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Acupuncture: does it alleviate pain and are there serious risks? A review of reviews is certainly a very reliable source. However, we say multiple times in the article that it found that real acupuncture was no better than sham acupuncture for pain (presumably all kinds of pain). But I couldn't find any statement to this effect in the paper. Could someone point out where in this paper it says that real acupuncture is no better than sham acupuncture, with respect to pain in general? Everymorning talk 14:41, 25 March 2015 (UTC)[reply]

Ernst, E.; Lee, Myeong Soo; Choi, Tae-Young (2011). "Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews" (PDF). Pain. 152 (4): 755–764. doi:10.1016/j.pain.2010.11.004. ISSN 0304-3959. PMID 21440191.

"...but real acupuncture was no better than sham."[1] Page 762. This is about "reducing pain" in general. QuackGuru (talk) 18:20, 25 March 2015 (UTC)[reply]

I came across a critique of this study which I think should be added in: The critique is by Dr. William Morris and he addresses almost every aspect of Ernst's review of reviews. We have critiques by Novella and others of acupuncture studies throughout the article, yet we don't have one yet for probably the most cited source in the entire article. Where should we put this? LesVegas (talk) 20:47, 25 March 2015 (UTC)[reply]

A lot of reviews are critiqued but they are not MEDRS compliant. Nothing new here. QuackGuru (talk) 20:49, 25 March 2015 (UTC)[reply]

Actually, we cite David Gorski critiquing reviews from a blog, Science Based Medicine. A blog like that isn't MEDRS, neither is Quackwatch. But we allow sources like these because they're not making medical claims. A critique of a review doesn't have to be MEDRS, unless it's actually making medical claims. So I don't see why we can't have this source if we're going to allow Science Based medicine to do the same thing. LesVegas (talk) 21:00, 25 March 2015 (UTC)[reply]

Fringe journal. Falls afoul of WP:FRIND for starters. Alexbrn ^{talk|contribs|COI} 21:06, 25 March 2015 (UTC)[reply]

The Acupuncture Today (Huntingt Beach) magazine or whatever is rubbish. QuackGuru (talk) 21:11, 25 March 2015 (UTC)[reply]

WP:FRIND could also be applied to science based medicine or Quackwatch. I don't think you guys can have it both ways. You can't critique only pro-acupuncture studies with the same level of sources as what you're disallowing. Should we remove the critiques from web blogs?LesVegas (talk) 21:14, 25 March 2015 (UTC)[reply]

Not so, you're falling into the WP:GEVAL trap; SBM and Quackwatch are mainstream sources for fringe subjects and good for us; fringey journals are generally not useful. Alexbrn ^{talk|contribs|COI} 21:27, 25 March 2015 (UTC)[reply]

Ah, but a quick google search shows me that SBM did a piece on the Acupuncture Today criticism of Ernst. While I disagree with your rationale, by it, I could critique Ernst from Acupuncture Today from SBM, but not directly from Acupuncture Today. So either way, the critique would go in. So how do we proceed fro here? LesVegas (talk) 21:49, 25 March 2015 (UTC)[reply]

"In essence, Morris seems to be arguing that acupuncture is even less safe than Ernst et al. depicted."[2] I don't think this adds much to the page. QuackGuru (talk) 21:53, 25 March 2015 (UTC)[reply]

No, and especially not when a poor conclusion about Morris's article was drawn like this. But a statement like "“For data on efficacy, it doesn’t provide information about how the studies were controlled" would add quite a bit. LesVegas (talk) 22:05, 25 March 2015 (UTC)[reply]

Everymorning, LesVegas, Alexbrn et. al. -- in context, one sees that QuackGuru's quote (real = sham) isn't a finding of Ernst's review of reviews, but rather the finding of one particular, high-quality trial which he believes is more accurate. See p.761, §4 Discussion (1st para suffices), and then 1st para on p.762. --Middle 8 (contribs • COI) 00:45, 26 March 2015 (UTC)[reply]

Oh, you're right. Now the question is why do we have a primary source so prominently displayed? So you're saying this was discussed before? What was the argument there? If it was only that it was more accurate, that would seem to be a problem.LesVegas (talk) 02:47, 26 March 2015 (UTC)[reply]

"...but real acupuncture was no better than sham."[3] This is a finding from the review. QuackGuru (talk) 04:58, 26 March 2015 (UTC)[reply]

QuackGuru - Not in context, per just above. Don't IDHT please. --Middle 8 (contribs • COI) 05:43, 26 March 2015 (UTC)[reply]

LesVegas - Yes, this has been discussed before, with the most recent, broad consensus (note that QuackGuru joined it) being to use this wording. But that wording was so awkward that editors kept "simplifying" it (in good faith), changing the meaning. Good alternative suggestion: [4] --Middle 8 (contribs • COI) 05:43, 26 March 2015 (UTC)[reply]

This is a quote from the source: "...but real acupuncture was no better than sham." It is in context. QuackGuru (talk) 05:50, 26 March 2015 (UTC)[reply]

Middle 8 was commenting about User:RexxS rather than focusing on content regarding same sentences way back in July 2014. See RexxS's ad hominem & general drama is a confession of weakness. See Wikipedia_talk:WikiProject_Medicine/Archive_51#Acupuncture_again. Months later, Middle 8 is continuing to argue over the same text. For example, Middle 8 is accusing me of IDHT even though I directly quoted the source to verify the claim. QuackGuru (talk) 06:59, 26 March 2015 (UTC)[reply]

Who cares about >6 month old drama? I can link to hot stuff others have said too; so what? It has nothing to do with WP:ENC. You should stop trolling, and do as others are doing here, and focus on substance. This is a legit content dispute; it's a flawed consensus -- one that another editor brought up BTW -- and on WP we can and should revisit content to whatever degree necessary till we get it right. Alert editors will note that you're insistently quoting just one part of a sentence, and thus failing to address the issue of context (hence the IDHT). --Middle 8 (contribs • COI) 11:51, 26 March 2015 (UTC)[reply]

This is really a mess. Ernst did not conclude that real acupuncture was no better than sham (but only alludes to it in a study) yet, not only do we say this in the article multiple times, (misleading the reader) but we also mislead editors here. Recently we had a long debate w/ Kww about this, and he was under the mistaken impression that Ernst concluded this and even wanted to exclude other research that was contrary to Ernst's "statement." Talk about an out of control snowball! How did it even get this way in the first place? And what do we do from here? Should we just delete this altogether? We could state it's an outcome from an RCT but that opens the door to using primary sources in the article, and I highly doubt editors here would like everyone to be doing that. But above all, we can't have primary research being quoted out of context as though it was a conclusion from a review. LesVegas (talk) 18:06, 26 March 2015 (UTC)[reply]

Later in the paragraph Ernst et al states "Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham". The review is not quoting other studies, but is their own drawn conclusion, not referenced to any specific source, but a statement of what they had found in reviewing the current evidence. As editors we have to adhere to follow what reliable WP:MEDRS sources say, not place our own WP:SYN interpretations on them. QuackGuru (talk) 19:22, 26 March 2015 (UTC)[reply]

LesVegas, I misinterpreted nothing. Ernst and Vickers both came to the conclusion that the difference between acupuncture's total effectiveness and the placebo effect for acupuncture was between small and non-existent. The only argument science has over acupuncture is whether it's ethical to prescribe a treatment that is primarily placebo on the off-chance that the small delta is an actual benefit instead of a statistical anomaly.—Kww(talk) 20:07, 26 March 2015 (UTC)[reply]

Kww, nobody is debating what Ernst or anybody else thinks about the state of acupuncture research today, the issue is what did he say in his review of reviews spanning 2000-2009, when study controls weren't as sophisticated. [5] --Middle 8 (contribs • COI) 01:35, 27 March 2015 (UTC)[reply]

I already explained this. Editors are not allowed to conduct their own interpretation of reviews. QuackGuru (talk) 01:39, 27 March 2015 (UTC)[reply]

PDF here. See p.761, §4 Discussion (1st para suffices), and then 1st para on p.762. --Middle 8 (contribs • COI) 01:50, 27 March 2015 (UTC)[reply]

I'm sorry if I misquoted you, or misremembered the conversation here a couple of months ago, Kww. But yet again, you interpret Vickers and claim 'science' says when it's not the case at all. One thing I do remember clearly from that conversation long ago was that you never commented on the Hopton/Macpherson source which stated that "since acupuncture is more effective than placebo shouldn't the research towards shifting research priorities away from asking placebo-related questions and towards asking more practical questions about whether the overall benefit is clinically meaningful and cost-effective?" anyway, back to current matters: what are we going to do about the misrepresented Ernst comments? LesVegas (talk) 01:49, 27 March 2015 (UTC)[reply]

We need to correctly represent the CONCLUSION of Ernst's review, not quote his statement about a primary source. QG we've had this conversation before, and I recommend you carefully avoid misrepresenting the source. Do the right thing.Herbxue (talk) 15:57, 27 March 2015 (UTC)[reply]

Please read this comment. This was a conclusion of the review not a primary source. As editors we don't read different paragraphs and come to own personal opinion of the review. We don't conduct our own review on Wikipedia. QuackGuru (talk) 18:07, 27 March 2015 (UTC)[reply]

No, QuackGuru, you're linking to another time you IDHT'd and from now whenever you IDHT, I think you lose your all valid objection and don't count in a consensus tally. If you don't want to be ignored in future discussions, I suggest you do is the courtesy to not ignore us. And since nobody else sees things your way (because they don't IDHT everyone else) let me point out that we're no longer talking about if Ernst was making a conclusion about a large amount of research, we're moving on to the question of what do we do with these statements? To that end, I say we work to reword them appropriately. If we can't do that, then we need to delete them because we don't make references to primary studies. LesVegas (talk) 21:37, 27 March 2015 (UTC)[reply]

Coming back to this discussion. First, User:LesVegas, my opinion about what people should study in the future isn't particularly relevant, but if you want it, here it is. Since research has adequately demonstrated that acupuncture is form of placebo, we should build on that to discover precisely why it is associated with such a strong placebo effect. What is it about the setting, the lies to the patient about mystic channels, the impressive looking needles or lasers, the impressive diplomas on the wall, that all combine to make the patient believe that he will feel better and how does that belief translate into something useful? When people discard the notion that acupuncture actually does anything they can begin to study something useful, because the key here is to learn how to control the patients' environment in a way that makes them feel better. It would be nice to know how to do that without lying to them.

That whole paragraph on pg. 762 is worth parsing.

The sentence in question, "Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham" is a summary of Suarez-Almazor, not specifically Ernst's conclusion. That said, and the reason why I object to this mindless quote-pulling literalism we've allowed these articles to degenerate into, he does pull that particular conclusion as an important and representative conclusion, along with Cherkin's conclusion that he was dealing with a placebo effect, not a real effect. That, combined with his own prediction of what better controls would bring, makes it fair to characterize Ernst's personal conclusion as being that acupuncture is a placebo. It is not, however, the formal conclusion of the study.

If I were going to generate a lay summary of that conclusion, it would be "Ernst's efforts to come to definitive conclusions about the effectiveness of acupuncture were frustrated by the poor quality of the underlying studies, but indicated to him that adequately controlled studies were likely to demonstrate that acupuncture has no or few specific effects on pain". —Kww(talk) 15:19, 28 March 2015 (UTC)[reply]

There is some text in the lede and body about the placebo effects: "Some research results suggest acupuncture can alleviate pain, though other research consistently suggests that acupuncture's effects are mainly due to placebo.[3]" If you think the article is lacking enough information about the placebo effects it would be better to use a source that specifically discusses the placebo effects such as the 2006 review. See http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2005.01584.x/full The ref citation is <ref name="Ernst2006"/>. QuackGuru (talk) 18:21, 28 March 2015 (UTC)[reply]

Kww, thank you for taking the time to read and parse that quote. I agree with your take on Ernst's intentions and summary. As far as I'm concerned you can go ahead and add it, and finally we'll have resolved this misrepresentation. "Mindless quote-pulling literalism" -- phrase of the week. --Middle 8 (contribs • COI) 06:19, 29 March 2015 (UTC)[reply]

The source said "Adequately controlling for nonspecific effects in future is likely to demonstrate that acupuncture has no or few specific effects on pain [89]." A "future" prediction is not current evidence. Literally what the source determined as of today is verifiable and current evidence.

User:Dominus Vobisdu,[6] User:McSly,[7] User:Jim1138,[8] User:Roxy the dog,[9], and User:Bobrayner[10] preferred the concise wording for the text. QuackGuru (talk) 06:55, 29 March 2015 (UTC)[reply]

It's perfectly possible for competent editors to get this wrong at first. Kww's reading, however, is essentially correct, and numerous editors who have read the source carefully have agreed. I'm not going to link to them all. Except one: User:QuackGuru [11]. Apparently you no longer trust that editor's take -- and I'm sure you're not alone. --Middle 8 (contribs • COI) 07:58, 29 March 2015 (UTC)edited 08:57, 29 March 2015 (UTC)[reply]

Having read both the source and now a decent amount of the debate on this, I not only agree with KWW's reading, but I think his suggested change is the absolute best anyone has suggested while this debate has been going on. Excellent work, Kww! LesVegas (talk) 12:54, 29 March 2015 (UTC)[reply]

If we're going to summarize these things (which we damn well should), then I suggest we take care of Ernst and Vickers together. "Ernst's efforts to come to definitive conclusions about the effectiveness of acupuncture were frustrated by the poor quality of the underlying studies, but indicated to him that adequately controlled studies were likely to demonstrate that acupuncture has no or few specific effects on pain. Vickers later corroborated this view, finding that any specific effects of acupuncture were small in relation to the placebo effects". Then we can delete this long laundry list of individual studies.—Kww(talk) 16:06, 29 March 2015 (UTC)[reply]

Kww, given how pointedly Ernst and Vickers have disagreed [12][13], saying they agree would do violence to both. (And while the laundry list can be condensed to, say, a table, some brief summary of the reviews shouldn't be removed, because unlike Ernst and Vickers, they're not just about pain. See also Hopton & MacPherson on chronic pain and Lee & Fan on PONV, who find for efficacy without significant caveats; I haven't seen you address either of these yet). So your formulation goes against both WP:STICKTOTHESOURCE and WP:SYN. And again... if there were general agreement, we wouldn't be seeing (i) fresh RCT's undertaken by Stanford Univ etc., nor (ii) epithets like "quackademic" (and similar criticisms) thrown around by lesser MEDR's critiquing better ones, nor (iii) invited pro/con editorials. Kww, I'm honestly not how you concluded there was sci consensus here; who else has expressed your view that Ernst and Vickers substantially align, let alone that all tert sources do? --Middle 8 (contribs • COI) 17:16, 29 March 2015 (UTC)[reply]

P.S. And there is a WEIGHT problem (insufficient coverage of [+]-efficacy views), when the article still (a) omits Hopton and (b) cites only the "con" editorial from Anesth. Analg. --Middle 8 (contribs • COI) 17:16, 29 March 2015 (UTC) edited 17:26, 29 March 2015 (UTC)[reply]

Vickers believes the small effects plus the base placebo effect are worth paying for, but still categorizes the effects as small. The discussion of the ethics of paying for placebos is completely separate from the discussion of whether the effects are primarily placebo. Vickers confirmed Ernst's conclusion, in that he found that any specific effects of acupuncture were smaller than the placebo effects, and small in any absolute terms as well. I've got no problem highlighting the difference in value judgements in any summary, but that should not be used to obscure the fact that they were in alignment on the fundamental results. A disagreement about ethics and social policy is not a disagreement on the underlying science.—Kww(talk) 17:31, 29 March 2015 (UTC)[reply]

Ernst said[14] "This important analysis confirms impressively and clearly that the effects of acupuncture are mostly due to placebo" - which sounds like agreement in one direction. Did Vickers comment on Ernst? Alexbrn (talk) 17:37, 29 March 2015 (UTC)[reply]

On Ernst's original study, or to Ernst's response to Vickers. I'd have to dig around for quotes, but the main response I remember is similar to the argument I'm having with Middle 8, centering around Vickers's willingness to classify the small results as significant and worth paying for.—Kww(talk) 17:49, 29 March 2015 (UTC)[reply]

Something that has small results and is still worth paying for seems contradictory. QuackGuru (talk) 17:51, 29 March 2015 (UTC)[reply]

(e/c's -- wow, active today) Kww, I get that there's some convergence; I do. And I agree we can add the points you make re the deltas, since they are echoed in some of the commentaries on Vickers. BUT... we can't only frame Vickers that way. Not only does he not say specific effects are clinically small, he doesn't say they're "small" relative to placebo: "smaller" (what Vickers' numbers show) ≠ "small" (your suggestion). To be specific, 5.75 isn't exactly "small" relative to 8 (and these are in fact his deltas in pain scores for back and neck). We need to present Vickers' conclusions the way he does (STICKTOTHESOURCE), and that's more than just an ethical difference.

Re Kww's proposal to remove the non-Ernst, non-Vickers stuff... to my & Les's counterexamples we can add (iv) responses like these[15] to Vickers.

Alexbrn, here's Vickers' response to Ernst's comment. Vickers' review itself also shows points of divergence, c.f. "BUT..." above. --Middle 8 (contribs • COI) 18:09, 29 March 2015 (UTC)[reply]

Acupunct Med is a fringe journal. QuackGuru (talk) 18:14, 29 March 2015 (UTC)[reply]

QuackGuru -- (a) Vickers' point is that the delta between verum and no-acu is the basis for the clinically relevant decision, not the delta between verum and sham. The former delta being greater than the MCID. (b) Per WP:SOURCES we can still quote experts even if their comments aren't in a great MEDRS. And we have parity with Ernst's comments since the latter weren't in a journal at all. --Middle 8 (contribs • COI) 18:18, 29 March 2015 (UTC)[reply]

By my reading Ernst suspects future will research will show that the small effect of acupuncture will be due entirely to placebo; Vickers that it won't. I'm not sure where that leaves us on whether or not these fellows disagree about the current state of knowledge. Alexbrn (talk) 18:21, 29 March 2015 (UTC)[reply]

Right, which is why I always center around summaries like "non-existent or small". No one thinks the difference is large, or that any future study will suddenly find a large delta. Vickers's conclusion that we should be focusing on no treatment vs. acupuncture instead of sham acupuncture vs. acupuncture is what I keep referring to as the ethical debate. Vickers is comfortable recommending treatment even in the cases where he is aware the treatment is primarily placebo, while others are not. I have my personal opinion about that, but the article should neutrally frame that as a debate over ethics, and not take a position as to which side is right. Unfortunately, people (including Vickers and Ernst themselves) allow that ethical debate to colour their debates over the statistics. Middle 8, it would be nice if you could link to a summary or analysis of Vickers's response that isn't hidden behind a paywall. The paper you link to appears to be a response to the wide range of vitriol that he received for his conclusion, and it's not possible from the abstract to specifically identify a response to Ernst himself.—Kww(talk) 18:45, 29 March 2015 (UTC)[reply]

A free version's here. Alexbrn (talk) 19:20, 29 March 2015 (UTC)[reply]

OK, based on that: "Ernst's efforts to come to definitive conclusions about the effectiveness of acupuncture were frustrated by the poor quality of the underlying studies, but indicated to him that adequately controlled studies were likely to demonstrate that acupuncture has no or few specific effects on pain. Vickers later corroborated this view, finding that any specific effects of acupuncture were small in relation to the placebo effects. Upon review of Vickers's results, Ernst concluded that Vickers had overstated the positive nature of the results and that instead of supporting the position that the results were small, they supported the position that the specific effects were, in fact, insignificant. Vickers rejects that analysis, stating that while the effects were small, they were clinically significant".—Kww(talk) 19:41, 29 March 2015 (UTC)[reply]

For now I added the mainstream view per weight. See Acupuncture#Pain. QuackGuru (talk) 02:51, 30 March 2015 (UTC)[reply]

Not even close to consensus for that at this point. More later --Middle 8 (contribs • COI) 05:47, 31 March 2015 (UTC)[reply]

Actually, it may be OK as long as we cover other views (cf my comments above); mulling over. --Middle 8 (contribs • COI) 05:59, 31 March 2015 (UTC)[reply]

I wasn't okay with using the fringe journal. I only added it because that is what editors wanted. In the future there will likely be a review covering the debate about the Vickers source and claims. When a better source is available in the future the fringe journal will probably be replaced. QuackGuru (talk) 04:49, 1 April 2015 (UTC)[reply]

Back to the issue of fixing the misrepresentation of Ernst's comments on real & sham: any more comments? Any reason not to reword per Kww above? --Middle 8 (contribs • COI) 05:07, 2 April 2015 (UTC)[reply]

What was misrepresented? Any reason not to reword per Kww above? See WP:OR. QuackGuru (talk) 05:10, 2 April 2015 (UTC)[reply]

The version we have does confuse the conclusion of a study quoted in the review with the conclusion of the review itself. My summary avoided that, and it doesn't violate WP:OR. You seem to believe that all summarization violates WP:OR. Where did you get that impression?—Kww(talk) 05:28, 2 April 2015 (UTC)[reply]

I read the source and then added to the article what the source said. I could not verify what you originally proposed. QuackGuru (talk) 05:39, 2 April 2015 (UTC)[reply]

That's interesting. What were you unable to verify? How could you read that source and conclude that Vickers did not reject Ernst's analysis of Vickers's paper, or that Vickers does not continue to claim that the acupuncture has a small but statistically significant effect?—Kww(talk) 05:45, 2 April 2015 (UTC)[reply]

Current wording: "Edzard Ernst later stated that "I fear that, once we manage to eliminate this bias [that operators are not blind] … we might find that the effects of acupuncture exclusively are a placebo response."[81] Andrew Vickers, lead author of the original 2012 paper and chair of the Acupuncture Trialists' Collaboration, rejects that analysis, stating that the differences between acupuncture and sham acupuncture are statistically significant.[81]" Actually, a lot of what you wanted is already in the article. What was added was only sourced text. Not sure what you are proposing to change. What you originally proposed was too much editorializing. QuackGuru (talk) 05:53, 2 April 2015 (UTC)[reply]

The bad text: "A systematic review of systematic reviews found that for reducing pain, real acupuncture was no better than sham acupuncture..." Re which, this (per Kww): The version we have does confuse the conclusion of a study quoted in the review with the conclusion of the review itself. Source: Ernst '11; see p.761, §4 Discussion (1st para suffices), and then 1st para on p.762. Everymorning, Jytdog: please comment if possible; notified Alexbrn already. Thanks very much, in advance. --Middle 8 (contribs • COI) 16:07, 2 April 2015 (UTC)[reply]

OK, Alexbrn has been heard from, and still [16] agrees with the in-context reading of the source that led to the last broad consensus at WT:MED [17] and on which all editors above, save one, agree. The question is then how to summarize the source based on this correct reading, and it looks like editors favor Kww's proposal. Any other comments before proposing specific edits to the lede and body? --Middle 8 (contribs • COI) 05:22, 7 April 2015 (UTC)[reply]

https://en.wikipedia.org/w/index.php?title=User_talk:Alexbrn&diff=654755110&oldid=654727107 Alexbrn has been heard from, and now you are putting words in his mouth. He did not specifically comment about the current wording. Kww's proposal was not sourced to the review of reviews. QuackGuru (talk) 18:52, 7 April 2015 (UTC)[reply]

None here. Just that I support Kww's wording entirely for the body. For the lede, though, I'm curious if there are any ideas on how to make it work per WP: WEIGHT? Commentary on a hypothesis isn't something we usually use in ledes, yet I want to keep the peace around here so I'm not proposing omitting it altogether from the lede, unless other editors feel similarly. I just wonder how we're going to work it into the lede? LesVegas (talk) 13:13, 7 April 2015 (UTC)[reply]

