| Revision as of 18:33, 31 October 2013 editLesion (talk | contribs)Autopatrolled, Pending changes reviewers, Rollbackers12,105 edits →Acupuncture and TCM: jps just reverses his/her position← Previous edit | Revision as of 18:40, 31 October 2013 edit undoජපස (talk | contribs)Extended confirmed users, Pending changes reviewers, Rollbackers60,480 edits →Acupuncture and TCM: rNext edit → | ||
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| ::::::::::Q: "How can a systematic review be a primary source?" A: If it is written by a fringe proponent, it can easily be a vector to promote a parochial or fringe opinion. When a cold fusion advocate writes a "systematic review of cold fusion", they are not writing a secondary source, they are writing a propaganda piece. Likewise with an acupuncturist writing a review of the evidence for acupuncture. You have to consider the source, not just the kind of work. I am not arguing to replace the section with a link to a blog. I'm arguing for using the Ernst reviews (which ARE properly independent) as replacements and to not mischaracterize them. Sorry if that wasn't clear. It would indeed be silly to ''replace'' Vickers et al. with blogs that dispute Vickers et al., for example. ] (]) 17:16, 31 October 2013 (UTC) | ::::::::::Q: "How can a systematic review be a primary source?" A: If it is written by a fringe proponent, it can easily be a vector to promote a parochial or fringe opinion. When a cold fusion advocate writes a "systematic review of cold fusion", they are not writing a secondary source, they are writing a propaganda piece. Likewise with an acupuncturist writing a review of the evidence for acupuncture. You have to consider the source, not just the kind of work. I am not arguing to replace the section with a link to a blog. I'm arguing for using the Ernst reviews (which ARE properly independent) as replacements and to not mischaracterize them. Sorry if that wasn't clear. It would indeed be silly to ''replace'' Vickers et al. with blogs that dispute Vickers et al., for example. ] (]) 17:16, 31 October 2013 (UTC) | ||
| :::::::::You say "acupuncurists all", but as far as I know none of the authors of these numerous reviews are acupuncturists. is certainly not an "acupuncturist" - he is a PhD career researcher at the Memorial-Sloan Kettering Cancer Center. I highly doubt he moonlights as an acupuncturist. As I said above, even if Vickers et al is completely removed from the picture, the conclusions of the other reviews are basically similar. And certainly, you can add ''published'' criticism of the Vickers review or any other review; although I know there are some people who've regarded letters or commentary articles "rebutting" reviews as automatically "not meeting MEDRS", I think that's an uncommon position. ] | (] - ]) 18:13, 31 October 2013 (UTC) | :::::::::You say "acupuncurists all", but as far as I know none of the authors of these numerous reviews are acupuncturists. is certainly not an "acupuncturist" - he is a PhD career researcher at the Memorial-Sloan Kettering Cancer Center. I highly doubt he moonlights as an acupuncturist. As I said above, even if Vickers et al is completely removed from the picture, the conclusions of the other reviews are basically similar. And certainly, you can add ''published'' criticism of the Vickers review or any other review; although I know there are some people who've regarded letters or commentary articles "rebutting" reviews as automatically "not meeting MEDRS", I think that's an uncommon position. ] | (] - ]) 18:13, 31 October 2013 (UTC) | ||
| ::::::::::Just read the guy's . He does not hide his support for societies, groups, and practitioners who use acupuncture and "integrative oncology" as a method. The conclusions being trumpeted in Misplaced Pages are that "A 2012 meta-analysis found significant differences between true and sham acupuncture, which indicates that acupuncture is more than a placebo when treating chronic pain." and "A 2012 meta-analysis concluded that acupuncture is effective for the treatment of chronic pain." This is in line with the fringe-promotion of Vickers et al. but is simply at odds with Ernst reviews, for example. Trying to lean on "published" reviews is a red herring. This is not how the life-cycle of identifying bad studies goes. Poor studies just suffocate from lack of exposure. ] (]) 18:40, 31 October 2013 (UTC) | |||
| :::::::::It is not a case of not being clear, at a few points in this thread you appear to clearly state that you think this blog is a suitable source. Now you are reversing your position and claiming you were talking about other sources by the blog author. Per Imperfectly's point above, published criticism (e.g. at least a letter to the editor in a peer review journal) wouldn't be removed by most editors I think, but a personal blog is another matter. Indeed, some of the systematic reviews now in the TMD#acupuncture section appear as "comment on" in the pubmed listing. You could say this is published criticism, although perhaps it is the worst criticism possible since the authors felt the need to start over and perform their own systematic review. ] (]) 18:33, 31 October 2013 (UTC) | :::::::::It is not a case of not being clear, at a few points in this thread you appear to clearly state that you think this blog is a suitable source. Now you are reversing your position and claiming you were talking about other sources by the blog author. Per Imperfectly's point above, published criticism (e.g. at least a letter to the editor in a peer review journal) wouldn't be removed by most editors I think, but a personal blog is another matter. Indeed, some of the systematic reviews now in the TMD#acupuncture section appear as "comment on" in the pubmed listing. You could say this is published criticism, although perhaps it is the worst criticism possible since the authors felt the need to start over and perform their own systematic review. ] (]) 18:33, 31 October 2013 (UTC) | ||
| {{od}}You have misunderstood me, I think. Blogs are certainly reliable sources for what the person who wrote them said. That's uncontroversial. When the person writing the blog is an expert, they are excellent sources for a particular topic. Did I ask for personal blogs to be included in the article? No. I just pointed out that a problematic source was being used and the experts who have commented on the subject have explained why the source is problematic. Then suddenly you proposed we remove the problematic source and ''replace'' it with the blogs. That's not even close to what I said. Go ahead and quote me where you think I said something to that effect. ] (]) 18:40, 31 October 2013 (UTC) | |||
| :::jps you do not have a leg to stand on, to exclude Vickers as a source per se, as others have said here - your hand-waving at the ] paragraph will not do, when (as Lesion writes above) the investigators are with universities, and funding came from the NIH (*yes, some funding also came from a nonprofit dedicated to altmed) and the journal is peer reviewed . I would be more interested in seeing what content people are adding based on Vickers. The effect size they found, while statistically relevant, is pretty small (just .5 SD) and if people are blowing this up to say that accupuncture cures chronic pain, rather than "may give clinically relevant relief" then there is a problem... ] (]) 13:10, 31 October 2013 (UTC) | :::jps you do not have a leg to stand on, to exclude Vickers as a source per se, as others have said here - your hand-waving at the ] paragraph will not do, when (as Lesion writes above) the investigators are with universities, and funding came from the NIH (*yes, some funding also came from a nonprofit dedicated to altmed) and the journal is peer reviewed . I would be more interested in seeing what content people are adding based on Vickers. The effect size they found, while statistically relevant, is pretty small (just .5 SD) and if people are blowing this up to say that accupuncture cures chronic pain, rather than "may give clinically relevant relief" then there is a problem... ] (]) 13:10, 31 October 2013 (UTC) | ||
| ::::The last sentence you state gives the problem as essentially that, so it's not very encouraging when you claim I "do not have a leg to stand on". Adopting blind and, frankly, ] credulity with respect to the interpretations of Vickers et al. is exactly the kind of nonsense going on in acupuncture and TCM. Two options: remove the source or properly contextualize it. To be clear, I actually don't care which, but the biggest issue here is that the reliable sources who have discussed this work (Ernst, for example) have taken ''direct issue'' with the interpretations being leveled in our articles -- namely the unfounded contention there is plainly evidence that acupuncture works better than sham acupuncture. Now, we could go on about the fact that this article has been raked over the coals and criticized in multiple ways by experts on acupuncture evidentiary studies, but this is often beyond the level of analysis necessary for Misplaced Pages. If you want to help providing context, that's fine, but to claim that this is an acceptable source and to leave it at that is essentially playing into the hands of pseudoscientific charlatans and makes a mockery out of Misplaced Pages's attempt at neutrality. ] (]) 13:36, 31 October 2013 (UTC) | ::::The last sentence you state gives the problem as essentially that, so it's not very encouraging when you claim I "do not have a leg to stand on". Adopting blind and, frankly, ] credulity with respect to the interpretations of Vickers et al. is exactly the kind of nonsense going on in acupuncture and TCM. Two options: remove the source or properly contextualize it. To be clear, I actually don't care which, but the biggest issue here is that the reliable sources who have discussed this work (Ernst, for example) have taken ''direct issue'' with the interpretations being leveled in our articles -- namely the unfounded contention there is plainly evidence that acupuncture works better than sham acupuncture. Now, we could go on about the fact that this article has been raked over the coals and criticized in multiple ways by experts on acupuncture evidentiary studies, but this is often beyond the level of analysis necessary for Misplaced Pages. If you want to help providing context, that's fine, but to claim that this is an acceptable source and to leave it at that is essentially playing into the hands of pseudoscientific charlatans and makes a mockery out of Misplaced Pages's attempt at neutrality. ] (]) 13:36, 31 October 2013 (UTC) | ||
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Proposed addition for identifying possible poor journals
While this guideline does a good job of identifying good journals and how to find them in the last paragraph of the Biomedical Journals section, I do not believe it does a good job of identifying poor journals (how to spot one, what to do when you have one). I bring up this proposal now because as I have noticed a large uptick in what can only be described as bad journal articles when I do a standard PubMed search. Unfortunately, PubMed Central is now indexing a number of non-MEDLINE indexed journals of dubious quality due these journals meeting their open access criteria (somewhat related previous discussions about open access journals and their reliability can be found here and here). Given the recent publicity about predatory journals, this problem will likely get worse, so I think we should deal with this now. This proposal is not meant to discuss open access journals per se, as there are plenty of good open access journals and poor print journals. However, I think we need to do a better job of directing editors away from poor journals, as well as dealing with the POV pusher who insists on using them.
