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I understand why the effectiveness section has gotten the way it has but maybe now is a good time to try and get it a little under control. I recommend we start small and go for some obvious deadweight. Can anyone defend the "Fertility and childbirth" section as being encyclopedic? As far as I can tell from reading it we have poor evidence for not much of anything with some rebutted evidence of not much with a little evidence of something not really looked at. Is there anything salvageable there or should it just be let go? 24.4.204.245 (talk) 05:53, 21 March 2015 (UTC)[reply]

I suggest gutting the entire section: see my discussion above at #No single scientific consensus on efficacy for pain or nausea.—Kww(talk) 05:56, 21 March 2015 (UTC)[reply]

I don't disagree I just think the push back would stop any improvement. I was hoping to start with entries that are cruft and then try and summarize the more controversial evidence sections. 24.4.204.245 (talk) 07:01, 21 March 2015 (UTC)[reply]

We typical don't delete relevant WP:MEDRS reviews. If there is no significant benefit and the section is short it can go in the other conditions. See Acupuncture#Other conditions. QuackGuru (talk) 06:32, 21 March 2015 (UTC)[reply]

But how relevant are they if they are not imparting any knowledge? I respect the work that went into the findings but don't they taken as an aggregate come to pretty much the conclusion that there is not much evidence for much at all as it pertains to fertility and childbirth? It reads to me that these reviews go into a rather long list of good work that could be used in a more general summery of the lack of evidence for acupuncture. Until then they are not much different that the exceeding long list in the "other conditions" section and could be added there in the interim with the refs kept. 24.4.204.245 (talk) 07:03, 21 March 2015 (UTC)[reply]

If the section is short like Acupuncture#Tinnitus and there is "no strong evidence of benefit" then it can be merged into Acupuncture#Other conditions. If the section is not short then I don't know how you could merge it without losing a lot of information. I would start by merging short sections with no benefit. QuackGuru (talk) 07:14, 21 March 2015 (UTC)[reply]

This is something I noticed earlier as well. The majority of the Effectiveness section reads like a series of lists, despite nominally being written in prose. Having so many single-paragraph sections is also poor style. Since we have a lot of high-quality sources, we can use editorial judgement to choose a subset of them instead of reporting them all. If any of the content might be useful, it can be split off into a sub-article (which could be a list, but doesn't have to be). Sunrise (talk) 10:29, 21 March 2015 (UTC)[reply]

The sections concerned in this discussion imho, appear to be populated in the main by reviews of acupuncture for various conditions. The conclusions have been cherry picked by advocates of acupuncture to suggest efficacy, rather than random statistical events that are normal when a large number of studies are trying to find an effect where none exists. It makes the article look pathetic, and suggests that there may be a remote possibility of efficacy where no possibility of efficacy exists. We don't do this sort of thing in articles about real medicine, why should we do it for this quackery? -Roxy the dog™ (resonate) 12:40, 21 March 2015 (UTC)[reply]

I remain in favor of gutting the section and replacing it with "The physiological benefits of acupuncture are non-existent or small. Most, if not all, of the benefits are derived from the placebo effect, where ineffective treatments appear to have an impact because the patient believes it will have an impact", citing it to Ernst and Vickers, and being done with it. Trying to do it piecemeal runs the risk of imbalancing this article further: there are so many of these attempts to validate acupuncture that come up with such a variety of extremely small results that I don't know how one would choose which ones to drop. That's the foundation of QG's argument, and I know how he got there: too many acupuncture advocates argued to remove the studies that found acupuncture was ineffective and retain all that show some small effect, so the only defense became to keep all studies that met certain criteria of reliability. The result is this: a giant laundry list that serves no purpose other than confusing and bewildering the reader.—Kww(talk) 13:22, 21 March 2015 (UTC)[reply]

I merged the short sections that shows little benefit. The other relevant and longer sections contain high-quality sources such as Cochrane reviews, systematic review of systematic reviews, systematic reviews, and reviews. QuackGuru (talk) 18:50, 21 March 2015 (UTC)[reply]

I agree that the section as-is basically boils down to a list of the conditions for which there is weak positive evidence consistent with Ioannidis' prediction for a null treatment. We should restrict this to conditions foir which there is unambiguous evidence of effect, assuming that any such actually exist. Guy (Help!) 00:23, 22 March 2015 (UTC)[reply]

See Acupuncture#Osteoarthritis. The Osteoarthritis Research Society International released a set of consensus recommendations in 2008 which concluded that acupuncture may be useful for treating the symptoms of osteoarthritis of the knee.[92] A separate guideline issued by the National Clinical Guideline Centre stated that acupuncture should not be used in osteoarthritis management.[93].

