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MMR vaccine controversy

Rename article? See Talk:MMR vaccine controversy#Suppression of dissenting voices.3F. SandyGeorgia (Talk)

medical article infoboxes hard to understand?

Hi docs:

I wondered what is the rationale for the infoboxes that I see on medical articles? Like this one:

I guess they are lists of External Links. I'm fine with that actually (never been a stickler for the approach of not referring to external content.) But my concern about the boxes is they are so inscrutable to a regular reader. Why not have some format that is more like normal external links, where we say what article and content people are heading to? I mean, maybe docs know what the letters and numbers are, but it is pretty cryptic even to a technically trained, smart, non doctor.

TCO (Reviews needed) 22:16, 8 January 2012 (UTC)

I agree. See Misplaced Pages talk:WikiProject Medicine/Archive 24#Helpfulness of data in infobox. Colin° 22:37, 8 January 2012 (UTC)

If you click on the ICD it will tell you that it is, the internal classification of diseases by the World Health Organization. Just one click away... Doc James (talk · contribs · email) 22:38, 8 January 2012 (UTC)

You all are very helpful here (honest, have gotten great help, don't get mad at me), but I still worry that the vast amount of people are getting crufty letters and numbers in a very "valuable piece of real estate". I mean, look at this infobox, is there any reason to have the MeshID (whatever that is) unique identifier so prominent? It feels like putting an ISBN or a LOC catalog number up in a very important area.

For what it's worth, I consider these links and their esoteric codes to be unhelpful, even detrimental, to Misplaced Pages's medical articles. It is especially ironic when COI editors attempt to justify adding external links that are actually more useful than these infoboxes' links. Axl ¤ 23:34, 8 January 2012 (UTC)

Yes as mentioned there has been discussion of what better could go in its stead. With respect to technical data elements such as mercury (element) and chemicals such as Acetic acid have a great deal more. Would be happy to hear about proposals for improvements.Doc James (talk · contribs · email) 00:09, 9 January 2012 (UTC)

I should keep my head low in Project Medicine. Have a little eh...wheelbarrow problem according to some.  ;-)

But seriously, thanks for letting me interact and even thinking about it. Really liked how you all tried to help me get the HF burn image. I finally tracked one down from a hand surgeon (fourth donation attempt!)

Getting serious, now though. Take a look at the different infoboxes. I think in some cases, infoboxes are actually bad (when they just repeat the lead, say for something in Project Mythology) and then they also drive a too small image in one of the few spots where a big image really great. I do like city infoboxes having some of the "World Almanac" info convenient. Am kinda meh on the species infoboxes with the long synonym lists, but they are OK. I think the element or chemical infoboxes are pretty useful. My gut feel is no infobox, would actually serve you better. Then put all the number stuff down in some penatlybox table at the end, sort of like a Project Aviation list of plane specs. but I am just babbling...TCO (Reviews needed) 00:35, 9 January 2012 (UTC)

Oh...and I was seeing some really good doc to talk about something...and he used the Wiki when a question came up! He was kind of young and academic and used a program that had more of a root cause analysis path (not like a normal neighborhood doc, no offense). But he sure as heck did NOT use the ICD stuff. He scanned the text. I had to push him to look at the ref (I'm such a good Wikipedian...but it was some paper by a Harvard doc...and on the web too...)

TCO (Reviews needed) 00:39, 9 January 2012 (UTC)

ICD and MESH codes are mostly a way of aggregating and categorizing data. I don't think they're particularly useful in clinical practice, nor would they be useful to the interested lay reader. It's a bit like including an ISBN or Dewey decimal number in a book infobox. I agree the ICD/MESH info maybe should appear somewhere, but I'd agree with those who think it doesn't belong in an infobox. I agree that there's plenty of borderline useless info in other infoboxes (e.g. elements), but we don't need to follow that lead in our articles if we think it's a bad idea. MastCell  01:03, 9 January 2012 (UTC)

I agree with MastCell here. I think the links in the infobox add important info and should be included somewhere in the article, but inclusion in the infobox skews the article towards their importance. I am a medical student – before I was, I found the boxes confusing. Now, I understand them, but don't find them useful.

Also, I think removing these links from the infobox template would free up room for information which a non-medical reader may find more useful (random examples: name of person who first described disease, date of first description, body system(s) affected etc.). The infobox at present seems to cater more to healthcare professionals as a technical tool, rather than to inform the layman. Basalisk ⁄_berate 01:17, 9 January 2012 (UTC)

Comments 1) Many diseases do not have discovers and have been described since antiquity. 2) Many conditions involved many body systems. 3) The main purpose for the ICDs IMO is the justify how we name the conditions in question. There are BTW exceeding useful when doing medical paperwork. Doc James (talk · contribs · email) 01:46, 9 January 2012 (UTC)

I realise those issues with the examples I suggested. To be honest, I wasn't suggesting them as an alternative, I was just trying to illustrate my point. The ICDs may well be useful to a professional as reference, but I don't think ICDs are useful to a non-medical reader, and it is non-medical readers we're writing for. Basalisk ⁄_berate 13:53, 9 January 2012 (UTC)

The content is "still in the article" even if you shift it to the end. You don't have to have an infobox, either. If the choice is no infobox or one with those Dewey decimal numbers, I would go no infobox and just have a big picture. Make the MESH, ICD stuff a table way at the end. I mean "refs" are helpful for paperwork also. But they are at the end. It's not a question of getting rid of the links, but do they justify their prominence, given low usage and inscrutability.TCO (Reviews needed) 15:59, 9 January 2012 (UTC)

I am happy to consider putting other stuff in the infobox but consider them a good idea in general, better than nothing, and better than the infoboxes for many other subject areas with respect to technicality and usefulness.Doc James (talk · contribs · email) 18:28, 9 January 2012 (UTC)

I agree that the present userbox is a lot better than nothing at all. Perhaps it could be expanded so that it isn't so dominated by the links. Basalisk ⁄_berate 18:49, 9 January 2012 (UTC)

Yes a sandbox was created to trial additions http://en.wikipedia.org/Wikipedia_talk:WikiProject_Medicine/Archive_24#Helpfulness_of_data_in_infobox Doc James (talk · contribs · email) 18:55, 9 January 2012 (UTC)

The ICD codes are actual content; some readers are actually looking for them.

