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== Semi-protected edit request on 24 September 2024 == | |||
==Outstanding issues == | |||
=== Acupuncture and placebo === | |||
{{edit semi-protected|Acupuncture|answered=yes}} | |||
* (2010) in '']'' with an impact factor of 1.846 | |||
I would like to make some suggestions to the acupuncture page. I do understand it is a contentious topic but believe some added edits and updated references would add better context as the WHO among others is expanding the use of traditonal medicine practices and has added a specific chapter in ICD11 for Traditional Medicine Acupuncture titled TM1 | |||
{{collapse top|collapse long requested changeset}} | |||
'''Change X''' - the theories and practices of TCM are not based on scientific knowledge, and it has been characterized as quackery.] | |||
'''to Y''' – . | |||
* (2010) in '']'' with an impact factor of 2.183 | |||
There is a range of acupuncture technological variants that originated in different philosophies, and techniques vary depending on the country in which it is performed. However, it can be divided into two main foundational philosophical applications and approaches; the first being the modern standardized form called eight principles TCM and the second being an older system that is based on the ancient Daoist wuxing, better known as the five elements or phases in the West. Acupuncture is most often used to attempt pain relief, though acupuncturists say that it can also be used for a wide range of other conditions. Acupuncture is generally used only in combination with other forms of treatment. | |||
The first review found some evidence that "biological differences" exist between a placebo response and sham acupuncture. The second review concluded that "acupuncture is more than a placebo". Are there any recent reviews that suggest otherwise? -] (]) 02:31, 11 August 2014 (UTC) | |||
The global acupuncture market was worth US$24.55 billion in 2017. The market was led by Europe with a 32.7% share, followed by Asia-Pacific with a 29.4% share and the Americas with a 25.3% share. It was estimated in 2021 that the industry would reach a market size of US$55 billion by 2023. | |||
'''Change X''' – ] | |||
=== Nocebo === | |||
'''to Y''' – . Acupuncture is generally safe when done by appropriately trained practitioners using clean needle technique and single-use needles. When properly delivered, it has a low rate of mostly minor adverse effects. When accidents and infections do occur, they are associated with neglect on the part of the practitioner, particularly in the application of sterile techniques. A review conducted in 2013 stated that reports of infection transmission increased significantly in the preceding decade. The most frequently reported adverse events were pneumothorax and infections. Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk. | |||
Article fails to discuss the ] effect of acupuncture: | |||
'''Change X''' – and many modern practitioners no longer support the existence of life force energy (qi) or meridians, which was a major part of early belief systems.] | |||
* (2014) in '']'' with an impact factor of 5.332 | |||
'''to Y''' - However, modern research substantiates the effectiveness of Acupuncture. Studies using functional magnetic resonance imaging (fMRI) have shown that acupuncture elicits changes in the brain that correlate with neurological effects. As confirmed by the world-renowned Cleveland Clinic, “Acupuncture affects the limbic and para-limbic networks in the brain and has a deep hemodynamic response, which is influenced by the psychophysical response. Acupuncture also stimulates the nervous system and improves conduction and communication between nerves. This improved functioning of the nervous system stimulates neurotransmitter actions and the release of the body’s natural endorphins and other opioids. For example, serotonin may be released following acupuncture, therefore helping patients feel more relaxed and sustain a sense of well-being that lasts for hours thereafter, if not longer. Research has also shown acupuncture’s ability in relieving myofascial pain by releasing muscular trigger points with ensuing concomitant anti-inflammatory effects.” | |||
-] (]) 02:31, 11 August 2014 (UTC) | |||
Acupuncture is believed to have originated around 100 BC in China, around the time The Inner Classic of Huang Di (Huangdi Neijing) was published, though some experts suggest it could have been practiced earlier. Over time, conflicting claims and belief systems emerged about the effect of lunar, celestial and earthly cycles, yin and yang energies, and a body's "rhythm" on the effectiveness of treatment. Acupuncture fluctuated in popularity in China due to changes in the country's political leadership and the preferential use of rationalism or scientific medicine. Acupuncture spread first to Korea in the 6th century AD, then to Japan through medical missionaries, and then to Europe, beginning with France. In the 20th century, as it spread to the United States and Western countries, spiritual elements of acupuncture that conflicted with scientific knowledge were sometimes abandoned in favor of simply tapping needles into acupuncture points. | |||
'''Add Y''' – . | |||
=== Allergy === | |||
'''Add Y''' – | |||
Article fails to mention acupuncture treatment for allergic diseases: | |||
'''Change X:''' | |||
* (2009) in '']'' with an impact factor of 2.746 | |||
[Clinical practice | |||
Acupuncture is a form of alternative medicine. It is used most commonly for pain relief, though it is also used to treat a wide range of conditions. Acupuncture is generally only used in combination with other forms of treatment. For example, the American Society of Anesthesiologists states it may be considered in the treatment of nonspecific, noninflammatory low back pain only in conjunction with conventional therapy. ] to | |||
'''to Y:''' | |||
* (2010) in '']'' with an impact factor of 1.846 | |||
Clinical Practice | |||
Acupuncture is a form of alternative medicine. It is used most commonly for pain relief, though it is also used to treat a wide range of conditions. Acupuncture is generally only used in combination with other forms of treatment. For example, the American Society of Anesthesiologists states it may be considered in the treatment of nonspecific, noninflammatory low back pain only in conjunction with conventional therapy. Practitioners who practice Acupuncture are trained and take didactical coursework and clinical practice in their education; and, pass the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) board exams, or a state-specific licensing exam in California. The Acupuncture training program includes techniques such as cupping, gua sha tui na, moxibustion, herbal medicine, lifestyle and nutrition based on Traditional Medicine principles. | |||
There is current research supporting that acupuncture has efficacy with pain management being the most well-known application. Conceptually, it is believed to stimulate the body's meridians, or energy-carrying channels, in an attempt to correct imbalances and to restore health. These benefits are thought to be derived from the proximity of acupoints with nerves through intracellular calcium ions. This lesson outlines a brief history of acupuncture and how it may be used to treat various types of physical and emotional pain and specific conditions, including overactive bladder and psoriasis. Acupuncture has been demonstrated to enhance endogenous opiates, such as dynorphin, endorphin, encephalin, and release corticosteroids, relieving pain and enhancing the healing process. Of particular note is that Acupuncture is now incorporated by highly-acclaimed Western Medicine providers as part of a treatment plan for numerous conditions. The world-renowned Memorial Sloan Kettering Cancer Center endorses the newly updated Society of Integrative Oncology’s recommendations for acupuncture for breast cancer patients with joint pain. . Medical institutions such as the Mayo Clinic, National Cancer Institute, City of Hope, and Cleveland Clinic also integrate Acupuncture into their patients care programs. ] (]) 19:39, 24 September 2024 (UTC) | |||
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:This is a hodgepodge of content ] verbatim from copyrighted sources. It can't be used. ] (]) 20:04, 24 September 2024 (UTC) | |||
::Also, {{tq|Historical records as old as 3,500 years demonstrate the effectiveness of Acupuncture}} is invalid reasoning - ] - not consistent with ], to give just one example. --] (]) 06:45, 25 September 2024 (UTC) | |||
== This article is racist == | |||
* (2014) in '']'' with an impact factor of 3.342 | |||
It must be changed. ] (]) 22:14, 23 October 2024 (UTC) | |||
-] (]) 02:31, 11 August 2014 (UTC) | |||
:Opposing ] such as ] and ] does not make me a racist. Why? {{talk quote| If an Indian, American, British, Nigerian or Brazilian scientist makes an empirical claim about the body, they're expected to prove it, and that proof must be replicable. Why should it be different for Chinese scientists?|WLU}} Quoted by ] (]) 22:16, 23 October 2024 (UTC) | |||
=== Mechanism of acupuncture === | |||
== Edit request on 3 December 2024 == | |||
Article fails to mention mechanism of acupuncture: | |||
{{cot|title=perennial complaints of 'bias' have been addressed countless times already}} | |||
It is not “neutral” to immediately dismiss acupuncture as “pseudoscience in the first paragraph and subheading. That is an expression of opinion that fails to take into account years of scientific research on the topic accepted by the US NIH and other major health organizations. I recommend that the current “pseudoscience” sentence be supplanted by a sentence stating “The U.S. National Institutes of Health (NIH) states “there’s evidence that acupuncture may have effects on the nervous system, effects on other body tissues, and nonspecific (placebo) effects. (https://www.nccih.nih.gov/health/acupuncture-effectiveness-and-safety) The current “psuedoscience” sentence can be attributed to critics of the field, e.g., “Critics have dismissed the scientific research on the effects of acupuncture and characterized it as psuedoscience” <!-- Template:Unsigned --><small class="autosigned">— Preceding ] comment added by ] (] • ]) 18:16, 3 December 2024 (UTC)</small> <!--Autosigned by SineBot--> | |||
:Have a look at ], and note that essentially nothing published by the ] - a political department set up to boost alternative medicine, which is /not/ under the supervision of the NIH - is a reliable source. ] (]) 18:53, 3 December 2024 (UTC) | |||
* in '']'', with an impact factor of 10.301 | |||
::So cherry-picking articles that prove your point of view is a more objective approach than referring to the US NIH as a reliable source? It would be fair to say that critics of acupuncture ''view'' it as psuedoscience after noting that there is significant scientific research showing a range of benefits, accepted by NIH and the increasing number of insurance companies that provide acupuncture coverage for proven purposes, like pain relief. | |||
::But it is highly biased to dismiss the entire field in the first sentences rather than providing a more appropriately balanced and nuanced perspective. I thought Misplaced Pages pages were supposed to be, not for people with axes to grind, but instead for the fair presentation of information for readers to make their own judgments. ] (]) 21:42, 8 December 2024 (UTC) | |||
* (2010) in '']'' with an impact factor of 3.240 | |||
:::Again, what you just cited is not 'the US NIH', nor is Acupuncure 'accepted by NIH'. Also, if you're looking for balance, you should know that Misplaced Pages doesn't do that, see ]. ] (]) 22:02, 8 December 2024 (UTC) | |||
::::NCCIH is literally on the NIH website, which is literally part of the HHS website. Not a shocker that the Misplaced Pages page on NCCIH shows the same consistent bias against all alternative medicine approaches demonstrated by this site, regardless of actual research or evidence. But I don’t see how you can deny the reality of a sub-organization being part of its parent organization. | |||
* (2011) in '']'' with an impact factor of 1.785 | |||
::::It is not “false balance” to refer to actual health research that has been reviewed and validated by major research organizations like NIH, WHO and others. It is a matter of telling the story fairly and accurately. | |||
::::And it’s odd that you all seem to believe that health insurance companies are stupid enough to be increasingly providing coverage for practices that you blithely equate with astrology or Tarot card reading without bothering to review the evidence or let others add it. Sad to see Misplaced Pages promoting biased entries and censorship in this manner. ] (]) 02:36, 9 December 2024 (UTC) | |||
* in '']'' with an impact factor of 2.949 | |||
:::::The NCCIH is 'literally' a separate institute which does not answer to the NIH director. That's because it was set up as a personal project by a US Senator who wanted an outfit that would validate the scientifically invalid bee pollen treatments he believed in. You are getting basic facts incorrect here, which is not going to be a basis for changes to this article. Some health insurance companies will cover ], too. That does not mean that homeopathy isn't nonsense. ] (]) 02:39, 9 December 2024 (UTC) | |||
::::::Please specify which facts I got wrong. NCCIH is indisputably one of the over two dozen centers and institutes of NIH. (https://www.nih.gov/institutes-nih/list-institutes-centers). Are you saying that the National Cancer Institute or National Institute of Allergy and Infectious Diseases are not part of NIH either and therefore have no validity as sources of information? | |||
* (2014) in '']'' with an impact factor of 5.163 | |||
::::::Also, to say that NCCIH is illegitimate because Sen. Tom Harkin was its original champion does not make any sense. All agencies of the U.S. Government ultimately derive from Congressional legislation and many are the result of particular politicians championing them. The Consumer Financial Protection Bureau, for example, was Sen. Elizabeth Warren’s pet project. Does that make it somehow “political” and therefore illegitimate? ] (]) 02:55, 9 December 2024 (UTC) | |||
:::::::I've already explained what you're getting wrong, but here it is one more time: The NCCIH is illegitimate because they publish nonsense. What they accept is not 'accepted by NIH' because the rest of the NIH (especially the NIH director) gets no say in the nonsense they publish. By conflating a fringe body with mainstream medical bodies, you are undermining your argument. If you have to cite the NCCIH for legitimacy, that is a sign to everyone else that what you're doing is promoting pseudoscience. We're now just repeating ourselves, so I imagine I will not comment again unless someone new comes up. Do not interpret my silence as agreement. ] (]) 03:05, 9 December 2024 (UTC) | |||
-] (]) 02:32, 11 August 2014 (UTC) | |||
::::::::Yeah, you refused to respond to any of my specific questions or points, so I guess we’re done. Interesting, though, to learn that the National Cancer Institute and all of NIH’s other Centers and Institutes aren’t part of NIH and therefore their work can and should be ignored by Misplaced Pages. ] (]) 03:17, 9 December 2024 (UTC) | |||
:::::::::You don't get it. NCCIH is not unreliable because NIH has no power over it. It is unreliable for other reasons, and it '''does not get to suck reputation from the NIH because NIH has no power over it'''. You tried to copy-and-paste the reliability from NIH to NCCIH, and that was refuted. Other centers and institutes are reliable or unreliable for their own reasons. | |||
=== Acupuncture and the brain === | |||
:::::::::Possibly, the NIH itself will lose reliability from 2025 on because it will be ruled by a quackery proponent who forces it to publish dangerous nonsense. --] (]) 08:15, 9 December 2024 (UTC) | |||
:I agree. Claiming acupuncture is pseudoscience is a bold non-neutral statement. Misplaced Pages is too biased in this regard and I won't donate a cent to them until they fix this. ] (]) 15:58, 5 December 2024 (UTC) | |||
Article fails to mention acupuncture's effect on the brain: | |||
::]. It's precisely ''for'' reasons of neutrality that Misplaced Pages is obliged to observe that acupuncture is a pseudoscience. ] (]) 16:13, 5 December 2024 (UTC) | |||
:To present that some say it's 'pseudoscience' or 'quackery' without presenting that there are multiple meta-anaylsis studies showing its efficacy is deeply misleading. It fails to show the scientific backing that acupuncture has. A meta-analysis study does not just look at one randomized study or one case report. It is an in depth look at multiple scientific studies. Multiplele meta-analysis studies confirm the benefit of acupuncture. | |||
* (2012) in '']'' with an impact factor of 3.534 | |||
:For example note the study "Acupuncture for chronic pain: update of an individual patient data meta-analysis" Authors: Vickers, A. J., et al. (2018)Published In: The Journal of Pain, 2018. This study clearly demonstrated the efficacy of acupuncture in multiple studies for muscloskeletal, headache and osteoarthritis pain. Full text is available here https://www.jpain.org/article/S1526-5900(17)30780-0/fulltext | |||
:To have an accurate article on this subject without giving a profession that medical professionals spend years in education and which multiple scientific studies back these types of articles need to be addressed. | |||
* (2013) in '']'' with an impact factor of 4.216 | |||
:Dismissing such a long-standing practice as quackery is simply not showing the full picture and incredible benefit this medical profession offers the public. ] (]) 16:23, 7 January 2025 (UTC) | |||
-] (]) 02:32, 11 August 2014 (UTC) | |||
::We might add a bit about contraindications for certain points, i.e. the "fordidden points" during pregnancy like LI4, SP6, and GB21. I don't remember the source that mentioned that but AFAIK it was a MEDRS. --] <small>(] • ] • ])</small> 03:09, 14 August 2014 (UTC) | |||
:These studies are of the brain's reactions to the body being poked with sharp things. They don't lay the foundation for the effectiveness of acupuncture, just that the brain does, indeed, react to the body being poked with a sharp object. I'm not aware of anyone that denies that.—](]) 13:37, 13 August 2014 (UTC) | |||
::No, they do. Read the meta-analyses carefully. -] (]) 13:56, 13 August 2014 (UTC) | |||
::: Please provide exact quotes from the meta analysis which you find relevant, something that tells us more than is already obvious, which is that every spot in the body has areas in the brain which not only control it but also areas which react to anything which affects it. That's too basic and "duh". What do you have from that source which we can use? -- ] (]) 23:58, 13 August 2014 (UTC) | |||
::::e.g. (bold text indicates subsection header): {{tq|'''Acupuncture at non-acupuncture points in close proximity to acupuncture points"''' Two third (64%) , – of 25 studies showed that acupuncture treatments were associated with more activation, mainly in the somatosensory areas, motor areas, basal ganglia, cerebellum, limbic system and higher cognitive areas (e.g. prefrontal cortex).}} That's 16 of the studies. Different or contradictory results were found in the remaining 9 studies. Also see other quotes under section titled '''Descriptive findings of differences between verum and sham acupuncture'''. --] <small>(] • ] • ])</small> 03:20, 14 August 2014 (UTC) | |||
Brain studies are not about acupuncture effectiveness or theory. There is specific information in the article about the mechanism of action. ] (]) 02:18, 7 October 2014 (UTC) | |||
:They are relevant in the scientific section. You removed them for different reasons than what you are protesting here. Why? ] (]) 03:01, 7 October 2014 (UTC) | |||
::I think ] put it pretty well . QuackGuru, the Kww's comment you quoted , are there any sources supporting that? I think a source for that would be the easiest way to solve this since unfortunately we can't use mere opinions to discard sourced material. | |||
::I can't see any "''strong disagreement with using these sources''" either, as it was stated in some deletion summaries. ] (]) 14:55, 7 October 2014 (UTC) | |||
::. Highly technical information about brain activity studies is confusing to the reader, is not directly about the acupuncture treatment itself, and it does not show whether acupuncture is effectiveness. This is undue weight. However, there is better information in the section that explains that the evidence suggests that acupuncture generates a sequence of events that include the release of endogenous opioid-like substances. ] (]) 19:51, 7 October 2014 (UTC) | |||
:::re QuackGuru's comments: | |||
:::* In the diff, QG wrote "Brain studies are not about acupuncture effectiveness or theory." So? The article isn't limited to those topics. Brain studies about acu are certainly on topic. | |||
:::* "Highly technical" information is all over Misplaced Pages, and this isn't ''that'' technical. | |||
:::* "is not directly about the acupuncture treatment itself, and it does not show whether acupuncture is effectiveness" -- again, the article isn't only about those things, no matter how much QG might like to make it that way. Indeed, it's undue weight to ''only'' cover the topics QG mentions without coving other aspects. | |||
:::* Endorphins -- sure, that's an aspect. But how is it "better"? The sources are fine and the arguments for excluding them are very thin. Aside: as Guy pointed out ], part of QG"s excessive OWN-ership of this article and chiropractic has included arguing that deleting ''any'' RS is bad. Now QG's wants to exclude RS material on thin grounds? This is self-serving. --] <small>(] • ])</small> 09:56, 10 October 2014 (UTC) | |||
:::::Self serving you say? My irony meter is off the scale. -] (]) 10:43, 10 October 2014 (UTC) | |||
:::::: Delightfully clever as always, Roxy, but have you so soon forgotten ? And I don't think you have an irony meter. Not when you get all and about wording when , but not when, say, and do. And that in the purported defense of reason and objectivity.... --] <small>(] • ])</small> 16:10, 11 October 2014 (UTC) | |||
::::::: Yet you still carry on with your same old "I don't have a COI" schtick. -] (]) 16:53, 11 October 2014 (UTC) | |||
:::::::: Not true. --] <small>(] • ])</small> 22:33, 12 October 2014 (UTC) | |||
:::::::::It should be noted any COI editors and any COI editor should follow the advise of ]. ] (]) 06:14, 13 October 2014 (UTC) | |||
=== Article does not conform to scientific consensus === | |||
This article fails to conform to scientific consensus | |||
;]: "The current scientific theories provide a basis for stating that acupuncture has an effect on the nervous system" ] | |||
;]: "The modern scientific explanation is that needling the acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain." ] | |||
;National Cancer Institute (USA): "Acupuncture may work by causing physical responses in nerve cells, the ], and parts of the brain" ] | |||
;National Health Service (Britain): "It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue." ] | |||
;''A Scientific Statement From the ]'': "In the manual form of acupuncture, the mechanism of effect appears to be through sensory ] and ] stimulation induced by ]s being wound around the needle and activated by ]. In the case of electroacupuncture, the effects appear to additionally involve the stimulation of peripheral nerve fibers, including ] afferents, that in turn activate central ] (and other) receptors or ] reflex pathways. Reflex increases in ] activity may also be reduced by electroacupuncture. The role of mechanoreceptor stimulation in the BP reductions in animal models is supported by the ability to attenuate this effect by ], which blocks stretch-activated channels. Both forms of acupuncture have similar ] effects, although electroacupuncture tends to have a greater intensity of effect as determined by ] studies in humans." (PMID 23608661) | |||
-] (]) 02:32, 11 August 2014 (UTC) | |||
::These are really good MEDRS's that we've neglected but I don't see how they meet ] any more than some of the meta-analyses we quote. --] <small>(] • ] • ])</small> 03:31, 14 August 2014 (UTC) | |||
: Excellent summary by A1! Given there is still doubt about exactly how acupuncture works, a true 'Mechanism of Acupuncture' section is probably still premature, but you have undoubtedly presented an outstanding case for rewriting the article to make it consistent with current scientific thinking and including a 'Possible Mechanism of action' section. Yet, we have been here before! I painstakingly set up a 'Possible Mechanism of Action' section for this article over a year ago - see: https://en.wikipedia.org/search/?title=Acupuncture&oldid=561592493. It lasted about a week before its reversion. The subheadings for that section are still current and in-line with A1's summary, although some of the refs might need updating. I'd consider putting it back in again, but would this put me up for another bout of reversion and a caution? ] (]) 21:47, 12 August 2014 (UTC) | |||
: It seems you have made your homework pretty well, ]! I find it quite impressive all the sources you have listed above. With respect to the scientific consensus issue, what would you suggest? =P ] (]) 10:37, 13 August 2014 (UTC) | |||
:: We already state, of scientists, that "They, along with acupuncture researchers, explain the analgesic effects of acupuncture as caused by the release of endorphins, and recognize the lack of evidence that it can affect the course of any disease." This (or some tweaked form of it) is enough - much more would be undue and a section on 'Possible Mechanism of Action' especially so, probably veering into OR territory. ] <sup>]|]|]</sup> 05:24, 13 August 2014 (UTC) | |||
::::Huh? You'd omit MEDRS even if they don't fully accord with what you just wrote (re: no point specificity)? See PLOS One source supplied by A1Candidate above and my diff giving e.g.'s of quotes from same . --] <small>(] • ] • ])</small> 03:28, 14 August 2014 (UTC) | |||
::: First of all, Misplaced Pages is an encyclopedia, not a scientific research paper. Its articles are not supposed to "conform to scientific consensus", although they do report it. They are encyclopedic articles, and of a special nature, largely because of our NPOV policy, which requires coverage of all significant aspects of a topic, unlike normal encyclopedias. | |||
::: Secondly, those nice snippets are basically saying "duh". Those are not surprising or unique results, and are about the same results as would be expected if you pinched someone or scratched them. Acupuncture does actually touch the body. It affects the body. It's not ], where hands are waved over the body without actually touching it. These are real effects, but they are non-specific responses to external influences on bodily tissues. This proves nothing special about acupuncture, and says nothing about any specific and unique results from a specific poke in a specific acupoint. There is no consistent, specific, and reproducible reaction from acupuncture which applies to everyone. | |||
::: There do seem to be some generalized reactions, sometimes of a somewhat positive nature (pain relief), but nothing one can count on, or that could not be obtained by any other method which triggered endorphin production, and certainly not better than, or as strongly or consistently or reproducibly as any of several standard analgesic drugs. That electroacupuncture seems to have a stronger effect is also unsurprising, and it's NOT acupuncture. It's electrotherapy. | |||
::: So, what specific wordings are you proposing to make to the article? This is all speculation about possible mechanisms, but it really adds nothing we don't already know, so do you have something specific and unique to acupuncture which is a new addition to the article? -- ] (]) 06:28, 13 August 2014 (UTC) | |||
::::You obviously failed to read the articles above. Scientific consensus isn't "speculation". It's something we summarize and conform to. -] (]) 09:31, 13 August 2014 (UTC) | |||
:::::Brangifer, do you have anything aside from your own ponderings? ] (]) 10:37, 13 August 2014 (UTC) | |||
:::::: A1, those aren't statements of "scientific consensus", they are simple statements of evidence, and that evidence is not special. Anyone, even the most ardent skeptic, will admit that they are true statements. So "...acupuncture has an effect on the nervous system". Duh! Of course it does. Has anyone denied that? No. So "... treatment can stimulate nerves under the skin and in muscle tissue." Duh! Of course it does. Has anyone denied that? No. I could go on with each one of the statements. | |||
:::::: This amounts to a two year old finding a penny and presenting it to its mother and thinking that it has found something which no one else in the world knows about, and now it thinks it has taught its mother about the existence of money. The mother says "Oh, what a pretty penny!" If that same child does this every day, all the way up into its twenties, the mother replies "Duh. This is getting old." | |||
:::::: So, we need to know what you're getting at, because you haven't brought anything new or enlightening to the table. How would you use these statements in the article? Don't we already acknowledge that the body does sense when it is poked? I don't think we deny that fact. The body is sensitive to anything which touches it. Duh! So what. We need more than what we already know and what we already acknowledge in the article. -- ] (]) 13:24, 13 August 2014 (UTC) | |||
I love the smell of inappropriate use of sources in the morning. Here, we have promotions for acupuncturists at Mayo and Johns Hopkins being touted as representative of scientific consensus on acupuncture. The others are lay descriptions of acupuncture used to describe services that the scientific community still dismisses as being no more effective than a placebo. That certainly is a creative way to describe the sources, but hints at a strong desire to distort reality.—Kww(talk) 13:33, 13 August 2014 (UTC) | |||
:The article in '']'' is classified in PubMed as a '''review article''', not a promotion piece. -] (]) 13:52, 13 August 2014 (UTC) | |||
:: I can't find anywhere on that page where it's referred to as a "review article", but that's really beside the point. It is a RS, in the general sense of the word, but for what purpose in this connection? What you've quoted from it isn't really worth using, even if it was a "review article" which passed the criteria in MEDRS, so what are you proposing that we can do with it? -- ] (]) 00:36, 14 August 2014 (UTC) | |||
:::The current scientific theories provide a basis for stating that acupuncture has an effect on the nervous system, but its effects cannot be explained with a single mechanism. -] (]) 16:29, 14 August 2014 (UTC) | |||
{{ping|A1candidate}} you are seriously misrepresenting the NHS source. I only checked that one since I used it not so long ago and did not remember it conforming to your description. And so it does not. This gives me very little confidence that the rest of your edits may be taken at face value. Perhaps a specific proposal where we can all vet your use of sources would be better received? - ] <small>(])</small> 17:23, 14 August 2014 (UTC) | |||
:I quoted from NHS exactly as it is stated on their website. If it looks different from what you last saw, that's because the page was changed last month. They update their articles evey two years, so you need to check with the newest version. | |||
:If you want a specific proposal from me, see ]. There's still no consensus over there, so your input is very much welcome -] (]) 18:00, 14 August 2014 (UTC) | |||
:: Nobody said you messed up the copy/paste. Please read more carefully to avoid wasting the time of your fellow editors. You are misrepresenting the conclusions of that source; read it again to see how they treat the subject compared to your proposed use here. They do not conform. This is *never* appropriate. We must only and exactly provide a ] representation of the sources without cherry-picking or quoting out of context. - ] <small>(])</small> 18:38, 14 August 2014 (UTC) | |||
:::And you are misrepresenting what I propose, which is that acupuncture stimulates the nervous system. That is exactly what the source says. -] (]) 18:43, 14 August 2014 (UTC) | |||
:::: I think we all agree that inserting needles under the skin has an effect on the nervous system, at least based on discussion above. Please strike or modify your above aggressive comment in accordance with ] and ]. - ] <small>(])</small> 19:04, 14 August 2014 (UTC) | |||
::::: (e/c) 2/0, I may be missing something, but I don't see A1 giving any worse than he's getting from you on the aggression front; you both sound exasperated, and it may be just a misunderstanding. The NHS page , as of today, indeed includes verbatim the quote "It is based on scientific evidence....". Is there some other dispute about that source that I'm missing? What misrepresentation are you referring to specifically? Forgive some entirely possible denseness on my side (literally; my sinuses are all too dense at the moment, and it's radiating to what's left of my brain), but I'm not understanding what A1C is proposing to do with the NHS source beyond simply citing or paraphrasing that quote. --] <small>(] • ] • ])</small> 19:25, 14 August 2014 (UTC) | |||