Proposed addition:
- 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 includes publication by a publisher that has a reputation for exhibiting "predatory" behavior, such as Bentham Science Publishers, Dove Medical Press, or OMICS Publishing Group, among others. These publishers may have questionable business practices and/or peer-review processes that raises concerns about the reliability of their journal articles. Other indications that a journal article is probably not reliable is its publication in a non-MEDLINE indexed journal, or the publication of an article whose content is outside the normal scope of that journal (for instance, a psychiatric nursing journal publishing an article on the treatment of cancer). Determining the reliability of any individual journal article should take into account whether the article has garnered significant citations in higher quality sources, suggesting wider acceptance in the medical literature despite any red flags suggested here.
I suspect that this addition merely writes down what many of our WP:MED editors already do when looking at the reliability of an article. Comments? Yobol (talk) 23:35, 23 July 2013 (UTC)
- I support inclusion of something of this nature, but the wording may need adjustment ... highlighting specific journals can be tricky. Also for new audiences to the MEDRS page, "predatory" might be defined on first occurrence (you have the link later). SandyGeorgia (Talk) 12:51, 24 July 2013 (UTC)
- Comments/Questions - 1) The sentences " A red flag that a journal article....reliability of their journal articles." are void for vagueness because they instantly beg the question "What is "predatory" behavior?". 2) The "MEDLINE indexed" thing might be a potentially valuable rule, but we should include instructions for naive users on how to check to see if a journal is MEDLINE indexed. 3) "garnered significant citations in higher quality sources" should be changed to "garnered significant citations in high quality sources" or "garnered significant citations in sources of undisputed reliability". 4) Completely appreciate the difficult question Yobol is trying to address. I'm not super familiar with familiar with WP:MEDRS, but it strikes me that most of the ideas being expressed here by Yobol could probably apply to other scientific literature. Do these ideas not already exist on other policy pages? NickCT (talk) 13:00, 24 July 2013 (UTC)
- There is a general policy called Misplaced Pages:Identifying reliable sources and then there is Misplaced Pages:Identifying reliable sources (medicine). No other project has written its own guidelines because no other project has had a daily need to send people to a customized explanation of good sources. Blue Rasberry (talk) 18:25, 25 July 2013 (UTC)
- Comment does this include Elsevier? They have a reputation for publishing fake journals Elsevier#Sponsored_journals. Pubmed indexing says little. This article was half copied from Misplaced Pages (and they copied wrong stuff) and half copied from a NEJM article . Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:26, 25 July 2013 (UTC)
- Comment Elsewhere in this discussion some users ask for a definition of "predatory behavior". There is this - Predatory open access publishing. There may be sources which could generalize this article to create an article called Predatory academic publishing practices, but right now, the unregulated predators seem to be using open access platforms because people have confused expectations about how open access works and thus bad people attack researchers from those platforms. Blue Rasberry (talk) 18:31, 25 July 2013 (UTC)
Proposal #2
Thanks for the comments, have attempted to address them below:
- 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 includes publication by a publisher that has a reputation for exhibiting "predatory" behavior, which include questionable business practices and/or peer-review processes that raises concerns about the reliability of their journal articles. (See "Notes" section below for examples of such publishers.) Other indications that a journal article
is probablymay not reliable is its publication in a journal that is not indexed in the bibliographic database MEDLINE, or the publication of an article whose content is outside the normal scope of that journal (for instance, a psychiatric nursing journal publishing an article on the treatment of cancer). Determining the reliability of any individual journal article should 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.
- 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 includes publication by a publisher that has a reputation for exhibiting "predatory" behavior, which include questionable business practices and/or peer-review processes that raises concerns about the reliability of their journal articles. (See "Notes" section below for examples of such publishers.) Other indications that a journal article
I have removed the mention of specific publishers (redundant with a citation to the more comprehensive list anyways), and moved the description of predatory up. Also added a note on how to determine if a journal is MEDLINE indexed. Yobol (talk) 15:14, 24 July 2013 (UTC)
- This doesn't address the problem. Journals don't typically fact-check (which would be a process that editors or peer reviewers may do in part but necessarily completely for an article, or that journalists do at newspapers for all facts). Journals have systems - they then rely on the systems to work, rather than themselves verifying the accuracy of everything that they publish. Not being MEDLINE-indexed does not mean "a journal article is probably not reliable". You would need some pretty strong evidence to support that claim. Citations are definitely not an indicator of quality - indeed, some of the most highly cited publications are those that are egregiously bad. Eg highly disreputable claims about vaccines for example become highly cited as egregious causes of problems. Hildabast (talk) 15:54, 24 July 2013 (UTC)
- I agree "probably" may not be the right word, and have changed it to "may". Have also noted that the citations should be positive and not negative to imply reliability (probably common sense, but best to avoid ambiguity). When dealing with reliability issues, we are dealing at its core reputation (as it is based off our core policy of verifiability which discusses reputation of fact checking as of paramount importance). MEDLINE indexed journals have been through a vetting process and would seem to be a good general guide for a discussion of reliability based on reputation (with obvious exceptions on both sides). Note I also included an "out" for any of these red flags with the basis on positive citations so that articles that have been recognized by the medical community can be included. Yobol (talk) 16:20, 24 July 2013 (UTC)
- This doesn't address the problem. Journals don't typically fact-check (which would be a process that editors or peer reviewers may do in part but necessarily completely for an article, or that journalists do at newspapers for all facts). Journals have systems - they then rely on the systems to work, rather than themselves verifying the accuracy of everything that they publish. Not being MEDLINE-indexed does not mean "a journal article is probably not reliable". You would need some pretty strong evidence to support that claim. Citations are definitely not an indicator of quality - indeed, some of the most highly cited publications are those that are egregiously bad. Eg highly disreputable claims about vaccines for example become highly cited as egregious causes of problems. Hildabast (talk) 15:54, 24 July 2013 (UTC)
- This doesn't address the problem. Still using the term "predatory behavior". As written it would be really hard for a naive editor to apply the policy. NickCT (talk) 12:52, 25 July 2013 (UTC)
- I'm hard pressed to think of a credible medical journal that does not subscribe to the ICMJE's Uniform Requirements for Manuscripts Submitted to Biomedical Journals, which includes a code of ethics. Are there any counter-examples? LeadSongDog come howl! 13:20, 25 July 2013 (UTC)
- @NickCT:I had hoped a wikilink to our page that describes those predatory behaviors, a brief description in the next clause, and link to two different lists (one peer-reviewed) of said publishers would suffice. How would you improve upon this?
- @LeadSongDog: An interesting criteria. Looking at the ICJME website here, however, it may be difficult to use as a criteria as there doesn't appear to be a comprehensive list of journals that follow it, nor does it appear that the ICJME specifically polices their own list vigorously, making this a difficult criteria to apply. (For instance, a journal could claim to follow the requirement but without policing there is no way to verify this). Do you know of a comprehensive list that is actively vetted by someone? Yobol (talk) 13:37, 25 July 2013 (UTC)
- (1) just dealing with this list, journals are notorious for adopting standards that they do not consistently live up to. Anyone can say they follow this standard. Equally important, only purely or predominantly medical journals normally list themselves here. Nature & Science & PNAS & PLOS Biology do not, and they all publish articles relevant to medicine. Some journals that do list themselves would normally be considered of very low quality.
- (2) more generally, predatory journals do not generally publish significant fraudulent work; anyone wanting to make an impact with such work will publish it in a journal that will be visible--as high ranking as possible, counting on the chance that the reviewers will be lazy; if they don;t succeed with one, they simply send it to another--there is no system by which a journal can know that a ms has been previously rejected. What predatory journals do is publish insignificant work, good or bad, with occasional fairly good work from authors who do not know better.
- (3) Beale's list is based on his individual judgement. I greatly respect his judgment, but he has been challenged about failure to remove from his list journals that improve, or dealing adequately with those publishers who have good intentions, but nonetheless are following a model often followed by those who are not as honest. My own opinion is that some of the challenges are correct. No single judge will always be perfect.
- (4) There is no foolproof test that everything published in a journal is reliable. The customary test is that people can repeat it--but since both parties may encounter the same hidden artifact, the real test is that people can build a strong structure on its basis.