See Acupuncture#Allergies. A 2015 clinical practice guideline released by the American Academy of Otolaryngology – Head and Neck Surgery stated that clinicians may offer acupuncture as a treatment for allergic rhinitis to patients interested in non-pharmacologic treatments.[107] The confidence in the evidence of effectiveness of acupuncture for this condition was low.[108]

Maybe we can trim some of the sections. There are over 300 sources (194,968 bytes currently) in this article. This suggests there might be bloat. Do editors want to delete the above? QuackGuru (talk) 03:20, 22 March 2015 (UTC)[reply]

I agree that the edits so far are an improvement. My thought is that as a first approximation, I would propose keeping all the content, but moving it to a sub-article (say, List of reviews and meta-analyses about acupuncture), and what remains here could just be a summary, probably the introductory paragraphs of the current section plus a few more paragraphs. That might be going too far in the other direction, but I think it would be an improvement, and we could add back parts as necessary afterward. There does need to be some objective standard, so one possibility is to only use MEDRS that analyze the literature on acupuncture as a whole. So information on individual conditions could still be included, but only if it is sourced to reviews that discuss it in the broader context of the entire field, giving us some idea of how much weight it should be accorded. Sunrise (talk) 03:44, 22 March 2015 (UTC)[reply]

I 'd rather avoid a subpage that will likely turn into a lengthy article with even more sources. QuackGuru (talk) 03:53, 22 March 2015 (UTC)[reply]

Another subpage would also provide another opportunity for advocates of Acu and other ALT-MED proponents to influence wikipedia their way. No. Too messy. -Roxy the dog™ (resonate) 11:35, 22 March 2015 (UTC)[reply]

Since there are a lot of reliable sources we can trim some that are not needed such as older ones. QuackGuru (talk) 20:34, 22 March 2015 (UTC)[reply]

please note Wikipedia_talk:Conflict_of_interest/Noticeboard#Template:Connected_contributor Jytdog (talk) 20:32, 22 March 2015 (UTC)[reply]

The US regulation section will need to be updated on both this site and the linked site Regulation of acupuncture

According to http://mx.nccaom.org/StateLicensing.aspx which has links to all the relevant state government pages except a few where it's banned, 22 states require its certification (which there is a link to educational requirement of on the page) to practice acupuncture, 6 states ban acupuncture entirely. I did a quick read through of the remaining 23 states. They all require state acupuncturist licences, and mention either one or more of the following: state exam, accreditation by the nccaom or acaom, degrees in tcm or acupuncture, often with specified required amounts of science and practical education. An important point which should be made in the acupuncture wiki page is if you are in the US and you see someone who is practising acupuncture without a state acupuncturist license, they are breaking the law and probably don't have adequate education to be safely or effectively sticking needles into people or ensuring proper hygiene while doing so.

Also, the Australian regulation section needs to be updated here as it has been on Regulation of acupuncture. Acupuncture and TCM are both now federally regulated. Gudzwabofer (talk) 08:29, 23 March 2015 (UTC)[reply]

This statement is so non-NPOV it's almost laughable; it needs to be attributed and not said in WP's voice because the reference used for the assertion doesn't meet WP:RS/AC. Additionally, acupuncture is used in mainstream medical settings, and -- common sense -- the doctors and scientists who use it wouldn't call it outright, unqualified pseudoscience. I went to far as to add Wang 2013 [1] (a good source, cf. WP:PARITY) in which the authors note that many scientists call acupuncture "pseudoscience" and disagree with that characterization. [2] My NPOV rewording was reverted by QuackGuru with no explanation and a misleading ES that simply said "c/e". QuackGuru also used Wang 2013 misleadingly, citing only the "many scientists consider it pseudoscience" part and omitting the author's own disagreement! What the fuck? Is this some kind of game? Whatever you think about acupuncture, we have an editor tendentiously and misleadingly using a source and disguising a revert with a bland ES. This isn't how a serious encyclopedia should be written. --Middle 8 (contribs • COI) 05:41, 24 March 2015 (UTC)[reply]