:::::: oh -- you mean that A1Candidate is overstating the degree to which the NHS source represents scientific consensus? If so: yes, I think that several of these sources aren't as close to meeting ] as A1C is suggesting. But the NHS source ''is'' an excellent MEDRS, one of the best, and I think there's room for disagreement over how close it is to representing sci consensus. A1C, I hope you're reading this as well: The problem, which Brangifer has imo correctly identified , is that there ''is'' no unified sci consensus on most aspects of acu (other than its not being an established treatment). That's why there's such a broad range of views, and so much polarization; the extremes at each end (in real life and on WP) piss each other off. That there are good reasons to use it as a complementary therapy for pain and stress is ''a'' mainstream view; that that same view is unsupportable is also a mainstream view. (Note I said "good reasons", which is a superset of "good evidence". Patients really liking it is an example of what many consider a good reason.) So I think it would be better for A1C to portray his sources not as representative of sci consensus, but as MEDRS's (many of them excellent ones) that we need to weight adequately, and so far haven't been (perhaps because editorial consensus has thus far been overaggressive about depicting acu as wholly fringe). A1C, would you consider not reaching quite so far? You're losing some editors by doing so, editors who are reasonable enough to (gasp) accept that we can use good MEDRS's that don't wholly dismiss acu. The fact that many of the sources you're presenting haven't been given more (or any) weight shows how excessively editorial consensus had tended to swing past skepticism into outright, undue debunking. We need less hyperbole all around. It's not hyperbole to say that A1C has found no more and no less than a bunch of MEDRS's, not all but some about as good as they get, that deserve proper integration and weighting. --] <small>(] • ] • ])</small> 20:14, 14 August 2014 (UTC) | |||
::::Note. Stimulating nerves does not mean it is effective. ] (]) 19:16, 14 August 2014 (UTC) | |||
:::::This is about the mechanism of action, not its effectiveness. -] (]) 19:20, 14 August 2014 (UTC) | |||
::::::Exactly; it's a different aspect of point specificity (which I'm sure the text of the article will make clear). --] <small>(] • ] • ])</small> 19:29, 14 August 2014 (UTC) | |||
::::::The text is under the heading "" not mechanism of action. ] (]) 19:34, 14 August 2014 (UTC) | |||
::::::: It is referring to the theories about the mechanism of action -] (]) 20:04, 14 August 2014 (UTC) | |||
:::::::: Is the fact that "acupuncture has an effect on the nervous system" some sort of great or new discovery? Has it EVER been denied? Is there any other possible "mechanism of action" when one touches or pokes the skin? (Hormones could also get involved, but that too is not specific.) I'm still not getting what this is about. It's still "duh", uninteresting, not unique, and not evidence for or against any claimed specific effects of acupuncture. | |||
:::::::: Please make a specific, precisely worded and sourced, proposal that isn't as foolish as the child with the penny, who is now twenty years old and is still presenting the same penny to its mother as if it has invented money. Please place your proposed edit here, in this thread. -- ] (]) 00:33, 15 August 2014 (UTC) | |||
:::::::::Just doing a search for "mechanism" in the turns up not even a "penny"-type comment. We have: | |||
:::::::::# "TCM is pseudoscience with no valid mechanism"'' (in lede and body); | |||
:::::::::# "The most common mechanism of stimulation of acupuncture points employs penetration of the skin by thin metal needles"; | |||
:::::::::# "... making many scholarly efforts to integrate evidence for efficacy and discussions of the mechanism impossible"; and | |||
:::::::::# "... even if research is still unable to explain its mechanism." | |||
:::::::::Similarly unhelpful stuff (with respect to mechanism) appears when one searches for the syllables "nerv" and "neur" (including examples of what is massive undue weight to serious adverse events). And the section '']'' is almost absurdly weighted to sources from the skeptic movement, and at any rate only mentions endorphins. We can do better than that! Even if a penny is all there is to be found (and there does appear to be more, e.g. point-specific neurological responses), readers at least deserve to know that the damned thing is round, shiny (for awhile), coppery, and a little bigger than a dime. Let's.... de-escalate a little in terms of confrontational approach. What's obvious to editors is not always obvious to the reader. A1Candidate has found some terrific ones, and I'd rather encourage them to keep at it. A1C, how would you do this? There's probably some stuff in those sources on fascia, no? There's stuff from Napadow and Kaptchuk.... a whole lot of stuff has been neglected, which is what happens when too few editors are involved. A1C and Brangifer, you're both great assets here; don't alienate each other. --] <small>(] • ] • ])</small> 05:41, 15 August 2014 (UTC) | |||
:::::::::Does the source say that "''It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue.''"? If it does, what's the problem? In my opinion, we better stick to the sources instead of our own ponderings. ] (]) 18:09, 17 August 2014 (UTC) | |||
{{od}}Yes, fascia (connective tissue) is discussed in the consensus statement of the ] as follows: | |||
:In the manual form of acupuncture, the mechanism of effect appears to be through sensory ] and ] stimulation induced by ]s being wound around the needle and activated by ]. | |||
PMID 23608661 -] (]) 09:32, 15 August 2014 (UTC) | |||
I added "The mechanism of action for acupuncture is still unclear. Evidence suggests that acupuncture generates a sequence of events that modulate pain signals within the central nervous system." ] (]) 17:55, 15 August 2014 (UTC) | |||
:You're doing it without consensus. The source is from 2008 and is way past ]. We have many newer reviews to use -] (]) 21:46, 15 August 2014 (UTC) | |||
* (2008) in '']'' with an impact factor of 3.422 | |||
::I added the source you proposed adding to the article. I added this source because it meets MEDRS and it was not ambiguous. ] (]) 02:53, 16 August 2014 (UTC) | |||
:::We should use the newest reviews, which are not ambiguous. -] (]) 03:02, 16 August 2014 (UTC) | |||
::::This was the specific source you wanted in the article and now you don't like what the source said? I added the source that was specifically about the mechanism of action for acupuncture, which was not vague or confusing. ] (]) 03:20, 16 August 2014 (UTC) | |||
:::::I was proposing to use it to ''replace the editorials'' only. I am not entirely against your edit, but I think it needs to be formulated in a different way. "Modulate pain signals" is an ambigous phrase that requires explanation. -] (]) 09:43, 16 August 2014 (UTC) | |||
::::::"They, along with acupuncture researchers, explain the analgesic effects of acupuncture as caused by the release of endorphins, and recognize the lack of evidence that it can affect the course of any disease." There is an explanation in the article. ] (]) 16:49, 16 August 2014 (UTC) | |||
:::::::Endorphins aren't pain signals. -] (]) 17:34, 16 August 2014 (UTC) | |||
::::::::The release of endorphins modulate pain signals. ] (]) 02:22, 17 August 2014 (UTC) | |||
:::::::::That is what the article should say to reduce ambiguity -] (]) 04:54, 17 August 2014 (UTC) | |||
::::::::::I added the context from the source according to the . ] (]) 06:01, 17 August 2014 (UTC) | |||
=== Arrhythmias === | |||
7 individual herbal therapies along with acupuncture and ] have been studied and reported as having an ] effect: | |||
* (March 2014) in '']'' | |||
Despite methodological shortcomings, these studies support acupuncture as an effective treatment for AF (]), paroxysmal ], inappropriate ], and symptomatic ] | |||
-] (]) 10:26, 15 August 2014 (UTC) | |||
:Good stuff -- hope you're being bold and adding at least some of these as you go, because good MEDRS's shouldn't be controversial -- as long as you're not removing others at the same time. If you also want to remove a MEDRS (for whatever reason), others might object to that part, so I'd do such an edit separately. (See situation below where an editor combined both good and bad edits into one big edit and it got reverted -- that was justified but could have been avoided.) --] <small>(] • ] • ])</small> 07:50, 17 August 2014 (UTC) | |||
::Have these been added into the article? If not, I don't mind helping you guys out here. ] (]) 16:33, 30 August 2014 (UTC) | |||
== 1997 NIH statement == | |||
The 1997 NIH panel statement is really old and a bit unusual. We should not use it to represent anything modern, though perhaps it can be retained for some historical significance. Thoughts on removing the reference? - ] <small>(])</small> 19:13, 16 August 2014 (UTC) | |||
:Agree that it should be removed. There is an explicit warning against using it: "They were current when produced, but are no longer maintained and may now be outdated." -] (]) 19:18, 16 August 2014 (UTC) | |||
:We are using the now. See ]. I recently fixed the text. ] (]) 19:21, 16 August 2014 (UTC) | |||
:: The statement was only being used to support some pretty basic and unlikely to be challenged information, so I boldly the reference. - ] <small>(])</small> 19:26, 16 August 2014 (UTC) | |||
:::I for the non-controversial claims. ] (]) 20:08, 16 August 2014 (UTC) | |||
:::: Why did you do that? We don't use sources for non-controversial claims. Such a request can be seen as disruptive, so why do it? You're not making sense. -- ] (]) 00:50, 17 August 2014 (UTC) | |||
:::::I am not making a request that we ''must'' use a source. I was stating when someone finds a source it can be added to the article. ] (]) 00:58, 17 August 2014 (UTC) | |||
:::::: Ooookaaay...? Then we can remove that CN, since it's not necessary. We don't clutter articles, especially the leads, with unnecessary things. If it's really necessary, the body will contain references. -- ] (]) 01:01, 17 August 2014 (UTC) | |||
:::::::I agree no tag was needed so I removed the tag from the body along with other tags from the body. But now an editor without consensus is deleting lots of text in the body. This . ] (]) 23:23, 11 September 2014 (UTC) | |||
::::::::Indeed, after all. My apologies. I think, however, that your rapid editing makes it really difficult to follow up what's going on. ] (]) 11:08, 12 September 2014 (UTC) | |||
{{tlx|edit protected}} | |||
Per the above two comments, it looks like should be undone and the cn tag removed. - ] <small>(])</small> 18:00, 12 September 2014 (UTC) | |||
:I don't see consensus to revert only one edit. I disagree with this edit protection request. I strongly disagree with the unprotection request to revert only one edit. . We should go back to and unprotect the article. ] (]) 18:19, 12 September 2014 (UTC) | |||
:: Well, never mind then; turning off the template for now. QG, I agree that there are several recent edits that need to be examined in detail, but I think that we can handle them individually. I am not seeking to have the article unprotected (I just yesterday requested that it be locked), just to have this one change made. Do you disagree that the article ''as it currently stands'' would be improved by restoring that sentence about use of qi as an explanatory framework? - ] <small>(])</small> 18:40, 12 September 2014 (UTC) | |||
:::I think we should go back to and it is a waste of time handling each edit individually. I don't see any reason to having this article locked. ] (]) 18:47, 12 September 2014 (UTC) | |||
:::: <s>I think you may have mixed up your pronouns there, as I do indeed think the article needs to be locked for now.</s> I would not necessarily be averse to reverting to that version, but the case would need to be made. - ] <small>(])</small> 18:57, 12 September 2014 (UTC) | |||
:::::I fixed the . This is what happened. I undid my own edits and removed the tags. Next, after the tags were restored sourced text was deleted. This is a strong case to removed the tags so this won't happen again. ] (]) 20:11, 12 September 2014 (UTC) | |||
== Safe? == | |||
With acupuncture ] (]) 17:28, 23 August 2014 (UTC) | |||
:Since when is ''The Daily Telegraph'' an MEDRS-compliant source? -] (]) 01:16, 25 August 2014 (UTC) | |||
::Yeah, I'd like to hear that as well. ] (]) 12:10, 25 August 2014 (UTC) | |||
:::Yes popular press should not be used for medical content. ] (] · ] · ]) (if I write on your page reply on mine) 12:35, 25 August 2014 (UTC) | |||
::::<s>If an editor (who should know better) were to suggest using popular press as MEDRS for "pro-acupuncture" statements, an admin would use that to support sanctioning that editor under AE. Strange the converse doesn't seem to be true.... --] <small>(] • ])</small> 08:47, 26 August 2014 (UTC)</s> | |||
:::::You were using a is engage in a "pro-acupuncture" statement. Do you think an admin would use that to support sanctioning you under AE? ] (]) 20:23, 26 August 2014 (UTC) | |||
::::::Ummm.... that shows me using a peer-rev RS for a non-medical claim. <s>That's not quite the same as your proposal to use a newspaper as a MEDRS.</s> (BTW, why is the link to your talk page in red? Redlinks imply that no such page exists; it's confusing.) --] <small>(] • ])</small> 04:07, 27 August 2014 (UTC) | |||
:::::::You added a that violated ] and . I did not make a proposal to use the source above. See ]. I was using the talk page to document what was missing from the article and . ] (]) 04:14, 27 August 2014 (UTC) | |||
::::::::If that was why you mentioned the news article, then you should have said so; three editors misunderstood you. In light of your clarification, I'm striking my comments about sourcing. With respect to the point you're trying to make, your quote was selective. The bit you quoted is preceded by "While most acupuncture causes little harm," is consistent with how the literature weights AE's. Omitting important context like that is not a great way to get others to AGF. More re which, please see your talk page. --] <small>(] • ])</small> 07:18, 27 August 2014 (UTC) | |||
:::::::::I wasn't trying to make a point. I was making a note. We are not using that source. ] (]) 07:28, 27 August 2014 (UTC) | |||
::::::::::Why did you post it at all then? Was it to show that the article needs to spend more time on infection and other adverse events? | |||
::::::::::Here's the full quote -- which is a pretty accurate depiction of our MEDRS's -- with the part you omitted in bold red: | |||
::::::::::{{!xt|'''"While most acupuncture causes little harm,'''}} {{tq|there is a risk of accidental puncture of nerves, which could lead to brain damage or strokes. Kidney damage can result from deep needling in the lower back, and unsterilised needles can transfer HIV and hepatitis."}} | |||
::::::::::The bold red part -- which you omitted -- shows why it's an UNDUE problem to devote excessive coverage to infection and other serious adverse events. Why did you omit it? --] <small>(] • ])</small> 10:21, 28 August 2014 (UTC) | |||
:::::::::::On the contrary, I added "Acupuncture is generally safe when administered using clean technique and sterile single use needles." See . I , I left a note on the talk page. ] (]) 19:08, 31 August 2014 (UTC) | |||
::::::::::::I'm not talking about article space edits -- and that was a good article edit, although you didn't make it until you got called out here. Taking material out of context anywhere, including article talk, can create a biased impression. Here, you omitted the one part of the quote that gives the rest of the quote proper weight. Why? See ]. --] <small>(] • ])</small> 04:54, 2 September 2014 (UTC) | |||
I did explain this was only a note. I did not omit anything from the note to myself. ] (]) 03:13, 8 September 2014 (UTC) | |||
:Strange place for a note to "yourself". Others use this page too. And ''four editors'' responded before you explained yourself (and then only when called out). --] <small>(] • ])</small> 12:34, 9 September 2014 (UTC) | |||
;Re recent edits listing specific infections, please see ] below. | |||
Discussion had already begun below, and the above discussion about the newspaper is extraneous, except for the UNDUE issue. --] <small>(] • ])</small> 10:21, 28 August 2014 (UTC) | |||
== Reliable source? - "''From Alien Abductions to Zone Therapy''" == | |||
What about this one: "''From Alien Abductions to Zone Therapy''", are we using books on extraterrestrials (!) now too? ] (]) 12:10, 25 August 2014 (UTC) | |||
:It is not a scientific source and we should not use it. -] (]) 20:27, 26 August 2014 (UTC) | |||
::We are not using a book on extraterrestrials in general. ] (]) 20:45, 26 August 2014 (UTC) | |||
<small>Copied from ]</small><br> | |||
* {{cite encyclopedia|editor=William FW|work=Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy|year=2000|publisher=Facts on File|isbn=978-1579582074|pages=3-4|editor=William F. Williams|title=Acupuncture}} This is not a random book. It is an encyclopedia.] (]) 16:10, 25 August 2014 (UTC) | |||
::I haven't yet found where to access that book. The name, however, implies that it has something to do with extraterrestrials, is that right? If so, are we using an encyclopedia on extraterrestrials to support claims on medical efficiency? ] (]) 09:35, 26 August 2014 (UTC) | |||
:::The Encyclopedia of Pseudoscience is not a book about extraterrestrials in general. The encyclopedia covers pseudoscience from Alien abductions to zone therapy. The name does not imply it is a book on extraterrestrials in general. It covers a wide range of pseudoscience topics. Please don't get involved in an edit war or claim the source is not reliable. Did you read the Encyclopedia of Pseudoscience page? ] (]) 19:40, 26 August 2014 (UTC) | |||
::::Have I made even one single revert concerning your addition of this book? ] (]) 20:10, 26 August 2014 (UTC) | |||
:::::You have made a comment on the talk page which concerns me. Do you agree was misleading or you made a mistake? ] (]) 20:16, 26 August 2014 (UTC) | |||
. ] (]) 20:34, 26 August 2014 (UTC) | |||
:The discussion belongs here, not on his talk page. -] (]) 20:38, 26 August 2014 (UTC) | |||
::He is . Do you concur? ] (]) 20:45, 26 August 2014 (UTC) | |||
:::I would agree that the book is certainly much more <s>about</s> than aliens and UFOs, but according to our article on ], many of its contributors hail from dubious institutions such as "Center for UFO Studies" and "Department of Religious Studies". The publisher does not sound very reputable either -] (]) 20:58, 26 August 2014 (UTC) | |||
::::You claim the book is much more about aliens and UFOs. No, I previously explained the encyclopedia covers many pseudosciences. | |||
::::Do you think the encyclopedia is widely used ? ] (]) 21:06, 26 August 2014 (UTC) | |||
:The publisher is in general a decent publisher and good enough to not disqualify one of its books on the basis of the publisher alone. But there do seem to be some perhaps reasonable grounds to question some of the content as per reviews in the article. It would help a lot if it was more clearly indicated what specific material from the book is being used as well as the name and reputation of the author of the specific article in question.] (]) 21:29, 26 August 2014 (UTC) | |||
<small>Copied from ]</small><br> | |||
:You changing your and questioning weather the book is reliable. You claimed | |||
:I told you the book is not on extraterrestrials in general. See ]. ] (]) 20:29, 26 August 2014 (UTC) | |||
:You are not giving a valid reason for . For example, you have not shown how the encyclopedia is unreliable. ] (]) 21:10, 26 August 2014 (UTC) | |||
::I meant to say that the book is much more than aliens and UFOs. Being cited on Misplaced Pages has no relevance to its reliability and I don't think it qualifies as an actual medical textbook. -] (]) 21:49, 26 August 2014 (UTC) | |||
No need to include any extraterrestrial / UFO authors for medical claims, that's it! Please do find a better source. So simple, problem solved! ] (]) 21:44, 26 August 2014 (UTC) | |||
:The above comment seems to be taking the editors own assumptions as conclusions and such behavior is not considered acceptable here. In short the only problem in this topic is the problem of the editor who apparently is making completely unwarranted assumptions about the content of a book based apparently simply upon a misreading of the title. The real list of articles contained in the book beyond the names of the first and last alphabetical entries can be found at ]. I might go further and say that it strikes me as being potentially problematic behavior to attempt to dismiss such a source on the extremely dubious rationale apparently being used here.] (]) 21:55, 26 August 2014 (UTC) | |||
::"Alien abductions", "extraterrestrial intelligence", "communication with extraterrestrial intelligence" ... are you pretty sure this is a medical textbook? So should we be using this as a medical source? ] (]) 22:10, 26 August 2014 (UTC) | |||
:::I never said it was a medical textbook and I very strongly suggest that editors here refrain from any further disruptive editing of that type. I had asked a question regarding what content the source is being used to support in the article. It is in fact generally common practice to indicate that at the beginning of a thread to make discussion easier and I am rather surprised that the OP had not indicated that earlier in the thread. I find the questions asked above to be counterproductive because they seem to be making implicit assumptions about matters which have never been so far as I can see specifically introduced into discussion. Unfortunately such conduct can be seen as problematic. I would very much welcome seeing more clearly useful comments perhaps along the lines of directly responding to the questions I had asked earlier.] (]) 22:23, 26 August 2014 (UTC) | |||
{{od}} | |||
], please stop the endlessly repetitive IDHT disruptive comments! When it comes to determining whether a source is a RS, it all depends on how it's used. No single source (even the '']'') is considered reliable in every situation, and there is practically no single source that isn't considered a RS for some very limited purpose (such as the nonsensical insane Twitter speculations of a weirdo, used in an article about that weirdo, for the purpose of documenting their POV). | |||
If you will check the two places where the Encyclopedia of Pseudoscience is being used in this article, it is used appropriately for the use intended in that context. Context is everything when determining whether a source is being used appropriately. If so, then it is a RS for that purpose. SMH...! (I really get tired of explaining this basic stuff when ].) Can we hat this yet?! -- ] (]) 22:57, 26 August 2014 (UTC) | |||
:Its contributors are mostly from the humanities department. The book is not from a notable academic publisher and it is '''more than a decade''' old. Please read ] carefully. -] (]) 23:40, 26 August 2014 (UTC) | |||
:: MEDRS does not apply to the way this source is being used. This is documenting the POV of those who consider the subject worthy of being included in an encyclopedia about pseudoscience. MEDRS citations rarely deal with pseudoscience. They generally ignore it. -- ] (]) 00:03, 27 August 2014 (UTC) | |||
:::All health content here is subject to ]. If you wish to edit Misplaced Pages, please respect our policies and guidelines. -] (]) 00:24, 27 August 2014 (UTC) | |||
::::Like I already said if you disagree and wish to resolve this matter the appropriate forum would be RSN. Also I believe you may be making a mistake of overgeneralization. Not all content in all articles relating to medicine broadly construed must necessarily always adhere to MEDRS and this particularly includes content relating to public perceptions and history and other material not of an explicitly medical nature.] (]) 00:33, 27 August 2014 (UTC) | |||
::::The source is not being used for ''biomedical information'' it being used for how acupuncture is described/viewed. Please read the guidelines you cite. While your at it read the core policy NPOV which requires we present the significant published views on the subject. Might I also suggest reading Tendentious editing. As above the appropriate forum is RSN, be sure to specify what content is supported by the source and why you don't think it is a reliable source for that content. - - ] (]) 00:39, 27 August 2014 (UTC) | |||
:::::The content backed up by the source is not just of a medical nature, it is also a direct health claim so ] applies. -] (]) 00:42, 27 August 2014 (UTC) | |||
:::::: ], there is another solution. Try to suggest altered wording which justifies using the source. You obviously believe the source is misused. How about suggesting tweaks of the wording? Maybe we can find a solution that way. Okay? -- ] (]) 00:51, 27 August 2014 (UTC) | |||
::::::Read the content ''some contemporary practitioners''...''have abandoned the concepts of qi and meridians as pseudoscientific.''" not a health claim but a description of the views and practices of some contemporary practitioners, and "''Some modern practitioners''...''They, along with acupuncture researchers, explain the analgesic effects of acupuncture as caused by the release of endorphins, and recognize the lack of evidence that it can affect the course of any disease.''" again neither biomedical information presented as fact nor a health claim but the explanations and realizations of an identified specific group. The source is RS for what some practitioners ''think'' or ''say''. Note also all of the information associated with this content that is of a biomedical nature is very well spelled out and supported with MEDRS quality sources when it is presented in terms of health claims and biomedical information. Your IDHT is becoming quite tendentious RSN has been suggested. This article is under discretionary sanctions. Consider this a notification of the PAG in relation to Tendentious editing and Discretionary sanctions {{u|A1candidate}}. Please consider this in your further editing. - - ] (]) 01:03, 27 August 2014 (UTC) | |||
:::::::I was referring to , not the one you quoted. -] (]) 01:19, 27 August 2014 (UTC) | |||
::::::::We can compromise and . ] (]) 05:19, 27 August 2014 (UTC) | |||
{{outdent|:::::::}}Thank you for the clarification. It really helps when objecting to a source to specify what content is being challenged. The content I quoted is all that is currently in the article supported by this source. | |||
I agree with A1candidate that the content in the provided above is difficult to justify supporting with Williams 2013. I agree a more MEDRS compliant source is appropriate for "''There is no evidence that inserting needles can affect the course of any disease''." I apologize for my contentiousness, it was due to a misunderstanding. - - ] (]) 01:32, 27 August 2014 (UTC) | |||
:This was very helpful. I can to a specific group. ] (]) 05:17, 27 August 2014 (UTC) | |||
The phrase in the article: 'lack of evidence that it can affect the course of any disease' is not consistent with a published Cochrane review. Tension-type headache are considered to be diseases by the current version of the WHO's ICD-10 (disease number G44.2). The 2009 Cochrane review of acupuncture for tension headache (www.ncbi.nlm.nih.gov/pubmed/19160338) states "acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches". The WP article actually refers to tension headaches in the Headaches and migraines section but incorrectly cites a Cochrane review on migraine and contradicts itself. With consensus, the latter incorrect citation should reasonably be corrected to cite the correct article and the contradictory statement should be removed. Is the Cochrane review on tension headache sufficient to withdraw the statement on lack of evidence that acupuncture can affect the course of any disease? ] (]) 05:52, 27 August 2014 (UTC) | |||
::The Cochrane review does not clearly state benefit. "'''could be''' a valuable non-pharmacological tool" With respect to affected long term disease outcomes it states "Long-term effects (beyond 3 months) were not investigated" ] (] · ] · ]) (if I write on your page reply on mine) 06:46, 27 August 2014 (UTC) | |||
===The source we are working with === | |||
It states "Orthodox researchers posit that the practice generates endorphines, chemicals imilar to narcotics, but they add that, although pain is reduced, there is no evidence that the application of needles can influence the course of any organic disease." | |||
The source is from 2013. The publisher is "Routledge" which is well respect in the humanities. Acupuncture being on the fringe of science is covered by the humanities and thus this source is not unreasonable. | |||
The next question is how should we summarize it. Maybe "Western medicine, while accepting it may affect pain through increasing the bodies release of endorphins, does not consider acupuncture to alter the long term course of diseases" ] (] · ] · ]) (if I write on your page reply on mine) 06:54, 27 August 2014 (UTC) | |||
:The text you're proposing is an excellent example of ]. All medical articles must rely on scientific sources. -] (]) 07:43, 27 August 2014 (UTC) | |||
::Should not be too difficult to support this by other sources aswell I imagine. In fact we have "The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits" which is basically the same thing. ] (] · ] · ]) (if I write on your page reply on mine) 07:06, 27 August 2014 (UTC) | |||
:::Yes, this review is much better than the non-scientific source. I have '''no objections''' to using it for now, although I note that it is slightly past ] so we should continue to look for more recent reviews. -] (]) 07:43, 27 August 2014 (UTC) | |||
::::<s>I agree with A1candidate. The source is being used for claims on medical efficiency, and it is already outdated per ]. We should not use outdated sources for such claims. ] (]) 17:22, 10 September 2014 (UTC)</s> | |||
::::My post below was almost e/c'd with A1C's post, and agree -- prefer the solid MEDRS. --] <small>(] • ])</small> 07:57, 27 August 2014 (UTC) | |||
:::::A1candidate, if you agree then what was the reason you tried to ? ] (]) 08:47, 27 August 2014 (UTC) | |||
:::It's not an unreasonable claim, and we should be able to work it in somehow. But acu isn't so fringe that we lack full-blown MEDRS's on it -- quite the contrary; it's been massively researched -- and I think we should use those whenever possible. | |||
:::And I'm not so sure that the amelioration of pain and stress doesn't affect the long term course of chronic diseases -- it's just a very very non-specific effect. Isn't that why it's used as a complementary therapy in academic medical centers like Harvard and U-Maryland etc etc? Or is that just to make patients feel better... or is that the same thing? (Seriously, just because critics call such use "quackademic" doesn't change the fact that these settings are about as mainstream as it gets. We need to reflect that. Why is it used so widely? The answer isn't irreconcilable with systematic reviews.) --] <small>(] • ])</small> 07:44, 27 August 2014 (UTC) | |||
::::Yes agree we can just stick with the better source that says more or less the same thing. ] (] · ] · ]) (if I write on your page reply on mine) 07:55, 27 August 2014 (UTC) | |||
:::::I also agree the source is reliable for the claim: "The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits". There is broad consensus to use the source for the claim but it was . I left a note on the about the tag. ] (]) 16:54, 10 September 2014 (UTC) | |||
::::::<s>The source is outdated per ], and it's used to support claims on medical efficiency. We should not use outdated sources for that. ] (]) 17:22, 10 September 2014 (UTC)</s> | |||
:::::::There are no objections to using this source. See . ] (]) 17:42, 10 September 2014 (UTC) | |||
Oops, got mistaken. The discussion here is about replacing Williams by Wang et al. (2008). The Williams source is still being used, but there is no consensus for Wang et al. (2008) on claims about medical efficiency on another sentences. No consensus for that one, it's not even been discussed. ] (]) 18:16, 11 September 2014 (UTC) | |||
==Academic centers== | |||
As mentioned above, acupuncture is used at a number of academic centers. This certainly belongs in the article; for starters, I've added its own subsection under ] . It's used at a great many such places, and at some point we might have so many that it may be a good idea to create a list. | |||
I know acupuncture is a fringe topic, and I would like to apologize in advance for pushing mainstream POV into it. :-) --] <small>(] • ])</small> 14:44, 28 August 2014 (UTC) | |||
: This is a good edit. I tweaked the text to indicate that the list presented is not exhaustive. We of course need to be careful not to imply that just because these centers use the practice that they know how it works (or even where it is effective), but we do need the information that it is used at hospitals as well as at stand alone clinics. A third or maybe even a fourth example citing non-US use would be good to help reflect a worldwide view. Maybe one from China and one from Germany or somewhere like that? - ] <small>(])</small> 15:25, 28 August 2014 (UTC) | |||
::Thanks; yes, good idea re worldwide view. We can also talk about acu's role in medical education worldwide; in China, IIRC, TCM is taught as anywhere from (very roughly) 5% to 50% of the curriculum. --] <small>(] • ])</small> 12:00, 30 August 2014 (UTC) | |||
::I agree, that's valuable piece of information. The sources are perfectly reliable to illustrate the use of acupuncture at academic centers. I'll try to see if I can find anything about the situation in Finland (HYKS, KYKS, OYKS, TYKS and TAYS). ] (]) 11:57, 1 September 2014 (UTC) | |||
:::''Acupuncture is among popular CAM treatments in all five Nordic countries but it is used less in Finland.'' | |||
:::''Since acupuncture is deregulated in Finland many people without education in healthcare are able to give acupuncture treatment.'' | |||
:::I have included specific information about Finland. ] (]) 20:05, 5 September 2014 (UTC) | |||
{{od}}Discussion re sourcing -- i.e. are the sites of these medical centers RS for their use of acu -- continues below at ]. --] <small>(] • ])</small> 05:31, 13 October 2014 (UTC) | |||
=== Primary sources/poor sources and original research === | |||
http://www.brighamandwomens.org/Departments_and_Services/medicine/Services/oshercenter/acupuncture.aspx | |||
This source is a link to a hospital website. It is unreliable. | |||
http://medicine.yale.edu/psychiatry/psychology/predoc/sites/cmhc/substanceabuse.aspx | |||
This source is a link to a School of Medicine website. Where does this link mention acupuncture? Auricular acupuncture and acupuncture are different. The sentence is poorly sourced and partly fails verification. See ]. ] (]) 02:02, 30 August 2014 (UTC) | |||