- (5)The best current book about biomed journals is, in my opinion, Philippa Benson and Susan Silver, What Editors Want: an Author's Guide to Scientific Journal Publishing University of Chicago Press, 2013 ISBN 9780226043142 (COI disclosure: I said so when I reviewed the book for Choice). DGG ( talk ) 16:12, 25 July 2013 (UTC)
- @Yobol: Yes, Nature Med and the other giants are rather special instances, working to rather more stringent standards than required by the UCM. They have the necessary clout to demand more of their authors. At this list of links from ICMJE we find quick access to some very helpful material. The Council on Publication Ethics (COPE membership include several of the Nature Med family, mostly review journals) provides a formal mechanism for addressing cases. The Council of Science Editors' member journals include the parent Nature, plus Nature Biotechnology, Nature Genetics, and Nature Neuroscience. The CSE has its own formal approach to scientific integrity. I suppose that, in the end, the specific codification is less important than the simple fact of adopting an externally-disciplined code with third-party arbiters. LeadSongDog come howl! 18:26, 25 July 2013 (UTC)
- @LeadSongDogInteresting links; though these appear to be suggestions for finding the highest quality journals, not for identifying particularly low quality journals. I wonder if we can incorporate some of this into the last paragraph already present in the Biomedical Journals section. Yobol (talk) 19:45, 25 July 2013 (UTC)
- @DGG: Thank you for that additional information. Do you think adding Beall's list is too prejudicial here, or is it a reasonable starting point to look out for journals/publishers to be wary of? I specifically worded this proposal with some ambiguity knowing his list is not in any way definitive. Yobol (talk) 19:47, 25 July 2013 (UTC)
- @Yobol: Yes, Nature Med and the other giants are rather special instances, working to rather more stringent standards than required by the UCM. They have the necessary clout to demand more of their authors. At this list of links from ICMJE we find quick access to some very helpful material. The Council on Publication Ethics (COPE membership include several of the Nature Med family, mostly review journals) provides a formal mechanism for addressing cases. The Council of Science Editors' member journals include the parent Nature, plus Nature Biotechnology, Nature Genetics, and Nature Neuroscience. The CSE has its own formal approach to scientific integrity. I suppose that, in the end, the specific codification is less important than the simple fact of adopting an externally-disciplined code with third-party arbiters. LeadSongDog come howl! 18:26, 25 July 2013 (UTC)
- I'm not sure that creating a suitable policy that will always be easily followed by the hypothetical "naive editor" is necessarily an achievable goal. We try to dance around the point, but the truth is that there just isn't, and won't ever be, a perfect recipe that can be blindly followed to reliably determine whether or not a published source is 'reliable'. There are definitely some bright-line rules, but there are also unavoidable swathes of gray.
- An individual who comes in without any familiarity with the world of academic publishing is almost always going to trip over an ugly surprise later or – more likely – sooner. What we need from this policy (rather than merely desire) is a clear framework that guides and allows experienced editors (those who come to the table with some knowledge of medical topics and academic publishing) to be able to reach reasonable conclusions about the quality of sources and how they can and should be used in Misplaced Pages—and to allow them to explain those conclusions to a naive-but-otherwise-competent fellow editor. TenOfAllTrades(talk) 16:45, 25 July 2013 (UTC)
- What is a suitable source also depends on what other sources are available. We sometimes use less than idea sources as that is the best there are. We really just want people to use the best available source. I have been discussing issues around this Lancet article in a few other circles.. The "up to 6 h" is not supported by the body of the article specifically . A number of us are of the opinion that they have taken extra liberty with the English language. Additionally there are concerns that the statistical methods used were not appropriate but they used them anyway. Additionally many of the authors receive funding from the company that makes the treatment in question. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:09, 25 July 2013 (UTC)
- I think we need to focus on getting a general guideline for identifying low quality journals rather than getting too deep into specific incidents. Does anyone have any specific concerns in the proposal, or ideas on how to improve it? Yobol (talk) 19:45, 25 July 2013 (UTC)
- What is a suitable source also depends on what other sources are available. We sometimes use less than idea sources as that is the best there are. We really just want people to use the best available source. I have been discussing issues around this Lancet article in a few other circles.. The "up to 6 h" is not supported by the body of the article specifically . A number of us are of the opinion that they have taken extra liberty with the English language. Additionally there are concerns that the statistical methods used were not appropriate but they used them anyway. Additionally many of the authors receive funding from the company that makes the treatment in question. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:09, 25 July 2013 (UTC)
- I'm hard pressed to think of a credible medical journal that does not subscribe to the ICMJE's Uniform Requirements for Manuscripts Submitted to Biomedical Journals, which includes a code of ethics. Are there any counter-examples? LeadSongDog come howl! 13:20, 25 July 2013 (UTC)
- Suggest
- When looking for high-quality sources, be wary of articles from journals with a reputation for "predatory" behavior. Another possible red flag is publication in a journal that is not indexed in the bibliographic database MEDLINE. An article on a topic outside a journal's normal scope may also arouse suspicion (e.g. an article dedicated to cancer treatment published in a psychiatric nursing journal). Note that such red flags may sometimes be counterbalanced by significant positive citations in reputable medical publications that suggest broader acceptance in the medical literature.
86.161.251.139 (talk) 12:55, 26 July 2013 (UTC)
- I'm neutral to your proposed change to the proposal compared to Proposal #2 above; I see merits to both versions, and would be happy with either (one is wordier, but explains the underlying policy reason for this paragraph; the other jumps to the meat of the problem). I do think that your "arouse suspicion" is a better wording, and it splits up MEDLINE indexing to its own sentence. I'm not sure discussion of "reputable" medical publications is a step forward, however, and prefer the one with "undisputed reliability" as it seems less prone to gaming. Yobol (talk) 12:01, 29 July 2013 (UTC)
- I agree gaming is a key concern. To my ears at least, "undisputed reliability" seems quite a claim. Would Lancet even pass on that...? 86.161.251.139 (talk) 13:22, 29 July 2013 (UTC)
- How about "whether the article has garnered significant positive citations in the highest quality medical sources"? Yobol (talk) 11:53, 30 July 2013 (UTC)
- Could you perhaps post another draft to consider? (Fwiw, the incipit "Determining..." sounded rather objective, to my ears at least, for what's always going to be, to some extent, a subjective judgement call.) 86.161.251.139 (talk) 14:33, 30 July 2013 (UTC)
- How about "whether the article has garnered significant positive citations in the highest quality medical sources"? Yobol (talk) 11:53, 30 July 2013 (UTC)
- I agree gaming is a key concern. To my ears at least, "undisputed reliability" seems quite a claim. Would Lancet even pass on that...? 86.161.251.139 (talk) 13:22, 29 July 2013 (UTC)
- I'm neutral to your proposed change to the proposal compared to Proposal #2 above; I see merits to both versions, and would be happy with either (one is wordier, but explains the underlying policy reason for this paragraph; the other jumps to the meat of the problem). I do think that your "arouse suspicion" is a better wording, and it splits up MEDLINE indexing to its own sentence. I'm not sure discussion of "reputable" medical publications is a step forward, however, and prefer the one with "undisputed reliability" as it seems less prone to gaming. Yobol (talk) 12:01, 29 July 2013 (UTC)
| Collapsed human error |
|---|
MEDLINE indexing - example queryThe following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion. So we're comfortable with red-flagging, say, reviews published in the Nature Clinical Practice series (eg ) prior to their first being indexed in MEDLINE (from 2009, in what became Nature Reviews)? 86.161.251.139 (talk) 14:14, 27 July 2013 (UTC)
|
Related proposal
See Misplaced Pages:Misplaced Pages Signpost/2008-06-30/Dispatches.
MEDRS has enjoyed broad community support over the years partly because it has been well tended, carefully written, and doesn't push unreasonably beyond general guidelines. One thing that might be done to address these newer (and valid) concerns is to write a new Dispatch, which would update the (now) older one, and discuss these new issues. At least it would be a stop-gap measure, and put the info in one place. SandyGeorgia (Talk) 14:30, 29 July 2013 (UTC)
- I think having something on the utility of PubMed Health for identifying systematic reviews could be good. But first, isn't it time we specifically mentioned this capability here in #Searching for sources? And if so, how to handle questions regarding the quality assessment filter within the broader context of MEDRS? 86.161.251.139 (talk) 16:23, 29 July 2013 (UTC)
- I am not familiar with these Dispatches, what, if any, role would they have here other than being the personal opinion of whoever writes them? Yobol (talk) 11:53, 30 July 2013 (UTC)
- They can go into more detail about things like "how to", are sometimes more user-friendly and readable, and I believe that particular dispatch is linked at MEDRS (or once was), because it wasn't just opinion ... it clarified how to use MEDRS in practice. SandyGeorgia (Talk) 13:33, 30 July 2013 (UTC)
- I am not familiar with these Dispatches, what, if any, role would they have here other than being the personal opinion of whoever writes them? Yobol (talk) 11:53, 30 July 2013 (UTC)
Notes
- ^ Beall, Jeffrey (2010). ""Predatory" Open-Access Scholarly Publishers" (PDF). The Charleston Advisor. 11 (4): 10–17.
{{cite journal}}: Unknown parameter|month=ignored (help) - ^ Beall, Jeffrey. "Potential, possible, or probable predatory scholarly open-access publishers". Retrieved 23 July 2013.
- To determine if a journal is MEDLINE indexed, go to this website, and search for the name of the journal. On the journal page, under the heading "Current Indexing Status", you can see whether or not the journal is currently indexed. Note that journals that have changed names or ceased publication will not be "currently" indexed on MEDLINE, but their indexing status, when they were being published, can be viewed under other headings on that same page.
- To see whether a journal is indexed in MEDLINE, search for the name of the journal here and locate its entry.
Avoid over-emphasizing single studies, particularly in vitro or animal studies
There is a calculus for weighing the inclusion of single studies.
The title to this section
Avoid over-emphasizing single studies, particularly in vitro or animal studies
suggests part of the calculus: Generally, omit in vitro or animal studies.
The calculus weighs in favor of relying on a single study or a few studies where
- no secondary authority is readily available.