The reference does not need to meet WP:RS/AC for this claim. It is irrelevant if acupuncture is used in mainstream medical settings. Please provide verification for the disagreement. QuackGuru (talk) 05:51, 24 March 2015 (UTC)[reply]

QuackGuru: Needless to say, per NPOV, we don't speak in WP's voice when significant views disagree. Which Wang 2013 does, in the 2nd paragraph; the intent is plain. And yes, acu's use in mainstream medical settings is a fact that weighs in how we depict its reception. --Middle 8 (contribs • COI) 09:49, 24 March 2015 (UTC)[reply]

My reading of the second paragraph is that the authors recognize that the scientific community views acupuncture as pseudoscience and that the authors believe that is unhelpful due to acupuncture having evidence of efficacy. I don't see them arguing that acupuncture isn't based on pseudoscience just that efficacy is the more important demarcation. If even acupuncture proponents recognize the pseudoscience consensus isn't that notable? 24.4.204.245 (talk) 17:52, 24 March 2015 (UTC)[reply]

(added after much of below thread but not really bearing upon it) @24.4.204.245: (a) Many sources say pseudoscience-demarcation depends on efficacy, e.g. Shermer (in Pigliucci; recent book chapter). (b) in context, no, Wang isn't saying that. --Middle 8 (contribs • COI) 23:21, 24 March 2015 (UTC)[reply]

I do agree with the statement as it is in the article and other sources...but do agree the article lacks any objective POV. The fact all the sources are so old makes the article look very dated.-- Moxy (talk) 06:41, 24 March 2015 (UTC)[reply]

Actually, Moxy, most of the MEDRS's are within the 5-year rule-of-thumb freshness date, and much of the rest are concerned with history and don't need to be recent. --Middle 8 (contribs • COI) 09:49, 24 March 2015 (UTC)[reply]

That something is "mainstream" does not automatically remove it from the realm of pseudoscience. That someone is employed at Harvard is not a guarantee against quackery. Acupuncture Is Theatrical Placebo Jim1138 (talk) 07:04, 24 March 2015 (UTC)[reply]

Jim1138: We're talking about the scientific and medical mainstream, which we follow, and that community is not uniform in its demarcation of acupuncture as pseudoscience/quackery. That Colquhoun & Novella editorial you just linked to is a good RS and they say acu is pseudoscience, so we say that and cite it. Wang 13, the source I added, is also good RS -- in fact it's the companion editorial to Colquhoun & Novella; Anesthesia & Analgesia invited both pro and con pieces -- and they dispute acu's characterization as pseudoscience and quackery, so we say and cite that too. Acupuncture in 21st Century Anesthesia: Is There a Needle in the Haystack?. (pdf) --Middle 8 (contribs • COI) 09:49, 24 March 2015 (UTC)[reply]

I agree that it's a violation of NPOV to include an unattributed assertion of pseudoscience in the article and omit the contrary view. These are companion editorials, pro and con. This article only cites these sources for the con -- a blatant violation. TimidGuy (talk) 10:26, 24 March 2015 (UTC)[reply]

@TimidGuy NPOV does not say we must balance the pro and can for each claim. In fact, that would be contrary to NPOV. Neutrality on wikipedia means presenting the arguments in proportion to their prominence in the relevant community (in this case, the scientific and mainstream med community), and within that community, there is no significant controversy that acupuncture is pseudoscience. Per WP:YESPOV, we must state that unequivocally.   — Jess· Δ♥ 11:36, 24 March 2015 (UTC)[reply]

Mann Jess, the statement that there is "no significant controversy that acupuncture is pseudoscience" needs a very reliable source to back it up, given the large number of studies of acupuncture in peer-reviewed journals. Do you have such a source? Everymorning talk 13:06, 24 March 2015 (UTC)[reply]

I haven't seen such a source; it would have to meet WP:RS/AC. Jess, journals don't invite pro/con editorials in areas where most of their readers have already made up their minds. --Middle 8 (contribs • COI) 16:40, 24 March 2015 (UTC)[reply]