But nobody's looking for the eMedicine section/number, so we could put anything we wanted there. However, I haven't been able to think of anything that doesn't seem pointless (like the name of the disease). WhatamIdoing (talk) 21:17, 9 January 2012 (UTC)

I tend to think of such links as useful in the early stages of article development, less so later on, but not terribly problematic even then. For example, using them avoids wp:OR in choosing article titles among various options. There's some value in them in helping to find different names for the same disease, and in kickstarting interlanguage linking (because the ICD code listings are available in many languages). That's an area that might well someday be bot-assisted. Editors are far from unanimous on the question of hiding information: some want everything reflected on the rendered page, others would happily bury such details on a subpage or under a show/hide toggle. The former perspective seems to be the one that holds sway most often. I'd suggest that the ICD codes should be accompanied by the plain-English name that the code represents. Again, this could be bot assisted. LeadSongDog come howl! 21:25, 9 January 2012 (UTC)

How does hiding the ICD code number help educate the person who actually wants to know what the code is? It's like hiding the atomic number on an element. We know from past comments that real people (both professionals doing medical coding and patients trying to figure out their paperwork) actually use Misplaced Pages to look up these ICD numbers. If you replace 733.9 with Other and unspecified disorders of bone and cartilage, how does the person find the "733.9" that he actually wants to know? By guessing at the number based on the URL? WhatamIdoing (talk) 16:52, 19 January 2012 (UTC)

I did say "accompanied", not "replaced". LeadSongDog come howl! 17:17, 19 January 2012 (UTC)

List of hospitals in India

Hello! This List of hospitals in India is very unorganized and obviously incomplete. I had some doubts about it. Hence thought that anyone would answer them here. Do we define what a Hospital means? I see many clinics also added to this list. Maybe they are hospitals but called as clinics or are clinics itself. But do we have some fixed thought on whats to be included here? And dont we require references? Very few of the enteries are blue linked and that will remain so forever. -Animeshkulkarni (talk) 14:25, 13 January 2012 (UTC)

Quick answers:

• Lists are supposed to define their inclusion criteria at the top of the page (in paragraphs of text). Don't rely solely on the title, which is often incomplete. If no one has defined this list, then anyone who wants to should feel free to do so.
• There is no requirement that lists contain only the names of hospitals that already have articles on Misplaced Pages.
• While references are very desirable, they are only required if one of these four situations apply, which is unlikely in the case of such a list. WhatamIdoing (talk) 16:12, 13 January 2012 (UTC)

Okay! Will discuss with other editors & have a suitable definition of the list on top. Simple definition would be just what the title says. But i think thats too vast. There is this infinte List of cities and towns in India and then there will be n hospitals in them!! Your point about including non-blue linked names is also right. Because many of them are not notable enough to withhold their own article space but are notable enough to be included in a list. Also; in this case references are not required. But this can only be a way to keep the list from getting out of bounds. -Animeshkulkarni (talk) 16:54, 13 January 2012 (UTC)

I understand your concern about the potential size of the list. It might make more sense to have a series of lists, one for each state and territory. A "List of hospitals in Gujarat" is likely to be more manageable. But if it's not actually too long right now, then the WP:SPLIT could be done at some future date. WhatamIdoing (talk) 18:07, 16 January 2012 (UTC)

Major Depressive Disorder (Vincent van Gogh: "At Eternity's Gate")

I refer the group to this thread on the Talk page at Major Depressive Disorder concerning the use of Vincent van Gogh's painting "At Eternity's Gate" in that article and to this comment of mine pointing out it has no place in the article and should be removed.

The essence of the complaint is that is fully documented that van Gogh's painting is not at all, nor was ever meant to be, a portrayal of depressive disorder but is rather merely a study of an old man. For that reason alone it should be removed for reasons of encyclopaedic accuracy.

As it stands it necessarily makes a judgement about the nature of depressive disorder, that it necessarily implies despair, even that it necessarily implies suicidal ideation (because of its title and van Gogh's own well known suicide). It is very much to be regretted indeed in my opinion that a Misplaced Pages administrator, Casliber, a practicising psychiatrist it seems but a poor historian of art, appears to be the prime mover behind perpetuating these poor judgements.

It also mythologises Vincent van Gogh himself who took the greatest care to separate his difficulties in life from his work; the nature of whose illness is not settled but which is not certainly typical of a depressive disorder; who is not documented as suffering from suicidal depressive moods in the last months of his life when this painting was completed and whose suicide itself has in the past year been plausibly questioned by a respected source as rather a manslaughter.

I ask that the image be removed. If it is felt necessary, and I cannot imagine why it should be, that the article be illustrated by a fine art image, then I suggest the original image, Durer's Melancholia, be reinserted. Skirtopodes (talk) 22:33, 13 January 2012 (UTC)

I shall respond to your post paragraph-by-paragraph.

1. Whether or not the painting was intended to portray an individual suffering from major depressive disorder, the contributors to the article thus-far (including some trained psychiatric professionals) believe it does accurately illustrate depression. Neither the caption nor the image description substantiate your claim that the painting is definitely not portraying a depressed man, and so the image is not misleading. To paraphrase: the image gets the point across. It's good for the article.
2. Though you're right in saying that not all depressive patients have suicidal ideations, suicide attempts and suicidal thoughts are one of the most prominent and severe symptoms of depression. The image accurately portrays this. If you go to Meningitis, you'll see an image of the characteristic rash of meningococcal septicaemia. This is a very common presentation of the disease, but meningitis can and does occur without it. That doesn't mean we exclude the image, as it is informative. That said, there is nothing about the image which specifically implies suicide, so I'm not sure what you're trying to argue there, whereas despair and hopelessness certainly are important and virtually universal features of depression.
3. The effect of including this image on the MDD article on either the artist or the artwork itself, is irrelevant. The fact that its inclusion may give rise to popular misconceptions about the mental state of Vincent van Gogh is of no concern when considering the quality of an article about MDD.