Agree that a prediction isn't as weighty as a finding, but we can still mention it: it wouldn't be fair just to say Ernst was unable to reach a conclusion. What I think we should do in the lede -- as a replacement for the inaccurate text -- is (a) stick close to the source's conclusions that are stated as such, and (b) define sham acupuncture. --Middle 8 (t • c | privacy • COI) 05:13, 8 April 2015 (UTC)[reply]

You have not shown the text is "inaccurate". Stating that Ernst was unable to reach a conclusion is original research. The article does define sham acupuncture. See Acupuncture#cite note-Madsen2009-18. QuackGuru (talk) 05:19, 8 April 2015 (UTC)[reply]

Have you not read this thread? I briefly explained the problem [18] and why it's persisted[19], and addressed a common objection.[20]. And Kww parsed it in detail: here et. passim. Don't IDHT, please. If you have a rebuttal, please address these points using one of the top three tiers of Graham's hierarchy of disagreement. (P.S.: Paraphrasing isn't OR.) --Middle 8 (t • c | privacy • COI) 00:58, 11 April 2015 (UTC)[reply]

I'm not interested in addressing this in detail. We should not replace sourced text with OR. If you think the proposal is sourced then please try to verify the claim according to WP:V. There is information in the body with Vickers's response. See Acupuncture#Pain. QuackGuru (talk) 01:29, 11 April 2015 (UTC)[reply]

Obviously, the burden's on you to justify keeping it.[21] Since you're unable to do so, sounds like we have consensus to remove it then. --Middle 8 (t • c | privacy • COI) 06:34, 11 April 2015 (UTC)[reply]

I asked "If you think the proposal is sourced then please try to verify the claim according to WP:V." You proposed new wording and you were unable to provide V. Editors previously discussed the wording for the lede and body and did provide V a long time ago. See Wikipedia_talk:WikiProject_Medicine/Archive_51#Acupuncture_again. QuackGuru (talk) 06:55, 11 April 2015 (UTC)[reply]

And this consensus result (the part about the systematic review and sham) was the outcome of that discussion, which you supported at the time. But as we've seen, that wording was so awkward that editors kept "simplifying" it (in good faith), which completely undid said consensus result. Given your earlier agreement to change it, your insistence on keeping the current wording defies logic. We need some alternative that is faithful to the consensus you once supported, like this, or something that gives proper weight in the lede to the numerous results that sham = real. --Middle 8 (t • c | privacy • COI) 02:26, 12 April 2015 (UTC)[reply]

User:Dominus Vobisdu,[22] User:McSly,[23] User:Jim1138,[24] User:Roxy the dog,[25] and User:Bobrayner[26] preferred the more concise wording. We should not re-add overly detailed wording to the lede. User:Yobol stated that it does seem to be a conclusion Ernst is making and therefore citable as a source for that conclusion.[27] The wording is just right. See Acupuncture#cite ref-Ernst 2011 12-1. QuackGuru (talk) 06:53, 12 April 2015 (UTC)[reply]

Didn't you bring this up at Kww's Talk Page in last October, QuackGuru[28] If I remember right, most of these "acts of support" were nothing else but blind reverts with no given rationale. Even back then, I notified you that what really counts is the quality of arguments; arguments, such as "I just don't like it" and "I just like it" carry no weight whatsoever.[29] I have to agree with Middle8 here. I think it's okay to proceed in this matter. Cheers! Jayaguru-Shishya (talk) 10:18, 12 April 2015 (UTC)[reply]

I disagree with Jay and M8 here. It seems clear that in accordance with PAG, QG is correct. It is not OK to proceed. -Roxy the Viking dog™ (resonate) 11:45, 12 April 2015 (UTC)[reply]

J-G is exactly right. It's easy to get this wrong at first, partly because the wrong answer is truthy: hence the blind reverts. But when one actually reads the source, it's clear enough, assuming literacy. Only perhaps in the vaguest "spirit of the law" sense is the simple-but-wrong wording somehow OK -- and I'm cool with weighting null findings correctly i.e. strongly, but not with misrepresenting a source. --Middle 8 (t • c | privacy • COI) 20:42, 12 April 2015 (UTC)[reply]

It was too long at first to have the additional details in the lede. That was why it was eventually rejected. The shortened text is concise and therefore much better. QuackGuru (talk) 00:52, 13 April 2015 (UTC)[reply]

Not when "simplifying" = removing text so as to alter the meaning. But you know that, because you have a big "thumbs up" to the accurate, and slightly longer, consensus result. And I can't wait for Roxy to explain how Kww and I and the rest of us are so wrong about this -- but perhaps he hasn't looked at it that closely; others have been fooled too. --Middle 8 (t • c | privacy • COI) 01:39, 13 April 2015 (UTC)[reply]

Simplifying the wording improved the readability for the reader. Now that the text is no longer incoherent I don't understand why anyone would complain. QuackGuru (talk) 01:46, 13 April 2015 (UTC)[reply]

So what's your real concern? Mentioning sham = real in the lede? Defining sham in the lede? We can do both without misrepresenting the source. --Middle 8 (t • c | privacy • COI) 11:40, 14 April 2015 (UTC)[reply]

We have had repeated attempts to POV push the lede one way only and keep parity out. There have been strong objections to using Wikipedia's voice in edits like this The sources used to back this claim up, don't suffice for "is pseudoscience". Why does it have to be a constant battleground full of edit warring? LesVegas (talk) 19:19, 30 March 2015 (UTC)[reply]

Please don't add weasel words or original research to the text. We are using strong sources for the claims. QuackGuru (talk) 19:22, 30 March 2015 (UTC)[reply]

Weasel words like "is"?LesVegas (talk) 19:29, 30 March 2015 (UTC)[reply]

To answer Les' question "Why does it have to be a constant battleground full of edit warring?" it is because we have to contain the excesses of advocates of acupuncture such as yourself. Also, you fail to understand why parity isn't an issue here. I suggest you read all the WP:PAG again before returning. Remember that with fringe and pseudoscientific subjects such as this, we are obliged to write from the mainstream pov, and while we are using good sources to illustrate the pseudoscientific aspects of Acu (all of it) we don't actually need to source the Pseudoscientific tag, as Arbcom has ruled that we can describe "obvious pseudoscience" as such. -Roxy the dog™ (resonate) 19:56, 30 March 2015 (UTC)[reply]

@ Roxy the dog - AFAIK, Arbcom doesn't dictate PAG (anymore). Although the wording of WP:FRINGE/PS is derived from an Arbcom decision, it's only by community consensus that it remains; that's my understanding anyway.

That said: FRINGE/PS distinguishes among "obvious PS", "generally considered PS" and "questionable S" (and used to do so more clearly [30]). And there's a pretty strong PAG case for acu falling under "questionable science", cf. the guideline's criteria: (a) has a following (used in mainstream academic settings); (b) significant debate exists (over efficacy and when to use, efficacy itself being seen as a criterion for demarcation by e.g. Shermer). Also cf. Kww's comment below to QuackGuru below, 2nd para, [31] re practice ≠ theory. Consequently, the "questionable science" designation has actually flown in a number of discussions, probably more often than "obvious" from what I've seen. Wonder what the estimable Hans Adler would make of this argument? Any wagers? :-) --Middle 8 (contribs • COI) 15:09, 31 March 2015 (UTC)[reply]

I went ahead and fixed some tenses in the article. Jayaguru-Shishya (talk) 22:22, 30 March 2015 (UTC)[reply]

Jayaguru-Shishya, can you explain to me how this edit can possibly be described as "tenses"? My first impression was that it was a blatantly deceptive edit summary, but I will extend you the courtesy of allowing you to defend it.—Kww(talk) 22:50, 30 March 2015 (UTC)[reply]

Kww I'm curious why you asked Jayaguru-Shishya about that edit, but didn't also ask QuackGuru about this edit?LesVegas (talk) 23:48, 30 March 2015 (UTC)[reply]

QG's summary at least included "wording". I agree, it was weak, and I should point out to QG that he needs to leave better edit summaries. It didn't seem to rise to the level of actively trying to deceive others as to what the contents of the edit were, though. JG's edit changed far more than "tenses", so that edit summary was worse than weak.—Kww(talk) 01:55, 31 March 2015 (UTC)[reply]

Three times now with a completely inadequate ES for the same edit and despite being asked not to; it's getting GAME-y. [32] --Middle 8 (contribs • COI) 05:43, 31 March 2015 (UTC)[reply]

I have reverted the tense change per my edit summary, also restored previous characterization. Zad68 04:06, 31 March 2015 (UTC)[reply]

It's not about tense -- "has been described" is adequate for present-day -- it's about using WP's voice. demarcation is a non-trivial judgement call, not a simple fact. [33] --Middle 8 (contribs • COI) 05:44, 31 March 2015 (UTC)[reply]

You previously added original research (along with the past tense). Now you restored the past tense. The past tense implies it is no longer pseudoscience. QuackGuru (talk) 06:03, 31 March 2015 (UTC)[reply]

This is not an issue of tense. Not by any stretch of the imagination. "Has been described" is a perfectly good way to describe the situation where it continues to be described as pseudoscience. The issue is whether acupuncture is so clearly pseudoscience as to be stated as fact, or whether it can only be attributed. If you keep arguing about the wrong things, you can't persuade anyone. Not even people inclined to agree with you.

In my mind, it's a demarcation issue. Acupuncture is clearly based on pseudoscience. If it has any effect at all, no one has put forth any credible scientific explanation for how it could have it (and please, don't anyone mention "endorphins" again ... that's not a credible explanation when people are claiming that it treats rhinitis and breech birth). However, the word "acupuncture" is also used to describe the procedure itself, not the underlying nonsense, which makes the statement "acupuncture is pseudoscience" a bit hard to parse. You need to work out something like "acupuncture is based on pseudoscience" before you can have a supportable statement that also parses correctly.—Kww(talk) 06:16, 31 March 2015 (UTC)[reply]

@QuackGuru - as Kww says, the grammar is fine. It's the present perfect tense and is not wrong, which is why I reverted. But simple present is just as good; it doesn't really matter. --Middle 8 (contribs • COI) 13:36, 31 March 2015 (UTC)[reply]

I prefer simpler wording for non-controversial facts. QuackGuru (talk) 17:31, 31 March 2015 (UTC)[reply]

As simple as possible, but not simpler, as the old saying goes. I could support "founded on pseudoscience", "based on pseudoscience", "derived from pseudoscience", etc.—Kww(talk) 19:04, 31 March 2015 (UTC)[reply]

I am not fully supportive of the current wording but I think Alexbrn was compromising with the wording. If you try to replace it with that wording you will get too much drama. Maybe if there were three refs at the end of the sentence to verify the claim the wording can be more straight forward. QuackGuru (talk) 04:41, 1 April 2015 (UTC)[reply]

Quote from WP:MEDRS: An integral part of finding high quality sources is avoiding articles from journals without a reputation for fact-checking and accuracy. A red flag that a journal article is probably not reliable for health claims might be publication by a publisher that has a reputation for exhibiting "predatory" behavior, which includes questionable business practices and/or peer-review processes that raise concerns about the reliability of their journal articles. (See "References" section below for examples of such publishers.[16][17]) Other indications that a biomedical journal article may not be reliable are its publication in a journal that is not indexed in the bibliographic database MEDLINE,[18] or its content being outside the journal's normal scope (for instance, an article on the efficacy of a new cancer treatment in a psychiatric journal or the surgical techniques for hip replacement in a urology journal). Determining the reliability of any individual journal article may also take into account whether the article has garnered significant positive citations in sources of undisputed reliability, suggesting wider acceptance in the medical literature despite any red flags suggested here.

The source is not currently MEDLINE indexed. The previous discussion resulted in no consensus. See Talk:Acupuncture/Archive_20#That.27s_not_a_review. WP:EXCEPTIONAL claims require high-quality sources. It is usually better to use independent source. See WP:MEDINDY and see WP:FRIND. We are currently using better sources in that section. QuackGuru (talk) 21:07, 4 April 2015 (UTC)[reply]

As said, "Evidence-based complementary and alternative medicine" is already used in the article (7 times, as far as I can count). Please do not edit war over the content that has already widely been accepted. Cheers and happy Easter, QuackGuru. Jayaguru-Shishya (talk) 22:09, 4 April 2015 (UTC)[reply]

Perhaps those other seven references need to be removed as well. Care to individually justify precisely why we should consider these citations to be acceptable?—Kww(talk) 22:19, 4 April 2015 (UTC)[reply]

As Middle 8 pointed out, eCAM is used as a source in 84 different articles on Wikipedia. This shows global consensus beyond the borders of this article, in places that aren't POV war zones. Kww, should we remove it from those articles too? And on what grounds? Lack of Medline indexing? MEDRS doesn't say that that's a clear reliability issue, only a possible one, and when you consider the journal's impact factor the protestations become moot. I have a better idea: if you can convince the MEDRS folks that we need to change MEDRS to read, "Sources are absolutely unreliable if they aren't Medline indexed" and, if you can do it, I will personally remove the source all over this article. We should focus our efforts on making our sourcing rules more clear instead of arguing ad nauseum about each source from partisan standpoints. LesVegas (talk) 02:23, 5 April 2015 (UTC)[reply]

No, it doesn't work that way. The appearance of a use of a journal somewhere else doesn't make it automatically RS for use in every case here. I started taking a look at that list of 84 uses, first one was as a primary source talking about animal studies, that should probably be removed; second was to describe the color of a substance bees make; third was one of two sources to support a general statement about some use people try to get out of a mushroom. A source can never be blanket "reliable" or "unreliable", you have to look at each proposed use in context. So, "84 uses" really holds absolutely zero weight here.

To answer, Yes, each and every use of that journal's use here should be reviewed here, and if that journal is being used to support a biomedical claim, it really needs to be addressed, possibly removed. Zad68 03:01, 5 April 2015 (UTC)[reply]

I find it disappointing but not surprising that such a poor quality source has been used 8 times in this article. I'll take a look to see if the article can be improved by removing that poor source and the material that it supports. That a journal should call itself "Evidence Based Complementary And Alternative Medicine" is a source of endless amusement in this household. Imagine the excitement each month when the subscription arrives in it's brown envelope, the anticipation mounts as the package is ripped apart, the glossy well illustrated (normally a happy Merkian family eating salad) cover has so much promise, but when opened ... all the pages are blank.) -Roxy the dog™ (resonate) 10:05, 5 April 2015 (UTC)[reply]

No, Zad, it doesn't work that way either. There is no consensus to remove the source. It's currently subject to an edit war. We need to go about it another way, either an RfC (which likely won't show consensus, either) or, better, what I suggested which was an amendment to MEDRS. Why not get that through? LesVegas (talk) 12:31, 5 April 2015 (UTC)[reply]

"Consensus" must be based on arguments grounded in policy and guideline. 100 !votes or supports that aren't grounded in content policy and guideline carry no weight at all, and can be overturned by the first argument that is. Regarding your MEDRS suggestion, you still aren't actually connecting to what I and others are saying. You should read through the archives at WT:MEDRS regarding previous discussions about how MEDRS should address being indexed (or not) in MEDLINE and other services. Getting MEDLINE-indexed is a particularly low bar, as there are a lot of not-particularly-great journals that are indexed. One way to think of this is that if a journal is not MEDLINE-indexed, that puts the journal in doubt to start, and a strong case must be made for it using other parameters. An impact factor of 2.175 does not in any way make it "moot." Zad68 16:53, 5 April 2015 (UTC)[reply]

But Zad, you're a smart guy. If we are to only use sources indexed in Medline, MEDRS should say so. It doesn't. So there is no policy or guideline that this is violating. It's just another silly edit war, really. LesVegas (talk) 17:41, 5 April 2015 (UTC)[reply]

Your responses continue not to connect to the points being made and so I am disinclined to continue the conversation. We'll start with the weakest use of inappropriate sources. Zad68 17:53, 5 April 2015 (UTC)[reply]

I did look at the MEDRS talk archives, but that's not a policy or guideline. Come on, if it's really a terrible source only because it's not in Medline yet, then it stands to reason it would be easy to change MEDRS to say that sources not in Medline are absolutely unreliable. Why is it that hard? And for the record, it's you who haven't addressed that question. Yes, MEDRS says that if its not Medline indexed, that's a possible red flag, but not a red alert. A red flag is only a warning to investigate further, not for supporters of the source to have to make a strong case for, and be dismissed for arbitrary reasons, all of which MEDRS says nothing about (like impact factor not being high enough). LesVegas (talk) 18:01, 5 April 2015 (UTC)[reply]

Actually, I would like to point something out. Here is MEDRS's language, in full:

Other indications that a biomedical journal article may not be reliable are its publication in a journal that is not indexed in the bibliographic database MEDLINE,[18] or its content being outside the journal's normal scope (for instance, an article on the efficacy of a new cancer treatment in a psychiatric journal or the surgical techniques for hip replacement in a urology journal).

Please note the word 'may', which MEDRS emphasizes in italics. Please also note the second part about "a journal's normal scope" and ask if Western biomedical journals like Nature or JAMA, prestigious as they are, are more appropriate than a CAM journal? Or should we only have acupuncture journals in an acupuncture article? How strict are we really going to choose to be with applying MEDRS? LesVegas (talk) 18:37, 5 April 2015 (UTC)[reply]

I think it's reasonable to be extremely strict with sources that promote magical thinking. It bears repeating that there is no such thing as "alternative medicine": when there is sufficient evidence that something works, it's just "medicine".—Kww(talk) 18:44, 5 April 2015 (UTC)[reply]

Why then did you want an allergy meta-analysis showing reductions in serum IgE deleted, even though it was published in an excellent journal.? Was it the magical thinking aspect or the medicine you objected to? LesVegas (talk) 19:04, 5 April 2015 (UTC)[reply]

Les, go and try this on with the medics please, and see what happens. Let us get on with editing the article. Believe me, it wont fly. -Roxy the Viking dog™ (resonate) 19:08, 5 April 2015 (UTC)[reply]

Wow! Viking dog? Why the change? Or was it a metamorphosis? By the way, you misspelled "own" as "on", but I'm not about to squabble with a freaking Viking Dog over something as paltry as spelling. LesVegas (talk) 19:20, 5 April 2015 (UTC)[reply]

Refresh my memory, Les. There are so many dubious studies being crammed into this article that I can't reproduce my objections to each one from memory.—Kww(talk) 20:44, 5 April 2015 (UTC)[reply]

Sure, Kww. Here was your comment:

This is an example of precisely why I think having this rack of individual studies distorts the POV of the article. If this new study had documented the prevailing view on acupuncture, would there have been such a rush to add it? I think not. Instead, because it takes the unusual point of view that jamming needles into one's body will impact the immune system, it gets presented here, well in advance of the remainder of the scientific community having an opportunity to examine and reject it.—Kww(talk) 20:27, 17 January 2015 (UTC) And: And while we wait, we get another advertisement for acupuncture. Funny how that works. I would suggest that we remove it unless and until it is confirmed by supporting studies.—Kww(talk) 05:52, 18 January 2015 (UTC) Anyway, their findings were real medicine if I've ever seen such a thing, even showing serum changes with extremely low P's. If memory serves me correctly, not only did you support deleting the source, you then attempted to have me and a few others topic banned for supporting it. LesVegas (talk) 20:55, 5 April 2015 (UTC)[reply]

I'll stand by my comment: if that study attracts supportive comments from reputable journals it's fine. If it had come to the prevailing conclusion (i.e., that jabbing needles into people doesn't have any particular effect on rhinitis), no one would have been eager to include it the moment of publication. The only reason that there was a push to include it so rapidly was because it came to the opposite conclusion. It's not that the source was unacceptable, it's that the inclusion was premature. It's been several months. Any interesting letters to the editor or similar responses that take any note of this study?—Kww(talk) 21:34, 5 April 2015 (UTC)[reply]

By the way, LesVegas, it's your support of pseudoscience that I believe should cause you to be banned from Wikipedia entirely. This particular study doesn't weigh heavily on that opinion one way or the other.—Kww(talk) 21:36, 5 April 2015 (UTC)[reply]

I guess it's too bad for you Arbcom saw differently, and you were roundly lambasted for bringing such a case to them. But anyway, just to be clear, where in MEDRS does it say anything about premature inclusion of meta-analyses, or that it needs letters to the editor? I'll find the letters if you find the MEDRS stipulation where we remove such sources. And not to change the subject, but we changed the subject. I was just asking editors here about where MEDRS requires journals to be indexed. Do you have anything to say about that? LesVegas (talk) 21:50, 5 April 2015 (UTC)[reply]

MEDRS is a minimum bar, and not the only criteria to be used. As for Medline, it mentions it solely as a red flag. That does shift the burden to people that wish to include it. As for an Arbcom decision that automatically brings all alternative medicine topics under that scope of discretionary sanctions, that was the best that I expected. That people are unwilling to block all pseudoscience advocates is a shame, but I recognized that aspect as a Hail Mary play. It would improve the lives of everyone on the project and the lives of everyone using Wikipedia as a source, but some apparently consider constant conflict to be preferable.—Kww(talk) 22:55, 5 April 2015 (UTC)[reply]

Hindawi is not on Beall's list of predatory publishers. [34] Also, EBCAM has an impact factor assigned by JCR, something not typically associated with disreputable journals. Everymorning talk 23:40, 5 April 2015 (UTC)[reply]

Good point, @Everymorning: if I remember correctly, there was already discussion about the same thing, maybe somewhere in between 6 and 12 months ago? :-P Jayaguru-Shishya (talk) 20:58, 8 April 2015 (UTC)[reply]

Kww, haven't you been ranting about that same stuff at Arbcomalready, where the case you filed miserably failed? I also remember similar threats[https://en.wikipedia.org/w/index.php?title=User_talk%3AKww&diff=652894137&oldid=652884244 you've made, not to mention the false administrative warnings over the subject. Time to drop the stick, don't you think? With due all respect, nobody is interested in your opinion. Please WP:STICKTOSOURCES. Cheers! Jayaguru-Shishya (talk) 20:37, 8 April 2015 (UTC)[reply]

I was replying to a direct statement on the topic, JG. I'm certain that you are uninterested in anything I have to say, and there's no reason to repeat that, either. I do promise to give anything you have to say the consideration it deserves.—Kww(talk) 20:48, 8 April 2015 (UTC)[reply]

Kww, you mean the editors you asked to be banned in your Arbcom case [35] Let me see, you said that:

My view is diametrically to John's: that it is our role as administrators to actively detect the users that are attempting to block a reflection of scientific consensus in the article, block them as appropriate, and help provide an environment that will allow our scientifically-minded editors to prevail. I would resolve this problem by blocking or topic-banning LesVegas, Jayaguru-Shishya, A1candidate, and, indeed, any and all editors that attempted to portray acupuncture as having medical legitimacy.