::IMO, the above criticisms from QuackGuru lack merit and the bit about competence (CIR) is gratuitous. Anyone else think QG is making any valid points here? --] <small>(] • ])</small> 12:00, 30 August 2014 (UTC) | |||
:::You are and text that failed verification. I previously explained, Auricular acupuncture (ear acupuncture) is not acupuncture. You ignored it was original research. See ]. Adding even . You have not shown how the sources are reliable in accordance with ]. ] (]) 17:41, 30 August 2014 (UTC) | |||
QG is correct that even Misplaced Pages has a separate article on ]. ] (]) 17:58, 30 August 2014 (UTC) | |||
:QG is incorrect. Ear acupuncture is a common form of acupuncture. See the meta-analysis below. -] (]) 18:37, 30 August 2014 (UTC) | |||
::Did you read the entry for ]? Do you understand this is a that says Auricular Acupuncture? ] warned you about . | |||
::"This systematic review evaluated the effects of ear acupuncture, ear acupressure and auriculotherapy for cigarette smoking cessation (SC) at end-of-treatment (EoT), three, six and 12 months follow-up." | |||
::According to the source ear acupuncture, ear acupressure and auriculotherapy are a bit different or is the source ambiguous? does not make sense given the evidence. ] (]) 03:50, 31 August 2014 (UTC) | |||
I did discuss with on Jayaguru-Shishya's talk page. Jayaguru-Shishya largely ignored my concerns or did not understand. "He wrote If you have a specific edit you'd like to discuss, please let me know. So far, you have said that "there is original research in the article using a primary source", and you are giving me a diff where QTxVi4bEMRbrNqOorWBV says at the Talk Page that "even Misplaced Pages has a separate article on ]". I am sorry, I don't really see the connection here? I did let him the issues. See ]. I left a on his talk page. ] (]) 19:16, 5 September 2014 (UTC) | |||
The source does not verify the claim "several". This the source does not say "several". ] (]) 19:33, 5 September 2014 (UTC) | |||
:So if Misplaced Pages has a separate article on ], how is it connected to original research? :D I alrady provided you a source (which seriously nobody needs). As Middle 8 well put it: "''just as auricular acu is a kind of acu, and chocolate milk is a kind of milk''". Just common sense. | |||
:QuackGuru, do you know what "paraphrasing" means? I think user NuclearWarfare has already noticed you about "getting caught over specific wording", right? If you have problems with paraphrasing yourself, please leave it to other editors, that's what I'd like to suggest. Cheers and happy weekend! ] (]) 20:27, 5 September 2014 (UTC) | |||
::Indeed, indeed... "''Being of a number more than two or three but not many''" (http://www.thefreedictionary.com/several) ] (]) 20:44, 5 September 2014 (UTC) | |||
::I fixed the issues by using another source that verified the claim rather than use a source that was ambiguous. As a bonus, I expanded the sentence and included Duke. ] (]) 20:41, 5 September 2014 (UTC) | |||
I had a discussion on Jayaguru-Shishya's talk page: ''You added using primary/poor sources. Rather than use poor sources I replaced it with independent sources. In my edit summary I explained . This was discussed . The section for the US under International reception already states "Acupuncture is used at many places in the US, including ], ], and ]." Independent sources were being used but you restored the text using a bunch primary sources. There is no need for duplication or a separate section. The text for each country can go into each specific section for each country in the ] section. Please stop adding poor/primary sources when better sources were found. Please don't continue to ]. ] (]) 21:22, 1 September 2014 (UTC)'' | |||
After I explained it too Jayaguru-Shishya that there is still problems with the text and he ignored my concerns and restored the . He also restored the tag . ] also explained Jayaguru-Shishya . See ] for the current text. ] (]) 15:57, 6 September 2014 (UTC) | |||
:Do you mean the discussion which resulted to an administrative warning to you? The one where you were making accusations against me? Well, let's see dear. | |||
** '''The first diff''' where you claim that I "''largely duplication using primary/poor sources''", it has been already discussed at the Talk Page. Consensus? No problem for using primary sources to illustrate the use of acupuncture at mainstream medical centers. | |||
** '''The second diff''', you said that: "'' I explained one of the sources failed verification''". That's not true, I'm afraid. When one opens your diff, the edit summary merely says: "''failed verification and duplication''". So where is the "explanation you mentioned? Answer: there is none. | |||
** '''The third diff''', you are saying that it was discussed that the source above ''failed verification''. Let's see your diff more closely: it is pertaining to user QTxVi4bEMRbrNqOorWBV's comment "''QG is correct that even Misplaced Pages has a separate article on ].''" So, what does this have to do with "a source failing verification"? You just picked up a random comment from the Talk Page and use it to "support" something that has nothing to do with it...? | |||
** You said: "''Please don't continue to WP:BATTLE.''". Funny, you got warned by an administrator for your post. | |||
** "... ''he ignored my concerns and restored the original research and unneeded primary sources''". Please see and participate the discussion if you have something meaningful to say. ] (]) 19:43, 6 September 2014 (UTC) | |||
==Summarize== | |||
The lead is supposed to be a simple summary. | |||
" A systematic review of systematic reviews highlighted recent high-quality ] which" can be summarized as "A systematic review" | |||
Because a "systematic review of systematic reviews highlighted recent high-quality ]" is a type of systematic review. We can get into the specifics in the body of the article. ] (] · ] · ]) (if I write on your page reply on mine) 04:19, 31 August 2014 (UTC) | |||
:Agree it was too much detail for the lede. ] (]) 04:34, 31 August 2014 (UTC) | |||
{{od}}Only problem is that it's now inaccurate. Here's the deal -- Doc, hope you're reading: | |||
# Efficacy is ''defined'' as real acu being better than sham -- that's the thing readers need to know, that we aren't telling them. | |||
# Ernst '11 found that a majority of the ''reviews'' he looked at were ''positive'' for pain, but then ''caveated'' that finding -- by pointing to findings from more recent and better ''trials''. Agreed that that level of detail belongs in the body, not the lede. | |||
# Some trials for pain show sham = real, and meta-analyses vary in their conclusions. We already say that in the lede when we talk about efficacy. | |||
So what we need to in the lede is simple -- drop the statement in question and replace it with a statement along the lines of #1. --] <small>(] • ])</small> 05:31, 31 August 2014 (UTC) | |||
::So what are you proposing? ] (] · ] · ]) (if I write on your page reply on mine) 05:39, 31 August 2014 (UTC) | |||
:::How about ? (good timing of your comment :-) --] <small>(] • ])</small> 05:47, 31 August 2014 (UTC) | |||
::::The proposal is now ambiguous and that summerised the body. Now the text does not summarise the body. Middle 8 has had a problem with . ], maybe we should also shorten the body. It says "The review also highlighted recent high-quality randomized controlled trials which found that for reducing pain, real acupuncture was no better than sham acupuncture." It is a bit too wordy. See ]. ] (]) 06:03, 31 August 2014 (UTC) | |||
:::::You need to use references per ] and ]. ] (] · ] · ]) (if I write on your page reply on mine) 06:03, 31 August 2014 (UTC) | |||
::::::We don't source every statement in the lede... and naive readers aren't going to know what sham acu ''is''. (I do hope for the sake of the article that you understand ... it's acu study design 101.) --] <small>(] • ])</small> 08:25, 31 August 2014 (UTC) | |||
::::::: the text you added to the lede did not summarise the body. ] (]) 08:29, 31 August 2014 (UTC) | |||
:::::::You claim readers won't know what sham is. See https://en.wikipedia.org/Acupuncture#cite_note-Madsen2009-11 ] (]) 10:13, 31 August 2014 (UTC) | |||
::::::::An accurate claim at the time , seeing you added that note subsequently -- which is a good addition, though I think the reader would be better served if it were in the lede and not a note. --] <small>(] • ])</small> 07:41, 1 September 2014 (UTC) | |||
:::::::::We should also tell the reader that another form of sham acu is the use of real needled at non-acupoint locations. --] <small>(] • ])</small> 07:52, 1 September 2014 (UTC) | |||
Anyway just noticed that we said the same thing already in the paragraph using that ref? So deleted it. ] (] · ] · ]) (if I write on your page reply on mine) 06:07, 31 August 2014 (UTC) | |||
:The statement is different from the other text. It is ''comparing'' sham versus real acupuncture. ] (]) 06:20, 31 August 2014 (UTC) | |||
This "while a systematic review of systematic reviews found little evidence that acupuncture is an effective treatment for reducing pain" | |||
Is more or less the same as "A systematic review found that for reducing pain real acupuncture was no better than sham acupuncture." | |||
When one says that there is little evidence for something one needs a comparator and that comparator is sham acupuncture. IMO we do not need to say both in the lead. ] (] · ] · ]) (if I write on your page reply on mine) 07:10, 31 August 2014 (UTC) | |||
:I will compromise and merge the other statement so there will only be one sentence. ] (]) 07:33, 31 August 2014 (UTC) | |||
The wording is simplified and . ] (]) 08:12, 31 August 2014 (UTC) | |||
:It is incorrect. Newer meta-analysis concludes that differences exist between sham and verum. -] (]) 15:28, 31 August 2014 (UTC) | |||
"Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, said the study "impressively and clearly" showed that the effects of acupuncture were mostly due to placebo. "The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies." | |||
{{cite news| first = Alok | last = Jha | title = Acupuncture useful, but overall of little benefit, study shows | url = http://www.theguardian.com/science/2012/sep/10/acupuncture-useful-little-benefit-study| newspaper = '']'' | date = 10 September 2012}} | |||
"What really matters is that Vickers et al showed that the difference is far too small to be of the slightest clinical interest." | |||
{{cite web| first = David | last = Colquhoun| title = Re: Risks of acupuncture range from stray needles to pneumothorax, finds study | url = http://www.bmj.com/content/345/bmj.e6060/rr/603200| publisher= ] | date = 17 September 2012}} | |||
A systematic review of ]s is a higher quality authoritative source. The author of this source is Edzard Ernst. He invalided the Vickers study. | |||
That Vickers study shows no meaningful difference according to which experts on the subject? See above. ] (]) 17:32, 31 August 2014 (UTC) | |||
::Ernst's review couldn't have "invalided" Vickers because the latter hadn't even been written yet. --] <small>(] • ])</small> 06:19, 1 September 2014 (UTC) | |||
:::The source says "We found acupuncture to be superior to both no-acupuncture control and sham acupuncture for the treatment of chronic pain," wrote Vickers in the September 10 edition of the ." Ernst was reviewing Vickers. ] (]) 06:27, 1 September 2014 (UTC) | |||
:Newspapers and news reports of BMJ aren't MEDRS compliant. An older review (2011) cannot be used to disqualify a newer meta-analysis (2012). -] (]) 17:54, 31 August 2014 (UTC) | |||
::You disagree that a systematic review of ]s is a higher quality source? | |||
::This is a newer 2013 meta-analysis written in part by Vickers: "When comparing acupuncture to sham controls, there was little evidence that the effects of acupuncture on pain were modified by any of the acupuncture characteristics evaluated, including style of acupuncture, the number or placement of needles, the number, frequency or duration of sessions, patient-practitioner interactions and the experience of the acupuncturist..." | |||
::{{cite journal |doi=10.1371/journal.pone.0077438 |title=Characteristics of Acupuncture Treatment Associated with Outcome: An Individual Patient Meta-Analysis of 17,922 Patients with Chronic Pain in Randomised Controlled Trials |year=2013 |editor1-last=Eldabe |editor1-first=Sam |last1=MacPherson |first1=Hugh |last2=Maschino |first2=Alexandra C |last3=Lewith |first3=George |last4=Foster |first4=Nadine E |last5=Witt |first5=Claudia |last6=Vickers |first6=Andrew J |journal=PLoS ONE |volume=8 |issue=10 |pages=e77438 |pmid=24146995 |author7=Acupuncture Trialists' Collaboration |pmc=3795671}} | |||
::According to your a 2012 is the newer meta-analysis. That is incorrect. See (PMID 24146995). ] (]) 18:09, 31 August 2014 (UTC) | |||
:::You conveniently ignored the fact that "Increased number of needles and more sessions appear to be associated with better outcomes when comparing acupuncture to non-acupuncture controls. This suggests that the dose of acupuncture is important", as they concluded in the 2013 meta-analysis. -] (]) 18:34, 31 August 2014 (UTC) | |||
::::This detail is in the body. See ]. The lede should be kept a summary. That would be too much detail for the lede and we are using a better source (a systematic review of systematic reviews) for the main point. ] (]) 18:47, 31 August 2014 (UTC) | |||
:::::A newer meta-analysis of 18,000 patients carries more weight than older systematic review of reviews. -] (]) 19:21, 31 August 2014 (UTC) | |||
:::::: Or at least it would if there was a remotely plausible mechanism of action, and solid evidence for the existence of qi and meridians, and evidence that the location of needling makes any difference. But there isn't. | |||
:::::: You have made it rather plain that you are a True Believer, and the review you promote was also written by True Believers. Oddly, when anyone who is not a True Believer conducts the test, the effect seems to vanish. I wonder why that is? <b>]</b> <small>(])</small> 23:17, 31 August 2014 (UTC) | |||
::::::: Yes, I'm a True Believer in science, if that's what you're trying to say. -] (]) 23:58, 31 August 2014 (UTC) | |||
:::::::Guy, even if it is written by true believers (and I'm not sure that's wholly true), it still passed peer review, and is still part of the literature that we seek to represent. The "effect" in this case -- the statistical significance of their findings -- is not belief-dependent. Nobody has suggested that if a non-true believer re-crunched the numbers, their findings would change; only the interpretation of those findings is contested. AFAIK, it's the ''only'' meta-analysis of individual patient data in acu research, which is the gold standard of meta-analysis., so it does weigh considerably. And in order for acu to have a small specific effect, prescientific Chinese ideas don't have to be true; how else would you expect them to have explained acu in their time? With reference to fascia and endorphins? ;-) --] <small>(] • ])</small> 06:16, 1 September 2014 (UTC) | |||
:::::::All this speculation about "true believers" is totally useless. If there is such a bias, it sure have been studied and one could find a source for it. If it's not, then we don't speculate on that either. | |||
:::::::I do agree with Middle 8 about the weight of that meta-analysis though. ] (]) 11:57, 1 September 2014 (UTC) | |||
:::::::::(e/c) A1Candidate almost always brings really good MEDRS's to the discussion, but shoots themselves in the foot by overstating their weight relative to other sources. But they still weigh. Multiple editors have commented that there is POV-pushing from both sides, but while the pro-acu side inevitably gets called out, the anti-acu side (no matter how extreme) gets a free pass. --] <small>(] • ])</small> 06:47, 1 September 2014 (UTC) | |||
::::::::The main point of (PMID 24146995) is redundant. The lede says more or less the same thing that there is little difference between sham and acupuncture. ] (]) 06:33, 1 September 2014 (UTC) | |||
:::::::::It depends on which trial or review one is talking about. Efficacy (to whatever degree it may exist) is defined as the (statistically significant) difference between sham and real -- period. Whatever generalization we make about sham should be nothing more or less than what we say about efficacy. And efficacy is handled reasonably well in the lede. Let's not act as if sham is some new thing to be hashed out and weighted. 2/0, A1Candidate, Brangifer, Jaya-S, Doc James and Guy will know what I'm saying, even if you, QG, claim not to. --] <small>(] • ])</small> 11:56, 2 September 2014 (UTC) | |||
:::::::::: Utter rubbish. Efficacy is the extent to which a treatment has a positive effect. Period. You're confusing the fact that 'sham acu' (a placebo) is effective, as is 'real acu' for exactly the same reason. What you're not prepared to accept is that any attempt to explain a mechanism for differential action between sham and real will inevitably be laughed at as unscientific mumbo-jumbo. --] (]) 16:45, 2 September 2014 (UTC) | |||
:::::::::::Hi RexxS. Of course sham acu is effective! When I say "Efficacy is the extent...." I mean "efficacy beyond placebo", which is what researchers are interested in. Ask 2/0 or Brangifer if you don't believe me. And tone down your rhetoric please. --] <small>(] • ])</small> 17:08, 2 September 2014 (UTC) | |||
Fixed wording to reflect source -- ES self-explanatory, and I'm that any science-literate editors willing to look at the source will see that it's accurate. But this being Misplaced Pages, who can say if that will happen? --] <small>(] • ])</small> 08:01, 1 September 2014 (UTC) | |||
:A systematic review of ]s found real acupuncture was no better than sham acupuncture and concluded that their is little evidence that acupuncture is an effective treatment for reducing pain. | |||
:A systematic review of ]s of acupuncture for pain concluded that there is little evidence that acupuncture is an effective treatment, i.e. that real acupuncture may be no better than sham acupuncture. | |||
:You added . You recently to the lede and now you are doing it again. | |||
:The source does not say it "may be" be no better. The other part was also misleading and ambiguous. The source says "In conclusion, numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain." Please stop adding '''original research''' to the lede. ] (]) 17:01, 1 September 2014 (UTC) | |||
:::<small>Neither of those diffs is OR; please see your . --] <small>(] • ])</small> 08:41, 2 September 2014 (UTC)</small> | |||
::Thanks for accurately quoting his conclusion (see PMID 21440191). Why not cite that? I don't see any mention of sham in the conclusion or the abstract. --] <small>(] • ])</small> 04:33, 2 September 2014 (UTC) | |||
:::Sham acu is a worthy topic but this paper doesn't support what you seem to want to say. You've been pushing this sentence for months and arguing that Moffet, then Ernst support it, but they don't. --] <small>(] • ])</small> 04:36, 2 September 2014 (UTC) | |||
::::The part you added "may be" no better I could not verify. The current text is . You claimed . You had a discussion on ]'s talk page too. See ]. We already had a discussion about this. See ]. ] (]) 14:33, 2 September 2014 (UTC) | |||
::::Again why use wording that's not in the abstract or conclusion, and not supported by the text? Especially when you demand that others meet that standard? (Nothing against RexxS, but he was wrong in that case, and Imperfectly Informed was correct. There aren't two correct answers. We could go to RSN if editors here don't figure it out.) --] <small>(] • ])</small> 16:19, 2 September 2014 (UTC) | |||
::::: No, I was not wrong. No matter how many times you try to deny it, you can't invalidate the conclusions of a reliable secondary source that you dislike by making your own amateur analysis to try to discredit it. Ernst is never in any doubt that real acu is no better than sham acu and we all know that any differences are so small as to be insignificant both statistically and clinically. That's the correct answer and that's what should be reflected in the lead if we should need that much detail (which we don't). --] (]) 16:45, 2 September 2014 (UTC) | |||
::::::Sure you were wrong; you made several mistakes interpreting the paper in the original discussion, and this is another. See ]. And of course sham acu is sometimes better than real acu: the majority of the 57 reviews he studied were positive for acupuncture, if you recall. (Positive meaning "showing efficacy", i.e. "efficacy beyond placebo", i.e. "real acu being superior to sham to a statistically significant degree.) Read the lede; of course there's still some debate over efficacy, mainly for pain and nausea, although that may be due to artifact. --] <small>(] • ])</small> 17:14, 2 September 2014 (UTC) | |||
:::::::The source does not specifically state "sham acu is sometimes better than real acu". ] (]) 17:18, 2 September 2014 (UTC) | |||
::::::::Not in those exact words, no. But that's what it found. I cover all that and more at ], which I hope you and others find helpful. -] <small>(] • ])</small> 19:24, 2 September 2014 (UTC) | |||
:::::::::You want to replace verified text in accordance with V with your own SYN/OR interpretation? ] (]) 19:34, 2 September 2014 (UTC) | |||
I would like to restore the . ] (]) 16:48, 2 September 2014 (UTC) | |||
:To QuackGuru (and all editors here): Most humble apologies for my overwrite of your edit, QG! https://en.wikipedia.org/search/?title=Talk:Acupuncture&diff=prev&oldid=623878169] I would never, ever do such a thing intentionally. In this instance, the buttons on my trackball are a bit sticky, so I must have accidentally selected your comment, not realized I'd done so, and then deleted it as soon as I started typing. To make matters worse, Doc James ] what was the deal with that edit, and I simply explained the text I added, being sufficiently out of it that I didn't see from the diff that I'd actually overwritten QG's comment. Have been editing a lot today, obviously need a break. Apologies to all for the distraction and any misunderstandings caused. --] <small>(] • ])</small> 12:53, 3 September 2014 (UTC) | |||
::According to you got upset about my comment. That was your initial reaction after I you . You added OR research to the lede twice recently. Is this a ]? ] (]) 17:16, 3 September 2014 (UTC) | |||
:::No, QG, as I said I had absolutely no idea what I'd done until Jytdog clued me into what Doc James meant by posting on my page asking, rightly, what was the deal. I'm sorry you choose to take my apology in bad faith. I didn't agree with your post (hence that first diff you cite ) but I sure as heck didn't delete it on purpose! | |||
:::I'm very disappointed that in response to my apology you'd reply with a post like this, implying ulterior motive, and repeating an inaccurate allegation that I added "OR to the lede". It takes some gall for you to do that, frankly, because I posted on your user talk speifically refuting that exact same assertion. is the diff; short version: Please stop calling it OR every time an editor merely uses wording that is not your exact preferred wording, or is not verbatim from a source. There's this thing called "paraphrasing". | |||
:::I'm also disappointed that after I posted to Doc's user talk explaining my mistake, and he replied saying he was glad it was just a mistake, that you would then post there seeking to depict my mistake as intentional. Why are you doing this? I'll ]: what can we do to end this apparent bad blood between us? I posted a sincere olive branch to you last week , but you deleted it without comment . --] <small>(] • ])</small> | |||
I went ahead and . ] (]) 16:51, 2 September 2014 (UTC) | |||
:<small>QG, since you're insisting on rehashing past heat rather than light, I'll say this for the record: Now go back and read RexxS's hyperbole. My comments are WP:SPADE and comparatively quite tame. But why focus on old drama? Why not comment on the substance at hand? I've given ample food fr thought at ]. --] <small>(] • ])</small> 19:10, 2 September 2014 (UTC)</small> | |||
{{cite news| first = Alok | last = Jha | title = Acupuncture useful, but overall of little benefit, study shows | url = http://www.theguardian.com/science/2012/sep/10/acupuncture-useful-little-benefit-study| newspaper = '']'' | date = 10 September 2012|quote=<small>Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, said the study "impressively and clearly" showed that the effects of acupuncture were mostly due to placebo. "The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies. Several investigations have shown that the verbal or non-verbal communication between the patient and the therapist is more important than the actual needling. If such factors would be accounted for, the effect of acupuncture on chronic pain might disappear completely."</small>}} Here is another source where Ernst makes a similar point. This is the same author who wrote the 2011 source. See (PMID 21440191). ] (]) 19:53, 2 September 2014 (UTC) | |||
:''The Guardian'' doesn't meet MEDRS for claims on medical efficiency, so we are not using it. ] (]) 20:19, 2 September 2014 (UTC) | |||
::Do you disagree that this is the same author who made a similar point? ] (]) 20:35, 2 September 2014 (UTC) | |||
::(e/c)::@{{U|Jayaguru-Shishya}} - Well, the interpretation that has prevailed (and with which I've agreed) is that the source is Ernst himself (and the Guardian is considered reliable for reproducing his words), and per WP:SOURCES (I think), someone like Ernst can be an RS when self-publishing because he's an expert who has published under peer-review, as long as they're talking about their field of expertise (in which they've published). That said I am reconsidering whether such a quote is acceptable as a MEDRS (as opposed to RS) and leaning toward not. If Ernst really wants to refute that paper there's a way to do it: publish something. Colquhoun did, and we can cite that, and it says much the same thing, so deleting Ernst shouldn't be a big deal IMO. We should probably draw the line at MEDRS, and not allow Ernst, because otherwise we get an UNDUE problem whereby an expert's opinion is given the same weight as a carefully crafted MEDRS. In fact, the gold standard of MEDRS's: meta-analysis of individual patient data. Yes, I know the criticisms of Vickers are that the differences he find between sham and verum, though statistically significant, aren't clinically significant and may be artifactual (unblinding). Still it weighs, and significantly. After all, criticisms can be made of other MEDR's, such as their non-adherence to STRICTA, and we don't deprecate them nearly as much as Vickers has been deprecated. (Matter of fact, QG, some time back, fought the inclusion of nothing more than the ''four types of pain'' Vickers looked at. Vickers, a gold-standard source, the biggest and most exacting meta-analysis ever (AFAIK) for acu. Yet more double-standard. (whew -- need a timeout) --] <small>(] • ])</small> 20:37, 2 September 2014 (UTC) | |||
:::What Ernst said in the past and present has not changed. There is no debate over what Ernst said then. ] (]) 20:44, 2 September 2014 (UTC) | |||
::::Which is irrelevant to whether his comment is a MEDRS. (RS, yes, it is, but he is making a MEDRS claim in that quote.) Now, if he criticize Vickers in a more recent review -- which I may have missed -- then that supersedes the Guardian source. --] <small>(] • ])</small> 21:01, 2 September 2014 (UTC) | |||
:::::Exactly, exactly.... ] (]) 21:05, 2 September 2014 (UTC) | |||
===Arbitrary break for more input=== | |||
I've outlined the issue regarding Ernst '11 (PMID 21440191), and have filed at ]. (I don't remember if we discussed this there or elsewhere before but that does seem the best venue.) --] <small>(] • ])</small> 17:49, 2 September 2014 (UTC) | |||
:See ]. Have also explained the issue clearly at ], and remember, you can email me (or any editor with access) for a copy. Let's go for more light and less heat, fellow editors! -] <small>(] • ])</small> 18:01, 2 September 2014 (UTC) | |||
:Is Middle 8 long after the discussion was over? Not sure why you are . | |||
::Do you remember you had a discussion on ]'s talk page. See ]. We did have a long discussion on this talk page and at ]. ] (]) 17:59, 2 September 2014 (UTC) | |||
: If I understand the point being made, it is pretty straightforward. Many trials exist of acupuncture vs. sham or placebo, but proper blinding to the the controls is difficult if not impossible due tot he nature of acupuncture (e.g. the tendency to leave bruising for up to a fortnight afterwards, a dead giveaway). There's also the problem that negative results are virtually never published in the acupuncture / TCM journals, and most are published in China where there is a well documented systemic bias. You want to assert the primacy of the larger trials, despite the lack of any proven mechanism of effect. Ernst makes the point, quite forcefully, in numerous venues including this paper, that the positive results are weak and not getting any stronger, whereas increasingly sophisticated controls show ever more strongly that needling is ineffective (and this is additive to the finding that the location of needling is irrelevant, as expected form the absence of any empirical basis for the locations traditionally used, and lack of unanimity between traditions). | |||
: However, I find reading any argument by pro-quackery editors frustrating and I become impatient, so if someone could distil the actual question into a short sentence, I will email it to the source and ask (this is legitimate when it's a matter of clarifying our interpretation, rather than original research). <b>]</b> <small>(])</small> 19:39, 2 September 2014 (UTC) | |||
::@ {{U|JzG}}: Here's a better, simpler summation than the below: ''should we cite Ernst's statement "real acupuncture was no better than sham" as being the conclusion of his review ''per se'', or not.'' The statement appears in the first paragraph on p. 762 of PMID 21440191. | |||
::In context, it is apparent that his statement refers to some recent, high-quality ''trials'' that showed null results. Contrary to QG's reading, it does not refer to the ''reviews'' he looked at, and is not a general conclusion of his review. The majority of those reviews were actually positive for acu, but with numerous contradictions and caveats. That's why he said those result should be seen in light of recent, better trials. The highlighted text at ] illustrates this context, and the unlikelihood of QG's reading. --] <small>(] • ])</small> 05:09, 3 September 2014 (UTC) | |||
::: And the answer is: yes, undoubtedly. That is his settled view, and you can read his blog yourself for plenty more to that effect. You are playing semantic games, when to an outsider it is very obvious what he means, and it is not in the least bit flattering or supportive of acupuncture. <b>]</b> <small>(])</small> 21:55, 3 September 2014 (UTC) | |||
:::: @ {{User|JzG}}/Guy - We can get both the ] right without doing violence to either. That's the hallmark of a good encyclopedia. Did Ernst reply to you? I'd like to see exactly what you asked and what he replied. Thanks, --] <small>(] • ])</small> 05:00, 4 September 2014 (UTC) <small>edited for wl 05:07, 4 September 2014 (UTC)</small> | |||
:::::@ {{User|JzG}}/Guy - Another way to put it is, what does that phrase "real acupuncture was no better than sham" refer to? Answer: one particular trial authored by Suarez-Almazon et. al., 2010. And I know that the results of that trial are consistent with Ernst's overall (and unsupportive) take on acu . I apologize for not asking the question as clearly as I should have. But I am not playing semantic games: I'm reading the source correctly. Read the source carefully if you doubt that, and AGF. --] <small>(] • ])</small> 09:18, 6 September 2014 (UTC) | |||
:::::: Acu fans say "Even sham acupuncture works as well as the real thing! Acupuncture is amazing!" - whereas the reality based community has stripped away first placement of needles and then whether needles are even used, and it makes no difference to the outcome, meaning that acupuncture is a placebo intervention and the effects are due to the theatre not the needles. If you are wedded to the outcome, this is a Big Problem and you must find ways to wave it away. If you are wedded to the process - i.e. finding out whether a treatment is real or not and using only those that have definie specific efgfects - then you shrug your shoulders, stop using that treatment and move on. Science is not threatened by acupuncture, nor is it threatened by the finding that it doesn't work. <b>]</b> <small>(])</small> 13:00, 6 September 2014 (UTC) | |||
:::::::Yes, ''and?'' All this is obvious to me, and has jack-squat to do with reading the source. You've fooled yourself into thinking this is about POV-pushing, just as RexxS did. Since I ], the two people who have looked at the source -- 2/0 and Peter Coxhead -- agree with my reading. That number will inevitably increase; it's ''not'' a difficult call. The ONLY reason there's a debate is that QuackGuru is yet again insisting on his way, and another "skeptic" decided it was all about "taking sides" -- plus I posed the question unclearly because I was so annoyed with the situation, causing eyes to glaze over. ] is pretty clear though, and see ]. --] <small>(] • ])</small> 18:59, 6 September 2014 (UTC) | |||
{{cot|title=earlier, longer reply to Guy}} | |||
::@ {{U|JzG}}: (I hope you're not counting me as pro-quackery.) tl;dr: The question is simply one of context: what does the statement "real acupuncture was no better than sham" (the bolded sentence in the excerpt at ]) refer to: (a) the high-quality trials Ernst points to (whose negative results Ernst correctly predicted set the pattern for future high-quality trials) -- that's the right answer -- or (b) the findings of the 57-odd reviews that he reviews. (end tl;dr) | |||