Overall, you seem to be obscuring this discussion towards a debate about whether van Gogh really was depressed. The inclusion of the image is not making any dramatic statement in this regard, it is simply seen as a good visual representation of depression. Basalisk ⁄_berate 20:23, 14 January 2012 (UTC)

No. The painting is at the Kroller-Muller in Holland (the original lithograph is apparently lost). The title "At Eternity's gate" is not van Gogh's but some traditional title and it is exhibited at K-M as "Sorrowful Old Man: At Eternity's Gate" http://www.kmm.nl/object/KM%20111.041/Sorrowing-old-man-At-Eternitys-Gate?artist=Vincent%20van%20Gogh%20%281853%20-%201890%29&characteristic=&characteristic_type=Painting&van=0&tot=0&start=63&fromsearch=1. The same collection has an accompanying lithograph from the period of the original lithograph with a title beginning "Sorrowful woman ... " and in addition there is another lithograph from that period depicting the same old man reading a book with concentration and not displaying any signs of strong emotion. It's not clear what van Gogh's theme was at the time (his letters of the time are concerned only with the technicalities of producing these lithographs) but it's clear that at most he was concerned to depict sorrow, which I expect your trained psychiatrists you mention will concede is not a clinical condition. It is in fact only the subjectivity of the viewer who introduces the idea of 'sorrow' looking at this picture, let alone a diagnosis of depressive disorder your trained psychiatrists apparently make.

If the trained pyschiatrists you mention were writing a book on depressive disorder and wished to illustrate it with a dust-jacket depicting this painting, they would have to seek the permission of the trustees of the Kroller-Muller museum and it is far from clear to me that the trustees would wish to grant that permission. As trustees of the estate and moral rights of one of our greatest ever artists, they would undoubtedly wish to see that his work was viewed freely without stereotyping or mythologising the artist and might very well look askance at this attempt to make, quite gratuitously, the painting an iconic representation of depressive disorder and the more so given the considerable difficulty in assessing to what degree illness played a part in the painter's life and indeed what the nature of that illness was.

What your trained pyschiatrists are really doing with this painting are peddling sterotypes and myths. It is absolutely disgraceful and a matter of concern to all art lovers, 'trained' or otherwise. When you consider further, as every beginning student of art history knows, that van Gogh himself wrote intelligently about the relationship between insanity and artistic creation (he took a view that was to become fasionable decades later, that society 'labelled' artists as mad and so indeed they did eventually become) it becomes little short of outrageous, because that labelling is precisely what your trained psychiatrists are doing with the subject of this painting. Skirtopodes (talk) 00:44, 15 January 2012 (UTC)

Look, you are completely missing the point. The effect of the inclusion of the image on the public perception of the work of art doesn't matter, because we are not having a discussion about the history of art. It doesn't matter what van Gogh called it or what he wanted to convey when he painted it, because here, today, it illustrates MDD well. This is the only reason the image has been chosen; not because it has some obscure link to a supposedly depressed artist. We could caption the image "Man about to hang himself in the midst of a major depressive episode triggered by the death of his dog by Duane van Eisenhower" and it wouldn't matter, because it would still accurately portray the condition we're describing. That is the only reason we use this image.

Moreover, we do not have to seek permission from anyone for anything, because the image you are talking about is in the public domain, and thus the trustees of the museum where the original is kept have no control over the distribution of copies.

Take this example. This image, I assume, was taken by the photographer to illustrate the impressive waves it pictures. That's fine. We could also use to portray California (where it was taken), or the Pacific Ocean (as indeed it is, at Pacific Ocean). We could even use it to illustrate how the sky appears blue, or how human settlements are often built by the sea. The fact that the author had none of this in mind when he took the photo would be no good reason to refrain from using it as such; we just use the images for whatever purpose they are useful.

The fact is, no one cares about this huge historical injustice which is apparently being done by using this image in the article, because it serves a good purpose there. It illustrates the subject, it isn't misleading, it isn't illegal. There's no good reason for it not to be there. Basalisk ⁄_berate 01:08, 15 January 2012 (UTC)

No again. It is you who deny an issue and you do it in the time honoured way of accusing me of misunderstanding the 'real' issue.

However, I shall take you as face value and treat what you decribe as the real issue - that the painting is a good representation of MDD (Major Depressive Disorder). I did notice, incidentally, that this last reply of yours moves to the royal wikisodality 'we'. Are we by any chance young and naive - a student perhaps? High school?

Whatever, will you please explain what it is about the image that makes it a good illustration of MDD? That the man is old? That he is holding his knuckles to his face in an apparent gesture of depair? What makes you say the image accurately portrays that suicide attempts and suicidal thoughts are amongst the most severe and prominent symptoms of depression (or so you characterised them for my instruction)?

Above all, will you please quote reliable sources, as should be the Misplaced Pages way, that attest this painting as a good image of MDD. Who are these 'trained pyschiatrists' you mention? It looks likes OR (original research) to me. Skirtopodes (talk) 02:09, 15 January 2012 (UTC)

I will simply say that an image of a man in an apparent state of private despair is a pretty good depiction of major depression (seriously, have you even read the article?). Apart from that, I'm not carrying on this debate and getting into an endless cycle of demands for citations to verify every word I type, especially as you seem willing to stoop to patronisation to derail the discussion. I've made my point. Suffice it to say I disagree with you, and I suspect others may as well. Regards Basalisk ⁄_berate 02:38, 15 January 2012 (UTC)(and congrats on making it as far as my user page and seeing the huge banner announcing that I have exams.)

I would say that it is simply an image of a man in an apparent state of despair and not that he was suffering major depressive disorder, which frankly does strike me as pretty condescending ('patronising') of you. It might be that he is simply in despair, perhaps because he's behind on the mortgage or can't get the Misplaced Pages community to see his point of view (or worried about his exams), and not in the least bit ill. Imagine.

Of course I read the article. Skirtopodes (talk) 02:52, 15 January 2012 (UTC)

Ok hang on, so we are agreed that the picture depicts a man in despair? Basalisk ⁄_berate 02:59, 15 January 2012 (UTC)

I had a funny feeling you may suddenly lose your voice. Anyway, allow me to illustrate:

1. Despair, defined by dictionary.com as loss of hope; hopelessness.
2. Hopelessness, along with anhedonia, is one of the two main prerequisite conditions for depression, according NICE guidelines.
3. Despair (and thus by extension, hopelessness) is portrayed, by your own admission, by the painting (controversially) titled At Eternity's Gate by Vincent van Gogh.
4. Thus, the painting accurately illustrates one of the two most important clinical features of clinical depression.

