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RFC: Are medical statements such as those from the World Lung Foundation reliable for medical content?

The following discussion is an archived record of a request for comment. Please do not modify it. No further edits should be made to this discussion. A summary of the conclusions reached follows.
Clear policy-based consensus that such statements are (a) reliable and (b) appropriate for inclusion. Guy (Help!) 08:50, 17 April 2015 (UTC)

The dispute revolves around material from the World Lung Foundation which was removed in this diff and mterial from the World Medical Association was removed in this diff.

The text from the WLF in our article was "The World Lung Foundation stated that "Researchers find that many e-cigarettes contain toxins, contaminants and carcinogens that conflict with the industry’s portrayal of its products as purer, healthier alternatives. They also find considerable variations in the amount of nicotine delivered by different brands. None of this information is made available to consumers so they really don’t know what they are ingesting, or how much."; cited to this statement released by the WLF.

The text from the WMA in our article was "In October 2012, the World Medical Association stated, "Manufacturers and marketers of e-cigarettes often claim that use of their products is a safe alternative to smoking, particularly since they do not produce carcinogenic smoke. However, no studies have been conducted to determine that the vapor is not carcinogenic, and there are other potential risks associated with these devices: Appeal to children, especially when flavors like strawberry or chocolate are added to the cartridges."; cited to this statement released by the WMA.

Should these statements be included in the article? Yobol (talk) 20:44, 19 February 2015 (UTC)