::QuackGuru wants to cite all or part of that sentence as referring to (b), and by extension, all of the acu literature. But the literature, as we know, still has some reviews finding efficacy (however artifactual) for pain and nausea -- ''that's why there's so much controversy in the blogosphere'', right? If it were slam-dunk like homeopathy is, Steve Novella wouldn't be skewering the extant reviews finding for efficacy. This isn't about how I or anyone might ''want'' it to be, it's what ''is'' the meaning of Ernst '11 and what ''is'' the current state of the literature, which is what we're obliged to depict. I mean, come on, per WP:ENC we don't play fast and loose with the meaning of Ernst's paper, even if that sentence is "the spirit of where Ernst thinks things are headed" (which is the source of much of the confusion). --] <small>(] • ])</small> <small>abridged 20:14, 2 September 2014 (UTC)</small> | |||
{{cob}} | {{cob}} | ||
== Rearrange == | |||
Section under "effectiveness" should be rearranged in a logical manner, either alphabetically or by physiologcally. The current arrangement appears random and unsystematic. -] (]) 01:52, 1 September 2014 (UTC) | |||
:I think ] is best at arranging sections and articles. ] (]) 03:25, 1 September 2014 (UTC) | |||
::IMO the one with the best evidence should go first. This means that pain should go first. No strong feeling about the ordering of the rest. ] (] · ] · ]) (if I write on your page reply on mine) 04:37, 3 September 2014 (UTC) | |||
After pain, low back pain goes next. ] (]) 04:59, 9 September 2014 (UTC) | |||
==Time out: Academic centers, again, and a request== | |||
A that four editors thought was adequately-sourced has disappeared without explanation in a complex partial revert by QuackGuru . (Previous discussion ].) | |||
Controversial changes are part of the process, but don't bury them; do them individually. An editor watching the page wouldn't even know there was a wholesale deletion. The ES gave no clue -- -- and so many other changes are made that the character count actually increases. | |||
This isn't the first instance of a complex edit that combines good edits with controversial or poor ones. There's , discussed ]. Two editors asked QG not to do that again, but he re-did a large part of it anyway . Such edits are hard to follow, hard to discuss individually (or revert, should BRD apply), and they need to stop. | |||
For the sake of collaboration, is it asking too much for editors to discuss changes, and not make complex edits that mix together decent changes with dicey ones? And to make one major edit at a time and use accurate ES's? --] <small>(] • ])</small> 10:01, 1 September 2014 (UTC) | |||
:Addressing QG's objections: | |||
:* Re ]: As pointed out, websites of academic centers and their affiliates are reliable for saying which procedures they offer. | |||
:* Re QG's ES: -- spurious; subsection header is "Academic centers" which isn't US-centric, and we can fill in with content from other countries too, per 2/0 ]. | |||
:(I tire of QG's ]; see also e.g. ] where he attempts to argue a review article isn't a review article.) --] <small>(] • ])</small> 10:16, 1 September 2014 (UTC) | |||
:You added largely duplication and I found better sourcing. You don't need to use a bunch of primary sources. "Acupuncture is used at many places in the US, including ], ], and ]." The article already stated this. The text each country can go into each specific section for each country in the International reception. You need to stop adding primary sources when better sources were found. ] (]) 17:12, 1 September 2014 (UTC) | |||
::As pointed out at ], the sources are perfectly reliable to illustrate the use of acupuncture at academic centers. I restored the original edits concerning this area. Please try to seek for ] before making controversial edits. ] (]) 18:18, 1 September 2014 (UTC) | |||
:::Thanks, agree, and I improved on your edit per ES --] <small>(] • ])</small> 18:44, 1 September 2014 (UTC) | |||
:::Jaya-S is right: Calling the sites of universities or their affiliates "Primary sources" is in this case a spurious objection; the sites are reliable for services they provide. And I'm not convinced "Academic centers" shouldn't have its own section, and QG hasn't explained why, other than "US-centric bias". Why should reception only be organized by country, as opposed to group (e.g. doctors, different organizations)? --] <small>(] • ])</small> 18:46, 1 September 2014 (UTC) | |||
::::We have more sections than needed. Why a section for just one sentence when that can be dealt with in the section above. Have adjusted. ] (] · ] · ]) (if I write on your page reply on mine) 23:43, 1 September 2014 (UTC) | |||
===Request re: collaboration=== | |||
{{U|QuackGuru}}: Will you '''PLEASE STOP MAKING MULTIPLE MAJOR EDITS AT ONCE?''' And discuss them on talk, and use clear ES's? Without a clear diff, discussion and/or ES, it's virtually impossible to tell what you're doing! --] <small>(] • ])</small> 18:49, 1 September 2014 (UTC) <small>moved 04:06, 2 September 2014 (UTC)</small> | |||
: This is normal for QuackGuru, and I think the time has come to request escalation. Large-scale rapid fire editing, ]ership and a dismissive response to dissent are a long-standing problem with this editor. <b>]</b> <small>(])</small> 09:08, 2 September 2014 (UTC) | |||
::Yes, it is normal behavior for him/her and IMO it has been allowed to go on for far too long. Normal differences in POV are good for an article, but this sort of behavior has resulted in a seriously flawed article. ] (]) 12:04, 2 September 2014 (UTC) | |||
::: On the contrary, a lot of QG's edits are valuable in redressing the POV-pushing by SPAs in articles like this. Many of those would love to see QG removed from these articles because he's not prepared to sit back and see them owned by the SPAs and practitioners who have a vested interest in seeing Misplaced Pages give a positive spin to their subject. If you have a problem with a particular edit, then take it to talk. Remember that this page is for discussing improvements to the article, so if you think QG has violated policy, name that policy, find the diffs, and take it to dispute resolution. Time to put up or shut, not smear other editors with unspecific grumbles. --] (]) 16:56, 2 September 2014 (UTC) | |||
::::I'd be happy to see QuackGuru get some mentoring, say from Doc James or Kww, but dunno if they'd want to take it on. And I don't think my request to do edits one at a time is POV-pushing. "Unspecified grumbles?" See diffs above: ]. BTW, RexxS, your civility, coolness and lack of NPA continue to underwhelm.--] <small>(] • ])</small> 19:00, 2 September 2014 (UTC) | |||
::::: I do not think anything short of a binding restriction to a maximum mumber of edits per article per day will work. <b>]</b> <small>(])</small> 19:42, 2 September 2014 (UTC) | |||
:::::: I agree. Mass edits without a chance for discussion creates problems. It's not collaborative editing, and QG does this far too often. Your idea might work. Set some limit. -- ] (]) 04:39, 3 September 2014 (UTC) | |||
::::::: Mentoring or something to help improve talk page usage would also help. A lot. Want to paraphrase a source (generally a desirable thing per COPYVIO)? Prepare for round after round of ''"I could not verify the text"'' and ''"OR was added to the article"''. --] <small>(] • ])</small> 20:43, 3 September 2014 (UTC) | |||
== What is this really about? == | |||
What is this really about?! We are probably all various types of healers, and probably all want to see people's pain and dysfunction relieved...Let's have a section called "Acupuncturists' Experiences" where those experienced in this form of therapy can share case studies. And another section can be there called "Not Everyone Agrees", where people who are threatened by this modality can voice their negativity.] (]) 03:15, 3 September 2014 (UTC) | |||
: That would be great for a blog or private website, but not here. We are creating an article in an encyclopedia, and all discussion should be directed towards that end. This is not a forum. Read ]. -- ] (]) 04:41, 3 September 2014 (UTC) | |||
== Not superior to sham for low back pain symptoms == | |||
"Acupuncture is considered to be a form of alternative or complementary medicine, and as noted above, it has not been established to be superior to sham acupuncture for the relief of symptoms of low back pain." ] (]) 06:26, 4 September 2014 (UTC) | |||
: <s>A good source, which weighs, along</s> {{brown|Being a <s>case study</s>, a review of clinical practice with only a small part devoted to efficacy, and not a systematic review, this is not a very strong MEDRS relative to}} <s>with</s> our other MEDRS's on low back pain -- which are not unanimously negative. Some are more recent too I believe. | |||
:Remember, if MEDRS's were unanimously negative on efficacy this wouldn't be nearly as controversial a topic. But right now we have good MEDRS's finding for efficacy for pain (probably acu's most significant indication), and a lot of the dissent is in sources that aren't MEDRS or even clear-cut RS. That's a picture of a field with significant remaining controversy. I trust that is a common-sense observation.... --] <small>(] • ])</small> 07:00, 4 September 2014 (UTC) <small>edited: struck text and added {{brown|new text}} 04:55, 7 September 2014 (UTC); edited said new text again11:13, 7 September 2014 (UTC)</small> | |||
::This source is also good MEDRS. I don't get the objection. This is specifically for low back pain not pain in general. ] (]) 07:14, 4 September 2014 (UTC) | |||
:::<s>It's not an objection.</s> {{brown|I wasn't objecting when I thought the source was a meta-analysis.}} My second para is a general comment; my opinion on the source is in the first para. Yes, it's fine, again keeping in mind whatever other MEDRS's we have for low back pain. But remember that we treat low back pain as a subset of back pain: distinct in a sense but not wholly distinct. --] <small>(] • ])</small> 08:45, 4 September 2014 (UTC) <small>edited: struck text and added {{brown|new text}} 04:55, 7 September 2014 (UTC)</small> | |||
::::I noticed you are still a little apprehensive about including this. ] (]) 02:42, 6 September 2014 (UTC) | |||
:::::No, I just want to make sure we WEIGHT it properly. --] <small>(] • ])</small> 20:10, 6 September 2014 (UTC) | |||
{{OD}} | |||
"Real accupuncture is not superior to sham acupuncture for alleviating low back pain symptoms." I summarised the text and the preceding sentence is a proposal. ] (]) 02:43, 6 September 2014 (UTC) | |||
:I thought it was a meta-analysis, but it's not, is it? It's a case study. Weak MEDRS. Instead we should find whatever source they used for that statement, and use attribution wording just as we do with other reviews on pain (because MEDRS's on pain aren't unanimous, and we don't use a source to speak in WP's voice when equally-strong sources disagree). | |||
:BTW, here's a game: "Find a statement that's incorrect/UNDUE/out-of-context but sounds like it should be correct, and propose it. If no one objects, put the POV edit in the article. If someone objects, depict their objection as a POV-push." But you wouldn't do something like that, right? --] <small>(] • ])</small> 20:10, 6 September 2014 (UTC) <small>edited 04:55, 7 September 2014 (UTC)</small> | |||
::The source is a review. I don't know why you think it is a case study. ] (]) 05:02, 7 September 2014 (UTC) | |||
:::OK, I've got it in front of me. Yes it's a review of multiple aspects of clinical practice, no it's not a systematic review. They cite seven sources, two of which are systematic reviews; these are superior and we should use them as well. They also cite five primary studies. So it's MEDRS but lower weight than systematic reviews. And no we do not speak in WP's voice with a source that is inferior to other MEDRS's including ones that contradict it. --] <small>(] • ])</small> 07:51, 7 September 2014 (UTC) <small>edited 11:15, 7 September 2014 (UTC)</small> | |||
::::And it's not a proper summary of the paper; they're actually endorsing using acu for low back pain because it's "more effective than no treatment". And they review not only "Clinical Evidence" but also "Pathophysiology and Effect of Therapy", "Clinical Use", and other aspects. You appear very eager to get those words "real acupuncture... not superior to sham" in the article no matter what. But we let sources dictate wording, not the other way around. Your proposal is not unreasonable, but it's not the best way to summarize the source, either. What the reader needs to know about sham is that it's a control and that it involved either faux points of faux needling. IMO you need to follow sources more, and spend less time thinking of wording you'd like to see and then trying to find sources to fit it. | |||
::::So I propose that instead of copying and pasting the phrase you've been pushing for, we get a copy of this source to other editors and figure out how best to summarize it. --] <small>(] • ])</small> 08:17, 7 September 2014 (UTC) | |||
== Tags == | |||
Hello everyone! I've added a NPOV tag to your article because I see on the talk page that its content is and has obviously been under dispute for a very long time. Just to remind everyone, per Misplaced Pages policy, please do not remove the tag until the disputes have been resolved and there is consensus to do so. Also, I came here from the Countering Systemic Bias project page, and am also considering adding in a systemic bias tag but wanted to ask everyone's thoughts first. My hope for that tag is to attract other editors to the page that come from other cultural and linguistic backgrounds who can add something positive to your work here. I lived in Asia for several years and can read Mandarin and see much information I can add here. I would just go ahead and add it, but don't want to shame the article by over-tagging it. This can also be a talk page section where we can work to positively resolve the neutrality issues, and any input is welcomed. Thank you! ] (]) 20:04, 4 September 2014 (UTC) | |||
:For a new, unexperienced editor such bold moves are ill advised. ] (]) 20:18, 4 September 2014 (UTC) | |||
{{quote|The root cause of the problem is the false equivalence given to the views of anti-fluoridationists and the scientific community. The scientific consensus, by definition, incorporates all significant valid viewpoints. It develops over time in response to new data. In maters of science, the scientific consensus view is inherently the neutral point of view for Misplaced Pages purposes. To "balance" that with anti- views is to compromise fundamental policy.|]|{{diff|Misplaced Pages:Dispute resolution noticeboard|607604238|607603099}}}} | |||
:Quoted by ] (]) 20:22, 4 September 2014 (UTC) | |||
::Hi Tgeorgescu! What moves are you referring to? Certainly not the neutral POV tag, as from this talk page alone, we see many editors with many disputes over the neutrality of the article. The tag I added seems highly appropriate and I'm frankly baffled why I'm the first person to add it. Of course, your input is very welcome and I'm glad to have you participating in this discussion! Regarding your quote, I'm not trying to balance the scientific view with unscientific viewpoints, nor do I think any editors here are trying to do so. For example, if you look at this talk page above at A1Candidate's proposed additions, he has numerous high quality scientific sources he wants to add in to give a more well-rounded viewpoint here, and perhaps this section on the talk page can be used as a medium to discuss how best to add these in. And I do want to be bold, as that's Misplaced Pages's motto, but not overly bold which is why I haven't added the systemic bias tag yet. What are your thoughts on that? If you'd like to read our discussion, you certainly can at ] ] (]) 20:40, 4 September 2014 (UTC) | |||
:::re "and perhaps this section on the talk page can be used as a medium to discuss how best to add these in" -- agree 100%! --] <small>(] • ])</small> | |||
:: {{reply to|Tgeorgescu}} Adding a tag is ''not'' a bold move. A good-faith invitation for more eyes on the article is always to be welcomed. Your comment is somewhat ]-y imho ... not an outright bite, but a bit of a snap. :-) Completely agree that we need to make sure that the reasons for the tag are clear and fairly precise. --] <small>(] • ])</small> 00:20, 5 September 2014 (UTC) | |||
Disputed content doesn't necessarily mean there is a POV dispute. Note that in placing a tag you should follow the instructions at ], which includes "pointing to specific issues that are actionable within the content policies." In other words: what POV is being under- or over-represented, and why? It seems to me from the talk discussion above that the article's representation of efficacy is fairly neutral, though of course I could be mistaken. I've removed the tag for now pending discussion of this. ''''']''''' ''<font size="1.8">(])</font>'' 21:06, 4 September 2014 (UTC) | |||
:Thanks for pointing out that I've only been vague thus far as to what the disputes are. So far, we have he lack of inclusion of: | |||
*1)A1candiate's information he pulled up on acupuncture and placebo | |||
*2) Nocebo | |||
*3) Allergies | |||
*4) Mechanism of acupuncture (which directly contradicts the lede, thus the neutrality dispute) | |||
*5) acupuncture and the brain data (again giving a mechanism of action) | |||
*6) inclusion of arrhythmia information | |||
*7) the validity of Quackwatch as a source. I see the large blockquotes content is specifically disputed. | |||
*8) Middle 8 has unresolved issues with acupuncture and safety as it's stated in the article | |||
*9) a dispute about an encyclopedia on aliens and related subjects ought to be used as a source | |||
*10) Weight issues | |||
*11) For me, systemic bias issues. I see additional weight issues by putting sources using non-STRICTA, and NIMH-adopted reporting standards ion equal footing with studies/review articles that do. | |||
:And going back into this talk page's archives I see: | |||
*1) unresolved conflicts regarding "Strong Bias Toward Sceptic Researchers" | |||
*2) lack of inclusion of well-sourced information regarding Myofascial Meridians. By the way, the person proposing this contacted me about the merger of that article and this one. He's been banned so while I don't think merging them is likely, I do think the idea behind that unresolved dispute should be honored and some of the contents of that article be added into this main one. | |||
*3) lack of inclusion of many sources showing positive results for acupuncture (many times, and these are unresolved conflicts from the best I can tell) | |||
*4) a source in Nature which has been disputed many times and appears to be unresolved | |||
*5) Weight issues in the lede, such as cost effectiveness which appear unresolved | |||
*6) unresolved conflicts, from what I can tell, regarding inclusion and placement of information on adverse events in the article | |||
*7) lack of inclusion on a dopamine-modulated mechanism of action for acupuncture | |||
*8) lack of encompassing international studies (which is another instance of systemic bias) | |||
*9) Unresolved conflicts on the dispute of cherry-picked sources in the pain section, from what I can tell | |||
*10) unresolved conflicts on removal of information from Nancy Snyderman | |||
*11) and this list goes on and on. I'll add to it as we proceed and invite anyone else to do so as well! | |||
:Anyway, now that we have an active list, I see no reason why the POV tag shouldn't be added back. Let's get to work so we can get rid of this tag! ] (]) 22:12, 4 September 2014 (UTC) | |||
::Thanks for the list, but it's still unclear what you think the POV disputes are. Discussions about the inclusion of specific content or the reliability of specific sources, or just commenting that a particular issue is not resolved, do not mean that we have an NPOV issue. Many disputes on Misplaced Pages remain unresolved when discussion stops, and that isn't unusual. A few of the entries seem like they relate to the NPOV policy, but they still don't specify what actionable issues you're identifying, except perhaps #11 in the first list. As I asked in my previous comment, what POV or POVs do you think are currently over- or under-represented in the article? ''''']''''' ''<font size="1.8">(])</font>'' 23:21, 4 September 2014 (UTC) | |||
::: Keep in mind that, per ], the article is ''supposed'' to reflect the weighted sum of ]-compliant sources without inserting a ]. The banned editor to whom you are referring was not banned for no reason - if you rely on their summary you will get a skewed view. I would like to second Sunrise's request for specificity in your objections. If you make your case reasonably I am certain we can ]. - ] <small>(])</small> 23:37, 4 September 2014 (UTC) | |||
::::Agree. His is a really good start (more than a start), and certainly adequate to justify the tag (I've seen edit wars over tags in the past and am glad we haven't "gone there". There are no deadlines on WP, and as long as we're making reasonable progress (or are stalemated but actively recruiting new editorial eyes), the tag is fine. --] <small>(] • ])</small> 00:33, 5 September 2014 (UTC) | |||
:::::Thanks guys for your participation! Sunrise, your original response prompted me to go back into the archives here and I've found many more objections to neutrality on this article. I knew it was odd nobody added a POV tag before, indeed it ''was odd'' because this tag has been added before, many times. Not once do any of the issues appear to be resolved before the tag is removed, per policy. So I'm not breaking new ground by arguing for this tag, as much as I'd love to pat myself on the head. Regarding which POV is underrepresented, I think it's safe to say the sceptic POV is over-represented (as another editor said in "Strong Bias Towards Sceptic Researchers) and all other viewpoints are under-represented. This includes, but is not limited to, alternative medicine proponents, governmental bodies (such as the NHS, Federal Joint Committee, the CMBV, and many more)' acupuncture professionals (there is a notable lack of information regarding various acupuncture styles, such as Tung, classical, Japanese styles, Korean, only TCM which is the sole subject of both praise and attack in the article,( although there is a separate tag for this particular example)), whatever POV Middle 8, A1candidate, Herbxue, Jayaguru-Shishu, Bob MeeowCat and many others represent (as they seem to have continuous unresolved problems with some dominant POV's in this article), as well as systemic bias for multiple reasons I won't go into here, but if interested, anyone is welcome to go into Again, the systemic bias issue is somewhat different, which is why I was proposing the addition of a systemic bias tag as well. I'd love to hear any opinions on that as well! I may be wrong here, and if I am, I totally don't mind putting a POV-check tag on the article instead and invite others to come here and check things out on the NPOV noticeboard. Nothing hurts from having more peeps give us their opinion. Anyway, I hope I answered your questions well! I'm always glad for input! Peace! ] (]) 01:02, 5 September 2014 (UTC) | |||
::::::About the skeptical bias, ]. So remove skepticism and there is no science left. ] (]) 01:07, 5 September 2014 (UTC) | |||
:::::::Hey there Tgeorgescu! Glad to see you again bro. I apologize for confusion about skepticism. I was largely using another user's objection which I found in the archives of this here talk page, entitled "Strong Bias Toward Sceptic Researchers". I totally agree with you, skepticism is a scientific pillar. What I think that editor really meant is there is a strong bias toward cynical researchers and the cynical point of view. In the archives, I noticed that there was a dispute between the researchers Vickers and Ernst, where conclusions of one of these gents's work (I don't remember which one) was criticized as nothing more than a platform to make ad homiem attacks. If true, that would be cynicism, and the article would have undue weight if that viewpoint were given a larger platform than it deserved. Anyway, sorry for the confusion, I'm not at all suggesting we get rid of sources rooted in valid scientific inquiry. Peace! ] (]) 01:31, 5 September 2014 (UTC) | |||
:::::::: Hi LesVegas! I knew what you meant by "skeptical bias", and semantics aside, I don't think the term is all that unclear. Of course one cannot be too scientific or too skeptical when it comes to the rational study of objective phenomena. However, one can take a given conclusion too far in a certain direction, or give too much weight to one segment of the mainstream. When the trend apparent in the acu literature suggesting the null result is overgeneralized (or perhaps prematurely extended) to all the literature, and we start saying without qualification (or with insufficient qualification, relative to extant MEDRS's) that acupuncture is a placebo, that's an example of skeptical bias. When the consensus of scientific skeptics is taken as being identical to the mainstream consensus despite ther being no unified mainstream consensus -- particularly on the question of whether there is a place for acu in medicine -- that too is an example of skeptical bias. Welcome! I like your approach on this page. --] <small>(] • ])</small> 07:22, 5 September 2014 (UTC) | |||
::::I think LesVeges' list gives justification enough to keep the tag. We've still got quite a lot to improve with this article! Cheers! ] (]) 14:46, 5 September 2014 (UTC) | |||
OK, now that there seems to be some agreement about the use of this tag, I propose we start by resolving issue número uno on the list, A1candidate's proposal to rectify this info on acupuncture and placebo, specifically, this: | |||
* (2010) in '']'' with an impact factor of 1.846 | |||
* (2010) in '']'' with an impact factor of 2.183 | |||
"The first review found some evidence that "biological differences" exist between a placebo response and sham acupuncture. The second review concluded that "acupuncture is more than a placebo". Are there any recent reviews that suggest otherwise? " as quoted by master editor A1candidate, Misplaced Pages, 2014 ] (]) 01:38, 5 September 2014 (UTC) | |||
: Note that A1candidate has a reputation for misrepresenting sources. We cannot use anything they propose without thoroughly checking it first. That said, your idea to add more about the several different styles and traditions of acupuncture is an excellent one. I could see adding such material under #Clinical practice, or maybe #Theory or #History, depending on how we present it. Does that sound like something worth working at? - ] <small>(])</small> 12:21, 5 September 2014 (UTC) | |||
:::Great idea! While we're waiting to see about these sources and how to use them, we could get to work on the varying styles and traditions. Now, I must confess that I'm not a practitioner of this medicine, but I have bounced around in Asia for several years and learned about this medicine firsthand, and here in the US I've worked on some translation projects regarding the medicine so I know a few things and can probably help guide it along. We will likely need the input of any professional acupuncturists to fill in the details I will surely miss. So, I'm thinking we start by adding in information about Master Tung style which is a family lineage system, Japanese Acupuncture (which has many sub-styles and could even be an article unto itself), Korean style acupuncture, European styles, and perhaps classical styles based primarily on the Huang Di Nei Jing Su Wen which are sometimes also family type lineage systems, ala Jeffrey Yuen, and sometimes classical style is steeped solely in the literature. There's also the 5 Element style of acupuncture, which was a lineage system that comes from a guy named Worsley I believe. TCM is just one form, and it has it's own unique history which we could add into the article. Alright, I'm glad you're in support of adding this information! Are there any pro's who would like to oversee 2/0 and I to make sure we have the best possible information to add? ] (]) 00:21, 6 September 2014 (UTC) | |||
::: {{reply to | LesVegas}} Did you bother to read the section ''Pain''? It answers your "issue número uno" - Yes there are newer reviews that suggest otherwise and they are cited in that section. It's worth noting as well that Hopton & MacPherson (2010), the second source you want included is already used in that section to cite {{tq|"A 2010 systematic review suggested that acupuncture is more than a placebo for commonly occurring chronic pain conditions, but the authors acknowledged that it is still unknown if the overall benefit is clinically meaningful or cost-effective."}} Now have you got any specific wording that you want introduced into the article or shall I just remove the tag until you've done your homework and have got something useful to add? --] (]) 18:16, 5 September 2014 (UTC) | |||
::::Hi RexxS! Thanks for your posting here. Yes, I noticed the Pain Practice reference last night when I got to work on researching this and am glad to see you did as well. The reason I included this example as "numero uno" was not really because it's the change I wanted to see, but what A1Candidate wanted. I suppose we can ask him specifically how he wants that reference included, but I imagine he would like to see it in a section on placebo and/or cost-effectiveness as well, which is why he included it on this talk page earlier under 7. Outstanding Issues, 7.1 Acupuncture and Placebo. I'll go to his talk page and ask him! Peace! ] (]) 23:41, 5 September 2014 (UTC) | |||
::::::The effectiveness section also covers sources that mention placebo too. There is no need for another section when it is already discussed in the appropriate section. The source is already used in the ] section. ''A 2010 systematic review found it is unknown if the overall benefit of acupuncture is cost-effective.'' ] (]) 00:12, 6 September 2014 (UTC) | |||
:::::::Thanks QuackGuru! See what I told you about how you cite everything? That's perfect, and it'll help us alot. Now, I should mention that I tend to babble and only said cost-effectiveness because it seemed appropriate in my sanguine mouth. But A1candidate never said it needed to be added to that section, only implied that it should be added as information regarding the acupuncture and placebo. I'm assuming he either means adding a section on acupuncture and placebo, or adding the information to the existing section "Scientific View on TCM Theory". But I'll let him speak for himself on that outstanding issue. ] (]) 00:33, 6 September 2014 (UTC) | |||
=== The tag was removed multiple times === | |||
*1) The information on acupuncture and placebo was resolved. If a source was not added to the article yet that does not mean we need a tag for that. | |||
*2) Nocebo Which specific source? A tag is not needed to add one or two sources. What is needed it to let editors know which source may be applicable for inclusion. | |||
*3) All the sources for allergies were added to the article. | |||
*4) Mechanism of acupuncture was added to the article which does not contradict the lede. | |||
*5) Acupuncture and the brain data was resolved. They don't show the . | |||
*6) Inclusion of arrhythmia information. What source is specifically about acupuncture? | |||
*7) The validity of Quackwatch as a source was resolved. | |||
*8) The issues with acupuncture and safety as it's stated in the article was resolved. If it is too long we can start a new article titled ''Safety of acupuncture''. | |||
*9) A dispute about the Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy was resolved. | |||
*10) I don't see any unresolved weight issues. | |||
*11) The Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) (and the National Institute of Mental Health (NIMH)-adapted standards ion equal footing with studies/review) is covered by ], and ] and ] on Misplaced Pages. There is not a strong Bias Toward Sceptic Researchers. See ]. | |||
*12) The information regarding Myofascial Meridians using primary and fringe sources were inappropriate to use. | |||
*13) There is no lack of inclusion of many sources showing positive results for acupuncture? What sources? | |||
*14) The source in Nature was resolved. | |||
*15) The issues in the lede was resolved. | |||
*16) The text about adverse events are in the proper place in the article | |||
*17) There is no lack of inclusion on a dopamine-modulated mechanism of action for acupuncture The following sentence is in the article. ''Evidence suggests that acupuncture generates a sequence of events that include the release of endogenous opioid-like substances that modulate pain signals within the central nervous system.'' | |||
*18) There is no lack of encompassing international studies. For example, the Chinese journals were unreliable. | |||
*19) The issues with sources in the pain section was resolved. For example, the following source is already in pain. {{cite journal |author=Hopton A, MacPherson H |url=|title=Acupuncture for chronic pain: is acupuncture more than an effective placebo? A systematic review of pooled data from meta-analyses |journal=] |volume=10 |issue=2 |pages=94–102 |year=2010 |pmid=20070551 |pmc=|doi=10.1111/j.1533-2500.2009.00337.x}} | |||
*20) The removal of information from Nancy Snyderman was resolved. It was resolved when the unreliable source was removed. See ]. | |||
*From what I can discern, the dispute is mainly with editors who did not like what the reliable sources said. There is no consensus for a tag that was and removed multiple times. | |||
* {{cite journal|last1=Koog|first1=Yun Hyung|last2=Lee|first2=Jin Su|last3=Wi|first3=Hyungsun|title=Clinically meaningful nocebo effect occurs in acupuncture treatment: a systematic review|journal=Journal of Clinical Epidemiology|volume=67|issue=8|year=2014|pages=858–869|issn=08954356|doi=10.1016/j.jclinepi.2014.02.021|pmid=24780405}} | |||
* {{cite journal|last1=Enck|first1=Paul|last2=Klosterhalfen|first2=Sibylle|last3=Zipfel|first3=Stephan|title=Acupuncture, psyche and the placebo response|journal=Autonomic Neuroscience|volume=157|issue=1-2|year=2010|pages=68–73|issn=15660702|doi=10.1016/j.autneu.2010.03.005|pmid=20359961}} | |||
* {{cite journal|last1=Langhorst|first1=J.|last2=Klose|first2=P.|last3=Musial|first3=F.|last4=Irnich|first4=D.|last5=Hauser|first5=W.|title=Efficacy of acupuncture in fibromyalgia syndrome--a systematic review with a meta-analysis of controlled clinical trials|journal=Rheumatology|volume=49|issue=4|year=2010|pages=778–788|issn=1462-0324|doi=10.1093/rheumatology/kep439|pmid=20100789}} | |||