Q.E.D.. Is this sufficient? Basalisk ⁄_berate 03:31, 15 January 2012 (UTC)

Jackie Duffin

Is Jackie Duffin better off merged into Marie-Marguerite d'Youville? Casliber (talk · contribs) 05:36, 15 January 2012 (UTC)

I think these should not be merged. NCurse _work 15:46, 15 January 2012 (UTC)

Violations of MEDRS at Prevention of migraines

Please take a look here: Talk:Prevention_of_migraines#Many_violations_of_MEDRS -- Brangifer (talk) 08:48, 15 January 2012 (UTC)

Prostate cancer. 174 references

A primary, empirical study
Primary studies	62
Secondary studies (reviews / meta-analysis)	40
Medical information resources	24
Epidemiology / statistics / overall studies	18
Newspapers / news sources	17
Textbooks	8
Uncertain and/or difficult to classify	5
SUM	174
Primary studies	35,6 %
Other studies etc.	64,4 %

Castration – resistant prostate cancer (CRPC) is being treated with the plant secondary metabolite taxol (class: alkaloid). I am about to rewrite the Pomegranate health section with a focus on ellagitannins and anthocyanins (class: phenols). Many authoritative reviews are available. It is my opinion that reviews are preferable (as a safeguard), but that they should not become a strait jacket (secondary studies are based on primary studies …). What do you think about the balance in the example above? Granateple (talk) 16:22, 15 January 2012 (UTC)

Absolutely not, per MEDRS, NPOV, and OR. --Ronz (talk) 16:51, 15 January 2012 (UTC)

Ronz, you need to remember that WP:OR is the policy that directly says "primary sources that have been reliably published may be used in Misplaced Pages". WP:USINGPRIMARY sources is permitted on the English Misplaced Pages, even in medicine-related articles. WhatamIdoing (talk) 18:20, 16 January 2012 (UTC)

Sorry I wasn't clearer: Absolutely not in the Pomegranate article. --Ronz (talk) 06:21, 19 January 2012 (UTC)

As I said, many peer reviewed and authoritative reviews are available, published in reputed academic journals. They assess both completed and ongoing clinical trials (ongoing: M.D. Anderson Cancer Center, Johns Hopkins Medical Center, University of California (LA) in collaboration with the National Cancer Institute). This pertain to Medicine. You are a man of few words, can you elaborate? Granateple (talk) 15:09, 19 January 2012 (UTC)

We'll have to see the sources, but looks to me like we're doing original research to make a case for heavily promoting a health claim into an article on a foodstuff that contains some bio-active substances that may have some positive health effects. --Ronz (talk) 16:36, 19 January 2012 (UTC)

One thing to remember is that we are permitted to WP:USEPRIMARY sources, even in Pomegranate—but that doesn't mean that we can use primary sources that way. For example, I recommend dumping the Kaplan mouse study, because no mouse study can "directly support" a claim that pomegranates reduce LDL oxidation in humans (which is what the sentence in the article clearly implies). WhatamIdoing (talk) 16:46, 19 January 2012 (UTC)

I agree with you. One part of the Pomegranate article is outdated. I will rewrite it and use secondary sources (reviews), and only cite a primary study when it fit into the context. Granateple (talk) 17:45, 19 January 2012 (UTC)

As I said, we'll have to see the sources. NPOV, OR, MEDRS all apply. If the information doesn't apply directly to pomegranates and there are no secondary sources guiding us around NPOV, OR, and MEDRS problems, then it doesn't belong. --Ronz (talk) 20:53, 19 January 2012 (UTC)

A centralized discussion was started on the Cranberry talkpage. A summary of the input from the community can be found there. Granateple (talk) 01:14, 20 January 2012 (UTC)

We're discussing the matter here and now at your request. Please continue if you want to be a part of the consensus-making. --Ronz (talk) 17:34, 20 January 2012 (UTC)

The primary sources need addressing, but this does not give you a carte blanche to discuss unproven or doubtful non-standard treatments.

Secondary sources are usually not "studies" but reviews or textbook chapters that place the mass of primary research in context, describe trends, and identify gaps in the knowledge base. JFW | T@lk 20:33, 15 January 2012 (UTC)

I depend on the community. I somewhat agree with you, but I prefer to use other words. The in vitro and in vivo results are promising, but the clinical findings (prostate cancer, rheumatoid arthritis etc.) are early and limited, and should be used with care.

As to the question regarding secondary sources vs. primary studies, it is my impression (being a Wikipedian for three months) that the majority do a very good job, respect the NPOV and do their best to build an Encyclopedia. That is why I think that something also must be left to the judgment of its members. Perhaps the contributors to the “Prostate cancer” article have found a certain balance? Granateple (talk) 00:18, 16 January 2012 (UTC)

Prostate cancer articles needs a rewrite using review articles. I will get there eventually. Look at featured articles like dengue fever for the appropriate balance. It uses all secondary sources. Doc James (talk · contribs · email) 08:40, 16 January 2012 (UTC)

It's a little complicated, because primary sources are always fine for some purposes (e.g., a particularly famous paper), and what the best balance is depends on both the subject (good luck finding a bunch of secondary sources for extremely rare diseases) and on the use (a textbook cited 20 times is more important to the article than three primary sources, even though you might say that 75% of the citations were to primary sources).

What we really want editors to do is to use the best type of source that is available. WhatamIdoing (talk) 18:20, 16 January 2012 (UTC)

I know WhatamIdoing likes to correct any statements that smack of WP:BANPRIMARYSOURCES but empirical evidence is that citations to primary research papers nearly always indicate an incorrect use of sources, an attempt to violate WP:WEIGHT, and evidence the editor is conducting their own review of the primary literature. For example this edit to ketogenic diet required reverting twice after this editor didn't get the point. Frequently we see such editors cite policy or guidelines in saying they "may use primary sources", even arguing no reviews exist (which in this case is clearly false). Can we, for balance, ensure that every time it is pointed out that one may use primary research papers as sources for medical articles, also point out that is is very likely that one should not. And the chances that one should not increase if one is in a dispute over content. In addition, discussion of PSTS without context is pointless. BTW, I can think of a "particularly famous paper" by a chap called Wakefield. Colin° 13:48, 23 January 2012 (UTC)

Ouch! But there are some generic instances that we can identify. Eponymously named diseases such as Alzheimer's, Parkinson's, etc generally got those names for a seminal paper that should be cited in our articles, just as those papers are frequently cited in subsequent reviews and texts. We could hardly ignore Wakefield in the articles on autism or the vaccination controversy. The trick is not to fall into the error of treating these primary or outdated sources as more reliable than the subsequent higher-quality sources in the article. They remain of interest to readers (if only historically) and should be included with appropriate context from current reviews. This is of course not an argument in favour of nonsense such as medicinal mushrooms where the use of primary sources has run amok. LeadSongDog come howl! 14:19, 23 January 2012 (UTC)

