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Changing the introductory paragraphs

I have just submitted a change to the introductory paragraphs. The original sentence relating to needling "acupuncture points" did not take into account the treating of Ashi points. My clarification, although quite lengthy, added this element. This is my first post so I hope that I have not transgressed in any way. Llj444 (talk) 16:44, 18 January 2008 (UTC)

Welcome aboard. I appreciate the spirit of your edit. If "ashi points" are not defined as "acupuncture points", they are certainly part of TCM theory... and researchers claiming to do "sham" acupuncture by needling "non-acupuncture-points" may be doing verum treatment if the "sham" points are also "ashi" points. That's an actively debated topic and should be mentioned. However, I'm not sure the lead section is the place to jump right into the specific meridians. Will think it over. Welcome! Jim Butler 21:42, 18 January 2008 (UTC)

For McCready: you asserted "bulk of scientists saying ac is crap." Source please? Also: "page needs to be 50kb max." Yes, your attempts at WP:GAME are duly noted. (Assume good faith isn't a suicide pact.) You've been blocked in the past for such behavior. Suggest you disengage a bit. --Jim Butler 10:20, 27 January 2008 (UTC)

Good the talk begins. But you are wrong in your allegation that I have been blocked for gaming. Pls apologise and pls answer for the third time, should the article be 30-50kb? Mccready (talk) 10:27, 27 January 2008 (UTC)

(1) Pls answer my question: "bulk of scientists saying ac is crap." Source please?

(2) You were blocked for tendentious editing. You're doing it again, and you ought to be blocked again for it, IMO. You're the one who owes an apology to the various editors whom you've stressed out.

(3) No, I don't see any reason to be rigid about article size, per other comments at Misplaced Pages talk:Article size. Also, I think the best way to go about reducing article size is discussion and splitting, not chopping out well-sourced material that you don't happen to like. --Jim Butler 10:41, 27 January 2008 (UTC)

1) Don't be silly. I suppose you'd want a cite that most scientists don't think the moon is made of blue cheese. 2) Not gaming. Don't be silly again. Editors are responsible for their own emotional state, not me. 3) Pls answer question. Do you agree or not that the article should be limited to 30-50kb? I'm quite happy for you to split away. A lot of the material is repeated elsewhere as I have said. Mccready (talk) 08:10, 28 January 2008 (UTC)

On (1), we've been over this before: see WP:NPOVFAQ#Pseudoscience and WP:RS#Claims_of_consensus. Prove your claim. The moon being made of blue cheese not a serious claim. Acu's effifacy for various things is, and is studied as such. On (3), what part of "no" didn't you understand? --Jim Butler 09:00, 28 January 2008 (UTC)

UNDUE Weight

Acupuncture Jim wants to cherry pick the slight amount of dodgy evidence that may exist for efficacy of acu and put it at the top. This is unacceptable. We all know that acupuncture has no demonstrated effect for the huge range of conditions for which it is used. Shouldn't we put that at the top if this is the route you want to travel? Mccready (talk) 08:23, 28 January 2008 (UTC)

Cochrane Collaboration is dodgy, eh? Sounds like an opinion straight out of the fringes of anti-science. It looks like more editors agree the lead is well-weighted in the version you dislike. The sources are impeccable, like Ernst, and the wording is clear about where there is and isn't efficacy per EBM. --Jim Butler 09:03, 28 January 2008 (UTC)

Are you being deliberately obtuse? It's not about Cochrane, which has its share of altmed nuts infiltrated anyway. You, Acupuncture Jim, gather every bit of evidence in support and want it in the top but have none which says for heaps of conditions it's crap. POV or not? For chrissakes why do you insist on filiform???Mccready (talk) 09:28, 28 January 2008 (UTC)

Ah, I think I see what happened; a sentence I'd thought was there dropped out along the way. Restored. Better approach than just deleting good V RS's, I think. Filiform? Of course, to distinguish them from other needles the reader might know of in a medical context, like hypodermic needles. I think that's called accuracy, not undue weight. --Jim Butler 10:45, 28 January 2008 (UTC)

Fair enough. Accepted. Now we have to address undue weight. The top needs to ack that science shows the bulk of conditions acu purports to treat are not amenable to acu. Mccready (talk) 01:38, 30 January 2008 (UTC)