- a groundbreaking study comes out that does not contradict reviews, consensus statements, etc.,
- a well-designed peer reviewed groundbreaking study is the only thing directly on point,
- a well-designed peer reviewed groundbreaking study is new, and was not available to peer reviewers who prepared other earlier reviews (e.g., a 2013 study was not available to the reviewers who prepared a review published in 2003), or
- A single new well-designed study that is consistent with and explains prior population studies.
The title "avoid over-emphasizing" aptly emphasizes the judgment process involved in avoiding over emphasis, which is determined by the quality, novelty, and importance of the study itself in the context of the other available authority.
Single studies are not automatically suppressed. That should be clarified, because this section is often cited to imply the contrary. Rather, single studies are used judiciously when needed, especially in the absence of better-established up-to-date authorities. And when single studies are used, the article should hew closely to the researchers own summaries, without violating copyright. Ocdnctx (talk) 16:19, 30 August 2013 (UTC)
- Note - the discussion that appears to have prompted this can be found here.
Zad6816:30, 30 August 2013 (UTC)
On "primary" sources as a secondary source
An issue (since resolved) on a page I edit came up earlier today and I was wondering what specifically the MEDRS guidance on this was, since it doesn't seem very clear to me.
If a "primary source" (I'm using this term loosely as something which isn't a review of literature) cites another paper to make a claim or reference that has nothing to do with the original research in that paper, is that a reasonable MEDRS secondary source, assuming all other relevant criteria are satisfied? I.e. it's independent of the source being cited, a human study as opposed to an animal study, satisfies WP:MEDDATE, etc.
I realize under those circumstances, that primary source is by definition a secondary source of that material, but I'm not not clear on whether that's sufficient for MEDRS. It seems to be sufficient for RS based upon the material from this page though. Seppi333 (talk) 21:14, 11 October 2013 (UTC)
- Too vague to respond to, can you give the example? thx I imagine you are talking about an Intro/background section, or the discussion. Either is a pretty weak secondary source and I would not give it to much weight. Intro, more than discussion (which by definition is building an argument). I would save the weight for a real secondary source... editors are often in a hurry but wikipedia is not... Jytdog (talk) 21:24, 11 October 2013 (UTC)
- I'm asking this in complete generality for future reference as opposed to determining if an existing source is ok.
- I guess a better question to pose is, under what circumstances is a non-review that is pubmed listed and published in a reliable/well-regarded journal a suitable MEDRS source when the content being cited makes it a secondary source? Seppi333 (talk) 02:24, 12 October 2013 (UTC)
- It is difficult to be general. The primary/secondary aspect of a text-source is only one factor. As Jytdog says, the background/info section of a paper isn't as good a secondary source as a proper literature review -- it isn't held to the same standards of comprehensiveness and impartiality by the peer-review or editorial review the paper gets. It is quite likely to cherry-pick the sources that support the theory the primary research is testing (though it is possible a fair writer may cite existing unsupportive research if he thinks the new research improves on it). Another factor is just how controversial or surprising the fact being included is. Something utterly mundane and nearly obvious wouldn't require a strong source. Colin° 11:30, 12 October 2013 (UTC)
- I actually wasn't aware of a different treatment between the citations of reviews of literature and non-reviews in peer-review, but in light of that fact I suppose it makes sense to only use reviews in articles. Thanks for pointing that out. Seppi333 (talk) 12:03, 12 October 2013 (UTC)
On a related point, you might want to read WP:Secondary does not mean independent. If Source #2 merely repeats what Source #1 says, it can be independent but still primary. Becoming a secondary source requires some sort of analysis or intellectual transformation. WhatamIdoing (talk) 10:26, 25 October 2013 (UTC)
Suggested reword to MEDDATE section
Propose changing:
"These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or few reviews are being published."
To
"This guideline applies mainly to Misplaced Pages articles concerning topics for which there is ongoing and active research. For articles on topics for which there are fewer available sources, it may be appropriate to include older sources if nothing recent can be found."
Rationale:
- the intro could be interpreted as stating that primary sources are desirable as Misplaced Pages sources. I am not greatly fussy about the wording, I just feel that it is sending out contradictory messages if we are not very clear. If anyone wants to reword please feel free. Mainly I thought the reference to primary sources needed to go... Lesion (talk) 12:39, 24 October 2013 (UTC)
- Support-- 100% more readable. I support this change. LT910001 (talk) 22:03, 24 October 2013 (UTC)
- Support - I think it's better as well. Seppi333 (talk) 23:29, 24 October 2013 (UTC)
- Oppose I believe language was selected intentionally to mention primary sources to provide a little push against the human tendency to become extremely rigid and rule-based. My impression here is that in the past few years this guideline has been interpreted in an extremely rule-based manner which is fairly hostile to newcomers and even a turnoff to some experienced people (at least myself). People can agree to disagree, but I guess it basically comes down to: is Misplaced Pages a place which has a whole lot of information, including pretty new stuff, or just information which has attracted a sufficient amount of high-profile interest that there's a review article or a few out there? I come down on the former side. Others can disagree, and that's OK, but I doubt my position will change. II | (t - c) 01:46, 25 October 2013 (UTC)
- I would point out that the change of wording does not explicitly say to use primary sources or not to use them. I feel it is better to leave this discussion to the dedicated part of the guideline, (which I suspect is the part of MEDRS that you actually want to reword?). Here we are talking about how to select recent sources, and I feel it is confusing to drag primary sources into it. Agree with you that MEDRS is interpreted rigidly by some. It is just easier to say "don't do that please" to a new user who has placed content based on small, in vitro studies which contradict the consensus with a strongly worded guideline than one which says "primary sources are OK sometimes, and other times they are less OK" and not clearly define when they are suitable ... Agree it is difficult for new users, but I assume most of us went through having our first edits reverted. Also, you have to question whether we want to encourage the kind of editors who want to cherry pick primary sources to back their own non-NPOV to stay. I feel that we need a guideline which is clear to this kind of editor that this is unacceptable. It is a bit of a compromise between the quality of the encyclopedia and a user-friendly environment in some respects. Lesion (talk) 12:37, 25 October 2013 (UTC)
- I noticed that it doesn't specify. I think this tends to get more used by experienced editors and suggests a "tone". I'm not going to hold it up if people want it (which it appears they do), and I agree that it doesn't fundamentally change the guideline. Reasonable people can disagree and I see why you want to tweak it. But I still think it's better to specifically note a relaxation of rules. As far as whether we want new editors, I think that anyone who has gotten to the point of figuring out how to navigate the system, and starts out their edits with actual medical literature, should be treated with respect and mentorship rather than accusatory hostility and suspicion. Misplaced Pages has always been pretty much a motley crew and I don't see that changing. Incidentally, when this guideline was being hashed out, one of the few editors I've encountered who has professed to be an actual researcher (Paul gene, although evidence was of course lacking) was one of its most vociferous opponents, and apparently left the project after losing the debate. My bigger concern with the guideline is that mostly when I see a primary source removed around here, there's a secondary source or several which could just as well support the information. II | (t - c) 23:46, 26 October 2013 (UTC)
- Suggest leave this proposal stand for longer to get more opinions. Lesion (talk) 10:00, 31 October 2013 (UTC)
- I noticed that it doesn't specify. I think this tends to get more used by experienced editors and suggests a "tone". I'm not going to hold it up if people want it (which it appears they do), and I agree that it doesn't fundamentally change the guideline. Reasonable people can disagree and I see why you want to tweak it. But I still think it's better to specifically note a relaxation of rules. As far as whether we want new editors, I think that anyone who has gotten to the point of figuring out how to navigate the system, and starts out their edits with actual medical literature, should be treated with respect and mentorship rather than accusatory hostility and suspicion. Misplaced Pages has always been pretty much a motley crew and I don't see that changing. Incidentally, when this guideline was being hashed out, one of the few editors I've encountered who has professed to be an actual researcher (Paul gene, although evidence was of course lacking) was one of its most vociferous opponents, and apparently left the project after losing the debate. My bigger concern with the guideline is that mostly when I see a primary source removed around here, there's a secondary source or several which could just as well support the information. II | (t - c) 23:46, 26 October 2013 (UTC)
- I would point out that the change of wording does not explicitly say to use primary sources or not to use them. I feel it is better to leave this discussion to the dedicated part of the guideline, (which I suspect is the part of MEDRS that you actually want to reword?). Here we are talking about how to select recent sources, and I feel it is confusing to drag primary sources into it. Agree with you that MEDRS is interpreted rigidly by some. It is just easier to say "don't do that please" to a new user who has placed content based on small, in vitro studies which contradict the consensus with a strongly worded guideline than one which says "primary sources are OK sometimes, and other times they are less OK" and not clearly define when they are suitable ... Agree it is difficult for new users, but I assume most of us went through having our first edits reverted. Also, you have to question whether we want to encourage the kind of editors who want to cherry pick primary sources to back their own non-NPOV to stay. I feel that we need a guideline which is clear to this kind of editor that this is unacceptable. It is a bit of a compromise between the quality of the encyclopedia and a user-friendly environment in some respects. Lesion (talk) 12:37, 25 October 2013 (UTC)
- Support - it's clearer, and since this is a guideline there is still scope for flexibility in truly exceptional circumstances. Alexbrn 07:35, 25 October 2013 (UTC)
Dissertations and theses
Presently, WP:RS says "completed dissertations or theses written as part of the requirements for a PhD, and which are publicly available, are considered publications by scholars and are routinely cited in footnotes. They have been vetted by the scholarly community..." Should this language be modified or expanded in any way? See the discussion at Misplaced Pages talk:Identifying reliable sources#PhD Theses. --Anthonyhcole (talk · contribs · email) 06:23, 25 October 2013 (UTC)
Acupuncture and TCM
Acupuncture (edit | talk | history | protect | delete | links | watch | logs | views)
Traditional Chinese medicine (edit | talk | history | protect | delete | links | watch | logs | views)
Just a heads-up. Acupuncturists and believers in traditional Chinese medicine have taken to crying WP:MEDRS as a way to shelter their pet statements that acupuncture is better than a placebo? They are trumpeting a source that has been roundly impeached here: . This Vickers et al. source is being spammed throughout Misplaced Pages as evidence that acupuncture is better than a placebo and that's very, very bad. Please help.
