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Revision as of 16:39, 9 December 2008

To discuss reliability of specific sources, please go to Misplaced Pages:Reliable sources/Noticeboard or the Wikiproject talk pages of WT:MED or WT:PHARM.

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through July 2008 through September 2008

Steps towards consensus

Kim Bruning (talk · contribs) suggested on Misplaced Pages talk:Consensus that those editors discussing contentious issues at WP:MEDRS answer four questions:

1. Your current position as to how MEDRS should be formulated (and reasoning why)
2. Some idea of where you're willing and able to compromise on that position.
3. Your current view/ best estimate of where each of the other participants stand, singly and as a group (and reasoning why).
4. Your current best estimate of where other participants are willing to compromise.

The idea hasn't been followed-through but may be worth exploring. Colin° 12:38, 25 September 2008 (UTC)

Colin's answers

My position

1. MEDRS should be in agreement with WP:PRIMARY in regarding secondary sources as the foundation of an article, and to use primary sources only with care. This policy is manifest in this guideline where we prefer to cite literature or systematic reviews rather than research papers. I note that some people have commented that there is a different definition of "primary source" within science (logbooks and database records); I'm using the definition on WP which is concerned solely with published material.
2. MEDRS should be in agreement with WP:V, which places peer-reviewed journals and academic books at the top of the quality tree, and mainstream newspapers at the bottom. ("In general, the most reliable sources are peer-reviewed journals and books published in university presses; usually followed by university-level textbooks; then by magazines, journals, and books published by respected publishing houses; then by mainstream newspapers."). WP:RS (or its example page) have long said that "popular newspaper and magazine sources are generally not reliable sources for science and medicine articles".
3. MEDRS does not need to spell out where editors should use common sense, judgement or talk pages. We have WP:IAR and other editor-behaviour guidelines for that. The whole guideline should be read in the context that it is merely a guideline, and is a part of a set of guidelines and policies that work as a whole. Colin° 12:38, 25 September 2008 (UTC)
4. The use of reviews (expert opinion and analysis of the primary literature) enables editors to write better and more encyclopaedic articles. Both experts and POV pushers tend to write articles that mention study after study (the former because that's the style they read in the science journals, the latter because one can find a study somewhere to backup almost any claim). Mention of a study may be interesting and it may be necessary to constrain our certainty of the facts, but by-and-large an encyclopaedia should assert facts, not prove them. Colin° 22:05, 1 October 2008 (UTC)

My compromise

I'm not sure how the core of the first two points can be changed without bringing MEDRS into conflict with policy. A few editors have expressed support for the New York Times but since I don't read it, I can't judge. I don't believe any British newspaper has shown itself capable of reporting medical information reliably. Even if judged reliable, other aspects of a newspaper article make it a poor choice for anything but the most trivial medical fact. The exact wording used to express these guidelines is, of course, open to discussion. The third point can be compromised if there is consensus that MEDRS needs to spell out what some regard as obvious or repetitive. Colin° 12:38, 25 September 2008 (UTC)

I'm less keen now, to accept the inclusion of the "common sense" clause immediately following the preference of reviews over primary studies. I believe it may be misused, cited and wikilawyered over. If challenged, editors should have a better reason for deviating from the general guideline than "I'm just using common sense" (the implication being the challenger is not being sensible). Colin° 22:05, 1 October 2008 (UTC)

Others' position

Paul regards the preference for reviews over original publications as "batty" because they are "written by the same people who do the original research, and they are subject to the same personal prejudices and biases". Therefore they should not be favoured. In addition, he would like the choice of secondary vs primary to emphasise the need for common sense, editorial judgement and discussion on talk pages.

Nbauman objected to how newspapers were regarded, though did not participate in the poll. Some effort was made to find a compromise wording that would be acceptable. A debate ensued where Nbauman believed this guideline's statements needed to be sourced per WP:V rather than be the collective opinion of WP editors. It was established that this requirement does not exist, but even if it did, sources could be found to support the idea that newspapers are not a good choice for medical facts. A compromise was reached with Nbauman where this statement was explicitly sourced in the guideline, even though such sourcing is not required. Ludwigs2 was another editor who objected to the anti-newspaper stance. Colin° 12:38, 25 September 2008 (UTC)

Mattisse has contributed opinions based on his experiences and we seem to be in agreement. Colin° 22:05, 1 October 2008 (UTC)

Others' compromises

Paul has suggested (on my talk page) highlighting the danger in using reviews written by authors with a COI over the original research they are citing. I responded that this sounds like a valid concern, but very difficult to detect or enforce, and only necessary where the subject is controversial. Perhaps this idea can be explored by other editors. I have encouraged Paul to make this suggestion to a wider audience; he has not done so yet.

I get the impression that most examples given for valid use of newspapers involve some kind of scandal (e.g., Vioxx). Newspaper journalists can do investigative reporting, and medical journals generally do not. Perhaps those editors would be happier if the scope of "avoid newspapers" was clarified and restricted. For example, there seems little problem citing newspapers for historical events, current affairs, social and political issues (e.g., that a drug isn't available on the NHS due to a ruling by NICE), etc.

Please add your own subsection and we can then discuss the opportunities for compromise or changing-of-minds that arise. Colin° 12:38, 25 September 2008 (UTC)

Excellent. Could Paul, Ludwigs2 and WhatamIdoing also reply? (Eusebus, Nbauman and others who would also like to post a similar text may do so too of course, it's still a wiki ;-) . Don't worry if your version is substantially shorter or longer than Colin's version. As long as each of the 4 key questions are answered as best you can.) --Kim Bruning (talk) 16:45, 25 September 2008 (UTC)

Colin: your answer to 1 lists requirements, but I'm not sure what to do with them. Can you explain what you would like to change about the page right now? --Kim Bruning (talk) 21:30, 25 September 2008 (UTC)

I'm happy with the current text and it meets those requirements and my present understanding of medical sources. That doesn't mean I'm not open to being educated further or that I think the text is perfect. Colin° 21:39, 25 September 2008 (UTC)

Ok, noted! :-) --Kim Bruning (talk) 22:40, 25 September 2008 (UTC)

Right. If Eubulides made the changes he proposes below, which of those changes would you *not* agree with, and why? Would you update your answers to the questions (especially 3 and 4) based on the data from Eublides? --Kim Bruning (talk) 21:23, 26 September 2008 (UTC)

Kim, the idea that you're trying to mediate between me and Eubulides is really funny. Colin° 21:40, 26 September 2008 (UTC)

Meh, there's discrepancies between his position and yours right now. If you agree with his position entirely, that's fine, and all I need to know. :) --Kim Bruning (talk) 22:05, 26 September 2008 (UTC)

You said you'd support improvements. :-) Are some of the changes that Paul Gene proposes actual improvements? If so, can you specify which? --Kim Bruning (talk) 19:05, 30 September 2008 (UTC)

No. Nothing Paul has suggested here improves the guideline. Colin° 17:36, 1 October 2008 (UTC)

Eubulides' answers

1. MEDRS should supplement WP:RS, WP:OR, and WP:V with advice specific to biomedical articles, advice that is in agreement with the mainstream scientific consensus on medicine and biology. MEDRS should not unduly repeat the policy pages, nor restrict itself to merely saying what the policy pages say. Nor should it emphasize parts of the policy that we like and deemphasize the parts we don't like.
2. It's OK to have brief summaries of what the policy pages say, to establish context.
3. There are two overlapping sets of disagreements. One set disagrees with the current standing of newspapers in WP:MEDRS, and would like newspapers to be viewed more highly as a source. Another set disagrees with WP:MEDRS's strong position on favoring secondary over primary sources.
4. #Common sense above explores one way to compromise over the secondary-versus-primary dispute, by briefly summarizing the policy page in question. It's possible a compromise may be found there. For newspapers, it may be helpful to give another example or two where citing newspapers is OK.

Eubulides (talk) 17:12, 25 September 2008 (UTC)

Ok, also wondering about your #1, which changes should be made to the current page to meet your requirements? (answers to all 4 questions should be about concrete actions, but let's start at #1). --Kim Bruning (talk) 21:32, 25 September 2008 (UTC)

For #1, it's not so much a question of meeting requirements, as it is of improving the article so that it's more useful, particularly to editors new to Misplaced Pages's medical articles. Here are a few suggestions off the top of my head:

• Remove the dispute tags.
• Give advice that's specific to the section of the medical article. Sources for an Epidemiology section will have different characteristics than sources for a Classification section.
• Give more examples.
• Make the section headers shorter. Use fewer section headers.
• Article type is out of place; it should be combined with the secondary sources bullet of Definitions somehow.
• Periodicals, Books, and Online should be combined into a single top-level section, with duplicative material removed. Almost everything's online now, for starters.
• Assess the quality of evidence available contains too much detail about evidence ranking schemes. It should summarize the point and give pointers to the details.

Eubulides (talk) 23:30, 25 September 2008 (UTC)

Ok, compare what you've written with the objectives written by Colin above (answers 1 and 2). Do you foresee Colin objecting to any of your changes? If so, why, and where do you believe you can reach a compromise? --Kim Bruning (talk) 21:25, 26 September 2008 (UTC)

Colin might object to some of those proposals; if so, I'd almost surely withdraw them, as Colin has more experience in this area and is a topflight editor. But I must say that it sounds like there's some confusion here, as Colin and I weren't disagreeing with each other. We were disagreeing with other editors, notably with User:Paul gene. Eubulides (talk) 21:39, 26 September 2008 (UTC)

Sure, noted. I guess you can tell I'm a neutral outsider here, since I'm just doing this systematically :-) --Kim Bruning (talk) 22:07, 26 September 2008 (UTC)

Alright, Paul Gene has pointed out his views now. Can you point out which changes that he proposes that you agree with? --Kim Bruning (talk) 19:04, 30 September 2008 (UTC) hopefully there's at least 1 :-)

I don't agree with the changes Paul gene proposes. The "compromise" in #Paul Gene's answers is not a compromise: it simply restates Paul gene's position, which is to remove guideline status from this page. The "compromise" also restates Paul gene's position to duplicate large chunks of text from a policy page, even though this would introduce redundancy and makes this page unbalanced. Paul gene has proposed these two changes many times, without anything remotely approaching consensus. In #Common sense, I attempted a compromise on the second issue, involving a WP:SUMMARY of the policy-page text, but so far this compromise has been rejected. Eubulides (talk) 20:13, 30 September 2008 (UTC)

Ok, noted. So there is no change proposed so far, (however small), that you agree with?

Alright. based on Pauls position, is there any (small) change you could propose that you could both agree on? --Kim Bruning (talk) 20:21, 30 September 2008 (UTC)

I have already done that, by proposing a change at the top of #Common sense that attempted to put text prominently at the start of a section, text that summarizes policy text that Paul gene wants to insert. This is indeed a small change: it's only 14 words, namely "Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages." Eubulides (talk) 20:36, 30 September 2008 (UTC)

Cool. I'll ask Paul about that. --Kim Bruning (talk) 20:38, 30 September 2008 (UTC)

I've got the following text back: "Sometimes choosing between reviews and original research papers is complicated and requires editorial judgment and discussion on article's talk pages." . Do you have any issues with this particular phrasing that would preclude placing it on the MEDRS page? Does it require further changes? --Kim Bruning (talk) 22:36, 2 October 2008 (UTC)

(outdent) That text wouldn't work as well, as it uses terms like "reviews" and "original research papers" before they are discussed. Furthermore, the "is complicated" and "requires" unduly scares the reader. We shouldn't start off the guideline with a sentence that puts off naive readers; we should start it off with a friendly sentence. How about the following rewording instead? "Editorial judgment and talk-page discussion can help when choosing sources." Eubulides (talk) 23:23, 2 October 2008 (UTC)

Ok, Well, let's see where that gets us. --Kim Bruning (talk) 16:05, 3 October 2008 (UTC)

Paul Gene's answers

(long by necessity as I tried to represent the points of views of all of the editors, and most of them are burned out)

My position

1 This page is not sufficiently developed to be a guideline and may actually be harmful in some aspects.(see two different views on how it is inadequate: and ) Several editors mention that this page is good for helping new editors. The same editors appear to agree that for an experienced editor this page adds almost nothing to the existing guidelines. Helping newbies is a good reason to exist for an assay, but the guideline should also be useful for others.

2 In particular, the definitions of primary and secondary sources are confusing.. They should be explained along the lines outlined by WhatIamdoing  : “Lab records=primary source for a given fact. Original paper reporting lab results=secondary source, but primary literature. Review paper (say, comparing half a dozen similar original papers)=tertiary source, but secondary literature.”

3 Since primary literature in medicine is actually secondary sources, it is generally reliable, and appeals to WP:NOR and WP:V to support the exclusion of research papers are without merits. Moreover, the idea to exclude original research publications is contrary to the community practice. Most of the references for the WP:MED featured articles are to original research papers not to the reviews. The exclusion of research publications may help newbies but it will make the life of experts (such as myself) miserable. This deficiency of the current page has been discussed by multiple contributors over the years and the compromise has never been reached. See for example

4 A procedural point, but only to answer the often raised argument that this page has been around for 22 months so it deserves to be a guideline. This page was set up as a proposed guideline 22 months(!) ago . Despite the continuous re-submission of this page as proposed guideline, the consensus could not have been reached for 22 months. According to normal WP process, it should have been labeled rejected or historical long time ago. Indeed it was labeled historical in January 2007 and reverted by Sandygeorgia. It was rejected in May 2007 (see and and related discussions). This rejection was reverted over the insistence by Sandygeorgia and Colin, who is the page owner. In June 2007 it was downgraded to just a project page Any work on the page then essentially stopped till June 2008. The page was again restored as a proposed guideline in August 2008 by WhatIamdoing. Now the story is being repeated again.

The existence of this "walking dead" page itself is an abuse of Misplaced Pages process. This Frankenstein monster is killed and revived again, unchanged, and it just never dies. To remind all involved the relevant policy WP:PG: “A failed proposal is one for which consensus for acceptance has not developed after a reasonable time period. Consensus need not be fully opposed; if consensus is neutral or unclear on the issue and unlikely to improve, the proposal has likewise failed. It is considered bad form to hide this fact, e.g. by removing the tag. Making small changes will not change this fact, nor will repetitive arguments. Generally it is wiser to rewrite a failed proposal from scratch and start in a different direction.”

My compromise

The opposed points of view on this page are - this is a rejected guideline vs. this is an accepted guideline. The compromise would be to return to the page's status as a project page. Then the disputed tags could be removed from the parts of this article. As a project page, this page would be still helpful for newbies while not hindering the work of experienced editors.

In this new project page we should insert the full quotation from WP:NOR to make it unbiased: “Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment”t (see this discussion for the background: Wikipedia_talk:Reliable_sources_(medicine-related_articles)#Common_sense).

The topic of reliability of sources is covered rather well in WP:NOR, WP:V and WP:RS. The new proposed guideline could be started, though, devoted to the question of what sources are the most useful for medical articles. It could be called MED:Sources, and incorporate the practical advice from this page.

Others' positions

Colin is happy with the current text and it meets his present understanding of medical sources, although it can be improved.

Eubulides thinks the page unquestionably meets the requirements for a guideline, although could be improved. He would defer to Colin who is “a topflight editor”. Eubulides would almost surely withdraw any proposal Colin disagrees with.

WhatIamdoing has “no interest in pushing cutting-edge research into Misplaced Pages. In fact, one of the goals of MEDRS's version of WP:PRIMARY is to keep unconfirmed, cutting-edge research out of Misplaced Pages by strongly preferring proper secondary literature (which takes months, if not years, to appear) to primary literature.”

Sandygeogia thinks that “in a content dispute, WP:V suffices to cover the content at MEDRS anyway, and the additional info there was only intended to provide specifics about medical sources. Whether the page is or isn't a guideline will not change good, policy-based editing on medical articles in practice; the absence of the page as a guideline will, however, make editing harder for new editors.”

Eversince – the page should not be a guideline because it will prevent the inclusion of the reputable views from the other fields (Philosophy, Psychology, History, Literature, etc) on medical topics. The current policies (WP:NOR, WP:V) are sufficient.

NBauman would like to see more nuance in the definition of the popular press coverage. The scientific evaluations of the accuracy of popular press should be used in the guidelines, not just simple assertions by the editors.

UnaSmith – this proposal is contrary to the intent of Misplaced Pages by being far too prescriptive, and trying to prescribe something which should be a matter of editorial judgment. For example, she has read far too many mediocre review articles that are a giant step backward from the original research literature they cite. In her opinion, this page is not an improvement on Misplaced Pages:Reliable sources.

Mihai Cartoaje is concerned with the conflict of interest, which permeates the medical research. (IMHO a very valid point, see )

Ludwigs2 – Although the news media can be wrong, it often “can and does present decent, effective, readable reports that can sometimes have distinct advantages over academic journal articles from the perspective of wikipedia”, for example, by being more readable and when medical researchers have a conflict of interest.

Others' compromises

Colin can compromise on the addition of the caveat from WP:NOR. He would not compromise on the definition of Primary and Secondary sources as he believes that his understanding of the issue reflects WP policies.

Eubulides tried to unsuccessfully find a compromise with me on the inclusion of the caveat from WP:NOR (see Wikipedia_talk:Reliable_sources_(medicine-related_articles)#Common_sense)

Paul Gene (talk) 14:50, 27 September 2008 (UTC)

Alright, can you point out some things that Eublides would like to change that you agree with (partially or entirely)? --Kim Bruning (talk) 19:03, 30 September 2008 (UTC)

Eublides proposes adding the words: ""Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages." , which he thinks/hopes you'll agree with. Do you indeed agree with that? --Kim Bruning (talk) 20:39, 30 September 2008 (UTC)

I agree with this statement the same way agree with the statement "The Earth is round". The Eubulides proposal is a platitude, does not add anything to the article, and there is no need to include it. Why not address the controversy directly: "Sometimes choosing between reviews and original research papers is complicated and requires editorial judgment and discussion on article's talk pages." Paul Gene (talk) 07:53, 2 October 2008 (UTC)

The wording of this principle, isn't it a matter for the core policy document Misplaced Pages:Reliable sources? EverSince (talk) 08:40, 2 October 2008 (UTC)

@Eversince: Basically. We can sync both documents, if you like. Incidentally, can you provide a reference for the term "core policy"? --Kim Bruning (talk) 22:34, 2 October 2008 (UTC)

Kim, what I meant really was Misplaced Pages:Verifiability: "Misplaced Pages:Verifiability is one of Misplaced Pages's core content policies...these policies determine the type and quality of material that is acceptable in Misplaced Pages articles" and its reliable sources section feeds into Misplaced Pages:Reliable sources of course. Don't know about sync'ing. EverSince (talk) 09:41, 3 October 2008 (UTC)

@Paul Gene. I take it that's a yes then. Would you actually be opposed to putting Eublides' wording on the MEDRS page? In the mean time, let me approach Eublides. --Kim Bruning (talk) 22:34, 2 October 2008 (UTC)

Yes, he can put that wording on the page, and 2+2=4, too. Unfortunately, that does not solve the problem. Paul Gene (talk) 12:38, 3 October 2008 (UTC)

I got back "Editorial judgment and talk-page discussion can help when choosing sources." . Is that any good? --Kim Bruning (talk) 16:07, 3 October 2008 (UTC) (Ok, this is a tad slow... I'm going to actually turn on my brain now. O:-) )

This wording is the same as 2+1=3. Let me outline the problem as I see it. Contrary to the WP:PG policy, the proposed guideline does not reflect the best community practice in writing medical articles. The best community practice is embodied in WP:MED Featured Articles. It is to use reviews and original research papers in approximately equal numbers. Examples: Chagas disease refers to 17 reviews and guidelines that are cited 29 times. It refers to 33 original research articles that are cited 39 times. Keratoconus refers to 19 reviews, guidelines and textbooks that are cited 41 times. It refers to 33 original research articles that are cited 47 times.Paul Gene (talk) 20:40, 3 October 2008 (UTC)(Ok, trying to move gears a bit. Feel free to tell me that I overstepped and I will scratch my reply.) )

• These numbers do not contradict the WP:MEDRS guidelines. WP:MEDRS says "medical articles should be based upon published, reliable secondary sources whenever possible" (my emphasis). Perhaps it wasn't possible in the cited articles.
• The cited articles are reasonably old. Chagas disease became featured in July 2005, and Keratoconus in March 2006. Both these dates are before the first version of WP:MEDRS. It's not clear these older articles would still pass; FA standards have gone up since then. WP:MEDRS attempts to document current guidelines, not past guidelines.

Eubulides (talk) 23:08, 3 October 2008 (UTC)

Eublides: "medical articles should be based on secondary sources" is confusing to me. Can you clarify for me: does it mean the[REDACTED] definition of secondary source, or do you mean the biomedical definition of secondary article? <scratching head> --Kim Bruning (talk) 23:13, 3 October 2008 (UTC)

It means the definition of secondary sources given in WP:MEDRS #Definitions, the section that contains the sentence "In general, Misplaced Pages's medical articles should be based upon published, reliable secondary sources whenever possible." that I was referring to above. Eubulides (talk) 23:18, 3 October 2008 (UTC)

%-/ <pulls hair out> No wonder there's confusion on that front! This is yet another, 3rd set of definitions. On the plus side, that explains a lot to me! :-) --Kim Bruning (talk) 23:28, 3 October 2008 (UTC) And it even links to PSTS, just to add to the confusion! <sigh>

Ok, having grabbed a cup of tea and thinking about it: Is it a consequence of the current wording that we should be avoiding the majority of texts published on pubmed ? --Kim Bruning (talk) 23:37, 3 October 2008 (UTC)

After some toast and some more reading, the wording appears to be VERY careful on this point, apparently some negotiation already happened there. I'm going to think about this and ask some more questions in the morning I think. (feel free to answer the question about avoiding pubmed though) --Kim Bruning (talk) 23:42, 3 October 2008 (UTC)

It's hard to say, but I'd guess that more than half of Pubmed should be avoided for medical articles. That is because more than half of Pubmed is over 10 years old, and older sources are likely supplanted by newer and more-reliable sources. Of course there are exceptions; please see WP:MEDRS #Use up-to-date evidence for details. And again, this is just a guess. Eubulides (talk) 00:56, 4 October 2008 (UTC)

Importantly, it's not just the source. No source is universally reliable. No source is universally appropriate. Whether a source is appropriate or reliable depends very much on how the source is used. Primary sources should not form the basis of the article. That's why MEDRS says that "medical articles should be based upon secondary sources", not "medical articles should only cite secondary sources". WhatamIdoing (talk) 01:10, 4 October 2008 (UTC)

Cool! WhatIamdoing, you may have found the source of the confusion. Some people may understand "should be based upon secondary" as "should always cite secondary". Let me see if I interpret you correctly. You are saying that reviews and textbooks do not have to be the numerically main part of the article, rather they should lay the groundwork or form the framework for it. That is something we could agree on. StevenFruitsmaak also expressed a similar sentiment here Paul Gene (talk) 03:20, 4 October 2008 (UTC) Jumping up and down at the chance to have a meaningful agreement.