Hehe, hey I just had this same statement made on the Talk:Chiropractic page. Mccready, are you trolling? I agree the article is long, especially the lead, but any shortening needs to be NPOV. More likely, the article could be split up, but don't delete hard work from other editors, make a new page and move it. Also, you can't just cut out one POV and expect it to stick. See if you can shorten it and still be saying the same thing... and it needs to be reliably sourced. ---- Dēmatt (chat) 02:35, 30 January 2008 (UTC)

Well, I removed the unsourced POV statement that remained. ---- Dēmatt (chat) 14:51, 30 January 2008 (UTC)

Thanks Dematt; agree entirely that what you removed was OR. I went even further and reverted, since the earlier wording remains the most accurate depiction of the sources cited (Ernst 2007, and the rest of the EBM reviews). As Ernst explains, the body of evidence is growing, and that evidence is showing efficacy for some conditions and a lack of efficacy for others. For many more conditions, there is not enough evidence to determine efficacy. That's what the sources say. A good example is their review of acupuncture for depression. cheers, Jim Butler 20:14, 30 January 2008 (UTC)

Are you guys deliberately ignoring the topic. The topic is UNDUE weight. It's a wiki policy. Pls address the issue.Mccready (talk) 01:55, 31 January 2008 (UTC)

"Undue weight", "article length" -- anything to justify your pruning particular views from the lead. It's called "wikilawyering". Your edits speak louder than your talk-page rationalizations. Happy editing and hope you have a great day, but don't think others haven't seen through your approach. I agree there is some accumulated cruft in the article, but I don't think you possess the objectivity to identify it. --Jim Butler 03:24, 31 January 2008 (UTC)

Temper, tempers please :-) I've not delved into the recent edit history, but this is generally a well written and informative article. I would though tend to feel that description of what acupuncture claims to be should come before critisms etc. Hence should last paragraph of leadin ("Traditional Chinese medicine's acupuncture theory predates... ") come as the second paragraph of the leader? David Ruben 03:36, 31 January 2008 (UTC)

Hi David - we could, although that paragraph (fourth one in the lead, this version) actually contains criticism, unlike the neutral evidence in the second. Maybe can rearrange somehow. I think it does have good article potential. (Mea culpa on temper, but do check the edit history for certain editors' deletionism.  :-) cheers, Jim Butler 05:19, 31 January 2008 (UTC)

Acupuncture Jim, Your abuse doesn't hide the fact the you refuse to engage in sensible discussion. We both know that for a huge range of conditions that acus treat there is no evidence of effectiveness. Does this or not need to be referenced in the top. Mccready (talk) 09:03, 1 February 2008 (UTC)

The reason for my revert is that we already talk about evidence in the lead, and specifically say "For most other conditions reviewers have found either a lack of efficacy (e.g., help in quitting smoking) or have concluded that there is insufficient evidence to determine if acupuncture is effective (e.g., treating shoulder pain)." It's redundant then to list a bunch of conditions where evidence for efficacy is lacking or uncertain.

Of cource acu is used clinically for conditions where EBM support is lacking, but that is also true for some biomedical modalities, including most surgical techniques. The Institute of Medicine, one of the four Academies of Sciences in the US, also makes this point (see last paragraph here). If you edited the lead sections of arthroplasty, etc., to add a list like you want to here, how far would you get? Be realistic. If your edits aren't judicious and supported by other editors (it's not just me objecting), they aren't going to stick. regards, Jim Butler 21:16, 1 February 2008 (UTC)

If we aren't going to mention specific conditions in the lead where acu is ineffective, then pls explain, Acupuncture Jim, why we should mention specific conditions were it is claimed to be effective. If you want to edit an article on surgical techniques go right ahead. Your point is irrelevant here. Mccready (talk) 11:27, 2 February 2008 (UTC)

The list of conditions that a particular compound or technique cannot treat is endless. I don't believe we apply your logic to other articles on WP, and surgical techniques are a good comparison because similar blinding issues apply to RCT's. Use common sense, please. --Jim Butler (t) 07:35, 3 February 2008 (UTC)

We're getting closer now. Of course the list is endless, but as you have it now you present one person's view that acu relevance is expanding. What are we to do about this UNDUE weight? I reiterate, your comments on other articles are irrelevant. We are talking here about the acu article. Mccready (talk) 03:07, 5 February 2008 (UTC)