I'd be careful if I were you, Kww. You are continuing to make similar claims as you did in your Arbcom case that did not succeed. There's a long list of such accusations even before that. As an admin you should know better. Please do throw your own considerations into the corner and focus on improving the article instead. Cheers! Jayaguru-Shishya (talk) 20:58, 8 April 2015 (UTC)[reply]

I do focus on improving the article. Please follow indentation standards, BTW: replies indented one step in relation to the comment they are replying to, inserted after the last thread that is also a reply to the same comment. LesVegas's comment at 21:05 is a reply to me, your comment at 20:37 was a reply to me, and the comments in between are at least indented to appear as if they were a reply to one of my subsequent comments (although it seems that they may not be). You should note that the Arbcom decision did make all alternative medicine articles subject to discretionary sanctions, which was a substantial step in and of itself. The next issue is to make those sanctions effective in reaching the goal set for all alternative medicine and pseudoscience articles on Wikipedia: that the article should reflect the scientific point of view on the topic, and take note of other views as existing, but not as being of equal merit.—Kww(talk) 22:25, 8 April 2015 (UTC)[reply]

@KWW. I would like to subscribe to your newsletter. -Roxy the Viking dog™ (resonate) 12:39, 9 April 2015 (UTC)[reply]

KWW I don't think it is appropriate for an admin to be putting editors that disagree with you into a category and seeking to silence them. If JS, A1, or Les Vegas individually violated sanctions or are trying to push edits knowingly violating our sourcing guidelines (like QG, Tippy Goomba, and Dominus Vobisdu have done), that would be one thing. But this is the second time you have suggested wholesale banning of people your perceive to have similar POV's that are counter your own. It is not justifiable to say that because they agree in disagreeing with your reading of certain sources that means they are somehow behaving inappropriately or violating WP policies. Herbxue (talk) 21:05, 10 April 2015 (UTC)[reply]

I don't argue with anyone that disagrees with me over the reading of certain sources. I argue with editors that consistently attempt to incorporate material that portrays pseudoscience and mysticism as being based in fact, as such material is completely incompatible with the notion of an encyclopedia. It's been a consistent stance of mine, dating to before my adminship, and is much wider than acupuncture. There's no reason to tolerate editors that use Wikipedia to elevate such things.—Kww(talk) 23:20, 10 April 2015 (UTC)[reply]

We're getting off-track relative to article content. I'm still dubious about EBCAM but LesVegas's point about pay-to-play -- i.e. that it's used in non-predatory contexts -- weighs, along with EBCAM's having been accepted in the past, and the fact that it's not on Beall's list. Thoughts? --Middle 8 (t • c | privacy • COI) 00:16, 11 April 2015 (UTC) typo fixed 06:27, 11 April 2015 (UTC)[reply]

The section is long and we are using Cochrane reviews among other independent reviews. We can use high-quality sources going forward. QuackGuru (talk) 01:24, 11 April 2015 (UTC)[reply]

KWW if you want to talk about banning people, please cite specific instances of them acting inappropriately, instead of unfairly casting very different individuals in the same light.Herbxue (talk) 03:24, 11 April 2015 (UTC)[reply]

Please, let's take non-article discussions to a user talk page. --Middle 8 (t • c | privacy • COI) 06:26, 11 April 2015 (UTC)[reply]

Yes, I agree. I don't even know how we got so off-topic. Regarding QG's objection, I agree that the section is a bit long, but then again, it is low back pain so if any section needs to be longer than all others, this is the one. The review Everymorning added was from 2015 so it's topical and relevant and if we're going to trim it would be better to take out older sources. Alexbrn objected that it's a fringe source, but I don't see that the argument has been made that MEDRS supports this idea. However, if anyone can find a policy or guideline statement that states otherwise, please post it here. Going forward, I think eCAM is a useful source and, since it deals in CAM topics, it might provide information that we can't find anywhere else. LesVegas (talk) 17:18, 11 April 2015 (UTC)[reply]

A non-MEDLINE indexed source devoted to fringe medicine has sufficient red flags that I would think the presumption would be that it is not a reliable source. When studies have sufficient merit to be included in journals devoted to medicine, they will appear there.—Kww(talk) 17:27, 11 April 2015 (UTC)[reply]

We can use high-quality sources going forward rather there any source for a mature lengthy article. See WP:MEDASSESS. QuackGuru (talk) 17:53, 11 April 2015 (UTC)[reply]

I have to agree with Kww and QuackGuru here: eCam is not a MEDLINE indexed source, and therefore it sure does raise red flags. According to WP:MEDRS, though, this does not mean that the source would be unreliable. Instead, it means that one should look further into the source. That's a good cautious procedure we should embrace.

When we examine eCam a bit closer, we can rest easy: it is not on the Beall's list — a list mentioned at WP:MEDRS — that describes publications "by a publisher that has a reputation for exhibiting "predatory" behavior"". And like Everymorning well noticed earlier, eCam has a JCR assigned impact factor.[36]

Summa summarum, 1) the source raised red flags (investigated), 2) it was not by a Beall-listed publisher "that has a reputation for exhibiting "predatory" behavior", 3) it has an impact factor assigned by JCR, and 4) the source is completely MEDRS compliant. Cheers! Jayaguru-Shishya (talk) 15:01, 12 April 2015 (UTC)[reply]

You didn't address the oxymoronic title or its inappropriate focus. Saying it is "completely MEDRS compliant" would appear to be a personal opinion.—Kww(talk) 21:04, 12 April 2015 (UTC)[reply]

Given that even if the journal met MEDRS it would be a poor one, I'm not sure why editors are arguing in favor of it when we have many unambiguous MEDRS that address the same topics. It's also unclear to me why absence from Beall's list is being cited as a point in its favor - it's a very low bar (the list is about questionable business practices, rather than being directly related to quality), and we have a statement from Beall himself published in Nature that it doesn't clear the bar by that much. Sunrise (talk) 21:19, 12 April 2015 (UTC)[reply]

Well, not being on Beall's list is simply one point amongst several. You have to look at the many favorable aspects, one being a Thompson Reuters impact factor as well. JCR won't assign impact factors to journals that are predatory. It's used throughout Wikipedia with no contention anywhere I've seen, except here. LesVegas (talk) 17:48, 13 April 2015 (UTC)[reply]

Impact factor is not a very useful metric, as we discussed before, but feel free to raise this at WT:MED. Just having a JCR impact factor is also an extremely low bar, requiring only the "basic publishing standards" such as publishing on time, articles having references, and peer review. Exclusion of journals is typically only due to questionable citation practices (and predatory journals can definitely get included), so we return to the same point; I'm not sure why editors are arguing in favor of it when we have many unambiguous MEDRS that address the same topics. Unfortunately, it is very common for unacceptable sources to be used widely across Wikipedia before they can be removed - there actually used to be a "Long-term cleanup" section at the top of WP:RSN that was used for this sort of thing. Sunrise (talk) 04:11, 15 April 2015 (UTC)[reply]

If we are telling readers that Cochrane Reviews are "high-quality", we should provide an appropriate citation.__DrChrissy (talk) 08:56, 15 April 2015 (UTC)[reply]

I have removed your unneeded CN tag. it isn't needed, so please don't place it again. thanks. -Roxy the Viking dog™ (resonate) 09:08, 15 April 2015 (UTC)[reply]

"Several Cochrane reviews of acupuncture for a wide range of pain conditions have recently been published. All of these reviews were of high quality."[37] QuackGuru (talk) 09:12, 15 April 2015 (UTC)[reply]

The source you quote is a primary source and should not be relied upon as indicated by WP:MEDRS. It requires a secondary source. Please replace the CN tag.__DrChrissy (talk) 09:20, 15 April 2015 (UTC)[reply]

Per my comments above, no. -Roxy the Viking dog™ (resonate) 09:24, 15 April 2015 (UTC)[reply]

Review.[38] QuackGuru (talk) 09:26, 15 April 2015 (UTC)[reply]

Calling a Cochrane Collaboration review "high-quality" is kind of WP:OBVIOUS; if sourcing is insisted on it need only be light-weight for such an uncontested label. I don't think sourcing is necessary. Alexbrn (talk) 09:27, 15 April 2015 (UTC)[reply]

I repeat, this is a primary source. It is like an experimenter saying in an experimental paper, "I have found X" and me including it in the article. WP:MEDRS would not allow this. It needs a secondary source to review the information about the strength of quality of Cochrane reports. The quality/existance of Cochrane might be obvious to some subject-experts, but it would not be obvious to many non-experts. In fact, I would imagine many non-experts have not even heard of Cochrane. I must say I am a little surprised to see such knee-jerk opposition to a suggestion that would only improve the strength of the article for the sake of providing one more source.__DrChrissy (talk) 09:35, 15 April 2015 (UTC)[reply]

I repeat, this is a review.[39] QuackGuru (talk) 09:38, 15 April 2015 (UTC)[reply]

The url provides a list of reviews. Just so we do not get distracted, please can you specify which review you are referring to. I really am surprised by this response. I had expected a flurry of responses from the medic guys providing overwhelming evidence of the high quality of Cochrane.__DrChrissy (talk) 09:44, 15 April 2015 (UTC)[reply]

Acupuncture for pain: an overview of Cochrane reviews.

Lee MS, Ernst E.

Chin J Integr Med. 2011 Mar;17(3):187-9. doi: 10.1007/s11655-011-0665-7. Epub 2011 Feb 27. Review.

PMID: 21359919

Related citations[40] QuackGuru (talk) 09:45, 15 April 2015 (UTC)[reply]

Thanks for that. The review states "Cochrane reviews have the reputation for being more transparent and rigorous than other reviews" Surely this is a primary source when used to make a statement about the quality of Cochrane. What we should be providing is a source which reviews papers that assess the quality of Cochrane reports and indicates the statement is correct. This is what WP:MEDRS guidelines indicate.__DrChrissy (talk) 10:25, 15 April 2015 (UTC)[reply]

If we've already got WP:MEDRS open, note that it says "Cochrane Library reviews are generally of high-quality" right in there, so it's already in the Guideline, a cite isn't needed. Zad68 14:12, 15 April 2015 (UTC)[reply]

For grading the quality of evidence (high quality, moderate quality, low quality, and very low quality), please see the GRADE guidelines. Cheers! Jayaguru-Shishya (talk) 13:55, 15 April 2015 (UTC)[reply]

@Zad But if we are to be using the WP:MEDRS guidelines as the support for this, it is like citing WP articles as sources, which we all know is inappropriate. A statement has been made that Cochrane articles are "high quality". The community needs an independent, external secondary source to support the contention that Cochrane reports are high quality...that is what WP:MEDRS requires.__DrChrissy (talk) 16:55, 15 April 2015 (UTC)[reply]

Not to be a stickler Zad (and I don't edit this article much), but in your quote it specifically says "generally" (meaning not always but usually the case). Normally, I have zero issues with the claim of Cochrane reviews being high-quality (and I certainly agree that they are). However, a Cochrane review on a separate topic (the whole oseltamivir debate) generated significant controversy and was opposed by numerous scientific bodies with respect to that specific issue. Just some reminders that Cochrane isn't perfect and perhaps shouldn't always automatically get a free pass on being high-quality just because it comes from Cochrane. I have no specific comments to offer about the cited Cochrane review itself but I don't see a compelling reason for Lee's review of reviews cited above not to be reassuring to DrChrissy since it says right in the abstract "Several Cochrane reviews of acupuncture for a wide range of pain conditions have recently been published. All of these reviews were of high quality." Also, please note that I'm also not saying that the oseltamivir Cochrane article wasn't high-quality (but their methodology was questioned by several opposing medical bodies during the controversy). The source of information should always be questioned and critiqued regardless of what journal it comes from, what collaborative group it comes from, etc. and evaluated for its merit so I don't agree with the spirit of it's Cochrane, therefore it's automatically okay, but I think you're on the verge of making a mountain out of a molehill on this one DrChrissy and I think your concerns have been adequately addressed. TylerDurden8823 (talk) 17:34, 15 April 2015 (UTC)[reply]

Thanks for this insightful comment. I really am not trying to make a mountain here. Earlier today, I read the Acupuncture article (for the first time I think) and I baulked when I read that a WP editor had written the articles reviewed were "good-quality". I wanted to know who said they were "good-quality". I realised that the writers of the review article described them as "good quality" but then got to thinking "it's a primary source of this view". If I was to write a WP article on Animal Intelligence and I wrote "There was a review of articles written in Animal Behaviour which the author described as good quality...." I think you would question this and deem it to be a primary source. Is this not the case? Is it not simple enough to find a secondary reference which states that Cochrane reports are good quality -- that is really all I am asking...not even ALL Cochrane reports.__DrChrissy (talk) 17:50, 15 April 2015 (UTC)[reply]

I already explained above the wording is accurately sourced using a WP:MEDRS review. QuackGuru (talk) 18:07, 15 April 2015 (UTC)[reply]

User:Alexbrn, you wrote "Calling a Cochrane Collaboration review "high-quality" is kind of WP:OBVIOUS; if sourcing is insisted on it need only be light-weight for such an uncontested label. I don't think sourcing is necessary." Actually the source verifies the claim. See "Several Cochrane reviews of acupuncture for a wide range of pain conditions have recently been published. All of these reviews were of high quality."[41] QuackGuru (talk) 18:07, 15 April 2015 (UTC)[reply]

Yes, and while Zad is correct that MEDRS states Cochrane reviews are high quality (and in many cases they are) we cannot cite a claim that they're "high quality" with a WP source. What we can do is use Cochrane reviews, and even give them higher weight versus a source that's less well known/established. But everything must be verified. And, yes, for the record, Cochrane reviews are great sources, but I've seen specifically with acupuncture research they're not the final word by any means. They currently seem unaware of acupuncture specific reporting standards adopted by CONSORT, for instance, and they take in plenty of sources which are unaware of these as well. Anyway, Cochrane is great, but we're misleading the reader if we act like Cochrane is the voice of God. And, just to be clear, we verify everything else on the page, even no-brainer statements like "it aims to treat a range of conditions," so the "high-quality" nature of Cochrane should get no special treatment. LesVegas (talk) 18:31, 15 April 2015 (UTC)[reply]

This is not about what MEDRS states. This is about what the review states. The objection was the review did not verify the claim but the review does verify the claim.[42] QuackGuru (talk) 19:01, 15 April 2015 (UTC)[reply]

Correct, Lee's 2011 review of reviews cited above unambiguously states that the Cochrane reviews it reviewed were all of high-quality. A review of reviews is certainly a secondary source that meets WP:MEDRS and is certainly a strong enough source for a relatively uncontroversial claim. That really should be the end of the matter. TylerDurden8823 (talk) 19:22, 15 April 2015 (UTC)[reply]

A review of reviews is not a secondary source if it states that the papers it reviews were good quality withour an independent source to verify this - who else says they were good-quality?. I can not believe this guys - you are all intelligent and articulate; if this is so obvious to you, why not simply provide a suitable secondary source or even a second primary source and the non-experts (me) will scurry back under their rocks satisfied, but none the wiser why this was such a problem for them!__DrChrissy (talk) 20:17, 15 April 2015 (UTC)[reply]

Right, they are "high quality" according to Lee, not according to God. It should be attributed, i.e., "the Cochrane reviews were high quality according to Lee.." We attribute and don't use Wikipedia's voice for claims of any kind. LesVegas (talk) 22:42, 15 April 2015 (UTC)[reply]

DrChrissy, are you suggesting we need a review of a review of reviews? That sounds over the top to me. How Wikipedia defines primary vs. secondary vs. tertiary can be seen here WP:PRIMARY. Secondary sources review the primary studies and then discuss the strength of the evidence (e.g., a systematic review and meta-analysis of RCTs evaluates those RCTs (the primary sources doing the original research of interest) and determines the strength of evidence after evaluating all of them, accounting for biases & methodology, etc etc). This does not seem different to me as a review of reviews since it appears to me to be a secondary source reviewing other secondary sources (which sounds like a tertiary source not a primary source). Your concern seems to strike at the heart of defining primary vs. secondary vs. tertiary sources. According to Wikipedia, here is how we define primary sources: "Primary sources are original materials that are close to an event, and are often accounts written by people who are directly involved." My read of that would be if the Cochrane review itself said something to the effect of our review is high-quality, then that would be a primary source account of it being high-quality whereas if another independent source (e.g., different authors, etc) reviewed the Cochrane review and said yeah, this Cochrane review was high-quality (as done in this 2011 Lee review of reviews), then that would be a secondary source account of it being high-quality. If anything, it's probably a tertiary source as it seems to fit Wikipedia's definition of that as seen here: "Tertiary sources are publications such as encyclopedias and other compendia that summarize primary and secondary sources." This review of reviews is summarizing secondary sources (Cochrane reviews that are reviews of primary sources). So, I really don't agree with the interpretation of this being a primary source for the claim of the Cochrane review being high-quality. Are you saying a review of Lee's overview of reviews is needed that has to say something like "According to Lee in his review of reviews, the Cochrane reviews were all of high-quality. We agree with this assessment."? I might agree with you if Lee or Ernst were one of the authors of the Cochrane review being reviewed... TylerDurden8823 (talk) 22:45, 15 April 2015 (UTC)[reply]

Apologies for banging the same drum but if this is such a non-problem, why doesn't someone simply supply a second source (secondary, primary, tertiary, quaternary...whatever) confirming these specific reviewed reports were high quality - I will then disappear in a puff of total confusion.__DrChrissy (talk) 23:19, 15 April 2015 (UTC)[reply]

Do you understand the current source being used is a review and does verify the claim? QuackGuru (talk) 23:21, 15 April 2015 (UTC)[reply]

QuackGuru, why are you IDHT'ing again? I would think you would be on better behavior with an Arbcom pending against you at the moment. Why have you failed to address the points Dr Chrissy and I have asked? Namely, that it is secondary for some purposes, primary for others. It was not a review on Cochrane, so it's not secondary for Cochrane. It's secondary for the data Lee/Ernst studied. Please observe TylerDurden8823's behavior and take note of how he addresses points and, even though he believes a mountain is being made from a molehill, note how responds to the concerns addressed. That is good behavior to follow in a dispute. IDHT'ing isn't. If you are going to actually start following policies, of all times, now would be the ideal time to do it. LesVegas (talk) 23:59, 15 April 2015 (UTC)[reply]

...DrChrissy, did you read any of what I wrote? The Lee review does confirm that these reports are high-quality. No further confirmation beyond that is necessary. TylerDurden8823 (talk) 23:49, 15 April 2015 (UTC)[reply]

Yes, I did read what you wrote and I have to say, starting a comment like that is a little inflammatory. There can be no denial that the Lee review states the reports were high quality ("All of these reviews were of high quality"). However, this is the opinion of the authors. You stated above that the Lee review "confirms" the reports are high quality, which means this has been written elsewhere. Where has it been written elsewhere, please?__DrChrissy (talk) 09:16, 16 April 2015 (UTC)[reply]

Well, try to put yourself in my shoes and read your comment after what I posted and you'll see how it could be a little frustrating. I genuinely did not know if you read what I wrote. I'm not trying to be inflammatory but perhaps you're also being a bit sensitive. Anyway, back to the matter at hand. A review of reviews is more than adequate. Of course it's the opinion of the authors, but the point is that the authors writing that opinion are not the authors directly involved in the primary research (or secondary research since they reviewed Cochrane reviews in this case) so their opinion is therefore secondary (i.e., they're reviewing the Cochrane reviews of interest). I disagree that we need another source to confirm or analyze Lee's evaluation. We do not need a third source saying that Lee's evaluation of the Cochrane articles as high-quality was a sound judgement and that they echo that sentiment. As I mentioned earlier, when we use secondary sources (e.g., lit reviews, systematic reviews, etc) they review primary sources and evaluate them for quality, etc and we often use those secondary sources to summarize what they say about the primary literature that they reviewed (e.g., a systematic review and meta-analysis concluded (based on its review of primary literature) that there is strong evidence (due to the high-quality methodology of the reviewed primary studies) that green is not the same color as blue). We use secondary sources in this manner all the time. The same principle applies here except this source is reviewing other secondary sources (reviewing Cochrane reviews which are themselves secondary sources). No additional sourcing beyond Lee is needed. For me, I'm considering the matter closed as I do not see any evidence that this is a primary source in any way and it confirms the uncontroversial claim of the Cochrane reviews being high-quality. TylerDurden8823 (talk) 14:42, 16 April 2015 (UTC)[reply]

OK. So, if I was to write "An overview of high-quality Association of Animal Behaviour reviews suggested that dogs are less intelligent than cats" - would you accept that statement?__DrChrissy ^(talk) 14:53, 16 April 2015 (UTC)[reply]

If you were a recognized expert on the subject, published an evidence-based analysis like that in the form of a literature review on the topic, and did so in an appropriate journal, then yes. TylerDurden8823 (talk) 15:23, 16 April 2015 (UTC)[reply]

Which leaves the obvious question "Who is an expert?" How do I know that Lee (et al.,) are experts?DrChrissy ^(talk) 21:00, 16 April 2015 (UTC)[reply]

It's well known for example that Ernst (2nd author of this review of reviews we're discussing) is an expert in the area of complementary and alternative medicine. I'm not personally familiar with Lee but I'm sure it's not difficult to verify his expertise. This also sounds more like a semantic argument now asking for the definition of an expert rather than questioning the credibility of the article itself. If you require verification of Lee's expertise, you can find an example of it here: https://www.elsevier.com/journals/european-journal-of-integrative-medicine/1876-3820/editorial-board/myeong-soo-lee TylerDurden8823 (talk) 21:30, 16 April 2015 (UTC)[reply]

user:Roxy the dog recently reverted an edit of mine[43] and left the following edit summary "Dr. Chrissy needs to read wp:RS to brush up his primary sourcing." The WP:Edit summaries states "Avoid using edit summaries to carry on debates or negotiation over the content or to express opinions of the other users involved.". Furthermore, user:Roxy the dog left no discussion of this reversion on Talk page. I also object to the incorrect useage of my username. This is becoming uncivil behaviour__DrChrissy (talk) 12:47, 15 April 2015 (UTC).[reply]

Note: I previously posted the edit above here[44] however, Zad68 deleted my edit[45] without discussing this first - simply leaving a note at my Talk page hardly constitutes "discussion". This is extremely disruptive and uncivil. Please do not edit/delete my edits again without discussing them first. I have explained on my Talk page that I am following advice given in WP:Edit summary which states "Avoid using edit summaries to carry on debates or negotiation over the content or to express opinions of the other users involved. This creates an atmosphere where the only way to carry on discussion is to revert other editors! If you notice this happening, start a section on the talk page and place your comments there. This keeps discussions and debates away from the article page itself." (my bold). Zad68, I consider this editing/deletion of my edits to be uncivil behaviour. Please stop immediately. For anyone else considering deleting or reverting this edit, I will deem this also to be uncivil behaviour. __DrChrissy (talk) 17:27, 15 April 2015 (UTC)[reply]

Roxy, I happen to see how DrChrissy could view that edit summary comment as impolite and condescending and I agree that such a comment has no business in an edit summary. You should refrain from such behavior in the future as such comments serve no purpose but to inflame editors and create an unnecessarily tense atmosphere instead of a collaborative and respectful one as discussed on WP:Five pillars. This does seem to be an ongoing pattern of behavior despite numerous editors talking to you about this and many statements from you that you will work on these behaviors. Please refrain from further impolite or condescending comments. TylerDurden8823 (talk) 17:41, 15 April 2015 (UTC)[reply]

I find it weird that the lead merely says that acupuncture "is described as a type of pseudoscience" while the "Conceptual basis" section flatly refers to it as "a type of pseudoscience". I think we should try to resolve this discrepancy, perhaps by removing the part in the conceptual basis section described above. There are sources that say that acupuncture is not pure pseudoscience--for example this book [46] says that it was considered pseudoscientific in the past but now there is plausible scientific evidence for its effectiveness. Thus I don't think it's appropriate to say that acupuncture is pseudoscience as if it were an undisputed fact. Everymorning talk 23:53, 15 April 2015 (UTC)[reply]

Agreed. As a matter of fact, for the sake of parity, we should even include that source in both the lede and the body. LesVegas (talk) 00:04, 16 April 2015 (UTC)[reply]

Actually, as I'm reading the source now I think it contains better parity than what we currently have in the lede in and of itself: "The claim that acupuncture is medically effective has in the past been declared a pseudoscientific claim (by e.g. Sampson, et al) (1991)), but we now have some plausible scientific evidence for acupuncture's effectiveness. (Achilles 1996, Jones 2002.)" The problem with the current wording in the lede, "many within the field of science view acupuncture as quackery" is the context, both before and after it. Here is how the source reads, in full:

Although >40 disorders have been recognized by the World Health Organization8 as conditions that can benefit from acupuncture treatment, many within the field of sci- ence view acupuncture as “quackery” and “pseudoscience,” and its effect as “theatrical placebo.”4,9–14 It seems some- what naive to totally condemn the practice of acupuncture, while accepting orthodox medicine as the basis for treating all medical conditions. Should we modify the lede to say "many within the field of science naively believe"? That wouldn't be popular, but that's what the source means. The claim does not verify the in-context source in that instance whatsoever. Further, we have the "borderlands science" quote by two individuals who are not notable enough to be in the lede. In my opinion, the best way for parity is to use the Routledge source. LesVegas (talk) 00:18, 16 April 2015 (UTC)[reply]

No one has ever demonstrated a mechanism for acupuncture to be effective beyond placebo, scientific consensus is that the primary effects of acupuncture are placebo effects, and there's nothing about being a placebo that would contradict the statement that it's pseudoscience. Homeopathy certainly has some placebo-based benefits as well, and I would hope no one here is dishonest enough to claim that homeopathy isn't pseudoscience.—Kww(talk) 02:07, 16 April 2015 (UTC)[reply]

There have been plenty of sources that have demonstrated that it's effective, high quality ones too, but you either keep deleting them or ignoring them. And I thought QuackGuru was the only one with an IDHT issue! LesVegas (talk) 02:20, 16 April 2015 (UTC)[reply]

The two primary reviews of effectiveness for acupuncture (Ernst and Vickers) both conclude that any actual effect of acupuncture is smaller than its placebo effects, and the conclusion that there is any effect at all is widely attacked as an artifact of Vickers's biases. There are some outliers (the one I find most hilarious is the study that purports to demonstrate that moxibustion cures breech birth), but you'll have to point out the one that demonstrates that there's a plausible mechanism beyond placebo. At best. there's some handwaving studies that can't conclude anything stronger than "suggesting" a possible mode that requires "further study". Precisely what is the explanation for how jabbing someone with a needle could effect his allergies that doesn't involve qi, yin, yang, meridians, or similar pseudoscience?—Kww(talk) 02:33, 16 April 2015 (UTC)[reply]

Affect (not effect)...just saying. Continue debate. TylerDurden8823 (talk) 02:42, 16 April 2015 (UTC)[reply]

Kww, why do you keep failing to address, for instance, the Hopton/MacPhereson review which you have been shown several times now? There's more like it, too, Kww, and you keep ignoring evidence. I just looked on Pubmed and only found one study within the last year which had negative findings for acupuncture and the rest (20+ or so) were positive. Look, it's okay to have an opinion here. Everyone does. But we quote sources, not delete the ones we don't like for no other reason than "I don't agree". That is Wikipedia:Randy in Boise to a T, and you're better than that. LesVegas (talk) 02:55, 16 April 2015 (UTC)[reply]

By the way, Kww, is this what your argument has come to, where the only way you can establish in the lede that "scientists believe acupuncture is quackery" is by quoting a source that defends acupuncture, in context, and actually calls these very scientists "naive" for believing acupuncture to be pseudoscience? Really? LesVegas (talk) 03:02, 16 April 2015 (UTC)[reply]

If you can demonstrate any reason to believe that that particular study is more reliable and more highly regarded than Ernst or Vickers, I'll pay attention to it. The particular source you are using here (Routledge) is an opinion piece about the various philosophies of when a topic should be considered pseudoscience, and doesn't refute the notion that acupuncture is widely considered to be pseudoscience, simply that the author thinks the reasoning people are using is up for debate. I'm willing to entertain better sources for stating that acupuncture is widely considered to be pseudoscience, but not removal of the description from the lead.—Kww(talk) 03:10, 16 April 2015 (UTC)[reply]

No Kww, IDHT'ing doesn't come with caveats like "demonstrate and I'll pay attention to it". But how about this? If you can demonstrate that it's not reliable, then I will stop asking you about sources like that every time you make a claim about scientific consensus to justify your overly restrictive editing beliefs. And at last count, the "consensus" equaled only one meta-analysis in your favor, but, hey, who's counting anyway? And I do agree with you that the Routledge source is an opinion piece on scientific philosophy. Sure, it's not the best for its claim, but a hell of a lot stronger than a pro-acupuncture source that describes scientists as "naive" for characterizing acupuncture as pseudoscience to back up the claim that "scientists believe acupuncture to be quackery." But I'll make you a deal. If you can find a good source that shows that many scientists call it quackery, I won't contest using it. However, if I find a reliable source that says there's active scientific debate on the topic and that not everyone agrees, we'll add that afterwords as NPOV policies state that we should, for parity. I won't add it in, though, if you are unable to find a reliable source saying that "scientists believe it's pseudoscience" or whatever. Agreed? In the meantime, we should remove the abysmal source from the lede. As Everymorning stated above, it is a bit weird for the article to flatly state that acupuncture is pseudoscience as if it were "an undisputed fact". It is especially weird to do it with a pro-acupuncture source that goes on to call these amorphous and unnamed scientists "naive" for their beliefs. LesVegas (talk) 04:36, 16 April 2015 (UTC)[reply]

LesVegas, the particular review you keep bringing up doesn't contradict Ernst or Vickers: "In general, effect sizes (standardized mean differences) were found to be relatively small" and won't even come to the conclusion that those effect sizes are significant, only that we should ask "more practical questions about whether the overall benefit is clinically meaningful". This isn't a case of IDHT on my part: try saying something that responds to my point. The underpinnings of acupuncture (meridians, yin, yang, qi) fall under the category of obvious pseudoscience. Is there any accepted scientific explanation for the purported effects of acupuncture? How jabbing needles into someone would relieve allergies? How it would have any impact whatsoever on breech birth, tinnitus, or the myriad other conditions it is used for?

As for this particular use of the Wang source, it's a statement counter to interests, which I use as a touchstone of reliability when I analyse something for bias. The statement it supports is "Many within the scientific community consider it [acupuncture] to be quackery." That's both obviously true and supported by the source. Our use of the source is not to make Wang feel better about himself, it's to indicate that even acupuncturists have noticed that many scientists consider them to be quacks. Certainly you aren't saying that scientists now embrace acupuncture and no one considers acupuncturists to be quacks anymore, are you? That would be quite a social revolution, and not one that I see any particular evidence of happening.—Kww(talk) 15:00, 16 April 2015 (UTC)[reply]

NOTE: This is a reply to Kww's immediately-preceding comment at 15:00, 16 April 2015. To preserve threading, please do not add comments between that comment and this one. --Middle 8 (t • c | privacy • COI) 12:59, 17 April 2015 (UTC)[reply]

@Kww, a few points:

1. How do we know that consensus about efficacy has already formed around Ernst and Vickers? Where is the source meeting WP:RS/AC that says so? Your burden. Additionally, trials for efficacy continue (which skeptics hate); this fact indicates a lack of consensus.
2. Remember that Ernst and Vickers are about acu for pain only; whatever degree of general agreement has formed or will form around pain doesn't generalize to other conditions. Again, your burden; additionally, cf. Cochrane's and Ernst's disagreement on PONV.
3. Wang, per WP:WEIGHT, should also be used to indicate Wang's disputation of the pseudoscience label and similar dismissals.
4. While the underpinnings of acu are pseudoscience (systematic, just like astrology), the practice of acu isn't: again, we don't see clinical trials looking for qi, but we do see them for efficacy.
5. Re mechanism as a criterion for demarcation: A plausible mechanism doesn't have to be proven, but possible (otherwise lots of drugs wouldn't get approved). Homeopathy lacks such, but reasonable hypotheses exist for acupuncture (and even for emergent correlates of meridians &c.), e.g. Langevin's hypothesis re fascia. BTW, the proposed mechanism for UB-67's traditional indications (breech baby, inducing labor; expelling the placenta) is oxytocin release. [47] No idea why stimulating the pinkie toe would do that, but that's consistent with what they see, and oxytocin does indeed cause uterine contractions (that's the mechanism by which breastfeeding helps expel the placenta).

happy editing, Middle 8 (t • c | privacy • COI) 12:59, 17 April 2015 (UTC)[reply]

I'm open to rewording to say "the foundations of acupuncture are superstition and pseudoscience, but scientific investigation shows that there is the possibility of an actual mechanism with some weak effects, however, no consensus that those weak effects both exist and have clinical significance exists" or some similar wording. As for it being my burden to dismiss a source: not so much, and I'm not. It, again, agrees with Ernst and Vickers as to the results: evidence of an effect beyond placebo, but so weak that it can't come to the conclusion that that weak effect is clinically significant. That places it closer to Ernst than to Vickers, except for the bizarre conclusion that demonstrating an effect without demonstrating clinical significance was worthy of notice.—Kww(talk) 14:55, 17 April 2015 (UTC)[reply]

That's actually pretty good wording re consensus & lack thereof; a good use of what RS we have. On your 2nd sentence, I didn't say you had a "burden to dismiss" any source; not sure what you mean there... you might want to re-read my #3. When you say "it" agreed with E. & V. are you talking about Wang's editorial? If so I see what you mean, but see Jytdog's asterisks 2, 3 & 4 here; we shouldn't depict mainstream use as bizarre except insofar as RS do (not that your wording above does). --Middle 8 (t • c | privacy • COI) 16:00, 17 April 2015 (UTC)[reply]

I strongly object to the statement, "the foundations of acupuncture are superstition and pseudoscience" mostly because Kww believes acupuncture's underpinnings are based on concepts like meridians and mystical energy. The word, "meridian" has no basis whatsoever in the Chinese language. There are words like jing mai 經脈 and luo mai 絡脈 which these gross mistranslations are based on. Jing, 經 like all characters, has a multitude of meanings at once. It can mean primary, main, or better, trunk-like and also, at the same time, it means vertical, upright or longditudinal. The idea here is that it is seen as patterning throughout the natural world and is shared by trees, rivers or even human beings. Mai 脈 means vessel, or container, although there is a connotation it is still somewhat permeable where essential elements individual to that natural being are allowed to move in and out of. When applied to plants, it is xylem and phloem. When applied to humanity, it is blood vessels. Every respectable sinologist translates 經脈 as blood vessels when applied to humans (although one translates it as "blood rivers" to preserve the permeability idea within the mai radical.) In the human being, jing mai 經脈 are vessels where Qi and Blood move through. Now, the character for Qi 氣 is created from two different characters: “rice” (米) and the character for “steam”(气). "Qi" is the steam which comes from cooking rice, meaning it is the essence of, or the finest matter composing anything. It is philosophical in nature, and if it applied in the realm of physics it is the energy contained in matter. It has nothing to do with the vitalistic notions that have been attached to it. I contend the only thing pseudoscientific about acupuncture is the modern, Western misunderstanding and mistranslations that have been attached to its concepts. I also find these connective tissue concepts Middle 8 brings up interesting from the standpoint of language, ie "Jing Jin" or connective tissue pathways which have been confirmed to exist. But I don't want to say the concept of meridian, or the misunderstanding of Qi isn't pseudoscientific, and perhaps we can distinguish this in the article in some way?

Now, as for the rest of Kww's proposed wording, perhaps I can address it while also addressing the reply above at 15:00? Kww, you seized on "relatively small" yet we don't know what that was in relation to. Afterall, several pain groups showed inconsistent results. How could you miss, "for short-term outcomes, acupuncture showed significant superiority over sham for back pain, knee pain, and headache" for instance? Since when did "significant superiority over sham" get reduced to effect size of small in all cases in your world? So I also contend the term "weak effects" which you seem to apply universally, to all conditions. If we're going to summarize sources in the lede, we have to do so more widely than that. As an aside, I think it's worth mentioning that this meta-analysis showing SSRI's are equal to placebos, except in severe cases is reflected on the SSRI article merely as "The efficacy of SSRIs in mild or moderate cases of depression has been disputed." Perhaps we should start taking a cue from articles like this? LesVegas (talk) 18:26, 17 April 2015 (UTC)[reply]

If you must replace qi and myridians with "imaginary conduits for imaginary forces concocted as explanations in prescientific times" or something of the like, feel free. The theoretical underpinnings of acupuncture are indisputably nonsense. If someone comes up with an explanation for the trivial effects it may have, it will have nothing at all to do with the explanations that were given when it was originally developed. As for SSRIs, of course there are other treatments that don't do much good, and some of those have certainly come from people that were trying to practice legitimate medicine.—Kww(talk) 18:57, 17 April 2015 (UTC)[reply]

No, qi or meridians don't translate as "imaginary conduits for imaginary forces concocted as explanations in prescientific times" either. Again, you're revealing your deep lack of understanding on the underpinnings of Chinese medicine, which can only be resolved with understanding of the language. Jing-Mai (oft mistranslated as meridians) actually translates as longitudinal blood vessels according to the foremost sinologists, and Qi translates as essence of, or most refined matter of any given material, much closer to the notions of physics than vitalism. My point on SSRI's was not that they lacked efficacy, but how editors on that article handle this supposed lack of efficacy in certain key situations, within the lede. LesVegas (talk) 19:35, 17 April 2015 (UTC)[reply]

And if I were to characterize the theoretical underpinnings of acupuncture, I think it's more accurate to say they would be philosophical in basis versus scientific. It's founded more on philosophical concepts like Yin/Yang and the 5 Phase cycle, is it not? The "scientific" term is really too Western in connotation. Why don't we use that term? I mean, it gets around the whole "before science" argument and its more accurate. LesVegas (talk) 20:05, 17 April 2015 (UTC)[reply]

We don't use concepts like Yin/Yang and the 5 Phase Cycle because they are superstitions, not science. Medical treatments are a scientific topic, not a philosophical one. We don't use terms like that because they would serve to promote superstition and pseudoscience, things that we are supposed to avoid.—Kww(talk) 20:14, 17 April 2015 (UTC)[reply]

Kww, I just wanted to comment real quick before I have to take a prolonged absence from Wikipedia (and I can hear your cheers right now) for some family reasons. Anywho, concepts like yin and yang aren't superstitions at all. It's a philosophical principle where everything in the universe can be reduced to being yin or yang relative to something else. And this philosophy, like all good philosophical systems, can be applied to everything, including human beings. So, the bottom of the foot is relatively more yin than the top of the head, which is relatively more yang because it gets more sun. Those underpinnings are the basis for the medicine and is why I was saying it's philosophical. If you're curious to see that I'm definitely not alone in this belief, you should read the Wikipedia article on Yin_and_yang where both the article and all the sources describe it as a philosophy. It's actually a good article for Wikipedia or even internet standards. At any rate, I don't know when I will be able to continue this conversation but I do hope you will one day see the light, and that light is relatively more yang than darkness. Just kidding, I do wish you the best regardless and hope to be back soon. LesVegas (talk) 18:31, 18 April 2015 (UTC)[reply]

For the record, I was expressing approval of the way Kww's wording handled sci consensus on efficacy. The "founded on pseudoscience and superstition" business can easily be overdone. Just say in the lede that it's based on Chinese philosophy -- that's what Brittanica does. Brittanica and very large majority of MEDRS's use the term pseudoscience sparingly. Does that make them woo-apologists? No, it just means they aren't as polemically-oriented as e.g. RationalWiki. In the body of our article, fine, cite RS's saying it's based on superstition etc., but attribute it, and (following the weight of Brittanica et. al.) don't weight it excessively. --Middle 8 (t • c | privacy • COI) 07:42, 22 April 2015 (UTC)[reply]

It's not based on reality, that's for sure. Chiojnese philosophy? Not convinced: modern-day acupuncture is essentially an invention of Mao, after all. Guy (Help!) 14:47, 22 April 2015 (UTC)[reply]

Mao came up with Yin and Yang and Qi and the zang fu and nine needles and meridians 'n shit? Pretty impressive. And even more amazing, the way he then traveled back in time to put all that stuff in centuries-old texts. Saying Mao invented acupuncture is like saying Huang Di himself did. Look to good RS for the history of Chinese medicine. --Middle 8 (t • c | privacy • COI) 01:44, 24 April 2015 (UTC)[reply]

Round and round we go. The purportedly scientific study of nonexistent concepts such as qi and meridians, is what makes acupuncture pseudoscientific. This is settled long since, and the fact that every few months a believer starts the debate again, never changes the facts or the outcome. There are no sources that demonstrate acupuncture to be effective other than as placebo or distraction therapy, the sources which purport to do so cannot, by their very nature, refute the null hypothesis. All they can do is provide a data point that appears greater than placebo, which Ioannidis tells us is most likely a false positive since (a) there is no plausible mechanism for most of the claimed effects and (b) tests on different conditions and pathologies that should yield similar results, in fact yield different results (a bit like homeopathy having different remedies for pain in the left versus the right hand). The claim that there are conditions "recognized by the WHO" is misdirection. The WHO statements on acupuncture are the result of political lobbying by believers. All that matters is, can scientists reliably demonstrate objective results that are not yielded by an appropriate placebo. The answer to that is: no, they cannot. All we actually know with confidence at this time is that it does not appear to matter where you place the needles, how deep you insert them (or if you even insert them at all), how long they remain in place, how hot or cold they are, whether you rotate them or not - in short, pretty much everything about the needles themselves appears to be arbitrary and irrelevant to the outcome. Guy (Help!) 14:44, 22 April 2015 (UTC)[reply]

The scientific consensus disagrees with you. See Harrison's Principles of Internal Medicine chapter on complementary medicine and NHS acupuncture. -A1candidate 18:10, 1 May 2015 (UTC)[reply]

The Routledge Companion to Philosophy of Science does not indicate the page number and the Google Books link does not provide anything about acupuncture. I have the 2008 edition of the work, and therein is nothing about acupuncture. Tgeorgescu (talk) 01:50, 16 April 2015 (UTC)[reply]

I copy/pasted the link in Google Chrome and indeed it is verified, but no page number is given. Tgeorgescu (talk) 01:55, 16 April 2015 (UTC)[reply]

I just verified the page # on Amazon's "look inside" feature. It's page # 470. LesVegas (talk) 02:25, 16 April 2015 (UTC)[reply]

I have found a source that says that "There is a strong scientific basis for traditional chinese medicine" in contrast to the article's current assertion (sourced to Quackwatch) that TCM isn't based on science. The source is this book, page 2, section 1.2. Does it seem reliable, and if so, more reliable than Quackwatch? It was, after all, published by the Royal Society of Chemistry.Everymorning talk 00:57, 27 April 2015 (UTC)[reply]

Wow, that is absolutely a very reliable source since it is a textbook published by the Royal Society of Chemistry. FYI, I'm not going to be available to discuss this at length due to real world circumstances right now, but for now I'll just pop in and say that, yes, anything published by the RSC that is specific to the topic of TCM is much more reliable than QuackWatch which is a POV pushing advocacy site. QuackWatch might be reliable for certain claims, but in this article any claim should always be attributed at the very least so that the reader knows where the information is coming from. Is it reliable for this claim, especially in light of this textbook from RSC? Well, I guess that will be for us to decide. Keep in mind, we also say in the lede that acupuncture founded on "pseudoscience" (and we use a pro-acupuncture source out of context to say that, big stretch with out sources!) As I see it, we have several options: option 1 is we use the source next to Quackwatch and others in the lede for parity. Option 2, we delete claims coming from Quackwatch and other one-sided sources because they might not be able to hold their weight next to a source like this. Option 3 we use the source and don't delete claims by Quackwatch and others, but we attribute those to let the reader know where the statements are coming from, in all cases. Option 4 we don't use a high quality source like this and edit war anyone who tries adding it in, yet keep bending sources to make the article appear that all things Chinese medicine are pseudoscience and keep doing this until someone files an RfC. ANywho, those are the options as I see them and I'm not sure which one I'm for yet, three of them seem reasonable, one terrible. LesVegas (talk) 01:43, 27 April 2015 (UTC)[reply]

Nobody mentioned Option 5 - we could, you know, examine the source, to um, see if it is any good. I have a small but exciting wager on the outcome. -Roxy the Viking dog™ (resonate) 03:00, 27 April 2015 (UTC)[reply]

But wait, Option 5 looks a whole lot like Option 4 especially since you did't even bother to say why a textbook published by RSC would be unreliable. I have a little time this morning to discuss this so if anyone would care to add something, let's hear it before we add the source in. LesVegas (talk) 15:45, 27 April 2015 (UTC)[reply]

It's certainly not a preferred source for medical topics. I also note that it includes an internal disclaimer that its contents are not endorsed by the RSC.—Kww(talk) 04:23, 28 April 2015 (UTC)[reply]

Sorry, KWW, but it looks like the RSC uses that as a standard disclaimer on all their newer publications. like this one and this one or this one. So perhaps since this source is rock solid after all, the conversation should begin to move towards how and where we add it in and what lower quality sources should be deleted with this taking its place? LesVegas (talk) 19:16, 28 April 2015 (UTC)[reply]

If they disclaim it, they disclaim it, so they are not relevant to determining the reliability. Any discussion of reliability can only pertain to the actual author and whether this particular material has survived peer review.—Kww(talk) 05:41, 29 April 2015 (UTC)[reply]

They disclaim every book. What is nothing published by RSC reliable now?. MEDRS states that the publisher matters (in cases of a low quality publication) but says nothing about standard legal disclaimers. But if you find something in MEDRS or any policy or guideline that states otherwise, feel free to add that to the discussion before we add this source into the article. LesVegas (talk) 14:06, 29 April 2015 (UTC)[reply]

No, but the source has to be evaluated on the merits of the author, not the publisher. If they disclaim it, they disclaim it. Given that it is so clearly a fringe view and not supported by the publisher, it doesn't merit inclusion.—Kww(talk) 18:40, 3 May 2015 (UTC)[reply]

KWW, I gave you several examples of RSC using that disclaimer in all their current texts. I could give more, but I have to assume you will ignore those as well. That issue isn't going away. Iff you want to have a discussion as to whether or not anything currently published by RSC is unreliable, we can have that discussion. As I see it, it is your burden to show that standard legal disclaimers are unreliable in Wikilaw. LesVegas (talk) 19:00, 3 May 2015 (UTC)[reply]

Just popping in to this discussion. Actually, both of them matter, but even meritorious authors might have published a lot of nonsense that have never passed the scrutinizing eyes of a notable publication. Therefore, we are highly interested in the publisher, but of course, the both have to match. Jayaguru-Shishya (talk) 17:15, 4 May 2015 (UTC)[reply]

I'm sorry that you don't understand the meaning of a disclaimer, but it's pretty straightforward: the RSC's reliability is irrelevant to the discussion. Doesn't mean the source is unreliable, but it doesn't mean it's reliable, because they have disclaimed responsibility for the material. If you believe such a ludicrously fringe view to be from a reliable source, you will have to defend its inclusion based on the authors expertise, not the publisher.—Kww(talk) 19:10, 3 May 2015 (UTC)[reply]

I have changed it to "Some scientists believe that the theories basis of TCM are poorly understood in the West". Is this a good enough compromise, User:Kww? We are not stating that TCM has a scientific basis whatsoever. User:Mann jess your input here would be helpful too. -A1candidate 19:42, 3 May 2015 (UTC)[reply]

I think the basis of TCM is well understood in the West: it's based on folklore and superstition. It isn't science, isn't based on science, and shouldn't be described as being on par with science. Describing it as "poorly understood" implies that it has some unappreciated merit. It doesn't. Your edits leave the reader with the false impression that there is some legitimate scientific controversy about TCM.—Kww(talk) 19:53, 3 May 2015 (UTC)[reply]

Well, I live in the West. And I certainly don't understand the theories of TCM. -A1candidate 19:54, 3 May 2015 (UTC)[reply]

All you need to understand about them is that they are entertaining folk superstitions at best. The specific details aren't important.—Kww(talk) 19:58, 3 May 2015 (UTC)[reply]

I'm afraid we have to disagree, because true skepticism entails understanding the contrary arguments, even if they are demonstrably wrong. -A1candidate 20:07, 3 May 2015 (UTC)[reply]