Yes, goodness me! The reason why PSTS is discussed at NOR is because it concerns how you use a source. If it mattered to whether you can use a source, it would be at WP:V. Nobody is banning primary sources. One reason we prefer reviews is because you can say more (with confidence, without OR, and having some assurance of WP:WEIGHT). Sure, for the details (especially if one needs to discuss the details of studies) the primary literature may be required. There are also allowances in this guideline for when the secondary literature isn't substantial enough to build on. So, yes, the groundwork and framework, the major points/facts and the contentious facts. This is how I worked on the ketogenic diet: it was written from a handful of reviews and then fleshed out with a mix of reviews and primary studies. I recently analysed the text and 76% of the words are based on secondary sources. The 24% is mostly uncontentious supplementary detail. I would have thought a big subject like epilepsy could easily be 100% sourced to secondary sources. On other articles, the figures may be much, much less. Colin° 08:32, 4 October 2008 (UTC)

Kim, in the archive you will find a list of online sources that define PSTS for science and medicine. I haven't found support for "the biomedical definition" you mention. Colin° 08:32, 4 October 2008 (UTC)

Drat. I had some sources lined up... but... no mind for now though, as it'd just get in the way of your conversation with Paul. I'll reserve the option to come back to this topic later in case things somehow get stuck, but I'm entertaining the hope that that won't be necessary at all! :-). --Kim Bruning (talk) 03:14, 5 October 2008 (UTC) (Turning brain back off)

Yes, Paul, you seem to understand. Perhaps you now also understand why so many of us were confused by your opposition. WhatamIdoing (talk) 16:44, 4 October 2008 (UTC) (who promises that if she ever intends for a guideline to require that something "always and only" be done in a single way, then the guideline will say so with an absolutely unambiguous phrase, like "always and only")

(undent) Would this wording be acceptable? Removal of the current wording is shown as the strike through. New wording is italics. - "In general, Misplaced Pages's medical articles should be based upon published, reliable secondary sources whenever possible. The best practice is to use reliable secondary sources, such as reviews and textbooks, to form the framework of the medical article. This framework can then be fleshed out by adding information from reliable primary sources, such as research articles. Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse. Use primary sources with care to avoid engaging into original research. For that reason, eEdits that rely on primary sources should only make descriptive claims that can be checked by anyone without specialist knowledge." etc Paul Gene (talk) 19:23, 4 October 2008 (UTC)

I'm so glad we're no longer fighting over the definition of secondary. We say "based upon"; NOR says "rely mainly on"; neither say "always cited to", but I do feel it is more than just a "framework", which makes it sound like a review might do little more than supply the section headings (rather than be the foundation or even the main building blocks). Plus it seems to actually advise that the fleshing out be with primary sources. And the "use with care because of the potential for misuse" is a very important statement I'm reluctant to lose. Original research is not the only danger; WP:NPOV is hard to get right without consulting/citing the opinion of experts, which is where secondary sources come in. I am a little frustrated that we've wasted a month partly because "based upon" was misinterpreted, but it is a carefully chosen phrase. But to avoid accusations of WP:OWN, I'm not killing your suggestion and am open to other opinions and, of course, other suggestions.

Paul, I'm interested to know if you can "live with" the current text, and interpret "based upon" to whatever extent you feel comfortable with (saying yes, doesn't diminish your argument that your proposed text is better). You see, if we know you are no longer at war with the guideline, it will help us all relax and take our time over polishing the text. Colin° 20:33, 4 October 2008 (UTC)

Hmm. I'm considering your "best practice" statement. I think there is value in describing an approach to article building that describes using core secondary sources as a foundation and adding a mix of primary and secondary material to flesh it out. Maybe this could go under "Basic advice". Perhaps we need input from a variety of our best editors to see how they've gone about the process. Then we can document the collective wisdom. Colin° 20:44, 4 October 2008 (UTC)

Excellent! --Kim Bruning (talk) 03:14, 5 October 2008 (UTC)

I note that a subsection on NOR was recently created within WP:Reliable Sources, linking to Misplaced Pages:No original research#Primary, secondary, and tertiary sources. And in it the phrase about secondary sources has become "based around", and the phrase about primary sources become "with extreme caution", while the relevant policy WP:NOR still says "with care" (as currently does MEDRS).

Can I also just note that MEDRS leads with "These guidelines supplement the general guidelines at Misplaced Pages:Reliable sources", but in fact (and as per above discussion) seems to also be about supplementing Misplaced Pages:No Original Research and Misplaced Pages:Neutral Point of View. And supplementing seems to involve rewording. EverSince (talk) 09:54, 5 October 2008 (UTC)

Colin, what do you propose to fix the ambiguous wording of the paragraph in question? And why cannot we refer to best actual practice in the beginning? It is not a legal document we are writing, where all the definitions should be verbatim or very close to some official statute, but a helpful guide. Paul Gene (talk) 11:56, 5 October 2008 (UTC)

I think it may be worth starting a new section (if that's allowed, Kim) because these proposals are getting lost in among the position-statements of each participant. You can open it with e.g. "I found the following passage ambiguous ... and propose this replacement". If you want, I'll wait for others to comment/refine rather than put my views in first. I didn't find it ambiguous and think it provides enough wiggle room. Eubulides is pretty good with words, perhaps he can come up with something.

Wrt documenting best practice vs giving rules and guidelines: I think we need both. Sometimes when you just describe "how we do it", people find it hard to apply that to their situation. If first, you outline the principles you are working to, and then describe how we do it, they can come up with their own variation that still obeys the principles. Also, before describing a "do this then this" approach, I'd like to know if that's how people work or have found effective. What I'm trying to say is I'd like to get other input rather than play prose-tennis with you until we're happy but everybody else feels left out. Colin° 13:04, 5 October 2008 (UTC)

If you both promise to proceed carefully, we could actually unprotect the page and try things out directly (possibly we could agree to let Eubulides do the typing for now? :-) ). If you're not entirely sure, or would like to discuss at the same time, feel free to open a new section; I propose we set the condition that every post in that section must suggest an edit for Eublides to carry out. A post in that section may discuss anything else too, including the weather in far off places, but must also include at least one instruction to Eubulides as well, however trivial. (if Eubulides thinks that this would be a fun and interesting thing for him/her to do? ) I have no problem solving the issues between Colin and Paul first. Often I first make a consensus of two, then add in number three, then four, etc... one at a time. --Kim Bruning (talk) 17:07, 5 October 2008 (UTC) The condition is designed so that each participant must propose progress of some sort, no matter what else they would like to discuss. Besides, discussing with restrictions is interesting. @Paul: Obviously I'll be monitoring such a section, so feel free to post there. :-)

Hmm. I was kind of hoping to tap Eubulides' brain for some suggested phrasings, rather than demote him to typist. Regardless of who the typist is, are you saying that each time we propose something, the page changes? Or only if we're both happy? What if Eubulides can, if he wants, suggest things to Paul and me, but then one of us has to propose it back (or similar) before it goes? Colin° 17:52, 5 October 2008 (UTC)

A procedure that I've found helpful is that someone thinks out loud about what changes should be made; for example, I did this in #Eubulides' answers above. Then someone (maybe the same person) builds on that to propose a specific change (down to each word that would be changed); I did this in #Section header cleanup below. Then, this gets discussed and the proposal gets modified as discussion goes on. Then, assuming there's consensus, the change gets installed. In such cases, it's often helpful for one editor to do all the typing for the particular proposal (usually it's the editor that made the specific proposal). Obviously any changes that get installed should reflect overall consensus; it wouldn't suffice to get agreement only among Colin, Paul gene, and me. Eubulides (talk) 21:27, 5 October 2008 (UTC)

Hmm... In 1988 I'd have agreed. In 1998 I didn't know better. It's now 2008, and we have a new-fangled invention called a "wiki". I wonder if we can use it to our advantage? O:-)

I'll go talk with Paul first I think, to see what direction his thoughts are going. This discussion is furthest along, so I'll concentrate here first.

--Kim Bruning (talk) 18:24, 9 October 2008 (UTC) You might think I'm being mildly sarcastic. Heck, even I thought I was being mildly sarcastic. But read back the talk page history for the past weeks. Has anyone actually mentioned trying to use the wiki to help solve the problems at hand in any way? But guess what... that's what a wiki is actually *for*. Let's see if I can show y'all, eh? :-) I may have some time this weekend I think (no promises yet, but I'll try!).

Mattisse's answers

My position

• The New York Times is no more reliable than, for example, BBCNews in providing accurate, medical summaries of data. It should be used only in combination with other reliable sources of medical information to present the "popular press" view and never as a sole source of medical information.
• Agree with WhatIamdoing on the issue of pushing cutting-edge research into Misplaced Pages. Specifically, in Psychology this is very risky as cutting-edge research can seem to support all sorts of "wacko" theories that are then presented as valid on Misplaced Pages.
• The use of editorial "common sense" likewise is risky for the general editor writing in the field of Psychology. Witness the recent inclusion of Parapsychology by a sophisticated editor in the category of Psychology in FAC. With expert writers, the use of "common sense" is somewhat less risky although it is still subject to the bias of that expert editor. WP:IAR is used to cover a multitude of sins. Again, this is especially true in Psychology, where the misuse of sources is rampant, to the point that it is almost impossible to maintain a respectable article.
• Agree that the use of primary sources should be undertaken only with great care and evaluation of the merits of the primary source. This includes primary sources in peer-reviewed journals also. Research articles are essentially OR, even if peer-reviewed since the researcher is reporting his observations (although a peer-reviewed journal is definitely superior to one that is not, as methodology is reviewed presumably). However, peer-reviewed journals contain articles on case studies, studies with low Ns, meta analyzes combining studies with widely varying methodologies, etc. Also, witness a peer-reviewed journal of the American Psychological Association apologizing, because of public pressure, for a research paper that was methodologically sound but had a politically-incorrect outcome. I strongly support the preference for citing literature or systematic reviews rather than research papers.
• I do not agree that WP:V and WP:NOR cover the sourcing problems that arise in medicine-related or science-related articles and that WP:MEDRS guideline is unneeded. Evaluation of sourcing is more rigorous for these articles and the application of rules for establishing reliabilty are somewhat different. Some of the information in WP:V, for example, can be seen as simplistic, misleading or inaccurate when used for this purpose.

—Mattisse (Talk) 17:13, 1 October 2008 (UTC)

Mattisse, thanks for joining the discussion. The above points look to be close to answering question 1 from Kim's four questions. Would you consider moving this section up to a sub-section of "Steps towards consensus"? It would also help if you could indicate what changes you would like to make to MEDRS. If you can answer questions 2-4 also, that would be great. Colin° 17:24, 1 October 2008 (UTC)

The positions of others

• I have no outstanding problem with the MEDRS guideline the way it is.
• I am not opposed to having MEDRS supplement WP:RS, WP:OR, and WP:V with advice specific to biomedical articles, as I do think the latter are misleading to the uninitiated editor which leads these editors to use inappropriate sourcing and therefore to (sometime wildly) inappropriate conclusions and even whole articles. In fact, I am inclined to support the primacy of MEDRS as a guideline for medicine-related articles.
• I agree that the use of common sense does not need to be specifically addressed in the MEDRS guidelines. In fact, I do not think it should be.
• I would be concerned about elevating the role of the popular press. As stated above, it can appropriately report on scandals and other issues not directly related to scientific evidence. Scientific American I would consider a tertiary source, useful for some purposes perhaps but not appropriate as a reference source to an article to support scientific findings.
• I do not agree with the statement, "primary literature in medicine is actually secondary sources." I believe strongly in the distinction between the two, having seen misleading information in articles when this distinction is not observed.
• I do not agree that the MEDRS page is not helpful to the experienced editor. I find it helpful and I consider myself experienced.
• I do not agree with Paul gene's statements on the differentiation and ranking of sources nor on the usefulness of the MEDRS page, so I would have difficulty in agreeing to the demotion or mass altering of the page along the lines he seems to be suggesting.
• I agree that MEDRS should be a guideline.

My compromises

I would have difficulty greatly compromising my views regarding the MEDRS page, but I am willing to be open to the opinions of others if they present practical reasons for not agreeing with me. —Mattisse (Talk) 20:16, 1 October 2008 (UTC)

Ok, this actually looks like it might be useful as part of an answer to question 2. If you have time, could you research the positions of other parties in more depth, and provide answers to 3 and/or 4 as well? --Kim Bruning (talk) 16:18, 3 October 2008 (UTC)

Apparently you might have the same misunderstanding as Orangemarlin below? I'm actually asking what you know about other people's opinions, rather than your opinion on their opinions. :-) See my answer to Orangemarlin, and see if it helps you. If you're still confused, tap me on the shoulder! :-) --Kim Bruning (talk) 23:44, 3 October 2008 (UTC)

As explained below, I am unwilling to make further comments. Since my own simple question was completely misinterpreted and therefore provoked a negative reaction, I am totally unwilling to make comments or guesses about what I think other editors might think or do beyond what they have stated. I would base any conclusions on what they have said and nothing else. I am unwilling to hypothesize. —Mattisse (Talk) 00:59, 4 October 2008 (UTC)

Well, everything you do on[REDACTED] is by necessity going to be based on some underlying hypothesis as to the position of others/the community. As you yourself point out, it's very easy to make mistakes! I'd very much prefer for people to explicitly state their underlying hypotheses, so that we can all work together to systematically review and test them, and thus deduce a viable "theory of consensus" ;-) on this topic. This approach should yield the optimal course of action (or something close to it).

Occasional misunderstandings and problems are to be expected when you work like this. But with this approach, misunderstandings and negative reactions are not failures: they merely serve to disprove the working hypothesis. One can simply formulate a new hypothesis and try again.

If you don't quite feel up to doing that kind of thing quite yet, you can always choose to just answer questions I ask you in this section. I'll then talk with others and take the heat, if any is forthcoming. I have a similar arrangement with Paul Gene at the moment; he seems to be making progress! :-) --Kim Bruning (talk) 03:01, 5 October 2008 (UTC)

I do not mind disagreements. I dislike comments meant to intimidate my participation made with out even taking time to understand my question. My question was neutral. Mastcell choose to react negatively to me personally, making assumptions about my position, without addressing the question. If Mastcell is no longer a participant here, or if he is willing to cease making such responses, then I am willing to continue in the discussion. —Mattisse (Talk) 14:26, 5 October 2008 (UTC)

Jfdwolff's answers

My current position is that MEDRS was about to become an widely endorsed guideline if not for the vocal protests of two contributors. I am of the opinion that the last stable version should be kept at guideline status, as such a guideline was long overdue.

I am not willing to compromise on the basic tenets behind this guideline, namely that secondary sources are out of necessity to be preferred over primary sources. I have always held, however, that editorial judgment should be exercised when selecting secondary sources, and if a secondary source seems poor-quality, unreliable or biased there are usually alternative secondary sources to choose from.

I am not going to guess others' perspectives. We have heard enough. Neither am I going to speculate on their willingness to compromise. JFW | T@lk 22:11, 1 October 2008 (UTC)

Ok. However, if you wish to participate in a consensus process, or wish to form a consensus, you should nevertheless be taking those steps, be it implicitly or explicitly.

1. If you do not know your own aims, you can never reach consensus, because there is nothing to reach consensus over.
2. If you are unable to compromise, it is very hard to reach consensus, because you have no flexibility to negotiate with others.
3. If you are unaware of the aims of others, you can never reach consensus, because you have no information to build a consensus on.
4. If you are unable to gauge the ability of others to compromise, you are severely handicapped, because you cannot take advantage of the flexibility offered to you by others.

I'll gladly hear back from you anytime if/when you change your mind, and wish to participate in consensus formation. :-) --Kim Bruning (talk) 16:27, 3 October 2008 (UTC)

My brusque response above reflects my frustration with the fact that we cannot get this vital policy off the ground. Please bear with me.

You misunderstood my response in the sense that I know my aims very well: a working policy that gives primacy to reliable secondary sources for medical content. As this is basically a consequence of core Misplaced Pages policies such as NOR, V and CITE I don't think there's much to compromise over, because it is not mine to compromise (to paraphrase the late Lord Jakobovits). However, I can accept (and will concede) that newspaper articles are on rare occasions useful as secondary sources, but there needs to be clear consensus between an article's contributors that a particular newspaper article is a reliable source for the information quoted from it. Hence, in most situations I find newspaper articles unsatisfactory (e.g. see the recent fracas at number needed to treat over an article from Business Week that made possibly valid points but badly lacked context). Primary studies are occasionally good sources of information, especially where there are no comparable secondary sources (e.g. on central core disease), where secondary sources have not yet included the information in question, or where there is other information (e.g. from a major newspaper article) that suggests that a primary study has been disregarded in reviews. Editorial judgement trumps any policy, and requires consensus on a case-by-case basis.

I am only partially aware of the agendas of other editors, but I know that Paul gene wants greater liberty at citing primary studies because he feels they are selectively quoted or misrepresented in reviews written by drug company shills. This is an understandable frustration but borders on a stated intent to violate WP:NOR/WP:SYNTH, which I why I have opposed this. I am unsure if there is any strong desire to compromise from Paul or from other editors (such as ImperfectlyInformed) who have opposed this policy. JFW | T@lk 19:53, 4 October 2008 (UTC)

Cool! Thank you for taking the time to formulate such a well thought out answer.

I'm going to think about your answer for a bit. In the mean time, would you be willing to invite ImperfectlyInformed to try to answer the 4 questions too? I hope they might be able to provide some of the information you feel is missing. --Kim Bruning (talk) 04:22, 5 October 2008 (UTC)

All editors who have previously opposed this guideline presumably have this talkpage on their watchlist, and have now had ample time to offer their perspectives. If, on reviewing previous discussions, you feel that a particular editor is going to be of importance in achieving consensus you might wish to contact any such contributor yourself. I my mind, adding even more voices to this debate is going to increase noise and decrease the likelihood of any form of consensus emerging. JFW | T@lk 09:04, 5 October 2008 (UTC)

EverSince Comment

My feeling is that, rather than just an exposition of technical issues specific to medical sourcing, MEDRS is asserting reworded versions of core policies, in a way that reflects a point of view (medical or medical establishment) based on Misplaced Pages:Ownership. Its basis in concepts of "medical articles" or "related to medicine" is problematic. I think there needs to be discussion somewhere of the need for guidance across different areas and how to develop and coordinate it in a way that doesn't potentially undermine NPOV. EverSince (talk) 07:33, 2 October 2008 (UTC)

Examples of rewording of core policies? SandyGeorgia (Talk) 07:43, 2 October 2008 (UTC)

WP:NPOV mandates that we express ideas in proportion to their representation among experts in the field. You may, if you wish, refer to these experts as the "medical establishment". This project's fundamental goal is to create a serious, respectable reference work. This guideline is intended to give specific advice to implement those objectives on medical topics. I'm not seeing a problem. MastCell  19:38, 2 October 2008 (UTC)

There is Misplaced Pages:Scientific citation guidelines. Is this Misplaced Pages:Ownership and undermine WP:NPOV? —Mattisse (Talk) 22:56, 2 October 2008 (UTC)

The scientific citation guideline addresses different issues. Obviously, I do not believe this guideline violates NPOV. Having re-read WP:OWN, I don't see what that policy has to do with this issue. MastCell  17:19, 3 October 2008 (UTC)

I was merely making a somewhat frivolous reference to the comment of EverSince, pointing out that there are accepted guidelines for special areas other than MEDRS and that these are not considered to violate Misplaced Pages:Ownership or undermine WP:NPOV. However, you are free to disagree with it if you like and to feel my comment was ridiculous and inappropriate if you like. —Mattisse (Talk) 18:22, 3 October 2008 (UTC)

In fact, I am perfectly willing to withdraw from this discussion, if you like. —Mattisse (Talk) 18:22, 3 October 2008 (UTC)

Ah, well, I misunderstood your comment. I'm sorry; it sounds like we're in agreement. Don't feel the need to leave on my account. MastCell  18:43, 3 October 2008 (UTC)

:-) --Kim Bruning (talk) 19:54, 3 October 2008 (UTC)

I do feel the need to leave on MastCell's account. I'm unwilling to participate in a discussion where an editor's comment (or short question, in this case) about content is treated with ridicule and condescension by another editor who decides he does not like the point of view he thinks the question expresses. Mastcell's apology is given only because he decides he agrees with me after all. A discussion where I cannot ask a simple question without being treated dismissively is not one where I feel comfortable in expressing myself further. —Mattisse (Talk) 00:42, 4 October 2008 (UTC)

I feel badly that you've taken offense; it was not my intention to be dismissive, but rather to concisely explain my opinion as it relates to the topic under discussion. MastCell  06:30, 5 October 2008 (UTC)

Re. details of examples, think better to address in another section (if do at all). Re. NPOV, it doesn't say "experts in the field", but "reliable sources on the subject". It also says "A balanced selection of sources is also critical for producing articles with a neutral point of view.". Re. WP:SCICITE, I did previously wonder that, but ultimately it's much more narrowly framed, "about specific details of inline citation" to help editors on scientific projects. EverSince (talk) 22:51, 5 October 2008 (UTC)

EverSince, I know that you're heavily involved in anti-psychiatry issues, but even in psychiatry, most of the "reliable sources on the subject" have been written by the "experts in the field," particularly when we're talking about basic medical/scientific facts. WhatamIdoing (talk) 18:55, 6 October 2008 (UTC)

Ok noted for future reference. Eversince, If you'd like to have changes made to this page, please answer the 4 questions at the top of the talk page, and let's see what we can do. --Kim Bruning (talk) 16:16, 3 October 2008 (UTC)

The New York times has an article about how psychiatry articles are manipulated for political lobbying, with the publication of some results being delayed for years. A former president of the APA has admitted to political lobbying:

"That is something we have been trying to accomplish for at least 20 years. Finally! I hope the state will make good use of it.

Dan Bornstein

former president of APA"

Who is the "we" he is referring to? And how did they try to accomplish this? Was manipulating psychiatry articles and delaying the publication of some results for years part of this trying? --Mihai cartoaje (talk) 08:57, 10 October 2008 (UTC)

Mihai, in your view what constitutes a reliable source for a psychiatry article? The NY Times article you quote talks very peripherally about the issue. It seems to be more about how schizophrenia might be dementia praecox after all.

Similarly, the Bornstein quote is a short letter to the Treatment Advocacy Center newsletter, hardly a shocking source. What is your point? JFW | T@lk 13:01, 10 October 2008 (UTC)

Andreasen's reported statement seems ambiguous about how much she is attributing to the antipsychotic adverse effects. Having said that...

(deindent) ...I actually object to the original way in which my comment was derailed via an ad hominem non sequitur, distracting from my anti-domination-by-medicine points such as "A balanced selection of sources is also critical for producing articles with a neutral point of view." EverSince (talk) 11:19, 11 October 2008 (UTC)

You seemed to suggest that while in other fields, expert sources are favoured over non-expert sources, somehow medicine is different. Or did I misunderstand you? It would be helpful if you clarified your points, and if possible your underlying motivations. That would prevent your comment from being misunderstood or being used as a springboard for ad hominem comments. JFW | T@lk 19:56, 11 October 2008 (UTC)

I suggested it is MEDRS treating medicine differently, by only presenting selected aspects of policies & guidelines, and talking as if only medical experts and medical sources existed (while incidentally neglecting a plethora of other issues relevant to evaluating medical sources, including but not limited to the pharma conflict of interest that Paul Gene partially raised).

Your "underlying motivations" comment is itself an ad hominem, and I maintain my objection to the earlier one; and I now see another below about supposed underlying levels of interest (perhaps this is all being encouraged by Kim in the format of this mediation, I do'nt know). In fact the reason I've limited my comments here from teh start, and evidentally need to continue to do so (especially as other dissenters seem to have dropped out), is precisely because editors who express dissent here seem to end up having their comments used as springboards for ad hominems. As long as it seems more House Un-Medical Activities Committee than Principle of charity, there's no motivation for dissenters to participate (and I think it's a shame MastCell's and Mattisse's considered points below haven't been responseed to by any of those who might previously have). EverSince (talk) 18:51, 16 October 2008 (UTC)

EverSince, I don't think that having an underlying motivation for a suggested improvement can be considered an attack on you as a person. Your motivation could be a particular interest in a specific sub-field where the existing advice could be less helpful than it is for others (probably a motivation for Paul gene and Matisse). Your motivation could be a current problem in a specific article (a common motivation for me). Your motivation could be wanting MEDRS to avoid conflicts with other guidelines (a common motivation for Sandy). Your motivation could be wanting MEDRS to be as little different from RS as possible. There are many entirely laudable motivations; I am sorry that you assumed that all motivations must necessarily be nefarious, or at least suspect. If you think your motivation is laudable, or at least legitimate, then please feel free to share it. Perhaps that will help others understand your issues more clearly and be able to address them more fully. WhatamIdoing (talk) 19:01, 16 October 2008 (UTC)

I never used the word "attack", I am well aware of what "motivation" can mean, and I didn't make any such assumptions. Your last suggestion is partially a repeat of Jfdwolff's suggestion that I start discussing my "motivation" (if I believe it is laudible or at least legitimate!) - but I already stated in response that I believe the personalization of this talk page has been detrimental to rational debate, and all I can do once again is object to this whole line of personalized inquisition. EverSince (talk) 20:48, 16 October 2008 (UTC)

SandyGeorgia comment

Because I haven't followed this page (which has enjoyed broad support for several years now) closely enough since it was elevated to a guideline, I can't speculate on the position of other editors or their willingness to compromise. I do know that only two vocal opponents have held up some elements of the page with ideas about sourcing that are at variance with WP:V.