• WP:RS/AC is being misrepresented here. It applies to "any statement in Wikipedia that academic consensus exists". Since we are not making a statement about "academic consensus" it does not apply. The pseudoscience statement is sourced to a strong WP:RS/WP:MEDRS (Baran et al.) that may be simply asserted. There are many such topics where the question of "academic consensus" simply isn't in the sources. We don't need WP:RS/AC to say that Roswell wasn't visited by aliens, that crystal healing doesn't work or that Time Cube is pseudoscience. We would only need it in ths specific case where we wish to invoke "academic consensus", as the policy makes clear.
• The Wang editorial comment seems to me to be misrepresnted too. I don't see Wang saying that acupuncture is not pseudoscience; Wang's line of argument instead is that "it works" (or at least is under investigation). We mustn't infer things from that.
• But why on earth are we using editorial/comment sources anyway? These are at the bottom of the heap when it comes to quality. Baran et al. is a modern medical textbook (so, good WP:RS/WP:MEDRS) specifically addressing the question of what, in healthcare, is science, not science and pseudoscience (aka the demarcation question). It categorizes acupuncture as pseudoscience. We should follow this up-to-date source without complicating the issue with weakly sourced material, especially in the lede. Alexbrn ^{talk|contribs|COI} 16:58, 24 March 2015 (UTC)[reply]

• The claim recently added by Middle 8 appears to be blatant OR. I kindly asked Middle 8 for verification for the claim but so far Middle 8 has refused to provide verification for the claim. The part "has been described as" was unnecessary wording and the part "though this designation has been questioned" appears to be the opinion of an editor rather than the source. Middle 8, I will request it again. Please provide verification for the claim (or move on). The source did not specifically question the pseudoscience designation. Understand? QuackGuru (talk) 17:45, 24 March 2015 (UTC)[reply]

The source did question the pseudoscience designation. The entire piece did, as a matter of fact. I've restored some of its spirit, (the WHO) but we should consider adding in other parts as well. LesVegas (talk) 17:49, 24 March 2015 (UTC)[reply]

I'm sorry, I must be missing it. Could you please quote me the text where the "pseudoscience designation" is questioned in this poor-quality source? some text which includes the word "pseudoscience". Alexbrn ^{talk|contribs|COI} 17:51, 24 March 2015 (UTC)[reply]

I disagreeing with restoring the weight violation and original research to the lede. The details are in the body without the misleading wording. QuackGuru (talk) 18:07, 24 March 2015 (UTC)[reply]

Alexbrn, I'm not supporting saying specifically that the pseudoscience designation has been questioned, as that could be OR, but the spirit of the piece was just that. Anyway, here's some quotes for you: "Although >40 disorders have been recognized by the World Health Organization as conditions that can benefit from acupuncture treatment.." (Which precedes "many scientists") "4 It seems some-what naive to totally condemn the practice of acupuncture, while accepting orthodox medicine as the basis for treating all medical conditions." and "Overall, acupuncture practice should not be seen as a placebo intervention or merely a needle therapy, but a medical option that not only treats disorders but also fosters a greater awareness of how harmonic interactions between self, family, work, and environment play a role in promoting health and restoring order." To pull an acupuncture equals pseudoscience quote, alone, out of this piece (which attempts to defend acupuncture's validity) is quote mining and we don't want to do that, least not in the lede. LesVegas (talk) 18:20, 24 March 2015 (UTC)[reply]

A WP:MEDRS compliant review stated "Perhaps the most obviously over-optimistic overview is the document recently published by the WHO [28] (Table 1). Critics of acupuncture, however, continue to be unimpressed by such evidence and draw far less positive conclusions from the existing evidence [101]: ‘effectiveness could not be established with confidence for any condition studied. Taken as a group, reviews of clinical studies published since 1990 on the clinical efficacy of acupuncture do not support the notion that acupuncture is effective for any variety of conditions and cast doubt on efficacy for some specific conditions for which acupuncture has been reported as effective’."[3]

It was also original research because it was not even though or recognizes its efficacy. They recognized it can have a benefit. The WHO mention in the lede is a weight violation because a better source which is a review criticized the WHO report. Please don't use a lower quality source to argue against a review that is used in the body. QuackGuru (talk)