A1, it is my belief that a compromise isn't necessary, but I want to thank you for trying to be a peacemaker. The source is accurate and attributed and reliable according to every guideline I know of, other than the ones being made up on the fly here. At some point this page needs to stop having two sets of rules. I would never suggest a reliable source that criticizes acupuncture is unreliable based on a standard legal disclaimer, even though I have found some in our article. LesVegas (talk) 20:04, 3 May 2015 (UTC)[reply]

And, if you read carefully, I haven't suggested that a source is unreliable because it contains a disclaimer either. I've said that you need to make the case for reliability based only upon the parties that haven't issued disclaimers about the contents. You haven't made any effort to do so. As for the page having two sets of rules, it doesn't: sources representing mainstream scientific thought have precedence over mysticism and fringe science. That should be a fairly simple rule to comprehend and abide by. That you persistently wind up on the wrong side of it is a different issue.—Kww(talk) 21:15, 3 May 2015 (UTC)[reply]

The content you wish to include is diametrically opposed to the vast majority of the quality sources we have on the topic. Many of those are already cited, including, for example, Ernst. Systematic reviews show, at most, efficacy for reducing certain types of pain, and no results beyond placebo for other conditions. Impartial reviews of TCM indicate it is not science-based or evidence-based, and is almost wholly rejected by the scientific community as a result. Here is a source which sets out explicitly to show that TCM should be seen to have a scientific basis, despite that trend. So, is it reliable? Well, it is a source with a clear agenda: advocating for a minority (or, more likely, fringe) position that I don't see advanced elsewhere. I think the burden on demonstrating its reliability is therefore quite high for it to overturn our MEDRS compliant sources, and even if that were done, it would need to be given due weight, not exclusive weight, when describing the subject.   — Jess· Δ♥ 21:37, 3 May 2015 (UTC)[reply]

Is Quackwatch a reliable source? I have raised this question at Wikipedia talk:Identifying reliable sources (medicine).DrChrissy ^(talk) 11:36, 27 April 2015 (UTC)[reply]

Hello Dr. Chrissy! Thank you for your contributions! This has been discussed at length before and the outcome of the discussion was that Quackwatch can be used as a source in certain cases. It is certainly not MEDRS, and in case where a source is more reliable than Quackwatch contradicts it, we should use that source and delete Quackwatch. I think it's pretty ridiculous to use Quackwatch to back up how Chinese medicine works, when we have textbooks that do a better job at it and are far more reliable to make those claims. I also think that Quackwatch is pretty much on par with something like Natural News for most claims. Some editors want to see Quackwatch sourced everywhere in articles like this, thinking it is reliable for non-MEDRS claims, but oddly scoff at something like Natural News or Mercola.com being used for non MEDRS claims. I just say, let's use all of them or none of them, but at the very least, let's please be consistent. I'm very busy currently but I'm willing to make some pop-ins to discuss this subject again, and I am glad you raised it. Dr. Chrissy, please feel free to ping me or keep me updated on my talk page. LesVegas (talk) 15:55, 27 April 2015 (UTC)[reply]

Thanks for that. I had not realised this has been discussed before. Consistency is exactly what I want here (and on many other pages where apparently medic-related editors use their WP:MEDRS scythes to raze an article to the ground). It seems that one rule is used in one context, and another in another context. For a neutral editor, it seems impossible to edit in a way that is not immediately slapped down by someone quoting any number of guidelines/policies/discussions etc. I think that for any medical related article, the very least a reader should expect as that the sources should have been peer-reviewed. This is not necessarily the case with Quackwatch articles. Will let you know what goes on.DrChrissy ^(talk) 16:33, 27 April 2015 (UTC)[reply]

There is a new discussion. See Wikipedia_talk:Identifying_reliable_sources_(medicine)#Is_Quackwatch_a_reliable_source.3F. QuackGuru (talk) 07:10, 28 April 2015 (UTC)[reply]

What, again? How many times has it been now? -Roxy the Viking dog™ (resonate) 08:37, 28 April 2015 (UTC)[reply]

Note the Quackwatch quote is attributed, has been in the article for some time, and the source has not been rejected as unreliable or inappropriate (far from it). --NeilN ^{talk to me} 17:55, 1 May 2015 (UTC)[reply]

See Wikipedia talk:Identifying reliable sources (medicine) -A1candidate 18:07, 1 May 2015 (UTC)[reply]

Yes, I know (it's linked above), and I do not think that discussion says what you want it to say. --NeilN ^{talk to me} 18:57, 1 May 2015 (UTC)[reply]

Serious silliness

Quackwatch is not a reliable source for health related content. Period. Is this health related content. Yes. Is there research in this area and multiple RS per Wikipedia more reliable than Qw. Yes. The good news is that most reading this article and coming across Quackwatch will have the good sense to question both that source and may possibly wonder further about the quality of an article which parades about a long quote based on this kind of source. Adding such a source merely brings the article and its content, sources, and editors into question. Maybe that's a good thing. Given the edit warring over a non MEDRS compliant source, I'd just leave it in the article where it has the opposite effect of underlining the reliability of the content and of the article. Maybe eventually, some will have the good sense to abide by WP and remove this content in favour of something compliant. Until then we have something seriously silly in this article.(18:15, 1 May 2015 (UTC)) — Preceding unsigned comment added by Littleolive oil (talk • contribs)

I support Olive by agreeing that the quote should remain. I disagree on everything else. -Roxy the Viking dog™ (resonate) 18:22, 1 May 2015 (UTC)[reply]

The source may have been for a long time in the article, but it's a good thing that it's been paid attention to right now. Just the mere fact that "it has been in the article for some time" does not make the source any more or less reliable, though. The question is whether QuackWatch is an appropriate source for this very instance. But no, QuackWatch is not reliable per se, something that has been voiced out by many editors. Should there be any claims on medical efficiency backed up this source, it is strongly advised to remove the material immediately.

I think the first step that we are required to do, is to remove the block quotes given for such a marginal source. Second, it should be considered whether acupuncture is a subject that hasn't attracted enough scientific research. If there's a rich variety of scientific research on the subject, then we don't want to include any claims so poor that haven't been even able to make their way through some notable peer-reviewed journal. Jayaguru-Shishya (talk) 19:19, 1 May 2015 (UTC)[reply]

So. This isn't health related content? Bottom line Roxy.(Littleolive oil (talk) 18:24, 1 May 2015 (UTC))[reply]

Sticking pins into people to cure them is health related? Answer : No. Actually it is serious silliness. -Roxy the Viking dog™ (resonate) 18:27, 1 May 2015 (UTC)[reply]

edit conflict

Repeat bottom line. This is a health related article and health related content. We are mistaken in thinking any personal opinion on whether any health related methods work or not, and that means allopathic as well as anything else, or have a place in determining what goes into articles. I have no clue if acupuncture works or not but that opinion or lack of it has nothing to do with what is added to this article. Make it simple. Get opinions out of the way and deal with WP compliancy.(Littleolive oil (talk) 18:42, 1 May 2015 (UTC))[reply]

Littleolive oil would you mind combining this with the section above Is Quackwatch a reliable source?? It's difficult when a single topic is split across multiple threads. Thanks... Zad68 18:36, 1 May 2015 (UTC)[reply]

You may do whatever you want with this. I doubt I'll comment further. We're dealing with something so incredibly basic here which I outlined. If editors will not abide by WP in this area there's little more here to be said or done. Feel free.(Littleolive oil (talk) 18:42, 1 May 2015 (UTC))[reply]

RS vs. other questions

Let's first resolve that QuackWatch is a perfectly reliable source for quoting something QuackWatch itself publishes on its own website. And that is all the content being challenged is doing, it's quoting QuackWatch with attribution ("Quackwatch states that 'TCM theory and practice are not based upon...'"), it's not using QuackWatch as a source to make an unattributed assertion in Wikipedia's narrative voice. So this isn't a WP:RS issue, and WP:BURDEN is met.

The questions that could follow are:

1. Is the use of QuackWatch in accordance with WP:DUEWEIGHT?
2. Can the article be improved by replacing the QW quote with an assertion in Wikipedia's narrative voice, sourced to something better than QuackWatch?

Zad68 18:38, 1 May 2015 (UTC)[reply]

1. No

2. Yes, it can be sourced to prominent medical textbooks such as Miller's Anesthesia, which says "A scientific basis may exist for acupuncture" (pg. 1235) and "When compared with placebo, acupuncture treatment has proven efficacy for relieving pain" (pg. 1235)

-A1candidate 18:54, 1 May 2015 (UTC)[reply]

A1 let's be careful here, the QW quote is talking about TCM theories (qi and meridians); Miller's just mentions that qi exists as part of traditional acupuncture theory, but doesn't make a statement about the validity of TCM theory, which is what QW is covering. Zad68 19:05, 1 May 2015 (UTC)[reply]

Well then use Oxford Textbook of Palliative Medicine , which says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266). The first part of this sentence refutes the validity of traditional theory, hence making QW all but obsolete. -A1candidate 19:32, 1 May 2015 (UTC)[reply]

Sorry A1 this is exactly the same problem as Miller's: there's a mention of the traditional theory, and then the text goes on to give a modern explanation. Zad68 19:38, 1 May 2015 (UTC)[reply]

<

"The first part of that sentence refutes the validity of traditional theory." Can you not read? -A1candidate 19:46, 1 May 2015 (UTC)[reply]

Why don't we pick this up again later... have a good weekend. Zad68 19:49, 1 May 2015 (UTC)[reply]

"Let's first resolve that QuackWatch is a perfectly reliable source for quoting something QuackWatch itself publishes on its own website. And that is all the content being challenged is doing, it's quoting QuackWatch ..." The issue is not whether any source is reliable for itself. QW is making assertions attributed or not and we are quoting them. The question is whether that source then can be used where it will influence health related topics. Quackwatch is a step removed from the research on acupuncture. Quack watch admits to its own biases, writes to its own viewpoints, selectively uses research to support those opinions. How is that we are not looking at the research itself and ourselves, and citing it for the information it contains rather than relying on the biased position of an intermediate source, Qw, to do it for us. Can Qw be verified per its own research, and on top of that can it be deemed reliable for another supposedly neutral view and article. This is an issue as to whether a source is reliable in an instance where it can influence health, where it is is being used to support a very specific view point that is health related. Further, the content being suggested for this article is so general that I doubt if we will find another source so explicitly general in nature, and frankly we don't have to do that. No one says we have to match the content being used in the article especially given the nature of its source. Due weight only comes into play after verifiability and reliability. Nothing said here tells me this source is reliable to make claims that edge on health issues, and the verifiability of what QW is attesting is based on its own research. are we ready to verify QW's own verifiability. If we want to narrow down MEDRS from the way it has been used in multiple article that's a different issue but right now. I see no argument that this is a reliable source so Due weight doesn't even come into play at this point.(Littleolive oil (talk) 20:11, 1 May 2015 (UTC))[reply]

Be honest Olive, if I did all that, you'd have me castigated through pillar and post for WP:OR, and you'd be right ! -Roxy the Viking dog™ (resonate) 20:20, 1 May 2015 (UTC)[reply]

If the topic has already been covered by significant amount of scientific research, then we shouldn't include any sources of poor reliability that make claims that have not made their way to the scientific literature of today. And if such claims are already covered by scientific literature, then we don't need to use QuackWatch. QuackWatch is a reasonable source when the topic hasn't managed to attract sufficient level of academic interest, and this hardly is the case with acupuncture. Jayaguru-Shishya (talk) 21:57, 1 May 2015 (UTC)[reply]

I might have you castigated for OR :O) but I'm not describing OR in that comment. I am describing a source that is dubious in the extreme, layer upon layer. Its the source that is layered in dubiousness (is that a word) not to be confused with synthesis in the article itself.(Littleolive oil (talk) 20:25, 1 May 2015 (UTC))[reply]

Quackwatch. Please point out the source you're using for "dubious in the extreme, layer upon layer". Thanks. --NeilN ^{talk to me} 20:29, 1 May 2015 (UTC)[reply]

It seems to me that How is that we are not looking at the research itself and ourselves is a definitive incitement to WP:OR -Roxy the Viking dog™ (resonate) 20:35, 1 May 2015 (UTC)[reply]

I don't need sources to voice a well-based opinion on a talk page. This isn't article content. And Roxy looking at research or sources is not OR, its a search for verifiable, reliable sourcing. (Littleolive oil (talk) 20:59, 1 May 2015 (UTC))[reply]

Well, we don't discount sources based on an editor's gratuitous opinion. "The NY Times is a dubious source in the extreme, layer upon layer" would go over real well. --NeilN ^{talk to me} 21:09, 1 May 2015 (UTC)[reply]

Sure. We aren't discussing the New York Times or any source but one, and of course all sources are in context of the content they source. Perhaps there are cases where the NYT would be considered an unreliable source. Too bad my cmt on a talk page after all I've tried to explain is considered gratuitous, a dismissive and rather uncivil comment. (Littleolive oil (talk) 21:33, 1 May 2015 (UTC))[reply]

It's gratuitous because you haven't provided any justification for your strong opinion of "dubious in the extreme, layer upon layer", which contradicts what sources are saying in Quackwatch. --NeilN ^{talk to me} 21:42, 1 May 2015 (UTC)[reply]

There are multiple editors who have voiced concern about this source over the years, and there is a discussion ongoing at this moment. I also mentioned earlier some general concerns I had with Quackwatch. Since you are involved in at least one of those discussions you know what they are.(Littleolive oil (talk) 21:51, 1 May 2015 (UTC))[reply]

I'm not sure I can say more. This is my position as I see it, and as it would support, in my opinion and per my reading of WP, neutrality, And I've stated it as well as I can. As things turn unpleasant I have an urge to leave it to those who are more invested in the content than I am.(Littleolive oil (talk) 21:43, 1 May 2015 (UTC))[reply]

I really feel an RfC is needed here.DrChrissy ^(talk) 22:56, 1 May 2015 (UTC)[reply]

Edit in question: diff

Section: Pain

Proposed content: "Several Cochrane reviews have demonstrated that acupuncture is effective for a wide variety of painful conditions."

Source cited: Alvarez, L. (2015). "Chapter 18: Acupuncture". Handbook of Veterinary Pain Management (3rd edition). Elsevier. {{cite book}}: Unknown parameter |editors= ignored (|editor= suggested) (help)

Direct link to page in source cited (Google books): link Zad68 02:57, 28 April 2015 (UTC)[reply]

user:Zad68 recently removed a comment I added, tagging the inline ref as "unreliable". Zad68, please would you elaborate why you think this is unreliable.DrChrissy ^(talk) 20:00, 27 April 2015 (UTC)[reply]

As my edit summary stated I don't think we should be using veterinary textbooks to support content related to human health. Appears to be a WP:MEDRS issue. Per WP:BURDEN it's really up to you to make the argument why we should make an exception here. Zad68 20:02, 27 April 2015 (UTC)[reply]

WP:Burden relates to verifiability and is a red herring. The source I have given is a secondary source. I do not see why because the comment is written in a veterinary source it makes any differerence whatsoever. The review comment is about studies conducted on humans, not non-human animals. Are you suggesting that an author writing in a veterinary text book is automatically deemed to be writing lower quality science than someone writing in a human related source?DrChrissy ^(talk) 20:31, 27 April 2015 (UTC)[reply]

Chrissy, WP:BURDEN is indeed relevant because that policy says the editor adding content must show that the content is supported by a reliable source, and whether something from a veterinary textbook is ideal to use as a source to support content about human health is the focal point of our disagreement, isn't it? Per WP:MEDRS, the best sources come from experts in the relevant field, and veterinary medicine isn't human medicine. Will you be providing a reason why the article should be making an exception here by using a veterinary textbook for a statement about human health? Zad68 02:57, 28 April 2015 (UTC)[reply]

Do we know that the author of the article is not an expert in human medicine?DrChrissy ^(talk) 08:54, 28 April 2015 (UTC)[reply]

Do we care? The only thing we need to decide here is if the coverage of animal acu, a cruel practice imho when real vetinary is available, is warranted in this article. I'm not sure if we should observe that the ethics of treating animals with a treatment that wont help is actually cruelty or negligence? -Roxy the Viking dog™ (resonate) 10:49, 28 April 2015 (UTC)[reply]

C'mon Roxy let's try to keep our own thoughts about the article topic off the Talk page... For this case, yes we do care, the edit proposed looks to add content related to human health based on a veterinary source, that's the point under discussion here. (And it might be reasonable to add a sentence regarding the ethics of vet. acu. if the sources discuss it, a brief mention here and more content at Veterinary acupuncture per WP:SUMMARY.) Zad68 11:57, 28 April 2015 (UTC)[reply]

Chrissy re "Do we know that the author of the article is not an expert in human medicine?"--again per WP:BURDEN that's your argument to make. If she is a published expert in pain care for human medicine it should be easy to find something she's published in that field, we cite that instead, and then this issue is resolved. Zad68 11:57, 28 April 2015 (UTC)[reply]

This is no longer an issue. I have edited the article and the reference we are discussing no longer pertains to human medicine. Our discussion does, however, raise the rather horrible thought that if editors challenge any of the human based citations, somebody would have to "prove" the authors are expert in that field.DrChrissy ^(talk) 13:26, 28 April 2015 (UTC)[reply]

Great! Thanks Chrissy.

I don't want to get into an expansive, general discussion about policy on a particular article Talk page but generally if the source clearly meets the relevant guideline there shouldn't be a reason to challenge. If there does appear to be a significant mismatch between the source and Wikipedia's sourcing guidelines, it's reasonable to raise that as a concern and it's up to the one interested in using that source to demonstrate that it does meet the guideline. Zad68 13:48, 28 April 2015 (UTC)[reply]

Yes, I do understand. If someone has published a paper in a reputable journal in a subject-area, that pretty much makes them an expert (in that subject area). It would be disruptive to go around challenging that without good reason.DrChrissy ^(talk) 14:26, 28 April 2015 (UTC)[reply]

We already discuss the various Cochrane reviews, and include the detailed results (generally that the effect is so small that its existence can be legitimately questioned and, even if it exists, is smaller than the placebo effect). What would we gain by adding a misleading one-sentence summary to the material we already have?—Kww(talk) 14:35, 28 April 2015 (UTC)[reply]

@Kww As I said above, the reference no longer pertains to human medicine. I don't follow the point of your posting.DrChrissy ^(talk) 14:59, 28 April 2015 (UTC)[reply]

I had not seen that it had been determined that the Cochrane reviews discussed in the quote were of veterinary studies, not the ones covering humans that we discuss.—Kww(talk) 05:38, 29 April 2015 (UTC)[reply]

Just to be clear, the Cochrane reviews were of human studies of acupuncture. However, the summary of the studies by Alvarez was from a veterinary handbook (making it a tertiary source). Some editors feel that because the summary is published in a veterinary source it is automatically of lower quality. The Alvarez source was then used by another editor here[51] to indicate non-human related content.DrChrissy ^(talk) 09:29, 29 April 2015 (UTC)[reply]

Has anybody besides the doc read that acu is pleasurable? Surely that isn't suitable for an encyclopedia? -Roxy the Viking dog™ (resonate) 10:41, 28 April 2015 (UTC)[reply]

WHOA! Sit Boy! If that is aimed at me, you are well off the mark. I have been puzzling over that same statement for several days.DrChrissy ^(talk) 10:49, 28 April 2015 (UTC)[reply]

Good, I'll remove it then. -Roxy the Viking dog™ (resonate) 10:50, 28 April 2015 (UTC)[reply]

The offending material was incorporated by Jtydog here.[[52]]

... and your point is? -Roxy the Viking dog™ (resonate) 11:02, 28 April 2015 (UTC)[reply]

My point is that it was not me that introduced the material which is what you seemed to be suggesting.DrChrissy ^(talk) 11:32, 28 April 2015 (UTC)[reply]

An editor recently indicated in an edit summary that there was a WP:coatrack issue here. Rather than just leaving it rather lazily and not very convincingly in an edit summary, raise it here and let's discuss it properly.DrChrissy ^(talk) 22:35, 28 April 2015 (UTC)[reply]

DrChrissy are you talking about this edit? When you're starting a Talk page discussion it'd really be nice if you'd help out your fellow editors by specifying the particular edit you're concerned about (and by dropping unnecessary adverbs like 'lazily'). I'd actually disagree with the characterization of that section as a "coatrack" problem but I'd rather not do a whole lot of typing here if that's not what you're talking about. Zad68 02:05, 29 April 2015 (UTC)[reply]

@Zad68 Yes, that is the edit - I will be more specific in the future. Sorry about the use of "lazily". It just seems rather unhelpful for an editor to drive-by, leave the template with a negative edit summary and not even bother to take this to the Talk page. I'll curb my frustration in the future.DrChrissy ^(talk) 09:13, 29 April 2015 (UTC)[reply]

What do you think doc? -Roxy the Viking dog™ (resonate) 09:39, 29 April 2015 (UTC)[reply]

Are you talking to me? If so, please use my user name or I might be wasting my time replying.DrChrissy ^(talk) 09:54, 29 April 2015 (UTC)[reply]

Are there any other docs on this page at the moment? So, what do you think? Genuine question. -Roxy the Viking dog™ (resonate) 10:14, 29 April 2015 (UTC)[reply]

Please use my user name so that other readers can follow who you are asking a question of.DrChrissy ^(talk) 10:52, 29 April 2015 (UTC)[reply]

Sure Chrissy, thanks... No, the inclusion of a short summary section on Veterinary acupuncture isn't a coatrack problem. A general review of the reliable sourcing on acupuncture in shows that vet. acu. is well-represented. This acupuncture article is really getting to be quite sizeable and comprehensive, so it isn't undue here either. Per WP:SUMMARY there should be a section here summarizing what's at the vet. acu. article, or what should be in that article (it's tiny now and given the sourcing available it really could be expanded quite a bit).

The one thing that needs be done though is to move that section to the end per WP:MEDMOS. Actually generally this article needs to be restructured per MEDMOS. Zad68 13:34, 29 April 2015 (UTC)[reply]

It is my intention to work on the Vet Acu article soon and we can then provide a summary of that here. Happy to see the Vet Acu section moved toward (to) the end - I appreciate that is the style of medical pages.DrChrissy ^(talk) 14:16, 29 April 2015 (UTC)[reply]

@User:Zad68 I moved the Vet section to the end of the article as both you and I agreed, but another editor has moved it back. I believe I am being goaded into edit warring by this, so I will not revert but thought I should let you know.DrChrissy ^(talk) 17:35, 2 May 2015 (UTC)[reply]

@DrChrissy - I've restored it back to where it belongs. Hopefully, the disruption will stop. -A1candidate 18:20, 2 May 2015 (UTC)[reply]

You have not explained how your edits were an improvement, especially with restoring the MEDRS violations. This edit added misplaced text that is already in the article,. QuackGuru (talk) 18:23, 2 May 2015 (UTC)[reply]

It was a reasonable shortening of the article according to User:Sonicyouth86. We do have a section for related practices. See Acupuncture#Related practices. QuackGuru (talk) 01:20, 4 May 2015 (UTC)[reply]

Quick comment: I didn't mean to endorse your edits with my self-revert. I just meant that, on second thought, your deletion of sourced content didn't appear like clear-cut vandalism to me because you did provide edit summaries and participated in discussions, that's why I decided to undo my rollback. I'll let editors with deeper knowledge of the subject decide if your edits were constructive. --SonicY (talk) 01:35, 4 May 2015 (UTC)[reply]

The lead paragraph contains the following statement "TCM theory and practice are not based upon scientific knowledge,<ref name=Barrett2007/>" I propose to delete this statement for the following reasons:

1)The source is outdated - how can this source represent present consensus when it is 7-8 years old.

2)The source is not/may not be peer-reviewed.