jps (talk) 02:51, 31 October 2013 (UTC)
- I could care less about acupuncture and have never used it. I think it's clinical effect is questionable and that it remains possible that its effects are due to placebo, and I think the sources largely support this view. However, the sources clearly do not say that evidence shows conclusively that it is entirely placebo. I do care about is misrepresentation of scientific sources and therefore I draw a bright line which jps is bent on ramming his way through. What initially spurred this discussion was an edit by jps (formerly ScienceApologist, who was banned until recently) at Traditional Chinese Medicine. I criticized his edit a couple hours ago (which came late, after an edit war I wasn't around for) with this:
Rather than an apology or understanding, this provoked the following comment from jps:Dude. This is your edit. You have added "Review articles discussing the effectiveness of acupuncture have concluded that its outcomes are due to the placebo effect" and cite 4 sources, the earliest from 2005 and the latest from 2008. The first, Ernst 2006, ends with "Some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response". Your summary of his conclusion is not even a half-truth and would likely earn you a very dark scowl from Ernst himself. It might be similar to calling the sky green and not blue, and the colors are not as far apart as red and blue, but it's still objectively untrue. The other reviews are similar; your summary contradicts Cochrane review Furlan et al 2005 perhaps most clearly, as it concludes that "For chronic low-back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment immediately after treatment and in the short-term only". It's also sad that you've dragged a couple people who really should know better (IRWolfie- and Alexbrn) into making this flagrantly false edit, the latter of which was a participant of a similar debate at acupuncture not long ago. Misrepresenting scientists who have carefully worded their conclusions is deeply offensive; it's probably most deeply offensive to the researchers themselves but it's also completely unacceptable to our readers and our reputation. As I mentioned when I saw this earlier, it reminds of me an incident that I helped out with. Now, if you want to work on rehabilitation, you should probably self-revert and then take a look at Vickers et al 2012 in JAMA. II | (t - c) 01:45, 31 October 2013 (UTC)
So he is now on a campaign against the 2012 meta-analysis by Andrew Vickers and his nine colleagues, published in JAMA Internal Medicine (formerly Archives of Internal Medicine). The fact that this is his response to an accusation of misrepresenting scientific sources is most troubling. In my view, it doesn't really matter whether he removes Vickers (and I don't care all that much if Vickers is cited or not), since the conclusions are roughly consistent with the other reviews. But it seems clear that he is not capable of hewing to the nuanced wording of these reviews. II | (t - c) 03:15, 31 October 2013 (UTC)Oooh... you guys really have gone down hill. Using Vickers? I will working on systematically removing Vickers from this encyclopedia on the basis of this: . Thanks for the heads-up. And please don't POV-push so much!
- Josh, if there's a windmill to tilt at, I wouldn't start here, at least not on Misplaced Pages. I don't know anything about acupuncture or Vickers but the basic parameters of the article (it's a recent MEDLINE-indexed meta-analysis and review published by well-degreed, university-associated authors in a well-respected journal with a high impact factor) would make it very hard to unseat from a Misplaced Pages article, if it would really be a good idea to try doing so in the first place. Over time our sourcing guideline has become rather prescriptive, and that's probably the only way to make it work when most editors are well-meaning but not very well trained amateur volunteers. There are more outlandish claims supported by much weaker sourcing in other articles... time would be better spend on those.
Zad6803:47, 31 October 2013 (UTC)- Really? The claim that acupuncture is effective has been the rallying cry of the alt med community for a while, and their insistence that researchers receiving funding from their alt med advisory boards pump out credulous papers in out-of-the-way journals is getting in the way of major points that are published in high-quality journals. This is a deplorable state of affairs similar to what was going on at homeopathy a few years ago when Dana Ullman took over and tried to "balance" all the facts about homeopathy being simply inefficacious nonsense with credulous studies from out-of-the-way journals. It's the same story. And we have part of the MEDRS guideline set-up to counteract that: the bit about independent sources. The Vickers article is not independent. The Ernst articles are. So why are we giving them WP:GEVAL? If you guys can't help, this guideline becomes toothless. jps (talk) 12:03, 31 October 2013 (UTC)
- The JAMA article appears to meet MEDRS, the blog is definitely not MEDRS and should not be used for anything on Misplaced Pages, especially removing other sources. Suggest jps is the one with non NPOV, and is heading for a minimum topic ban on acupuncture given the history of previous behavior. Lesion (talk) 10:07, 31 October 2013 (UTC)
- The "JAMA" article is not from the actual high-impact JAMA but from an out-of-the-way attempt to compete with trade journals. It is not reliable as a source because it doesn't demand independent confirmation and thus is in contravention of our MEDRS rule for independent sourcing. jps (talk) 12:03, 31 October 2013 (UTC)
- It appeared to me that you were basically saying "I'm going to remove this source because of what this blog said" (paraphrase). This is inappropriate. On a related matter, I am interested in your comments on this section: Temporomandibular_joint_disorder#Acupuncture, which I think I wrote and I believe represents the mainstream opinion. Lesion (talk) 12:59, 31 October 2013 (UTC)
- The attempt to say, "it's only a blog" is a lot of red herring. Consider the source. Ernst is the pre-eminent (one might argue ONLY expert) in acupuncture efficacy research. His point about this source is that the interpretations being used on it should be, "There is no evidence that acupuncture is better than a placebo". That's not being communicated when this source is being spammed across Misplaced Pages.
- Here's my comment on what you wrote: you are using improperly vetted, poorly controlled, and out-of-the-way studies in poor-quality journals to essentially make Misplaced Pages recommend the use of acupuncture for this condition. Terrible thing you've done, actually. The issue is that acupuncture has no mechanistic basis and the claimed "placebo" being administered wasn't done properly. Yes, there's a shit-ton of bad papers out there on this subject. Misplaced Pages should either avoid them completely or give proper context. This was not done in that section. jps (talk) 13:41, 31 October 2013 (UTC)
- Respectfully, regardless of who writes this blog, it does not meet MEDRS. Surely you have to agree? It follows that we should not use it as a source, or as justification to remove other sources.