Alexbrn, demarcation is a judgement call, and the moon landing is a fact. Not quite the same, you know? For opinions, NPOV demands that we account for all sig views. If we call something pseudoscience in WP's voice, it must be (cf. WP:FRINGE/PS "generally considered pseudoscience by the scientific community". "Generally considered" invokes WP:RS/AC. No, acupuncture isn't "obvious pseudoscience" in the same way Time Cube is (skeptical polemic notwithstanding), because it has a broad following, cf. its use in mainstream medical settings, where most/all of its proponents do not consider it unqualified pseudoscience. (Meanwhile other academics disagree, and from the blogosphere, call its Ivy League proponents "quackademics": gee, that sure sounds like a real, mainstream debate.) As I said above, acu's use in mainstream medical settings is a fact that weighs in how we depict its reception. And of course Wang disputes the characterization, Wikilawyering readings of that source aside (I knew QuackGuru would pretend I didn't answer him). --Middle 8 (contribs • COI) 19:23, 24 March 2015 (UTC)[reply]

Hello my favourite SPA COI ed. Are you saying that sticking sharp thin bits of metal into people cures them, or has real effects other than the victim saying "Hey, I can feel that"? -Roxy the dog™ (resonate) 19:38, 24 March 2015 (UTC)[reply]

From WP:RS/AC: "Stated simply, any statement in Wikipedia that academic consensus exists on a topic must be sourced" (my bold). Your argument that this is mysteriously "invoked" by anything else is a novelty of interpretation not supported in our WP:PAGs. In general, it is not helpful to bend our WP:PAGs in pursuit of a position.

Homeopathy has a broad following. By your arguments Wikipedia wouldn't be characterizing that as pseudoscience either, wouldn't you say?! It is better to stick to WP:RS/WP:MEDRS and avoid special pleading for pet subjects. Alexbrn ^{talk|contribs|COI} 19:43, 24 March 2015 (UTC)[reply]

Alexbrn, nothing mysterious about it; it is WP:FRINGE/PS that invokes generally-held sci opinion. And I think it's apparent that acu is not in the same category than homeopathy. One doesn't see invited pro/con editorials in non-alt-med journals, nor the active degree of research. --Middle 8 (contribs • COI) 20:29, 24 March 2015 (UTC)[reply]

So (at the risk of getting off-topic), you're saying that our policy in practice is that WP:RS/AC applies for describing acupuncture as pseudoscience, but not for homeopathy? (Add: a few years back Integrative Cancer Therapies ran "pro" and "con" pieces on homeopathy, and of course homepathy has its own Elsevier-publisher journal.[4]) Alexbrn ^{talk|contribs|COI} 20:37, 24 March 2015 (UTC)[reply]

Of course not Alex, Homeopathy is an entirely different type of magic to Acu. You should know that by now. -Roxy the dog™ (resonate) 21:19, 24 March 2015 (UTC)[reply]

Roxy the dog, please do keep quiet if you have nothing useful to add. --Middle 8 (contribs • COI) 21:50, 24 March 2015 (UTC)[reply]

Alexbrn No, PAG for both are (obviously!) the same -- and for homeopathy, we do have at least one sci-consensus level source (The Royal College Of Pathologists [5], meeting WP:RS/AC) saying (essentially) it's pseudoscience. We don't have such a source for acu. Read WP:FRINGE/PS; it's clear enough. --Middle 8 (contribs • COI) 21:50, 24 March 2015 (UTC)[reply]

P.S. If I must unpack WP:FRINGE/PS further: Acu's "following", journals and research are what demarcate it into "questionable" rather than "obvious" pseudoscience. But "following" or not, once you have the sci-consensus source for a topic being PS, it flips into "generally considered". See? Our PAG's (the development and application of which I've followed closely) are internally consistent, and ensure that we follow (MED)RS.--Middle 8 (contribs • COI) 21:50, 24 March 2015 (UTC) c/e 23:14, 24 March 2015 (UTC)[reply]