3)The source is from a web site with a blog-like approach

4)The source is a partisan site - not NPOV

5)The source is an opinion piece of just a single person and therefore the statement is WP:UNDUE

DrChrissy ^(talk) 10:56, 2 May 2015 (UTC)[reply]

Still reliable for our use, as explained to you multiple times by multiple users. Any more of this will be disruptive. -Roxy the Viking dog™ (resonate) 11:09, 2 May 2015 (UTC)[reply]

• Support - In addition to what DrChrissy said, we have much better sources including prominent medical textbooks such as Miller's Anesthesia, which says "A scientific basis may exist for acupuncture" (pg. 1235) and "When compared with placebo, acupuncture treatment has proven efficacy for relieving pain" (pg. 1235) or Oxford Textbook of Palliative Medicine , which says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266). This is the mainstream medical consensus, as stated in the NHS's description of acupuncture: "It is based on scientific evidence that shows the treatment can stimulate nerves" and in Chapter 14e of the latest edition of Harrison's Principles of Internal Medicine: "In addition, new research is shedding light on the effects of meditation and acupuncture on central mechanisms of pain processing and perception and regulation of emotion and attention. Although many unanswered questions remain about these effects, findings are pointing to scientifically plausible mechanisms by which these modalities might yield benefit." (pg. 14e-3) -A1candidate 11:11, 2 May 2015 (UTC)[reply]

Still reliable for our use, as explained to you multiple times by multiple users. Any more of this will be disruptive. -Roxy the Viking dog™ (resonate) 11:36, 2 May 2015 (UTC)[reply]

How can opening a discussion on a Talk page be disruptive! If you don't want to join in, simply walk away - the article content has not been changed!DrChrissy ^(talk) 11:40, 2 May 2015 (UTC)[reply]

Nothing wrong with a new discussion Doc, and I encourage you to open discussions on any topic you wish. But please stop opening new discussions on the same subject over and over and over again, especially when you already know the answer. That's disruptive -Roxy the Viking dog™ (resonate) 11:50, 2 May 2015 (UTC)[reply]

Firstly, as I have requested on several occassions before, please use my correct user name. Second, it has been suggested several times that the reliability of QW as a source needs to judged on a case-by-case basis. This is what I am doing. Neither you nor I know the "answer" as to whether the source is reliable in this particular case, therefore it can not be disruptive. Perhaps you would like to comment on any one of the 5 points I raised above, rather than trying to disrupt this thread.DrChrissy ^(talk) 11:58, 2 May 2015 (UTC)[reply]

QuackWatch is not reliable per se, and there's a firm consensus that it should be used only on a case-by-case basis. I think we could proceed by endorsing the steps of 1) paraphrasing the text in such a manner that there are no longer block quotes, and 2) considering whether acupuncture is a subject that hasn't attracted enough scientific research. If there's a rich variety of scientific research on the subject, then we don't want to include any claims so poor that haven't been even able to make their way through some notable peer-reviewed journal. Jayaguru-Shishya (talk) 12:39, 2 May 2015 (UTC)[reply]

• Oppose removal. Came here from posting on WT:MEDRS by DrChrissy. Quackwatch is reliable for its own opinion, and is generally considered reliable on alt med topics of which Acupuncture is one.Use of Quackwatch is appropriate here, but should not be overemphasized if better sources are available. I should caution against the cherry-picking of specific sources that may be "positive" or "negative" towards acupuncture, but to give the full spectrum of opinion by reliable sources per WP:WEIGHT, of which Quackwatch is one. Yobol (talk) 13:38, 2 May 2015 (UTC)[reply]

If and I quote: Quackwatch is reliable for its own opinion then using the same logic, DrChrissy opinion, that it is not, -nullifies QW's opinion. Oh come on folks- if my grand children came out with this muddled thinking I'd be on the phone to my lawyer to reclaim back their education fees!--Aspro (talk) 16:07, 2 May 2015 (UTC)[reply]

Yobol, just to clarify, are you supporting the use of QW for the particular sentence I indicated in my original posting?DrChrissy ^(talk) 14:19, 2 May 2015 (UTC)[reply]

Yes. As far as I know, the underlying principles of TCM (Qi, meridians, etc) is not based on scientific knowledge (based instead on traditional pre-scientific hypotheses/superstition) and therefore appropriate for QW to be used in this context. Yobol (talk) 14:23, 2 May 2015 (UTC)[reply]

Is there a more reliable source to confirm this, or is this a marginal position outside the scientific mainstream? Jayaguru-Shishya (talk) 13:02, 3 May 2015 (UTC)[reply]

It's an easily falsifiable statement. History confirms that the statement is correct, and since there is no evidence to the contrary, it's a good one and properly sourced. -- BullRangifer (talk) 18:59, 3 May 2015 (UTC)[reply]

QW is sufficiently reliable for this statement.—Kww(talk) 14:36, 2 May 2015 (UTC)[reply]

Good, that is a real problem solver. Maybe we can include the sources to the article? After all, we don't include claims of marginal position outside the scientific mainstream. Jayaguru-Shishya (talk) 17:19, 4 May 2015 (UTC)[reply]

Do we not have a more recent, secondary or tertiary source for this? Surely the medical scientists have published something more reliable in the past decade or so.DrChrissy ^(talk) 14:52, 2 May 2015 (UTC)[reply]

Scientists generally don't publish about pre-scientific hypotheses/superstitions which have no basis in human physiology and is generally considered nonsensical in modern terms. This is why we have WP:PARITY. Yobol (talk) 15:25, 2 May 2015 (UTC)[reply]

So why is it that when I go to Cochrane Collaboration and type in "Acupuncture" I get 134 hits for systematic reviews?DrChrissy ^(talk) 15:48, 2 May 2015 (UTC)[reply]

The content in question is the proposed mechanism of how acupuncture has been traditionally considered to work by acupuncturists/TCM practitioners (Chi, meridians, etc). There is, to my knowledge, no high quality medical source that says any such entities actually exists in the human body. The studies you are seeing are studies as to whether or not acupuncture has an effect, which is a separate question as to whether or not the traditionally proposed mechanisms are correct. Yobol (talk) 15:55, 2 May 2015 (UTC)[reply]

You may be correct that there is no high quality medical source to say this, so instead, let's fall back on the opinions of just a single person and forget about how we say that only the highest quality evidence should be used in medical articles. I trust my incredulity comes through.DrChrissy ^(talk) 16:16, 2 May 2015 (UTC)[reply]

Um, what? We should be using the highest quality sourcing for this; in this case, Quackwatch fits the bill. Insisting that we have peer-reviewed studies for things that medicine views as nonsense is of course not reasonable and is precisely why we have WP:PARITY, because high quality peer-reviewed sources usually do not talk about what is generally considered nonsense. If you have high quality sourcing saying that Meridians or Chi or whatever actually exists, present them. Otherwise, Quackwatch is perfectly reliable for saying such nonsense does not exist. Yobol (talk) 16:21, 2 May 2015 (UTC)[reply]

Well if you don't mind me for saying so that is Pseudoskepticism. Can't argue against a pseudo-skeptic because they can't be proved wrong (and when they are, they just move the goal posts). So its turtles all the way down and no one can disprove it – so they are always right – even when wrong. Lets move on and not waste our time arguing about if QW might sometimes, have something of merit. Over all, we (the bulk of editors) acknowledge that QW is not to be viewed as a reliable source.--Aspro (talk) 16:51, 2 May 2015 (UTC)[reply]

Please stop the nonsense of claiming "the bulk of editors" agree with you when you have no evidence of this. Thanks. Yobol (talk) 18:32, 2 May 2015 (UTC)[reply]

The talk pages on WP gives evidence to this. Jimmy Wales said and I quote: Zero information is preferred to misleading or false information'. So stop inundating us with pseudo arguments. Scientist are naturally skeptic but they don't grasp at stuff just because it gives their prejudices a warm feeling inside. Thanks.--Aspro (talk) 14:47, 3 May 2015 (UTC)[reply]

Well, this article is about acupuncture, not about traditional Chinese medicine, but both of the subjects have attracted significant amount of scientific research. So I have to disagree with Yobol here: yes, scientists do publish a great deal of research concerning acupuncture and traditional Chinese medicine. And what those studies don't say, well it obviously cannot be called part of "scientific mainstream". QuackWatch may be considered as a reliable source in such cases where the subject is so marginal that it hasn't been able to attract scientific attention (e.g. reiki healing). Just imagine, how many researchers are ready to waste their time on such nonsense? On such cases, QuackWatch fits the bill. But that's not the case at acupuncture, I am afraid. We should bear in mind the ArbCom conclusion, labeling QuackWatch as a partisan site. Anyway, the first step is to paraphrase the source so we don't have to use block quotes anymore. The second step is to think about if there are better sources available, or if we are dealing with claims not presented by the scientific consensus. Jayaguru-Shishya (talk) 13:06, 3 May 2015 (UTC)[reply]

Please note that I have proposed a specific sentence for deletion. It would help if users !voted and left a clear indication of this in bold at the beginning of one of their posts. This will avoid arguments about "bulk of editors" etc.DrChrissy ^(talk) 18:46, 2 May 2015 (UTC)[reply]

• Support as the OP.DrChrissy ^(talk) 18:47, 2 May 2015 (UTC)[reply]
• Oppose as the source is reliable for the claim. QuackGuru (talk) 18:49, 2 May 2015 (UTC)[reply]
• Oppose per WP:PARITY QW is valid source for discussion of FRINGE notions like modern claims that qi exists and flows along meridians Jytdog (talk) 19:20, 2 May 2015 (UTC)[reply]

• User:Jytdog, we have a prominent medical textbook (Oxford Textbook of Palliative Medicine ) which says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266), thereby refuting the notion of vital energy. Why promote QW when there are better sources? -A1candidate 19:26, 2 May 2015 (UTC)[reply]

oxford press does not have WP:PSCI and WP:FRINGE governing its content; wikipedia does, and here we call pseudoscience, pseudoscience. we don't just skip over the first part of that sentence you quoted. we pause and say the equivalent of "which is complete bullshit" albeit in a nicer way. we don't "promote" QW, we use it. Jytdog (talk) 19:34, 2 May 2015 (UTC)[reply]

I don't see anything useful that isn't already covered by the Oxford textbook. -A1candidate 19:40, 2 May 2015 (UTC)[reply]

I don't see anything relevant to this statement covered by the Oxford textbook. — Arthur Rubin (talk) 19:43, 2 May 2015 (UTC)[reply]

IT REFUTES THE VALIDITY OF VITAL ENERGY. Did you not read? -A1candidate 19:47, 2 May 2015 (UTC)[reply]

That's not what the quote says, and, even if that is elsewhere in the book, it wouldn't support the statement in the article, as it doesn't even imply that there aren't other (potential) bases for acupuncture, accepted by acupuncturists, which are not incompatible with scientific research. 04:38, 3 May 2015 (UTC)

Yes, that is a quadruple negative. Those without an advanced knowledge of English might misinterpret it. — Arthur Rubin (talk) 04:43, 3 May 2015 (UTC)[reply]

You obviously speak a different type of English, because the source does imply that it is compatible with neuroscientific research. Whether it is accepted by acupuncturists or not is of peripheral importance. Acceptance by the medical community is what matters. -A1candidate 09:08, 3 May 2015 (UTC)[reply]

• Oppose per WP:PARITY and WP:DEADHORSE. — Arthur Rubin (talk) 19:43, 2 May 2015 (UTC)[reply]
• Oppose Quackwatch has repeatedly been shown to be reliable at RSN, and WP:PARITY indicates we can use non-MEDRS sources on articles such as these. Further, even if that weren't true, the statement is sourceable elsewhere. This has been discussed to death already.   — Jess· Δ♥ 05:26, 3 May 2015 (UTC)[reply]
• Comment Not quite, Jess. There is a firm consensus that QuackWatch is not relaible per se, and it may be only used on a case-by-case basis. So better not say: Quackwatch has repeatedly been shown to be reliable. Actually, we have an ArbCom ruling labeling QuackWatch as a partisan source that should be used with caution. Well, that's not a surprise since not even QuackWatch itself claims to be a peer-reviewed source. QuackWatch sure has its place on some few articles, but acupuncture has been studied relatively lot, and therefore we don't have a compulsive need to include QuackWatch. Jayaguru-Shishya (talk) 13:19, 3 May 2015 (UTC)[reply]
  • Not quite, Jayaguru-Shishya. You are overreaching yourself. Three quotes from the amendment: "It is not the job of this committee to determine whether sources are reliable.", "There is an observation that Quackwatch tends to be partisan, and should not be a preferred or exclusive source, but not that it is not a reliable source as is generally understood." "Deeming a source to be reliable or unreliable is almost always going to be a content decision and as such beyond our remit." Most sources can be deemed reliable for certain things and unreliable in others. When I say the NY Times is a RS in reference to a biography it is foolish to say, "better not say: NY Times has repeatedly been shown to be reliable" because it's not a WP:MEDRS. --NeilN ^{talk to me} 15:18, 3 May 2015 (UTC)[reply]
  • NeilN, my comment wasn't addressed to you nor did I say anything about the NYT. I agree with the quotations you gave, however. I've also been emphasizing strongly that the reliability is a matter of context. I guess there was a misunderstanding there. It's also been voiced out by many editors that QuackWatch is reliable in such topics that haven't attracted sufficient scientific interest. And this is exactly the problem we are tackling with many fringe articles. Jayaguru-Shishya (talk) 15:43, 3 May 2015 (UTC)[reply]

• Comment: Some editors here may be unwittingly be putting words in the the mouth of The Journal of the American Medical Association (JAMA) by suggesting they uphold QW to be a reliable medical source. Should we not ask them for an official statement? As it could effect their reputation- what with WP being so widely read. WP editors should not speak on the behalf of another organization as it is not professional behaviour. If I worked for The Journal of the American Medical Association I would be on to the lawyers quickly, to make it very clear that mention of QW does not mean that we accept that QW as a reliable source and any mention is solely down to the writer of such an article -and we 'expect' s/he to have performed due diligence in this respect. We cannot be held responsible for any contributors lapses. We have nothing to comment upon the reliability or otherwise of this site known as QW. Period . Just asking.--Aspro (talk) 15:20, 3 May 2015 (UTC)[reply]

• Your hypothetical life is of no interest here. --NeilN ^{talk to me} 15:26, 3 May 2015 (UTC)[reply]

• And you comment is just trying to deflect! Lets be civil OK. It is to improve the quality of WP that is important here, please remember that.--Aspro (talk) 15:35, 3 May 2015 (UTC)[reply]

• Articles aren't improved by putting your words in the mouth of a source. I mean, you even say, "WP editors should not speak on the behalf of another organization" and then you blatantly go ahead and do it. Is there anything here that can't be directly surmised by JAMA statements? --NeilN ^{talk to me} 15:53, 3 May 2015 (UTC)[reply]

• You know very well that I was not blatantly putting words into The Journal of the American Medical Association's mouth. Then you go on to ask "Is there anything here that can't be directly surmised by JAMA statements?" Yes there is: all of the above. Is there anything on the the Journal of the American Medical Association site to say that they uphold QW? Think you keep getting your premises mixed up. Take deep breath and stand back, so as to take a fresh look. --Aspro (talk) 17:04, 3 May 2015 (UTC)[reply]

@Aspro Is there anything on the the Journal of the American Medical Association site to say that they uphold QW? You mean besides their publication, in their journal, that specifically says Quackwatch is a resource that provides "reliable health information"? Yobol (talk) 23:46, 3 May 2015 (UTC)[reply]

@ Yobol The Journal of the American Medical Association does not accept anything ether way. The Journal of the American Medical Association publishes topical articles. Were do you think in their choice of published articles, suggests that they adopt everything their contributors write about? As intimated to -NeilN above, you should keep premises separate. To suggest that the Journal of the American Medical Association support and accept everything they publish is a misunderstanding of the work of journals. So it is absolutely wrong for some editors here to claim that the Journal of the American Medical Association considers QW as a reliable source of medical information based on the articles that they publish. Can I say that any clearer. We (some of us) provide guidance which some editors prefer to ignore (Think to yourself: what is the root of the word ignorant. Step back and look at the bigger picture.) But maybe, I am just trying to catch the wind.--Aspro (talk) 13:28, 4 May 2015 (UTC)[reply]

@Yobol (or anybody else) If you have evidence that JAMA supports Quackwatch, please would you provide this evidence - I have looked and I can't find it.DrChrissy ^(talk) 13:10, 4 May 2015 (UTC)[reply]

@Aspro, @DrChrissy, have you all not read the Quackwatch article, which references JAMA's specifically citing Quackwatch as a reliable source for medical information? Sigh. Yobol (talk) 13:48, 4 May 2015 (UTC)[reply]

That is interesting. Wonder if the executives are aware that their lower down minions in their organization upholds QW. As I said before, we need a qualified statement from the Journal of the American Medical Association to save them from embarrassment. And believe you me, when your read through that QW site it, it is hardly a reliable medial source. The Journal of the American Medical Association's PR may refuse to reply and take the risk that it will not put the journal's reputation into question, based on that link provided, in the short term. Yet what of the future, when WP, being the first port of call for many a medical researcher, who find the Journal of the American Medical Association supports QW as reliable. Is s/he going to add included JAMA in his thesis. Think not. The argument is swaying to the Journal of the American Medical Association to officially state their position on QW as to remove all doubt. Get it from the horses mouth, rather than just guesstimate. For those that are familiar with this sort of things - it don't mean nothing unless it is a policy statement from the executive. Yobol should understand this. — Preceding unsigned comment added by Aspro (talk • contribs)

So you read the statement made by JAMA, published in JAMA, explicitly calling Quackwatch a reliable source for medical information and you call that a "guesstimate"? Now I remember why replying to you is an incredible waste of time. Yobol (talk) 15:52, 4 May 2015 (UTC)[reply]

Repeating the sentiment from above, we're not interested in what you think organizations should do to "save them from embarrassment." Focus on what they're actually stating, not on what you would like them to state. --NeilN ^{talk to me} 15:54, 4 May 2015 (UTC)[reply]

Again I ask and point out: Do the executive know about this? Is this what the executive supports. If you have left high skool and worked for a large organisation you should be aware that much of what ends up on a company web-site is not kosher. i.e. just because it is written in black and white it is not gospel – it is just stuff put up on their web-site – which you take to be gospel - can I explain that any more simply? Come on folks, use your brain cells here, If you can edit WP you must have more than two. What is the third one doing? --Aspro (talk) 17:10, 4 May 2015 (UTC)[reply]

They have apparently not checked JAMA, so this is just IDHT behavior. On a "JAMA Patient Page", under the heading "How to find reliable online health information and resources," they list Quackwatch, among other sources. JAMA clearly recommends QW as "reliable". This is good enough for us to continue using it on a case by case basis. -- BullRangifer (talk) 14:53, 4 May 2015 (UTC)[reply]

Both BullRangifer and Yobol directed us to [53] as evidence that JAMA supports Quackwatch. I am unable to open this article fully, but I can open the previous and subsequent articles. Seems rather odd. Perhaps the article [54] has been removed/redacted? I am able to see the date of publication was 1998. Perhaps in the subsequent 17 years(!) JAMA have seen fit to update their reputable sources?DrChrissy ^(talk) 16:04, 4 May 2015 (UTC)[reply]

We can use QuackWatch on a case-by-case basis when the topic is so marginal that it hasn't attracted enough scientific attention. If plenty of sources exist, however, we will use those instead of QuackWatch. Jayaguru-Shishya (talk) 17:23, 4 May 2015 (UTC)[reply]

I can open the article just fine, it is still available on the website. Do you have any reason, other than your own apparent dislike for Quackwatch itself, to think JAMA no longer thinks Quackwatch is reliable? If and when you find a similar publication by JAMA saying Quackwatch is no longer reliable, please bring it forward. All I see here are editors who do not like Quackwatch trying their hardest to not acknowledge what high quality sources have said about it. Yobol (talk) 16:09, 4 May 2015 (UTC)[reply]

What I am trying to do at the moment is verify statements made by other users. At the moment, I am unable to do this, but I am happy to watch for comments that it can be verified. FYI, I do not dislike Quackwatch, I just intensely dislike its use by some editors when they are too lazy to go and find other peer-reviewed, NPOV secondary sources.DrChrissy ^(talk) 16:24, 4 May 2015 (UTC)[reply]

Boys, boys... For claims on medical efficiency we need peer-reviewed MEDRS compliant sources, no matter whom JAMA cites. If the topic is well covered by scientific research, then we don't need QuackWatch. There are subject though, that have been left in the shadows of mainstream science, and therefore QuackWatch is a decent source until better ones pop up. Jayaguru-Shishya (talk) 17:25, 4 May 2015 (UTC)[reply]

First, I already verified it and downloaded it. It has not been retracted. Second, sources are not required to conform to the Wikipedia policy WP:NPOV, so the term "NPOV source" is meaningless; the proper application of WP:NPOV is whether or not we (as editors) are using the sources in a manner consistent with NPOV. We use partisan/biased sources all the time and they are often necessary to have a fully NPOV compliant article that establishes all significant points of view. Now that it is clear that you and Aspro are showing clear WP:IDHT behavior, I won't waste any more of my time here. Cheers. Yobol (talk) 16:45, 4 May 2015 (UTC)[reply]

That page on that site : the Journal of the American Medical Association (that only quacks like I and Yobol can accesses apparently) , (ie not publicly assessable and thus not open to public scrutiny) has small print. That gets the the Journal of the American Medical Association off the hook regarding QW don't you think. Unless the Journal of the American Medical Association makes a official statement upon QW, then there is no substance as to why we should use it. That page referred to (not an article) but just a page – it is just that! How do we put this to you (and et al) that hidden information is not Verifiability. Otherwise people could hid information a splatter WP with nonsense. Cheers--Aspro (talk) 20:31, 4 May 2015 (UTC)[reply]

Oppose removal. Perfectly accurate statement, backed up by history. -- BullRangifer (talk) 19:06, 3 May 2015 (UTC)[reply]

• Attribute to Stephen Barrett per WP:ATTRIBUTEPOV if it's going to be kept in the lead. Zad68 16:03, 4 May 2015 (UTC)[reply]
• Support the removal and the removal of most Quackwatch sources. There are better sources out there to make the claims it makes, and if there aren't, then what does that tell us? Quackwatch is also diametrically opposed to a textbook source I added and doesn't hold weight to it even for parity, so there's that. I do think we should still have Quackwatch on the article to back up what skeptics think about acupuncture, but maybe only one or two cites at most, per weight, and the it should be attributed as Zad says. But I would attribute to Quackwatch or Quackwatch and Stephen Barrett and not Stephen Barrett alone. LesVegas (talk) 17:10, 4 May 2015 (UTC)[reply]

And yet another reason not to use QuackwatchI have been editing the Acupuncture article to remove a statement attributed to Quackwatch. I simply could not find the statement in the source provided. I challenged this. The content was re-introduced and suddenly the Quackwatch source provided the content! It appears the source I was originally following was an archive. After my challenge, this was suddenly cleaned up here[55]. How misleading this can be and what a complete waste of my time. It is so dangerous to be using Quackwatch as a source when it is so dynamic! It is a Blog and should be treated as such!DrChrissy ^(talk) 18:57, 4 May 2015 (UTC)[reply]

• Do you have any reason to believe that this was anything different than the normal case of an archive and the current text falling out of sync? That's a pretty common phenomenon across all internet sources.—Kww(talk) 19:01, 4 May 2015 (UTC)[reply]

(edit conflict)You're upset that the website changed in the last 5 years? Websites tend to do that. Your opinion of quackwatch is, however, not one shared by the editors at RSN, nor by the other reputable sources which reference it.   — Jess· Δ♥ 19:02, 4 May 2015 (UTC)[reply]

Chrissy before you started working with that quote from Quackwatch it was quoting the website accurately and the website's most recent version of the content matched what we had in our article. I don't understand what you're saying here, but it probably doesn't matter: the article and the source are now in sync. Zad68 19:03, 4 May 2015 (UTC)[reply]

I am wondering whether we are talking about the same quote. I am referring to the quote in the "Scientific reception" section in the version here [56] which states

"Quackwatch states that:[7] TCM theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. TCM practitioners disagree among themselves about how to diagnose patients and which treatments should go with which diagnoses. Even if they could agree, the TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care.