- 100% disagree. To give a comparable example, if the most famous heart surgeon in the world is quoted as saying, "Please do not read Journal of XXX as it is not a reliable source for research about heart surgery" Misplaced Pages should take that kind of statement EXTREMELY seriously. jps (talk) 15:20, 31 October 2013 (UTC)
- This is not a comparable example. Such would be "the most famous heart surgeon in the world said on his personal blog ...". One the one hand you appear to say that evidence is everything, on the other you say that self published expert opinion trumps sources published in peer review journals. At least quote him from a proper source, not a blog. Lesion (talk) 15:32, 31 October 2013 (UTC)
- What you're failing to understand is there is essentially no such thing as a WP:MEDRS quality source that would include the evaluation "Please do not read Journal of XXX as it is not a reliable source for research about heart surgery" because that's not what journals are for. The BEST SOURCE we can have for such an evaluation is a direct quote from an expert. Just because the expert says it on a blog, in an interview, or at a conference does not make the statement unreliable. jps (talk) 15:35, 31 October 2013 (UTC)
- This is not a comparable example. Such would be "the most famous heart surgeon in the world said on his personal blog ...". One the one hand you appear to say that evidence is everything, on the other you say that self published expert opinion trumps sources published in peer review journals. At least quote him from a proper source, not a blog. Lesion (talk) 15:32, 31 October 2013 (UTC)
- 100% disagree. To give a comparable example, if the most famous heart surgeon in the world is quoted as saying, "Please do not read Journal of XXX as it is not a reliable source for research about heart surgery" Misplaced Pages should take that kind of statement EXTREMELY seriously. jps (talk) 15:20, 31 October 2013 (UTC)
- Re. the section Temporomandibular_joint_disorder#Acupuncture, I have used one up to date systematic review to form the basis of this section. Following your comments I have searched for other suitable sources, and found 2 other systematic reviews/meta analyses which have similar conclusions (i.e. limited evidence of efficacy) ,. I also found this source which I believe is what you are talking a bout above Acupuncture may be no more effective than sham acupuncture in treating temporomandibular joint disorders.. I will add these sources to the section, but apart from adding the conclusion of the 4th systematic review, I do not see a need to change the "limited evidence of efficacy" statement of this section. The other additional secondary sources are not cherry picked, and add other opinions for and against the use of acupuncture for TMD. I also point out that the section receives due weight relative to other sections in the treatment section. I therefore disagree with your interpretation "Misplaced Pages is basically recommending this for this condition", as it is in the context of a long treatment section. Lesion (talk) 14:54, 31 October 2013 (UTC)
- But consider the sources you are using. High-quality journals should be availed and the presumption with any medical procedure is one of the null result, which isn't taken seriously by these source. "Limited" efficacy is actually giving too much weight to the studies that are not demonstrating the gold standard of control. So while you can mention that people have tried to study the efficacy using uncontrolled studies, there is no evidence that acupuncture is better than a placebo. That's the kind of writing that I would give a gold star. jps (talk) 15:20, 31 October 2013 (UTC)
- I am uncomfortable adding my own interpretation of MEDRS sources. We should follow closely what the sources state. This section has 5 recent systematic reviews now (all meet MEDRS imo), I think it is fine as I have given voice to both sides of the argument. Lesion (talk) 15:32, 31 October 2013 (UTC)
- Writing Misplaced Pages is an act of translation, but you have to be careful when translating the words of fringe theorists. They can only be used, even when published in what look to be otherwise respectable publications, to show what they think. As you have currently written the section, it reads as though their studies are evidence when in fact it is just the authors (acupuncturists all, I might add) who are saying that. This is the very reason we ask for independent sources whenever we do analysis. You are including analysis from primary sources and it should probably be removed or replaced with Ernst. jps (talk) 15:37, 31 October 2013 (UTC)
- This section contains no primary sources. How can a systematic review be a primary source? It is by definition a secondary source because it is based on primary sources... Until a Cochrane review comes out on this topic, which hopefully we can more sure is independent, these will have to do. I certainly do not think it is appropriate to remove this section and place a link to some blog instead. You have a strange idea of how the encyclopedia should be. Your recommendation does not represent MEDRS. Please feel free to suggest how you feel the guideline should be changed, but while it stands in its current form, you have no basis to place this blog as a source or use it to replace any content. This is nonsense. Lesion (talk) 15:58, 31 October 2013 (UTC)
- Here is my understanding of how you would need to change MEDRS: "Please use only recent, reliable secondary and tertiary sources. Do not use primary sources to refute the findings of mainstream sources found in peer review journals, UNLESS it is the self published material of an expert whose opinion jps agrees with, in which case, ignore any reliable sources because they carry less weight. If you disagree with the conclusions of said sources, feel free to liberally apply your own unsourced interpretation of their inadequacies." Lesion (talk) 16:22, 31 October 2013 (UTC)
- Q: "How can a systematic review be a primary source?" A: If it is written by a fringe proponent, it can easily be a vector to promote a parochial or fringe opinion. When a cold fusion advocate writes a "systematic review of cold fusion", they are not writing a secondary source, they are writing a propaganda piece. Likewise with an acupuncturist writing a review of the evidence for acupuncture. You have to consider the source, not just the kind of work. I am not arguing to replace the section with a link to a blog. I'm arguing for using the Ernst reviews (which ARE properly independent) as replacements and to not mischaracterize them. Sorry if that wasn't clear. It would indeed be silly to replace Vickers et al. with blogs that dispute Vickers et al., for example. jps (talk) 17:16, 31 October 2013 (UTC)
- You say "acupuncurists all", but as far as I know none of the authors of these numerous reviews are acupuncturists. Andrew Vickers is certainly not an "acupuncturist" - he is a PhD career researcher at the Memorial-Sloan Kettering Cancer Center. I highly doubt he moonlights as an acupuncturist. As I said above, even if Vickers et al is completely removed from the picture, the conclusions of the other reviews are basically similar. And certainly, you can add published criticism of the Vickers review or any other review; although I know there are some people who've regarded letters or commentary articles "rebutting" reviews as automatically "not meeting MEDRS", I think that's an uncommon position. II | (t - c) 18:13, 31 October 2013 (UTC)
- Just read the guy's CV. He does not hide his support for societies, groups, and practitioners who use acupuncture and "integrative oncology" as a method. The conclusions being trumpeted in Misplaced Pages are that "A 2012 meta-analysis found significant differences between true and sham acupuncture, which indicates that acupuncture is more than a placebo when treating chronic pain." and "A 2012 meta-analysis concluded that acupuncture is effective for the treatment of chronic pain." This is in line with the fringe-promotion of Vickers et al. but is simply at odds with Ernst reviews, for example. Trying to lean on "published" reviews is a red herring. This is not how the life-cycle of identifying bad studies goes. Poor studies just suffocate from lack of exposure. jps (talk) 18:40, 31 October 2013 (UTC)
- It is not a case of not being clear, at a few points in this thread you appear to clearly state that you think this blog is a suitable source. Now you are reversing your position and claiming you were talking about other sources by the blog author. Per Imperfectly's point above, published criticism (e.g. at least a letter to the editor in a peer review journal) wouldn't be removed by most editors I think, but a personal blog is another matter. Indeed, some of the systematic reviews now in the TMD#acupuncture section appear as "comment on" in the pubmed listing. You could say this is published criticism, although perhaps it is the worst criticism possible since the authors felt the need to start over and perform their own systematic review. Lesion (talk) 18:33, 31 October 2013 (UTC)
- Writing Misplaced Pages is an act of translation, but you have to be careful when translating the words of fringe theorists. They can only be used, even when published in what look to be otherwise respectable publications, to show what they think. As you have currently written the section, it reads as though their studies are evidence when in fact it is just the authors (acupuncturists all, I might add) who are saying that. This is the very reason we ask for independent sources whenever we do analysis. You are including analysis from primary sources and it should probably be removed or replaced with Ernst. jps (talk) 15:37, 31 October 2013 (UTC)
- I am uncomfortable adding my own interpretation of MEDRS sources. We should follow closely what the sources state. This section has 5 recent systematic reviews now (all meet MEDRS imo), I think it is fine as I have given voice to both sides of the argument. Lesion (talk) 15:32, 31 October 2013 (UTC)
- But consider the sources you are using. High-quality journals should be availed and the presumption with any medical procedure is one of the null result, which isn't taken seriously by these source. "Limited" efficacy is actually giving too much weight to the studies that are not demonstrating the gold standard of control. So while you can mention that people have tried to study the efficacy using uncontrolled studies, there is no evidence that acupuncture is better than a placebo. That's the kind of writing that I would give a gold star. jps (talk) 15:20, 31 October 2013 (UTC)
- Respectfully, regardless of who writes this blog, it does not meet MEDRS. Surely you have to agree? It follows that we should not use it as a source, or as justification to remove other sources.
- It appeared to me that you were basically saying "I'm going to remove this source because of what this blog said" (paraphrase). This is inappropriate. On a related matter, I am interested in your comments on this section: Temporomandibular_joint_disorder#Acupuncture, which I think I wrote and I believe represents the mainstream opinion. Lesion (talk) 12:59, 31 October 2013 (UTC)
- The "JAMA" article is not from the actual high-impact JAMA but from an out-of-the-way attempt to compete with trade journals. It is not reliable as a source because it doesn't demand independent confirmation and thus is in contravention of our MEDRS rule for independent sourcing. jps (talk) 12:03, 31 October 2013 (UTC)
You have misunderstood me, I think. Blogs are certainly reliable sources for what the person who wrote them said. That's uncontroversial. When the person writing the blog is an expert, they are excellent sources for a particular topic. Did I ask for personal blogs to be included in the article? No. I just pointed out that a problematic source was being used and the experts who have commented on the subject have explained why the source is problematic. Then suddenly you proposed we remove the problematic source and replace it with the blogs. That's not even close to what I said. Go ahead and quote me where you think I said something to that effect. jps (talk) 18:40, 31 October 2013 (UTC)