"Essentially" is OR. There is, as far as I know, no RS that states plainly that there is a scientific consensus that homeopathy is a pseudoscience. This is because there has been a lot of discussion about this at that article (check the archive). However, the article simply says that homeopahy *is* a pseudoscience, and that is well-sourced. Your argument that WP:RS/AC is needed before asserting anything is a pseudoscience is your own fancy, your argument about "following" nothing but special pleading.Alexbrn ^{talk|contribs|COI} 07:32, 25 March 2015 (UTC)[reply]

No, it's based on PAG. Funny to see you disputing a scientific body's criticism of homeopathy as unscientific on a semantic technicality; that was the objection rendered by editors seen as alt-med apologists. We're allowed to use/rely on paraphrasing, and on that basis the source was accepted by consensus; check the archives for "generally considered pseudoscience by the sci community". So yes, homeo ≠ acu, demarcation-wise. You seem unwilling to accept FRINGE/PS's wording at face value, but whatever, we can seek further input. (If we continue this exchange let's do below; threading is getting messy, since Everymorning commented before your comment above and this reply.) --Middle 8 (contribs • COI) 02:01, 26 March 2015 (UTC)[reply]

I don't dispute their criticism, just note that we can't say there is "a scientific consensus" unless the source has exactly those words: that's what WP:RS/AC says. It's extremely rare to find that formulation, even for the most obviously woo topics. Anyway, it seems we have consensus and the article text is sticking so as far as I'm concerned we're done here. Alexbrn ^{talk|contribs|COI} 06:17, 26 March 2015 (UTC)[reply]

In the past, RS/AC has also been taken as saying that a sci-consensu source, e.g. from a scientific academy, inherently indicates consensus. But anyway, yes, this wording is in fact consensus, that works for me. --Middle 8 (contribs • COI) 12:00, 26 March 2015 (UTC)[reply]

To me, the main difference between homeopathy and acupuncture is the existence of government-level reviews saying that homeopathy is ineffective, [6] whereas no such reports have been published as far as acupuncture is concerned (to my knowledge). Besides that there is a fair amount of research into the possible mechanism of action of acupuncture, [7] while we know that it is physically impossible for homeopathy to work. [8] Everymorning talk 22:20, 24 March 2015 (UTC)[reply]

This whole topic is a bit silly - pejorative terms like pseudoscience are thrown around by pundits, while scientists actually study acupuncture and only make conclusions based on specific questions being asked. Real scientists and doctors don't obsess over this term, they just do their best to find what works. Acupuncture is clearly becoming more mainstream, as evidenced by the journal Science recently publishing a series of articles on the integration of TCM with biomedicine Summary of part 1. We're just arguing about name-calling again while the actual world of science and medicine moves on.Herbxue (talk) 23:01, 24 March 2015 (UTC)[reply]

@Herbxue: but yikes - that supplement is a vanity project (paid-for, not reviewed). Smacks more of desperation if stuff needs to get published this way. Alexbrn ^{talk|contribs|COI} 06:32, 25 March 2015 (UTC)[reply]

Well said, and great find re AAAS/Science pub. [9] Quote: From the new WHO Traditional Medicine Strategy to the application of systems biology in studying TCM, we aim to highlight the potential for creating an integrated, network-based health care system. That nicely balances the much-discussed Nature diss of systems biology.[10] Again, an active research area, debated in mainstream sources. --Middle 8 (contribs • COI) 23:26, 24 March 2015 (UTC) NOTE: The preceding comment about balancing Nature is off-topic for this thread; I'm referring to a different debate about systems biology and Nature's well-worn "fraught" quote[11]. --Middle 8 (contribs • COI) 06:24, 25 March 2015 (UTC)[reply]

The source said ...we aim to highlight the potential...[12] A "potential" is not solid evidence and that source did not address the pseudoscience designation. You did not provide V for the edit after I repeatedly requested for V. If Wang disputes the pseudoscience characterization then you would have no problem providing V. Otherwise, I think we are done here. QuackGuru (talk) 02:49, 25 March 2015 (UTC)[reply]

QuackGuru: (a) You misunderstand; I'm not saying that AAAS/Science source [13] goes directly to demarcation. (b) As for Wang and PS, I indeed provided V, yet you claimed I'd "refused" to. Hey - don't IDHT! You may not like or agree with my V/RS but don't pretend I didn't provide it. --Middle 8 (contribs • COI) 04:51, 25 March 2015 (UTC)[reply]