* {{cite journal|last1=La Touche|first1=Roy|last2=Goddard|first2=Greg|last3=De-la-Hoz|first3=José Luis|last4=Wang|first4=Kelun|last5=Paris-Alemany|first5=Alba|last6=Angulo-Díaz-Parreño|first6=Santiago|last7=Mesa|first7=Juan|last8=Hernández|first8=Mar|title=Acupuncture in the Treatment of Pain in Temporomandibular Disorders: A Systematic Review and Meta-analysis of Randomized Controlled Trials|journal=The Clinical Journal of Pain|volume=26|issue=6|year=2010|pages=541–550|issn=0749-8047|doi=10.1097/AJP.0b013e3181e2697e|pmid=20551730}} | |||
* {{cite journal|last1=Kim|first1=Tae-Hun|last2=Choi|first2=Tae Yong|last3=Lee|first3=Myeong Soo|last4=Ernst|first4=Edzard|title=Acupuncture treatment for cardiac arrhythmias: A systematic review of randomized controlled trials|journal=International Journal of Cardiology|volume=149|issue=2|year=2011|pages=263–265|issn=01675273|doi=10.1016/j.ijcard.2011.02.049|pmid=21421272}} I added lots of good sources to the article. ] (]) 20:14, 5 September 2014 (UTC) | |||
::Hi Quackguru! Thank you for contributing here, the more the merrier! I appreciate the amount of work you put into your post, and think you can be a valuable asset towards resolution here because I see you frequently put a tremendous amount of effort into making your points, and it appears you have a good deal of knowledge about the history of the disputes on this topic. I also see that you reference your points quite well on this talk page, and that's a big plus to any discussion. Clearly you have a passion for this subject and you put in a great deal of work towards your efforts. I see, for instance, on #17 that you provided an excellent reference to support your point. I didn't see what appeared to be a complete resolution on the talk pages, but then again I'm human and I may have overlooked something on that one issue. Would you be so kind as to provide sourcing for when/where exactly some of these other issues were resolved? No hurry, I don't want to overburden you, it will take time to resolve the issues where there is still clear disagreement. That way, we can all debate whether we feel like there has been a valid resolution, point by point, or not. If 3-4 feel like issue #10 is resolved and 3-4 feel like it's unresolved, well then the tag would still be justified, right? But if we all feel it's a non-issue, then we could go ahead and scratch it off the list and spend our time on other issues on the list. That's where I think you can be a tremendous asset to everyone here. | |||
::Regarding consensus for the tag, I very sorry but I must disagree with you as there are several other editors who support this tag. If all the issues had been resolved, these editors wouldn't support the tag. And in my opinion, we also wouldn't have had a history of this tag. But you did state that the POV tag was removed multiple times already( per consensus and not just some random single editor) and I will look into the edit history deeper to see who removed it, why it was removed, and what everyone's justification was for de-tagging the page and report these findings back here because I think they can be a great help in this current effort. And please feel more than free to disagree with anything I'm saying here. If you feel the inclusion of this tag to still be unjustified, you will have my full support to go onto the neutral point of view noticeboards and ask for an outside/third-party opinion. Again, I appreciate your response and look forward to working with you! ] (]) 23:22, 5 September 2014 (UTC) | |||
:::As an editor who has yet to weigh in here, I'm feeling the need to jump in now to count myself among those who do not support the POV tag. I know that there are a few outstanding issues, and in articles with this one there likely always will be, but I don't see that a case has been made here for the POV tag. Cheers, ] (]) 23:44, 5 September 2014 (UTC) | |||
:::: Hi Dawn Bard! I'm sorry I just now saw your post here. Thank you for contributing your POV about the debate on POV!. It is my understanding that the outstanding issues that are unresolved are the purpose of the tag, but I could be wrong. Anyway, I'm filing something on the NPOV noticeboard for clarification just so we know for sure. Again, I appreciate you adding to the debate here. Peace! ] (]) 03:50, 8 September 2014 (UTC) | |||
===The history of the tag=== | |||
Hey QuackGuru, I hope you're well! I apologize for just now getting back to you and everyone else on this, but I've been going through the acupuncture edit history, edit by edit, to see what the history of the neutral point of view tag removal was. In the process, I've learned a great deal about the history of point of view disputes on this page, and I also saw, as you stated, we have had tags and had them removed multiple times. Not because everyone worked out their differences on the talk page, but because one editor removed the tag, often saying that this page is "always under dispute, so there's no reason for the tag." Here are the diffs of the tag removal prior to the tag I put on the other day: and . Again, after finding these instances I went to the talk page to see if some semblance of consensus regarding the neutrality issues was achieved, and it wasn't. Under all three of these instances, that editor was you, QuackGuru. Now, please forgive me here because I promise I'm not trying to be argumentative whatsoever. I'm just trying to understand your reasoning here so we can all move forward and resolve this impasse. I may be completely wrong here, but my understanding behind the purpose of the tag to let readers know there is a debate going on, and that we need new editors to come to the talk page to help give a fresh perspective? And, I may also be wrong, but isn't there an accepted Misplaced Pages community protocol as for when to remove the tag? As long as the tag has merit, and a list of disputed items is provided, and there is a clear debate occurring, certain conditions must occur before the tag can be removed, correct? And those conditions are that 1)the disputes have been resolved, either by consensus or arbitration, and 2) there isn't an active debate occurring on the talk pages. Those are the conditions to remove a valid tag as I understand them. Again, my intention wasn't for this to be a "gotcha" moment. I'm only trying to understand what your reasoning is so that we can move forward. When you said "the tag was removed multiple times", I assumed the community as a whole removed it because certain conditions were met and the tag was no longer seen as needed, because the disputes had been resolved. I did not anticipate that you were the one who removed the tag multiple times, but now that I discovered this, I just want to understand your reasoning in case there is something I'm missing. ] (]) 02:58, 8 September 2014 (UTC) | |||
:You make a good point there, LesVegas. I can't find any ''"always under dispute, so there's no reason for the tag."'' from ], so I don't think it can be considered as a valid argument. I think the circumstances when the tag can be removed have been expressed by you clearly at ]. ] (]) 18:59, 8 September 2014 (UTC) | |||
== Failed verification? == | |||
Wiki-aricle: | |||
:''"Acupuncture is used at several{{FV}} academic medical centers,"'' | |||
QuackGuru : | |||
:''" Failed verification. How does the source verify the claim Acupuncture is used at "several" academic medical centers? Encyclopedic content must be verifiable."'' | |||
The given reference : | |||
:''"As it turns out, Johns Hopkins is coming late to the party. Acupuncture is already a fait accompli at many peer institutions—Mayo Clinic, Duke, Stanford, UCLA and at least a dozen others included. Most of these medical centers"'' | |||
So, verified. ] -] 19:25, 5 September 2014 (UTC) | |||
:The sources does not state it is only used at "several" academic medical centers. The source goes much beyond that. Acupuncture is used at '''many''' academic medical centers,... ] (]) 19:57, 5 September 2014 (UTC) | |||
::Please feel free to change it to "many" per the source. Seems straightforward. --] <small>(] • ])</small> 04:20, 6 September 2014 (UTC) | |||
== Whitewashing == | |||
in {{diff2|624338715|this edit}} Jayaguru-Shishya removed Gorski's well-sourced commentary on the reception of acupuncture in the USA without any hint in the edit summary: "So far, it seems you are the only editor having problem with the text. Please get consensus first for your further edits. See Talk:Acupuncture#Academic_centers". This kind of whitewashing of critical content by stealth is utterly unacceptable. If JS is only here to POV-push for an acupuncture article that has all criticism removed, he needs to be topic-banned from the subject. --] (]) 23:31, 5 September 2014 (UTC) | |||
''Acupuncture is used at many academic medical centers, including Duke Center for Integrative Medicine, the Johns Hopkins School of Medicine, Mayo Clinic, Stanford University School of Medicine, David Geffen School of Medicine at UCLA, Harvard Medical School, and Yale School of Medicine.'' The current wording is sourced in accordance with V. The previous text . I also fixed the wikilinks to the appropriate articles and added Duke. | |||
There is no basis for . See ]. ] (]) 23:45, 5 September 2014 (UTC) | |||
:Whoa, let's AGF -- I don't see Jaya-S attempting to whitewash. Jaya-S's ES references the section above ], in which I pointed out that acu is used at academic centers, which are mainstream. Indeed, Harvard, Yale and Stanford are as mainstream as it gets. That means acu isn't wholly fringe, which affects WEIGHT. We shouldn't preface mainstream use of something by saying "according to one scientist, the following is an example of pseudoscience": that's pretty far from NPOV! --] <small>(] • ])</small> 03:39, 6 September 2014 (UTC) <small>edited 05:54, 6 September 2014 (UTC), 06:00, 6 September 2014 (UTC)</small> | |||
::Gorski's comments are well-sourced and should go in but not with the wording in that diff (pre-change) . --] <small>(] • ])</small> 09:07, 6 September 2014 (UTC) | |||
::Remember what A1Candidate wrote above: 1b. '''What Harrison's says''' - "''Although methodological problems continue to plague acupuncture trials, belief has been growing even in academic centers that acupuncture may be effective''", as quoted directly from {{cite book|title=]|publisher=]|isbn=9780071748902|page=2-5 |date=2011}} (). --] <small>(] • ])</small> 03:39, 6 September 2014 (UTC) | |||
:::Meta-comment: And those views in academic centers are not incompatible with systematic reviews, if they're using acu ''for its non-specific effects''. Non-specifically, yes, it does make patients feel better. Both real and sham do that. If the question is "whether to refer", then the difference between sham and real isn't very relevant. <small>Maybe acu will evolve into a non-specific thing like massage. That's how I and a lot of my colleagues see it already. More than one of my profs has said candidly (in front of the whole class) that it doesn't really matter where you put the needles. Go figure. The TCM diagnostic system is mostly for herbs.</small> --] <small>(] • ])</small> 04:03, 6 September 2014 (UTC) <small>edited 06:00, 6 September 2014 (UTC)</small> | |||
:::Middle 8, you took the words out of my mouth. We have these renowned mainstream academic centers like Yale, Harvard and Stanford that use acupuncture. We don't have to filter the light through lenses of any color. ] (]) 11:08, 6 September 2014 (UTC) | |||
== Template POV: When to remove the tag == | |||
Hi guys, just so we're all on the same page here and there's no confusion, I wanted to post this information from ] on when to remove a tag: | |||
=== When to remove === | |||
This template is not meant to be a permanent resident on any article. You may remove this template whenever any one of the following is true: | |||
# There is consensus on the talkpage or the ] that the issue has been resolved. | |||
# It is not clear what the neutrality issue is, and no satisfactory explanation has been given. | |||
# In the absence of any discussion, or if the discussion has become dormant. | |||
Since #3 is clearly not applicable to this highly discussed page, and since #2 is not applicable since I listed the many outstanding neutrality issues, we have one way to remove the tag, which is to #1 resolve the neutrality issues with consensus. Now I know that may sound like an impossible task, but I believe everyone here is capable of collaboration. Now let's hold hands and sing Kumbaya! ] (]) 01:21, 6 September 2014 (UTC) | |||
:I agree. I don't see consensus to remove the tag, and edit-warring over a tag is VERY lame. There are good-faith and policy-based reasons to keep it, including integrating some of the sources A1Candidate has put forth. As I've said before, although A1C sometimes overstates the weight of those sources, they are MEDRS's, and properly weighted, generally should be integrated into the article. The tag invites more eyes, and more eyes are good: it's been hard to find a middle ground between excessively entrenched "pro" and "anti" acu views, and more than one very good editor has become disillusioned about that state of affairs and left. So let's get more eyes on this article and break the logjam. --] <small>(] • ])</small> 04:18, 6 September 2014 (UTC) | |||
:Agree. I can't really see why the template should not be there. ] (]) 11:10, 6 September 2014 (UTC) | |||
::If that tag is ''really'' that offensive to some, perhaps a compromise choice of a different tag would work. --] <small>(] • ])</small> 04:25, 6 September 2014 (UTC) | |||
A general note -- I'm really impressed with LesVegas's enthusiasm and being able and willing to provide specific ideas. ] been around for only two months, and that level of cluefulness and collaborative spirit is unusual in such a recently-joined editor. Once again, welcome LesVegas! Your contributions are very much appreciated! --] <small>(] • ])</small> 04:34, 6 September 2014 (UTC) | |||
] explained "" There is no need for any kind of tag. See ]. ] (]) 16:10, 6 September 2014 (UTC) | |||
:I should have gone a bit farther, actually, ] - not only do I not think a case has been made for the tag, but reading everything here, I ''do'' think a case has been made ''against'' the tag. Thanks to everyone who's participating here; it's clear a lot of effort has been made. Cheers, ] (]) 18:40, 6 September 2014 (UTC) | |||
I think that there should be a {{tl|alt-med}} template which implies a neutrality dispute, because it is implicit in any Misplaced Pages article touching on alternative medicine that it will either display a reality-based bias and thus be hated and reviled by the quacks that support the therapy, or it will not yet have gained attention from the reality based community and will therefore be non-compliant with NPOV. This may be a slightly cynical view... <b>]</b> <small>(])</small> 22:24, 6 September 2014 (UTC) | |||
:Bias can go in any direction if there are WP:OWN issues and tendentiousness; it all depends upon the balance of editors. True for any article. --] <small>(] • ])</small> 03:03, 7 September 2014 (UTC) | |||
{{od}}So anyway, trying to determine consensus re the issues for which the article was tagged. As Les Vegas pasted in from ], it's ok to remove once "There is consensus on the talkpage or the ] that the issue has been resolved." | |||
* No NPOV concern; don't need tag - QuackGuru, Dawn Bird, Guy (I think), 2/0 (I think), Tgeorgescu (I think) | |||
* NPOV concern; do need tag - LesVegas, Jayaguru-Shishya, myself, A1Candidate (I think) | |||
I may have missed a few, but even so I don't see consensus here. The reasons for concern are non-trivial: weighting of sources, specifically integrating A1Candidate's suggested MEDRS's, which do weigh even if A1C sometimes overestimates their weight. I would also add the concern of too much given to sources on adverse events. Kww, e.g., was dubious about putting <<5 known deaths in 10 years>> in the lede. | |||
The explicit purpose for that tag is new editorial eyes. Surely THAT cannot be a bad idea. In order to avoid edit warring I'm not going to put it back right away. In the meantime: is this reasoning flawed? --] <small>(] • ])</small> 09:07, 7 September 2014 (UTC) | |||
:Well, in general it's a bad idea to rely much on counting editors, because (as it is said) consensus is not a vote (], ], ]). But if the purpose is just to get new editorial eyes, an easy way around having to deal with this tag dispute would be to request input from a page like the NPOV noticeboard. ''''']''''' ''<font size="1.8">(])</font>'' 00:23, 8 September 2014 (UTC) | |||
:::{{reply-to|Sunrise}} - Certainly true that consensus isn't ''only'' about numbers, but numbers can factor in; it's hard for me to see how ca. 35-45% of editors with NPOV concerns is compatible with concensus. I'm not going to insist on it, but my understanding has always been that the default is to ''keep'' an NPOV tag when a significant number of editors have good faith and comprehensible policy-based concerns. Do you disagree with that understanding, or do you think the concerns I mentioned in my post above (beginning with "So anyway, trying to...") aren't relevant, or what? Happy editing, --] <small>(] • ])</small> 20:42, 8 September 2014 (UTC) | |||
::::Of course numbers can and do factor in, but they're never the end of the story. :-) Determining consensus is often pretty difficult - I have some experience as an RfC closer, and I would make two points: i) in a discussion as complicated as this one it might take hours of analysis for even the most experienced closers to determine a consensus, and ii) it is not that uncommon for consensus to be established even against the majority of editors in a discussion. I agree that the default is generally to keep a tag on the article if valid concerns have been shown, but then the question is whether the concerns are valid, and I don't think that has been established at this point. The POV tag is also somewhat of a special case that it pays to be cautious about, because it is so commonly misused as a "mark of shame." ''''']''''' ''<font size="1.8">(])</font>'' 21:54, 8 September 2014 (UTC) | |||
::Yeah Sunrise! That's a great idea. I'll request input from the NPOV noticeboard so we can get some clarification! Thanks for your valuable suggestions! ] (]) 03:17, 8 September 2014 (UTC) | |||
:::FWIW, my suggestion was that you could use it to draw attention to the article itself and any specific NPOV issues you see, and thus ''avoid'' dealing with a tag dispute. Tag disputes, not being directly related to article content, tend to be unproductive. The question you've posed at NPOVN might lead to a long dispute, but I wouldn't expect much to come out of it - we'll get a wider audience to look at the page, but it will be harder for them to contribute unless you can describe the issues that you see more clearly. ''''']''''' ''<font size="1.8">(])</font>'' 19:14, 8 September 2014 (UTC) | |||
::::{{reply-to|Sunrise}} -- agree, when concerns are pervasive and general it's hard to boil them down for a noticeboard. Hence in part my preference for a tag; editors can browse the page and jump in and ask. What we ''really'' need is an infusion of ca. a half-dozen science-literate editors seeking a "reasonable middle", as Jytdog put it, and who aren't here to fight either side of the alt-med wars. --] <small>(] • ])</small> 20:42, 8 September 2014 (UTC) | |||
:::::I agree in part, but I would add that if specific concerns can't be established, other editors won't be able to tell whether you have a point or not, and will probably be inclined to assume that you don't. I would also add that since the ultimate goal is to accurately reflect the RS, in some cases the article may reflect somewhere between any two positions but in other cases it will not - e.g. ] and ]. Whether or not that's the case here I can't say, since I don't really want to get deep into the article content myself, although my superficial analysis is that the article is at least fairly close to neutrality on most issues. ''''']''''' ''<font size="1.8">(])</font>'' 21:54, 8 September 2014 (UTC) | |||
::::::{{reply-to|Sunrise}} This is probably stale, but I'll comment just for the record. This is probably more granular than you said you were interested in, but if you don't want to consider this further, someone else may at some point. | |||
::::::I agree with your two points (mentioned above in the post starting with "Of course numbers can...."), and with your observation about ] as applied to articles like ]. The problem is that we have POV-warriors from the "skeptic" side who are eager to depict acupuncture research as being just as settled as that of ] (i.e. that it doesn't work), and who are objecting to NPOV-tagging even subsections of the article despite good reasons being given (see ]). | |||
::::::With acupuncture there is a real debate in the literature, even if one side is wrong. There exist MEDRS's of equal weight disputing whether or not acupuncture is effective for some types of pain and nausea; this is apparent in the lede and body. But the article is dominated by editors who take the stance that skeptic bloggers do -- that the MEDRS's finding for efficacy are all flawed -- and gives short shrift to sources finding that it works. If NPOV and VER mean anything, they mean that we should follow the debate as reflected in MEDRS's, not as depicted in blogs, many of which are barely V RS. | |||
::::::So that's some of the the context for my concerns expressed above in the post starting with "So anyway, ...". See also ], where editors Guy and QuackGuru object to simply specifying the kinds of pain a review examined, the former misusing ]'s reasoning. | |||
::::::Again, my comment is mostly for the record. I think that in almost any other topic area, the tag would be kept. In the current environment -- where, e.g., one editor is allowed to dominate the whole article with impunity -- it's not even possible to keep the tag alive, let alone engage the debate that it's meant to indicate. --] <small>(] • ])</small> 07:01, 15 September 2014 (UTC) | |||
== Low level details restored against consensus == | |||
"" Acupuncture is effective for the treatment of ''chronic pain'' and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture. The source says it was for ''chronic pain''. So why delete text what the source said? See ]. | |||
"We need to be sure not to imply this is for chronic pain in general either by specifying "kinds of pain" or enumerating those kinds. I prefer shorter, but it's no biggie." ] explained on January 4, 2014. | |||
The Vickers study was largely criticised by experts. Instead of deleting the controversial Vickers sources we reached a compromise with the wording. But now Middle 8 decided to add the extra details again. This when the previous discussion was against including it. | |||
We already had a discussion about the details for the Vickers text. The result of the discussion back in January 2014 was against including the extra details. See ]. ] (]) 01:39, 7 September 2014 (UTC) | |||
:"Consensus" at that time was ] and is likely to change. Sure been criticized, but the way to handle that is to weight the criticism adequately. This type of source is the gold-standard of meta-analysis: it uses individual patient data (cf. ). Yet we ] than multiple studies of rare SAE's in the pain section. This imbalance is primarily a result of your ] and POV-pushing and needs to change. | |||
::My proposal: {{tq|A 2012 ] of individual patient data conducted by the Acupuncture Trialists' Collaboration found "relatively modest" efficiency of acupuncture (in comparison to sham) for the treatment of back and neck pain, osteoarthritis, chronic headache, and shoulder pain, and on that basis concluded that it "is more than a placebo" and a reasonable referral option.}} | |||
:This is too sparse: | |||
::Your proposal: {{!xt|A 2012 ] conducted by the Acupuncture Trialists' Collaboration found "relatively modest" efficiency of acupuncture (in comparison to sham) for the treatment of four different types of ], and on that basis concluded that it "is more than a placebo" and a reasonable referral option."}} | |||
:So why omit the kinds of pain?? We give that detail for all our other reviews. Am tagging the efficacy section with Template:POV-section for this reason. --] <small>(] • ])</small> 02:41, 7 September 2014 (UTC) | |||
::::{{Reply-to|QuackGuru}} - I tagged that section at , and you removed it less than 24 hours later () without any comment here. That's completely inappropriate! --] <small>(] • ])</small> 06:32, 9 September 2014 (UTC) | |||
::::::It is inappropriate to add a tag that disputed an entire section when it was only a dispute over one sentence. ] (]) 06:37, 9 September 2014 (UTC) | |||
:::::::So improve it, put in a better one. Respect other editors' effort at WP:DR and don't be so OWN-y and revert so much. --] <small>(] • ])</small> 11:19, 9 September 2014 (UTC) | |||
::: We should omit the kinds of pain because there is no evidence that acupuncture is specific, and no reason to believe that the effect on subjective outcomes like pain is due to specific effects or indeed anything other than placebo effects and other confounders. <b>]</b> <small>(])</small> 08:49, 8 September 2014 (UTC) | |||
:::: {{reply-to|JzG}} That reasoning puts the cart before the horse. Yes, acu probably isn't specific, but the existence of MEDRS's like this is why the question is still debated. Even if/though you hate it, this paper passed peer review in a legit journal and found specificity to statistical significance, and weighs not insignificantly, because of the type of meta-analysis it is (). Anyway, other meta-analysis we cite, we say what type of pain it studied, and Vickers was basically four reviews in one. Also, I'm restoring the tag that QG inappropriately removed. --] <small>(] • ])</small> 19:57, 8 September 2014 (UTC) <small>edited20:27, 8 September 2014 (UTC)</small> | |||
:::::IOW: Misplaced Pages lags sources. How would you handle that with acu? Would you depict it as being as settled (per MEDRS) as homeopathy? --] <small>(] • ])</small> 01:05, 9 September 2014 (UTC) | |||
{{od}}''Funding/Support'':The Acupuncture Trialists' Collaboration is funded by an R21 (AT004189I from the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) to Dr Vickers) and by a grant from the Samueli Institute. Dr MacPherson's work has been supported in part by the UK National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0707-10186). The views expressed in this publication are those of the author(s) and not necessarily those of the NCCAM NHS, the NIHR, or the Department of Health in England." | |||
Was the study was funded or ran by alternative medicine promoters? Is the funding of NCCAM notoriously indicative of very shoddy research? Were they exposed in the ? ] (]) 22:19, 8 September 2014 (UTC) | |||
:NCCAM funding indicates nothing other than that it pisses off some people; no V RS impeaches it definitively, it's just one view. Per NPOV we cover all views, we don't suppress major ones, especially when they pass peer review and are published in a good journal. And Skeptical Inquirer lacks PARITY with that journal. Even if you found a MEDRS of comparable weight to Vickers that impeached NCCAM, all that would mean is that we'd give the former equal coverage. Nice try. --] <small>(] • ])</small> 11:19, 9 September 2014 (UTC) <small>(copy-edited, added sentence 05:34, 15 September 2014 (UTC))</small> | |||
==Explaining sham acu to the reader in lede== | |||
ES self-explanatory. We do need to tell the reader about both kinds of sham acu (faux needling and faux points). I made sure in this edit to explain exactly what it means when real is no better than sham, i.e. no efficacy. Also semi-boldly removed Ernst '11 with its inadequate depiction of context for statement re sham (it shouldn't be there anyway while it's being challenged; those who want it haven't met WP:BURDEN). (Now a certain editor may feel the need to evert, claiming this is OR....but please read on.) | |||
Anyway, never let it be said that I oppose discussion of sham in the lede, and what it means when real acu is no better than sham. All I insist on is proper sourcing, ''especially'' not distorting sources. Here, we manage to get the job done by simply paraphrasing existing sources on study design (and obvious scientific principles about controls) to present an uncontroversial explanation. If editors feel that more sourcing is needed, try adding a fact tag instead of reverting. After all we should be improving each others' edits whenever possible, and not edit-warring, right? --] <small>(] • ])</small> 13:08, 7 September 2014 (UTC) | |||
::To clarify, use of Ernst '11 in the lede is being discussed at ]. My objection is to citing it in the lede without saying what he's talking about (i.e., we shouldn't make it look like it's a general statement). Half of the people who have looked at it agree that Ernst's statement about sham is specifically about one paper, not the whole body of literature. Given that, I felt that those who wanted to keep it hand't met WP:BURDEN, so I removed it -- perhaps prematurely; I certainly didn't want it to lead to ]. --] <small>(] • ])</small> 12:53, 8 September 2014 (UTC) | |||
:Are continuing to edit against consensus? You are continuing to try to rewrite or delete the same sentence. This is going on far too long. Now you replaced sourced text with . You have a you are repeatedly adding OR to this article. I will stop calling your edits original research when you stop adding original research to this article. ] (]) 18:00, 7 September 2014 (UTC) | |||
::Well, SYN ''is'' a kind of OR. How is what I wrote OR? Its a rudimentary explanation of study design. --] <small>(] • ])</small> 03:25, 8 September 2014 (UTC) | |||
::In my impression, it is typical for you to call every edit that doesn't please you as OR. I can tell that from my own experience when you have failed to explain even I have asked you. You must learn to explain why you consider some specific edit as OR. That kind of editing is not helpful even despite of the good intentions. ] (]) 19:46, 8 September 2014 (UTC) | |||
:::You were previously for when you made an to the lede on 31 August 2014. You made on 7 September 2014 and here we are again at the talk page. For starters, I previously explained that the part "that indicates a lack of effectiveness" was SYN/OR. I assume you read my comment when you made but you still . Your edit was also not a summary of the body in accordance with lede. Do you agree you will stop adding original research to this article? ] (]) 03:47, 8 September 2014 (UTC) | |||
::::Right, Doc James that needed a reference, so in I used Madsen as a ref (for sham as faux needling), and fact-tagged the other bit about sham at faux points (which should be easily findable). What's the problem? | |||
::::Re OR, you're saying that this is OR: "when real acupuncture is found to be no better than sham acupuncture, that indicates a lack of effectiveness (i.e., compared to placebo)." WHAT??? Sham acu is the placebo! So my statement is the same as saying "when a treatment is no better than a placebo, the treatment is ineffective," which is about the same as saying "the sun is a big bright ball in the sky!" | |||
::::I will address the diffs you cite above in another post. --] <small>(] • ])</small> 10:56, 8 September 2014 (UTC) | |||
::::QuackGuru, you are making '''untruthful claims''' here. You said: "''For starters, I previously explained that the part "that indicates a lack of effectiveness" was SYN/OR.''", but when taking a look at at the diff, '''you do not explain anything'''. Why do you do this? In that diff you merely repeat your opinion that it was SYN/OR. '''Where are the explanations that it is SYN/OR'''? Not only you fail to communicate yourself here, your diffs are misleading and disrupting the development of this article. ] (]) 19:46, 8 September 2014 (UTC) | |||
:::::https://en.wikipedia.org/Acupuncture#cite_note-Madsen2009-13 | |||
:::::That text for Madsen2009 is in a note towards the bottom of the page. It does not belong in the lede. | |||
:::::This is the first sentence: ''Acupuncture (from Latin, 'acus' (needle) + 'punctura' (to puncture)) is the stimulation of specific acupuncture points along the skin of the body involving various methods such as penetration by thin needles...'' | |||
:::::The text for non-acupoints does not belong in the lede and the reader already knows that acupuncture is stimulation at acupoints. Therefore, at non-acupoints it is not traditional acupuncture. | |||
:::::The part "when real acupuncture is found to be no better than sham acupuncture, that indicates a lack of effectiveness (i.e., compared to placebo)." is OR and had no citation at the end of the sentence. Do you understand now that you are replacing sourced text with OR and with text that did not summarise the body? The previous wording was sourced and is a summary of the body. ] (]) 15:31, 8 September 2014 (UTC) | |||
:::::::{{reply-to|QuackGuru}} - Re Madsen, it sounds like you're objecting to my making a change simply because it changed something you'd written earlier. Madsen is a source explaining what sham is, and my edit used it that way, while you used it as a footnote. Either is acceptable. Yes, sham is different from real acu, and is a control, hence the need to explain the difference to the reader, since research is a hot topic. (There being two kinds of sham: faux needling and faux points.) | |||
:::::::QG, no, I don't agree with you about your take on OR. Paraphrasing a source or explaining how a simple concept like a ] works with acu is ''not'' OR. --] <small>(] • ])</small> 20:19, 8 September 2014 (UTC) | |||
::::::Sham is placebo. We don't need a source for that, just like we don't need to cite Galileo Galilei when we say that the world is round. '''QuackGuru, you have been notified by admin NuclearWarfare already before about not getting stuck with specific wordings'''. You show complete incompetence to paraphrase sources when it comes to your comments. It's not helping to develop the article. ] (]) 19:46, 8 September 2014 (UTC) | |||
:::::::{{reply-to|Jayaguru-Shishya}} - Great analogy! BTW, I agree (entirely!) re the importance of not getting stuck over specific wording, but I don't read the diff from NW as commenting on QG's wording. --] <small>(] • ])</small> 20:06, 8 September 2014 (UTC) | |||