Read more carefully, please. Ernst doesn't say acu relevance is expanding; he says the evidence base is, which is a simple statement of fact: more RCT's are being done every year. Your attempt to add a list to the lead is tendentious, redundant and stylistically inappropriate. It's good in the article but ridiculous in the lead. The lead is a summary; we already say that evidence is equivocal or lacking for "most other conditions" in the lead, and I hold firm to my view that enumerating them in the lead is plain silly. And comparisons to other articles are entirely relevant: your edits would never stick in any other article either. How many things does aspirin not treat? Please, common sense applies. You've been blocked before for disruptive editing and I wouldn't be at all surprised to see it happen again. --Jim Butler (t) 05:34, 5 February 2008 (UTC)

Stuff to add

This is interesting, re mechanism. --Jim Butler 05:19, 31 January 2008 (UTC)

And here is a link that (currently) provides free full access to the text and PDF version: Acupuncture Anesthesia and Analgesia for Clinical Acute Pain in Japan. MeekMark (talk) 11:36, 31 January 2008 (UTC)

I would hardly consider that journal to be reliable. And basically, they're saying that acupuncture treats every pain ever known. I would be opposed to using it. I'm not at all a supporter of junk science, so I've added some very reliable references to this article. I intend to be as neutral as I can to balance both sides of this story. But this article doesn't even entice me to look beyond it. Unsupported claims always makes me yawn. OrangeMarlin 03:19, 2 February 2008 (UTC)

Agree it is fairly underwhelming as a review, but as for the journal itself, Ernst and Kaptchuk are pretty studly and are on the review board. Not sure though about the general quality of articles or publication bias. --Jim Butler (t) 06:47, 2 February 2008 (UTC)

• Good one re sham acu and placebo effects: Kaptchuk et. al., BMJ 2006;332:391-397. Article about it in Science News. --Jim Butler (t) 06:47, 2 February 2008 (UTC)

Added. --Jim Butler (t) 07:58, 3 February 2008 (UTC)

Maybe more stuff

This research was published yesterday in the British Medical Journal. It includes meta analysis, which is something that never gives me any feeling of confidence. However, the paper suggests a NNT of 17:1 so it is note worthy from that point of view. Manheimer, Eric; et al. (7 February 2008 ).Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. doi:10.1136/bmj.39471.430451.BE.--Aspro (talk) 16:55, 8 February 2008 (UTC)

Williams

Good; undue weight to cite that guy in lead anyway. --Jim Butler (t) 04:15, 2 February 2008 (UTC)

Cleanup

If all goes well, I'm hoping to clean up the article and prune/merge some stuff into Traditional Chinese medicine, Channel (Chinese medicine), Zang Fu, etc. --Jim Butler (t) 04:18, 2 February 2008 (UTC)

It may take awhile, since edits like this are nontrivial and I haven't edited a couple of the above articles before. But the result will be a shorter, tighter article. --Jim Butler (t) 05:29, 2 February 2008 (UTC)

I made a small but significant change to the lead, in accordance with the sources we have in the article (AAMA etc), which list mainly pain and other symptoms. --Jim Butler (t) 07:57, 3 February 2008 (UTC)

Lead-in discussion on verification

Clearly Mccready's steady drastic reduction of the lead-in's discussion of the research and verification basis for acupuncture is not agreed with by several editors who have reverted it back (warning issued re risk being seen as edit warring). However I do have issues with the lead-in concentration on this:

• The leadin should really explain what something is and its historical & social background before getting too heavily into criticism & proofs.
  • The leadin current is sparse on history and even less mention of social/society issues. The first date mentioned in the leadin is not some estimate of when the practice first started (or a referrence to first written record to at least give a minimum timeframe) but "2007" for an American Journal publication.
  • The leadin needs give a little more description of history and uses. NB this should be noncontentious to indicate what it has been/is used for, which is quite distinct from an assertion of effectiveness - cf antibiotics often given for sore throat in the UK (true) but this not the same as whether blanket prescribing helps (contentious and certainly less clear-cut than the previous generation of doctors thought, and I certainly prescribe in well under half of cases as most are clearly self-resolving viral infections). Some mention also should be made of spread of practice into Western World (we surely all agree that acupuncture more prevalently available and practised in UK & US than say 100 years ago, but precisely what was this process (NB needs citing of course)
• Given I do not dispute that acupuncture is widely practised in the Far East, acupuncture is clearly not a trivial-minority opinion. Therefore the leadin should at least make some better mention of TCM viewpoint on disease and how acupuncture is thought to aid health. Likewise, given there are some positive scientific studies, how modern science (which does not see evidence for Qi) suspects acupuncture might exhibit its effects (ie pain-gate model, neuro-immunological effects or whatever).
• Of course given the alternative/complimentary aspect of how acupuncture is perceived, the leadin needs cover the evidence supporting or refuting claims of effectiveness, but this should not I think form the largest part of the leadin (relocate details to the "Scientific research into efficacy" section).