I broadly agree with the answers from Colin, Eubulides, Jfdwolff and Mattisse, although I'm unaware of the "Common sense" compromise they reference. I would be wary of any relaxing of acceptance of primary sources and lesser quality sources than peer reviewed journals because they are the means by which fringe theories are inserted into medical articles, and any common sense compromise in that area would be susceptible to wikilawyering. Paul Gene's answers are too long to read: if a position on sourcing can't be summarized concisely, a position unsupported by Wiki policy may be present; Wiki policy is clear on primary and secondary sources, and delving into dictionaries for alternate definitions isn't relevant. I did note that he has somewhat misrepresented me twice on this page, and I see he neglected to mention that Una Smith opposes the guideline because she disagrees with other Wiki policy pages.

Most of the basics of this page aren't open to compromise without bringing them in to conflict with WP:V policy; the page is useful as a guideline to explain how policy is applied and interpreted in a specific group of articles. Secondary sources are preferable to primary sources, and that will prevail per policy, with or without this guideline.

On the newspaper issue, I have never, ever, once in 20 years of research, encountered a single newspaper or magazine account of Tourette syndrome that didn't have basic, fundamental errors. Here's a simple example from a 2005 article in The New York Times. No, GTS did not first describe TS in 1885; Itard did in 1825. This is the kind of inaccuracy one often finds in the laypress. And that's not even a medical fact; that's basic history, and the NYT didn't even get that right. They do worse on the medical; there are a few significant and numerous subtle medical inaccuracies in the article as well. (Side note, Eubulides, note the 750,000 children; I found this article just now on Google.) Even in the NYT, except for their quotes of Zinner, it's fluff at best, inaccurate at worst. Newspapers are not reliable for reporting medical information, but I agree with Eubulides that we could expand the examples of when newspaper, magazine and other sources can be used.

I apologize for not having followed closely, and that I can't add much more to the discussion, but I will try to stay better tuned in from here forward. SandyGeorgia (Talk) 09:19, 2 October 2008 (UTC)

Agree with the above. FYI, the "Common sense" compromise is at Misplaced Pages talk:Reliable sources (medicine-related articles)/Archive 2 #Common sense. It proposed prepending "Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages." to WP:MEDRS #Definitions. Nobody else supported the compromise. Eubulides (talk) 17:58, 2 October 2008 (UTC)

Thank you. You sort of answer the 4 "question essential to consensus" that I posed, but the answers are intermingled. If at some point you find time to organize your thoughts further, that would be appreciated. :-)

It is to be understood that answers to question 3 and 4 will always contain inaccuracies. That's one of the reasons I'm asking for those answers explicitly, so that we can root out misconceptions between people. Can you point out where Paul Gene's perceptions need correction? Thank you so far for the information on Una Smith. I hope Una Smith shows up themselves, and provides more information on that. --Kim Bruning (talk) 16:12, 3 October 2008 (UTC)

Tourette syndrome is not a controversial topic. --Mihai cartoaje (talk) 08:59, 10 October 2008 (UTC)

Right. Gotcha. SandyGeorgia (Talk) 09:03, 10 October 2008 (UTC)

OrangeMarlin comments

I'm deeply troubled that we're engaging in this long discussion because two editors, one of whom has a long history of disrupting medical articles, have complained loudly about this guideline. Consensus does not mean two editors can stand in the way of progress. If this were true, the long history of any article in this project is doomed to failure. However, setting aside the personalities of two dissenters, details of my thinking are below:

My position

1. MEDRS should be in agreement with WP:VERIFY, WP:RS and WP:PRIMARY. Because medical articles must have a slightly higher standard than articles in other fields (using as an example, an article about recent politics), it should be clearly described. In other words, as others have stated, this guideline is specific to medical articles, and sets standards, though based on other guidelines, has got to take it to another level. When I write an article, I never use popular press (i.e., newspapers, magazines, etc) to support a statement. When I see a popular press citation, I remove it and replace it with a peer reviewed article. It takes very little time to do so. The popular press, because it's journalism and not peer reviewed, has a tendency to position information to the requests of its readers, rather than to state what has been researched.
2. I really have no concerns with the guideline as it is. It will useful in establishing what can be used as citations for articles. I can't be happier, so that I quit seeing cruft being thrown into articles with the support being some off-hand statement in the New York Times. OrangeMarlin 19:17, 2 October 2008 (UTC)

The positions of others

1. I disagree that this guideline is only useful to new editors. I completely disagree. Not only will this be a good guideline for me when I'm unsure, but it can be used in content disputes in articles.
2. I do not agree that this guideline is just a repeat of other guidelines that I've mentioned above. It's not. It's an improvement specifically for medical articles. For example, a New York Times article is fine for discussing Sarah Palin, but not very useful for Alzheimer's disease.
3. I agree with SandyGeorgia's comments about newspaper articles. They're more often inaccurate rather than useful.
4. I disagree with the comments about primary sources that are published in peer-reviewed journals as being the equivalent of secondary sources. In fact, some individuals use "letters to the editors", which are very primary sources, as citations, when they have no usefulness. Secondary sources are the best.

Compromise

1. None. Two editors complaining loudly is not a reason to have these issues with a guideline endorsed by a large number of editors. OrangeMarlin 19:27, 2 October 2008 (UTC)

Ok, this answers question 1, and refutes the need for a question 2 (which is your prerogative) . Could you also answer questions 3 and 4? (to wit 3. what *are* the positions of others, as accurately as you can ascertain, and 4. where are others willing to compromise?) --Kim Bruning (talk) 16:30, 3 October 2008 (UTC)

Kim, I think I stated what I see as what others are saying. I happen to agree with the reasonable editors like Colin et al. There are no compromises. MEDRS should stay a guideline, and Paul should find another project for wasting people's time. OrangeMarlin 17:45, 3 October 2008 (UTC)

Alright. Feel free to come back any time, when you are willing/able to answer the 4 questions as posed. --Kim Bruning (talk) 18:16, 3 October 2008 (UTC)

Dude, no need to be rude. I thought I had answered the four questions above. I just thought 1&2 were combined, as you surmised. My viewpoint of the positions of others is up there. My compromise, which is NONE, is up there. Not sure what you're asking, but either I'm totally misunderstanding you, or you're intentionally being a pain in my butt. OrangeMarlin 19:59, 3 October 2008 (UTC)

Dude! I'm not trying to be a pain in your butt. Well... not too much of a pain in your butt. I'll assume you're doing the same.

I think see I the misunderstanding. You gave your opinions and views *about* the positions of others. However, those are based on a set of premises we haven't quite checked yet, which is whether everyone actually understands *what* those positions really are. Does that make (logical) sense to you?

So my actual question is ₍₃₎ what are (/do you know about) other peoples views, and ₍₄₎ what compromises do you think they are willing/able to make?

So far, from diverse answers, I've already learned that there are at least 2 different definitions of secondary sources, and (elsewhere) I've learned that sociologists treat sources in one way and biomedical researchers treat them in another way.

I wonder what kind of things you might be able to pick up yourself?

Finally, ₍₂₎ are you really that absolutely certain of yourself that you could never be wrong, and no compromise is ever possible? It could be true in this case, of course, but think and see if there may yet be some way you could show some amount of flexibility to someone? Just to be sure!

--Kim Bruning (talk) 20:38, 3 October 2008 (UTC) The four questions are basically an intelligence-gathering exercise wrt consensus. ₍₁₎ Know your own position and ₍₃₎ those of the other community members, and _{(2 and 4)} find out where compromises are possible between those two positions. Potential uncontroversial edits and potential pitfalls become obvious very quickly, that way. It also quickly becomes obvious if someone is acting in good faith or not.

I really want to engage in this conversation, but I just don't get what you want me to do. I keep thinking I'm answering the questions at the top of this thread. As for compromise? How can there be one if two editors, without a real understanding of consensus, have caused this massive discussion. And from what I've read, several regular editors agree. So, please bullet point what you want me to say, and I'll respond. OrangeMarlin 03:21, 5 October 2008 (UTC)

I think the massive discussion happened because no-one bothered to take the time to properly educate said 2 editors early on, at the first signs of trouble. A stitch in time saves nine. Why do I always manage to get called in so late, I wonder? ^^;;

Actually, there's at least 4 editors we may want to consider. You've mentioned 3 of them yourself, right?

Taking things step by step in wiki-time will be slow going, but let's try. This also means I need to expand questions quite a bit, to come to the following long-form. (and I'm not even being exhaustive yet, I'm sure ^^;;)

• (2) Identify a number of flaws with the current state of the page, where's room for improvement?
• (2) Rules by necessity sometimes have an arbitrary element (eg. some countries say you must drive on the left, some say drive on the right, it's arbitrary, but as long as everyone does the same thing, there won't be any accidents). Identify arbitrary elements in the page.
• (2) Divide aspects of the page into those that are essential to you and those that are less essential. Which aspects of the page could be deleted or altered, without essentially harming (your intent for) the page? You may have already partially answered this question with the 2 points above. If there is a lot to consider, list aspects in order of priority.
• (2) Summarize some low priority aspects that could be altered, in as few words as possible (to prevent TLDR ;-) )
• The answer to question 2 tells you how much room you have to maneuver. You may be able to sacrifice something with a low priority to gain consensus on something with a higher priority.
• (3) Name all the participants who have edited the page. Separately, name those who participate on the talk page.
• (3) Examine the opinion of each participant. What would this person write if they were editing the page by themselves? summarize it. (Do not discard the opinion of any participant!)
• (3) Note which participants tend to work together and/or agree with each other
• (3) Using the data from the above two points, cluster the participants into groups. (the less groups, the better you can summarize, but beware of overgeneralization! IMPORTANT: This particular clustering is a means to summarize data and reduce work -for your convenience only-, it is not indicative of actual cliques or cabals.)
• (3) for each group, determine their primary course of action. How would they write the page if no other group was present? Summarize
• The answer to question 3 is -by necessity- imperfect, as you are basing yourself on external information. It is best considered a hypothesis. Later steps will test this hypothesis (the most obvious approach being to simply ask people if your hypothesis is correct or not :-), though other approaches exist as well )
• (4) The answer to question 3 provides you with a number of groups and their objectives. Like yourself, these groups are attempting to reach consensus, and are maneuvering for position. Like yourself they'll be trying to find answers to question 2. For each group: what will the members of that group answer for question 2?
• If you have trouble finding a single answer for each group, perhaps you need to revisit question 3
• The answer to question 4 is -by necessity- even less perfect than the answer to question 3. Not only must you base yourself on external information, but you may also need to speculate more about other people's motives. As discussion progresses, you may find yourself updating the answers to question 4 often.

Perhaps it's a good idea to answer just a few points at a time, so we can go over each step? Let's take our time :-) --Kim Bruning (talk) 04:57, 5 October 2008 (UTC)

I wonder if there's a better way in this case? --Kim Bruning (talk) 05:35, 5 October 2008 (UTC)

LeeVanJackson comments

1. As an jackson of all trades I was trying to make sense of numerous seemingly out-of-place facts on a medical article and spent hours(years even) trawling around primary papers, I was referred here as part of a GA review, suddenly the penny clicked, some of the references were out of place, some put there in good faith - others promoting so and so research or institutes, readdressing using reviews to double check and leaving primary papers for specific facts and whola article starts making sense :) My position is as long as editors reading this guide ( note no _line / essay / policy - since it's exact status doesn't matter as long as it's helpful ;) can be saved the same time and confusion, it's ok by me!
2. I have not contributed to the actual guide, but anything that moves confrontation to collaboration ( in keeping with 1.) and let's these good editors get on with their admirable passtime(s:).
3. I think misunderstandings of the complicated business of consensus has caused some editor's to dig their heels in.
4. .. but as long as everyone feels their views have been heard respectively and fairly should be ok.
5. I think you may have stumbled on a cross-disciplinary problem, with different emphasis, respect and commercial bias of sources. Kim's pointer to a strange map of the sciences also seems to back this fact up. This would explain vehement sticking to principles - since one discipline might not see eye-to-eye and the difficulty finding happiness. I would suggest that we may need an ancillary essay exploring the differences between disciplines, that way editors from different arenas of science could directly address the relevant sections and we'd have a collaborative - who know's might help solve some of the world's problems at the same time :) LeeVJ (talk) 22:19, 2 October 2008 (UTC)

You're seeing the same things I am! \o/

If you see a (partial) solution, try and see if you can answer the 4 questions wrt that solution? If you're careful and smart, you might be able to boil down your answer to just a few sentences per question. If you can, you're almost certain to gain consensus on that. :-)

--Kim Bruning (talk) 16:36, 3 October 2008 (UTC)

Fvasconcellos comments (not answers)

It seems everyone has left their two cents already, so I guess I should follow suit :)

• I have no major problem with the current state of this page. It could do with a little copy editing, and maybe some rewording (leaving content mostly unchanged) here and there, but that's it. It does reflect current practice (more on that later), it does not conflict in any perceivable way with WP:V, WP:NOR, or WP:RS, and it is not the same page that was rejected last year. It has grown and improved substantially—compare and .
• I agree with Sandy and LeeVJ that the status of this page is actually of little consequence. Sure, being a guideline would (a) lend it greater credence and (2) make it known to a wider audience, but it would be no less useful (or less reliable) as a subpage of WP:MED or whatnot. WP:CHEMSTYLE (though fundamentally different in purpose) has always been in WikiProject space and that's not a problem.
• I respectfully disagree with Paul that this page is a "Frankenstein monster", is somehow owned by Colin, and has an "anti-research paper bias". The current wording is actually abundantly clear in that respect: Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse. That's it. This page in no way forbids the use of research papers or limits their use beyond "gold-standard" current practice. Paul's experiment of counting citations to primary and secondary literature in FAs is very interesting, and I'd like to see it taken one step further: note which statements are being supported by which type of literature. I believe you'll find most (if not all) recent FAs, and even one recently saved from FAR such as Chagas disease, do not conflict with the current wording of this page.
  I disagree with the consideration that "Since primary literature in medicine is actually secondary sources, it is generally reliable". In Misplaced Pages, the wording "primary/ secondary/ tertiary source" always refers to primary/ secondary/ tertiary literature, making this a moot point (and I mean "moot point" in the U.S. sense of the word—please, no misunderstandings :).
  I also disagree (not with Paul specifically, of course) that this page is not useful for experienced editors. Have a look at Misplaced Pages:Reliable sources/Noticeboard—you'll find that experienced editors and even administrators (who should, in a perfect incarnation of Misplaced Pages, know policies and guidelines backwards while blindfolded and sedated) need help with referencing practices.

I think the intelligence-gathering exercise proposed by Kim is quite helpful, but we also need to think about how we're going to move forward once people have presented their views, so we can actually build consensus—whether for the first or the umpteenth time—and decide on the status of this page. Let's make a dance and call it "the Compromise". Fvasconcellos (t·c) 12:19, 4 October 2008 (UTC)

I haven't followed the whole discussion here, but I fully agree with Fvasconcellos' opinion stated here. --WS (talk) 12:54, 4 October 2008 (UTC)

The intelligence gathering is a first step - it's what I always do before I hit 'edit' or 'submit'. The next steps depend on the answers provided. There are many pages that describe what steps to use for different situations. We'll be getting to those steps soon, I think :-) --Kim Bruning (talk) 05:07, 5 October 2008 (UTC)

In the mean time, feel free to answer the 4 questions for yourself, if you'd like to participate in consensus formation! Of course your own opinion is important, but by itself it is not actually sufficient for us to establish a consensus with you. (normally this fact is hidden and implicit, I'm just making it explicit today, for the sake of informal mediation ) --Kim Bruning (talk) 05:14, 5 October 2008 (UTC)

Section header cleanup

The table of contents is a bit scraggly. I propose shortening some section headers and removing some others (for very-short sections), as follows:

• 'Do not use primary sources to "debunk" the conclusions of secondary sources' → 'Respect secondary sources'
• 'Cite peer-reviewed scientific publications and check community consensus' → 'Summarize scientific consensus'
• 'Assess the quality of evidence available' → 'Assess evidence quality'
• 'Medical textbooks'. Remove this section header (keeping the contents).
• 'Popular science and medicine books'. Remove this section header. Replace the following 'These' with 'Popular science and medicine books'.
• 'Online'. Rename to 'External links', and move to the end of the page.

Eubulides (talk) 16:24, 1 October 2008 (UTC)

This is the TOC for the archive page? (I don't see a problem on *this* page?) --Kim Bruning (talk) 16:31, 1 October 2008 (UTC)

Sorry, I meant the table of contents for WP:MEDRS, the project page. Eubulides (talk) 16:36, 1 October 2008 (UTC)

Eubulides, I'm not sure I agree with the change to "Online". These aren't proposed "External links" for medical articles. The first set are proposed online reliable sources. We can, of course, discuss whether the set is a good one. I'm not sure we need to keep the "Background reading" section at all as they aren't proposed sources. Colin° 17:16, 1 October 2008 (UTC)

OK, thanks, I struck the 'Online' suggestion. The other ideas are reasonable but let's make them part of a later proposal. Eubulides (talk) 17:46, 1 October 2008 (UTC)

Agree with the shorter titles; as I recall, we inherited them from WP:RS during the ATT debacle, and they are clunky. SandyGeorgia (Talk) 07:48, 2 October 2008 (UTC)

That's probably not a problem. :-) Give me a bit of time to get the page unprotected? --Kim Bruning (talk) 16:46, 1 October 2008 (UTC) This would require ensuring there won't be an edit war. Might take 24-48 hours at a guesstimate

Unprotection would be a seriously bad idea. Just ask an admin to make any consensual changes for now. Colin° 17:16, 1 October 2008 (UTC)

That's a very tempting course of action, yes. It would make it seem like I'd personally (with a little admin help) "solved" the situation quickly and easily, and I can go about showing off as Kim The Great Mediator, or some such, I suppose. :-P

Unfortunately, the approach of "let an admin do it" fails to encourage mutual trust, doesn't restore an equitable situation, fails to teach people how to find consensus by themselves, leaves people too dependent on administrators and/or mediators, and forces an administrator into a role they were never chosen for. All these are things we really Do Not Want.

So let's resist the "let an admin do it" siren song as much as possible. Does that make sense? :)

The next step here is to get multiple people to agree to a way of working that hypothetically precludes edit-warring, and then we take things step by step from there.

We can then test our hypothesis by unprotecting. If people immediately grasp a new way of thinking, sing Kumbayah, and work in perfect harmony (unusual - but possible :-P), then great! If there's hiccups, we smooth them over. But even if people immediately revert or even edit war, that provides useful information, and we can work from there. Depending on what happens, we can draw conclusions, invite people to participate in discussion, block people, or do something else entirely.

If something strange does happen, I'm known to be very creative. But so far, things have mostly happened the same way they always do, and there haven't been any surprises. Alright? --Kim Bruning (talk) 19:19, 1 October 2008 (UTC)

I see what you are trying to do. I'm just not convinced we're ready to take the stabilisers off yet. Go on. Test your hypothesis. Colin° 20:19, 1 October 2008 (UTC)

:-) *nod*. Before we do that, we're still waiting for some feedback from Paul Gene, and it might be wise to contact Ludwigs2 too? *goes off to check* --Kim Bruning (talk) 20:34, 1 October 2008 (UTC)

Mostly Paul Gene at this point, I guess, though I see Matisse has a slightly different position from Colin and Eublides? I'll also wait to see if SandyGeorgia has anything to add. :-) --Kim Bruning (talk) 20:40, 1 October 2008 (UTC)

Well, I had great intentions many hours ago that I would make it here today, but FAC, FAR and the moon had other plans for my day. Tomorrow should be better. SandyGeorgia (Talk) 07:48, 2 October 2008 (UTC)

So once again, instead of relying upon the vast opinions of numerous reliable editors, Kim Bruning decides to get the opinions of two disruptive editors. Great. OrangeMarlin 19:29, 2 October 2008 (UTC)

Shorter titles are good. Is that what we're talking about here, content-wise? MastCell  19:34, 2 October 2008 (UTC)

Yup. :-) --Kim Bruning (talk) 22:50, 2 October 2008 (UTC)

Orangemarlin: First off, please don't call less experienced people "disruptive editors". It's labeling, and not a very productive approach to conflicts.

But that said; *duh* I'm going to spend most of my time on the less experienced people. If I ask a more experienced person (like Jimbo Wales) to be civil and follow consensus, I'm not going to get much of a return on investment on that, because the experienced person will know to do that on their own. On the other hand, if I explain things to a less experienced participant in a discussion, the gain is much higher, since it adds a noticeable amount of clue to the discussion.

In short, I'm relying on the regulars to play nice, not make trouble, and cover my back while I work on talking with people who are not-so-regular. I'm not going to get any trouble from any particular regular person, am I? :-) --Kim Bruning (talk) 22:50, 2 October 2008 (UTC)

Well, I disagree. And my comment wasn't because they were inexperienced, but because they had an odd definition of consensus, which is disruptive. Ludwigs2 has been blocked for edit warring about 4 or 5 times. Not sure why we require his opinion on anything useful. OrangeMarlin 00:44, 3 October 2008 (UTC)

Well, let's find out, shall we? You may be surprised! --Kim Bruning (talk) 16:39, 3 October 2008 (UTC)

Kim, people don't change. Ludwigs has been blocked 5 times. He will be blocked 5 more. I don't AGF disruptive editors. OrangeMarlin 17:41, 3 October 2008 (UTC)

Some people learn. Some don't. Those that don't are rightly banned. Those that do often become our better contributors. --Kim Bruning (talk) 18:15, 3 October 2008 (UTC)

I'm much more realistic and cynical. We balance out each other. OrangeMarlin 19:57, 3 October 2008 (UTC)

As these changes are unrelated to the dispute and there seems to be clear consensus, I went ahead and made the changes. --WS (talk) 11:49, 4 October 2008 (UTC)

Dang! I'd been saving those for when we unprotect the page as a set of easy edits to establish trust. O:-) No matter, I'm sure We'll find something else. In the mean time, thank you very much for taking the initiative, that's worth quite a lot by itself. Will you be around in the coming days? :-) --Kim Bruning (talk) 02:43, 5 October 2008 (UTC)

RfC Archive

An active RfC was evidently archived to /Archive 2#Rfc Promotion of MEDRS to guideline. I'm not sure if there was discussion about this, but I would recommend either unarchiving it, or turning it off (removing the template). These things generally run 30 days and then automatically turn themselves off, but in less time than that, premature archiving ends up with the odd situation of a "live" RfC in the archive, and a link from the RfC page that sends interested editors to an archive page (not a good idea): Template:RFCpolicy list. If no one else has a preference, I'll go ahead and unarchive it, but I wanted to check first. --Elonka 22:27, 1 October 2008 (UTC)

No additional comments in the last 10 days. Colin° 22:43, 1 October 2008 (UTC)

The discussion and consensus about archiving the RfC is in the same linked page as the archived RfC. (I looked in the archive and can't decipher what is needed to "turn it off".) SandyGeorgia (Talk) 22:49, 1 October 2008 (UTC)

Okay, I got it (I nowiki-ed the template). The bot should notice within the next hour or so, and automatically update the RfC list. I'll keep an eye on it and tweak as needed if that wasn't enough. --Elonka 23:24, 1 October 2008 (UTC)

An example of the problem

As an example of one of the areas where this guideline is essential, I invite your attention to our article on colloidal silver. This product is marketed as the cure to whatever-ails-ya. There are no data indicating its effectiveness, and it has the unfortunate tendency to turn people blue, usually permanently, if they use too much. Numerous secondary sources note the ineffectiveness and potential toxicity of this product:

• Review from the M. D. Anderson Cancer Center.
• Review from the Memorial Sloan-Kettering Cancer Center.
• The U.S. Food and Drug Administration: PMID 10558603 (see also here)
• The Australian Therapeutic Goods Administration: see here

This is supported by numerous primary sources (articles in the peer-reviewed medical literature) attesting to complications of colloidal silver use. Now view this edit. It cites a handful of long-outdated, unrelated, or cherry-picked primary sources to counter the clear and unanimous opinion of medical experts as expressed by the secondary sources above. MastCell  22:48, 5 October 2008 (UTC)

My problem regarding this discussion

My problem is that much of my graduate education in my field consisted of indoctrination in the use of the "scientific method" and the associated rules and methodologies for evaluating data. This has served me well in my professional life. (I won't wikilink to the Misplaced Pages article on the scientific method because I have no faith in the accuracy of the Misplaced Pages article on the subject.) Because of the ethics in my field, I cannot compromise on this subject personally. This is why, long ago, I learned to avoid editing, or being involved in any way, in articles in my field. I am willing to avoid editing articles that do not respect the scientific method. I believe, however, that the lack of respect for the scientific method is responsible for the deplorable state of the articles in my field. There is one FA on a fairly limited subject in my field that is very large in number of Misplaced Pages articles.