You did not provide the specific wording on the talk to verify the claim. QuackGuru (talk) 05:09, 25 March 2015 (UTC)[reply]

Okay, so we have a strong WP:RS & WP:MEDRS source, Baran et al., which flat out categorizes acupuncture as pseudoscience. We have no equivalent countering source. We have policies which tells us we construct neutral articles by accurately reflecting what's in RS. Against this we have invented rules about WP:RS/AC and the determination (by, it must be said, some interested editors here) that acupuncture has enough of a "following" (interesting word) that we just can't use the word "pseudoscience", and that we should be using a "sponsored supplement" (i.e. advertorial[14]) from Science Magazine for balance.

I would prefer we remove all the weak sources on this and stick with the strong only. Alexbrn ^{talk|contribs|COI} 05:57, 25 March 2015 (UTC)[reply]

Shorter Middle 8: "WP:FRINGE requires proof of general sci agreement to call something pseudoscience in WP's voice"; shorter Alexbrn: (crickets). "Generally considered PS by the sci community" isn't "invented". My response above to your attempted reductio ad absurdum is straight from PAG and you offer no rebuttal (other than trying to ignore FRINGE's clear instructions, and a bit of ad hominem).

Re Science source, see [15] -- I'm not advocating its use here; my fault for not being clear on that. --Middle 8 (contribs • COI) 06:56, 25 March 2015 (UTC)[reply]

As I've said follow the sources. We don't need to decide about the demarcation question ourselves because RS does it for us. Baran et al. considers what is "science", "not science" and "pseudoscience" and places acupuncture in that latter category. Without equivalent countering sources, that's all the "proof" we need; the fact that Middle8 of Wikipedia disagrees with it is neither here nor there. Also see the Good (2012) source, which goes to the point that the question of efficacy is orthogonal to the question of pseudoscience:

• Good R (2012). Khine MS (ed.). Chapter 5: Why the Study of Pseudoscience Should Be Included in Nature of Science Studies. Springer. p. 103. ISBN 978-94-007-2457-0. Believing in something like chiropractic or acupuncture really can help relieve pain to a small degree [...] but many related claims of medical cures by these pseudosciences are bogus. {{cite book}}: |work= ignored (help)Alexbrn ^{talk|contribs|COI} 07:05, 25 March 2015 (UTC)[reply]

Fine, so cite them with attribution wording and that's that. --Middle 8 (contribs • COI) 02:36, 26 March 2015 (UTC)[reply]

My question is, how are we going to better reflect the source in question? It seems odd to state acupuncture negatively from the Wang source, when it is a defense of its supposed scientific merits. For parity, how could we add in statements like: "It seems some-what naive to totally condemn the practice of acupuncture, while accepting orthodox medicine as the basis for treating all medical conditions." and "Overall, acupuncture practice should not be seen as a placebo intervention or merely a needle therapy, but a medical option that not only treats disorders but also fosters a greater awareness of how harmonic interactions between self, family, work, and environment play a role in promoting health and restoring order." Middle 8 summarized all of this but it was reverted and claimed to be OR. However, if we more directly quote from the source, it's not OR. My question is how do we do this? LesVegas (talk) 13:16, 25 March 2015 (UTC)[reply]

We should not use that source at all, it's crap compared to Baran/Good. Alexbrn ^{talk|contribs|COI} 13:20, 25 March 2015 (UTC)[reply]

Strange, Alexbrn, earlier you seemed to think that a Nature editorial was fine in the lede for saying whether acu is pseudoscience. [16] Why the inconsistency? --Middle 8 (contribs • COI) 02:32, 26 March 2015 (UTC)[reply]

Actually, on its merits, that source is inferior. It's nothing more than editorializing without basis. Dr. Wang at least uses research to form his conclusions. And it was peer reviewed, something I don't see in Baran/Good. Published in Anasthesia Analgesia. Exactly how is it crap? Surely not because of its conclusion? LesVegas (talk) 13:32, 25 March 2015 (UTC)[reply]