If you click on the [7], then click on the hyperlink of the title of the article, it takes you here[57]. This does not contain the quote, it does not even contain the section "The bottom line is". Try searching for the word "nebulous".

DrChrissy ^(talk)

See "TCM theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. TCM practitioners disagree among themselves about how to diagnose patients and which treatments should go with which diagnoses. Even if they could agree, the TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care. "[58] QuackGuru (talk) 21:25, 4 May 2015 (UTC)[reply]

Wow! The POV editing regarding Quackwatch is just incredible. I have just edited Quackwatch to indicate that the website does not always contain peer-reviewed articles (which it admits on its own FAQs) only to have this reverted twice. Surely this is a fundamental characteristic of Quackwatch which readers need to know. What is wrong with stating what a web-site says about itself?DrChrissy ^(talk) 23:53, 4 May 2015 (UTC)[reply]

• Oppose removal By definition, traditional Chinese medicine ("based on a tradition of more than 2,000 years") is not based on scientific knowledge, unless the word "science" is redefined to include what anyone thinks. After the event, it may turn out that some traditional remedies involve components with useful medicinal properties, but TCM is based on chi and meridians and the source is fine (WP:PARITY) for pointing out that TCM is something quite different from medicine based on science. Johnuniq (talk) 01:29, 5 May 2015 (UTC)[reply]
• Remove source...keep statement As all can see quackwatch is not seen by all here as the best source (lets assume the same can be said for our readers)....so lets find sources that have a better overall rep....thus readers and edtors will have more confidence in the article overall. I suggest we keep the sentence and just source it with something newer that mentions both TCM and Acupuncture.... like - James M. Humber; Robert F. Almeder (2013). Alternative Medicine and Ethics. Springer Science & Business Media. p. 10. ISBN 978-1-4757-2774-6. -- Moxy (talk) 01:58, 5 May 2015 (UTC)[reply]

User:NeilN, there is no solid evidence for the existence of acupuncture points. Until there is, speculations such as the one you're promoting [59] are simply wild hypotheses which are not taken seriously by the scientific community. -A1candidate 18:24, 2 May 2015 (UTC)[reply]

Yes, it has been taken seriously by researchers. QuackGuru (talk) 18:27, 2 May 2015 (UTC)[reply]

Which researchers? -A1candidate 18:28, 2 May 2015 (UTC)[reply]

Many researchers, including Edzard Ernst. QuackGuru (talk) 18:29, 2 May 2015 (UTC)[reply]

Another source would help solidify the theory's notability. --NeilN ^{talk to me} 18:31, 2 May 2015 (UTC)[reply]

It would be duplication if I added more material to the page. QuackGuru (talk) 18:41, 2 May 2015 (UTC)[reply]

• @QuackGuru - It is still complete speculation, based on an outdated source from 1999. Can you please stop promoting this tattoo hypothesis as an equivalent to "contemporary acupuncture points"? -A1candidate 19:54, 2 May 2015 (UTC)[reply]

• There are more sources such as a 2006 review from Edzard Ernst. QuackGuru (talk) 19:56, 2 May 2015 (UTC)[reply]

• All he did was refer to the 1999 source some time after it was published. I follow Ernst closely and I believe he has never mentioned this in recent years. Correct me if I'm wrong. -A1candidate 19:58, 2 May 2015 (UTC)[reply]

• The sources did not say it was speculation. For issues on recent years see WP:MEDDATE. QuackGuru (talk) 20:01, 2 May 2015 (UTC)[reply]

• So it's accepted by the scientific community? In that case we should elaborate more on these "acupuncture points", shouldn't we? -A1candidate 20:13, 2 May 2015 (UTC)[reply]

The words "pseudoscience", "quackery" and the like seem to be thrown at acupuncture without a second thought. My second thought was to check whether these terms really do apply. So, I turned to WP:MEDRS to find out which would be the best way to research this. WP:MEDRS states "Cochrane Library reviews are generally of high-quality...", so I went to the Cochrane Collaboration site and typed "acupuncture" into their reviews search engine. I got 248 hits. I went through the first 20 of these and found the following -

"There is low to moderate-level evidence that compared with no treatment and standard therapy, acupuncture improves pain and stiffness in people with fibromyalgia."[60]

"Limited evidence suggests that acupuncture may have some antipsychotic effects as measured on global and mental state with few adverse effects."[61]

"In the previous version of this review, evidence in support of acupuncture for tension-type headache was considered insufficient. Now, with six additional trials, the authors conclude that acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches."[62]

"In the previous version of this review, evidence in support of acupuncture for migraine prophylaxis was considered promising but insufficient. Now, with 12 additional trials, there is consistent evidence that acupuncture provides additional benefit to treatment of acute migraine attacks only or to routine care."[63]

"Acupuncture may reduce period pain, however there is a need for further well-designed randomised controlled trials."[64]

"There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment."[65]

I only looked at the first 20 hits of the search, but if this is a representative sample, it means that approximately 25% of Cochrane reviews find a positive effect of acupuncture. Pseudoscience? Quackery? hmmmm....DrChrissy ^(talk) 20:31, 2 May 2015 (UTC)[reply]

Talk pages are not a forum to bring up topics to discuss in general, but are here to improve the article. What specific suggestions do you have to change the text of this article, citing which source? Yobol (talk) 20:36, 2 May 2015 (UTC)[reply]

@Yobol Perhaps you missed it but in the opening paragraph it states "TCM theory and practice are not based upon scientific knowledge,[7] and acupuncture is described as a type of pseudoscience.[8][9] Many within the scientific community consider it to be quackery[10]"....that to me seems to be undue weight.DrChrissy ^(talk) 20:53, 2 May 2015 (UTC)[reply]

The rules for lead indicate that that content should be mentioned. That's about as short a mention as is possible, and it's properly sourced, so those words are obviously not "thrown at acupuncture without a second thought." -- BullRangifer (talk) 21:53, 2 May 2015 (UTC)[reply]

@DrChrissy - What do you think of the following sources:

1. Harrison's Principles of Internal Medicine: "In addition, new research is shedding light on the effects of meditation and acupuncture on central mechanisms of pain processing and perception and regulation of emotion and attention. Although many unanswered questions remain about these effects, findings are pointing to scientifically plausible mechanisms by which these modalities might yield benefit." (pg. 14e-3)
2. Essentials of Small Animal Anesthesia and Analgesia: "Basic research on acupuncture's mechanisms in Western societies started in 1976 after the endorphin hypothesis of acupuncture's mechanism of action was introduced. Further advancement of acupuncture research was prompted by the introduction of functional magnetic resonance imaging (fMRI) and positron emission tomographic scanning, which revealed the relation between acupuncture stimulation and activation of certain brain structures" (pg. 132)
3. Miller's Anesthesia: "A scientific basis may exist for acupuncture. Acupuncture stimulates high-threshold, small-diameter nerves that activate the spinal cord, brainstem (i.e., periaqueductal gray area), and hypothalamic (i.e., arcuate) neurons, which trigger endogenous opioid mechanisms. The effect of acupuncture analgesia can be reversed by administration of naloxone." (pg. 1235)

I'm particularly interested in your opinion about source #2, since it relates to veterinary medicine. -A1candidate 20:49, 2 May 2015 (UTC

I think all three are excellent sources. I came across the second a few days ago and it is something that we really need to incorporate. It's probably not worth discussing in detail here because a member of the WP:MEDRS police will step in and say because it is veterinary it should not be discussed here. Funny how different factions of the medical profession can have such open or closed minds.DrChrissy ^(talk) 20:59, 2 May 2015 (UTC)[reply]

@DrChrissy, I don't think WP:MEDRS forbids the use of veterinary medical textbooks in topics on veterinary medicine. If there are no objections, I'll incorporate the text into the article. -A1candidate 21:07, 2 May 2015 (UTC)[reply]

No it does not forbid it because WP:MEDRS does not apply to veterinary science or to animals. I have already incorporated the reference into Veterinary acupuncture - I'll expand a little bit tomorrow. Thank you very much for the reference. Much appreciated.DrChrissy ^(talk) 21:26, 2 May 2015 (UTC)[reply]

I beg to differ. MEDRS applies to direct medical claims, even veterinary. If it doesn't say so in the policy, it should. -- BullRangifer (talk) 21:46, 2 May 2015 (UTC)[reply]

There is an ongoing discussion on Wikipedia talk:Identifying reliable sources (medicine) regarding the possible inclusion of vet medicine into MEDRS - surprised you have missed it. There are not really any strong arguments for it. I seem to remember somewhere that even Jtydog suggested it should not apply to animal articles.DrChrissy ^(talk) 22:11, 2 May 2015 (UTC)[reply]

-This section is a jumble, and my attempt to make it legible was reverted. I will not be participating further. Yobol (talk) 21:17, 2 May 2015 (UTC)[reply]

At the significance 0.05, 1 in 20 papers will produce a false positive. See WP:EXTRAORDINARY. Tgeorgescu (talk) 21:34, 2 May 2015 (UTC)[reply]

Nah - that is pseudoreplication. Each study is independent of all the others. Besides which, they look at the effects of acupuncture on different dysfunctions - totally wrong to lump them together like that. In any case, you are talking about 1 in 20 papers as being a Type I error - how do you explain the findings of the other 5 studies?DrChrissy ^(talk) 21:46, 2 May 2015 (UTC)[reply]

Just in response to this comment, you can't make a conclusion on that because you need to know the numbers of both positive and negative results, not just the number of positives. There are also plenty of ways for bias to occur - independence is a pretty big assumption! Sunrise (talk) 02:18, 3 May 2015 (UTC)[reply]

User:Sunrise, these issues were obviously taken into account by the Cochrane reviewers, haven't they? -A1candidate 09:03, 3 May 2015 (UTC):::[reply]

Your ping didn't work, by the way. In any case, I was responding in the abstract to an abstract statement, without referring to specifics, so that would be a different subject. Sunrise (talk) 08:40, 4 May 2015 (UTC)[reply]

Let's not get diverted by this. The 25% which I stated above is probably OR on my part. It was meant as a throw-away comment and not to taken as ststistical evidence trying to convince a reader about any "fact" or trend. My point of the OP was to indentify that there are multiple Cochrane reports out there which have a positive finding with regard to acupuncture. In my mind, the medical dogmatists are wanting it both ways. They are quoting extremely loaded words such as "quackery" and "Pseudoscience" (without quotes by the way!), and then playing down the findings of sources which they normally defend as being amongst the most reliable possible.DrChrissy ^(talk) 10:25, 3 May 2015 (UTC)[reply]

Scientific publications have a bias for publishing significant results only; so for every published significant result for it, there could be 19 results which never get published, due to such bias. Tgeorgescu (talk) 10:42, 3 May 2015 (UTC)[reply]

Yes, I agree. The Cochrane reviews seem to be different than other branches of science in that they do take into account "no significant difference". I would be the first to say that because I found 6 of 20 reviews had a positive conclusion for acupuncture, this means 14 did not.DrChrissy ^(talk) 10:49, 3 May 2015 (UTC)[reply]

Not our job to speculate on such matters. There are statistical methods to evaluate the publication bias, so let's leave that for the scientists. Jayaguru-Shishya (talk) 13:19, 3 May 2015 (UTC)[reply]

Our job is also to be careful not to represent pseudoscience as having merit. That a minority of studies on a treatment with such a notably strong placebo effect show weak results of positive impact, using such weak language as "low to moderate-level evidence" and "limited evidence shows that acupuncture may", is unsurprising and unpersuasive.—Kww(talk) 18:48, 3 May 2015 (UTC)[reply]

Leave that to the scientists. For you, I'd recommend to WP:STICKTOSOURCES. Ps. Don't you worry about disclaimers, doesn't affect our position in anyway. Jayaguru-Shishya (talk) 17:18, 4 May 2015 (UTC)[reply]

Disclaimers don't affect things? I'm sorry that you don't understand their meaning or purpose, Jayaguru-Shishya.—Kww(talk) 18:59, 4 May 2015 (UTC)[reply]

I just reverted a series of edits which indicate quite strongly that TCM has scientific backing and is "effective" without qualification. I think this needs significantly more discussion before being inserted into the article, as it turns our coverage of Acupuncture's efficacy on its head. What sources are we referencing when adding this content? Why are we now aiming to exclude our existing sources which say the precise opposite?   — Jess· Δ♥ 19:55, 3 May 2015 (UTC)[reply]

We are using Miller's Anesthesia. Which sources are we excluding, User:Mann jess? -A1candidate 19:57, 3 May 2015 (UTC)[reply]

It's not that you are attempting to exclude existing sources, it's that you were attempting to provide false parity.—Kww(talk) 20:03, 3 May 2015 (UTC)[reply]

Statements of authoritative medical textbooks need to be given due weight. What would both of you suggest as a compromise? -A1candidate 20:11, 3 May 2015 (UTC)[reply]

(edit conflict)First of all, you've taken these three sources: [66], [67], [68] and replaced them with just one: [69]. You've not just provided equal weight to this new source, but you've actually given it significantly more weight ("scientists vs quackwatch"). Your edits to later parts of the page are of more concern, but for essentially the same reason.   — Jess· Δ♥ 20:15, 3 May 2015 (UTC)[reply]

Well, we can put them back in? I would also appreciate some suggestions from you about how we could give both sources equal weight, User:Mann jess. -A1candidate 20:21, 3 May 2015 (UTC)[reply]

In such cases we go with the scientists and omit QuackWatch. Jayaguru-Shishya (talk) 17:20, 4 May 2015 (UTC)[reply]

Equal weight? Why should "Traditional Chinese Medicine: Scientific Basis for Its Use" be given equal weight to those three sources? Why is it of that high a quality?   — Jess· Δ♥ 20:28, 3 May 2015 (UTC)[reply]

Because it is written by experts in a relevant scientific field (pharmacology) and it is from a respected publisher (Royal Society of Chemistry)? Don't you think this is grounds for a legitimate scientific discussion, User:Kww? -A1candidate 20:32, 3 May 2015 (UTC)[reply]

To the extent that it makes claims about pharmacology, I haven't got any objection to its use. There are certainly herbs used in TCM that have legitimate medical value. To the extent that it makes the claim that the underlying concepts of TCM, such as qi, yin, and yang, make scientific sense, I don't see that the expertise in pharmacology is applicable, and the claim itself is clearly a fringe claim. As the publisher has disclaimed responsibility for the contents, the publisher's credentials don't factor into the discussion.—Kww(talk) 21:20, 3 May 2015 (UTC)[reply]

The purpose of pointing to the publisher's credentials isn't to imply that they are responsible for contents, but to demonstrate that they are independent of, and unrelated to, the acupuncture community. In any case, we have a prominent medical textbook (Oxford Textbook of Palliative Medicine ) that says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266). This demonstrates the medical community's preference for a modern explanation of acupuncture in lieu of a purely traditional explanation ("vital energy"), User:Kww. Also, what good reason do we have to replace a good medical textbook with QuackWatch, User:Mann jess? -A1candidate 22:10, 3 May 2015 (UTC)[reply]

KWW, it is claiming TCM has a strong scientific basis, not that TCM herbalism alone has a strong scientific basis. It is simply suggesting that herbs have a pharmacological method of action under TCM, which it's claiming has a strong basis in science. LesVegas (talk) 22:20, 3 May 2015 (UTC)[reply]

Exactly, and that's what makes it a fringe claim. That TCM has identified some valuable herbs is non-controversial. I can't imagine any reputable scientist arguing that an herb couldn't possibly have value because TCM uses it. That TCM has a scientific foundation is controversial (controversial to the point of being ludicrous, in fact) and a background in pharmacology doesn't provide strong support for claiming that qi, yin, and yang are viable approaches to studying chemistry.—Kww(talk) 01:13, 4 May 2015 (UTC)[reply]

A1, the quote you've provided does not address the first section you changed. It also does not indicate acceptance of TCM or acupuncture within the scientific community. Why use quackwatch? Because it explicitly addresses the claim we are sourcing without interpretation or synthesis, and its findings are consistent with the plethora of other sources which describe the scientific community's opinion.   — Jess· Δ♥ 22:29, 3 May 2015 (UTC)[reply]

I am not arguing that TCM is accepted within the scientific community. I am arguing, however, that medical acupuncture is accepted by a large faction of the medical profession (at least the modern explanations for acupuncture are). QuackWatch should be given less weight because it fails to address this second issue. -A1candidate 22:36, 3 May 2015 (UTC)[reply]

Thanks, Mann jess. If the findings of QuackWatch "are consistent with the plethora of other sources which describe the scientific community's opinion", then we will remove QuackWatch on the peculiar instance and replace it with some of those sources describing the scientific consensus. Jayaguru-Shishya (talk) 17:22, 4 May 2015 (UTC)[reply]

You're not? Well, you removed content that said TCM was not based on scientific knowledge, and wrote in its place that scientists believe TCM is just misunderstood. Again, your source does not address that topic, but the ones we are using do, and they back up the existing wording. Also, I don't see any part of your edit which discusses the acceptance of modern explanations of acupuncture by medical professionals. All I see are suggestions that acupuncture is efficacious and backed by science, and our MEDRS compliant sources contradict that claim.   — Jess· Δ♥ 01:37, 4 May 2015 (UTC)[reply]

Like I said, I have nothing against restoring that content. What I wrote was "poorly understood", not "misunderstood" - Both terms have different meanings. The part on acceptance by the medical profession was removed here. I stand by this addition, firmly, and request an explanation of why this content should be removed. -A1candidate 02:33, 4 May 2015 (UTC)[reply]

"Poorly understood" and "misunderstood" have different meanings, but the difference is not significant to what I wrote. As for the diff, I did not remove that content, so I'm not the one to ask why it was taken out. I'd venture a guess that there is an effort to trim the article, since it's become unwieldy to the point of being nearly incomprehensible.   — Jess· Δ♥ 03:02, 4 May 2015 (UTC)[reply]

Trimming the article = Reverting the edits of other editors? Since you're not willing to defend the removal, I request that someone else do so. Otherwise I'm going to restore it back to this version. It is not perfect but at least it's something all of us could (hopefully) live with. -A1candidate 06:54, 4 May 2015 (UTC)[reply]

This edit is completely inappropriate. It wholly removes the description of Acupuncture's scientific reception from the lead, and on top of that, goes on to summarize it as an opinion from 2007. The edit was made when discussion thus far has shown such changes to be contentious. Please discuss edits like that before instituting them (and reverting to get them in the article!)   — Jess· Δ♥ 13:57, 4 May 2015 (UTC)[reply]

I added a POV tag to the lede since its neutrality is under dispute by several editors. Here are the two versions being disputed. I'm contending additional reliable sources are needed for parity. Furthermore, one source is being misrepresented since it's used out of context for a strong claim. Let's hear any ideas on how we can resolve this dispute. LesVegas (talk) 22:04, 3 May 2015 (UTC)[reply]

Is anyone disputing it that doesn't have a COI in relationship to TCM? Or is it just people that rely financially on people misunderstanding its status as folklore and superstition that object?—Kww(talk) 03:13, 4 May 2015 (UTC)[reply]

I don't make a living in relationship to TCM, and I don't appreciate the accusation nor the implication of COI. Kww, I've always tried being cordial with you and yet I feel like you are cotinually being very uncivil towards me. Why? LesVegas (talk) 16:01, 4 May 2015 (UTC)[reply]

Because you insistently and persistently portray TCM as having validity. Either you know better, which means your edits fall under one category of problem, or you do not, which means your editing falls under another category of problem.—Kww(talk) 17:42, 4 May 2015 (UTC)[reply]

For the record, I don't think TCM is very valid. But it's not what I believe, we are going to rely on what sources say. We're not going to delete reliable sources just because they don't correspond to our point-of-view. Regardless, your justification doesn't excuse your constant incivility, and I'm going to ask that you stop right now and start treating myself and others with more respect. I would not accuse you of working for an industry that is threatened by acupuncture in order to justify edit warring, disruption and other bad behavior. You are an administrator and seem to be intelligent so I shouldn't have to be telling you any of this, but please stop. LesVegas (talk) 18:37, 4 May 2015 (UTC)[reply]

I too have absolutely no COI or relationship to TCM. I dislike that you may be lumping me into that. I had not realised until the posting above that you were an administrator. TuT TuT - I would have expected a much more measured posting.DrChrissy ^(talk) 19:24, 4 May 2015 (UTC)[reply]

My response was quite measured and not uncivil. I admit that there is a third form of problem that plagues the article: the occasional well-meaning editor that believes that we gullibly parrot sources without evaluating them for fringe science and pseudoscience. Regardless of the motivation, editors that consistently and intentionally make this article misrepresent acupuncture are a problem.—Kww(talk) 19:36, 4 May 2015 (UTC)[reply]

We had this discussion about the tag before. We don't need a tag at the top of the page again. Do you remember the previous discussion on this? The result was no consensus to restore the tag. QuackGuru (talk) 20:37, 4 May 2015 (UTC)[reply]

How nice of you to finally post here over a day later to justify your removal of the template. Of course, the dispute then was never resolved so you're disrupting again and regardless, this is a new dispute with many new sources being contended. Can you please explain why you ignored the sentence on the template that says, "Please do not remove this message until the dispute is resolved"? Why do you constantly remove POV templates? Also, why did you ignore the rules about removal which say,

Remove this template whenever:

There is consensus on the talkpage or the NPOV Noticeboard that the issue has been resolved

It is not clear what the neutrality issue is, and no satisfactory explanation has been given

Since there was no consensus that it was resolved, and since I made it very clear what the neutrality issue was, what again made you think you could quickly remove the tag? LesVegas (talk) 20:54, 4 May 2015 (UTC)[reply]

Editors disagree with making the lede longer. QuackGuru (talk) 21:35, 4 May 2015 (UTC)[reply]

User:Arthur Rubin, you deleted a statement from the American College of Chest Physicians which says "in patients with cancer related pain". How is this not part of "cancer-related conditions"? -A1candidate 11:02, 4 May 2015 (UTC)[reply]

The same statement in the same article is being paraphrased differently in two different sections. It should only be there once, or it should be explicitly noted that it is the same statement in the same article. The first use refers to "nausea and vomiting from either chemotherapy or radiation therapy", and the second use refers to "cancer-related pain" (and something not relevant and not in the article). Although it's not a fringe article, both references are outside of the medical specialty that the organization and journal normally represent. In other words, both clearly fail WP:MEDRS, unless the authors are expert in the field of the article, not just the field of the journal. I'm beginning to think that both statements should go. — Arthur Rubin (talk) 19:54, 4 May 2015 (UTC)[reply]

@A1candidate: — Arthur Rubin (talk) 19:55, 4 May 2015 (UTC)[reply]

If that item is listed, it should be under "pain", rather than under "cancer-related conditions". It might be still better to paraphrase the statements together under "Cancer-related conditions", rather than separately under "pain" and "nausea". I still have doubts about it being appropriate at all, though. — Arthur Rubin (talk) 20:12, 4 May 2015 (UTC)[reply]

Both are weak sources. These are political opinions rather than scientific evidence. We are using many reviews. We don't need to reach down to lower-quality sources to argue with better sources. QuackGuru (talk) 23:58, 5 May 2015 (UTC)[reply]

The clinical practice guidelines is poor evidence and only suggestions. The solid evidence is Cochrane reviews. QuackGuru (talk) 08:23, 8 May 2015 (UTC)[reply]

Yes, but they're not perfect. That is why WP:MEDORG must not be ignored. -A1candidate 08:51, 8 May 2015 (UTC)[reply]