I do not mind if people use primary sources in the history or society and culture sections of an article. It is when they use them for medical information especially when secondary sources are available. This editor wishes to discuss palates for hernia treatment as seen here and justifies it by saying MEDRS states no academic sources can be used with causion .Doc James (talk · contribs · email) 14:28, 23 January 2012 (UTC)

We absolutely do not cite seminal papers "just as those papers are frequently cited in subsequent reviews and texts" -- for reviews and other text cite the source research paper as a matter of course and in order to attribute credit. Citations can appear in WP articles for two reasons. The most common is when referring to a source used by the editor for the article. Another less common reason is to fully identify the work or study referred to in the text. The former typically appears as footnotes in a References section. The latter could appear in the article body (e.g., a list of papers published by someone, in their bio article), in a Bibliography section or as a footnote. It is not uncommon to see such footnotes interspersed with article-source citations in the References section but there could be a separate Notes section or the Bibliography could be hyper-linked from the body text if one wanted. If you haven't actually read the paper, then WP:SAYWHEREYOUGOTIT requires you add a "cited by..." suffix if you put it in with the References. Such info-citations aren't covered by WP:V or WP:MEDRS: they aren't sources.

Editors may wish to list Parkinson's seminal work(s) to inform the reader. But lets not pretend they are sources . You didn't, one dull wet afternoon in an obscure corner of the university library, happen upon some old manuscript and say to yourself "You know, this Parkinson fellow might just have been the first person to describe that shaking palsy disease". Unlike in academia, we should not be ashamed to cite the true secondary source of our information, and we are under no obligation to credit the original discoverers of new information.

Using primary sources in the History section is as potentially troublesome as using them in any part of WP. The history of medicine might generally be less controversial than the efficacy of alternative medicine or the toxicity of western drugs but the problems remain. Colin° 20:04, 23 January 2012 (UTC)

Template problems

Hi, some medical navigation templates, such as Template:Nervous tissue and Template:Virus topics, contain a whole bunch of gibberish, like "noco(m/d/e/h/v/s)/cong/tumr, sysi/epon, injr" and so on. Has something gone wrong with these? If it is for some reason intentional then it seems a rather bad idea. Who is supposed to understand it? 86.181.172.222 (talk) 18:31, 15 January 2012 (UTC)

Yep. They are quite incomprehensible without prior knowledge, purest wp:Easter eggery. LeadSongDog come howl! 14:20, 16 January 2012 (UTC)

It looks like the original author (Arcadian) wanted to crosslink all relevant templates to each other. I'm sure this could be done in other ways. JFW | T@lk 16:47, 16 January 2012 (UTC)

See Template:Medicine navs, and the notes at the bottom. --Arcadian (talk) 19:29, 21 January 2012 (UTC)

linking to Clinicaltrials.gov as a reference

Is there a policy of linking to clinical trials as a reference? In general I make it a habit to remove links to prospective or ongoing clinical trials; though there's guidance regarding external links, what about those found in the body of the article? As an example, I just removed an entire table of "advanced disease-modifying drug (DMD) candidates". It would seem to violate WP:CRYSTAL. Is this is what is implied by the statement "Misplaced Pages is not a directory of clinical trials or researchers" in the diseases section of MEDMOS?

For context, right now "clinicaltrials.gov" is found nearly 600 times and even on the first page a lot seem to be direct links to ongoing trials. WLU (t) (c) Misplaced Pages's rules:/_complex 15:22, 17 January 2012 (UTC)

I agree that they violate WP:CRYSTAL and thus should in most situations be removed. There are secondary sources that put ongoing research into better perspective.--Doc James (talk · contribs · email) 16:01, 17 January 2012 (UTC)

I don't see how saying "As of 2011 ClinicalTrials.gov listed over 600(/only one/no) active clinical trials on X disease" would violate CRYSTAL. It provides a crude but impartial measure of how much research is being conducted on a topic. It is a wp:ROUTINE factoid that doesn't need MEDRS secondary sourcing afaikt. The problems arise when the details of such trials start being put as facts in the voice of WP, which would need RS or even MEDRS (depending on what was being stated). LeadSongDog come howl! 17:34, 17 January 2012 (UTC)

My issue, particularly if a single clinical trial were linked to, would be the implication that this clinical trial will have impprtant results. What do you think of the diff I included in my first post? WLU (t) (c) Misplaced Pages's rules:/_complex 18:40, 17 January 2012 (UTC)

Looking at the version prior to your edit I don't see any very controversial assertion made in the table, but I agree that the criteria for inclusion should have been made clear -- in fact I doubt they were ever systematically considered in this case. I might have looked for a statement including all results of this query which found 14 records on "alzheimer AND Studies With Results AND Interventional Studies AND disease modification AND Phase III, IV", then perhaps adding an end date limit, on the premise that any truly significant results will have been reviewed after two years, and thus be available in better quality sources.LeadSongDog come howl! 20:27, 17 January 2012 (UTC)

I think that, at best, it might be a barely acceptable primary source, but I generally discourage them.

In particular, for something like Alzheimer's (where excellent sources about the state of research exist), it smacks of advertising and promoting trials. If it were some rare disease, then that website might be the best source available to the editors, but that's never going to be the case for Alzheimer's. WhatamIdoing (talk) 21:51, 17 January 2012 (UTC)

• I certainly do not agree that linking to clinicaltrials.gov would violate WP:CRYSTAL. In fact, that page says this specifically: "It is appropriate to report discussion and arguments about the prospects for success of future proposals and projects or whether some development will occur, if discussion is properly referenced". If someone is now going to change that, please let me know because I don't have it watchlisted. Mentioning on ongoing clinical trial does not say that it will be successful, but it does provide further, often notable information on the topic, and when the due date for the clinical trial comes up, it provides a reminder for the editor to go look for the results. My opinion is that removing these without a good reason is a poor use of time, likely to lead to pointless and lengthy arguments (if nobody else, I may defend their inclusion), and does not serve the reading public in any way that I can tell. Admittedly, ideally these trials would be large and have secondary coverage. Also, considering that trials are often eager to find people, from a public policy perspective they could help connect potential participants connect to trials, a perennial problem (see, e.g., http://www.nytimes.com/2009/08/03/health/research/03trials.html?pagewanted=all) and help draw scrutiny to clinical trials prior to publishing, which is often nice given the common methodological flaws which are discovered after all the money and effort is spent. II | (t - c) 21:52, 17 January 2012 (UTC)

II, makes me think of the injunction in the "Diseases" subsection that points out we're not a directory of clinical trials (and not said there but implied - we're not here to help recruit people).

