC)

Headbomb and Crossroads, I agree with you in general, but I think you've accidentally overstated the case. When a local/regional journal reports specifically local information (e.g., number of measles cases in Foobari last year, whether you can get the drugs your patients need), then we should not treat them the same as you treat the "SCAM" industry. ("SCAM" is a pointedly disparaging abbreviation for "Supplements, Complementary, and Alternative Medicine".) There might very well be a "Western bias" that makes larger journals yawn and drop such papers in the trash, when they would accept the same type and quality of paper if the country reported on figured more prominently among its subscribers. Not all biomedical information is about efficacy.

(Crossroads, AFAICT Freud has nothing to do with the French approach to ADHD. The fact that it's illegal to give methylphenidate and similar drugs to young children is probably relevant, though.) WhatamIdoing (talk) 22:48, 9 October 2020 (UTC)

Meansell's two edits (diff) are spot on. I hope they will be restored, but I won't hold my breath. // MEDLINE indexes biomedical literature. If an article on a biomedical topic cites a journal that MEDLINE doesn't index, that journal begins with a deficit (in terms of credibility & reliability. Of course, such journals will occasionally publish really good articles, but the burden of proof is on the citing Wikipedian. // On the other hand, MEDLINE does not index scores of top-notch psychology journals, and probably hundreds of high-quality social science journals generally. That's not a criticism of MEDLINE by the way. MEDLINE's indexing policy is clear, as is its purpose. // Unfortunately, my experience over the years is that arguments to bring more nuance and clarity to WP:MEDRS usually get shot down. Bang, bang, you chased me out of town—again. Mark D Worthen PsyD (talk) [he/his/him] 17:47, 9 October 2020 (UTC)

Nuance is perceived as the opposite of clarity. Some editors want bright-line rules that they can enforce against other people's contributions. WhatamIdoing (talk) 22:50, 9 October 2020 (UTC)

Well said, WhatamIdoing. Mark D Worthen PsyD (talk) [he/his/him] 17:53, 12 October 2020 (UTC)

• I was asked to comment: In all countries, there are journals that primarily treat national problems. This occurs in all the descriptive sciences, in engineering,, and in public heath. Medline is an Index originally prepared primarily for the US, but with the intent of having an international audience, and it includes all journals in its field dealing in a significant way with world wide problems, and also all journals in its field deal with problems local to the US. In deciding whether to include journals dealing with problems specific to other countries, it focuses on the traditional English speaking countries, and even hereit is less complete than for the US. It includes only the most important journals from elsewhere, regardless of the level of development. This applies as much to France as it does to Nepal. The countries that are most disadvantaged by this at the moment are Japan and China--there are hundreds of Chinese medical journals that would probably be included if they were published in the US in English. Scientists in China and Japan know this, and if they are aiming for an international audience they publishing in the important English language international journals--this is in fact a formal requirement for promotion in the Chinese academic system.

The example "number of measles cases in Foobari last year" is unfair. There are very significant medical problems that rarely occur in the US, but frequently do elsewhere. A great many public health problems are specific to a particular political system. There would be no reason for work in most of these, however important, to be published in a Medline journal. Fwiw, this problem is even more severe in some social science fields: for example, essentially everything on Norse archeology is published in non-English journals that are very rarely found in the US. I've had considerable difficulty getting academics working in such fields accepted into WP. DGG ( talk ) 07:28, 13 October 2020 (UTC)

Thanks for this information, DGG. And, I repeat WAID's "Not all biomedical information is about efficacy." We seem to focus way too much on that, and the kind of sources that are only really focused on that. -- Colin°^Talk 09:07, 13 October 2020 (UTC)

DGG, are there other/reputable indexes that you would consider to be helpful in identifying decent journals for biomedical-related information? (I'm assuming your advice isn't to give up entirely on using any indexes at all.) WhatamIdoing (talk) 21:24, 13 October 2020 (UTC)

my advice is to consider the principal journals in each field in each country as notable. There are indexes for Japanese and 'Chinese journals, bt I am unable to use them. There is no index for Indian journals. The available international indexes are Excerpta Medica and the various parts of the Commonwealth Agricultural Bureau databases, but I have never had occasion to use them. DGG ( talk ) 02:14, 14 October 2020 (UTC)