- jps you do not have a leg to stand on, to exclude Vickers as a source per se, as others have said here - your hand-waving at the independent sources paragraph will not do, when (as Lesion writes above) the investigators are with universities, and funding came from the NIH (*yes, some funding also came from a nonprofit dedicated to altmed) and the journal is peer reviewed with an impact factor of 11.46. I would be more interested in seeing what content people are adding based on Vickers. The effect size they found, while statistically relevant, is pretty small (just .5 SD) and if people are blowing this up to say that accupuncture cures chronic pain, rather than "may give clinically relevant relief" then there is a problem... Jytdog (talk) 13:10, 31 October 2013 (UTC)
- The last sentence you state gives the problem as essentially that, so it's not very encouraging when you claim I "do not have a leg to stand on". Adopting blind and, frankly, incompetent credulity with respect to the interpretations of Vickers et al. is exactly the kind of nonsense going on in acupuncture and TCM. Two options: remove the source or properly contextualize it. To be clear, I actually don't care which, but the biggest issue here is that the reliable sources who have discussed this work (Ernst, for example) have taken direct issue with the interpretations being leveled in our articles -- namely the unfounded contention there is plainly evidence that acupuncture works better than sham acupuncture. Now, we could go on about the fact that this article has been raked over the coals and criticized in multiple ways by experts on acupuncture evidentiary studies, but this is often beyond the level of analysis necessary for Misplaced Pages. If you want to help providing context, that's fine, but to claim that this is an acceptable source and to leave it at that is essentially playing into the hands of pseudoscientific charlatans and makes a mockery out of Misplaced Pages's attempt at neutrality. jps (talk) 13:36, 31 October 2013 (UTC)
- Whether a given source is valid, and what content one crafts based on a source, are two entirely different issues. You started this by challenging the validity of the source itself. On that, you have no leg to stand on and you are discrediting any arguments you want to make about content by making it seem that you cannot think clearly and that you do not understand Misplaced Pages guidelines and policies. I know what it is like to be in the trenches of very contentious issues, and making sloppy arguments only makes things worse for you. By the way, are there publications in MEDRS-compliant sources (please do not bring up the blog again - doing so only further discredits you) in which the Vickers study has been criticized? You do not actually cite any. If they exist and are at least as good as Vickers (which is very good) they can be used to craft "however..." content.14:21, 31 October 2013 (UTC)
- No, they are NOT entirely different issues. The "validity" of the source according to WP:GEVAL is pretty close to being "invalid", so I don't see where you are coming from there. I'm not disputing the fact that the source exists, I'm disputing its use (which is the only thing that matters for sources at Misplaced Pages... we aren't DMOZ). Further, attempts to claim that rejoinders to how Vickers et al. is interpreted should be in "MEDRS compliant sources" which, I assume, is code for, "has anyone peer-reviewed a criticism of Vickers et. al?" is a terrible request. That's 100% NOT how discourse in science works. Negative and null results or criticism letters are not published in peer-reviewed journals. That's not where such critique happens and the currency of scientific discussion happens in the context of how the experts in the subject handle a given source. The reason for this should be clear: journals are subject to the editorial whims of the publisher, the chief editor, the editorial board, and the general philosophy of the publication. They often cannot and do not accommodate such back-and-forth, and in the case of this "JAMA" article (note that it's only under the JAMA header due to a poorly executed Internal medicine resource rescue attempt by the JAMA publishing board), it is clear that the editorial board is predisposed to accommodate acupuncture believers and promoters. The blog, which you snidely attack but is written by an acknowledged EXPERT in this subject, points this out rather plainly. MEDRS is fine for situations where the normal process of scientific discourse is taking place, but in the case of WP:FRINGE claims like those relating to acupuncture, that's not a functional alternative. jps (talk) 14:35, 31 October 2013 (UTC)
- First you show know that based on what you have said here so far, I ~think~ I am on the same "side" as you, in terms of reigning in claims that go too far (it is hard to tell because you are all over the place). So please don't bring your battle to me. But you are not thinking clearly. When you write things like "that's 100% not how science works" so emphatically, you are showing that you don't understand how Misplaced Pages works. You are hurting your own argument. Content needs to be closely based on what reliable sources say and for health-related content, that means MEDRS-compliant sources. And you cannot shoot down a study that is our gold-standard level source under MEDRS with a lesser source. If you could, then all kinds of hell would break loose the other way. All that can be done, is to tone down any content based on this source that goes too far.Jytdog (talk) 14:53, 31 October 2013 (UTC)
- Here's the problem with your claim. You have evaluated the source as being "gold-standard level". It's plainly not because the interpretations that the authors included in their text have been roundly criticized by every single independent expert who has evaluated the paper. Now, you seem to think our hands are tied here, but they clearly aren't. This is a primary source and it hasn't been used by others or cited by anyone but by acupuncturists because it is a poor source. That's a WP:REDFLAG and it is our duty to either figure out how to responsibly characterize the claims or remove them entirely. The idea is that Misplaced Pages asks editors to evaluate sources. Accordingly, this Vickers source is poor not because of the work it cites but because of the interpretations it offers (see below for more on this). However, Misplaced Pages is using its interpretations to promote claims of efficacious acupuncture. This is not only wrong, it's outrageous. AND, I might add, MEDRS has a very coherent explanation of this very problem. We need to be prepared to apply the axe when it is necessary and it is clear to me that in studies that are poorly executed by acupuncturists and their supporters that claim efficacy are not good studies. Incidentally, don't be confused by the "JAMA" header. It's not the flagship journal: it's a low-impact internal medicine journal that JAMA gobbled up wholesale and left to fester in out-of-the-way places. If this is a "gold standard" source, then you guys need to re-evaluate how you are judging "gold standard", because you're not doing a good job. jps (talk) 15:01, 31 October 2013 (UTC)
- I understand Vickers to be our gold standard "meta-analyses of randomized controlled trials (RCTs)". I don't see how you could call it a primary source and not that. I know you don't like its conclusions but I don't understand how you are categorizing the source. Please explain.Jytdog (talk) 15:08, 31 October 2013 (UTC)
- "Rules are for the Guidance of the Wise and the Obeisance of Fools" - the intent of the WP:MEDRS guideline is to ensure good sources are being used. Exceptionally, a guideline will guide us wrong. The question is: is it doing that here? (add: I agree though that it is a secondary source). Alexbrn 15:17, 31 October 2013 (UTC)
- I understand Vickers to be our gold standard "meta-analyses of randomized controlled trials (RCTs)". I don't see how you could call it a primary source and not that. I know you don't like its conclusions but I don't understand how you are categorizing the source. Please explain.Jytdog (talk) 15:08, 31 October 2013 (UTC)
- Here's the problem with your claim. You have evaluated the source as being "gold-standard level". It's plainly not because the interpretations that the authors included in their text have been roundly criticized by every single independent expert who has evaluated the paper. Now, you seem to think our hands are tied here, but they clearly aren't. This is a primary source and it hasn't been used by others or cited by anyone but by acupuncturists because it is a poor source. That's a WP:REDFLAG and it is our duty to either figure out how to responsibly characterize the claims or remove them entirely. The idea is that Misplaced Pages asks editors to evaluate sources. Accordingly, this Vickers source is poor not because of the work it cites but because of the interpretations it offers (see below for more on this). However, Misplaced Pages is using its interpretations to promote claims of efficacious acupuncture. This is not only wrong, it's outrageous. AND, I might add, MEDRS has a very coherent explanation of this very problem. We need to be prepared to apply the axe when it is necessary and it is clear to me that in studies that are poorly executed by acupuncturists and their supporters that claim efficacy are not good studies. Incidentally, don't be confused by the "JAMA" header. It's not the flagship journal: it's a low-impact internal medicine journal that JAMA gobbled up wholesale and left to fester in out-of-the-way places. If this is a "gold standard" source, then you guys need to re-evaluate how you are judging "gold standard", because you're not doing a good job. jps (talk) 15:01, 31 October 2013 (UTC)
- First you show know that based on what you have said here so far, I ~think~ I am on the same "side" as you, in terms of reigning in claims that go too far (it is hard to tell because you are all over the place). So please don't bring your battle to me. But you are not thinking clearly. When you write things like "that's 100% not how science works" so emphatically, you are showing that you don't understand how Misplaced Pages works. You are hurting your own argument. Content needs to be closely based on what reliable sources say and for health-related content, that means MEDRS-compliant sources. And you cannot shoot down a study that is our gold-standard level source under MEDRS with a lesser source. If you could, then all kinds of hell would break loose the other way. All that can be done, is to tone down any content based on this source that goes too far.Jytdog (talk) 14:53, 31 October 2013 (UTC)
- No, they are NOT entirely different issues. The "validity" of the source according to WP:GEVAL is pretty close to being "invalid", so I don't see where you are coming from there. I'm not disputing the fact that the source exists, I'm disputing its use (which is the only thing that matters for sources at Misplaced Pages... we aren't DMOZ). Further, attempts to claim that rejoinders to how Vickers et al. is interpreted should be in "MEDRS compliant sources" which, I assume, is code for, "has anyone peer-reviewed a criticism of Vickers et. al?" is a terrible request. That's 100% NOT how discourse in science works. Negative and null results or criticism letters are not published in peer-reviewed journals. That's not where such critique happens and the currency of scientific discussion happens in the context of how the experts in the subject handle a given source. The reason for this should be clear: journals are subject to the editorial whims of the publisher, the chief editor, the editorial board, and the general philosophy of the publication. They often cannot and do not accommodate such back-and-forth, and in the case of this "JAMA" article (note that it's only under the JAMA header due to a poorly executed Internal medicine resource rescue attempt by the JAMA publishing board), it is clear that the editorial board is predisposed to accommodate acupuncture believers and promoters. The blog, which you snidely attack but is written by an acknowledged EXPERT in this subject, points this out rather plainly. MEDRS is fine for situations where the normal process of scientific discourse is taking place, but in the case of WP:FRINGE claims like those relating to acupuncture, that's not a functional alternative. jps (talk) 14:35, 31 October 2013 (UTC)