::::::::Oooh, perhaps I have understood something wrong about it? :O I guess I have to take another look. ] (]) 20:21, 8 September 2014 (UTC) | |||
I previously explained ''The part "when real acupuncture is found to be no better than sham acupuncture, that indicates a lack of effectiveness (i.e., compared to placebo)." is OR and had no citation at the end of the sentence.'' Middle 8 claimed "QG, no, I don't agree with you about your take on OR." Middle 8 was not paraphrasing a source and the edit violated lede. See ]. ] (]) 22:06, 8 September 2014 (UTC) | |||
:@ QG - I already explained my view re OR and will only add that we have plenty of sources on study design and don't need to source every statement in the lede, especially obvious ones. CIR? Give me a break; you totally misread OR. --] <small>(] • ])</small> 11:21, 9 September 2014 (UTC) ...... comment moved to proper section 11:29, 9 September 2014 (UTC) | |||
::A study design in not a summary of the body and the edits were largely OR. The previous version before your edit was sourced. Your view on OR is to ]? ] (]) 15:48, 9 September 2014 (UTC) | |||
:::Not ''"a"'' study design. The general concept of a ], as underlies all sham studies, where sham is the placebo control. --] <small>(] • ])</small> 16:20, 9 September 2014 (UTC) | |||
===Important: Could you clarify?=== | |||
Hi QG, this is important, so please read it and respond. | |||
At WT:MEDRS you wrote: | |||
:"To clarify, we do cite the not the older source for the text. We usually don't use randomized controlled trials (RCTs) as good MEDRS. We typically use the reviews who cite the RCTs and/or other sources." | |||
First question: This sounds like you're acknowledging that when we cite Ernst '11 in the lede, we are citing it as a summation of what Suarze-Almador is saying, as opposed to his summary of the literature as a whole. Is that true? If not, could you explain your reasoning? | |||
Second question: Would you please answer my question from WT:MEDRS, regarding your quote above -- and if not, again, could you explain your reasoning? Here: | |||
:"Are you agreeing that Ernst's statement "real acupuncture was no better than sham" can be cited for Suarez-Almazor 2010 and only for Suarez-Almazor 2010? If you and other editors agree, then we can close this. (In no way to I dispute what )." | |||
Thanks! Since you're accusing me of misconduct at Kww's user talk, I'm sure he (let alone I) would very much appreciate seeing a straight, clear answer from you, in order to know you're being clear and aboveboard. We all want to de-escalate and avoid drama, and open communication is the best way to do that. Feel free to either answer here or just cut and paste this and reply at my user talk. Also for question #2, obviously, please go ahead and reply at WT:MEDRS. But please don't ignore either question.... they are very important, imo, to WP:DR right now. --] <small>(] • ])</small> 12:11, 8 September 2014 (UTC) | |||
The above was to . | |||
:We should cite the 2011 systematic review of ]s for the text not the older source or another source. See . It is irrelevant to this discussion on Misplaced Pages what Ernst is citing for his conclusion. We should not continue to second guess MEDRS compliant sources and we should not use another source such as Suarze-Almador to cite the text. ] (]) 15:31, 8 September 2014 (UTC) | |||
::{{reply-to|QuackGuru}} QG, sorry, I don't understand what you mean. Both questions are "yes" or "no" questions. Could you start by stating "my answer to Middle 8's question one is and my answer to Middle 8's question 2 is ", and then briefly explain your reasoning if the answer to either is "no"? I'd appreciate that very much. I ''think'' the answer to both may be yes, and we disagree on how to frame Ernst '11 in the lede, but I want to be sure. Thanks for your help here. --] <small>(] • ])</small> 19:50, 8 September 2014 (UTC) | |||
:::{{cite journal|last1=Suarez-Almazor|first1=Maria E.|last2=Looney|first2=Carol|last3=Liu|first3=Yanfang|last4=Cox|first4=Vanessa|last5=Pietz|first5=Kenneth|last6=Marcus|first6=Donald M.|last7=Street|first7=Richard L.|title=A randomized controlled trial of acupuncture for osteoarthritis of the knee: Effects of patient-provider communication|journal=Arthritis Care & Research|volume=62|issue=9|year=2010|pages=1229–1236|issn=2151464X|doi=10.1002/acr.20225|pmid=20506122}} | |||
:::{{cite journal|last1=Ernst|first1=E.|last2=Lee|first2=Myeong Soo|last3=Choi|first3=Tae-Young|title=Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews|journal=PAIN|volume=152|issue=4|year=2011|pages=755–764|issn=03043959|doi=10.1016/j.pain.2010.11.004|pmid=21440191|url=http://www.researchgate.net/publication/50866673_Acupuncture_does_it_alleviate_pain_and_are_there_serious_risks_A_review_of_reviews/file/504635268b703595fc.pdf}} | |||
:::What specifically does Ernst's statement "" refer to? It is not applicable to improving the acupuncture page whether Ersnt cited the Suarez-Almazor 2010 source for the text. | |||
:::First question: It is completely irrelevant what Ernst cited. We don't question reliable sources. | |||
:::Second question: According to MEDRS we cited recent reviews not RCTs or primary sources. We are using Ernst 2011 as . | |||
:::According to your ] you think we should not use Ersnt 2011 for sham verus real acu or it seems you think we should add context that is your own personal interpretation or add unsourced text to the lede. There is a footnote that explains what sham is. It is not a summary for text in the lede. ] (]) 22:06, 8 September 2014 (UTC) | |||
::::@ QG - (see below re your ]-ish "disruption" allegations.) See, I was hoping you'd just give a straight answer, not dodge the question by saying {{brown|"It is not applicable to improving the acupuncture page whether Ersnt cited the Suarez-Almazor 2010 source for the text."}} It's this kind of unwillingness to have a simple dialogue that frustrates consensus-building, and is why I sometimes ]: to ''try'' to get a productive discussion moving. | |||
::::It makes a big difference what Ernst is referring to when he says "real acupuncture was no better than sham". Context matters, and to argue that it doesn't is not only tendentious, it's absurd. We can't just pick any statement made by Ernst in that review and then say "Ernst said that"; that's obvious. And of course we ''do'' say in the body that Ernst's statement is about more recent trials (actually just Suarez-Almador), so I think you know it is relevant. | |||
::::I'm not saying Ernst is endorsing acupuncture at all; 2/0 got it exactly right at WT:MEDRS, and I agree Ernst's prediction is clear, is consistent with Suarez-Almador, and has largely proven correct. Nor do I want to keep sham out of the lede (obviously, per my last edit that ]). I'm just saying, let's get it right, per ], and provide context. | |||
::::All this argument over such a basic thing! No wonder most editors don't stick around here! --] <small>(] • ])</small> 12:24, 9 September 2014 (UTC) | |||
:::::To clarify: If we ''were'' to cite any given statement without context, we'd get contradictions: e.g. Ernst also said {{tq|"The majority of the early reviews arrived at negative conclusions , while the majority of the 57 recent reviews were positive."}} That statement and the statement "real acupuncture was no better than sham" cannot both be true about the same thing. And of course the former (green) statement refers to the dataset (the 57 reviews) while the latter refers to the more recent trial by Suarez-Almador. So of course we need to say, in the lede, what Ernst's latter statement is referring to, and that's why Vzaak's bold compromise edit was ]. | |||
:::::So here I am, explaining how ''context matters'' to the editor who just said that it didn't. I doubt that you actually believe your statement {{brown|"It is not applicable to improving the acupuncture page whether Ersnt cited the Suarez-Almazor 2010 source for the text."}} But the kind of disingenuous tendentiousness exhibited in your comment attracts no warning from admins. I know very well that some admins read these exchanges. Apparently, striking a "skeptic" pose allows an editor to get away with actions that harm the encyclopedia: in this case, allowing a content error to remain in the lede. --] <small>(] • ])</small> 06:03, 15 September 2014 (UTC) | |||
::::@QuackGuru -- I'll discuss those "disruptive" diffs of mine that you posted . First consider how dramatically you've affected the editing environment for anyone else here; see ''''''. You have 206 mainspace edits since May 29th. That's more than the next 10 editors ''combined''. You dominate the article and you are not helpful at talk. Sometimes you don't reply, while ignoring other editors' concerns in mainspace: see ], and ], and ]. Or you reply inadequately, e.g. refusing to answer a simple question just above. Or you use the talk page in just plain odd ways, like ]. | |||
::::Under those circumstances, the occasional bold edit makes sense: see ]. But you revert and ''then'' say I'm editing against consensus? Dude, a great deal of the "consensus" here is just you! Maybe the real problem is that I'm challenging your "ownership" and that pisses you off. | |||
::::So here are the diffs, ''', , , ''' and '''.''' (xx is a duplicate of B). | |||
::::* 8 July, '''''': Bold and justified, and worked out well: Triggered a debate resulting in another bold edit by Vzaak , which was accepted; see talk: ]. Vzaak's edit: "A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which found that for reducing pain real acupuncture was no better than sham acupuncture." Addresses my concerns re context in the lede nicely (cf. above) and was fine by others too. You liked Vzaak's compromise also; your words: "It is a good compromise with the in-text attribution." (Why the change of heart since?) | |||
::::* 27 August, Doc James , being (almost certainly) unaware of earlier discussion & consensus. 30 August, I notice that and ''revert back to consensus version by Vzaak'': . 31 August, Doc reverts again and opens discussion above at ]. I join discussion and make mildly bold edit '''''', which is my first edit attempting to define sham for the reader and explain the simple concept of placebos and efficacy -- the stuff you think is OR. However Doc James once again reverts, wanting a source , which I assume was meant for the two types of sham. | |||
::::* On 1 Sept, I make a moderately bold edit, ''rewording to satisfy Doc James while being faithful to the spirit of Vzaak's compromise'': edit '''''', i.e. {{tq|A systematic review of ]s of acupuncture for pain concluded that there is little evidence that acupuncture is an effective treatment, i.e. that real acupuncture may be no better than sham acupuncture.}} This is a different angle, a shorthand way of describing Ernst's feelings that the results of newer trials may well generalize to future research; my ES implies this but could've been clearer. Pretty simple idea, that in the future we may see the general result of real = sham.... but given your highly literal and narrow take on OR, you disliked this, of course. And less than 9 hours later, you reverted , and complained at Talk about how we'd covered this, somehow forgetting about Vzaak's compromise edit that we all liked (except Doc James who wasn't around for the discussion). At this point, I file at ] and continue to discuss ]. | |||
::::* 7 September: Again to break an impasse I try a bold edit, this time ''improving on my edit '''B''' by using a source per request'': edit ''''''. This was like B except: (1) it partly sourced sham, using Madsen, which you'd added as a note to the header about sham as faux needling. (Yes, I know I changed your note around... it's a wiki). (2) I fact-tagged the other aspect of sham (faux points); not a disputed concept. (3) Removed Ernst's wording entirely -- and this I would ''not'' have done in hindsight, but the whole business of WT:MEDRS had me wikistressed and not thinking clearly. After "sleeping on it" I actually decided to self-rv, but you'd already done so. It would have been better to somehow retain the spirit of Vzaak's compromise, and I stand corrected, or rather reverted. | |||
:::: So all these edits are good ones, except part of '''D''' where I the outright removed of Ernst '11 rather than improving wording. I'm obviously sticking close to the consensus version and I'm improving rather than reverting outright. Yet you don't recognize good edits; you see only someone ''doing it differently than you'', which you can't stand. | |||
:::: Why is it bad when I make changes, but not when other editors do? Others are outright reverting more than I am. Why do I get the special treatment of your clamoring to take me to AE? | |||
:::: Finally a general note: We need to remember that a certain amount of good-faith reverting is inevitable, and doesn't somehow "disrupt" the article when it's non-combative and infrequent, as here. ''In that situation'', "disruption" just becomes a convenient excuse to go after "undesirable" editors (which is a bit reminiscent of when cops in places like ] arrest people for "trespassing" in public places, or "disorderly conduct" for peaceful gatherings). | |||
:::: So overall there's no disruption except in the world where you, QG, own this page and any challenge to your ownership is intolerable. You need to de-escalate with me specifically; don't ever do this selective evidence thing with me again . And you need to disengage from your extreme ownership of this page imo. --] <small>(] • ])</small> 16:24, 9 September 2014 (UTC) <small>copy-edited 06:09, 15 September 2014 (UTC)</small> | |||
::::::Don't worry, another user who quickly stopped by at the article, he also noticed the same thing. :-) ] (]) 17:31, 9 September 2014 (UTC) <small>This comment originally came right after the final bullet point in my post above dataed 16:24, 9 September 2014. Moving it so that it's not splitting latter comment --] <small>(] • ])</small> 22:23, 15 September 2014 (UTC)</small> | |||
The text for the systematic review of systematic reviews was redundant. It was simplified into one sentence rather than have two separate sentences. The edits by ] did not improve the page. Ignoring ] and ] is not productive. ] (]) 16:33, 9 September 2014 (UTC) | |||
:And that comment takes the cake for IDHT, given how you just repeated yourself about those diffs so quickly after I discussed them in detail and refuted your claim. And no, omitting context is not redundant. Later. --] <small>(] • ])</small> 16:44, 9 September 2014 (UTC) | |||
:And those five diffs, how do they not improve the page? How do they ignore ]and ]? The thing that's not productive here is you. If you do not have the capability to communicate yourself, I'd advise you to choose an easier topic. I do assume good faith with you, but "''The proverbial bull in a china shop might have good intentions, but he's clearly bad for business.''" ] ] (]) 17:36, 9 September 2014 (UTC) | |||
::I was not responding to your specific comment above. I was making a note about the redundant text and to explain to other editors that your edits violated V and LEDE. Middle 8 continued to violated original research and LEDE but does not acknowledge his mistakes. The reason he rearranged the part that is because he thinks the source . But the text is obviously sourced. ] (]) 16:51, 9 September 2014 (UTC) | |||
== Outdated reviews in the article == | |||
Greetings! I tagged the source "Ernst, E. (2006)" for being outdated per ]. The tag was first removed by 2/0 per "''thank you, but this is a statement of history, not medicine; minor gmr''", even it is used in the text to support claims on medical efficiency. The text says: | |||
<blockquote><p>"Ernst also described the statement in a 2006 peer reviewed article as "Perhaps the most obviously over-optimistic overview ", noting that of the 35 conditions that the WHO stated acupuncture was effective for, 27 of the systematic reviews that the WHO report was based on found that acupuncture was not effective for treating the specified condition."</p></blockquote> | |||
This can be found from the original review under the title "''Clinical effectiveness''". I don't really see why this would be about history, not efficiency. Anyway, the tag was later restored by user LesVeges until it got removed again by QuackGuru per "''The source is a review and reliable.''". QuackGuru, exactly. According to ]: | |||
<blockquote><p>Look for reviews published in the last five years or so, preferably in the last two or three years.</p></blockquote> | |||
The source is a 2006 review used for claims on medical efficiency, and therefore it's outdated. The review is also used at the Efficiency section. I think the source should be removed and we should look for more up-to-date sources instead. :P ] (]) 10:45, 10 September 2014 (UTC) | |||
: <small>Efficacy section</small> | |||
: That particular statement is describing that particular WHO report and the state of research at that point in time. The text does not seem to be misleading. No opinion on other uses of the source. - ] <small>(])</small> 10:54, 10 September 2014 (UTC) | |||
::Isn't that what you can say on every mention of an outdated source? "''Well, it reported the state of research at that point in time''"? Science is accumulative in nature, and like ] puts it, we should only use sources that are recent enough. I'd understand something like: "''In the 1930's it was still believed...''", but now we are dealing with a 2006 review in the Journal of Internal Medicine. The review goes about the medical efficiency, and as such it is used in the article. Not just the review is outdated, I wonder why we are including such statements in the Ethics section? ] (]) 11:32, 10 September 2014 (UTC) | |||
::: You seem to be ] my position. | |||
::: More productively, do you have a suggestion for replacing each instance where the source is used? - ] <small>(])</small> 12:08, 10 September 2014 (UTC) | |||
::::2/0, sorry if you feel like I was misreading your position, that wasn't my intention. To answer your question: no, I don't have anything to replace the source. As I said earlier, I think the source should be removed as an outdated one ''when it is used for claims on medical efficiency''. If someone finds newer sources to support these claims, they'd be more than welcome. For statements like "''Clinical practice varies depending on the country.''", I think it suits just well. ] (]) 13:16, 10 September 2014 (UTC) | |||
:::::You are continuing to tag even after consensus was reached the . ] (]) 16:59, 10 September 2014 (UTC) | |||
::::::QuackGuru, I'm very sorry but I have to agree with Jayaguru-Shisha on this one. Again, I appreciate how you cite everything you say on this here talk page, but in this instance I checked your links and don't see where any consensus was reached about this source. That's not the source he is talking about, it appears to be an older argument. I'm sorry if I'm mistaken when reading your link, but I see a different source that a few editors agreed upon, not this one. We need to tag sources older than 5 years and remove statements if they cannot be backed up with more recent sources. They may have been reliable in the past, but science moves fast and they are outdated now. You seem reasonable so I'm sure you can agree that we don't need any fossils decaying the page. ] (]) 03:45, 11 September 2014 (UTC) | |||
::::::::We don't tag and delete sources just because they are older than five years. ] (]) 03:50, 11 September 2014 (UTC) | |||
:::::::::Actually, that's not true, I see on acupuncture many times where this has happened. A few days ago, I went though and examined almost every single edit over the past year. Anyway, there are plenty of edits where outdated sources are removed. Please look and . By the way, not to quibble, but most of those edits were yours. ] (]) 04:38, 11 September 2014 (UTC) | |||
:::::::::::The older sources were removed when we had better sources. I deleted the older sources because I found . ] (]) 04:45, 11 September 2014 (UTC) | |||
::::::::::::Well that's exactly what we're trying to do with the tags. We are trying to find more current sources. Did you replace all the other sources with new ones too? Not that you're required to do that or anything, but I am just curious. But I think my links speak for themselves, and that you do agree old sources can't be used. ] (]) 04:56, 11 September 2014 (UTC) | |||
:::::::::::::No, first you should find other sources. If you can't find another source you should not tag the source or remove the source. ] (]) 05:05, 11 September 2014 (UTC) | |||
::::::::::::::Now QuackGuru, be honest, did you do this in every instance? Did you replace the sources with new sources? Did other past editors in my list of links do it, such as Roxy the Dog or Jmh649? Not that you or they or anyone is required to do so, I don't see anywhere on ] where it says you are required to replace outdated material with fresh material, only that sources should be 2-3 years old and definitely within 5 years old. I also don't see anywhere where you are required to tag it, I just think tagging is better than deleting it right away (which is what everyone in my list of links did.) To me, this seems very reasonable. I came onto this page tagging the article with a POV tag because all tags, used appropriately, are much more reasonable than the alternative. ] (]) 05:30, 11 September 2014 (UTC) | |||
:::::::::::::::You should not delete any source because it is older. I previously explained to you that you should first find another source. ] (]) 05:53, 11 September 2014 (UTC) | |||
::::::::::::::::There is no such policy. We don't use outdated sources in the article. ] (]) 09:54, 11 September 2014 (UTC) | |||
:::::::::::::::::Of course we use older sources in articles. Only when a newer source is found we replace the older source with a . ] (]) 17:31, 11 September 2014 (UTC) | |||
:::::::::::::::::::What about in these other instances? and If you could address all of these instances that would be helpful because I don't see that these were all replaced with new sourcing. Again, not that it's a requirement. I see nowhere in the policies where this is required, only that aged sourcing isn't allowed. But if we decided on a precedent somewhere, I don't see much evidence for it yet and am more than willing to hear your case out! ] (]) 17:52, 11 September 2014 (UTC) | |||
According to LesVegas, QuackGuru is ''''''. ] (]) 18:42, 11 September 2014 (UTC) | |||
: QuackGuru, I commended you earlier for citing everything you say, but when I actually click on what you cite, I have noticed that you repeatedly cite diffs which do not truly say what you claim. Please see ] for why this is a problem. When you do this repeatedly, as you have done recently by claiming a fellow editor has 4 reverts when he hasn't, when you falsely cite a claim of consensus, and when you say "do not delete any source because it is older" and I provide you diffs where you did just that, and you ignore them, it becomes problematic. I engaged in discussion with you on this thread for far too long. I repeatedly asked you questions and you repeatedly danced around them ] and then you edited as you saw fit. I've been nothing but nice to you, but don't mistake that for being a pushover. ] (]) 04:24, 12 September 2014 (UTC) | |||
=== Wang, Shu-Ming; Kain, Zeev N.; White, Paul F. (2008) === | |||
:The source is an outdated one per ]. ] (]) 19:27, 10 September 2014 (UTC) | |||
::Please don't again. ] (]) 19:52, 10 September 2014 (UTC) | |||
::There is broad consensus to use the 2008 source. See ]. ] (]) 17:31, 11 September 2014 (UTC) | |||
:::<s>Better not to ] QuackGuru. You already made clear your stance at my Talk Page, where I replied to you that: "''So far, it seems you, A1candidate, Middle 8, Doc James and I who have commented there. You and Doc James seem to be in favor of the source (even it's outdater per ]), and I'd like to hear clarification from Middle 8 and A1candidate.''" Five editors commenting does not establish "''a broad consensus''", as you put it. Especially when ]and ] are wished to provide clarification for their comments. And like ] already said: "''I checked your links and don't see where any consensus was reached about this source.''". ] (]) 18:15, 11 September 2014 (UTC)</s> | |||
::::Actually, see my latest post . What you pertain as "consensus" has nothing to do with the the source that is tagged as outdated now. The original source being used is expressed here by Doc James: . The replacement for it is being suggested here: . The original is still being used. You have also been noticed about this by user LesVegas. '''You are falsely claiming consensus'''. | |||
::::. Anyway, the discussion about removal of Wang et al. (2008) is related to whole different uses of that source. At the moment, we are using an outdated source for medical claims. Cheers! ] (]) 18:30, 11 September 2014 (UTC) | |||
:::::Nope. See diffs. ] (]) 18:39, 11 September 2014 (UTC) | |||
Jayaguru-Shishya was informed of the disruptive editing at the in April 2014. User:Jayaguru-Shishya was restoring a to another sentence. Revert 1. Deleting . Revert 2. Restoring a lot of . Revert 3. Restoring . Revert 4. After making edit after edit it suggests there may be no consensus for at least some of the changes. ] (]) 20:24, 11 September 2014 (UTC) | |||
:Indeed, how does a notice from April - when I just had started editing here - does have to do with the issue on your mind? However, you just got warned by administrator last week. If I was you, I'd keep extremely careful; I hope you will learn from your mistakes. | |||
:"'' Revert 1. Deleting tags''"? I reverted the edits by user ], and I informed about this on his/her Talk Page. LesVegas agreed with my revert after the correction that I made. What's your problem with that? | |||
:"''Revert 2. Restoring a lot of tags''", what problem are you having there? As clearly stated in the edit summary '''after the 24 edits you made in a row''': "''Woa! 24 edits in a row! Anyway, I had the time to check up only the 4 first of your tag removals. The others should have be inspected as well. I'll recover the other edits you made with the next edit (even it took a lot of time)''". Please state it clearly if you are unhappy with something. As these unsourced sentences are tagged, I and the rest of Misplaced Pages community has a change to review if those sources given later really do not verify the claims. I already removed some which I had time to take a look. | |||
:"''Revert 3. Restoring QuackGuru's edits and deleting material''" I reverted back to your edit :-) ! LOL! | |||
:Revert 4 ... ??? ] (]) 20:55, 11 September 2014 (UTC) | |||
::Where are the ? I already . The 4 diffs show 4 reverts. I already discussed it that the sources are reliable for the claim. ] (]) 21:04, 11 September 2014 (UTC) | |||
:::Why do you ask "''Where are the 4 reverts''" when you quote them straight afterwards? ...and you actually keep pertaining to those over and over again... | |||
:::Anyway, please answer now honestly QuackGuru ("yes" or "no"). First, are the sources outdated per ] (older than five years) to support any medical claims? Second, are the sources in question used to support medical claims (MERDS)? ~Thanks. ] (]) 21:23, 11 September 2014 (UTC) | |||
== MEDDATE == | |||
The above section seems to have gone off the rails a bit, so I am starting a new one, with an admonishment to please stick to the ] instead of sniping at each other (@], @], @]). | |||
My reading of the ] guideline is right there in the header for the section: use up-to-date evidence. The bit about capturing a full review cycle seems key. The way we know that evidence is not up-to-date is that it has been superseded by a source of similar or higher quality; most of the time, updated sources will indicate that the text should be tweaked - scientific revolutions are rare. Rather than wholesale deleting verifiable material, I respectfully suggest that we use {{tl|update inline}} and update the material as new sources are found. - ] <small>(])</small> 18:15, 12 September 2014 (UTC) | |||
:We don't wholesale delete verifiable material because it is older than five years and we don't tag sources older than five years. When newer sources are found then we update the material. You don't see on other articles editors tagging sources just because they are a bit old. Lost of articles have sources older than five years. The tag 'updateinline' wikilinks to ]. That makes no sense. Tags for medical claims are only used to delete the source. ] (]) 18:23, 12 September 2014 (UTC) | |||
:I agree with you 2/0. I think tagging the old sources is a lot better way than to just delete an outdated source straight away. This is how the other editors can easily pay attention to sources needing update as well. ] (]) 19:33, 12 September 2014 (UTC) | |||
::The tag you used is not about tagging older sources. I previously explained the tags are not relevant to medical claims and the tags for medical claims are typically used for deleting older sources when there are newer sources or for deleting unreliable sources. What is the benefit for a tag that wiklinks to ]? ] (]) 19:38, 12 September 2014 (UTC) | |||
2/0, I want to thank you for having the article protected and for moderating this discussion. Yes, I completely agree, tagging outdated sources is what needs to be done here. Science changes all the time and we need to find updated sourcing. I don't agree that tags for medical claims are only used to delete the course, that is only one potential outcome amongst several. More likely, we find a new source to back it up, or we modify whatever statement is being made based on whatever the newer sourcing says. But a tag buys us time to do that. And I may be wrong here, but in Misplaced Pages's policies and guidelines I don't see anywhere where it says we are required to tag it, only that old medical sourcing can't be used. I just feel that tags are a much more reasonable solution than just going out and immediately deleting everything outdated. ] (]) 18:38, 13 September 2014 (UTC) | |||
:You have not given a reason to tag numerous sources. You wrote "I don't see anywhere where it says we are required to tag it". There is no need to tag source after source. ] (]) 18:53, 13 September 2014 (UTC) | |||
::My point was we could just outright delete them. Would you prefer that or the tag? ] (]) 19:14, 13 September 2014 (UTC) | |||
:::It is not appropriate to suggest we delete solid MEDRS compliant sources and you know it is not required to tag sources. ] (]) 19:19, 13 September 2014 (UTC) | |||
::::Part of MEDRS compliance is MEDDATE. I'm going to ask kindly that you please don't twist my words. ] (]) 19:29, 13 September 2014 (UTC) | |||
:::::Do you think it is required to tag solid MEDRS compliant sources? ] (]) 19:34, 13 September 2014 (UTC) | |||
::::::No, because a solid MEDRS compliant source meets all requirements for reliability, including MEDDATE. And thank you for deescalating your questions, and giving me an actual question. I do appreciate it QuackGuru. ] (]) 19:39, 13 September 2014 (UTC) | |||
:::::::Even if a source is over 10 (or even 20) years old, it is still a solid MEDRS source unless you can present a newer source. ] (]) 19:59, 13 September 2014 (UTC) | |||
::::::::Yes, well there are exceptions made for history sections, Cochrane Library reviews that have been updated and seminal works in the field. If it's an area where few reviews are being published in the field, then it's okay. If other, newer reviews are published, we use those instead and delete the older reviews. First we should tag them, though. And all other cases MEDDATE says we want sources to be within the last 5 years, but preferably the last 2-3. Further, review articles should use recent primary studies. I'm afraid I have to disagree with keeping it because it was once a solid MEDRS source. Some of these sources are aged rockstars with potbellies trying to sing well past their prime. ] (]) 20:47, 13 September 2014 (UTC) | |||
::::::::: I think you are still missing the point of MEDDATE, LesVegas and Jayaguru-Shishya. The timespans are given to provide context for what the guideline means by "recent"; the term is relative, and interpretation could be a point of contention if that context were lacking. A source is only actually outdated and in need of replacement if the research has moved on; that is why the focus on capturing a complete review cycle - different fields update at different rates. If further clarification is required, ] or ] should be able to provide. - ] <small>(])</small> 21:24, 13 September 2014 (UTC) | |||
::::::::::Yes, MEDDATE does talk about looking for reviews within one full review cycle. But only relying on the idea of a review cycle creates a great deal of ambiguity. What are the date ranges we should be using? Do date ranges then not apply at all? This seems especially inapplicable since, worldwide, the acupuncture literature is updated on a very regular basis. Further, we have seen a recent increase in the reporting standards in acupuncture literature due to the STRICTA checklist becoming the official extension of CONSORT in 2010. Many reviews published before that time used studies which used poor quality reporting standards. Not all literature follows CONSORT, but now there's defined parameters, we know if they do not follow it, they can be criticized for not doing so. Coincidentally, it is now nearly 2015, and it's been five years after the adoption of these standards. All the more reason for us to follow Misplaced Pages's MEDDATE guidelines of 5 year maximum lifespan, there actually is wisdom in these numbers. Of course, I don't mind replacing the outdated literature with newer stuff myself. But when we're not sure if there's newer stuff, we should use {{tl|update inline}} so we can get other editors on board to check. ] (]) 00:38, 14 September 2014 (UTC) | |||
::::::::::::I previously explained that tag links to ]. That makes the tag irrelevant to medical claims. You want to use a tag that is not applicable? Until there is a newer source the current source is reliable. ] (]) 00:44, 14 September 2014 (UTC) | |||
:::::::::::::No it doesn't. Update inline wikilinks to ], explaining it needs an update. ] (]) 00:51, 14 September 2014 (UTC) | |||