Bottom line: I have very little room to compromise. Consensus on Misplaced Pages and scientific consensus in the real world are unrelated. —Mattisse (Talk) 00:04, 6 October 2008 (UTC)

Mattisse, I understand that this topic may be too close to your heart for you to feel able to endorse a compromise you are uncomfortable with, and therefore feel you can't participate in consensual editing if this leads away from your principles . However, I encourage you to stick around here as there is certainly room for editors to impart wisdom from their (real world) experiences, without fully joining in the editing process. Colin° 08:51, 6 October 2008 (UTC)

My further problem is that I can no longer follow this discussion. If it is taking place I do not know where.

Is there still a discussion of primary versus secondary sources? Somewhere, I thought I saw that Eubulides made a comment that PMID articles are frequently out of date. I have found PMID articles to be frequently used in misleading ways in articles by general editors. The claim is that because the article is a scientific study, it counts more. Never, in my experience, is such an article evaluated for methodology or relevance timewise in the[REDACTED] article. Often editors take a general statement or two from the Abstract and use that to support statements in the article. —Mattisse (Talk) 18:53, 9 October 2008 (UTC)

The discussion seems mostly resolved. User:Paul gene's complaints were based on misunderstanding the text, which means exactly what it says, not something sorta like what it says. He now hopes to change the text to make it less likely to be misunderstood, and perhaps also to make it more supportive of his personal preferences in the process. The silence after his recent proposal indicates both non-acceptance of his specific proposal and weariness with the general process. I think we all have more useful things to do at this point. WhatamIdoing (talk) 19:23, 9 October 2008 (UTC)

Great! Thanks for the info. —Mattisse (Talk) 19:40, 9 October 2008 (UTC)

WhatAmIDoing is slightly optimistic, perhaps, though he does summarize the discussed positions. I think we have Paul's issue boiled down to tasks that can be resolved through editing now. This does not necessarily mean that other issues might not crop up, in steps that follow. We'll find out the truth when we unprotect the page, eh? O:-) --Kim Bruning (talk) 23:15, 9 October 2008 (UTC)

Taking a back seat

I'm going to take a back seat for a while. I've been involved in most discussions at MEDMOS and MEDRS since their creation. This last month has been exhausing and I need a break from it. With MEDRS especially, I always hoped that more experienced editors (both on Wiki and in real life) would come on board and push it forward. Well, there's loads of experienced editors on this talk page and I want to read you guys for a while rather than staring at my own words in the preview window.

For those who haven't spotted, this edit by WhatamIdoing seemed to be the turning point, leading to this reply by Paul. Note that WhatamIdoing repeated the guideline's exact words, followed by a clarification on what it does not say. Please read the discussion that followed in Paul's section. Currently, I see no pressing need to alter the following two sentences:

In general, Misplaced Pages's medical articles should be based upon published, reliable secondary sources whenever possible. Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse.

since "in general"; "based upon"; "can" and "be used" all indicate we do not mean "should always cite secondary" as Paul suggests "some people" may take it.

Kim has asked Paul and I to play at consensual editing here but I don't have the heart for it right now, to be honest. No offence to Paul -- another topic and another time, perhaps. I don't believe consensus is to be found in a straight line halfway between me and Paul. Consensus is a team game in three dimensions. Over to you . Colin° 12:30, 6 October 2008 (UTC)

Let's remove tag on Popular press

The above discussion has been going on for two weeks now, and with complete unanimity on the topic of the popular press. So, let's remove the {{disputedtag}} on WP:MEDRS #Popular press. Eubulides (talk) 23:34, 9 October 2008 (UTC)

Support. JFW | T@lk 00:13, 10 October 2008 (UTC)

Support OrangeMarlin 00:38, 10 October 2008 (UTC)

Oppose, just because someone isn't typing on this page 24 hours per day doesn't mean there's unanimity. --Mihai cartoaje (talk) 08:34, 10 October 2008 (UTC)

Actually, the lack of discussion on this topic is a reason to remove the disputed tag. The guideline says "This template is only for ongoing, active disputes that are evidenced in talk page discussion. It is not intended for flagging a projectpage or section as vaguely controversial, nor for indicating a personal dislike of the document. There is no such thing as an indefinitely disputed policy or guideline." There was a discussion on this, and the overwhelming response agreed with the guideline. Colin° 10:50, 10 October 2008 (UTC)

See the essay Misplaced Pages:Silence and consensus, ya need to squeak. WLU (t) (c) 13:29, 10 October 2008 (UTC)

(S)he squeaked, which is grounds for listening! ;-)

Go ahead Mihai cartoje? --Kim Bruning (talk) 09:20, 15 October 2008 (UTC)

Support, no basis for it. SandyGeorgia (Talk) 08:50, 10 October 2008 (UTC)

Support, of course. Colin° 10:50, 10 October 2008 (UTC)

Support - never did agree with tag. —Mattisse (Talk) 13:11, 10 October 2008 (UTC)

Support, though I note that the discussion of the laysummary = parameter in {{cite journal}} is an opening for errors within the popular press to creep in. Might be worth a re-stating that the the main page is to be based on the citation and not the lay summary but that might also be redundant. I'm a huge fan of instruction creep WLU (t) (c) 13:29, 10 October 2008 (UTC)

Support the removal of the tag as stale. Verbal chat 13:49, 10 October 2008 (UTC)

Support. WLU, removing the tag doesn't mean the text cant't be tweaked—it will, of course, still be open to discussion. Fvasconcellos (t·c) 13:57, 10 October 2008 (UTC)

Ja, agree. I don't even think it's sufficiently problematic to advocate a change, it's more my gut reaction to re-reading the paragraph. It's very much implicit anyway. Incidentally, it may also lead to fights between editors on the "best" lay-summary if reported in several mediums (media?). But there's always WP:UCS as a rebuttal. WLU (t) (c) 14:05, 10 October 2008 (UTC)

Sure: If not unanimity (which is basically unheard-of on Misplaced Pages), there is at least consensus to move forward. The section isn't set in stone, but it can at least be de-tagged. MastCell  18:44, 10 October 2008 (UTC)

Support. It seems stale and unnecessary at this point. Celarnor 19:02, 10 October 2008 (UTC)

No change to any page should ever be made on the basis of a poll alone. Also, I don't want admins editing the page at all if possible, I'd prefer if you fine folks edited it yourselves, of course! :-)

Now, here there's one dissenting opinion, which is the one thing of value here. I'd like to hear about the dissenting opinion, please. (It ain't just a good idea, it's the rule). Mihai cartoaje, can you explain why you're opposing please?--Kim Bruning (talk) 09:27, 15 October 2008 (UTC) Is everyone familiar with requests for adminship, and how people often end up in discussions with the dissenters, but hardly ever with the supporters? Same mechanism here! :-)

The popular press is allowed everywhere else. Having different rules for different topics would mean less scrutiny, so it would be abused by tendentious editors. In psychiatry, there is disagreement between forced-drugging advocates and people who support human rights. The essay is biased by saying that only forced-drugging advocates are sources and that people who support human rights are not sources. It is contrary to our neutrality and fair representation policies. --Mihai cartoaje (talk) 15:24, 16 October 2008 (UTC)

Mihai, do you see anything in MEDRS that actually disallows the appropriate use of popular press articles? I don't.

This guideline say that the popular press is "generally not a reliable source for science and medicine information" and that "A news article should not be used as a sole source for a medical fact or figure". I highlight these words because they are important. Actual, concrete, scientific facts, like the number of people that get horrible side effects from a drug, are best sourced to a high-quality scientific source, and not to an industry (or anti-industry) rag.

This guideline then goes on to say that the popular press is a good source for social issues. Can we agree that government actions, such as court-ordered treatment, constitute social issues instead of scientific facts? WhatamIdoing (talk) 18:48, 16 October 2008 (UTC)

I stopped arguing with you when you started using personal attacks. --Mihai cartoaje (talk) 03:46, 17 October 2008 (UTC)

I am thoroughly confused by this response. I have said nothing about you as a person. I quoted what the guideline says, I identified the specific words that I thought were relevant to this discussion, and I asked a question. There is not a single word in my response that could possibly be construed as saying anything about you, much less saying anything negative about you. WhatamIdoing (talk) 05:31, 17 October 2008 (UTC)

@Mihai cartoaje: is there a specific case or article you're thinking of? --Kim Bruning (talk) 22:40, 17 October 2008 (UTC)

To answer the questions:

1. Having different rules for different topics would mean less scrutiny, so it would be abused by tendentious editors.

2. Having different rules for different topics would mean less scrutiny, so it would be abused by tendentious editors.

3. WhatamIdoing, Jfdwolff, MastCell, Cyclonenim, Casliber, Mattisse and OrangeMarlin are pov pushers who have already tried to remove all criticism from the Biological psychiatry article, remove all information about malpractice from the Medicine article, etc... If you look at the discussions about removing all the information about malpractice from the Medicine article you will see a lot of overlap in the names: . SandyGeorgia's topic area is Tourette syndrome and Colin's topic area is epilepsy. Neither of them have experience on controversial topics and have voted based on their topic areas without considering controversial topics. The others I haven't interacted with and it's difficult to have an impression from only a comment. For example: Arcadian only voted support.

4. About the pov pushers listed above: they try to silence everyone who supports human rights. For example, MastCell tried to delete the MindFreedom International article: . All my assumptions of good faith of them turned out to be false. --Mihai cartoaje (talk) 08:52, 27 October 2008 (UTC)

Your concern seems to be that MEDRS might affect the sourcing requirements on a discussion of malpractice. I don't see that MEDRS has anything to say on that issue. While malpractice is likely to be discussed and analysed in medical journals, it is also a social and legal issue that is dealt with by the press and other non-medical sources. If one of the above editors is citing MEDRS when removing such text, then they might be wrong (a diff would help). FWIW, I don't think MEDRS introduces "different rules". I hope that, as a guideline, is is merely helping editors apply other rules and policy wrt medical facts and articles. There is a consensus that the popular press generally fails WP:V's requirement for sources with a "reputation for fact-checking and accuracy" wrt medical facts. But, for example, a legal case of malpractice against a doctor is likely to be reported by the press with some degree of care. Colin° 11:52, 27 October 2008 (UTC)

Mihai, if your position (question 1) and the position of other editors (question 2) are exactly the same, then what's the problem?

I'd also suggest that you go back and carefully review the accusations you're making about POV pushing. I believe you'll find, for example, that I've not edited any of the articles you name. WhatamIdoing (talk) 18:13, 27 October 2008 (UTC)

@Mihai cartoaje: I see. That *is* a large can of worms. Let me think about it for a little while. --Kim Bruning (talk) 19:44, 27 October 2008 (UTC)

It's a remarkably small can of worms, in fact. Any process is open to abuse by tendentious editors. We have different "rules" for different topics because they are different, for the same reason there are different "rules" for apples and oranges. The remainder of Mihai's post is not worthy of response. MastCell  20:05, 27 October 2008 (UTC)

Mihai, the cases you are referring to are not actually relevant to this policy. Deletion of MindFreedom International is a notability issue, not a sourcing one. My suppression of your content on medicine had to do with the fact that your edits reflected on the specific area of malpractice legislation in Canada, something that would be disproportionate for the article attempting to discuss the breadth of medical practice through the ages and worldwide.

Discounting Colin's and SandyGeorgia's votes because they have a particular interest is odd. You have a particular interest in mental healthcare and legal parameters to involuntary treatment. Does that disqualify you as a voice in this discussion? JFW | T@lk 20:32, 27 October 2008 (UTC)

I am being called a "POV pusher" by one editor who alleges that I "already tried to remove all criticism from the Biological psychiatry article, remove all information about malpractice from the Medicine article, etc...". Please find one instance where I have done this. One editor, Mihai cartoaje, (who did not follow Kim's time consuming rules above, that were "required" in order to participate in this discussion) is now calling me a "POV pusher" because my opinion is at odds with his and is in accord with the overwhelming majority? What is the point of all this? —Mattisse (Talk) 20:51, 27 October 2008 (UTC)

Response to Mihai cartoaje

1. The popular press is allowed everywhere else.

   It's not disallowed here. This page is in line with WP:V: In general, the most reliable sources are peer-reviewed journals and books published in university presses; university-level textbooks; magazines, journals, and books published by respected publishing houses; and mainstream newspapers. As a rule of thumb, the greater the degree of scrutiny involved in checking facts, analyzing legal issues, and scrutinizing the evidence and arguments of a particular work, the more reliable it is.

2. Having different rules for different topics would mean less scrutiny, so it would be abused by tendentious editors.

   Disagree. First, there are no "different rules". Second, tendendtious editors tend to favor the popular press, as they can find something in the news to back even the most fringe of fringe theories, and even when peer-reviewed research refutes their conclusions. SandyGeorgia (Talk) 17:51, 28 October 2008 (UTC)

3. SandyGeorgia's topic area is Tourette syndrome and Colin's topic area is epilepsy. Neither of them have experience on controversial topics and have voted based on their topic areas without considering controversial topics.

   Not so at all. First, Tourette syndrome is not at all uncontroversial, and I first got a Wiki account initially to engage in a mediation. It may appear to be uncontroversial now because it is well cited and well written, so hasn't come under attack recently by fringe elements (darn, WP:BEANS). And you neglect to mention Colin's and my participation in several different articles that are and were controversial: autism, Asperger syndrome, schizophrenia, Alzheimer's disease, Lyme disease and many others (too many to list). I "voted" based on having seen the kinds of sources tendentious editors use to introduce fringe theories to medical articles, even when peer-reviewed secondary souce journal articles disagree. SandyGeorgia (Talk) 17:51, 28 October 2008 (UTC)

Kim,

1. The tag was removed because there was "no active discussion", which is part of the guidelines for maintaining such a tag ("If there is no active discussion, then the tag may be removed by any editor."). The poll is regrettable (see below) but irrelevant as far as Steven's admin action was concerned.
2. On the basis of what is written above, we only have a "dissenting opinion" on whether the disputed tag should remain. Mihai wishes the tag worked in ways that it doesn't and if he wants to change that he can discuss it over at Template talk:Disputedtag. We haven't been given (despite a request to "squeak") a dissenting opinion on the section itself. Rather than being "of value", such comments merely wastes people's time and leads to folk debating a bloody tag rather than the wording of the article. We wasted a month debating a guideline tag rather than productively discussing the content of the article.

It would be more helpful, if rather than lecturing us on how WP works, you agreed that the disputed tag currently has no justification, was removed correctly, and that if Mihai wishes to discuss the content of that section, he need only press the little button at the top of this page. Should such discussion indicate a dispute, then the tag may once again be justified. Colin° 11:27, 15 October 2008 (UTC)

I agree that Mihai hasn't shown up yet, so we can proceed with the current state for now. Just remember that we may need to backtrack later. We need to be able to show that we were scrupulously fair to everyone, else changes we make will eventually not be accepted by the larger community. We need to keep in mind what will happen when the page is unprotected, as it will be very easy to enter the bold-revert-discuss cycle, or even go back to edit warring. Obviously this is not my preference. --Kim Bruning (talk) 18:08, 15 October 2008 (UTC) Those who forget history are doomed to repeat it. ;-)

On WP:SILENCE, and unprotection

WP:SILENCE presupposes that a page is not protected. So if we'd want to test if WP:SILENCE applies, we'd need to unprotect the page now, and see if there's a revert (which heads us into WP:BRD territory).

Some people seem to be apprehensive about such a move though. I am kind of curious what would happen if the page were to be unprotected now. Would anyone care to make predictions? Would anyone still edit war? If so, who, and on what grounds? --Kim Bruning (talk) 10:03, 15 October 2008 (UTC) this falls under question 3, in fact :-)

Silence is not always broken by a revert, and protection does not completely prevent editors voicing their disagreement. Saying "let's see if there's a revert" seems to be goading editors into the worst possible behaviour. How about "let's see if folk can make productive edits"? I think this page should be unprotected, if only because we've sunk into consensus paralysis where editors can't do simple things (such as removing stale disputed tags) without determining consensus (albeit in a flawed way) beforehand. Colin° 11:27, 15 October 2008 (UTC)

Let's unprotect. --Steven Fruitsmaak (Reply) 11:40, 15 October 2008 (UTC)

Agree to unprotect. I would be surprised at a reversion, given there had been plenty of discussion and encouragement of even more (although the structure and mandatory discussion format has been confusing with apparently nothing accomplished in terms of moving forward). Hence, a straw vote took place over one issue in frustration over the enforced editorial paralysis. As per WP:SILENCE, if one person out of 11 squeaks without any explanation in a straw vote, and has made no further comment either before or after, and that falls under WP:SILENCE and is seen to promote and justify a reversion, then in my view WP:SILENCE is deeply flawed. I see overwhelming consensus here; a reversion without discussion first would not be bold but completely inappropriate. —Mattisse (Talk) 14:22, 15 October 2008 (UTC)

Further, I propose we drop the current confusing discussion format and adopt one that more straightforwardly addresses specific issues. These can be tackled in smaller chunks at a time, I think, without swallowing the whole bolus at once. We seem to be bogged down with no progress, except for the few consensus changes made by editors discussed above. —Mattisse (Talk) 14:41, 15 October 2008 (UTC)

Nice try. :-) But if you can't answer the 4 questions, you don't get to edit. Alright?

I'll gladly walk you through the 4 steps in any manner you like, using any medium you like, and I can/shall protect you from any abuse that might arise, provided you do so. In fact, if that wasn't explicit before, I'm making it explicit now. Fair? --Kim Bruning (talk) 17:48, 15 October 2008 (UTC)

Kim, I don't suppose you're familiar with WP:PPP? You're investing (or wasting, depending on the POV) an enormous amount of energy in process, and it's the final product that really matters. We have work to do -- work on regular articles -- and the elaborate process on this page has been impeding that work by consuming everyone's time and attention. Rather than imposing another process rule, how about following a practical content-driven rule? As in, don't bother proposing any changes here until you've got a real, live conflict in a regular article where common sense and good editing is being prevented by (misunderstandings of) this guideline. WhatamIdoing (talk) 19:23, 15 October 2008 (UTC)

I was not asking "to get to edit". I was proposing that we drop the confusing discussion format on this page, unreadable now, and more clearly address specific issues. I have never edited the article page, but it is good to know that you have decided that I "don't get to edit". Frankly, it makes my head ache to try to decipher this talk page and the interminable discussions on it.

I guess you are saying, that I have no voice on this page (WP:SILENCE) because I cannot fathom your way of doing things. SandyGeorgia said nothing that I did not say, so is she allowed to voice opinions here? She said, "I broadly agree with the answers from Colin, Eubulides, Jfdwolff and Mattisse...", then said in different words approximately what I said. Well, I broadly agree with her. Your answer to her was, "Thank you. You sort of answer the 4 "question essential to consensus" that I posed, but the answers are intermingled. If at some point you find time to organize your thoughts further, that would be appreciated. :-)".

If I intermingled my answers as she did, would that qualify? I looked at the massive number of questions you are requiring Orangemarlin to answer. I don't have several days to pore over this talk page discussion plus the versions of the article (to determine who edited the page, what their opinions are, who tends to work together, how their editing behavior clustered, and speculate how each would write the article), organize all this information (not over generalizing) and write it all down—the massive amount of work required give you answers. This feels like a school exam. Or is this a game show like Big Brother where I have to memorize qualities about the house guests? —Mattisse (Talk) 20:39, 15 October 2008 (UTC)

Kim's questions

• (2) Identify a number of flaws with the current state of the page, where's room for improvement?
• (2) Rules by necessity sometimes have an arbitrary element (eg. some countries say you must drive on the left, some say drive on the right, it's arbitrary, but as long as everyone does the same thing, there won't be any accidents). Identify arbitrary elements in the page.
• (2) Divide aspects of the page into those that are essential to you and those that are less essential. Which aspects of the page could be deleted or altered, without essentially harming (your intent for) the page? You may have already partially answered this question with the 2 points above. If there is a lot to consider, list aspects in order of priority.
• (2) Summarize some low priority aspects that could be altered, in as few words as possible (to prevent TLDR ;-) )
• The answer to question 2 tells you how much room you have to maneuver. You may be able to sacrifice something with a low priority to gain consensus on something with a higher priority.
• (3) Name all the participants who have edited the page. Separately, name those who participate on the talk page.
• (3) Examine the opinion of each participant. What would this person write if they were editing the page by themselves? summarize it. (Do not discard the opinion of any participant!)
• (3) Note which participants tend to work together and/or agree with each other
• (3) Using the data from the above two points, cluster the participants into groups. (the less groups, the better you can summarize, but beware of overgeneralization! IMPORTANT: This particular clustering is a means to summarize data and reduce work -for your convenience only-, it is not indicative of actual cliques or cabals.)
• (3) for each group, determine their primary course of action. How would they write the page if no other group was present? Summarize
• The answer to question 3 is -by necessity- imperfect, as you are basing yourself on external information. It is best considered a hypothesis. Later steps will test this hypothesis (the most obvious approach being to simply ask people if your hypothesis is correct or not :-), though other approaches exist as well )
• (4) The answer to question 3 provides you with a number of groups and their objectives. Like yourself, these groups are attempting to reach consensus, and are maneuvering for position. Like yourself they'll be trying to find answers to question 2. For each group: what will the members of that group answer for question 2?
• If you have trouble finding a single answer for each group, perhaps you need to revisit question 3
• The answer to question 4 is -by necessity- even less perfect than the answer to question 3. Not only must you base yourself on external information, but you may also need to speculate more about other people's motives. As discussion progresses, you may find yourself updating the answers to question 4 often.

Mattisse's answers to Kim's questions above

• (2)The page is fine and I cannot identify a number of flaws.
• (2)I identified what I accepted and would not accept in my answers above, in the section under my name.
• (2)Low priority aspects that could be altered are the headings. Perhaps the wording could be more elegant. Depending on the ultimate content (whether it is in accord with my beliefs as stated above in the section under my name), it is a high priority that this page be a guideline. I don't know what TLDR means.
• (2)The article history includes SandyGeorgia, Eubulides, Colin, Mastcell, OrangeMarlin and Paul Gene, as well as a number of people who are not participating on this talk page discussion, some of them quite extensively such as Petersam. The others made only a few edits and apparently are not interested enough in the article to follow what is happening now.
• (3)The people who participated on the talk page are Paul Gene, SandyGeorgia, Colin, Eubulides, Jfdwolff, OrangeMarlin, Fvasconcellos, MastCell, Mattisse. A number of people gave one or two comments but did not participant to any extent.
• (3)I believe SandyGeorgia, Colin, Eubulides, Jfdwolff, OrangeMarlin, Fvasconcellos, MastCell and I could work together. I believe Paul Gene and Mihai cartoaje perhaps could work together, although I have no idea if they have any common ground. As Sandy, Fvasconcellos and LeeVJ regard the status of this page as of little consequence, and perhaps do not care that much what it says (they believe RS and V policies cover the issue) they appear to be less interested in the issues. LeeVanJackson and EverSince appear to have little interest in the particular issues regarding medicine-related articles nor have particular beliefs.
• (3)I would cluster Colin, Eubulides, Jfdwolff, OrangeMarlin, Fvasconcellos and me as supporting the current article status and content. I would cluster SandyGeorgia, Fvasconcellos and LeeVJ as not being that interested as they feel other Misplaced Pages policies cover the issue. I would cluster Paul Gene separately. I would cluster EverSince, LeeVanJackson and Mihai cartoaje as basically uninvolved.
• (3)I believe Paul Gene would write the page according to his beliefs that primary sources are to be emphasized, although his beliefs on this issue are in dispute and have not been clarified recently. It appears that he has a unique view about use of general news articles, but I am not clear what it is, i.e. whether it is more or less inclusive. I do not know how Mihai cartoaje would write the page as his beliefs appear to revolve around WP:SILENCE and not the article content. I believe SandyGeorgia, Colin, Eubulides, Jfdwolff, OrangeMarlin, Fvasconcellos, Mastcell and I would keep the article close to its current state. LeeVanJackson and Eversince do not appear to have much experience with the issues regarding the article and would be uninterested in making it a guideline or in particular issues of medicine-related content.
• (4)I do not know enough about the others to answer this question. From what I can tell, everyone has been extraordinarily patient but they are about to wear out and withdraw from participation for a while. Paul Gene may have already done so as he has made no recent comments.