Generally, according to WP:MEDASSESS opinion pieces are near the bottom of the quality heap, and PUBMED classified Wang just as lowly "comment". Worse, Anasthesia Analgesia is not a serial specializing in the field of philosophy of science (the realm in which questions of pseudoscience is contemplated) - another WP:REDFLAG. Baran et al. is in a well-published (Springer) healthcare textbook (an "ideal" source per MEDRS) and is completely on-point since it's title is "Pseudoscience, and Not Science: How Do They Differ?". Good too is in a Springer textbook, this time on the nature of science research - so again completely on point: "Why the Study of Pseudoscience Should Be Included in Nature of Science Studies". Wang doesn't even address the question of pseudoscience. Alexbrn ^{talk|contribs|COI} 14:00, 25 March 2015 (UTC)[reply]

You made an interesting point. While I would rather we pull from a text that is specifically on acupuncture and not just makes a brief mentioning of it (lumping it in with chiropractic) I do think a Springer text could be a higher quality source. I also found another Springer text that might be even better, Current Research in Acupuncture which has much excellent stuff, and I particularly like it because it is specific to acupuncture research. "Substantial evidence has suggested that acupuncture can significantly affect various functions, and treat various diseases,especially ones based on neural mechanisms, through needle stimulation.." If others agree, we could remove the current wording, and replace it with that of Baran/Good and do so alongside a sentence like I suggested above. This way we achieve a degree of parity, albeit from two seperate sources. LesVegas (talk) 20:39, 25 March 2015 (UTC)[reply]

Actually, on second thought, Everymorning already fixed it to achieve parity with "borderlands science" which might work just as well. The Springer text I cited might work best in other places. LesVegas (talk) 20:52, 25 March 2015 (UTC)[reply]

What you had proposed is irrelevant to the pseudoscience designation.

For effectiveness we already have a similar sentence in the lede that summarises the body. See "An overview of high-quality Cochrane reviews suggested that acupuncture may alleviate some, but not all, kinds of pain.[16] ". QuackGuru (talk) 20:55, 25 March 2015 (UTC)[reply]

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."[17] 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."[18] 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."[19] 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: [20] --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. [21] --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,[22] User:McSly,[23] User:Jim1138,[24] User:Roxy the dog,[25], and User:Bobrayner[26] 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 [27]. 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 [28][29], 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[30] "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[31] 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 [32] agrees with the in-context reading of the source that led to the last broad consensus at WT:MED [33] 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 [34] and why it's persisted[35], and addressed a common objection.[36]. 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.[37] 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,[38] User:McSly,[39] User:Jim1138,[40] User:Roxy the dog,[41] and User:Bobrayner[42] 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.[43] 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[44] 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.[45] 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]

The section is a bit long. See Acupuncture#Low back. Maybe we can remove this. Thoughts? QuackGuru (talk) 21:31, 25 March 2015 (UTC)[reply]

All I care about is that we allow equality in criticism from non-MEDRS sources. We can remove it, and others like it and leave out criticisms of Ernst, or we can allow them all in. I don't care either way, just as long as we're not only criticizing pro-studies from the same level of sources as those we're excluding on the con-study side. Makes no difference which way we go and length isn't as big of an issue here as neutrality. LesVegas (talk) 21:41, 25 March 2015 (UTC)[reply]

This discussion is only for the Acupuncture#Low back section. Not other sections or sources. The section is apparently long. I thought it could be trimmed a bit. QuackGuru (talk) 21:45, 25 March 2015 (UTC)[reply]

I'd remove that, yes. It doesn't belong there; it might belong elsewhere, e.g. an article about the skeptic movement -- there, the issue of its (much) smaller weight relative to the NEJM review wouldn't be as much of a problem. --Middle 8 (contribs • COI) 12:53, 26 March 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 [46]). 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, [47] 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. [48] --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. [49] --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. [50] 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 [51] 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.[52]

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."[53] 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.[54] 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.[55] 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[56] 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."[57] 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.[58] 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[59] 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[60] however, Zad68 deleted my edit[61] 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 [62] 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. [63] 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]

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]

Roxy, why did you make this edit deleting comments here?[64]DrChrissy ^(talk) 20:53, 16 April 2015 (UTC) Actually, I doubt very much I will get an answer from you on that, so please apologise for being WP:uncivil. DrChrissy ^(talk) 21:09, 16 April 2015 (UTC)[reply]