::::::::::::::This is the ]. Click where it says . When you click on the tag it links to ]. . ] (]) 01:02, 14 September 2014 (UTC) | |||
::::::::::::::::OK, you're right, when you click on that it does go to Manual of Style. I do apologize. But it does indicate there the need for updating, which is helpful. Alternatively, I see that we could use the {{Medrs}} tag, and since the source falls outside the range, it violates one aspect of MEDRS. Any opinions? ] (]) 01:18, 14 September 2014 (UTC) | |||
:::::::::::::::::The Update inline tag does not indicate there a need to use a newer source. That is not what the tag is used for. I created the MEDRS tag to tag an unreliable source. You haven't shown what source is unreliable. ] (]) 01:32, 14 September 2014 (UTC) | |||
{{outdent|:::::::::::::::::}}The contention that a source is outdated needs to be supported by a more current source. Per MEDRS, "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." Consideration of the level of quality of the source is also appropriate, a brand new low quality source carries less due weight than a solid high quality source that is not as recent. Another consideration is the weight given the source in other publications. If an older source is frequently cited by recent publications it still carries weight. - - ] (]) 05:53, 14 September 2014 (UTC) | |||
* I have requested clarification at ]. I have tried to accurately and neutrally represent the positions taken here; as we are seeking outside input, please only comment there to clarify if your position differs significantly from my summary. - ] <small>(])</small> 16:51, 14 September 2014 (UTC) | |||
::Like I stated at ], "I think that WP:MEDDATE is clear on the matter; we should not remove a medical source simply because it's not published in the last five years or so. Unless, of course, more recent reviews are available. But WP:MEDDATE points out, "''Within this range, assessing them may be difficult. While the most-recent reviews include later research results, do not automatically give more weight to the review that happens to have been published most recently, as this is ].''" And it gives space to areas that are less researched, stating that sourcing "may need to be relaxed in areas where little progress is being made or few reviews are being published." My opinion on the particular case you are citing is that "we leave it alone until newer sources of similar caliber are identified." ] (]) 17:03, 14 September 2014 (UTC) | |||
::: The steps to take are fairly obvious to anyone used to dealing with MEDRS: | |||
:::* If a source is more than about five years old (less where the literature is extensive, more when it isn't), then identify the quality of the source by using the guidance at MEDRS. | |||
:::* Next start examining the best literature for a newer source of the same or better quality. Again MEDRS indicates what sort of journals and what type of secondary sources represent the highest quality. | |||
:::* If no newer sources of the same or better quality exist, then the old source remains the best we have and will stay. Never replace a source with one of a lower quality even if that one is newer. Never delete a source ''purely'' on the grounds of age. In some fields that I am familiar with, the seminal work was done 70 years ago. | |||
:::* If there is a newer source of equal or better quality, then see if the content needs to be amended (often a newer review comes to the same conclusions as the previous one). If no change is needed, you can just replace the older source. | |||
:::* If the newer source of equal or better quality indicates an amendment to the content, then make the changes and replace the old source with the new one. At that point, you will probably find you may have to justify ''both'' your summary of the newer source ''and'' your assumption that the newer source is no worse than the older one it replaces. | |||
::: The purpose of tagging is to attract more editors to an article; it is not to cast doubt on the content. If there is a lack of editors engaging at a particular subject, then tagging is justified; otherwise it isn't. In this case {{tl|update}} and its section- and inline- variants really isn't the tag to warn of potential problems with MEDDATE. | |||
::: In the event of disagreement, the article talk page is the first place to discuss issues. The talk page at ] is watched by a editors with a broad range of interests and considerable experience with MEDMOS and MEDRS and is probably the best place to seek further opinions related to those topics. --] (]) 17:57, 14 September 2014 (UTC) | |||
Okay, so now we have discussed the interpretation of MEDDATE and how strictly we should follow the 5 year limit. How about the <nowiki>{{inline update}}</nowiki> tag, what's the sentiment on that one? ] and ] seemed to agree that it should not be used. ] said at some point that we can use it though. How about ] and ], what's your opinion? ] (]) 14:20, 21 September 2014 (UTC) | |||
: I was trying to reach for a compromise, but the consensus is crystal clear on both tags. - ] <small>(])</small> 16:06, 21 September 2014 (UTC) | |||
:: I see the discussion going on about the <nowiki>{{cn}}</nowiki> tags, but not about the <nowiki>{{update inline}}</nowiki> tags. That's why I am asking for clarification from MrBill3 and LesVegas actually. I'd suggest that let's wait for their answers (and why not anybody else aswell) first. =P ] (]) 16:18, 21 September 2014 (UTC) | |||
::: I don't think the "update inline" tag is appropriate unless there is good reason to believe the material has been superseded by more recent quality references. Perhaps when there are several recent lower quality sources and a more current review/meta-analysis is expected. The tag might be appropriate when there is a updated Cochrane review to call attention to an editor who has full access or another high quality source is available but not free, thus calling attention to the content so an editor with access can update it. For content that there is no more current, high quality source the tag is not appropriate. It is to call attention for editors to update the content from more current sources, not to insert an editor's opinion that the subject of the content should be studied again. If the academic/medical community considers the subject important enough or the earlier results/conclusions currently inadequate new studies will be done and they will be analyzed and discussed, otherwise the tag is based on WP editors' opinions. TLDR: MEDDATE and WP policy defer to the scientific consideration of the medical/academic consensus. - - ] (]) 07:27, 22 September 2014 (UTC) | |||
::::The "update inline" tag links to ]. That makes the tag irrelevant to medical claims. The tag is not applicable in this situation. See ]. ] (]) 16:48, 22 September 2014 (UTC) | |||
:::::Yes, I agree with QuackGuru here in that update inline is a manual of style tag and we likely should not use it in these cases. We could use the unreliable MEDRS tag, but another user said we should only tag citations if the page has few editors. I'm starting to agree. Sources shouldn't be tagged on the acupuncture article, we should simply remove them if they are out of date and irrelevant, keep them if they are out of date and relevant, or replace them if they are out of date and there is a better source on the subject (whether it comes to the same conclusion or the opposite one). I could be wrong though and maybe there is precedent set for the use of this tag elsewhere? ] (]) 03:55, 26 September 2014 (UTC) | |||
::::::You don't exactly agree with me. We must not use a tag that is irrelevant to medical claims and no reason has been given to use the MEDRS tag I created. ] (]) 04:01, 26 September 2014 (UTC) | |||
:::::::If a source is indeed outdated and there is a strong belief that new sources are available, but are not yet on the article, then I think the MEDRS tag would be appropriate. You said you created the tag, but it's for unreliable sources. And MEDDATE, properly applied, pertains to reliability. Older sources are unreliable when newer ones are likely available. I noticed you used the MEDRS tag for old sources . What was your reasoning in those two instances? Why did you use it to tag old sources there? What am I not understanding? ] (]) 05:19, 26 September 2014 (UTC) | |||
::::::::There are newer sources that say relatively the same thing. ] (]) 05:32, 26 September 2014 (UTC) | |||
== Mao's "new acupuncture" == | |||
is directly supported by the source immediately following it. I might phrase it slightly differently, but that can wait until the article is unlocked. Would there be any objection to restoring the material through protection? - ] <small>(])</small> 18:43, 12 September 2014 (UTC) | |||
:. A lot of text was deleted. We should go back to before the controversial edits were made. ] (]) 18:52, 12 September 2014 (UTC) | |||
== Early superstition == | |||
The source given for appears to be in Chinese, but the text itself is readily supported by Taylor 2005 later in the paragraph. Would there be any objection to restoring the text using that as a source? - ] <small>(])</small> 18:49, 12 September 2014 (UTC) | |||
:We can request to go back to to fix all the problems rather than continue arguing or we can wait for the article to be unprotected. ] (]) 18:56, 12 September 2014 (UTC) | |||
:Good. I find it important that the <nowiki>{{cn}}</nowiki> tags are kept. That helps the editors to evaluate the text and whether it's properly sourced or not. ] (]) 19:33, 12 September 2014 (UTC) | |||
::There is even unsourced text in the lede for mundane claims. The tag was used to delete the text. The tag is for editors. It is not for readers. ] (]) 19:42, 12 September 2014 (UTC) | |||
::: {{ping|Jayaguru-Shishya}} I am having trouble parsing your comment as pertains to this discussion. Do you support restoring the text you removed using the source I verified? Do we have consensus to use {{tl|editprotected}} to edit the material back into the article? - ] <small>(])</small> 17:38, 14 September 2014 (UTC) | |||
::::I don't think we need a edit protected request. The incompetent editors who deleted sourced text and/or tag MEDRS compliant sources need a vacation from this article. If you insist on an edit protected request I support a larger revert before the incompetent edits were made. See ]. ] (]) 17:48, 14 September 2014 (UTC) | |||
::::Sorry for the late answer 2/0. Yes, we can use Taylor 2005 in order to restore the text. Would you suggest the old phrasing or something else? For example, the source goes as follows: | |||
::::<blockquote><p>Mao called for the 'co-operation of Chinese and Western medical doctors' in Yan'an in 1944, but was not explicit as to how such a co-operation might be achieved. His slogan was interpreted as a general 'scientification of Chinese medicine and popularization of Western medicine. In order to remove the feudalist and superstitious elements of Chinese medicine, some physicians attempted a rigorous transformation of the medicine according to the foremost precepts of the Communist revolution, i.e. those of the 'new', 'scientific', and 'unified'. Acupuncture came to represent this 'new' medicine largely because of its practical value during wartime. The term 'new' implied free from superstition and the heavy links to a feudal past. Instead of the components of the new culture would have to be forward-moving and enterprising. Mao advocated that such a change would be possible through the use of 'science'. By 'science' Mao was not so much referring to the science linked with the Western investigation of nature, but more to the Marxist ideal of science as the criteria for true knowledge. For Mao stated that 'this type of new democratic culture is scientific. It is opposed to all feudal and superstitious ideas: it stands for seeking the truth from facts, it stands for objective truth and for unity between theory and practice'.</p></blockquote> | |||
::::The edit protect, I think the "Edit protected" template is not needed as long as we don't have to make a mass revert back to the version where all the <nowiki>{{cn}}</nowiki> tags were removed. It's much easier to make fixes to the current version rather than the version some 24-29 edits (?) ago. Cheers! ] (]) 17:52, 15 September 2014 (UTC) | |||
:::::The old phrasing or something else is not relevant to this discussion. It is much easier to revert back to the version before the were restored all over the place and before you . You ? ] (]) 18:39, 15 September 2014 (UTC) | |||
:::::: Focusing specifically on this discrete improvement to the article, I find the old text adequate but would not object to something else along the same lines. That whole section could use more detail anyway. | |||
:::::: @]: if we decide to do a larger revert, the edit proposed here will just be subsumed in it - no harm done, easily fixed. In the meantime, it looks like we are much closer to consensus that this material improves the article. Would you be open to providing this material to our readers now while we finish discussing everything else? - ] <small>(])</small> 19:13, 15 September 2014 (UTC) | |||
:::::::There never was consensus in the first place to delete the text or add tags all over the place. You can request ] now and we can move on. ] (]) 19:21, 15 September 2014 (UTC) | |||
::::::::No tags have been added, the existing ones just have been restored. ] (]) 19:30, 15 September 2014 (UTC) | |||
:::::::::I previously explained I self-reverted my own edit. Now you have to explain why you want tags everywhere. Are you adding tags to other articles? ] (]) 18:44, 16 September 2014 (UTC) | |||
::::::::::Perhaps you should try to follow up the discussion more carefully, QuackGuru? Please see the latest . A quote from there: "''I still can't understand, however, why <nowiki>{{cn]]</nowiki> tags are being removed from sections where obviously no sources have been given. (See ).''" ] (]) 18:57, 16 September 2014 (UTC) | |||
:::::::::::I previously asked, "Are you adding tags to other articles?" Apparently not. ] (]) 19:01, 16 September 2014 (UTC) | |||
== Protected edit request on 12 September 2014 == | |||
{{edit protected|Acupuncture|answered=yes}} | |||
<!-- Begin request --> | |||
Listed on Add "|displayauthors=9" where 9 authors are listed in a citation. | |||
<!-- End request --> | |||
] (]) 19:00, 12 September 2014 (UTC) | |||
:This can be done after the text is restored otherwise it may make it difficult to to the previous version. ] (]) 19:14, 12 September 2014 (UTC) | |||
:: {{done}}. If we revert over the change, it is easy enough to fix. - ] <small>(])</small> 19:16, 12 September 2014 (UTC) | |||
::::I think "<nowiki>|displayauthors=4</nowiki>" is preferable there is no need to list nine authors. Four is pretty much standard on WP. Just my 2¢. - - ] (]) 05:43, 14 September 2014 (UTC) | |||
== Larger revert == | |||
Above, QuackGuru suggests that we revert to an earlier version of the article and discuss from there; . It looks like that would quell a bit of cite-bombing basic aspects of the article (good), some update-inline (discussed elsewhere), a restore wikilink to Quackwatch (I think that is the first instance in the article, so linking is indicated), and restore the three edits I just mentioned as accurately cited. A wholesale revert to this version would be fine with me, or we can work on it piecemeal. - ] <small>(])</small> 19:05, 12 September 2014 (UTC) | |||
:I think it'd be much easier to keep working from the current version of the article. The alternative would be this large . These edits have not been discussed at all. Compared to that, restoring three edits is a lot easier option. ] (]) 19:55, 12 September 2014 (UTC) | |||
::You wrote "These edits have not been discussed at all." So where is the previous discussion or consensus for the tags in the first place? I undid my own edits when I removed the tags. ] (]) 19:57, 12 September 2014 (UTC) | |||
:::"''I had the time to check up only the 4 first of your tag removals. The others should have be inspected as well. I'll recover the other edits you made''". Clear and simple, if there is a claim that we have unsourced material in the article, sure it needs to be inspected. Indeed, you could easily have explained at the Talk Page if you found unnecessary <nowiki>{{cn}}</nowiki> tags. ] (]) 20:08, 12 September 2014 (UTC) | |||
:::::You have not given a reason to have the unnecessary tags and they should be removed or do you want to delete more text? I explained it in my edit summary I undid my own edit. Were the tags discussed? See . I was only undoing my own mistake. ] (]) 20:20, 12 September 2014 (UTC) | |||
2/0, I wouldn't mind reverting back to that version and taking out and altering problematic edits as you and QuackGuru suggest. However, this does bring up a larger question: when someone makes 24 rapid-fire, unchecked edits, in my view it becomes impossible not to do anything other than what Jayaguru-Shishya did in his large revert. If, out of those 24 edits, let's say 16 were good quality uncontroversial edits. How could an editor possibly handle what he thinks are 8 problematic edits piecemeal without going over the 3RR? I'm really not trying to bring up old history here, but old history is once again new history, as some other editors mentioned ] so it seems that going forward we need something solid in place to prevent incidents like this from happening again. Jayaguru-Shishya, do you think that's a reasonable solution? Do you think we could revert back and discuss all the problematic edits? QuackGuru, what do you think could be done to prevent things like this from happening again? Or am I off base here? ] (]) 19:06, 13 September 2014 (UTC) | |||
:You haven't . There was . ] (]) 19:12, 13 September 2014 (UTC) | |||
::QuackGuru, you're right it wasn't 24 edits, it was actually . I'm trying not to go there again with you, I'm trying to have a reasonable discussion this time. ] (]) 19:24, 13 September 2014 (UTC) | |||
::: QuackGuru also catches flak for making multiple changes in a single edit. I am sure neither of you, Jayaguru-Shishya and LesVegas, would bring such a complaint since it would be wildly inappropriate to try to institute a backdoor article ban in that way. Laziness is not a valid reason to ], and the suggestion that it is smacks of trying to ] the article content. We have a history function and ]. | |||
::: To move the discussion back where it belongs, focusing on the content rather than the contributor: I did actually take the time to sort through the series of edits in question. It was neither difficult nor particularly time-consuming. The edit summaries were accurate and the content changes relatively simple and straightforward. Are there any policy-based objections to the changes? - ] <small>(])</small> 21:08, 13 September 2014 (UTC) | |||
We have now had four independent MEDRS-savvy editors weigh in on tagging older sources where no better source has been identified. Does this give us ] to go back to and work from that base? - ] <small>(])</small> 11:55, 16 September 2014 (UTC) | |||
:There is consensus to go back and continue to improve the article. ] (]) 15:17, 16 September 2014 (UTC) | |||
:: You are right, I should have linked to the version sans tags. - ] <small>(])</small> 15:37, 16 September 2014 (UTC) | |||
::: Well, it's possible to continue editing even if a larger revert is made. I still can't understand, however, why <nowiki>{{cn]]</nowiki> tags are being removed from sections where obviously no sources have been given. (See ). The content of should equally be restored. ] (]) 18:35, 16 September 2014 (UTC) | |||
== Efficacy and Safety of Needle Acupuncture for Treating Gynecologic and Obstetric Disorders: An Overview == | |||
Any thoughts on using for stating/supporting that the evidence for use for pelvic and low-back pain during pregnancy, pain during labor, primary dysmenorrhea, and menopausal symptoms is inconclusive? - ] <small>(])</small> 00:43, 16 September 2014 (UTC) | |||
:We don't need any more fringe journals. If we allow this then we can expect a huge flood. ] (]) 02:46, 16 September 2014 (UTC) | |||
:: Works for me, thanks. - ] <small>(])</small> 11:45, 16 September 2014 (UTC) | |||
:::For effectiveness we have plenty of sources. For other sections it is a case by case basis. Sometimes we can use fringe journals to fill in the blanks. The flood is over for now. ] (]) 15:20, 16 September 2014 (UTC) | |||
== Quick MEDMOS fix == | |||
{{editprotected|answered=yes}} | |||
At the end of the first paragraph of ], the sentence "For the majority of cases, the needles will stay in place for 10 to 20 minutes while you are lying still" should be replaced with "For the majority of cases, the needles will stay in place for 10 to 20 minutes while the patient remains still" per ]. - ] <small>(])</small> 18:07, 16 September 2014 (UTC) | |||
:I think it should be person rather than patient. ] (]) 18:25, 16 September 2014 (UTC) | |||
:: Or just end the sentence after "20 minutes"? - ] <small>(])</small> 18:28, 16 September 2014 (UTC) | |||
:::The person is also lying down. ] (]) 18:30, 16 September 2014 (UTC) | |||
:::: The acupuncturist is ] also a person, though. | |||
:::: What if we combine with the penultimate sentence: "A typical session entails lying still while approximately five to twenty needles are applied and left in place for ten to twenty minutes."? - ] <small>(])</small> 19:19, 16 September 2014 (UTC) | |||
:::::The two sentences are making separate points. | |||
:::::If you still don't like the word person we can use another word. | |||
:::::"For the majority of cases, the needles will stay in place for 10 to 20 minutes while the individual is lying still." ] (]) 20:05, 16 September 2014 (UTC) | |||
:::::: The points are different but not disparate. Having the extra clause in there breaks up the flow of the sentence in a somewhat awkward manner. Combining the sentences also helps with the synonym problem - we use "typically", "common", "regular", and "majority" in those four sentences cited to the same source to describe how a session usually progresses. We could try: "A typical session entails lying down while approximately five to twenty needles are inserted; for the majority of cases, the needles will be left in place for ten to twenty minutes." - ] <small>(])</small> 21:46, 16 September 2014 (UTC) | |||
:::::::"A typical session entails lying still while approximately five to twenty needles are inserted; for the majority of cases, the needles will be left in place for ten to twenty minutes." ] (]) 22:03, 16 September 2014 (UTC) | |||
::::::::Very important this. Think of the complications that would ensue if the patient didn't lie still at a crucial moment, and the acupuncturist punctured the patient ''in the wrong place.'' Malpractice suits, treating patients for the wrong condition, it'd be awful. -] (]) 22:28, 16 September 2014 (UTC) | |||
::::::::: That wording looks good to me, thanks for working on this. - ] <small>(])</small> 23:32, 16 September 2014 (UTC) | |||
A quick grammatical fix: the first clause of ], "For the following conditions, the Cochrane Collaboration or other reviews have concluded there is no strong evidence of benefit for" should be replaced with "For the following conditions, the Cochrane Collaboration or other reviews have concluded there is no strong evidence of benefit:". - ] <small>(])</small> 18:27, 16 September 2014 (UTC) | |||
:Both ] '''Done'''<!-- Template:EP -->. — ''''']''''' <sup>]</sup> 06:09, 17 September 2014 (UTC) | |||
::Your differs slightly from the proposal. ] (]) 07:16, 17 September 2014 (UTC) | |||
::: Eh? It looks right to me - what is missing? - ] <small>(])</small> 10:59, 17 September 2014 (UTC) | |||
::::There was an additional change made to the ref. No worries. I fixed it in my sandbox. ] (]) 15:57, 17 September 2014 (UTC) | |||
== Regarding new consensus on MEDDATE's application == | |||
Hey all! I want to thank 2/0 for posting to the MEDRS board to get feedback regarding dating of sources. I also would like to ask questions amongst some editors here because there has been differing opinions on MEDDATE's application, even amongst individual editors here over time. Here is an example between which appears to have very different reasoning than . I would also like to highlight these edits and since they now differ with our current community consensus on how to apply MEDDATE to sourcing. Now I just want to make it clear, I'm not criticizing anyone or calling anyone a hypocrite because I believe we are all free to change our opinions, and hey, I happen to now agree, based on the reasoning of everyone at the MEDRS talk page. I also discovered this very subject was discussed during the ] With that in mind, I just want to get everyone's opinion on a matter. If this community now believes that we shouldn't regard the 5 year rule as sacrosanct how would everyone feel if I restored any of the content that was removed from any of the diffs showing removal of old sources, provided they are still reliable and there are no new updated sources on the subject? ] (]) 18:44, 17 September 2014 (UTC) | |||
:The old diff you cite shows you are mistaken. The ref that was older than ten years old and was replaced with a newer source. I already explained, that the older sources were removed because we are using newer sources. I don't see any reason to continue arguing about this. However, if a source was deleted that was not making a medical claim it could still be reliable. ] (]) 19:36, 17 September 2014 (UTC) | |||
:: New consensus same as the old - glad I am that we have that settled. | |||
:: Your links and are arguing different points. Your protestation that you are not insinuating hypocrisy is appreciated. | |||
:: : The 1997 consensus statement is now only of historical interest. We discussed this not so long ago. | |||
:: : A banned tendentious sockmaster might on occasion make an edit that we would like to keep, but the present case is not the exception. | |||
:: : "dated" is stronger reasoning than merely "old". | |||
:: : I am not sure we should be according that source any weight anyway, but that is not a medical claim. | |||
:: If you have a specific proposal for text or sourcing that should be added to the article, we should discuss that. - ] <small>(])</small> 15:34, 18 September 2014 (UTC) | |||
:::2/0, please forgive me if I came across as ugly or sarcastic in any way in my post. That was not my intent in the least. I really wasn't trying to be sarcastic at all, but was trying to point out that when we come to a new consensus regarding posts we should take a moment to go back and review older edits where we operated under different beliefs about policy. Anywho, I'm sorry if I'm reading too much into your last post but it looked like you were being sarcastic about me claiming not to call others hypocritical. Seriously, that was not my intent at all. Regarding specific proposals, yes, I think we should add each of these references back in since they were removed when editors on this page believed MEDDATE states 5 year old sources must go and do not need to be replaced with new sources. I don't see where any of these were replaced with new sources, but I could be mistaken. And regarding example #5, you said "dated" is stronger reasoning than merely "old". While I don't understand what you mean by that in regards to MEDDATE, it did give me a new idea! I pulled up those instances by going to the revision history and doing a keyword search in the edit summaries for the word "dated" and that's how I pulled each of those edits up. Anywho, I just did a new keyword search for the word "old" and here are the edits I came up with: As you can see, these edits were justified because of the "old" understanding we had about MEDDATE, but now that we have a new understanding we ought to discuss these as well. Just like the "dated" bunch I found before, this group was just over the past year alone. I'm sure there's more like these, but this will give us enough to discuss for now. And, just so you know, there were several edits I found where new sources were used to replace old ones. I didn't use those here because we all agree (at least I think!) that replacing old sources with new ones are appropriate uses of MEDDATE. ] (]) 04:46, 26 September 2014 (UTC) | |||
::::There is nothing to add back in because the older sources were replaced with newer sources. ] (]) 04:55, 26 September 2014 (UTC) | |||
:::::I'm sorry but I don't see it in any of these cases. I saw it in a few other cases and I didn't post those here, but with these, no new sources were added in. If I'm wrong, you are more than welcome to show me the diffs where old sourcing I'm claiming was removed for being too old, and show that it was actually replaced by new sourcing and we can talk from there. ] (]) 05:07, 26 September 2014 (UTC) | |||
::::::The older sources were removed for various reasons. The main reason was that new sources were found. We don't need to continue to talk about this. These are old issues there were resolved a long time ago. ] (]) 05:17, 26 September 2014 (UTC) | |||
:::::::What were the various reasons? All I see in the edit summaries were that they were "old" or "dated". From what I see there are no other reasons they were removed. Now that we have come to a new consensus, I see no reason they shouldn't be added back in. That is, unless you can show me the diffs that show justification beyond just "dated" or "old" sources. ] (]) 05:26, 26 September 2014 (UTC) | |||
:::::::I think this is a good start for a new discussion. I am not sure which "consensus" we are talking about here now, but I think MrBill3 gave a pretty good summary earlier about the MEDDATE one. | |||
:::::::When it comes to sources that have been removed already but still could be use in the article, I see no obstacles for those (providing that they are MEDRS or RS depending on the case). ] (]) 19:07, 28 September 2014 (UTC) | |||
::::::::There is no new consensus and there is no reason to continue to explain every little thing. This is old news. ] (]) 05:30, 26 September 2014 (UTC) | |||
:::::::::QuackGuru, I'm sorry but you did not explain these and show where new reviews have supplanted them. Therefore, according to MEDDATE's statement regarding review cycles, I see no reason why they shouldn't be in the article. I'm going to add these back in one at a time, as long as they're pertinent. Cheers! ] (]) 02:48, 2 October 2014 (UTC) | |||
::::::::::There may be a new consensus if we look into the new sources, if something's come in that isn't dated or old. I wanted to comment on the creation of tags. Considering that Acupuncture is a form of 'alternative medecine,' it's very possible that some of the sources might be reaching out of credibility. I read somewhere above that there is a strong belief that there are new sources being produced currently, and when regarding MEDDATE vs MEDRS, it seems appropriate to just represent the interests of both. — Preceding ] comment added by ] (] • ]) 05:57, 26 September 2014 (UTC)</span></small> | |||
== New paper == | |||
, David H. Gorski, Nature Reviews Cancer (2014) doi:10.1038/nrc3822, Published online 18 September 2014 - paywall though. The main relevant passage: "When acupuncture is tested in the clinic, overall, with possibly one exception (for example, to treat nausea123), recent evidence strongly suggests that its effects are nonspecific and indistinguishable from placebo effects124, 125, 126, 127, 128 that are highly dependent on practitioner–patient interaction129, 130. Moreover, meta-analyses almost always conclude that there is insufficient clinical evidence to make a determination of efficacy123, 131, 132, 133 and include studies with a high risk of bias134, 135, 136. Also, contrary to the claimed mechanism of redirecting the flow of qi through meridians, researchers usually find that it generally does not matter where the needles are inserted, how often (that is, no dose-response effect is observed)137, or even if needles are actually inserted138. In other words, 'sham' or 'placebo' acupuncture generally produces the same effects as 'real' acupuncture138, 139, 140, 141, 142 and, in some cases, does better143. Even what is arguably the most persuasive meta-analysis144 concluding that acupuncture has some efficacy against chronic pain included studies without sham acupuncture controls, and the reported difference due to acupuncture was still less than the minimal clinically important difference in pain for osteoarthritis145, 146, strongly suggesting that acupuncture effects are probably not clinically relevant. The most parsimonious explanation for this body of evidence is that acupuncture almost certainly has no specific effects greater than placebo for any condition19, with the possible exception of nausea123." | |||
:Refs in this: | |||
:122.Hurt, J. K. & Zylka, M. J. PAPupuncture has localized and long-lasting antinociceptive effects in mouse models of acute and chronic pain. Mol. Pain 8, 28 (2012). CAS | |||
:123.Garcia, M. K. et al. Systematic review of acupuncture in cancer care: a synthesis of the evidence. J. Clin. Oncol. 31, 952–960 (2013). PubMed | |||
:124.Cho, S. H., Lee, H. & Ernst, E. Acupuncture for pain relief in labour: a systematic review and meta-analysis. BJOG 117, 907–920 (2010). PubMed | |||
:125.Ernst, E. Are the effects of acupuncture specific or nonspecific? Pain 152, 952 (2011). CAS | |||
:126.Ernst, E., Lee, M. S. & Choi, T. Y. Acupuncture: does it alleviate pain and are there serious risks? A review of reviews. Pain 152, 755–764 (2011). CAS | |||
:127.Gilby, A. Y., Ernst, E. & Tani, K. A systematic review of reviews of systematic reviews of acupuncture. FACT 18, 8–18 (2013). Show context | |||
:128.Posadzki, P. et al. Acupuncture for cancer-related fatigue: a systematic review of randomized clinical trials. Support Care Cancer, 21, 2067–2073 (2013). PubMed | |||
:129.Street, R. L. Jr., Cox, V., Kallen, M. A. & Suarez-Almazor, M. E. Exploring communication pathways to better health: clinician communication of expectations for acupuncture effectiveness. Patient Educ. Couns. 89, 245–251 (2012). PubMed | |||
:130.White, P. et al. Practice, practitioner, or placebo? A multifactorial, mixed-methods randomized controlled trial of acupuncture. Pain 153, 455–462 (2012). PubMed | |||
:131.Dodin, S. et al. Acupuncture for menopausal hot flushes. Cochrane Database Syst. Rev. 7, CD007410 (2013). PubMed | |||