We have WP:WEIGHT too. This page has over 300 references and is very long. For a mature topic with many reviews we should use better sources. QuackGuru (talk) 09:24, 8 May 2015 (UTC)[reply]

I would suggest deleting the blog of David Gorski and remove his polemical statements -A1candidate 09:58, 8 May 2015 (UTC)[reply]

I did remove the source David Gorski from a long section. See Talk:Acupuncture/Archive 23#Long section. If you want to remove more specific information I suggest starting a new section. QuackGuru (talk) 18:36, 8 May 2015 (UTC)[reply]

Regarding this revert: Huh? This is the first time (to my knowledge) the pseudoscience descriptor was removed from that section, so the accusation of edit warring is bizarre.   — Jess· Δ♥ 13:54, 4 May 2015 (UTC)[reply]

I was talking about your pattern of editing, not a single revert.DrChrissy ^(talk) 14:27, 4 May 2015 (UTC)[reply]

My "pattern of editing"? I reverted you only once prior to that, on an entirely different edit, and I commented on the talk page regarding both reverts. This edit, however, is edit warring; it is a revert of a revert without discussion with the intent of forcing a proposed change into the article despite opposition. You should read WP:EW before citing it. That all said, you undid my change above without providing any rationale. Why did you do that?   — Jess· Δ♥ 15:24, 4 May 2015 (UTC)[reply]

And this version was not an improvement. DrChrissy please discuss and get consensus for significant changes before you make them. --NeilN ^{talk to me} 14:02, 4 May 2015 (UTC)[reply]

Please see WP:BRD.DrChrissy ^(talk) 14:24, 4 May 2015 (UTC)[reply]

I have been trying to bring a little stability and order to this article. I have tried to take details (not the subject) about adverse effects from the lede to the main body of the article. Result - disruptive edit warring! I have tried to take the scientifc basis of acupuncture to its own section so that the lead can remain stable for at least 24 hrs. Result - more disruptive edit warring! I even chose to place this scientific basis above the section on clinical practice. I think everybody would agree that the scientific basis of acupuncture is contentious, so why do those doing the edit warring not want such a section. We can all have our say and leave the lede alone!DrChrissy ^(talk) 14:10, 4 May 2015 (UTC)[reply]

You wanted the lead to be stable for 24 hours, so you made significant changes to it? That's a strange rationale. The lead must summarize the body, so there are two problems with your edit: 1) Moving the scientific reception of acupuncture out of the lead means it no longer summarizes the body, and indicates that acupuncture's scientific reception is not a significant part of the topic. 2) Since this detail is already covered in the body, moving the lead into the body means it is now covered twice in two different places (but still not in the lead).   — Jess· Δ♥ 14:14, 4 May 2015 (UTC)[reply]

As I stated in the edit summary I was trying to make the first para neutral so we could all leave it alone. Yes, the lead must summarize the body of the article, at the moment, there is little, if any, discussion of the scientific basis in the body of the article. This should be discussed in the body, not the lead, and the lead should only summarize it. I believe it's importance justifies its own heading.DrChrissy ^(talk) 14:21, 4 May 2015 (UTC)[reply]

1) We don't have sections in leads. 2) If your intent was to move that entire section out of the lead, it would remove all indication that the mainstream medical community regards acupuncture as a fringe treatment. --NeilN ^{talk to me} 14:40, 4 May 2015 (UTC)[reply]

My intent was/is to move it out of the lead, discuss the section, then when consensus is clear, make a summary in the lead. At the moment, we appear to be having the discussion in the lead which is probably why several editors have already commented it is too long and complicated. My sole intention is to improve the article.DrChrissy ^(talk) 14:53, 4 May 2015 (UTC)[reply]

There really are two issues here, and let's not conflate them. The benefits of acupuncture are contentious to the extent that there is legitimate research that shows that it may have some small actual effect through mechanisms that have not been properly isolated. Because of that, we cannot flatly state that acupuncture itself is pseudoscience or quackery. The underlying theories of TCM, however, with yin, yang, qi, meridians, and the like are obvious pseudoscience to the point that they should be unequivocally and decisively described as such in Wikipedia's voice and the smattering of contradictory studies dismissed as either erroneous or intentional fringe science. As for moving it "out of the lead": absolutely not. The lead serves as the summary and takeway for readers that skim, and the important takeaway on acupuncture is that it is a practice with dubious benefits that are not certain to exist, and that the theoretical underpinnings on which it was founded are superstition and folklore. Someone that reads the lead should not come away with the impression that it is a widely accepted medical treatment or that there is some kind of controversy over its origin.—Kww(talk) 15:04, 4 May 2015 (UTC)[reply]

Wikipedia is WP:NOTFORUM. Less personal opinions, more sources. Thank you Kww. Jayaguru-Shishya (talk) 17:24, 4 May 2015 (UTC)[reply]

Less interruptions of discussion flow, please. I have provided a reasonable summary of scientific opinion and your implication that I have not is completely unwelcome.—Kww(talk) 17:45, 4 May 2015 (UTC)[reply]

• Kww really highlights the issue here, it's the conflation of the TCM ideas (qi, meridians) and the evidence for effectiveness (RCT results). We have to be careful to cover these as separate topics. If there is some evidence for effectiveness beyond placebo, we cannot allow the article to imply that TCM has an accepted basis as the cause of it. Zad68 17:54, 4 May 2015 (UTC)[reply]

Where are the extensive talk page discussions for this? --NeilN ^{talk to me} 17:26, 4 May 2015 (UTC)[reply]

See Talk:Acupuncture#Acupuncture_has_.22proven_efficacy.22_and_scientific_backing -A1candidate 17:28, 4 May 2015 (UTC)[reply]

@NeilN - Are you going to provide an explanation for your removal? -A1candidate 17:31, 4 May 2015 (UTC)[reply]

Yes, please use a less misleading edit summary next time. A discussion that's less than one day old, begins with "I think this needs significantly more discussion before being inserted into the article", and was not even about moving content into the lead is not "extensive talk page discussions". You should know that. --NeilN ^{talk to me} 17:37, 4 May 2015 (UTC)[reply]

You still have not provided a policy-based explanation for removing MEDRS sources. -A1candidate 17:43, 4 May 2015 (UTC)[reply]

Because your laundry list was misleading and undue. Look at your very first source - (weak recommendation, moderate-quality evidence). The only recommendation classified as "weak". --NeilN ^{talk to me} 18:00, 4 May 2015 (UTC)[reply]

So what do you suggest to make it less misleading, without deleting the views of medical organizations? -A1candidate 18:03, 4 May 2015 (UTC)[reply]

What about a section called "National reception" or "Reception by national medical organisations" (or something like that), with a summary in the lead? We alraedy have one section on Scientific reception and another section that could easily be called "Popular reception".DrChrissy ^(talk) 18:13, 4 May 2015 (UTC)[reply]

Why would we worry about "popular reception" of an activity that purports to be medicine?—Kww(talk) 18:37, 4 May 2015 (UTC)[reply]

• The actual discussion history (started yesterday) cannot be reasonably used to "restore" something that never had consensus for inclusion in the lead in the first place, so per WP:BRD we restore the status quo ante and discuss the proposed change.

  The existing wording in the lead is "Clinical practice varies depending on the country." sourced to Ernst. I can support a small expansion of that one sentence, sourced to a high quality secondary source (note that statements from the individual medical organizations would be primary sources for this purpose). Zad68 18:16, 4 May 2015 (UTC)[reply]

Zad, if the medical organizations state their view is based on scientific evidence, doesn't this make them secondary sources?DrChrissy ^(talk) 19:58, 4 May 2015 (UTC)[reply]

This is a subtlety in that the same source can be primary or secondary depending on what it's used for. For example, this practice guideline from the American College of Physicians contains some discussion of acupuncture that might be used as a secondary source for "Acupuncture may be helpful for those with chronic back pain that does not respond to other treatment." (However I rush to point out that the guideline is from 2007 and there are plenty of more up-to-date sources.) But that practice guideline itself would be a primary source for "The American College of Physicians has suggested the use of acupuncture for some groups of patients" (to use the wording from the edit that started this discussion). Make sense? Zad68 20:17, 4 May 2015 (UTC)[reply]

Yes, I know what you mean. (You may be interested to look here[Wikipedia:Identifying primary and secondary sources for biology articles] at an essay I wrote on the subject.) I was actually thinking about the UK site [70] which states "NICE makes these recommendations on the basis of scientific evidence."DrChrissy ^(talk) 20:30, 4 May 2015 (UTC)[reply]

If we have reliable sources that offer parity, we have to expand the lede for neutrality purposes. If we are worried about the lede being too long, then we have to delete parts of it. But what we cannot do is have it full of one-sided sourcing only. Hence the tag I added. LesVegas (talk) 21:35, 4 May 2015 (UTC)[reply]

This information was about effectiveness but we already have information about effectiveness to summarise the body. See "Evidence on the effectiveness of acupuncture is "variable and inconsistent, even for single conditions".[15] An overview of high-quality Cochrane reviews found evidence suggesting that acupuncture may alleviate certain kinds of pain.[16]" QuackGuru (talk) 21:40, 4 May 2015 (UTC)[reply]

That information serves as parity against Quackwatch calling its basis pseudoscience. Oh, and Quackwatch doesn't hold much weight against a plethora of sources like that so it needs to be replaced by something with equal weight to those national scientific bodies, or be deleted altogether. LesVegas (talk) 21:47, 4 May 2015 (UTC)[reply]

Why do you insist on providing "parity"? What parts of our policies and guidelines about pseudoscience do you misinterpret as requiring us to provide equal time to the notion that TCM isn't pseudoscience?—Kww(talk) 21:49, 4 May 2015 (UTC)[reply]

Just popping in. If we have more reliable sources than QuackWatch, we can replace it by the more reliable ones. Jayaguru-Shishya (talk) 21:54, 4 May 2015 (UTC)[reply]

Effectiveness and pseudoscience are two separate issues. QuackGuru (talk) 21:59, 4 May 2015 (UTC)[reply]

@ Kww, I don't mean Wikipedia:PARITY when I say parity, I mean Wikipedia:BALANCE. All the edits A1 Candidate and DrChrissy and I made in the lede's expansion were towards providing a counter argument to Quackwatch's claims. I didn't delete Quackwatch, even though it really fails the test on Wikipedia:GEVAL if you stand Quackwatch up next to notable textbooks, multiple government health organizations, and notable scientific books that disagree with Quackwatch. Really, if we are going to use the claim, we need to find a source that has equal weight to the many acupuncture-positive ones that were deleted. LesVegas (talk) 23:11, 4 May 2015 (UTC)[reply]

But the scientific consensus is that TCM is claptrap. I agree that the lead can't describe acupuncture itself as pseudoscience directly and without attribution, but that doesn't apply to TCM. Sources that describe TCM as having a foundation are WP:FRINGE, and cannot be included as being on par and are not necessary (or even desirable) for balance. We don't balance science with pseudoscience, nor present fringe claims as being on par with accepted science.—Kww(talk) 23:19, 4 May 2015 (UTC)[reply]

Scientific consensus? Where are you getting your information about scientific consensus saying TCM is a claptrap? Don't tell me the Wikipedia article! Kww, don't you know that editors there only pretend there is a consensus amongst scientists by deleting all scientific sources that suggest otherwise? They do, I promise you. These editors actually delete scientific sources and statements that come from the NIH, the NHS, the Routeledge Encyclopedia of Science, texts published by the Royal Society of Chemistry, anesthesia textbooks, and then they claim there is scientific consensus all because Quackwatch says so. They can't ever seem to find anyone else who says exactly what Quackwatch says, but they merely repeat words like "scientific consensus says" which confuses editors just passing by, and making them think the folks trying to add statements by the NHS and NIH are fringe kooks who are just trying to push another strange theory into the encyclopedia. And they also don't want Quackwatch attributed when it says something about TCM, even though an RfC on TCM suggested otherwise. Seriously, if you want good information on TCM or Acupuncture, I'll show you some sources by scientific bodies. Don't read Wikipedia for your information anymore. LesVegas (talk) 00:13, 5 May 2015 (UTC)[reply]

No, I'm afraid it's people pushing superstition and fraud that are pretending.—Kww(talk) 01:55, 5 May 2015 (UTC)[reply]

...for three days. Let's try and continue this here, rather than on the article please. --kelapstick^(bainuu) 18:48, 4 May 2015 (UTC)[reply]

DrChrissy, what are you talking about? Have you actually clicked the link and read the web page? --NeilN ^{talk to me} 19:03, 4 May 2015 (UTC)[reply]

Stop being so patronising. The link has been changed very recently. When I made my comments, I was being directed to an older version of the Quackwatch article that did not include the statement. The current source now does. The lack of stability in this web-site/blog is another reason we should not be using Quackwatch.DrChrissy ^(talk) 19:19, 4 May 2015 (UTC)[reply]

I went back to a 2013 version of the article. Same quote, same link, so your explanation does not make sense to me. --NeilN ^{talk to me} 19:25, 4 May 2015 (UTC)[reply]

The version of the article here[71] directs to this source.[72] I was unable to verify the statement from that source.DrChrissy ^(talk)

Chrissy, the bit of the Quackwatch article we quote here has been on the source web page since April 2011. I'm not seeing support for the idea that the content suffers from "lack of stability". Zad68 19:28, 4 May 2015 (UTC)[reply]

Actually, I was talking about the stability of the source, Quackwatch. It is clear that articles are updated - I have no idea how frequently or infrequently, but I wonder if editors are careful enough to keep WP updated with Quackwatch.DrChrissy ^(talk) 19:51, 4 May 2015 (UTC)[reply]

Yes I understood you correctly. Quackwatch does indeed update their articles, which many would consider to be a pro and not a con, in that they keep their articles up-to-date. You can use archive.org to see how many updates are made over time. But I get your point, and we probably shouldn't be using a big direct quote like we're using currently, I'd prefer if we summarized it (with attribution). Zad68 19:56, 4 May 2015 (UTC)[reply]

Thanks for that and the helpful advice on archive.org. I would agree totally with a summary with attribution, rather than a quote which seems to be a little Wp:Undue.DrChrissy ^(talk) 20:13, 4 May 2015 (UTC)[reply]

Please add the {{content}} tag to the article. There is absolutely no disagreement that there is and has been a content dispute, and that either some content not in the article belongs there, or that some content in the article does not belong there. I see no chance that the dispute will be resolved in the near future, but some of the disputes are being discussed, so I believe the tag is appropriate, even while the article is protected. — Arthur Rubin (talk) 20:02, 4 May 2015 (UTC)[reply]

I don't see how a tag will improve the article. It solves nothing. QuackGuru (talk) 20:09, 4 May 2015 (UTC)[reply]

Yeah, I can support the addition of such a tag in this case. — {{U|Technical 13}} (e • t • c) 22:58, 4 May 2015 (UTC)[reply]

 Administrator note awaiting further comments — Martin (MSGJ · talk) 08:02, 5 May 2015 (UTC)[reply]

• Support along with Arthur if this is the tag he's talking about, and I've added one or two similar ones myself. I really believe they'll help attract new editors. But how do we keep the war zone away? Well, what I really think will do the trick there is to dramatically lower the threshold for topic bans. Make a couple of disruptive edits, you're automatically topic banned. Go over the 3RR twice, you're topic banned. Act uncivil towards editors, topic banned. Administrators should also not feel impervious to the possibility of being banned either. People need to stop feeling like they are entitled to grossly violate rules here. That'll prevent this battleground editing for good. LesVegas (talk) 12:29, 5 May 2015 (UTC)[reply]

great idea Les, but what will you do after you get indeffed from fringe topics, broadly construed. -Roxy the Viking dog™ (resonate) 12:34, 5 May 2015 (UTC)[reply]

Good question. I guess I'll start editing bumblebee and Disney articles with you! LesVegas (talk) 12:45, 5 May 2015 (UTC)[reply]

• Oppose - We don't need a tag again. According to previous discussion there was no consensus to have the tag. What is the purpose for the tag when there are many editors currently discussing this article? How will the tag improve the article? QuackGuru (talk) 16:06, 5 May 2015 (UTC)[reply]

• Support - I see no harm with including the tag, especially since the tag is closely linked to many of the questions discussed here at the Talk Page. Hopefully it will attract more editors to the article. Jayaguru-Shishya (talk) 19:36, 5 May 2015 (UTC)[reply]

• How will the tag attract more editors to the article? What would be the purpose of attracting more editors? I think we need less editors not more. QuackGuru (talk) 19:41, 5 May 2015 (UTC)[reply]

What the article needs is people who can talk things out...not article owners. -- Moxy (talk) 19:52, 5 May 2015 (UTC)[reply]

To talk about what things exactly? Should we talk about the format change? Should we talk about things like what happening to the lede? Or is this a waste of time? QuackGuru (talk) 20:10, 5 May 2015 (UTC)[reply]

So far those talks are a good step...but no need for all the edit wars (thus why the page is locked). If people are not aware of the editing habit problems here then they need to step-back and look at what's going on again. All should follow our basic expectations on how to deal with content and sourcing arguments. I understand that this article has had a long history of problems....but this does not mean the basics should not be followed. Perhaps the community should impose a 1 revert for this topic....this may help. -- Moxy (talk) 20:39, 5 May 2015 (UTC)[reply]

Why would it be a good step to talk about a format change? Why would it be a good step to talk about a what happening to the lede? Maybe it would help if ArbCom would accept the case rather that talk things out. Talk things out about for what? The edits don't improve anything. QuackGuru (talk) 20:48, 5 May 2015 (UTC)[reply]

There are many editors here with different POV's ...thus we have a talk page to talk things out ...this falls under common sense. You may believe all is perfect and nothing should change.. but this is not how it works here.....others may voice opinions or edit the page at will. If they or even you are reverted after a bold edit then a talk should take place...not an editwar. All should try to propose solutions ...not kick each-other in the nuts. If this is beyond peoples capability then they should think about editng other topics that are not as controversial. -- Moxy (talk) 22:22, 5 May 2015 (UTC)[reply]

Okay. Who supports this change to the lede? Anyone? QuackGuru (talk) 22:37, 5 May 2015 (UTC)[reply]

Hell no. That attributes the mainstream view, widely held, to a single individual, which gives an entirely false impression. Guy (Help!) 22:45, 5 May 2015 (UTC)[reply]

We had this before A1candidate's edits of 19:36, 3 May 2015:

Some believe that TCM has a strong scientific basis, ^[1] but according to Quackwatch, it is not based upon scientific knowledge,^[2] and others describe acupuncture as a type of pseudoscience.^[3][4]The claim that acupuncture is medically effective has in the past been declared a pseudoscientific claim, but there is now plausible scientific evidence for acupuncture's effectiveness.^[5] However, Massimo Pigliucci and Maarten Boudry describe it as a "borderlands science" lying between normal science and pseudoscience.^[6]

Any thoughts on this? Jayaguru-Shishya (talk) 17:35, 6 May 2015 (UTC)[reply]

This was rejected. QuackGuru (talk) 20:30, 6 May 2015 (UTC)[reply]

You seem to be in danger of the fallacy of false equivalency. Some people's POV is that disease is caused by imbalance of yin and yang and can be cured by balancing the flow of qi through meridians using acupuncture. That is a POV, just as the age of Earth being 6,000 years is a POV, but both are based on superstition and dogma, and both are wrong.

This is not a matter of balancing POVs of equal validity. It is a matter for making specific, actionable edit requests, and seeing if there is consensus for them. Science is not a POV, it's a method for separating truth from falsehood.

It is also a matter for controlling long-term civil POV-pushing by acupuncture advocates. We do this on articles like Homeopathy (edit | talk | history | protect | delete | links | watch | logs | views) all the time. Guy (Help!) 22:43, 5 May 2015 (UTC)[reply]

All great points....so what to do...we show many sources for what many may seem as contentions ...that is we have both MED sources and textbook source....why textbook source??? Because they go into details about topics and this will let others see the reasons behind the conventional thinking. So do you think a one revert option on this article would help? -- Moxy (talk) 23:03, 5 May 2015 (UTC)[reply]

Editors can review all the changes or lack of changes with the recent edits. After over 235 edits little has changed. QuackGuru (talk) 22:48, 5 May 2015 (UTC)[reply]

•  Added the maintenance tag — Martin (MSGJ · talk) 08:31, 6 May 2015 (UTC)[reply]

The lede currently contains the text:

Although minimally invasive, the puncturing of the skin with acupuncture needles poses problems when designing trials that adequately control for placebo effects.

The difficulty of designing trials is adequately sourced, but as far as I can tell "although minimally invasive" is editorial and appears to violate WP:SYN. It is invasive enough to result in numeorus case histories of cardiac tamponade, infection and other adverse events, after all. I can't find a robust source for the implicit claim that acupuncture is a member of the class of minimally invasive procedures (see Invasiveness of surgical procedures § Minimally invasive procedure for a description of the normal use of the term). Minimally invasive is a term normally reserved for techniques that reduce the invasiveness of an established procedure; pain management is normally not invasive at all, whereas acupuncture is, so I think this text is misleading and incorrect. Guy (Help!) 22:54, 5 May 2015 (UTC)[reply]

The body says "Due to acupuncture's invasive nature, one of the major challenges in efficacy research is in the design of an appropriate placebo control group.[18][19]" I wonder who made the changes to the lede or the body. QuackGuru (talk) 23:02, 5 May 2015 (UTC)[reply]

A meta-analysis has just been published that might warrant inclusion here. "Acupuncture therapy can significantly improve the hearing of patients with nerve deafness, and the efficacy of acupuncture in combination with medication is superior to medication alone." [73] I am leaving it here for regular editors to decide if it is worth including. — Preceding unsigned comment added by 108.181.201.237 (talk) 19:32, 6 May 2015 (UTC)[reply]

• This is a low-impact journal, so I personally think it should probably be left out. Everymorning talk 20:13, 6 May 2015 (UTC)[reply]
• The authors are Jiang Y, Shi X, and Tang Y. They might have a COI. QuackGuru (talk) 20:16, 6 May 2015 (UTC)[reply]
• The journal is not MEDLINE indexed. Zad68 20:26, 6 May 2015 (UTC)[reply]
• Looks great to me! WP:MEDRS states "The best evidence comes primarily from meta-analyses of randomized controlled trials (RCTs)" Authors sometimes choose for their own reasons to publish in low impact journals - that does not mean the article itself is poor quality. Not being Medline indexed does not necessarily mean it is poor quality. Perhaps we could have some evidence of the COI accusation?DrChrissy ^(talk) 21:10, 6 May 2015 (UTC)[reply]
• Leave it out, not MEDLINE indexed, in a low impact journal. Yobol (talk) 21:17, 6 May 2015 (UTC)[reply]
• Please provide the impact factor of the journal as evidence it should not be used.DrChrissy ^(talk) 21:25, 6 May 2015 (UTC)[reply]
  • Before sticking your neck out on this one, why not read the paper's own discussion section, and note carefully the drawbacks the authors bring up... Also read WP:EXCEPTIONAL. Zad68 21:30, 6 May 2015 (UTC)[reply]
• I am not sticking my neck out, I am simply asking another editor to provide evidence to back up their arguments that 1) there is a potential COI, and 2) the impact factor of the journal.DrChrissy ^(talk) 21:36, 6 May 2015 (UTC)[reply]
  • The impact factor is on their website: 1.422. As a comparison to some of the top general medical journals NEJM has a impact factor >50, JAMA ~30, Annals of Internal Medicine ~16. Compared to 2013 impact factors, this would place it #72 in the general medicine category, slightly ahead of the Croatian Medical Journal and the Libyan Journal of Medicine. Yobol (talk) 21:37, 6 May 2015 (UTC)[reply]

  • "Looks great to me!" seems like sticking your neck out... Zad68 21:38, 6 May 2015 (UTC)[reply]