These links would be very susceptible to link rot as the trials end and new ones begin, and if secondary sources exist discussing a clinical trial then they are redundant.

There's no consensus apparent on removing them and that pretty much addresses my original question, thanks for everyone's comments. WLU (t) (c) Misplaced Pages's rules:/_complex 23:15, 17 January 2012 (UTC)

Under the recommendation for a section called ==Research directions==, it says "Misplaced Pages is not a directory of clinical trials or researchers." It's been there since the summer of 2010. The nearly identical injunction at WP:MEDMOS#External_links is even older. WhatamIdoing (talk) 01:46, 18 January 2012 (UTC)

Of course, Misplaced Pages is not a "directory" for anything (Misplaced Pages:DIRECTORY#Wikipedia_is_not_a_directory). So that by itself is not saying anything we don't already know. II | (t - c) 21:45, 20 January 2012 (UTC)

DSM copyright

Could someone check the copyright status on Global Assessment of Functioning? There are past problems noted on its talk page, and I think they may have resurfaced. WhatamIdoing (talk) 01:41, 18 January 2012 (UTC)

A copy of it is here http://www.medi-mouse.com/graphics/GAFScale.pdf Doc James (talk · contribs · email) 06:49, 19 January 2012 (UTC)

References

As many of you know I am working on a project to translate our top importance articles into as many other languages as possible. One problem I have encountered is that while {{cite}} is support in other wikis {{vcite}} and {{sfn}} is not. Is there any agreement here to go with cite?Doc James (talk · contribs · email) 09:00, 20 January 2012 (UTC)

Please excuse the refactoring James. Did you mean you wanted to use 'cite' to replace 'vcite' and 'sfn' (and presumably {{harvnb}}?) in our en-Misplaced Pages articles, or in the translated articles in other language wikis? --RexxS (talk) 12:16, 20 January 2012 (UTC)

Are you proposing changing the en.wiki articles? Then no, please leave the templates alone. Any {{vcite}} template on en.wiki can be converted to a {{cite}} template on another wiki by just dropping the "v". Colin° 12:52, 20 January 2012 (UTC)

What I am wanting is that text I have worked on and cited with "cite" not be changed to other reference styles by those who do this and where not involved in writing the content in question.

What is the benefit of "vsite"? And why is this bot doing it?

If justification can be provided I might be convinced... Doc James (talk · contribs · email) 14:58, 20 January 2012 (UTC)

On some articles, such as Alzheimer's disease, the sheer number of cited references has meant that the switch from {{cite journal}} to {{vcite journal}} was necessary for technical reasons. The html rendering is much smaller and faster. LeadSongDog come howl! 14:53, 20 January 2012 (UTC)

While if that is the case how much work is it to switch other wikis over? And should we be going be vcite across the board? I see there is already a bot that does this... We should change the ref tool in the edit box aswell... Doc James (talk · contribs · email) 15:08, 20 January 2012 (UTC)

There is a discussion of the relative speeds of citation templates at Misplaced Pages talk:Featured article candidates/Citation templates (technical). Vcite is quicker than Cite because it does not offer as many features. In addition, Vcite uses a "Vancouver" style of reference formatting, rather than the normal "wikipedia house style" (which I think is mainly based on a "Chicago" style). You'd need to make proposals to change policy in such a major fashion at the Village pump, but be prepared for lots of opposition as everyone has their own favourite referencing schemes, and will defend them because each offers some advantages over the others. --RexxS (talk) 15:17, 20 January 2012 (UTC)

The issue discussed at Talk:Alzheimer's disease was that the NewPP limit report (shown as a comment in the rendered html) was showing the Post-expand include size maxed out at 2048000/2048000 bytes, breaking the subsequent navigation templates at the end of the page. Changing to vcite cut that number to 1058289/2048000, even after the additional templates at page-end were once again correctly rendered. Compare the before and after versions. For medical topics, Vancouver is generally accepted anyhow, having been developed and adopted (with minor variances) for use by all the major medical journals. It's used, for instance at Parkinson's disease, which is FA-class. LeadSongDog come howl! 20:49, 20 January 2012 (UTC)

The applicable rules are at WP:CITEVAR. Misplaced Pages does not have a single "house style". The style chosen varies between articles, based on what editors at that particular article believe is best. If you want to change the style on an article, you must have a discussion (at each and every single article, not just one mass discussion here) that demonstrates a consensus to change the style for that article. This means, by the way, that if the article is already using vcite, then you need to use vcite for any material that you're adding or re-working, even if that means going to the trouble of manually typing a "v" into the template that Diberri's tool generates for you. WhatamIdoing (talk) 04:47, 22 January 2012 (UTC)

At the risk of being pedantic here, Misplaced Pages does have a "house style" (although I feel we are using it in different senses), which is the default produced by the {{cite}} templates: author1 last name; comma; author1 first name; semicolon; additional authors; year in parentheses; period; title in quotes and linked; period; publication in italics; period; etc. This is neither Chicago, nor API , nor Vancouver, but a hybrid that Misplaced Pages has created. In that sense alone, it is our house style, but obviously is not mandatory. Everything else WAID said is absolutely correct however, and editors may invest a lot of effort into deciding which style of reference works best in any given article. They will often not take kindly to wholescale changes for no obvious reason. --RexxS (talk) 03:05, 23 January 2012 (UTC)

Last I checked, several of the cite templates are incompatible with other cite templates.

If your definition of house style is "made up on Misplaced Pages", then we have hundreds of house styles, and four or five commonly used ones. WhatamIdoing (talk) 03:44, 23 January 2012 (UTC)

The {{cite}} series use a common set of core routines and have been tweaked over time to return reasonably consistent results within the family. Of course {{citation}} gives a noticeably different format, so the two shouldn't be mixed; likewise for {{vcite}}. The editing interface presents an editor with the 'cite' family from the toolbar, and I expect that the majority of citation templates are inserted by that route using default settings in a style that appears to be unique to Misplaced Pages. That was what I had in mind when I used the phrase "house style". --RexxS (talk) 14:50, 23 January 2012 (UTC)

"In other animals"?