Positions

  • Include statements. Both statements are reliably sourced to WP:MEDRS compliant sourcing, specifically position statements by medical organizations. Arguments for their removal including assertions that tertiary sources cannot be used on Misplaced Pages fly in the face of WP:MEDRS which explicitly allows for the use of tertiary sources including medical textbooks. While I would agree that these are not the most ideal MEDRS sources, neither of these statements appear at all controversial in content, and the sourcing is adequate for the purpose. I should also note that it has been argue above that there is a "consensus" that only review articles can be used as sources here. I will note that this declaration of a consensus appears to have been made up whole cloth out of thin air, and no evidence whatsoever of any such consensus has been produced. Yobol (talk) 20:44, 19 February 2015 (UTC)
KimDabelsteinPetersen, you deleted a number of sources including reviews. So what is your explanation for also deleting the secondary reviews you state should be used instead? QuackGuru (talk) 17:47, 9 March 2015 (UTC)
First, you have no idea whether these statements are secondary or tertiary, as you do not know what data or studies the sources base their statements on. Second, even if they were tertiary sources, however, tertiary sources are not disallowed by WP:RS, WP:MEDRS or any other policy or guideline on Misplaced Pages. Removing them repeatedly merely on the basis that they are tertiary sources does not comply with any Misplaced Pages guideline or policy. Yobol (talk) 20:57, 19 February 2015 (UTC)
If it is not tertiary - then they are then primary... which doesn't make it better. Once more: We should use the best secondary review WP:MEDRS compliant papers. If the information in a position statement cannot be found in the secondary review literature - then there really is a problem with using position statements - because then they are purely politically based. There is a specific article for position statements. --Kim D. Petersen 21:02, 19 February 2015 (UTC)
They clearly are not primary as they are using the underlying medical literature as a source (either the primary or secondary literature), making those statements at least secondary in nature. You are trying to make up your own rules on what is allowable per MEDRS. These are position statements by medical organizations and therefore MEDRS compliant. We don't have additional rules that they have to be corroborated by a published review article, and we certainly do not have a restriction to only review articles in MEDRS. Please stop making up your own rules. Yobol (talk) 21:07, 19 February 2015 (UTC)
Are you truly trying to say that we cannot decipher or "know what data or studies the sources base their statements on"?? And then you still want to use it? Erh? Don't you see a problem here? I would assume that they get their positions from the secondary literature, and not just make up stuff that isn't in the medical literature already. --Kim D. Petersen 21:04, 19 February 2015 (UTC)
They could also be basing it off the primary medical literature, making the statements a secondary source. Yobol (talk) 21:07, 19 February 2015 (UTC)
Then we should be able to decipher what secondary sources they are based upon. Position statements are less reliable than secondary review articles under all circumstances. If they are purely based upon primary material, then they even less reliable than secondary review papers. So use: Secondary review material instead - just as consensus has been on electronic cigarette articles all of the time. --Kim D. Petersen 21:18, 19 February 2015 (UTC)
There is no such consensus, and repeatedly declaring such a consensus exists does not make it so. Yobol (talk) 21:20, 19 February 2015 (UTC)
There most certainly has been such a consensus - no matter how much you argue against it. But consensus can of course change, but please consider the consequences. So far everything has been based upon secondary review material from highranking MedLine indexed journals - are we throwing that requirement away? --Kim D. Petersen 21:28, 19 February 2015 (UTC)
If such a consensus exists, that the only sources allowable for medical content is published review articles, please point out the talk page section or RfC which establishes it. We use MEDRS compliant sourcing for medical content, which includes statements by medical organizations. Yobol (talk) 21:31, 19 February 2015 (UTC)
  • Use secondary review WP:MEDRS sources Formal policy statements that are review quality can also be used. Because formal scientific reports are mentioned on WP:MEDRS which says " formal scientific reports, which can be the equal of the best reviews published in medical journals". The World Lung Foundation souse that is cited as an example is a Press release (clearly marked as one in the yellow bar at the top as a Press Release) and not a source that should be relied on for medical claims.AlbinoFerret 21:08, 19 February 2015 (UTC)
WP:MEDRS does not have a restriction to only using published journal article reviews. Yobol (talk) 21:09, 19 February 2015 (UTC)
Press releases are not appropriate for medical claims. AlbinoFerret 21:11, 19 February 2015 (UTC)
Where you see a press release, I see a position statement adopted by the general assembly of the organization. Yobol (talk) 21:16, 19 February 2015 (UTC)
This is a press-release. And it is one of the sources that you argue for in the above. --Kim D. Petersen 21:22, 19 February 2015 (UTC)
There is also no language in that press release saying this was "adopted by the general assembly of the organization". AlbinoFerret 16:50, 20 February 2015 (UTC)
Eligible certainly. But less useful, and carrying significantly less weight than secondary review literature, which has so far been the consensus position as the threshold for material on electronic cigarette articles. --Kim D. Petersen 21:20, 19 February 2015 (UTC)
You keep saying there is a "consensus" that only review articles are allowed to be used as medical sources. Please point me to the thread or RfC which established such a consensus. Absent this, please stop making up your own "consensus". Thanks. Yobol (talk) 21:24, 19 February 2015 (UTC)
Sigh! Reliable secondary review WP:MEDRS compliant papers, in high quality MedLine indexed journals has so far been the consensus. Can you tell me what is wrong about that previous consensus? Don't you think that we should use the very best material available per WP:MEDRS? --Kim D. Petersen 21:33, 19 February 2015 (UTC)
@KimDabelsteinPetersen: Actually no, there are many circumstances in which the position statements of major bodies (NHS, NICE, ACS, WHO) offer the strongest source - or at the very least one which should not be omitted. Alexbrn 21:25, 19 February 2015 (UTC)
That is why we have a whole article Positions of medical organizations regarding electronic cigarettes based upon these sources, and summarize them at Electronic cigarette. Can you tell me why reliable secondary review material isn't enough here? --Kim D. Petersen 21:31, 19 February 2015 (UTC)
Where is the talk page section or RfC which establishes that only published review articles can be used? Yobol (talk) 21:32, 19 February 2015 (UTC)

The question of whether there is a local "consensus" to eliminate position papers as sources for this article is irrelevant, because there is a broader consensus across all of Misplaced Pages that these are ideal sources for this type of content. Have you taken a look at WP:RS recently? It states unambiguously that

Ideal sources for biomedical assertions include general or systematic reviews in reliable, third-party, published sources, such as reputable medical journals, widely recognised standard textbooks written by experts in a field, or medical guidelines and position statements from nationally or internationally reputable expert bodies.

WP:RS
The statement is repeated in WP:MEDRS

Ideal sources for such content includes literature reviews or systematic reviews published in reputable medical journals, academic and professional books written by experts in the relevant field and from a respected publisher, and medical guidelines or position statements from nationally or internationally recognised expert bodies.