:132.Franconi, G., Manni, L., Schroder, S., Marchetti, P. & Robinson, N. A systematic review of experimental and clinical acupuncture in chemotherapy-induced peripheral neuropathy. Evid. Based Complement Alternat. Med. 2013, 516916 (2013). | |||
:133.O'Sullivan, E. M. & Higginson, I. J. Clinical effectiveness and safety of acupuncture in the treatment of irradiation-induced xerostomia in patients with head and neck cancer: a systematic review. Acupunct Med. 28, 191–199 (2010). CAS | |||
:134.Cheuk, D. K. & Wong, V. Acupuncture for epilepsy. Cochrane Database Syst. Rev. 5, CD005062 (2014). PubMed | |||
:135.Kim, T. H. et al. Acupuncture for treating acute ankle sprains in adults. Cochrane Database Syst. Rev. 6, CD009065 (2014). PubMed | |||
: 136.White, A. R., Rampes, H., Liu, J. P., Stead, L. F. & Campbell, J. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst. Rev. 1, CD000009 (2014). PubMed | |||
:137.Chiu, H. Y., Pan, C. H., Shyu, Y. K., Han, B. C. & Tsai, P. S. Effects of acupuncture on menopause-related symptoms and quality of life in women on natural menopause: a meta-analysis of randomized controlled trials. Menopause http://dx.doi.org/10.1097/GME.0000000000000260 (2014). Show context | |||
:138.Cherkin, D. C. et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch. Intern. Med. 169, 858–866 (2009). PubMed | |||
:139.Linde, K. et al. Acupuncture for patients with migraine: a randomized controlled trial. JAMA 293, 2118–2125 (2005). CAS | |||
:140.Pastore, L. M., Williams, C. D., Jenkins, J. & Patrie, J. T. True and sham acupuncture produced similar frequency of ovulation and improved LH to FSH ratios in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 96, 3143–3150 (2011). CAS | |||
:141.Manheimer, E. et al. The effects of acupuncture on rates of clinical pregnancy among women undergoing in vitro fertilization: a systematic review and meta-analysis. Hum. Reprod. Update 19, 696–713 (2013). PubMed | |||
:142.Bao, T. et al. Patient-reported outcomes in women with breast cancer enrolled in a dual-center, double-blind, randomized controlled trial assessing the effect of acupuncture in reducing aromatase inhibitor-induced musculoskeletal symptoms. Cancer 120, 381–389 (2014). PubMed | |||
:143.Goldman, R. H. et al. Acupuncture for treatment of persistent arm pain due to repetitive use: a randomized controlled clinical trial. Clin. J. Pain 24, 211–218 (2008). PubMed | |||
:144.Vickers, A. J. et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch. Intern. Med. 172, 1444–1453 (2012). PubMed | |||
] (]) 13:20, 22 September 2014 (UTC) | |||
:As of 2012, the impact factor was . I added a little something to '']''. ] (]) 23:09, 22 September 2014 (UTC) | |||
== Possible original research and not a conclusion == | |||
The following sentence is in the article: ''The mechanism of action for acupuncture is still unclear. Evidence suggests that acupuncture generates a sequence of events that include the release of endogenous opioid-like substances that modulate pain signals within the central nervous system.'' See ]. | |||
A . . I could not verify the claim and there are newer sources for osteoarthritis of the knee. See ]. ] (]) 03:22, 2 October 2014 (UTC) | |||
== Duplication == | |||
There is similar information in the same section and . For example, ''Acupuncture is generally safe when administered using clean technique and sterile single use needles.'' ] (]) 03:26, 2 October 2014 (UTC) | |||
This is even more . What is the point? ] (]) 03:42, 2 October 2014 (UTC) | |||
:Hello QuackGuru, the review found that results from pediatric acupuncture AE's mirrored those of AE's in general, and that's relevant to that section. But I will modify it to only include information on AE's in general. I appreciate your input in this instance. ] (]) 03:51, 2 October 2014 (UTC) | |||
::The information is similar with text . The text is also misleading according to the conclusions of full text. ] (]) 04:00, 2 October 2014 (UTC) | |||
The first sentence for ] says "Acupuncture is generally safe when administered by an experienced, appropriately trained practitioner using clean technique and sterile single use needles." ] (]) 01:06, 7 October 2014 (UTC) | |||
== Statement: Exhaust financial resources by pursuing ineffective treatment == | |||
I could not verify the statement, "As with other alternative medicines, unethical or naïve practitioners may induce patients to exhaust financial resources by pursuing ineffective treatment." with . Quackwatch is also a source, but Quackwatch does not meet MEDRS compliance. ] (]) 04:03, 2 October 2014 (UTC) | |||
:{{cite web|title=Final Report, Report into Traditional Chinese Medicine| url= http://www.parliament.nsw.gov.au/prod/parlment/committee.nsf/0/ca78e168ce1b6fa2ca2570b400200a34/$FILE/reportversion2.pdf | format = PDF | publisher = ] | accessdate=3 November 2010 | date = 9 November 2005}} The link works. | |||
:QW is reliable for the claim. ] (]) 04:04, 2 October 2014 (UTC) | |||
:: I'm sorry to have to be disagreeable in this instance, but QW is not reliable for this claim. In fact, here is what MEDRS says about it <blockquote>Press releases, blogs, newsletters, advocacy and self-help publications, and other sources contain a wide range of biomedical information ranging from factual to fraudulent, with a high percentage being of low quality. Conference abstracts present incomplete and unpublished data and undergo varying levels of review; they are often unreviewed and their initial conclusions may have changed dramatically if and when the data are finally ready for publication. Consequently, they are usually poor sources and should always be used with caution, never used to support surprising claims, and carefully identified in the text as preliminary work. Peer reviewed medical information resources such as WebMD, UpToDate, Mayo Clinic, and eMedicine are usually acceptable sources in themselves, and can be useful guides about the relevant medical literature and how much weight to give different sources; however, as much as possible Misplaced Pages articles should cite the more established literature directly. </blockquote> ] (]) 04:14, 2 October 2014 (UTC) | |||
:The words "'''never to support surprising claims''' is most pertinent. We need to be quoting direct from peer-reviewed secondary sources only, as it tells us to do in the MEDRS passage above. ] (]) 04:19, 2 October 2014 (UTC) | |||
::There were previous discussions about QW as a source. The result was QW is reliable. ] (]) 04:21, 2 October 2014 (UTC) | |||
:::Can you show me this? Did they bring up the passage I quoted? I was not part of this discussion then, but I'd be glad to be part of it now. ] (]) 04:24, 2 October 2014 (UTC) | |||
::::Here is one example: ]. ] (]) 04:29, 2 October 2014 (UTC) | |||
:::::Thanks for providing that, I read it but see no consensus whatsoever. I see that another editor brought up my argument, but it wasn't addressed. Would you care to do so? Seriously, Misplaced Pages seems quite clear on this topic. You wouldn't want a pro-acupuncture website to be used as a source. That's why there's a policy on this. QuackWatch's citations are original research, and QW is a blog, not a peer-reviewed journal, and "should never be used to support surprising claims". It violates MEDRS on multiple counts. We should "cite established literature directly" not through QW. I see no policy that allows us to include it for claims like this, not by a long shot. ] (]) 04:52, 2 October 2014 (UTC) | |||
{{od}} As I recall, the article wording is paraphrased from the Australian PDF -- but I can't recall which statement/part exactly. QuackWatch -- is it being used as a MEDRS here? I wouldn't really say so.... and FWIW, exhaustion of resources on ineffective treatment ''is'' a genuine ethical concern and risk (both with alt-meds and experimental or off-label use of mainstream meds). --] <small>(] • ])</small> 13:26, 2 October 2014 (UTC) | |||
:There was an extensive discussion about the use of QuackWatch as as source here: ]. I start to agree more and more with position of Bullrangifer and Middle 8: QuackWatch can be used as an RS (not MEDRS) on a case-by-case basis. Aside from that view, there was a strong opposition against using QuackWatch at all, and the other extreme basically labeled everyone objecting QuackWatch as "POV-pushers" or "advocates". I find Bullrangifer's and Middle 8's position the most constructive for consensus building though. ] (]) 13:54, 2 October 2014 (UTC) | |||
This isn't a medical claim, so ] is irrelevant. I'm actually not sure whether QW should be considered reliable for this statement, but there are certainly adequate sources. — ] ] 18:38, 2 October 2014 (UTC) | |||
:Thanks everyone! You're all right, it's not a medical claim, and much thanks for pointing that out. Peace! ] (]) 00:10, 3 October 2014 (UTC) | |||
== Theatrical placebo == | |||
More research confirming that acupuncture is a theatrical placebo: . Commentary here: '''' <b>]</b> <small>(])</small> 08:47, 4 October 2014 (UTC) | |||
== Adenosine and a good overall summary == | |||
From , Nature Reviews Cancer (2014) doi:10.1038/nrc3822: | |||
{{quotation|It has been proposed on the basis of mouse studies that acupuncture relieves pain through the local release of adenosine, which then activates nearby A1 receptors. Unfortunately, the key studies that made this conclusion suffered from the awkward grafting of concepts of ‘qi’ and meridians onto what would other-wise have been straightforward interesting neuroscience studies of the role of the A1 receptor in pain modulation. Instead, needles were inserted into an ‘acupuncture point’ on the mouse that, relative to the mouse leg, was far larger and far closer to a major nerve than in the human. In essence, because this caused more tissue damage and inflammation relative to the size of the animal in mice than in humans, such studies unnecessarily muddled a finding that local inflammation can result in the local release of adenosine with analgesic effect, and they still fail to demonstrate a sufficiently biologically plausible mechanism to justify clinical?trials.<br /><br />This phenomenon goes beyond basic science. When acupuncture is tested in the clinic, overall, with possibly one exception (for example, to treat nausea), recent evidence strongly suggests that its effects are nonspecific and indistinguishable from placebo effects that are highly dependent on practitioner–patient inter action. Moreover, meta-analyses almost always conclude that there is insufficient clinical evidence to make a determination of efficacy and include studies with a high risk of bias. Also, contrary to the claimed mechanism of redirecting the flow of qi through meridians, researchers usually find that it generally does not matter where the needles are inserted, how often (that is, no dose-response effect is observed), or even if needles are actually inserted. In other words, ‘sham’ or ‘placebo’ acupuncture generally produces the same effects as ‘real’ acupuncture and, in some cases, does better. Even what is argu-ably the most persuasive meta-analysis concluding that acupuncture has some efficacy against chronic pain included studies without sham acupuncture controls, and the reported difference due to acupuncture was still less than the minimal clinically important difference in pain for osteoarthritis, strongly suggesting that acupuncture effects are probably not clinically relevant. The most parsimonious explanation for this body of evidence is that acupuncture almost certainly has no specific effects greater than placebo for any condition, with the possible exception of nausea.}} | |||
''Refs for above:'' | |||
:19. Colquhoun, D. & Novella, S. P. Acupuncture is theatrical placebo. Anesth. Analg. 116, 1360–1363 (2013). | |||
:121. Goldman, N. et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nature Neurosci. 13, 883–888 (2010). | |||
:122. Hurt, J. K. & Zylka, M. J. PAPupuncture has localized and long-lasting antinociceptive effects in mouse models of acute and chronic pain. Mol. Pain 8, 28 (2012). | |||
:123. Garcia, M. K. et al. Systematic review of acupuncture in cancer care: a synthesis of the evidence. J. Clin. Oncol. 31, 952–960 (2013). | |||
:124. Cho, S. H., Lee, H. & Ernst, E. Acupuncture for pain relief in labour: a systematic review and meta-analysis. BJOG 117, 907–920 (2010). | |||
:125. Ernst, E. Are the effects of acupuncture specific or nonspecific Pain 152, 952 (2011). | |||
:126. Ernst, E., Lee, M. S. & Choi, T. Y. Acupuncture: does it alleviate pain and are there serious risks A review of reviews. Pain 152, 755–764 (2011). | |||
:127. Gilby, A. Y., Ernst, E. & Tani, K. A systematic review of reviews of systematic reviews of acupuncture. FACT 18, 8–18 (2013). | |||
:128. Posadzki, P. et al. Acupuncture for cancer-related fatigue: a systematic review of randomized clinical trials. Support Care Cancer, 21, 2067–2073 (2013). | |||
:129. Street, R. L. Jr., Cox, V., Kallen, M. A. & Suarez-Almazor, M. E. Exploring communication pathways to better health: clinician communication of expectations for acupuncture effectiveness. Patient Educ. Couns. 89, 245–251 (2012). | |||
:130. White, P. et al. Practice, practitioner, or placebo A multifactorial, mixed-methods randomized controlled trial of acupuncture. Pain 153, 455–462 (2012). | |||
:131. Dodin, S. et al. Acupuncture for menopausal hot flushes. Cochrane Database Syst. Rev. 7, CD007410 (2013). | |||
:132. Franconi, G., Manni, L., Schroder, S., Marchetti, P. & Robinson, N. A systematic review of experimental and clinical acupuncture in chemotherapy-induced peripheral neuropathy. Evid. Based Complement Alternat. Med. 2013, 516916 (2013). | |||
:133. O’Sullivan, E. M. & Higginson, I. J. Clinical effectiveness and safety of acupuncture in the treatment of irradiation-induced xerostomia in patients with head and neck cancer: a systematic review. Acupunct Med. 28, 191–199 (2010). | |||
:134. Cheuk, D. K. & Wong, V. Acupuncture for epilepsy. Cochrane Database Syst. Rev. 5, CD005062 (2014). | |||
:135. Kim, T. H. et al. Acupuncture for treating acute ankle sprains in adults. Cochrane Database Syst. Rev. 6, CD009065 (2014). | |||
:136. White, A. R., Rampes, H., Liu, J. P., Stead, L. F. & Campbell, J. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst. Rev. 1, CD000009 (2014). | |||
:137. Chiu, H. Y., Pan, C. H., Shyu, Y. K., Han, B. C. & Tsai, P. S. Effects of acupuncture on menopause-related symptoms and quality of life in women on natural menopause: a meta-analysis of randomized controlled trials. Menopause http://dx.doi.org/10.1097/GME.0000000000000260 (2014). | |||
:138. Cherkin, D. C. et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch. Intern. Med. 169, 858–866 (2009). | |||
:139. Linde, K. et al. Acupuncture for patients with migraine: a randomized controlled trial. JAMA 293, 2118–2125 (2005). | |||
:140. Pastore, L. M., Williams, C. D., Jenkins, J. & Patrie, J. T. True and sham acupuncture produced similar frequency of ovulation and improved LH to FSH ratios in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 96, 3143–3150 (2011). | |||
:141. Manheimer, E. et al. The effects of acupuncture on rates of clinical pregnancy among women undergoing in vitro fertilization: a systematic review and meta-analysis. Hum. Reprod. Update 19, 696–713 (2013). | |||
:142. Bao, T. et al. Patient-reported outcomes in women with breast cancer enrolled in a dual-center, double-blind, randomized controlled trial assessing the effect of acupuncture in reducing aromatase inhibitor-induced musculoskeletal symptoms. Cancer 120, 381–389 (2014). | |||
:143. Goldman, R. H. et al. Acupuncture for treatment of persistent arm pain due to repetitive use: a randomized controlled clinical trial. Clin. J. Pain 24, 211–218 (2008). | |||
:144. Vickers, A. J. et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch. Intern. Med. 172, 1444–1453 (2012). | |||
:145. Stauffer, M. E., Taylor, S. D., Watson, D. J., Peloso, P. M. & Morrison, A. Definition of nonresponse to analgesic treatment of arthritic pain: an analytical literature review of the smallest detectable difference, the minimal detectable change, and the minimal clinically important difference on the pain visual analog scale. Int. J. Inflam. 2011 , 231926 (2011). | |||
:146. Tubach, F. et al. Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: Results from a prospective multinational study. Arthritis Care Res. 64, 1699–1707 (2012). | |||
A decent summary, I think, and current (September 2014) and in an extremely reliable source. <b>]</b> <small>(])</small> 12:26, 6 October 2014 (UTC) | |||
:::Given the above, is it now time to take a slash and burn approach to the article as it currently stands? We have been pandering to quacks for far too long, so I suggest the wholesale removal of Section 2 Effectiveness, to be replaced with a quote - perhaps the following, "acupuncture almost certainly has no specific effects greater than placebo for any condition, with the possible exception of nausea." | |||
:::just delete section 3.2 Cost effectiveness as it obviously isn't. | |||
:::The Ethics section must now make clear what a bunch of self serving quacks acupuncturists are. | |||
:::This is just an off the cuff response to Guy's post above, but something needs to be done to clear up article cruft. | |||
::: best wishes. -] (]) 19:12, 6 October 2014 (UTC) | |||
{{od}} Careful of ] before going after the article with pliers and a blowtorch .... acu's use in mainstream settings shows the existence of sig views diverging from Gorski's, cf. ]. The disagreement is (as far as I can see) over whether to use/refer. Some believe that if it enhances a patient's sense of well-being and is low-risk, then it's justified, even if the effects are mostly/fully non-specific. This "logic" understandably drives people like Gorski nuts, but it is what it is. --] <small>(] • ])</small> 10:53, 9 October 2014 (UTC) | |||
== Removed material == | |||
Greetings. Why this material was removed? | |||
<blockquote><p>Based on growing literature, regarding acupuncture's physiological effects, a 2014 review proposed a model combining both connective tissue plasticity and peripheral sensory modulation as a needle response.</p></blockquote> | |||
<blockquote><p>One review cited considerable development regarding neural mechanisms of both manual (hand stimulated) acupuncture and electrical acupuncture, stating manual acupuncture activates all types of afferent fibers, while electrical acupuncture can produce an analgesic effect by exciting Abeta and part of Adelta fibers. The same review found that acupuncture signals ascend mainly through the spinal ventrolateral funiculus to the brain.</p></blockquote> | |||
<blockquote><p>Several brain nuclei are involved in processing acupuncture analgesia. In addition to opioid peptides, glutamate, 5-hydroxytryptamine, and cholecystokinin octapeptide contribute to mediating acupuncture analgesia. In electroacupuncture, the release of opioid peptides is frequency dependent. Brain regions responsible for acupuncture analgesia in animal studies have been confirmed in humans via functional imaging.?</p></blockquote> | |||
Were the sources unreliable or what? I can't find any "''strong disagreement with using these sources''" either, as it was stated in some deletion summaries. | |||
I can't see any reason why not to add these sources, but please do correct me if there's something I have missed. Cheers! ] (]) 15:32, 7 October 2014 (UTC) | |||
:This was explained in . See ]. ] (]) 20:38, 7 October 2014 (UTC) | |||
== RSN: Sourcing medical centers' use of acu == | |||
There's been debate ] over whether the websites of medical centers are RS's for the fact that they use acupuncture. Several editors have agreed this such use is fine; despite this one editor (QuackGuru) who disagrees has twice removed such sources, arguing that as "primary sources" they don't meet RS. I think they're fine per ], as well as ]. I've posted about this at ]. --] <small>(] • ])</small> 05:28, 13 October 2014 (UTC) | |||
:You are making a series of controversial edits that were previously resolved. For example, the in-text attribution was removed by ] but you restored it to the . Better sources were found and editors have moved on. ] deleted the unnecessary too. He also commented on the and the matter was resolved. ] (]) 06:58, 13 October 2014 (UTC) | |||
::@QuackGuru - Unfortunately your comments and ES's address fail to address my arguments. I'll reply in order with specific requests: | |||
::* Your first sentence relates to the section below, which please see. | |||
::* As far as sourcing medical centers, we will see what RSN says. '''(1)''' But you're ignoring my argument that their sites are fine per ], as well as ]; please address that. | |||
::* '''(2)''' You're also ignoring the UNDUE argument for this pair of edits:. Medical centers at Harvard, Stanford etc etc all vastly outweigh Gorski and Novella, and my 2nd edit explains their position consisely -- which is more than enough. Please address. | |||
::* Your revert has a very misleading RS ("reorder"); please don't do that. | |||
::We've had difficulty communicating in the past, and I've accused you of IDHT, but now I'm going to AGF and assume we've just had difficulty communicating. Therefore I'm being as specific as possible. Please be equally specific in your responses to my questions '''(1)''' and '''(2)''' above. It will help me and probably others as well. Thanks! --] <small>(] • ])</small> 08:44, 13 October 2014 (UTC) | |||
==Restoring consensus wording re Ernst review== | |||
, and left a note on Doc James' page (section ]) since I was reverting him. My edit restores the latest consensus wording which was a bold edit by User:Vzaak that accords with the source . QuackGuru among others accepted this edit as we see in ]. That was a broad consensus; there were a lot of editors involved spanning more than one talk page, and those who didn't comment implicitly accepted Vzaak's edit per WP:SILENCE. | |||
That said, I think that when it comes to efficacy we can do better than Ernst's 2009 review of reviews whose dataset spans 2000-2009. But for safety that source remains fine. --] <small>(] • ])</small> 07:37, 13 October 2014 (UTC) | |||
:{{U|QuackGuru}}: You reverted my edits to the lede and body , saying "violation of consensus". WHAT??? | |||
:As stated, my edit ''restored'' the broad consensus reached at ] supporting Vzaak's edit. In fact, as stated, you that consensus. '''(1)''' Please justify your edit in light of consensus, and show evidence for any supposedly more recent broad consensus. (Note that in e.g. , the wording in the body reflects Vzaak's consensus wording. Is there any discussion of what that later changed?) '''(2)''' Please explain why you changed your mind . | |||
:Also, above, you said: "Better sources were found and editors have moved on." '''(3)''' Which "better sources"? | |||
:Again, I'm being very specific. I sometimes have a hard time understanding your writing. So if you indicate which question you're replying to, it will help me with WP:DR a great deal. Thanks, ] <small>(] • ])</small> 08:50, 13 October 2014 (UTC) <small>revised 09:05, 13 October 2014 (UTC)</small> | |||
::I do not see the justification for | |||
::"A ] of systematic reviews highlighted recent high-quality randomized controlled trials which found that for reducing pain..." | |||
::When this can be summarized as | |||
::"A ] of systematic reviews..." | |||
::Why exactly is "highlighted recent high-quality randomized controlled trials"? A proper systematic review for an intervention of course only includes high quality RCTs. ] (] · ] · ]) (if I write on your page reply on mine) 11:27, 13 October 2014 (UTC) | |||
::: (e/c) Because it was a review of reviews and the RCT was cited as an exception. The dataset was reviews of efficacy for pain, a majority of which were actually positive. But Ernst considered those results dubious, because of the low quality of many RCT's that the reviews looked at. (The reviews spanned 2000-2009, so the RCT's they looked at go back even further.) As part of his explanation of why he thought the positive reviews dubious, he pointed to some high-quality RCT's, including one from 2010, Suarez-Almazor, to which the phrase "real acupuncture was no more effective than sham" (on the last page of the review) refers. Then he went on to predict (correctly) that in the future, as RCT's got better, results would be likely to show small efficacy or none. | |||
:::So we need to get both the spirit and the letter right while doing violence to neither. To do that we need to stick with the precise, consensus wording as long as we're citing Ernst 2009 in the lede for efficacy. And better, use more up-to-date reviews that actually ''find'' lack of efficacy. | |||
:::Also see my comment on your talk page. And feel free, Doc James and all editors, to email me if you'd like a copy of the review. --] <small>(] • ])</small> 13:50, 13 October 2014 (UTC) | |||
::I likewise find Middle 8's proposed rewording greatly weakens the conclusion of the systematic review, and amounts to little more than whitewashing. ] (]) 13:35, 13 October 2014 (UTC) |
Latest revision as of 15:16, 8 January 2025
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Semi-protected edit request on 24 September 2024
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I would like to make some suggestions to the acupuncture page. I do understand it is a contentious topic but believe some added edits and updated references would add better context as the WHO among others is expanding the use of traditonal medicine practices and has added a specific chapter in ICD11 for Traditional Medicine Acupuncture titled TM1
collapse long requested changeset |
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Change X - the theories and practices of TCM are not based on scientific knowledge, and it has been characterized as quackery.] to Y – . There is a range of acupuncture technological variants that originated in different philosophies, and techniques vary depending on the country in which it is performed. However, it can be divided into two main foundational philosophical applications and approaches; the first being the modern standardized form called eight principles TCM and the second being an older system that is based on the ancient Daoist wuxing, better known as the five elements or phases in the West. Acupuncture is most often used to attempt pain relief, though acupuncturists say that it can also be used for a wide range of other conditions. Acupuncture is generally used only in combination with other forms of treatment. The global acupuncture market was worth US$24.55 billion in 2017. The market was led by Europe with a 32.7% share, followed by Asia-Pacific with a 29.4% share and the Americas with a 25.3% share. It was estimated in 2021 that the industry would reach a market size of US$55 billion by 2023. Change X – ] to Y – . Acupuncture is generally safe when done by appropriately trained practitioners using clean needle technique and single-use needles. When properly delivered, it has a low rate of mostly minor adverse effects. When accidents and infections do occur, they are associated with neglect on the part of the practitioner, particularly in the application of sterile techniques. A review conducted in 2013 stated that reports of infection transmission increased significantly in the preceding decade. The most frequently reported adverse events were pneumothorax and infections. Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk. Change X – and many modern practitioners no longer support the existence of life force energy (qi) or meridians, which was a major part of early belief systems.] to Y - However, modern research substantiates the effectiveness of Acupuncture. Studies using functional magnetic resonance imaging (fMRI) have shown that acupuncture elicits changes in the brain that correlate with neurological effects. As confirmed by the world-renowned Cleveland Clinic, “Acupuncture affects the limbic and para-limbic networks in the brain and has a deep hemodynamic response, which is influenced by the psychophysical response. Acupuncture also stimulates the nervous system and improves conduction and communication between nerves. This improved functioning of the nervous system stimulates neurotransmitter actions and the release of the body’s natural endorphins and other opioids. For example, serotonin may be released following acupuncture, therefore helping patients feel more relaxed and sustain a sense of well-being that lasts for hours thereafter, if not longer. Research has also shown acupuncture’s ability in relieving myofascial pain by releasing muscular trigger points with ensuing concomitant anti-inflammatory effects.” Acupuncture is believed to have originated around 100 BC in China, around the time The Inner Classic of Huang Di (Huangdi Neijing) was published, though some experts suggest it could have been practiced earlier. Over time, conflicting claims and belief systems emerged about the effect of lunar, celestial and earthly cycles, yin and yang energies, and a body's "rhythm" on the effectiveness of treatment. Acupuncture fluctuated in popularity in China due to changes in the country's political leadership and the preferential use of rationalism or scientific medicine. Acupuncture spread first to Korea in the 6th century AD, then to Japan through medical missionaries, and then to Europe, beginning with France. In the 20th century, as it spread to the United States and Western countries, spiritual elements of acupuncture that conflicted with scientific knowledge were sometimes abandoned in favor of simply tapping needles into acupuncture points. Add Y – . Add Y – Change X: [Clinical practice Acupuncture is a form of alternative medicine. It is used most commonly for pain relief, though it is also used to treat a wide range of conditions. Acupuncture is generally only used in combination with other forms of treatment. For example, the American Society of Anesthesiologists states it may be considered in the treatment of nonspecific, noninflammatory low back pain only in conjunction with conventional therapy. ] to to Y: Clinical Practice Acupuncture is a form of alternative medicine. It is used most commonly for pain relief, though it is also used to treat a wide range of conditions. Acupuncture is generally only used in combination with other forms of treatment. For example, the American Society of Anesthesiologists states it may be considered in the treatment of nonspecific, noninflammatory low back pain only in conjunction with conventional therapy. Practitioners who practice Acupuncture are trained and take didactical coursework and clinical practice in their education; and, pass the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) board exams, or a state-specific licensing exam in California. The Acupuncture training program includes techniques such as cupping, gua sha tui na, moxibustion, herbal medicine, lifestyle and nutrition based on Traditional Medicine principles. There is current research supporting that acupuncture has efficacy with pain management being the most well-known application. Conceptually, it is believed to stimulate the body's meridians, or energy-carrying channels, in an attempt to correct imbalances and to restore health. These benefits are thought to be derived from the proximity of acupoints with nerves through intracellular calcium ions. This lesson outlines a brief history of acupuncture and how it may be used to treat various types of physical and emotional pain and specific conditions, including overactive bladder and psoriasis. Acupuncture has been demonstrated to enhance endogenous opiates, such as dynorphin, endorphin, encephalin, and release corticosteroids, relieving pain and enhancing the healing process. Of particular note is that Acupuncture is now incorporated by highly-acclaimed Western Medicine providers as part of a treatment plan for numerous conditions. The world-renowned Memorial Sloan Kettering Cancer Center endorses the newly updated Society of Integrative Oncology’s recommendations for acupuncture for breast cancer patients with joint pain. . Medical institutions such as the Mayo Clinic, National Cancer Institute, City of Hope, and Cleveland Clinic also integrate Acupuncture into their patients care programs. Sam Collins 33 (talk) 19:39, 24 September 2024 (UTC) |
- This is a hodgepodge of content copied verbatim from copyrighted sources. It can't be used. ScienceFlyer (talk) 20:04, 24 September 2024 (UTC)
- Also,
Historical records as old as 3,500 years demonstrate the effectiveness of Acupuncture
is invalid reasoning - argumentum ad antiquitatem - not consistent with WP:MEDRS, to give just one example. --Hob Gadling (talk) 06:45, 25 September 2024 (UTC)
- Also,
This article is racist
It must be changed. 2600:100F:A110:4802:ED55:9578:694F:5135 (talk) 22:14, 23 October 2024 (UTC)
- Opposing quackery such as acupuncture and Traditional Chinese Medicine does not make me a racist. Why?
Quoted by tgeorgescu (talk) 22:16, 23 October 2024 (UTC)If an Indian, American, British, Nigerian or Brazilian scientist makes an empirical claim about the body, they're expected to prove it, and that proof must be replicable. Why should it be different for Chinese scientists?
— User:WLU
Edit request on 3 December 2024
perennial complaints of 'bias' have been addressed countless times already |
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It is not “neutral” to immediately dismiss acupuncture as “pseudoscience in the first paragraph and subheading. That is an expression of opinion that fails to take into account years of scientific research on the topic accepted by the US NIH and other major health organizations. I recommend that the current “pseudoscience” sentence be supplanted by a sentence stating “The U.S. National Institutes of Health (NIH) states “there’s evidence that acupuncture may have effects on the nervous system, effects on other body tissues, and nonspecific (placebo) effects. (https://www.nccih.nih.gov/health/acupuncture-effectiveness-and-safety) The current “psuedoscience” sentence can be attributed to critics of the field, e.g., “Critics have dismissed the scientific research on the effects of acupuncture and characterized it as psuedoscience” — Preceding unsigned comment added by Kindlerva (talk • contribs) 18:16, 3 December 2024 (UTC)
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