- Whether a given source is valid, and what content one crafts based on a source, are two entirely different issues. You started this by challenging the validity of the source itself. On that, you have no leg to stand on and you are discrediting any arguments you want to make about content by making it seem that you cannot think clearly and that you do not understand Misplaced Pages guidelines and policies. I know what it is like to be in the trenches of very contentious issues, and making sloppy arguments only makes things worse for you. By the way, are there publications in MEDRS-compliant sources (please do not bring up the blog again - doing so only further discredits you) in which the Vickers study has been criticized? You do not actually cite any. If they exist and are at least as good as Vickers (which is very good) they can be used to craft "however..." content.14:21, 31 October 2013 (UTC)
- The last sentence you state gives the problem as essentially that, so it's not very encouraging when you claim I "do not have a leg to stand on". Adopting blind and, frankly, incompetent credulity with respect to the interpretations of Vickers et al. is exactly the kind of nonsense going on in acupuncture and TCM. Two options: remove the source or properly contextualize it. To be clear, I actually don't care which, but the biggest issue here is that the reliable sources who have discussed this work (Ernst, for example) have taken direct issue with the interpretations being leveled in our articles -- namely the unfounded contention there is plainly evidence that acupuncture works better than sham acupuncture. Now, we could go on about the fact that this article has been raked over the coals and criticized in multiple ways by experts on acupuncture evidentiary studies, but this is often beyond the level of analysis necessary for Misplaced Pages. If you want to help providing context, that's fine, but to claim that this is an acceptable source and to leave it at that is essentially playing into the hands of pseudoscientific charlatans and makes a mockery out of Misplaced Pages's attempt at neutrality. jps (talk) 13:36, 31 October 2013 (UTC)
- jps you do not have a leg to stand on, to exclude Vickers as a source per se, as others have said here - your hand-waving at the independent sources paragraph will not do, when (as Lesion writes above) the investigators are with universities, and funding came from the NIH (*yes, some funding also came from a nonprofit dedicated to altmed) and the journal is peer reviewed with an impact factor of 11.46. I would be more interested in seeing what content people are adding based on Vickers. The effect size they found, while statistically relevant, is pretty small (just .5 SD) and if people are blowing this up to say that accupuncture cures chronic pain, rather than "may give clinically relevant relief" then there is a problem... Jytdog (talk) 13:10, 31 October 2013 (UTC)
See, when primary sources masquerade as secondary sources, we get confused. Vickers et al. is a secondary source only for the previous work they cite. Their interpretations of those works they cite (the interpretation of their meta analyses) are absolutely WP:PRIMARY. This should be obvious to anyone reading the work. jps (talk) 15:25, 31 October 2013 (UTC)
- Well I haven't read it. I now will ... (later: well, it looks like a secondary to me; it may be a bad secondary but I don't think that makes it a primary). Alexbrn 15:37, 31 October 2013 (UTC)
- I was afraid that is what you would say, jps. That is not a valid description but is rather a WP:TENDENTIOUS one. I am going to step away from this; it is not a rational conservation.Jytdog (talk) 15:48, 31 October 2013 (UTC)
- "Valid description" of what? You were afraid that I would point out that when a source makes a novel or original claim they are acting as a WP:PRIMARY source? Have you read Vickers et al.? jps (talk) 17:18, 31 October 2013 (UTC)
- Yes. Every meta-analysis creates a "new" data set from the gathered data, and is therefore able to make new syntheses of that data. That is what every meta-analysis does, and is exactly what our gold standard is. By your definition, there is no such thing as a meta-analysis, and that is just plain crazy. Sorry. I get it that you don't like the result (it appears to be a disaster in your world, and I am sorry about that). You will notice, I hope, that no one here is joining you so far in your idiosyncratic and errant classification of this source... it may be that some will do and I am shown wrong, but to me you seem to be really twisting things to try to knock this source out. I don't believe you will succeed. Jytdog (talk) 17:53, 31 October 2013 (UTC)
- "Valid description" of what? You were afraid that I would point out that when a source makes a novel or original claim they are acting as a WP:PRIMARY source? Have you read Vickers et al.? jps (talk) 17:18, 31 October 2013 (UTC)
- To be clear, I don't want WP:MEDRS to be toothless. I actually think I'm close to the last in line for wanting to weaken that guideline or its application. I'm on board with making sure that Vickers is represented accurately and appropriately in articles.
Zad6813:57, 31 October 2013 (UTC)- I think that'd be fine, but it's a bit much for Misplaced Pages. It's been somewhat scandalous that Vickers et al. has included the far-reaching interpretations of the plain results that it did, and we are parroting the author's credulity throughout the encyclopedia. This needs to be at least hedged and I often think removing problematic sources is better than trying to fairly describe complicated back-and-forths. jps (talk) 14:01, 31 October 2013 (UTC)
- To be clear, I don't want WP:MEDRS to be toothless. I actually think I'm close to the last in line for wanting to weaken that guideline or its application. I'm on board with making sure that Vickers is represented accurately and appropriately in articles.
Not sure if it's been raised yet but this newspaper article gives Ernst's verdict on the Vickers paper: that it "impressively and clearly" showed that the effects of acupuncture were mostly due to placebo. Alexbrn 14:03, 31 October 2013 (UTC)
- Exactly. However, this is not the interpretation of the work that is being trumpeted in our articles on the subject, and, worse, referencing this study is being used to claim that we need to claim that acupuncture is effective in places like the lead of acupuncture or the evidence section of traditional Chinese medicine. I'm appalled that MEDRS is being used by such advocates as a smokescreen, and it's clear from the reaction that I'm getting here that this is a big risk with the way this particular guideline is being monitored by some. jps (talk) 14:28, 31 October 2013 (UTC)
- Well, I'll take Ernst's steer on how to interpret an acupuncture paper as being reliable over any random wikipedia editor (even me) any day. It seems to me there is an unusual complicating factor here in that there is an agreed mainstream context in which these studies need to be interpreted (where, for example, the precise nature of the blinding is critical) - and Misplaced Pages needs to be sophisticated enough to reflect that. Or maybe that's just too sophisticated to be workable here? Alexbrn 14:37, 31 October 2013 (UTC)
- I think you summarizing the confounding factors well. The issue is one of WP:FRINGE proponents pocketing a low-impact journal for their own promotional use and Misplaced Pages being unable to handle it because, essentially, Misplaced Pages cannot understand that low-impact journals publish garbage ALL THE FRICKIN' TIME and the community simply ignores that garbage. Here's where it gets even more interesting: it appears Vickers has been able to publish a "peer-reviewed" rejoinder to his detractors . This is plainly indicative that the journal is corrupt and any competent researcher worth his or her salt would plainly just say, "alright, this is just too rabbit-holy -- stick with the high-impact Ernst studies and move on: this controversy can't be meaningfully described without explaining a context in academic publishing that is entirely peripheral to the subject at hand." So I said, "remove the source". But the problem is many editors here say, "the source is fine, can't we contextualize it?" The answer is, sadly, not without becoming a clearinghouse of original research, which, I might add, one could plainly see is the problem with the Vickers et al. paper in the first place (there are no citations to it by independent groups). jps (talk) 14:49, 31 October 2013 (UTC)
- Yes, and that's just an example of the meta-problem with editing fringe topics: there are not enough good editors in this area (and sadly one fewer today, it seems) so it feels like an eternal last-ditch defence of Helm's Deep against the forces of endarkenment. For understandable reasons, the level of grip on sourcing issues is generally very low even among some editors with many thousands of edits (I'm still learning).
- I think you summarizing the confounding factors well. The issue is one of WP:FRINGE proponents pocketing a low-impact journal for their own promotional use and Misplaced Pages being unable to handle it because, essentially, Misplaced Pages cannot understand that low-impact journals publish garbage ALL THE FRICKIN' TIME and the community simply ignores that garbage. Here's where it gets even more interesting: it appears Vickers has been able to publish a "peer-reviewed" rejoinder to his detractors . This is plainly indicative that the journal is corrupt and any competent researcher worth his or her salt would plainly just say, "alright, this is just too rabbit-holy -- stick with the high-impact Ernst studies and move on: this controversy can't be meaningfully described without explaining a context in academic publishing that is entirely peripheral to the subject at hand." So I said, "remove the source". But the problem is many editors here say, "the source is fine, can't we contextualize it?" The answer is, sadly, not without becoming a clearinghouse of original research, which, I might add, one could plainly see is the problem with the Vickers et al. paper in the first place (there are no citations to it by independent groups). jps (talk) 14:49, 31 October 2013 (UTC)
- Well, I'll take Ernst's steer on how to interpret an acupuncture paper as being reliable over any random wikipedia editor (even me) any day. It seems to me there is an unusual complicating factor here in that there is an agreed mainstream context in which these studies need to be interpreted (where, for example, the precise nature of the blinding is critical) - and Misplaced Pages needs to be sophisticated enough to reflect that. Or maybe that's just too sophisticated to be workable here? Alexbrn 14:37, 31 October 2013 (UTC)
- That said I think with acupuncture, Misplaced Pages can't get ahead of itself and we need to lag the implications of the science a bit. As Ernst says in that Guardian article, "I fear that, once we manage to eliminate this bias from acupuncture studies, we might find that the effects of acupuncture exclusively are a placebo response". The day is nigh, but not here yet. That is not to say that we can't improve the way the Vickers study is framed here ... Alexbrn 15:01, 31 October 2013 (UTC)
- The way acupuncture efficacy should be characterized is with preference to the null result. Namely, "the extant evidence is consistent with acupuncture's efficacy being due to the placebo effect". That is 100% in line with what Ernst is saying in all of his works. jps (talk) 15:25, 31 October 2013 (UTC)
- That said I think with acupuncture, Misplaced Pages can't get ahead of itself and we need to lag the implications of the science a bit. As Ernst says in that Guardian article, "I fear that, once we manage to eliminate this bias from acupuncture studies, we might find that the effects of acupuncture exclusively are a placebo response". The day is nigh, but not here yet. That is not to say that we can't improve the way the Vickers study is framed here ... Alexbrn 15:01, 31 October 2013 (UTC)
Sourcing at Misplaced Pages:Fringe theories/Noticeboard#Acupuncture
Over at Misplaced Pages:Fringe theories/Noticeboard#Acupuncture there is an ongoing discussion concerning the sources used to support claims about the effecticveness of acupuncture. This could really use another set of eyes looking at it. --Guy Macon (talk) 18:28, 31 October 2013 (UTC)
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