WP:RS

These guidelines reflect broad consensus from editors across all of Misplaced Pages. You cannot create a local exception just because you don't like what "ideal sources" stay about these devices. If you want to change this, you have to get consensus to change both WP:RS and WP:MEDRS. I doubt very much you will be successful. Formerly 98 (talk) 21:33, 19 February 2015 (UTC)

Cherry picking from WP:MEDRS and WP:RS now? Are you truly saying that WP policy is that we should prefer tertiary sources over secondary, or that position statements are the equivalent of reviews? Have you btw. read WP:Tertiary, WP:CON or WP:WEIGHT recently? --Kim D. Petersen 21:36, 19 February 2015 (UTC)
I have no idea what you are referring to by "cherrypicking". The term is usually used to refer to picking out a single article that favors a certain POV out of a set of many that express a different opinion. There is only one WP:MEDRS and only one WP:RS and both clearly and unambiguously prohibit this sort of exclusion of ideal sources. I'm sorry you don't like what these sources say. I suggest you find a different strategy for trying to exclude them, as this one will not survive review even if successful locally. Formerly 98 (talk) 01:21, 20 February 2015 (UTC)
Im surprised you want to included press releases. AlbinoFerret 01:29, 20 February 2015 (UTC)
To clarify, that press release links to another from the CDC saying almost the same thing! essentially intended to promote awareness of a paper published the same day, 20 Aug 2014: "Intentions to Smoke Cigarettes Among Never-Smoking US Middle and High School Electronic Cigarette Users: National Youth Tobacco Survey, 2011-2013" PMID 25143298. That (large primary) paper compares to "E-cigarette prevalence and correlates of use among adolescents versus adults: a review and comparison", PMID 24680203. That too indicates that youth using e-cigarettes (compared to never-using them) are more likely to later try conventional cigarettes, though the precise details and wording vary.LeadSongDog come howl! 03:59, 23 February 2015 (UTC)
So we have press releases to promote primary sources? By the way the Chapman review is already in the main e-cig article. AlbinoFerret 04:30, 23 February 2015 (UTC)
Just abit about tertiary sources:

Policy: Reliable tertiary sources can be helpful in providing broad summaries of topics that involve many primary and secondary sources, and may be helpful in evaluating due weight, especially when primary or secondary sources contradict each other. Some tertiary sources are more reliable than others, and within any given tertiary source, some articles may be more reliable than others.