Hope I got the names clustered correctly and the views described correctly as it is very confusing to follow. I get some of the names mixed up. —Mattisse (Talk) 20:34, 15 October 2008 (UTC)

Kim has repeatedly asked User:Paul gene not to respond to other people's comments as Kim considers Paul's responses to be shooting himself in the foot. I don't think that the absence of responses actually indicates agreement. WhatamIdoing (talk) 22:59, 15 October 2008 (UTC)

(undent) @Matisse: Cool! You don't need to read the entire page all the time if you don't want to, if you just talk with me for now, that works fine. :-)

But it looks like you read through the entire page anyway. And you answered the long version of the questions. I sincerely appreciate the effort.

The reason I'm asking everyone to answer these questions is to explicitly check whether they understand the current consensus (and/or at least make people think about it). Obviously, it's not a good idea to let people near the page if they don't understand what the current consensus is.

More directly, what the questions let met do is to check what assumptions one person is making against answers other people are giving. (So your answer to question 3 about Paul can be checked against Paul's answer 1 +any consequent statements he has made).

Most of your answers are pretty perceptive too!

Now that I know your position, and your understanding of the current consensus, I'm able to discuss with you directly.

So far, I think I've spotted one misconception. You state that Paul Gene would prefer that primary sources be emphasized. AFAICT, he now agrees with Colin on how a medical article should be written on wikipedia: First build the framework using mostly secondary sources, and (only) use primary sources to fill in parts not covered by those secondary sources. (this is my own summary, and I take full responsibility if I have any misconceptions)

Do you yourself also think that this is a fair or correct approach? If not, what flaws do you see? --Kim Bruning (talk) 01:30, 16 October 2008 (UTC)

Well, I don't think that is quite what Colin said. I don't think his statement was quite that rigid. But I agree with whatever he did say. Too tired to go find exactly what he did say now but I remember agreeing with it at the time I read it. I have not seen a recent statement of Paul Gene so I do not know if he now agrees with Colin or not. —Mattisse (Talk) 03:03, 16 October 2008 (UTC)

Ok, I think that's probably good enough to say there's a consensus between the three of you then (Though it's probably a good idea to doublecheck me, to be sure I haven't missed any important details.). --Kim Bruning (talk) 15:56, 16 October 2008 (UTC) How long did that take (in posts and/or hours) from the moment you posted your answers to the questions? :-) Oh, three or four hours. —Mattisse (Talk) 18:56, 16 October 2008 (UTC)

@WhatamIdoing: I'm quite familiar with WP:PPP, and agree with it. :-) The problem I'm encountering here is that people don't always seem to be carefully checking whether each of their edits has consensus before they make them. So I'm sort of trying to find out what's causing all the trouble.

It's a bit like taking a car apart to really check everything for a change. It looks all compact under the bonnet, but if you take out all the parts to check them, you have this huge mess of components on the floor. Obviously, at some point everything goes back under the bonnet in a well-repaired, well-oiled state, and we can make much faster progress. :-) --Kim Bruning (talk) 01:41, 16 October 2008 (UTC) I'm hoping to see consensus purring along soon after we unprotect ;-)

Ok, let's go

@Colin: Heh, you're more optimistic than I am today. I didn't want to say that, because I wasn't sure people would believe me ;-).If we get productive edits, that'd be ideal, but if there's some fits and starts, that's fine too.

@Everyone: If possible, for any edit you make, please list the 4 steps here on the talk page. Try to keep it to 1-2 sentences per step. I want to see people working towards consensus 4 steps at a time. You don't have to like each other to be able to cooperate, just follow the procedure and you'll be fine. If anything shows up, before I see it, my talk page is just a click away. :-)

If you're not sure what the reasoning should look like, please discuss with me (any time, any medium, drop me a mail for options), and I'll write one for you, the first time.

For now, just make 1 edit each, and show your reasoning in the 4 easy steps provided. If anyone does *not* follow the rule, point them here and/or to my talk page, but do not immediately revert them.

If you don't see a need to make an edit, please don't edit.

@ uninvolved admin: Please unprotect! --Kim Bruning (talk) 17:59, 15 October 2008 (UTC)

Didn't see the above. I was too busy figuring out how to request unprotection: here. Colin° 18:11, 15 October 2008 (UTC)

:-) --Kim Bruning (talk) 18:13, 15 October 2008 (UTC)

Let's remove tag on Definitions

It's been ten days now with no discussion about the {{disputedtag}} tag on WP:MEDRS #Definitions. Almost all the discussion has been about procedures for editing the page. There was a bit of discussion about the popular press. Let's remove that tag and then move on. It may well be time to remove protection on the project page too. Eubulides (talk) 17:51, 15 October 2008 (UTC)

So you feel that the definitions are currently undisputed? Then please make that your edit on unprotection. (see above) --Kim Bruning (talk) 18:10, 15 October 2008 (UTC)

I doubt whether all editors currently agree on this subject. However, they haven't commented here in the past 10 days. Maintenance tags like that should be removed when there is no active discussion. Eubulides (talk) 18:26, 15 October 2008 (UTC)

In a short while, Make the edit and find out :-). --Kim Bruning (talk) 18:29, 15 October 2008 (UTC)

OK, done. Eubulides (talk) 02:57, 16 October 2008 (UTC)

Cool! Let's see what happens. --Kim Bruning (talk) 02:58, 16 October 2008 (UTC)

Section: Online

I propose we review the Online section.

1. Compared to other sections, this offers no general advice. Can we think of any?
2. The list of reliable sources contains just four entries. Should any of these be removed, qualified, or do folk have others to suggest?
3. Should there be a list of unreliable online sources or types of unreliable source?
4. Is the background reading section relevant for this guideline?
5. Should we mention Google Scholar or other search engines. Would those be better mentioned in the Journals section?
6. Google Books. Thoughts?

Colin° 19:08, 15 October 2008 (UTC)

• I don't use any of the online sources mentioned in WP:MEDRS #Online, other than Pubmed. Do other editors regularly use them?
• I've suggested before that Periodicals, Books, and Online should be combined into a single top-level section, with duplicative material removed. Almost everything's online now, for starters, so "Online" is to some extent a useless name for a section these days.
• I suggest rewriting the combination of the three sections to be more useful to common problems of novice editors. Typically, a new editor will start with a search engine, so the combined section should emphasize search far more than WP:MEDRS does now. It might also be helpful to talk about search first, rather than last.
• One possible way to start the ball rolling on such a rewrite would be to steal chunks from the "Search" discussion in Misplaced Pages:Misplaced Pages Signpost/2008-06-30/Dispatches.

Eubulides (talk) 19:37, 15 October 2008 (UTC)

Regarding your proposals, my thoughts are the following regarding the Online section (or whatever the title will be):

• Suggest little general advice as it tends to get dry quickly and is read only by those who already know it.
• eMedicine has been sold to WebMD and is a consumer site. Have never used the others. Any list should links to the web sites rather than to unreliable Misplaced Pages articles with "citations needed" tags. It would be great to offer a list of web links.
• List of inappropriate online sources, especially those that tempt nonprofessional editors in Misplaced Pages articles, could be useful as examples.
• Don't see point of background reading section. Either it is a reliable source or forget it.
• Mention Google Scholar or any other search engine or search techniques under this section as the nonprofessional editor is unlikely to have access to journals or books that are not online and is more likely to use search.

Regarding your other suggestions, I think the following:

• No, I have not used the online sources mentioned except for PubMed. They need to be checked out.
• Have no problem combining sections, as long as accessible online links are clear, as nonprofessionals will probably start there for reasons stated above.
• Agree with your rationale of presenting directions for search engine use first.
• Agree that chunks from the "Search" discussion in Misplaced Pages:Misplaced Pages Signpost/2008-06-30/Dispatches could be a good starting point, with the objective of paring the chunks down and making them more focused, less discursive, easier to scan. Including links to citation tools is a good idea

I really admire Misplaced Pages:Scientific citation guidelines as the writing is clear and informative, all the wikilinks go to a respectable article, and it educates without preaching or using jargon. How do they get away with it? —Mattisse (Talk) 04:22, 16 October 2008 (UTC)

FWIW I've found google books really helpful lately - many high-quality sources are available for free using a limited preview and extremely handy search feature. Can't say for sure how much this will apply to medical sources and pages because much of my recent work as been more social sciences than medicine, but it's definitely worth mining for sources and starting points. WLU (t) (c) 17:47, 20 October 2008 (UTC)

Preferring journal sources with free-text

Whilst we're at it what do people think about preferring sources with free-text? When finding text on Pubmed, I perform an advanced search to find any decent articles with freely available text first, and sometimes as a backup for high-quality non-free text ones, I believe this aids verifiability for other editors ( hardly anyone has access to all journals and papers ). LeeVJ (talk) 10:33, 16 October 2008 (UTC)

Very good idea. —Mattisse (Talk) 12:22, 16 October 2008 (UTC)

There was an attempt by Nephron and DavidRuben, way back in early 2007, to have the Misplaced Pages:Citing sources guideline express a preference for open access journals. It failed, and arguably that was the wrong guideline (it deals with how to cite, not what to cite). I don't know if the attempt was repeated at WP:RS or WP:V.

Technically, the accessibility of sources is irrelevant to whether it is reliable. However, the general reader benefits more from a link to a free-text source than from one that will charge him $20. There are also potential benefits for the quality of the article: such sources can be accessed by lay and expert (in other fields) editors who are then able to do a more thorough review or to better collaborate, or help folk editing many months in the future. If we do say something encouraging in this regard, we should IMO give practical reasons rather than moral ones. Colin° 12:33, 16 October 2008 (UTC)

Agree strongly. This is entirely an issue of practicality. It encourages the nonprofessional Misplaced Pages editor to participate in useful and satisfying way, rather than having that editor frustrated by a series of demands for money or messages of exclusion from sites not freely accessible. Editors use sources they can access. If inappropriate ones are all they find accessible, they will use those. If we want editors to write correctly cited Misplaced Pages medicine-related articles, we should attempt to provide them with appropriate accessible resources for their use. Morality has nothing to do with it and should not be addressed, in my opinion. I don't understand how morality enters into the issue. —Mattisse (Talk) 12:50, 16 October 2008 (UTC)

I agree with this, and suggest that while we're stealing from Misplaced Pages:Misplaced Pages Signpost/2008-06-30/Dispatches, we steal from its Accessing sources section, which starts off this way:

"Other things being equal, it is better to cite a source whose full text is freely readable, so that your readers can follow the link to the source. However, many high-impact journals, such as Nature and Science, require a fee or a subscription, and as these journals publish some of the best papers it can still be best to cite them."

and then goes on to give advice about free abstracts, getting copies of non-free sources, and so forth. Eubulides (talk) 16:37, 16 October 2008 (UTC)

That sounds good. I was also thinking that a list of sample inappropriate sites: info from the Mayo Clinic site (e.g. Clinic study suggests that proper management of asthma will decrease odds of breast cancer metastasis to the lung), WebMD: Attention Deficit Hyperactivity Disorder: What Is ADHD? (I would question this, although it is "reviewed" by a physician reviewer for Physicians' Review Network, Inc., an independent medical review organization - what do you think?), other "guidelines" sites that are popular, and some samples of "programs for sale" that mask themselves as medical information, like Dr. So-and-So's Guide to Curing Whatever, such as Effective & Caring Stuttering Therapy Approach for Children, Teens & Adults currently a reference in Stuttering therapy. I am going to start keeping a list of the ones I see used frequently. —Mattisse (Talk) 17:52, 16 October 2008 (UTC)

I agree that a brief example list of less-reliable sources would be useful. We can't of course make it exhaustive, but a list containing (say) three to five well-known sites that have reliability problems could be helpful to novice editors, to show them what sort of things to look out for. Eubulides (talk) 19:25, 16 October 2008 (UTC)

In principle, using accessible sources when all else is equal is good editing, but in practice, we have to be very very careful about how it is worded, so that superior sources aren't deprecated to accessibility. I'm afraid that all other things being equal may not be strong enough, and some editors may overlook the significance of that clause or remove the best sources to replace them with accessible sources, citing this page. For example, I am personally horrified whenever I see a Mayo Clinic source, as the last time I checked, they had inaccurate info on TS. (I haven't checked today.) On the other hand, the most glaringly inaccurate info on TS I've ever seen was printed in the New England Journal of Medicine and is accessible, but didn't even define the condition correctly, so I would never hoist that review upon our readers ... Anyway, yes, I agree with this, but wish we could make the wording much more explicit than in the Dispatch. SandyGeorgia (Talk) 18:01, 16 October 2008 (UTC)

I agree with this comment. This comment used the phrase When all else is equal. Would it suffice to replace Other things being equal with When all else is equal in the abovementioned quote stolen from Accessing sources? If not, what other words should be added? Eubulides (talk) 19:25, 16 October 2008 (UTC)

I'm not a good wordsmith, but I'd like to see something even stronger if anyone can come up with it: we have to leave no doors open for editors to use this page as a reason to replace superior sources with inferior ones just because one is accessible. The very best TS reviews aren't accessible (e.g.; Advances in Neurology, more or less vetted by everyone who is anyone): I only replace them sparingly and when I'm certain the accessible review is causing no harm. Maybe some sort of very explicit wording: don't replace a superior source with another just because it's accessible (thinking the faulty NEJM TS review over the Advances in Neurology papers). SandyGeorgia (Talk) 19:31, 16 October 2008 (UTC)

It seems like there's lots of support for choosing free-text journal articles as long as it can't be used to trump an editor desire to choose the best source they have access to. Perhaps discussion of that choice should be clearly separated from reliability issues -- in its own paragraph or subsection. What is less likely to be acceptable is substituting with less scholarly freely accessible online material (such as press releases from the Mayo clinic).

I've re-titled this section and made it top-level. We can discuss non-scholarly free access online sources in the section above. Colin° 20:37, 16 October 2008 (UTC)

It doesn't seem clear how this is an issue specific to medicine or, as mentioned, to reliability; and therefore why such decisions/guidance are the domain of this article and talk page, rather than a more central policy or guideline page. EverSince (talk) 20:53, 16 October 2008 (UTC)

While I think it's rather clear in the fact that many medical articles rely on journal sources, PubMed in particular, for which sometimes only abstracts are available online. Many other content areas may rely more heavily on sources that are available online (pop culture articles come to mind), which is why we may need to further explain for medical articles. Guideline pages help explain policy for particular areas: the particularity of this area is PubMed. Someone may be frustrated that only a PMID abstract is available, but we don't replace a superior source with Mayo clinic to avoid that. SandyGeorgia (Talk) 21:00, 16 October 2008 (UTC)

I think we all agree that the best reference shouldn't be replaced, but free text articles are helpful? How about I try some initial wording...

"Commonly the most reliable medical references are not free to access, so it is helpful to supplement these with a free text source if one is available; this must be reliable itself and cover the same subject area, without contradiction." LeeVJ (talk) 17:21, 19 October 2008 (UTC)

Do we actually need this? Given that many editors don't have access to non-free materials, don't you think that we have a systemic bias in favor of free materials already? This seems WP:CREEPy to me. WhatamIdoing (talk) 19:47, 19 October 2008 (UTC)

The intention would actually be to curb this bias and ensure the best refs were used primarily, and putting free-text articles into context - I'm don't think I've seen them mentioned elsewhere. It is aimed at editors who do have access to paid for sources, to point them in a direction to aid verifiability. Whether it's needed or not .. I think they should be mentioned somewhere? LeeVJ (talk) 20:14, 19 October 2008 (UTC)

(BING) Primacy should always be to the best, most reliable, highest-quality source. Accessibility should only be a concern when there are two completely equal sources (and in that situation, I'd probably cite both). Honestly, I think common sense and talk pages will be the best ways to resolve situations like this (and I think they'd be extremely unlikely anyway - how often do you find two completely equal sources, let alone one that's a free full text?).

From a purely practical standpoint, I'd suggest posting any guidance we can dredge up for two subjects mentioned here - where/how to find full text sources and what lay-sources to avoid. Emedicine and WebMD are quite tempting, and problems with them should be highlighted. Emphasizing availability rather than reliability seems very much the wrong way to go in my mind. WLU (t) (c) 17:58, 20 October 2008 (UTC)

Lee, I don't think that a section titled "preferring sources with free text", or anything even remotely like that, will ever have the effect of curbing the bias towards using free materials. WhatamIdoing (talk) 19:09, 20 October 2008 (UTC)

WhatamIdoing, I'm didn't mean a whole new section - just as part of online sources. I concede to WLU's view, although giving instructions on finding the free text articles might help the bias further - but at least for those looking how to use them properly will have some direction.. LeeVJ (talk) 19:26, 20 October 2008 (UTC)

Directions on how to find free articles may increase the number of free articles available (which can only be a good thing; even having a full text to review and discard is helpful) but does not mean the free article should or will be included automatically. There's nothing inherently bad about free articles, and one really good thing (they're free!) but editors will still review each one individually to ensure they are sufficiently reliable, there is sufficient oversight and peer review, and ultimately that they are appropriate to the page. A "how to" or starting point guide should certainly state this, but it's really the beating of a dead horse - NPOV is one of the pillars, and it is the appropriate policy to invoke because NPOV is what guides us to represent the mainsteram scholarly consensus. Anyone trying to cite the Journal of Orthomolecular Medicine on cancer will get smacked firmly in the face with NPOV and UNDUE, and that is what will preclude it's use, not it's availability. This might all be best covered in a MEDRS FAQ rather than the policy or main page. Do we have a FAQ? Might be a good idea, might be redundant, might be lengthy enough to cover aspects like "can I cite emedicine" and "where can I find good sources". Having free sources isn't a bad thing, using them willy-nilly is, but that's just as likely to happen if free or paper. WLU (t) (c) 19:52, 20 October 2008 (UTC)

Draft replacement for Periodicals, Books, Online

Here is a draft replacement for the sections WP:MEDRS #Periodicals, WP:MEDRS #Books, and WP:MEDRS #Online. It attempts to take all the above discussion into account. It's a bit rushed and wordy, and could stand some improvement, but I thought I'd get it out the door sooner rather than later. Comments are welcome in #Comments on Draft replacement for Periodicals, Books, Online below. Eubulides (talk) 00:59, 21 October 2008 (UTC)

Sections of draft replacement

Each of the sections of the draft replacement are intended to be top-level sections in WP:MEDRS. They are 3rd-level sections here, so that it's nested properly in the talk page. Eubulides (talk) 00:59, 21 October 2008 (UTC)

(start of draft replacement)'

Search

Search engines are commonly used to find biomedical sources. Each engine has quirks, advantages, and disadvantages, and may not return the results that you need unless used carefully. It typically takes experience and practice to recognize when a search has not been effective; even if you find useful sources, you may have missed other sources that would have been more useful, or you may generate pages and pages of less-than-useful material. A good strategy for avoiding sole reliance on search engines is to find a few recent high-quality sources and follow their citations to see what your search engine missed. It can also be helpful to perform a plain web search rather than one of scholarly articles only.

Pubmed is an excellent starting point for locating peer-reviewed medical sources. It offers a free search engine for accessing the MEDLINE database of biomedical research articles offered by the National Library of Medicine at the U.S. National Institutes of Health. Although PubMed is a comprehensive database, many of its indexed journals restrict online access; an additional site, PubMed Central, provides free access to full text. There are basic and advanced options for searching PubMed. Clicking on the "Review" tab will help you narrow your search to reviews. The "Limits" tab can let you further limit your search, for example, to meta-analyses or to freely-readable sources.

Other useful search engines include:

• The Cochrane Library contains a database of systematic reviews and meta-analyses, and is a key resource in evidence-based medicine. Its reviews are generally considered to be of very high quality.

• Google Scholar covers all scholarly sources. It is useful not only as a sanity check for Pubmed searches, but also to cover topics outside Pubmed's core purview, such as the sociological or cultural aspects of medicine.

• Google Books can also be quite useful for medical searches: it can let readers peek at a few sentences in books even when full access is not granted, and can help editors find reliable sources quickly, either by looking at the book's references or by citing the book itself.

• EMBASE is a high-quality index that often generates better results than Pubmed. Unfortunately, it is proprietary and requires a subscription.

• CINAHL is a proprietary index on nursing and allied health care.

Accessing sources

A Misplaced Pages article should cite the best and most-reliable sources regardless of whether they require a fee or a subscription. When all else is equal, it is better to cite a source whose full text is freely readable, so that your readers can follow the link to the source. Some high-quality journals, such as JAMA, publish a few freely-readable articles even though most are not free. A few high-quality journals, such as PLoS Medicine, publish only freely-readable sources. Also, a few sources are in the public domain; these include many U.S. government publications, such as the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention.

When searching for sources, it is wise to skim-read everything available, including abstracts of papers you can't fully access, and use that to get a feel for what reliable sources are saying. However, when it comes to actually writing a Misplaced Pages article, it is generally not a good idea to cite a source after reading only its abstract, as the abstract necessarily presents a stripped-down version of the conclusions and omits the background that can be crucial for understanding exactly what the source says. You may need to visit a medical library to access the full text, or ask somebody at the WikiProject Resource Exchange to either provide you with a copy or read the source for you and summarize what it says; if neither is possible, you may need to settle for using a lower-impact source or even just an abstract.

Citations as documentation

Citations should document precisely how to access sources. Normally, medical citations should contain a Pubmed identifier (PMID). It is good practice to also supply a digital object identifier (DOI) if available. A common practice is to supply a uniform resource locator (URL) to a source if and only if its full text is freely readable. If the {{Cite journal}} template is used, all this information can be supplied with the "pmid=", "doi=", and "url=" parameters, respectively. It is also helpful to mention whether a source is also available on Pubmed Central; with {{Cite journal}} this can be done with the "pmc=" parameter. For example:

{{cite journal |author= Bannen RM, Suresh V, Phillips GN Jr, Wright SJ, Mitchell JC |title= Optimal design of thermally stable proteins |journal=Bioinformatics |volume=24 |issue=20 |pages=2339–43 |year=2008 |pmid=18723523 |pmc=2562006 |doi=10.1093/bioinformatics/btn450 |url=http://bioinformatics.oxfordjournals.org/cgi/content/full/24/20/2339}}

produces this:

Bannen RM, Suresh V, Phillips GN Jr, Wright SJ, Mitchell JC (2008). "Optimal design of thermally stable proteins". Bioinformatics. 24 (20): 2339–43. doi:10.1093/bioinformatics/btn450. PMC 2562006. PMID 18723523.{{cite journal}}: CS1 maint: multiple names: authors list (link)

If a source is available in both HTML and some other form, normally the HTML form should be cited, as it is the most likely to work on a wide variety of browers.

Biomedical journals

As mentioned above, the biomedical literature contains two major types of sources: primary publications describe novel research for the first time, and review articles summarize and integrate a topic of research into an overall view. In medicine, primary sources include clinical trials, which test new treatments; secondary sources include meta-analyses that bring together the results from many clinical trials and attempt to arrive at an overall view of how well a treatment works. It is usually best to use reviews and meta-analyses where possible, as these give a balanced and general perspective of a topic, and are usually easier to understand!

Peer-reviewed medical journals are a natural choice as a source for up-to-date information for medical articles. They contain a mixture of primary and secondary sources, as well as less technical material such as biographies. Although almost all such material will count as a reliable source, not all the material is equally useful. Journal articles come in many types: original research, reviews, editorials, book reviews, correspondence, biographies and eulogies. Research papers are primary sources; although they normally contain previous-work sections that are secondary sources, these sections are typically less reliable than reviews. A general narrative review of a subject by an expert in the field makes a good secondary source that can be used to cover various aspects of a subject within a Misplaced Pages article. Such reviews typically contain no original research but can make interpretations and draw conclusions from primary sources that no Misplaced Pages editor would be allowed to do. A systematic review uses a reproducible methodology to select primary studies meeting an explicit criteria in order to answer a specific question. Such reviews should be more reliable, accurate and less prone to bias than a narrative review. However, a systematic review's focus on answering one question limits its usage as a source on Misplaced Pages.