WP:MEDMOS recommends inclusion of a section "In other animals" in medical articles. While this may be appropriate for predominantly "animal diseases" such as myxomatosis, I don't think that it is appropriate for "human diseases", or least articles that are clearly about the disease in humans. For such articles, could we change the guideline to recommend the section title "In animals" instead? (Yes, I am aware that humans are technically animals.) Axl ¤ 16:27, 20 January 2012 (UTC)

I like "in other animals" as there are still some who try to claim humans are not. Most articles I agree will not and do not have this section. We can make it optional maybe?Doc James (talk · contribs · email) 16:34, 20 January 2012 (UTC)

I prefer "in other animals" too. I think that it connects humans to the tree of life. Snowman (talk) 17:32, 20 January 2012 (UTC)

I suppose "in other species" might be a more general answer, plus avoiding the problem of confusing the bizzarely large number of people with the misconception that only mammals are animals. LeadSongDog come howl! 21:02, 20 January 2012 (UTC)

I quite like "In animals", because when asked to make the distinction people will probably distinguish between "people" and "animals". JFW | T@lk 22:58, 21 January 2012 (UTC)

Dissociative identity disorder

There is a full-blown edit war going on at this article and it could use the intervention of some level-headed editors from this project. Thanks. --Guillaume2303 (talk) 10:28, 21 January 2012 (UTC)

Looks like things have quieted down a bit.Doc James (talk · contribs · email) 17:35, 21 January 2012 (UTC)

• Since midnight, over 25Kb of text has been added again to the talk page in 51 edits, with accusations of meatpuppetry and off-wiki hounding... --Guillaume2303 (talk) 09:29, 22 January 2012 (UTC)

And now we have one of the editors deciding unilaterally that we should not be producing a table of contents where a section has a single subheading because it doesn't match his concept of what a sub-division should entail, and dismissing any advice to the contrary. More eyes at Talk:Dissociative identity disorder would be much appreciated. --RexxS (talk) 03:30, 23 January 2012 (UTC)

The environment for that article is really screwed up. We seem to have a couple of POV pushers—maybe a couple on each side, but definitely two on the "There is no controversy whatsoever about this condition" side of things. The appearance of several level-headed editors would be appreciated. WhatamIdoing (talk) 04:31, 23 January 2012 (UTC)

Potential project for a student

I am going to be apply for a summer student and have proposed a project here Comments welcome.Doc James (talk · contribs · email) 13:48, 21 January 2012 (UTC)

MEDRS and sock check

• http://en.wikipedia.org/Special:Contributions/NutritionalNeuroscientist
• http://en.wikipedia.org/Special:Contributions/Mariahsalyer

New account takes up where Mariahsalyer left off; adding primary studies to articles. SandyGeorgia (Talk) 18:01, 21 January 2012 (UTC)

Thanks and fixed.Doc James (talk · contribs · email) 18:17, 21 January 2012 (UTC)

Golding Bird

Golding Bird has been nominated for FA. You are welcome to add your comments there. SpinningSpark 13:09, 22 January 2012 (UTC)

Really amazing job! NCurse _work 12:36, 23 January 2012 (UTC)

Image caption in pneumothorax

Re: File:Pneumothorax CXR.jpg. This image was uploaded to Commons and described there as an X-ray of someone how had clinical tension pneumothorax. The caption for this image on the Pneumothorax article is being discussed at Misplaced Pages:Featured article candidates/Pneumothorax/archive1. The current caption is "Chest X-ray of left-sided pneumothorax (seen on the right in this image). The left thoracic cavity is partly filled with air occupying the pleural space. The mediastinum is shifted to the opposite side." Currently, the caption and the Commons image description may be unstable. I think that mention of tension pneumothorax should be included in the image's caption in the Misplaced Pages article. Any comments? Snowman (talk) 14:24, 22 January 2012 (UTC)

Yes there is a debate. As per this ref and my years of ER training a CXR that shows a tension is one that should never have been taken as treatment should have been carried out before hand.. And while not diagnostic a X rays can be consistent with tension pneumothorax and this is indeed common medical usage. It can also be suggested by an Xray per and some cases are missed clinically as health care is not perfect. Doc James (talk · contribs · email) 16:23, 22 January 2012 (UTC)

This editor has repeatedly been ignoring my contention (based on the sources) that X-ray appearances do not correllate with the presence or absence of tension. One of the sources on pneumothorax (Noppen & De Keukeleire) states unequivocally that mediastinal shift is a common feature on X-rays in people with pneumothorax, and that this is not a proxy for tension. The sources make very clear that tension is defined by the clinical state of the patient. Despite this, Snowmanradio has repeatedly insisted on adding to the image caption that the "X-ray is consistent" with tension, something that one simply cannot conclude from the image. JFW | T@lk 01:14, 23 January 2012 (UTC)

I think that Snowmanradio's changes amount to a straightforward NOR violation and should be rejected. I also think it inappropriate for him to worry about the state of the Commons information page, as what appears not only a completely separate page, but actually a completely separate project is irrelevant to the FAC. WhatamIdoing (talk) 01:20, 23 January 2012 (UTC)

There is no element of NOR in writing "consistent with tension pneumothorax" in the caption. The original X-ray description on commons said that the person, who was X-rayed had tension penumothorax clinically. I agree with User Doc James that "abc changes are consistent with a diagnosis of xyz" is a commonly used expression. The phrase is used in X-ray reports, pathology reports, and probably many other situations. I think that than an X-ray, like this one, consistent with a potentially life threatening condition should have "consistent with tension pneumothorax" (or another phrase to mention tension pneumothroax or an emergency in an appropriate way) written clearly in the caption. I am concerned partly because readers might look at the image and read its caption, but not read the text in the article. Incidentally, I think that image documentation on Commons it a legitimate topic for FAC, especially when there are important differences between the two. Snowman (talk) 09:54, 23 January 2012 (UTC)

Yes a CXR does not rule in a tension pneumo but it does rule it out if one only sees a small pneumo.Doc James (talk · contribs · email) 11:39, 23 January 2012 (UTC)

I am not quite sure exactly what Doc James is saying "yes" too, but I think he is again confirming that "consistent with a tension pneumothorax" is a useful thing to say about this X-ray. I do not see a mass of fibrosis that could be pulling the mediastinum to one side in the lung not affected by the pneumothorax. I maintain that this X-ray is consistent with a tension pneumothorax and that this dangerous possibility should be mentioned in the caption. Snowman (talk) 13:58, 23 January 2012 (UTC)

I agree with Doc James' statement that a person with a "clinically diagnosed tension pneumothorax" should not proceed to x-ray prior to treatment. That assertion alone makes the Commons text questionable. The Commons text continues: "Due to the fact this is an posterior to anterior x-ray of the patients chest, the patient's left is your right (as if you are looking at the patient facing you". That statement is unequivocally false. The only information that we can definitively claim from the x-ray alone is that there is a pneumothorax with tracheal deviation away from the side of the pneumothorax. We can't even be sure which side is the left; for some reason the marker has been obscured. (I accept that the shape of the heart suggests that the x-ray is in the conventional orientation.)