So, IMHO, the material Mccready has removed and paraphrased was overly harsh with the scythe, but I agree currently unduely long and needs some triming with expansion of other more straight forward encyclopaedic description aspects. David Ruben 12:02, 7 February 2008 (UTC)

Thanks David. Good finally to get the discussion started properly. The diehard defend acu at all costs acus who inhabit this page have refused to discuss properly despite an outward appearance. The points you made are valid on the whole. But the overwhelming evidence is that acu is BS. Even the one metastudy on P6 that AcuJim likes to tout has been criticised by scientists. AJ operates, as do most altmeders, by 1) muddy the waters by saying it's controversial and scientists can't agree (we've seen it classically in the tiny minority of global warming deniers among scientists) 2) suggesting their fav altmed as soln, 3) crying that they are cut off from research fund which would soon prove the moon is green cheese (thus AcuJim likes to quote any source he can that concludes more research is needed) 4) wikilawyering to prevent any sensible analysis or presentation of facts unsullied by UNDUE weight (thus a sensible conclusion is labelled OR and out of court, or a syllogistically correct statement is also thus labelled.

The facts are 1) most of the "science community" pays no attention to altmed because they've got b better things to do. Therefore statements about what the community thinks are fraught and need to be carefully verified. 2) the huge bulk of papers conclude acu is BS 3) this article's LEAD gives UNDUE weight to the minority of studies finding acu may have a point. The current statement in the lead "For most conditions acupuncture has no effect." is a huge compromise as it is. But AcuJim doesn't even accept that compromise. He can name no condition for which acu has unequivocally, to the satisfaction of the science community, been shown to have effect. There are even editors here who claim to be skeptics but have stated on their pages that they think acu has a demonstrated analgesic effect. Show me the studies proving that I say. Looking forward to sensible discussion. Mccready (talk) 00:53, 8 February 2008 (UTC)

(Further repeated blanking of section being discussed was disruptive and your block warranted). Whilst above indeed probably the views of majority established "conservative" conventional medical doctors, your points are merely items that the acupuncture criticism section might cover. Rather what I am trying to generate is discussion that the lead-in should have more information describing what acupuncture is, its historical context and views of claimed modality of effect, rather than be so heavily dominated by just the modern scientific verification/justification. The problem, I see, is over balance of spread of covered aspects, not a POV desire to downplay the veracity of the technique (of which I am an intrigued sceptic), so could some pro-acupuncture editors help here by suggesting how the verification discussion in the lead-in might be summarised down just a little and the other items I mention be more fully covered. The article's tone as set in the lead-in should really be a positive affirmation of what acupuncture is, and not what might be seen as an apologetic justification piece. David Ruben 01:02, 9 February 2008 (UTC)

David - I think your idea on moving forward with the lead is great, and the only reason I haven't responded sooner is I am time-poor and was asked to resolve a BLP problem elsewhere. Will work on this as soon as I can, certainly this weekend.

BTW, for Mccready, I'd appreciate being referred to by my handle here, and not nicks like "Acupuncture Jim" and the like. This isn't a political campaign, and as I mention on my user page, I prefer not to label people based on a single attribute, and in the spirit of the Golden Rule ask that others refrain from doing so with me. Also, WP:NPA comes into play.

As for Mccready's other comments... I feel that acu should be held to the same standards as anything else in medicine, and there is plenty already cited in the article (just go to Pubmed and read the studies cited in the reviews from Cochrane, Ernst etc.). However, Mccready seems to have a double standard for acupuncture, doubting any result and questioning the motives of the researchers. Not unlike his approach to wikiquette, interestingly. So, I'm not sure if there's anything else I can say to address his concerns. regards, Jim Butler (t) 06:27, 9 February 2008 (UTC)

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