The 2003 Brandon/Hill selected list includes 141 journals suitable for a small medical library. Although this list is no longer maintained, the listed journals are of high quality. The core general medical journals include the New England Journal of Medicine, The Lancet, Journal of the American Medical Association (JAMA), Annals of Internal Medicine, British Medical Journal (BMJ), and Canadian Medical Association Journal. Core basic science and biology journals include Science, Cell, and Nature.

Medical textbooks published by the academic press are excellent secondary sources. Ensure the book is up-to-date, unless a historical perspective is required. Doody's maintains a list of core health sciences books, which is available only to subscribers.

Popular press

The popular press is generally not a reliable source for science and medicine information in articles. Most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits. Articles in newspapers and popular magazines generally lack the context to judge experimental results. They tend to overemphasize the certainty of any result, for instance presenting a new experimental medicine as the "discovery of the cure" of a disease, or an every-day substance as the "cause" of some dreaded disease. Newspapers and magazines frequently publish articles about scientific results before those results have been peer-reviewed or reproduced by other experimenters. Such articles may be based uncritically on a press release, which can be a biased source. They also tend neither to report adequately on the scientific methodology and the experimental error, nor to express risk in meaningful terms.

A news article should not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source, for example with the "laysummary=" parameter of {{Cite journal}}.

On the other hand, the high-quality popular press can be a good source for social, biographical, current-affairs and historical information in a medical article. For example, popular science magazines such as New Scientist and Scientific American are not peer reviewed but sometimes feature articles that explain medical subjects in plain English. As the quality of press coverage of medicine ranges from excellent to irresponsible, common sense and the general guidelines presented in the verifiability policy and general reliable sources guideline should be considered in determining whether a popular press source is suitable for these purposes.

Popular science and medicine books are usually tertiary sources, but there are exceptions. Self-published or books published by vanity presses are generally not subject to any form of independent fact-checking or peer review and may not be reliable sources.

(end of draft replacement) Eubulides (talk) 00:59, 21 October 2008 (UTC)

References

1. Greenhalgh T (1997). "How to read a paper: Papers that summarise other papers (systematic reviews and meta-analyses)". BMJ. 315 (7109): 672–5. PMC 2127461. PMID 9310574.
2. Hill DR, Stickell H, Crow SJ (2003). "Brandon/Hill selected list of print books for the small medical library" (PDF). Mt. Sinai School of Medicine. Retrieved 2008-09-16.{{cite web}}: CS1 maint: multiple names: authors list (link)
3. Shedlock J, Walton LJ (2006). "Developing a virtual community for health sciences library book selection: Doody's Core Titles". J Med Libr Assoc. 94 (1): 61–6. PMC 1324773. PMID 16404471.
4. Schwitzer G (2008). "How do US journalists cover treatments, tests, products, and procedures? an evaluation of 500 stories". PLoS Med. 5 (5): e95. doi:10.1371/journal.pmed.0050095. PMID 18507496. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: unflagged free DOI (link)

Comments on Draft replacement for Periodicals, Books, Online

(Please put comments here.) Eubulides (talk) 00:59, 21 October 2008 (UTC)

Wikischolar citation template generator is now broken, has been for a while. Would be great if someone could re-create it. The text also gives the impression that google books is only good for finding other references, and I have reworded to avoid discouraging the use of books themselves as references; though books should in many disciplines be used slightly more carefully, their use in general shouldn't be restricted (natually, depending on publisher and oversight; that may be missing or assumed in my adjustments).

My apologies if I've stepped on your toes Eubulides, I've made some other adjustments to the text to place more emphasis on the reliability over the accessibility (I feel very strongly that this is the best way to write an article). If people disagree, then please go ahead and revert to the original wording and discuss!

Another comment - "if neither is possible, you may need to settle for using a lower-impact source or even just an abstract" - this actually discourages writing articles in my mind. I very rarely have access to the full text, and often am insufficient of an expert to judge an article based on the specifics of methods and statistical analyses. I've written many an article based on abstracts alone, and have received few complaints (but given the dearth of expertise on wiki, perhaps that says something about the system rather than my writing). An abstract should normally include the most salient conclusions, and generally any significant methodological flaws, or follow-on sources should raise these issues rather than editors.

I'm also of the opinion that discarding an article or placing qualifications on the mainspace page regards it's usefulness (i.e. "...but these conclusions should be regarded with caution because of a lack of control group.") is very dangerous grounds, very close to original research, and am dubious about its inclusion. We're not Nupedia with expert oversight and the ability to criticize conclusions, and to enter into this territory sets a shaky precedent in which we'll have another layer of unofficial expertise or authority - regular users, admins, and "those who can discard studies on the basis of methodology". TimVickers, Eubulides and many of the heady powereditors who are regulars on MEDRS I would trust with this judgement, but it is begging, just begging for trouble as soon as a content dispute arises where one side has a very strong POV. These are comments about articles that I think should be made by verifiable sources, not by us, and if it's a serious flaw then very shortly after the original publication a qualification, retraction or criticism should be published by a relevant expert in a relevant field. Just my thoughts, grist for the mill, and I'm always delighted to see what the excellent contributors on MEDRS are going to do to destroy my wikiworldview this week. You know for the longest time I didn't know there was a difference between policies and guidelines? WLU (t) (c) 01:11, 21 October 2008 (UTC)

WLB, if you look above on this page to Steps towards consensus, you will see that we have engaged in a discussion lasting over a month, with an informal mediator, on the issues you bring up now. Please take the time to read through the reasoning of the participants. It has been very hard on us all and it would indeed be disappointing if it were all for nothing and we were to start over at square one. Regards, —Mattisse (Talk) 02:27, 21 October 2008 (UTC)

oops, my bad. I will read tomorrow if I've the time and until then will refrain from edits and suggestions. Please feel free to revert all changes including my above comments. I had thought this a separate issue. WLU (t) (c) 02:51, 21 October 2008 (UTC)

No problem. Your changes had good ideas. I took the biggest point and moved it into a new section #Citations as documentation above. I also edited the changes further. Thanks! Eubulides (talk) 06:13, 21 October 2008 (UTC)

@WLU: Making improvements to a page is a good thing. Just edit the page like normal. :-) That's the whole point of wikipedia, and it's what we've been working towards. If anything happens (I hope it won't, but it might), drop me a line and I'll help sort it out. --Kim Bruning (talk) 17:49, 21 October 2008 (UTC) The rule on[REDACTED] is: someone has to do the consensus homework, else you may have ...some... trouble finding consensus at times. ;-) And I'll admit I'm rebelling a little: why should it always be the (informal) mediator who gets to do all the work? People should learn to do the homework themselves for a change! That way the workload is spread out over several people, and the mediators job is a lot lighter. In fact, why need a mediator at all? A stitch in time saves nine: If you try to understand the current consensus _before_ you get into an edit war, rather than after, well sure, it might cost you a couple of hours (only at first, with practice you can get it down to a couple of minutes), but it will save you a month of torture at the hands of an evil mediator! O:-)

PubMed and PubMed Central

Above suggested wording states PubMed Central as an "alternative" of PubMed - but in reality both hosted by NLM. They each provide a different webpage to search the database and whilst one shows PMID abstracts (which will mention any PMC links if available), the other only shows archived copies of articles. "additional" resource tool rather than "alternative" might be a better choice of wording ? David Ruben 00:13, 22 October 2008 (UTC)

Thanks for catching that. I changed "alternative" to "additional" in the above draft. Eubulides (talk) 07:34, 22 October 2008 (UTC)

I'm old fashioned, I like to use history and diffs and other such wiki tools. None of this new fangled "ink", "draft" and "dead tree" stuff for me ;-). Could you do l'il old me a favor and add the changes to the page itself, so I can check them in my own old fashioned way? O:-) --Kim Bruning (talk) 01:47, 23 October 2008 (UTC) try split it into multiple edits, one paragraph at a time, perhaps.

The proposal has only been out for a couple of days; I'm a bit leery to install it now. But if you want to see the diffs, and the new version, please check here and here, respectively. The diffs aren't that useful, I'm afraid; the change is too big. Eubulides (talk) 03:05, 23 October 2008 (UTC)

That's why you make the change in steps, so that your diffs actually make some kind of sense. :-) --Kim Bruning (talk) 10:15, 23 October 2008 (UTC)

But that's for next time. I've unreverted you. Let's see what edits people make. :-) (I found some odd stuff in a hidden text, so I made it slightly friendlier already, I haven't touched visible text yet.) --Kim Bruning (talk) 10:20, 23 October 2008 (UTC) I hope you won't unrevert-war with me. That'd be a novelty! ;-)

Yes, PubMedCentral is not an alternative to PubMed in any sense at all; PMC is an archive of articles posted as being the result of mostly NIH sponsored investigations from about 2007/8+, with some earlier--its a wonderful thing to have these open access articles and will become more and more useful, but they are not a complete record of anything. PubMed provides abstracts only for all published articles in biomedicine. The place to search for material is unquestionably PubMed, using PMC as a convenient source of full articles for the ones it has.DGG (talk) 05:17, 23 October 2008 (UTC)

PubMed Central manuscripts vs final versions

Consider the following citation:

Turetsky BI, Kohler CG, Indersmitten T, Bhati MT, Charbonnier D, Gur RC (2007). "Facial emotion recognition in schizophrenia: when and why does it go awry?". Schizophr Res. 94 (1–3): 253–63. doi:10.1016/j.schres.2007.05.001. PMC 2571079. PMID 17583481.{{cite journal}}: CS1 maint: multiple names: authors list (link)

This uses the "pmc=" parameter of {{Cite journal}}, so that if you click on the article title, you visit the PubMed Central manuscript for that article. This manuscript, though, presumably differs in minor ways from the final version of the article (which is viewable only with a subscription).

So, my question is: is such a citation a reasonable one? Or should it be altered to make it clear to the reader that the URL is to something other than the final version of the paper? There is an argument for convenience and for encouraging people to read freely-available versions of papers; but there is also an argument for making it clear which is the final (and presumably best) version of the paper.

Should WP:MEDRS have some guidance about this issue?

Eubulides (talk) 20:45, 23 October 2008 (UTC)

See Author Manuscripts in PMC. I think the differences should usually be trivial, possibly on a par with the difference between the PDF and HTML forms. But there is a risk that final editorial changes were significant. Where both are free, this implies that editors should be recommended to read and cite/link the journal's final edition and not include the "pmc=" version. If the PMC is the only free edition, but supports the text of the article, then I'd recommend using that. Does anyone know how much they tend to differ? It doesn't seem worthwhile to link to a paid-for version merely because it has had a final touch of copyediting. Colin° 21:43, 23 October 2008 (UTC)

I do think though that journals own versions of articles (assuming free to access) tend to have better inclusion of tables and charts than the version rendered at PMC. {{cite journal}} therefore links the title to the url parameter if given, rather than the pmc value if it is given too (i.e. the pmc link will do, but url to "original" journal takes preference) David Ruben 00:24, 24 October 2008 (UTC)

I would not link the "author manuscript" with the PMC tag. There may be significant differences between the submitted manuscript and the final version that has undergone extensive peer review. JFW | T@lk 00:32, 24 October 2008 (UTC)

PMC is not necessarily manuscripts; a number of publishers deposit full versions, formatted in PMC's special XML. And when PMC has manuscripts they have invariably undergone full peer review--the difference is the lack of publishers' copyediting. There is consensus, though, in the academic community that the published version is the one for official citation--and consensus on WP that we always also give a convenience citation to the free version if available. Incidentally, as for the differences see my "Open access and accuracy: author-archived manuscripts vs. published articles " in Learned Publishing, 20:3, July 2007 , pp. 203-215 open access.and the refs listed therein. They are very rare--nobody has every demonstrated anything substantial. DGG (talk) 01:05, 24 October 2008 (UTC)

That's a very useful article! We can even reference it ;-) --Kim Bruning (talk) 02:29, 24 October 2008 (UTC)

Wow. I've never seen that happen before in an article, never mind a guideline page. I asked "Does anyone know how much they tend to differ?" and and within a few hours an editor has responded (effectively) "Well, actually I'm a expert on this topic and here's the freely available published/reviewed answer." Great.

BTW, I find it deeply ironic that Wiley's Epilepsia want me to pay $35 to read their open access policy. Colin° 08:10, 24 October 2008 (UTC)

Heh. It's not as common as it used to be. --Kim Bruning (talk) 16:33, 24 October 2008 (UTC)

Thanks, I made this change to cover the topic and cite DGG's paper. But there's a tasty irony here. As far as I can tell, Ingentaconnect, the publisher of DGG's paper, does not provide a stable URL to the full final version of the paper. Instead, one must go through a couple of levels of indirection, and that gives you a URL with session info in it, compromising both portability and privacy (so much for "open access"). My edit therefore contains this citation:

Goodman D, Dowson S, Yaremchuk J (2007). "Open access and accuracy: author-archived manuscripts vs. published articles" (PDF). Learn Publ. 20 (3): 203–15. doi:10.1087/095315107X204012. Retrieved 2008-10-24.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Here the DOI is to the final version, but the URL http://dlist.sir.arizona.edu/1968/01/OAandA%5FGDY.pdf points instead to the authors' preliminary manuscript. I sure hope that the paper's results apply to the paper itself! Eubulides (talk) 08:59, 24 October 2008 (UTC)

How about modifying the cite journal template so that it tells the reader they're getting a rough copy? ☺ Coppertwig (talk) 00:40, 26 October 2008 (UTC)

Journals

It seems unfortunate/unbalanced for Misplaced Pages that there isn't actually a central guideline covering the various journal database and access issues above (unless I've missed it). To cover all the main databases, for different editors and points of view (pubmed of course is misleadingly titled/described 'cos it includes a large number of non-medical journals). Which could then split off into specific databases/topics if length dictated it. Avoiding cart before horse or tail wagging dog. EverSince (talk) 11:27, 24 October 2008 (UTC)

I look forward to reading your new page! :-) --Kim Bruning (talk) 16:28, 24 October 2008 (UTC)

Just found in this dispatches reoport on reliable sources, hidden in the basement.. Misplaced Pages:Misplaced Pages Signpost/2008-06-26/Dispatches.. 15:12, 25 October 2008 (UTC)

Also Dispatches 2008-06-30: Sources in biology and medicine and Dispatches 2008-07-28: Find reliable sources online which as per talk page of the former were initially one guide but then split for dispatch purposes. I asked at citing sources a few months ago about where an actual guideline along those lines might go, but no response. EverSince (talk) 16:21, 25 October 2008 (UTC)

I don't think we should restrict references to particular databases, but I personally would strongly object to the citation of articles from journals not indexed on Medline. I have a preference for freely accessible sources, but if there is a better source that is not freely accessible then the second one still wins... JFW | T@lk 18:58, 25 October 2008 (UTC)

there are 3 types of sources not indexed on Medline: one is journals not regarded as relevant to scientific medicine, a second is local journals outside the US, and a third is journals that have material relevant to medical topics, though in other sciences. None of them can be assumed to be not freely available. The problem in RS of course is for the first when one deals with fringe medicine: the major alternative medical journals that have some pretense to science are included, the lesser ones and the frankly non-scientific are not. In practice, we have been using inclusion in Medline a criterion of at least possible suitability for citing in this topic when one wishes to cite a possibly rational approach--if one wishes to cite what people believe, the spectrum is of course much wider. Local non US/Canada journals can have a high standard, but this cannot be assumed--a rough check is whether they are included in Excerpta Medica, even though that actual database is not widely available outside major medical schools. And journals in any area of physical or social science or humanities can be relevant--an example is that the journals dealing with medical ethics are included in Medline; the general philosophical journals are not, though they may have articles on the subject of just as high quality.

But this does not say anything about availability: many less-developed worlds journals are available open access, hough not in Medline. and many that are do not have even the abstracts freely available--this is particularly true for review articles. and I hope everyone realises that many open access versions are available outside PMC--the only way of getting most of them all is to check Google Scholar or Scirus as well.DGG (talk) 02:54, 27 October 2008 (UTC)

At the end of the day, Medicine and Medline represent only part of the knowledge that may exist for a given article - including potentially at the scientific core of a subject. I know those aren't necessarily free to access, I'm just trying to illustrate. EverSince (talk) 20:53, 27 October 2008 (UTC) p.s. this point has of course been well made already by Kim's pointer to the citation diagram EverSince (talk) 20:59, 27 October 2008 (UTC)

The above points about non-medical journals/articles potentially being relevant (whether or not indexed on medline, and even if they are they may also be accessed/linked via a non-medical database) seem to question how this guideline can legitimately only refer to medical journals/textbooks in the lead... EverSince (talk) 16:17, 1 November 2008 (UTC)

(watches the tumbleweeds go by)...I guess the above issues about the lack of a neutral cross-disciplinary guideline on finding/assessing articles, and the illegitimacy of this guideline being founded on a priori privileging of reliable medical sources over reliable non-medical sources, can be added to the list of critical issues that remain unaddressed/ignored. Another one is that a sourced critique of press sources is included in this guideline - tendencies, things they miss out, exaggerate etc - but not a similar critique of medical sources. Here's a long list of the sorts of points that might be relevant, not saying these specific sources are necessarily ideal but they seem to support the presence of widespread issues & tendencies equivalent to those covered for press articles:

In the 150 years since Virchow produced his principles, medicine has strayed from this vision . Despite television images of trapped hurricane survivors searching for food and the knowledge that 44 million Americans (most of them working) do not have health insurance, medical research continues its biomedical trajectory in search of expensive “magic bullets” and more sophisticated interventional technologies, rather than understanding the social determinants of health...Why then is social science often excluded? For one, academic medicine has been preempted by the glamour of technology and by the rewards it brings to those who discover and employ it . For another, social scientists are unwelcome when they discover unpleasant facts, such as life circumstances trumping medical care in determining the health status of populations and that disparities in health care are part of the system rather than oversights . These discoveries not only threaten medical hegemony, but they challenge the larger social order

If structural violence is often a major determinant of the distribution and outcome of disease, why is it or a similar concept not in wider circulation in medicine and public health, especially now that our interventions can radically alter clinical outcomes? One reason is that medical professionals are not trained to make structural interventions. Physicians can rightly note that structural interventions are “not our job.” Yet, since structural interventions might arguably have a greater impact on disease control than do conventional clinical interventions, we would do well to pay heed to them.

When 'medical facts' must be derived from 'magical beliefs' in the centres of biomedical science, the state often intervenes to criminalize practitioners of alternative medicine. But, when profits are to be made on the fact that 'the magical' sells in alternative medicine, the state also makes it possible to shift ownership of medical knowledge, sometimes by way of the randomized controlled trial and the pursuit of active ingredients. The possibility of relocating the label of 'crime' is explored in this paper by way of an inquiry into processes that enable this shift in ownership, and a relocation of what constitutes medical 'fact' versus 'belief'.

studies have found high error rates in references in biomedical journals

Selective reporting of trial results exists for commonly marketed drugs

use the voices and stories of the poor to explain the impact of structural adjustments...I argue that masks the real absence of the voices of the poor and their suffering on the world stage. There is no international public sphere within which these voices might be heard; rather, there is a set of claims about justice and human rights.

contested areas of science-society discourse...militaristic metaphors are still part of a pervasive, but by no means inevitable, mode of science and policy communication.

disease in the Western world has been primarily constituted by the imagery of war...it derives its immediate nourishment and historical root from a corresponding language of war within medicine itself

Medical journals are an extension of the marketing arm of drug companies

The eight questions that I pose in the opening paragraph – having to do with blindness and deafness, mild depression and slow running, black racial features and plain facial features, obesity and anorexia – have become, even in today’s world of limited resources and imperfect technology, principal lightning rods for debate over the final limits to medicine ... treatments for conditions such as deafness, obesity, or anorexia may actually be a form of cultural genocide

Under the Medical Gaze serves as a powerful illustration of medicine's power to create and inflict suffering, to define disease and the self, and to manage relationships and lives.

Three decades ago, Ivan Illich argued polemically that the medical establishment was “medicalising” life itself , and in the 1990s Lynn Payer described widening the boundaries of illness as “disease mongering” , highlighting the role of pharmaceutical companies. Today's debate about this phenomenon, while still maturing, both acknowledges the axiomatic interest of corporations and professionals in maximizing turnover and appreciates that well-informed citizens may choose to embrace the medicalisation of health problems previously regarded as troublesome inconveniences.

The unequal distribution of power in contemporary society is reflected and reproduced in medical ideology. The present article analyses some articles from Israeli medical journals in order to show the ways in which biomedicine—the dominant medical ideology—is reinforced through hegemonic discourse. The central ways by which this is achieved are medicalization—which includes the desocialization of disease and the explanation of social phenomena in medical terms—and the affirmation by the Israeli medical literature of national, ethnic, class and gender relationships of domination. Analysis of the Israeli example provides useful insights about biomedicine's desocializing role, as the disregard for the social dimension of disease is particularly telling in a society characterized by several cleavages which determine a clearly unequal distribution of power and resources.

"Social conditions such as poverty and crime have all too often been attributed to mental illness, biology, and genetics. This has created a kind of nihilism on the part of mental health professionals, which has proven to be an impediment both to research and health care delivery. These deterministic views of race-based psychology have continued to appear in the literature and continue to exert a pernicious influence."

the dominance of biomedicine is delegated rather than absolute, these processes reflect the growing accommodation on the part of alternative practitioners to the reductionist disease theory which is compatible with capitalist ideology.

The "Medical-Industrial complex" has led to the commercialization of health care well beyond what traditional practitioners would consider ideal. Medicine is being treated as a business, with cost curtailment measures and profit margins often dictating physicians' choices

the transformation of continuing medical education into an enterprise for drug marketing. The chore of teaching doctors how to practice medicine has been handed to the pharmaceutical industry.

By accepting only advertisements for drugs and medical devices, medical journals have accepted an exclusive and dependent relationship with corporations... Advertisements and other financial arrangements with pharmaceutical companies compromise the objectivity of journals.

pharmaceutical industry organizations often front for sections of the pharmaceutical industry by retaining public relations consultants and sometimes by coordinating the funding of psychiatric research. An important line of agenda setting communication is via a two-way exchange between PR/advertising and the psychiatric profession/researchers. Public relations firms are often used to disguise the sources of drug company funding for psychiatric research and there is also a constant barrage of drug company advertising in psychiatric journals aimed at persuading psychiatrists to use specific drugs. The reverse flow, from psychiatry to PR, involves the utilization of psychiatric research, and psychiatric expertise, in public relations campaigning.

the erosion of professional values and medical education by commerce shows no sign of slowing. The latest scandals involve Medscape

One of the nation’s most influential psychiatrists earned more than $2.8 million in consulting arrangements with drug makers from 2000 to 2007, failed to report at least $1.2 million of that income to his university and violated federal research rules, according to documents provided to Congressional investigators.

Leading medical journals seem to be having a difficult time disentangling themselves from the pharmaceutical and medical device industries. If they cannot stop printing articles by scientists with close ties to these businesses, they should at least force the authors to disclose their conflicts of interest publicly so that doctors and patients are forewarned that the interpretations may be biased.

residents indicate that they do not have the time nor the mentors to deliver effective cross-cultural care, and are not evaluated on their ability to do so

both EBM and CCM have been accused of fostering stereotypes and have therefore suffered some degree of backlash. EBM experienced a backlash over fears of “cookbook medicine,” or clinical stereotyping, while CCM experienced a backlash over fears of cultural stereotyping.

the issue about the predominance of the neurosciences has less to do with truth than with the current economical and legal climate and hence it is imperative that other approaches to mental illness are allowed to participate in the process of understanding..." "Indeed, it could even be said that it would be unethical not to allow other approaches to participate in the common epistemological enterprise. Without such wider conceptual participation, the haematoma auris or the drapetomania stories will happen again."

EverSince (talk) 21:34, 23 November 2008 (UTC)

Too long, didn't read.

The fact that there isn't a neutral guideline to reliable sources in multiple fields is a red herring. Nothing in this guideline -- I repeat, nothing -- prohibits the editor from using any and all types of reliable sources for non-scientific information. It's only when you're talking about actual scientific facts, such as whether this molecule interacts with that molecule, or whether this medical sign is associated with that medical condition, that we're recommending that the editors rely on medical/scientific sources instead of, for example, a newspaper article written by a journalist that had never heard of the condition until he started the interview with a local patient.