WP:Tertiary
WP:MEDRS#Definitions might also give a hint here. WP:MEDRS compliant secondary review papers are the best sources we can use. So why would we choose lesser sources? --Kim D. Petersen 21:40, 19 February 2015 (UTC)
Seems to me that for some editors it is not enough with the material that they can find in the best available sources per WP:MEDRS and thus want to WP:COATRACK material that belongs in Positions of medical organizations regarding electronic cigarettes into this article. Tertiary sources, position statements, policy statements etc. are lesser sources than review material! --Kim D. Petersen 21:43, 19 February 2015 (UTC)\
You can also look at Other sources on the WP:MEDRS wich directly addresses press releases. AlbinoFerret 03:11, 26 February 2015 (UTC)
Kim and Albino, what part of "Ideal sources for such content includes... medical guidelines or position statements from nationally or internationally recognised expert bodies", repeated in both WP:RS and WP:MEDRS is hard to understand? Formerly 98 (talk) 15:17, 26 February 2015 (UTC)
Whats hard to understand is why you want to include press releases. You also seem to be ignoring Other sources on the WP:MEDRS and completly ignoring "The reliability of these sources range from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature." WP:MEDORG. Press releases are not even spoken of, and in no way are these formal policy statements. This is an example of a formal policy statement that was published in a peer reviewed journal, its in the article as we discuss this. What is trying to be included is lower quality material, fine for the Position page, so it is included, but not to make medical claims on this page. AlbinoFerret 16:55, 26 February 2015 (UTC)
You are against including formal policy statements too. You tried to delete it. See https://en.wikipedia.org/search/?title=Safety_of_electronic_cigarettes&diff=642107506&oldid=642095256 If it is fine for the Position page then it should be fine for this page too because the Position page also includes medical claims. Even a service announcement may be used. Where does MEDRS say press releases from reputable organisations are unreliable? It appears you are making up your own rules for this e-cig page to exclude any source that is not a review. QuackGuru (talk) 17:44, 26 February 2015 (UTC)
You are making another misstatement that has been clairified before, yet you continue in the faulty premise. The source has COI, addressed in the source. Not only did some of the authors recieve funding from the pharmicutuical industry, they sit on the boards of dirctors for pharmicutical companies. It wasnt removed because its a formal policy statement as the next edits prove diff. I recommend you stop characterising peoples edits falsely as its a clear violation of AGF and may be, and is by me, considered a personal attack. AlbinoFerret 18:04, 26 February 2015 (UTC)
You wrote above "This is an example of a formal policy statement that was published in a peer reviewed journal, its in the article as we discuss this."
Yet you deleted this source. https://en.wikipedia.org/search/?title=Safety_of_electronic_cigarettes&diff=642107506&oldid=642095256
Brandon, T. H.; Goniewicz, M. L.; Hanna, N. H.; Hatsukami, D. K.; Herbst, R. S.; Hobin, J. A.; Ostroff, J. S.; Shields, P. G.; Toll, B. A.; Tyne, C. A.; Viswanath, K.; Warren, G. W. (2015). "Electronic Nicotine Delivery Systems: A Policy Statement from the American Association for Cancer Research and the American Society of Clinical Oncology". Clinical Cancer Research. doi:10.1158/1078-0432.CCR-14-2544. ISSN 1078-0432.
The next edits shows there is a problem the with context you added. For example, "I don't think it's original research, but it sure seems over-the-top. Perhaps a better description than WP:OR would be WP:UNDUE, or WP:FRINGE (in emphasis), perhaps WP:POINTy, WP:EDITORIALIZING, WP:ALLEGED, or trying to WP:RIGHTGREATWRONGS, using a WP:PRIMARYSOURCE to sneak in an editor's POV rather than simply reporting what well-accepted reliable sources say." according to BarrelProof. See Talk:Safety_of_electronic_cigarettes/Archive_1#Original_research_2. So why do you want to ignore MEDRS and use only secondary reviews when MEDRS allows reviews, statements from respected organisations, and medical textbooks? Claiming that only reviews are allowed is disruptive. QuackGuru (talk) 19:38, 26 February 2015 (UTC)
Your rehashing of the same edit will receive the same response. I really dont care if BarrelProof, like you have applied the wrong reasons for the edit. They are clearly shown in further edits, but you dont look at them, because it doesnt fit with your preconceived rationalizations. The source had, and still has has COI issues including the authors sitting on the board of directors of pharmaceutical companies. BarrelProof questioned if the COI was OR, but it isnt because the COI is clearly laid out in the source itself. Your question is misleading and a lie, I have never said formal policy statements by the groups listed in WP:MEDORG cant be used. You want to include press releases which are not even mentioned in the section you keep referring to.AlbinoFerret 22:30, 26 February 2015 (UTC)
You are clearly against including any statement that is not a formal policy statement from an organisation against MEDRS. You are also against including this source and this review you deleted. So why should there be different rules for this e-cig page? QuackGuru (talk) 23:04, 26 February 2015 (UTC)
You are clearly trying to use press releases against WP:MEDRS.So why should there be different rules for this e-cig page? AlbinoFerret 23:28, 26 February 2015 (UTC)
The statement from the World Lung Foundation organization is reliable. The World Lung Foundation stated "A recent study indicated that e-cigarette vapor causes changes at the cellular level in a similar way as traditional cigarettes. As the WHO points out, e-cigarette vapour is not just water vapour as the e-cigarette industry likes to claim..." That indicates the statement by World Lung Foundation is also a secondary source because it reviewed the evidence. I previously explained you deleted other sources that are also reliable. This includes this source and this review among others. So why did you delete a number of sources including reviews against MEDRS? QuackGuru (talk) 23:39, 26 February 2015 (UTC)
Reliability does not guarantee inclusion. AlbinoFerret 04:02, 27 February 2015 (UTC)