" While not diagnostic a X rays can be consistent with tension pneumothorax and this is indeed common medical usage. "

— Doc James

" I agree with User Doc James that "abc changes are consistent with a diagnosis of xyz" is a commonly used expression. The phrase is used in X-ray reports, pathology reports, and probably many other situations. "

— Snowmanradio

I am unable to view the links that Doc James provided. Radiologists and pathologists are provided with a lot of extra clinical information. Indeed they keep insisting that clinicians provide as much relevant information as possible, because it assists them in reporting. Despite extra clinical information, radiologists may "sit on the fence" with terms such as "consistent with", purely because the diagnosis must be made in the clinical context, not from the x-ray alone. Axl ¤ 14:18, 23 January 2012 (UTC)

I would like to advance the discussion, because I think that writing in the possibility of a significant diagnosis in a X-ray or pathology report with "consistent with a diagnosis of xyz" is primarily to inform clinicians useful information and it is not simply a case of "sitting on the fence". Writing in "consistent with a diagnosis of xyz" is proactive, while at the same time being honest about the limitations of the material or images at hand. It is also for medico-legal reasons, to insure that the clinician is aware of the possibility of a significant diagnosis or sometimes to write in a working clinical diagnosis that has ample alternative documentation. I would agree about delays taken to do an X-ray of a clinical case of tension pneumothorax could be very important here, and the expected delays are dependant on the whereabouts of the patient. I was reading one reference yesterday, which said that some tension pneumothoraces take hours to evolve, while others are very quick. If the X-ray facilities are distant then this would make the time delays of doing an X-ray even more unacceptable. I would agree that the image description on Commons could be improved. The image shown in the article is a cropped version and the un-cropped image can be seen in the file history in Commons. The shape of the heart, a possible stomach bubble under the left of the diaphragm and the possibility of a radio-apaque liver under the diaphragm on the right are all indicators of the left and right orientation, and I think that there is no doubt about its orientation. I had access to two out of three of the external links Doc James provided. Snowman (talk) 14:52, 23 January 2012 (UTC)

The image description on Commons may need to be rewritten carefully with the information of a fictional case showing this X-ray at clinical cases. I am used to reading about "true cases" and I am not sure to what extent the case history on clinicalcases is fictional or real (with some circumstances changed). The websites disclaimer says; "There are no real life patient data on this website." Snowman (talk) 16:43, 23 January 2012 (UTC)

I think that this discussion should be continued on Talk:Pneumothorax or on the FAC page. JFW | T@lk 20:39, 23 January 2012 (UTC)

I have tidied up the image description on Commons. Snowman (talk) 10:28, 24 January 2012 (UTC)

Inguinal hernia

User:Mokotillon wish to add the following text to inguinal hernia supported by a ref to http://www.groin-hernia.com/herniabible/exercises.html and a youtube video. He feels that these refs are supported by WP:MEDRS as mentioned here .

Alternative treatments to surgery, like pilates exercices, have been suggested, but they have neither been backed nor denied by empirical studies.

1. Hernia Bible - exercices These exercices do NOT constitute a medical advice. However, they are not medically contra-indicated either, and there potential efficiency has not been studied.
2. Hernia Exercises These exercices do NOT constitute a medical advice. However, they are not medically contra-indicated either, and there potential efficiency has not been studied.

IMO this is WP:OR and WP:UNDUE. As well as not supported by WP:MEDRS. Further comments welcome.Doc James (talk · contribs · email) 16:10, 23 January 2012 (UTC)

Nope, it's straight WP:FRINGE and has no place in Misplaced Pages. I think Mokotillon is acting in good faith, but is clearly mistaken about what our requirements are for medical claims. I've pointed him to WP:REDFLAG as well to try to establish some perspective. --RexxS (talk) 16:43, 23 January 2012 (UTC)

More pneumothorax

Hello all, at the risk of boring everyone, I'd really appreciate some more comments at the FAC for pneumothorax. JFW | T@lk 22:50, 23 January 2012 (UTC)

should articles about medical conditions only deal with medical information?

Should articles about medical conditions only deal with medical information? Or can they also report about what people actually do with their disease, (as far as this practice meets WP:notability), even if the medical community has not written anything about it? The current guidelines WP:MEDRS do not deal with this topic: they deal with non-academic sources http://en.wikipedia.org/Wikipedia:Reliable_sources_%28medicine-related_articles%29#Other_sources as sources of medical information, but they do not deal with them as sources of information about social practices related with a medical condition. This is different: I think that medical information should clearly be separated from social practices information, but I also think that both can be part of the same article. For example, evolution article has a section "Social and cultural responses".Mokotillon (talk) 14:47, 24 January 2012 (UTC)

Open Access Journals and related issues

There is a serious question about the legitimacy of "open access" journals as sources under WP:MEDRS. Clearly, the concept that the author pays to have his paper published is at odds with the traditional model of academic journals, raising questions about the extent to which the journal's editorial standards (assuming it has any to begin with) are compromised by the lure of the cash from the prospective authors. Many open access journal publishers have been singled out as nothing more than the academic journal version of a vanity press, others identified as being on a "watchlist" for having vanity press aspects that raise questions. This question came to my attention because of a large number of articles in open access journals of recent vintage being extensively used as sources in the Misplaced Pages article Transcendental Meditation research. See discussion here Talk:Transcendental_Meditation_research#Sources_under_scrutiny I question (i) whether any "open access" journal can serve as a source and (ii) if being an "open access" pay-to-play journal is not automatically disqualifying, how we establish for purposes of WP:MEDRS whether a particular publisher or a particular journal is indeed high-quality, accepted and reputable. Anybody nowadays can publish an online-only journal, claim to have peer review, put an impressive name on it, and have someone at Misplaced Pages use it as a source on a medical article. Thoughts? Fladrif (talk) 16:05, 24 January 2012 (UTC)