Listing COVID vaccine trials

Could we get some eyes on this conversation? NickCT (talk) 16:47, 21 October 2020 (UTC)

Core clinical journals

A recent edit (diff) included this statement in the edit note: "(→‎Searching for sources: ...update wording to fit current PubMed interface - hum... "core clinical journals" option gone awol[?])". The "core clinical journals" are also known as the Abridged Index Medicus. However, "the Abridged Index Medicus (AIM) was the list of journals covered in the hardcopy publication 'Abridged Index Medicus', which ceased with the December 1997 issue. Until early 2020, the journal list was also used online as a search subset limit or filter called 'Core clinical journals' in PubMed®." So, the editor is correct, "core clinical journals" is not longer a subset limit when searching PubMed, although the list of journals is available at Abridged Index Medicus. Just FYI. Mark D Worthen PsyD (talk) [he/his/him] 19:28, 15 October 2020 (UTC)

Thanks for that Markworthen. Given that the edit was merely a further update to ==Searching for sources== I didn't think it was necessary to post here. But now I notice that that handy (for us) PubMed feature was also referenced earlier on the page, under ==Biomedical journals== (now also trimmed[9]). (Fwiw - and OT with respect to WP:MEDRS - personally, I'm missing other traditional features that seem to have gone missing in the current interface, including the ability to to see one's search query "translated" into the string actually used by the search engine - I want to look into this when I get a moment, because I find it hard to believe this is no longer possible). 86.190.128.65 (talk) 17:10, 16 October 2020 (UTC)

Advanced --> Details > and there it is! Jrfw51 (talk) 19:07, 16 October 2020 (UTC)

Ah thanks, Jrfw51, I should have spotted that (my bad - now struck above). I still haven't seen a "core clinical journals" filter, but perhaps I've missed that too. 86.190.128.65 (talk) 19:36, 16 October 2020 (UTC)

Also ping Mcbrarian (hoping she may have some useful input to share regarding the recent changes to the PubMed interface). 86.190.128.65 (talk) 17:22, 16 October 2020 (UTC)

Hi! Legacy PubMed is still available until October 31 if you still want to use the Core Clinical Journals Feature. I'm home with a sick kid today so my work is scattered but let me know if you want me to draft a search string you can add to any search to limit to only the core clinical journals. I could whip it up pretty easily.Mcbrarian (talk) 14:55, 19 October 2020 (UTC)

"Core-journals" grouping perhaps deemed by NLM to be past its use-by date? (as an oldie, I'm loathe to suggest anything too substantial has changed since the good old days when libraries housing the latest physical volumes of Indexus Medicus could also function as surrogate gyms ;-) 86.186.94.139 (talk) 14:17, 17 October 2020 (UTC)

It looks like if you put jsubsetaim into the search box (along with whatever else you're searching for), then it will limit the results. WhatamIdoing (talk) 02:34, 28 October 2020 (UTC)

References

POVFIGHTER

FYI

 – Pointer to relevant discussion elsewhere.

Please see: Wikipedia talk:Tendentious editing#POVFIGHTER. Summary: A provision has been added to WP:TE that appears to have implications for this page and editorial activity relating to it.  — SMcCandlish ☏ ¢ 😼  15:57, 2 January 2021 (UTC)

Are systematic reviews and meta-analyses MEDRS compliant?

PubMed has several article types you can select when searching. [10]. Just double checking that systematic reviews and meta-analyses are MEDRS compliant? Looks like they are from the pyramid graphic in the article, but I want to double check. Thanks. –Novem Linguae (talk) 21:43, 13 January 2021 (UTC)

The very top of WP:MEDRS should make that clear. Note that a systematic reviewed published in a unreliable source is still unreliable. Headbomb {t · c · p · b} 04:17, 14 January 2021 (UTC)