Can you give me an example of a real problem? For example, can you type up an example of something you'd like to include in an article, with a non-scientific source that you'd like to cite, but which you think is deprecated under this guideline? Or are there no actual problems in practice, but you just don't feel like this guideline sufficiently represents your personal POV about the field of medicine in general? WhatamIdoing (talk) 19:53, 24 November 2008 (UTC)

I understand that intention regarding the press, and I'm not talking about deprecating. Those aren't my words, they're quotes from sources. I don't think the lack of a more comprehensive guideline to help editors find/assess sources is irrelevant. The real problem is that this guideline frames itself as about medicine and the medical, and it privileges medical/biomedical journals as "ideal" or "natural", and it guides people towards medical standards & databases. But then there's this bait and switch(caption bill?) (I don't mean in the deliberate advertising sense, just logical structure) where the terms "science" and "scientific" get conjoined to medicine & medical, and thus the implicit claim that there are medical sources which constitute the scientific facts (not necessarily, in fact), and then the "non-scientific" - actually a vast realm of non-medical science and factual perspective (as sourced above). EverSince (talk) 11:00, 25 November 2008 (UTC)

So you haven't actually encountered a situation in a live article in which this guideline, as written and reasonably interpreted, is actually causing any problems? This is just a hypothetical, somebody-might-misunderstand issue? WhatamIdoing (talk) 18:52, 25 November 2008 (UTC)

No it's not about potential misunderstanding of what the guideline says, it's bias in what it actually does state - which several editors in various ways have repeatedly identified over a long period of time now and which I've again tried to outline and source above. Are you disagreeing that it's biased, and if so how, or are you suggesting it doesn't matter? It's not necessary to sidetrack into trying to establish examples of institutional bias in order to address its presence in policies (and also, btw, in the favored citation template that doesn't accept DOIs & doesn't really seem to work with URLs, but only Pubmed IDs for articles). EverSince (talk) 11:58, 26 November 2008 (UTC)

Generally, I favor writing guidelines so that they can be correctly interpreted by an idiot, because if you're writing, for example, a school weapons policy, it's pretty safe to assume that at some point there will be a pointy-haired idiot interpreting the policy. (True example: most American schools have a weapons policy that technically requires them to report to the local police department that their own police officers carry duty weapons every single time any officer sets foot on campus.)

However, in this case, I'm leaning towards a "ain't broke/don't fix" approach. The guideline does not supersede the normal rules. It is meant to provide helpful advice in limited circumstances. Its limitations are apparently clear to everyone, because nobody has reported any actual problems. So I don't see any point in adding a paragraph that explains what everyone already seems to know (e.g., that government policies towards people with mental disorders aren't scientific facts or figures). WhatamIdoing (talk) 17:58, 26 November 2008 (UTC)

I agree guidelines should be as simple as possible. I note it has previously been alleged that this entire guideline represents instruction creep by trying to detail how to implement policies. I understand from what you are saying that you don't think it does so in a biased way, but is at most limited, in ways that are appropriate for Misplaced Pages and not significant. I don't understand the last sentence as I do'nt see who has suggested adding a paragraph along those lines.

While that may be your view, it doesn't specifically address/refute the specific points that have been raised and reasoned and sourced, regarding bias and policy conflicts in the guideline (e.g. the privileging of medical journals/databases over non-medical ones; outlining typical flaws in press coverage but not about typical flaws in the medical literature). I don't see how it can be said that correcting those would necessarily make the guideline more complicated. And again I think it is unreasonable to now suggest that examples of problematic impact are required before something in the guideline can be changed (and I'm not thereby saying there aren't any). EverSince (talk) 20:33, 26 November 2008 (UTC)

Sorry, but that last point doesn't sound right to me. Every change I've made to this project page has been motivated by a real problem in a real article, a problem that I could (and often did) point to when explaining why the change was useful. As far as I can tell, no specific changes are being proposed now, if any are eventually proposed, I suggest accompanying them with specific examples of why the changes are useful. Eubulides (talk) 21:12, 26 November 2008 (UTC)

Is the issue that these guidelines are biased in favor of the medical literature? Press reports are used for sources in medical articles by well meaning editors. An explanation of why news reports are not good sources for medical statements addressed that frequently found problem. To get into flaws in the medical literature, methodological or whatever, is a huge topic unto itself. The guidelines do address possible misuse of medical literature by distinguishing between primary, secondary and tertiary sources, as well as stressing the importance of using recent sources, review articles etc. —Mattisse (Talk) 22:04, 26 November 2008 (UTC)

Therapeutics Initiative

Wondering what others think about the Therapeutics Initiative as a reference source for medical articles. Another editor disagrees with its use. I presume this would be classified as a secondary source.

http://ti.ubc.ca/en/letter69

--Doc James (talk) 22:10, 31 October 2008 (UTC)

A quick reaction: that source looks reliable. It's peer-reviewed and it is a secondary source. However, it's not a medical journal in the usual sense (it's not PubMed-indexed, for example), and it would be better to cite its sources directly. Its References section looks good. Eubulides (talk) 22:21, 31 October 2008 (UTC)

I assume that you mean "it would be better to actually find and read and cite its sources directly"? WP:SAYWHEREYOUGOTIT still applies. WhatamIdoing (talk) 01:33, 1 November 2008 (UTC)

Yes, that's what I meant, and thanks for clarifying. Eubulides (talk) 02:02, 1 November 2008 (UTC)

A researcher and university professor (ICBSeverywhere) has taken issue with an article from this source and written at length finding fault with this citation and the called it misleading. She also stated, The "Therapeutics Initiative" IS an anti-pharm activist group. She posted once near the bottom of the thread and I quoted a personal e-mail about the same topic up a little higher in the thread. http://en.wikipedia.org/Wikipedia:Mediation_Cabal/Cases/2008-10-09_Attention-deficit_hyperactivity_disorder#Lets_resolve_one_issue_and_go_from_there Ironically, this issue came to light at Doc James Med Cab. http://en.wikipedia.org/Wikipedia:Mediation_Cabal/Cases/2008-10-09_Attention-deficit_hyperactivity_disorder --scuro (talk) 05:40, 11 November 2008 (UTC)

it's a tertiary source primarily summarizing other reviews. The members of the review panels do not impress me as necessarily being authorities--and they say they use the same panel for all drugs whatsoever. DGG (talk) 18:17, 4 December 2008 (UTC)

Problematic article

The Aspartame controversy article has some pretty lousy self-published or non-PubMed sources. It needs a good thinning. The whole controversy was started by one woman, and she's the one who keeps it alive, but she's not a reliable source in any sense, and her supporters (a few radical fringe MDs) aren't good sources either. -- Fyslee / talk 02:19, 1 November 2008 (UTC)

This "one woman" claim is blatantly not true, the controversy has been going on since the early 1980s. By the way, the article is about a regulatory and political conflict. This article is only partially about medicine/science: NPOV trumps SPOV. MaxPont (talk) 17:58, 19 November 2008 (UTC)

Well, that shouldn't be an issue: news sources discuss the regulatory/political issues, whereas scientific sources are most appropriate to discuss the scientific issues. Seems pretty straightforward. MastCell  19:59, 25 November 2008 (UTC)

sources that are only available through paid subscriptions and not mentioned anywhere else

I have found sources that are only available through paid subscriptions. When one does a google search no other mention of the article can be found beyond the links to subscription service. Is that an acceptable source?--scuro (talk) 05:45, 11 November 2008 (UTC)

That depends. "Subscription" is somewhat orthogonal to "reliable". "Not mentioned anywhere else" has a weird whiff, but could be OK. Can you be more specific? Eubulides (talk) 06:14, 11 November 2008 (UTC)

Subscription journal articles are invariably available free in major libraries, and can almost always be obtained in interlibrary loan through any public or school library. They have always been accepted as references in Misplaced Pages, just as printed books have. WP is not an encyclopedia limited to things one can research without using libraries. There are a few cases of purely electronic subscription-based services that are not available otherwise, and these might have some problems--the situation also occurs with some financial services and newsletters, especially market research newsletters, which are in practice not available to the public in any reasonable way. If these were proposed as references they would have to be individually considered--in some cases we might simply not regard the material as actually published or reliable. But journal articles, it does not make any difference--be sure to cite the printed version also, which you can get from the reference, or, if not, from PubMed. DGG (talk) 09:25, 23 November 2008 (UTC)

It is a difficult issue. Quite often the results of journal articles are taken out of context and used in a misrepresentative way in an article. I find this commonly in the use primary sources in medicine-related articles, but also with review articles when I have access to the original. I do not know what the solution is but I think it is major problem. I do not have access to off-line library sources, not being a student and working hundreds of miles from land. —Mattisse (Talk) 19:17, 25 November 2008 (UTC)

Just ask someone with full-text access to the citation to verify the claims made on Misplaced Pages. A lot of editors have this sort of access; you could ask at WT:MED as a starting point. MastCell  19:56, 25 November 2008 (UTC)

Hmm, thanks, WP:MEDRS suggested only WP:LIBRARY for that; I made this edit so that it now also suggests WT:MED. Eubulides (talk) 20:10, 25 November 2008 (UTC)

Yes, although in practice I have never found sourcing help there. —Mattisse (Talk) 21:38, 26 November 2008 (UTC)

a montage of correspondence, on reviews and citable sources

I've been corresponding with a researcher about the topic of reviews. I've collected her thoughts and organized them, taking ideas from different e-mails and stringing them together. Hopefully I have done her justice. She has broadened my knowledge about quality of sources and I thought some may find what she has to say of interest.

Review articles just review the literature, so they are not better sources than research reports; they are just a good place to get a general overview of what's new (when they are good). Research findings are primary sources, so they are always superior. If you can read the report, you can evaluate the validity of the finding first-hand. Reviews are hearsay. Reviews are excellent sources - when they are published in peer-reviewed academic journals. In my field, for example, there are entire journals devoted to this kind of work. They have names like "Current Directions in..." and "Annals of..." and are published by organizations like the American Psychological Association and the Association for Psychological Science. Any literature is static, too, and reviews are meant to summarize the recent literature.

The problem is that the term "review" could be used to describe any piece of crap. Anyone can WRITE a review. Not just anyone can get a literature review PUBLISHED (at least in a "real" journal). Everybody does literature reviews as part of graduate education, but published review articles are written by individuals that have published several important findings in the field, especially recent ones. The quality of a review varies just like studies, but they are usually good when published in appropriate journals. There are journals that will publish any article if you pay them. They are academic & sometimes peer-reviewed, but not of high quality. There are journals created by activist groups. They are not academic, not peer-reviewed (by the usual definition of "peer"), and usually qualify as propaganda. NOBODY uses these in science.

Websites are never appropriate in my opinion, unless it's a government organization like NIMH or NSF. Anybody can say whatever they want on a website. Statements and summaries by the NIMH and NSF are some of the best information available with the most thorough and strongest citations. They are not technically the kind of literature review that I described above, but they are reviews in a loose sense.

She would most likely speak to this if there is enough interest.--scuro (talk) 21:58, 29 November 2008 (UTC)

The problem with primary sources is their relative impact. Reviews are excellent in separating chaff from corn; they string together the findings from primary sources into useful theories that can then be tested. In diseases where numerous hypotheses exist, review articles can balance the various hypotheses against each other and consider their plausibility.

Misplaced Pages can't engage in these tasks, and reviews tend to be much more useful in writing encyclopedia articles. I'm not sure whether your source is speaking specifically about the suitability of sources for an encyclopedia.

I have stated before that the choice of review is an editorial decision. That's because some reviews are pieces of stunning brilliance (usually those in the core journals, by avowed experts with wide clinical experience in the subject), and some reviews are pieces of stunning lunacy (usually in smaller journals and by semi-controversial characters who ride their hobby horses). JFW | T@lk 22:40, 29 November 2008 (UTC)

I've never been a fan of primary sources in[REDACTED] medical articles. Furthermore, like the vast majority of wiki users, I don't have the skills to, "evaluate the validity of the findings firsthand". On the otherhand do the vast majority of users have the skills to judge the quality of a review? As noted, quality varies from "crap" to "stunning brilliance". Yet, reviews are labeled as ideal sources. Newspaper articles could be more reliable then some reviews. If Misplaced Pages is an encyclopedia that anyone can edit, shouldn't the article, Reliable sources (medicine-related articles), have better guidelines for contributors to determine the quality of a review?--scuro (talk) 01:22, 30 November 2008 (UTC)

• The advice from the researcher who criticized reviews and preferred primary sources is good advice, if you are a researcher. But it is not good advice if you are a novice in the subject, that is, if you are a member of Misplaced Pages's target audience.
• I agree that it would be better if WP:MEDRS gave good advice about assessing the quality of a review. Its current assessment section, WP:MEDRS #Assess evidence quality is not that useful for that purpose: that section's subject is mostly primary studies, which articles shouldn't be emphasizing anyway. I would support a rewrite of WP:MEDRS #Assess evidence quality to make it more useful to Misplaced Pages editors (WP:MEDRS's target audience). Of course this will take some work. ...

Eubulides (talk) 06:57, 30 November 2008 (UTC)

Agree with Eubulides, though would like to clarify that the advice is only good for researchers doing research. If researchers want to write for Misplaced Pages, they would be advised to choose the same type of sources as everyone else. Read the primary literature, sure, but read and cite the secondary literature on Misplaced Pages, as a general rule. That's the way we can confidently say "X is a common cause of Y.(Smith 2008)". Editors using primary studies may produce horrible non-encyclopaedic prose like "An analysis of 200 patient histories for all hospital admissions in Essex for Y in 2005, showed X to be a common cause.(Jones 2006)" Colin° 09:07, 30 November 2008 (UTC)

Here's the problem with the arguments given by Eubulides & Colin: The goal here is to produce an ACCURATE Wiki entry, not put together a list of "further reading"! How easy a work cited is for the audience to evaluate is entirely IRRELEVANT. Citations are evidence that supports a statement made. Good citations do so. Bad citations do not.

The only reason to discuss the criteria of a "good source" is to make it easier for people who are EDITING the entries to quickly eliminate some statements made (without reading every source first-hand).

Reviews are filtered through the reviewer, so they are ALWAYS hearsay. Research-reports are first-hand, so it is ALWAYS better to cite them. That does not mean that the research is always GOOD; it simply means that the source is less biased than a second-hand source.

ALL editors should cite sources that support their statements, and be prepared to defend those sources, PERIOD.

If you are not able to evaluate your OWN sources, then you should not be contributing to the Wiki entry in the first place. If you are unable to evaluate the sources of other contributors (either yourself or with the help of someone with more expertise in a topic), then you shouldn't criticize it. ICBSeverywhere (talk) 18:33, 30 November 2008 (UTC)

I think you misunderstand the reason why we place so much emphasis on reviews. You are quite wrong that reviews "must be hearsay". Quite the opposite, reviews filter out the "noise" (especially in heavily researched areas, where lots of research leads to dead-ends or is of questionable quality). We cannot allow discussions to get bogged down by claims of one study vs the next - contradictory results are obtained all the time, and reviews are exactly the tool to deal with such phenomena.

I agree that sources need to support their statements, but a corollary of this is that if there is no reliable source (i.e. a review) we must be prepared to drop a certain subject, however much it tickles our collective fascination.

You have very few article edits, but you seem to be fishing in the same pond as Scuro. Could you clarify what the disagreement is about, and how any of us could assist in dealing with this disagreement? JFW | T@lk 20:07, 30 November 2008 (UTC)

I think what is misunderstood here is my use of the word "hearsay". Reviews are reports about the work of others - secondary sources. Your statement that reviews "filter out noise" is a gross overgeneralization, implying that all literature reviews are equal. They are not.

Literature reviews are NOT a way to reconcile findings that contradict one another, although the author may clarify why findings appear to contradict one another, saving a reader some work. Meta-analysis is a better way to do this, however. My point here is that review articles are summaries and everything in them is filtered through the author. They are SECONDARY sources.

I do not understand why anyone would prefer secondary sources, which would make the entry MUCH more removed from evidence than would primary sources. However, I did not, and would not, say that literature reviews should not be cited.

I maintain that ALL sources are open to scrutiny and a "first pass" is the legitimacy of the publication in its field. In science, "peer-reviewed academic journal" is the standard for that first pass. Beyond that, methodology must be examined.

I also think that many contributors to this discussion have misunderstood the purpose of citations. The purpose of citing sources is to provide evidence that what one says/writes is accurate, not to give people something else to read.

I fail to see the relevance of my association with Scuro OR the number of article edits that I have made. ICBSeverywhere (talk) 23:11, 30 November 2008 (UTC)

Your beef is with WP:RS, not with us. Please go there. Encyclopedias shouldn't be examining methodology. JFW | T@lk 23:17, 30 November 2008 (UTC)

I agree with JFW's remarks on reviews. Secondary sources aren't perfect, of course, but they're better than the alternative of relying only on Misplaced Pages editors' judgment. Moreover, we have a Misplaced Pages policy that prefers secondary sources like reviews to primary sources like reports of experiments (see WP:PRIMARY). We can't overturn that policy in this guideline. Eubulides (talk) 20:17, 30 November 2008 (UTC)

The "pond I'm fishing in", is that all reviews are not equal, yet wiki makes little distinction about the quality of reviews. You can have a "crap" review not worth much more then the cost of toilet paper, yet under current guidelines it may be considered an ideal or near ideal source. That ain't right. Also, propaganda often is made to look real. Simply stating that, "secondary sources aren't perfect", ain't the way to deal with this gaping hole.--scuro (talk) 21:21, 30 November 2008 (UTC)

I do not think that it is possible to put together a policy that can address the quality of sources published in peer-reviewed academic journals, but I do think it is entirely possible to limit citations to sources that are peer-reviewed to reduce the amount of propaganda that could occur in a free-for-all Wiki.

That said, NO source is error-free and NO source should be beyond questioning. ICBSeverywhere (talk) 23:11, 30 November 2008 (UTC)

Scuro, could you have a stab at generating a list of useful discriminators that will help editors distinguish between a sterling and a faecal review? JFW | T@lk 22:24, 30 November 2008 (UTC)

She didn't really hit upon one of the biggest problems with reviews in the context of Misplaced Pages. That is, one can cite a review which actually cites one or two little articles. Also, as she hinted, the reader doesn't get the straight facts because the paper is perceived through the possible bias of the reviewer, who may not understand the science going on as well as the author. This can go both ways, but JFW has insisted that the author's credentials (ie publication history) doesn't matter as much as whether a paper is a review or not, or whether it's in a journal that's a household name even among laypeople (BMJ, Lancet, NEJM, ect). An inflexible insistence upon reviews can therefore be harmful to lay readers, who often can't even access the full-text of the review to find out what that paper is basing its assertions on. In academia, citing secondary and tertiary sources is frowned upon for exactly this reason. It adds an extra step finding the real underlying data. Systematic reviews help to overcome this to problem to some degree.

Phenylalanine brought this issue up over at WP:RS/N a while ago. I suggested that he cite the reviews and then indicate what they were basing their arguments on. As you can see from this section of the paleolithic diet, he agreed with me and did that. It adds wordiness, but I think it is often worth it. II | (t - c) 23:38, 30 November 2008 (UTC)

So there is broad consensus that reviews are not a "widget" of uniform quality?..and that[REDACTED] needs to address this issue?--scuro (talk) 12:52, 1 December 2008 (UTC)

All sources vary in quality. These guidelines already prefer reviews from reputable medical journals, which should filter out the "crap" reviews. But really this is not WP's most pressing problem. An analogy: "Eat in a restaurant rather than from a burger van, if you want quality food, safely prepared". We're getting comments above along the lines of "Well I've seen some really dodgy restaurants, and food inspectors often find poor hygiene when they inspect them." Totally ignoring the burger van is using week-old fat and has no running water or toilet facilities for staff. It is easy to find bad WP articles that cite primary sources that superficially appear to support the text. In my experience here, I've yet to see the same problem with reviews being widely misused. I agree with almost nothing in II's first paragraph above, and don't even understand the "An inflexible..." sentence. Academic practice to sourcing isn't relevant on WP and thinking our papers should be researched and sourced the same way as an academic review shows a big misunderstanding over WP fundamentals. II once again claims reviews add "bias", as though the primary research paper contained virgin facts, unsullied by another's opinion. Primary sources are widely misused on WP for at least three reasons:

1. Cherry picking. Picking some studies rather than others.
2. Extrapolation. Taking basic science, animals studies or case notes and extrapolating the findings to the public at large.
3. Abstracts. Editors without access to the paper's full text can often glean something from the abstract in a research paper. The abstract of a review often gives away only the scope. Some of the comments above pontificate about methodology or quality but many primary studies are cited by folk who have only read the abstract. That is no more going to the source of the information than watching a movie trailer is of a film.

ICBSeverywhere, your lack of edits doesn't devalue your opinions but does cast doubt over your experience of applying existing WP guidelines and policy when writing articles. Remember that only a tiny proportion of topics on WP are controversial. Writing an article sourced to reviews is much easier than trying to do so from primary research papers. Most folk disputing WP guidelines have an issue with a controversial aspect of a topic. What is often forgotten is that it is practically impossible to source an entire topic to primary research. WP:NOR does not allow you to fill in the blanks. Colin° 20:31, 1 December 2008 (UTC)

Scuro, I think the person you're talking to doesn't quite grasp the goal here. She writes, for example: "Research findings are primary sources, so they are always superior."

Sure: I want the primary sources. No -- strike that, I want the original dataset, on my own computer, and I'm going to have a long, personal chat with the people that generated it. I'm also going to drop a note to a couple of people that have worked with these individuals, and to a couple of people that work in the same field.

But are primary sources always superior?

Certainly not: If you gave my grandmother a research paper about her high blood pressure, she would be utterly lost.

Here, the goal is not to find out the Truth™. It's to find out what is currently "known". We're writing an encyclopedia. That means that we are assembling and summarizing the state of human knowledge. Secondary sources are the best way to do that. That's why the entire encyclopedia (and not just medicine-related articles) is (supposed to be) based upon secondary sources. Ideally, they'll also be high-quality secondary sources, but as you have noticed, the quality variable is independent of whether the source is primary or secondary. WhatamIdoing (talk) 02:39, 2 December 2008 (UTC)

I have seen many examples of the misuse or primary sources. There are also problems with reviews. The issue can be quality but it can be pov pushing too. I have never seen an example in[REDACTED] of a bogus research paper. I have seen very questionable reviews. As ICB states, anyone can write a review. They are always hearsay. Reviews are easier to manipulate towards a biased point of view. I have also seen reviews from 25 years ago being used as citations. If reviews are a "state of the nation report" on our current understanding about a topic, then they should have a well defined shelf life. To me it just seems that reviews have been put up on a pedestal, that any review will be deemed as good by association to the designation of ideal source. This is the way most contributors see reviews, no matter what the quality. That is not reality, and this will cause problems over time.--scuro (talk) 12:46, 2 December 2008 (UTC)

Can you give some examples of reviews in a quality journal that "manipulate towards a biased point of view"? And why should you think this is "easier" for a review than for a research study? We already recommend against using old sources, so 25 year-old sources would be unlikely to be a good source, review or not. Being a review doesn't exclude the source from any other check recommended by MEDRS, WP:RS or WP:V. For example, a review in a journal of an organisation seeking to promote a particular POV might be dismissed for being a biased publication, as with any source. Even if the world was populated only with high quality reviews and high quality research papers, we'd still prefer reviews as sources. They are different beasts, and there are aspects of reviews that make them vital sources on WP, and those attributes are simply missing from primary studies. Colin° 18:41, 2 December 2008 (UTC)

• "I have never seen an example in[REDACTED] of a bogus research paper." This doesn't match my experience; I often run into uses, or attempts to use, research papers that are highly questionable. A few days ago, for example, another editor wanted to cite Geier et al. 2008 (PMID 18817931) in Causes of autism to support the fringe claim that mercury poisoning a significant cause of autism. This paper is coauthored by Mark Geier, who has serious credibility problems (see Mark Geier #Ethics). I'm afraid this sort of thing happens all too often: editors get excited or interested in a recent primary study of a medical topic and want to throw it into an article, without having the context and quality control that a good review would provide.
• Now that we have a recent example of a primary study misuse, can we also see a recent example of review misuse in Misplaced Pages?

Eubulides (talk) 20:58, 2 December 2008 (UTC)

Dated and low-quality reviews

Okay, on the premise that reviews which are seen as an ideal source and have limitations. These limitations get short shrift on the guideline page. I will attempt to find examples of:

• reviews that contributors used long past their "best before" date
• reviews that are not reviews but more propaganda
• reviews of questionable quality

If other contributors can easily find examples of such reviews, it would be appreciated if you shared that with us. :)--scuro (talk) 12:03, 3 December 2008 (UTC)

I'm not sure that I'd bother looking for outdated reviews, because that's every bit as much of a problem with primary sources as it is with secondary sources. But examples of low-quality and promotional reviews, especially if there are actually good primary sources on that point, would be desirable. Everyone is in favor of killing low-quality and biased references. WhatamIdoing (talk) 19:28, 3 December 2008 (UTC)

Then we are agreed that the limitations of outdated reviews should be spelt out more clearly on the med. reliable source page. Following wiki processes, old reviews can be removed but this can be time consuming and frustrating. It has been a source of conflict in the past. A contributor will find a review and argue that the informtation on the review is relevant, when in reality it clearly no longer is. Clearer guidelines may nip these sort of problems in the bud.--scuro (talk) 20:16, 3 December 2008 (UTC)

Clear guidelines regarding date parameters for reviews would be helpful. It would hopefully give weight when discussing this issue when complaining about an "old review" on an article talk page. I find that editors often don't seem to consider the "best before" date when using reviews as sources. Also, the use of primary sources is prevalent. "Some claim that Blah."<primary source> —Mattisse (Talk) 20:36, 3 December 2008 (UTC)

• WP:MEDRS already says "Look for reviews published in the last five years or so, preferably in the last two or three years." If that's not clear, can someone please suggest a specific wording change that would be clearer?
• It's not that hard to find reviews, even recent reviews, that Misplaced Pages should not cite uncritically. One example would be Nissen & Wolski 2007 (PMID 17517853), published in NEJM no less. This meta-analysis has been heavily criticized; just look at the PubMed record's "Comment in:" field for starters. I'm not saying that the review shouldn't be cited; only that its results should not be presented uncritically.

Eubulides (talk) 21:14, 3 December 2008 (UTC)

The guideline is clear IMO. In addition, I see no issues raised that are specific to reviews. In other words, if one reads this guideline in conjunction with other sourcing guidelines and policy, there doesn't appear to be a problem that needs to be fixed. Remember these are just guidelines. There can be perfectly valid reasons for citing a 10-year-old review. For example, it discusses a notable therapy that nobody (apart from a few cranks) uses any more, but which once had a following. Colin° 21:55, 3 December 2008 (UTC)

Yes, it does tell you what[REDACTED] desires. But, what if a review falls outside of this parameter, which pragmatically speaking is where disagreement usually happens on the talk page. Are there guidelines that tell us when a review is clearly out of date? I remember a contributor getting rather heated because they wanted to use a 1977 review on ECT (http://www.ncbi.nlm.nih.gov/pubmed/900284) to make the case that ECT causes brain damage. Never mind that no one uses devices from that time period currently. This may seem obvious to all of you that a 30 year old review would be highly questionable. But, not everyone editing[REDACTED] has the marked intelligence of those contributing to this thread. I say, spell it out. Granted there are exceptions for every rule, but a general guideline or two indicating what is not acceptable may be just as useful to the garden variety editor, as guidelines which state what is desirable.--scuro (talk) 00:09, 4 December 2008 (UTC)

That is a good example of the kind of referencing encountered. And not every reader carefully looks at the dates of all references and evaluates accordingly. —Mattisse (Talk) 00:24, 4 December 2008 (UTC)

Scuro, the guideline already says that editors should use up-to-date evidence. See WP:MEDRS#Use_up-to-date_evidence. We have an entire section dedicated to that specific issue. Were you unaware of that section? WhatamIdoing (talk) 03:02, 4 December 2008 (UTC)

Perhaps if I used the term "update" the guidelines, that would be more palatable. I did read that section, WAID. It could be clearer. What happens with a review of say 10 years? 20 years? 30 years of age? There are no guidelines there. The section tells us what[REDACTED] wants. It doesn't tell us what is not wanted. And as a contributor who deals with this sort of stuff issue on a regular basis, you inevitably hear, "you make up the rules as you go along". And what can a contributor say at that point? There is nothing to show what[REDACTED] doesn't want. So the newbie reasons if an ideal source can be 5-7 years old, then a review that is 10-20 years is good, and one 30 years is okay. It still is a review after all. We have newbie contributors who thus get turned off of the process of researching information and using wikipedia...just my 2 cents worth.--scuro (talk) 03:25, 4 December 2008 (UTC)

How about if we append "Avoid older reviews." to the end of the first bullet of WP:MEDRS #Use up-to-date evidence? Eubulides (talk) 04:23, 4 December 2008 (UTC)

Simple...sure, it's better then what is there now.--scuro (talk) 04:36, 4 December 2008 (UTC)

OK, done. Eubulides (talk) 04:46, 4 December 2008 (UTC)

On further reflection, I'd be happier with a more general statement. "Avoid older reviews" could be (and should not be) interpreted as "Delete the 1985 review, and add in the 1983 primary paper that the review cited favorably." What we want is more along the lines of "Just because it's a review doesn't mean that it's exempt from the normal rules about using up-to-date evidence." WhatamIdoing (talk) 19:57, 4 December 2008 (UTC)

Likewise, I'm unconvinced by this new sentence. Good use of sources requires editorial judgment and an indepth knowledge of the topic. I've read almost everything of significance written about Tourette syndrome in the last 12 years, and if a five-year-old review is still a top notch, accurate, well written review, there's no reason for me replace it with, for example, a newer NEJM review which is available online and contains an incorrect definition of the condition! Blanket statements about dates aren't as helpful as statements that lend to editorial judgment; I think we can find a better way to phrase this, and don't recommend removing sources based on date alone. SandyGeorgia (Talk) 20:33, 4 December 2008 (UTC)

All good points, thanks, and I reverted that change. Suggestions for better wording are welcome. Eubulides (talk) 21:12, 4 December 2008 (UTC)

These things should not be phrased in terms of rules. This is a guideline. There's going to be wikilawyering when they're phrased as hard rules. Just yesterday I ran into Mattisse saying that a 2002 American Journal of Nutrition review is unciteable because it is not within the 5 year date. Yet this particular 2002 review has free full-text. A 2005 review (PMID 16021987) has essentially the same conclusions, but it lacks full-text. II | (t - c) 20:13, 4 December 2008 (UTC)

What I've done in cases like these are to use a single <ref> and cite both reviews, the newer one first, with the older one marked as being older but freely readable. Something like this inside the <ref>:

• Williams AL, Girard C, Jui D, Sabina A, Katz DL (2005). "S-adenosylmethionine (SAMe) as treatment for depression: a systematic review". Clin Invest Med. 28 (3): 132–9. PMID 16021987.{{cite journal}}: CS1 maint: multiple names: authors list (link) A freely readable but older review supporting the same claim is: Mischoulon D, Fava M (2002). "Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence". Am J Clin Nutr. 76 (5): 1158S – 61S. PMID 12420702.

As it happens this particular example is not a good one, as the first source is actually freely available on the net via an authorized copy, so that a simpler citation would be:

• Williams AL, Girard C, Jui D, Sabina A, Katz DL (2005). "S-adenosylmethionine (SAMe) as treatment for depression: a systematic review" (PDF). Clin Invest Med. 28 (3): 132–9. PMID 16021987. Retrieved 2008-12-04.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Eubulides (talk) 21:12, 4 December 2008 (UTC)

Argh! I'm with Sandy (and with II) on this one. Editorial judgement trumps "rules". I support a general warning to stick to modern sources ceteris paribus, but if an older source is better we'd be doing the reader a disservice by sticking to a newer source that happens to be junk. JFW | T@lk 20:55, 4 December 2008 (UTC)

Yes, thanks, I reverted that bit of advice as mentioned above (just before you made the comment). Eubulides (talk) 21:12, 4 December 2008 (UTC)

"This statement is more than five years old and is provided solely for historical purposes. Due to the cumulative nature of medical research, new knowledge has inevitably accumulated in this subject area in the time since the statement was initially prepared. Thus some of the material is likely to be out of date, and at worst simply wrong. For reliable, current information on this and other health topics, we recommend consulting the National Institutes of Health's MedlinePlus". -- This is an example of a blurb from the NIH.

I understand why[REDACTED] wants reviews in the last 5 years. I understand that some reviews a few years older might still have value. I understand that in inactive fields, reviews have longer shelf life. I understand that seminal reviews also have value. But generally speaking, at some point a review is no longer a review. Time makes the review obsolete and it becomes archival history. This is clearly a time sensitive limitation that taints information and MEDRS states nothing about this. If[REDACTED] reflects societies current understanding about a topic, what are we doing romantically clinging onto the notion of a review as an ideal source, which allows scientific understanding from a generation or two ago, to meet little resistance from getting onto the page? --scuro (talk) 02:54, 5 December 2008 (UTC)

Here is the passage that Scuro want to remove from the ADHD "The controversies have involved clinicians, teachers, policymakers, parents, and the media with opinions regarding ADHD that range from those who do not believe it exists at all to those who believe that there is genetic and physiological basis for the condition, and also include disagreement about use of stimulant medications in treatment." It is in the past tense and is not a review per say.

Here is the reference. http://www.ahrq.gov/clinic/epcsums/adhdsum.htm

The reference from the therapeutics initiative is there aswell that is contested. Doc James (talk) 03:39, 5 December 2008 (UTC)

That's a nice little tidbit Jmh, it might even have some merit but your wrecking my train of thought here. I am talking about reviews in general, and specifically about how[REDACTED] MEDRS makes no mention about one of the chief weaknesses of reviews. Over extended periods of time they can become virtually useless, and although guidelines suggest around 5 years max, what is the unknowledgeable contributor to make of an "ideal source" that is a fair bit older? --scuro (talk) 05:31, 5 December 2008 (UTC)

Scuro, I have two points for you:

• A review stays a review, even if it's a hundred years old. It does not quit being a review when it gets out of date. It does not magically transform into primary research, or into tertiary summaries. It remains a review. What it quits being is a good source for current information. These are entirely separate considerations.

• This guideline advises -- note that this is a direct quote from the guideline -- "Look for reviews published in the last five years or so, preferably in the last two or three years". Now why do you keep asserting that "MEDRS states nothing about this"?

--WhatamIdoing (talk) 05:33, 5 December 2008 (UTC)

Yes, a review, is a review, but over time, excellent often does morph into questionable or even useless. Take the 1970's ECT review, where they no longer use that machinery currently. That review is now virtually useless. For us it makes sense not to use it. But what of vast majority of the scientifically uniformed contributors? What will they think when they see "good evidence" from a review that is 10, 20, or 25 years old? A review is an "ideal source" after all. Isn't a goal of wiki to educate? When I read MEDRS I see that much of what is in that article is educational. The article tells how to determine what makes a good review. Why can't that same page also educate the reader about the chief limitation of a review?--scuro (talk) 12:57, 5 December 2008 (UTC)

Because age isn't the "chief limitation of a review" any more than it is an aspect to consider for any source, be they primary research papers, books, newspapers, etc. Please credit our "scientifically uniformed contributors" with some common sense. I think this "issue" has been discussed enough. Colin° 15:13, 5 December 2008 (UTC)

Not sure what you mean about crediting "scientifically uniformed contributors". A current FAC uses a year 2000 source for data on medication types, strategies and doses. The source may be originally a good one, but many current medications in use today were not being used in the year 2000 and prescribing practices have changed since then. Is this what you mean? —Mattisse (Talk) 16:02, 5 December 2008 (UTC)

And therefore, your argument is that the topic being discussed has changed significantly in the last 8 years and so a year-2000 source is unlikely to be very useful. What has this got to do with medicine-related articles or reviews that isn't equally valid for any topic on WP that is still actively studied? An eight-year-old article on mobile phone technology is also unlikely to document the "state of the art" accurately any more. Colin° 16:59, 5 December 2008 (UTC)

I am referring to the origin of this thread regarding dated reviews. So you are saying that the issue of an 8 year old review for medications that do not include the most recent and frequently used is irrelevant, Colin? Don't understand this argument of yours. —Mattisse (Talk) 22:02, 7 December 2008 (UTC)

I'm saying that out-of-date sources is a general problem that isn't medicine-specific. Let's try to focus MEDRS on problems that are specific to this area. This issue you raise isn't "irrelevant" and it sounds like your example is a genuinely problematic use of old sources -- but that isn't a problem that MEDRS needs to rule on. Colin° 22:16, 7 December 2008 (UTC)

(Undent) Scuro, this guideline already says that recent reviews are preferable. Now why are you insisting that this guideline doesn't say that recent reviews are preferable? WhatamIdoing (talk) 19:16, 5 December 2008 (UTC)

Gray areas

"Because age isn't the "chief limitation of a review" any more than it is an aspect to consider for any source, be they primary research papers, books, newspapers, etc". - as I understand it, the function of a review is to summarize what is known about a topic, at any given moment in time. MEDRS speaks of the review cycle. Renewal, is part of that cycle. New reviews are needed as our understanding about a topic expands. A review documents recent findings and then more research is done. It follows a cycle. Primary research can get dated by other research, BUT time is not inherently woven into the structure of research. That is a major difference.

"Scuro, this guideline already says that recent reviews are preferable. Now why are you insisting that this guideline doesn't say that recent reviews are preferable"? - Well lets look at grey areas or what the guideline doesn't cover. Lets say there is an old review on a specific topic. Lets also say that there has been primary research done since then but no new review. Which is the better piece of evidence? Is the review still the better source or is the primary research better? How about another example. What if there are several reviews that state different things? Does the age of the review matter in such a case? Can the viewpoint of an older review be used for "minority opinion" if it conflicts with a recent reviews? How about if a VERY OLD review states something that several new ones don't even touch upon. Is that unique bit of information good or must we see that in context of what is known since then? Before you come up with your answers, here is another question...are the answers obvious to all? The guidelines could possibly miss these issues because they only focus on what is wanted from reviews. --scuro (talk) 14:28, 6 December 2008 (UTC)

• I don't think the guideline can come up with advice that is definitive for every circumstance; there will always be some gray areas. We can make gray areas smaller, but we have to do so carefully, as the cost of shrinking gray areas is often greater than the benefit.
• For all your examples, the answer is, "it depends". In your first example, if the review is quite old and says X, and if reliable primary studies since 2006 all agree on not-X in their previous-work sections (because of new evidence that came out in 2006), then the article shouldn't claim X and cite the review. Conversely, if the review was done last year, has a lot of authors at respected institutions, and is published in a leading journal on its subject, whereas the more-recent primary studies were all published by fringe sources, then you go with the review.
• To move this discussion forward, it would help if specific wording-changes could be proposed to address the concerns. I tried to do that with a simple "Avoid older reviews." and got shot down for the good reasons cited above. Can you propose better wording?

Eubulides (talk) 19:57, 6 December 2008 (UTC)

Scuro, you're making points similar to the ones that Paul gene and I (among some others) made earlier. There's nothing about a review per se which makes its conclusions more reliable than the conclusions of a research article. Reviews are less common than research articles, so they can be dated. And research articles are not just primary sources, they are also secondary sources. Reviews are also sometimes very general, and when a review is general, it has to stuff a bunch of information in only a few pages. That means it gives it a light treatment -- just a sentence or two -- when sometimes we want to give topics a detailed treatment on Misplaced Pages. Research articles tend to give focused attention to a particular line of research. Their introduction/discussion sections together often give fairly lengthy reviews of the topic. Scuro's example of areas where reviews are dated and research articles are recent is a good one. Eubulides suggests that we should only use such research articles if they "all agree", but that imposes an unrealistic burden upon those wishing to present well-sourced information on Misplaced Pages. My suggested wording would be: "Research articles may provide secondary information on an area of research. Citing these research articles may be preferable if reviews on the topic are dated or too limited in scope." The concern, as always, is that one might cite some "fringe" research article for an overview of a topic. But this concern applies to reviews as well, and shouldn't invalidate citing good information. II | (t - c) 22:50, 6 December 2008 (UTC)

It might be worthwhile backtracking to why we've focused on review articles. The bottom line is that we don't want editors to use their own prioritization and synthesis of the primary literature - it's too easy for an even moderately sophisticated editor to mine the literature and create a "reliably sourced" article that violates WP:WEIGHT. One workaround to prevent this sort of abuse (which I've found to be relatively common) is to insist that our use of the primary literature mirrors the synthesis and weighting applied by experts in the field. Review articles give us a window to see what experts in the field think about the state of the primary literature. They're not magical or infallible, and they're probably not even necessary for every single sourcing question - but reviews are very useful to prevent editorial mining and abuse of the primary literature to circumvent WP:WEIGHT. If that's a problem, then we should go to review articles to solve it. If there's no such problem, then there's no problem. I think this all falls under the rubric of Misplaced Pages:Use common sense. MastCell  23:37, 6 December 2008 (UTC)

I'm not sure I agree. Citing a bunch of research articles individually to synthesize a point involves much more work than to than citing one research article which makes a fairly bold claim, sometimes even secondarily through its own synthesis. I feel like the bigger concern has to do with undue weight. I think combating this sort of undue weight through restricting the citation of research articles is not right. If I felt like it, I could cite both recent reviews and research articles in decent journals which say there's a connection between thimerosal and autism. The argument would not be that these are original research, but that it would be "undue". Anyway, what do you think about my suggested wording above? I don't really like relying upon common sense in what is really a bureaucracy. People cling to rules. II | (t - c) 07:30, 7 December 2008 (UTC)

ImperfectlyInformed, you've made this point over and over, and I continue to disagree that the "introduction" and "discussion" sections of research articles should be put on the same level as review articles. They tend to be focused particularly on information directly relevant to the topic under research, and may completely ignore alternative theories. This is not a rare occurrence.

If a review makes a bold claim, and the evidence doesn't stack up, then this should be addressed through the usual channels. You are correct that reviews sometimes make bold claims based purely on clinical experience and "gut feeling" of clinicians who have studied a condition for most of their career. If this ends up in the Misplaced Pages article, and others disagree that this should be included, it can be discussed on the talk page. On the whole, that is only a minor problem with reviews.

People do indeed cling to rules, which is why we have WP:IAR. JFW | T@lk 07:49, 7 December 2008 (UTC)

If you read my suggested wording, it doesn't say that research articles and review articles should be given the same priority. It says: "Research articles may provide secondary information on an area of research. Citing these research articles may be preferable if reviews on the topic are dated or too limited in scope. II | (t - c) 08:13, 7 December 2008 (UTC)

Reviews also have degrees of quality. A systematic review for example is often better then a literature review. The Cochrane collaboration being one of the most famous sources of these.

Systematic reviews that are recent are preferable to a single research article. As would large reviews from groups such as the NHS. I have seen research articles selective pick from the available research only that that supports the conclusions of their study.

If a review or primary research article is wrong /dated then it should be easy to find other sources that refute its conclusions. And this should be the discussion that takes place on the talk page of the article. WRT the review which showed ECT caused brain damage one could easily word things: "a review from 1975 indicted that ECT might cause brain damage, further research however showed that this was not the case" etc. This type of info might be interesting under the history section of an article. One acknowleges the review and then refutes its conclusions.--Doc James (talk) 14:23, 7 December 2008 (UTC)

A few points on the above (sorry if a little off-topic)

1. These are guideline for writing a comprehensive medical article, not just for those parts that are contentious. To that end, a systematic review is often not "better" (in terms of usefulness, not quality) than a literature review, because its scope is very narrow. They are very good at what they do, but one is unlikely to be able to source an FA-comprehensive article to Cochrane and his mates.
2. Try to avoid referring to medical literature in the article body. Unless a paper is itself highly notable (e.g., Wakefield's infamous MMR), it should not be mentioned (as a paper). To the reader, a "review" is a guide to what's on telly tonight -- so avoid that jargon. A review is just a form of literature. Would you say "a paperback from 1975..."? I'm unable to read the full text of the review on ECT, and know little about the subject, but it looks very much like that review is of case studies and is very explicitly one author's opinion. Why should it be mentioned at all?
3. Prefer to state the facts with an appropriate level of confidence as supported by your sources. The reader wants to know if ECT causes brain damage. Not whether one author said this and another author said that. Or if one small study found this or a larger study found that.
4. If it is necessary to refer to the research, talk about studies and meta-analyses (though that term usually needs explained) rather than papers and reviews. There are places where historical, recent and ongoing research should be explicitly discussed in a medical article, but they are fewer and more discrete than is typical on WP (both Wikidocs and POV pushers are guilty here IMO).

Colin° 19:10, 7 December 2008 (UTC)

Re the proposed wording "Research articles may provide secondary information on an area of research. Citing these research articles may be preferable if reviews on the topic are dated or too limited in scope.": this gives too much leeway in the troublesome direction of editors citing primary studies instead of reviews. For example, in the scenario where a high-quality mainstream review was done last year, and more-recent research articles were put out by fringe sources, an editor could argue that the fringe sources trump the review. How about the following wording instead? It would be inserted after the 3rd bullet of WP:MEDRS #Use up-to-date evidence.

• In a lightly-researched area lacking recent reliable reviews, it may be possible to summarize non-review sources; however, extreme care should be taken, as these sources often tend to focus narrowly on one subtopic to the exclusion of alternative theories, and it is all too easy when combining this material to synthesize it to advance a position. It is often better to say nothing, or to say that evidence is lacking, than to attempt to summarize a poorly-reviewed medical area.

Eubulides (talk) 20:24, 7 December 2008 (UTC)

I'm not keen. This page can guide readers to what is best (and therefore what is "better" when comparing sources offered by editors who are in conflict) but we should be careful not to restrict editors beyond what policy requires. I would not want to see this guideline being used to remove text sourced, for example, to an NHS page or a reputable charity information page, merely because it wasn't a review in a peer-reviewed medical journal. While an editor without access to medical journals is unlikely to achieve FA, they should not be excluded from contributing. There are many medical articles that are utterly unloved and could benefit from extra material. emphasise the spectrum of quality, and range of article types, rather than just say "use this; avoid that" black & white. Colin° 21:11, 7 December 2008 (UTC) (Though I think some sources (newspapers) are so far down the quality spectrum that "avoid" is quite justified. Colin° 21:12, 7 December 2008 (UTC))

"I'd like us to emphasise the spectrum of quality, and range of article types".-I like that better already. Not all reviews are equal. If we get beyond the ideal review and inform the reader of indicators that may demonstrate reviews further down on the spectrum, I think that is a step in the right direction...stuff like that would be helpful to me as an editor and I am sure to others.--scuro (talk) 00:29, 8 December 2008 (UTC)

Here is a crack at spectrum analysis of determining quality in Reviews.

not peer reviewed <--> peer reviewed by independent body

not published <--> published in well-known and well-respected academic journal

reviewed literature is not academic <--> reviewed literature comes from well known and well respected journals

review is several or more review cycles old (unless it is a seminal work) <--> review from previous or last review cycle

author's focus is narrow <--> authors focus is wide

author is unknown in field <--> author is widely known expert in field

Whadya think?--scuro (talk) 04:30, 9 December 2008 (UTC)

Some points are unnecessary. Peer review is usually anonymous but also independent; it would be tautological to insist on "peer review by independent body".

How do you propose to establish whether an author is known in his field? Could this not simply be something we can resolve by consensus, rather than trying to cast this in stone? JFW | T@lk 10:31, 9 December 2008 (UTC)

What may be obvious to you or me, many not be obvious to the majority of contributors. Probably a majority of contributors have no real idea what a review is. This is why the MEDRS article is most likely largely an educational article. Such a guideline would educate but it would also help any contributor determine what a bad "review" is. Are there not examples of reviews, or something that walks and quacks like a review, where the "peer review" is neither anonymous or independent? Consensus is not always an easy thing to achieve, especially when a majority of the contributors do not have the background to make an educated judgement. Couldn't a guideline based on a model such as this save countless wikipedian man hours and make articles more accurate? I agree that is not a simple task to determine whether an author is well known in his field. --scuro (talk) 12:45, 9 December 2008 (UTC)