So the sources are all reliable and you have not given a specific reason to exclude them. QuackGuru (talk) 04:04, 27 February 2015 (UTC)
I am not going to go into specifics of edits with you in this RFC, because it does no good, its round in circles and right back to "they are reliable" when reasons are given. AlbinoFerret 04:08, 27 February 2015 (UTC)
You confirmed the sources are reliable yet you refuse to explain what is wrong with including relevant information about safety. You are not collaborating. QuackGuru (talk) 04:15, 27 February 2015 (UTC)
I have discussed this with you to no end, you dont seem to get it, or dont want to hear it. This entire RFC has the position laid out. There are numerous sections on the talk pages on this. Collaboration is a two way street. You dont discuss edits, no discussions on mammoth edit you tried recently, nothing. AlbinoFerret 04:21, 27 February 2015 (UTC)
You have not given a reason to exclude reliable sources. Claiming "Reliability does not guarantee inclusion." without any specific reason is not a valid reason. The statements from the organisations and the text from the reviews are about the safety of e-cigs. Why are you not explaining a specific reason to exclude reliable sources relevant to the topic? Do you understand that claiming "Reliability does not guarantee inclusion." is not a good reason to exclude pertinent information? QuackGuru (talk) 04:34, 27 February 2015 (UTC)
Thanks for proving my point. Even after additional discussions, you circle back to the beginning. If you havent seen the reasons, it isnt because they are not there. I suggest you reread archive 2, and at this point silence on my part does not mean consensus WP:SILENCE. AlbinoFerret 15:09, 28 February 2015 (UTC)
In reaching consensus we all may learn something: Misplaced Pages only works when editors collaborate to form a consensus. Discussion is as important in the editing process as editing itself. While participation is not a requirement at the talk page, refusing participation can be perceived as a refusal to collaborate, and is not conducive to consensus-building. You are continuing to refuse to explain your deletion of a number of position statements from reputable organisations and a number of reviews. Again, claiming that "Reliability does not guarantee inclusion." is not a specific reason to exclude pertinent information. Do you understand? QuackGuru (talk) 21:15, 28 February 2015 (UTC)
No one is talking about excluding. The article Positions of medical organizations regarding electronic cigarettes is for this kind of material, and this article is medical information from high quality reviews and major medical textbooks. All of which gets summarized in Electronic cigarette, of which both articles are subarticles. All of it has its place, and this is not the place for policy or position statements, this is about the underlying secondary review class material. --Kim D. Petersen 21:47, 19 February 2015 (UTC)
  • Use review articles and meta-analyses: While there is a case for the inclusion of statements by medical organizations, these should only be sourced to authoritative institutions that issue health guidelines regularly, such as the U.S. National Institutes of Health, the U.K. National Health Service, or the World Health Organization. I don't think the statements of the World Lung Foundation or the World Medical Association are considered to be authoritative, and, as far as I know, none of them issue medical guidelines on a regular basis. The World Lung Foundation, in particular, appears to be a relatively new society founded in 2004 and may be of questionable notability (and reliability). Anyone can issues health statements, but not all are widely recognized and even fewer are considered to be authoritative. -A1candidate 21:56, 19 February 2015 (UTC)
    • A1candidate also deleted a number of sources including review articles. So what is the explanation for the blanket reverts? A1candidate, are you going to continue make blanket reverts including deleting a number of reviews? QuackGuru (talk) 17:47, 9 March 2015 (UTC)
  • Reliable per WP:MEDRS. I'm not going to wade into this further for now due to lack of time aside from saying that press releases are plenty fine for policy statements by organizations like this. That's often how reputable medical organizations make their positions known. Press releases are not ok though for trying to assert scientific fact, and that's where you bring in review articles instead. That's a relatively clear distinction that seems like it's being missed here. Whether the source is secondary, tertiary, etc. is irrelevant in this conversation, partly seen in our article that describes when there can be ambiguity between the two as well. Instead, we look for reviews and statements from reputable medical organizations regardless of what degree of source we call them. Above, A1candidate may have a case from a WP:WEIGHT perspective on how noteworthy the organization actually is, but at my first glance it seems adequate. Kingofaces43 (talk) 22:28, 19 February 2015 (UTC)
Thats why we have the Positions of medical organizations regarding electronic cigarettes page. For those types of statements. This page is a medical page for medical facts. The sources are on the Positions page, but they want to bring them here for medical claims. AlbinoFerret 22:34, 19 February 2015 (UTC)
Looks like a problem with a WP:POVFORK in having that article. The two really should be the same. However, this RfC is about whether the source in question is reliable in this article on the safety of e-cigs. It seems to have a decent fit here regardless of what's going on at other articles. If an article is going to be titled safety of e-cigs, then you're going to need to discuss relevant medical organizations perspectives in that article. This article doesn't even have a section summarizing the organization statement page (which is the norm with daughter articles), so it's looking like there is some undue weight in the omission of summarizing the medical organizations. That's mainly why I'm not seeing a legitimate reason not to include it. Kingofaces43 (talk) 22:56, 19 February 2015 (UTC)
The two pages were originally under the Health effects section, It was not my choice to split them off instead of the section itself. It was Doc James who split them like this, at the same time. AlbinoFerret 23:01, 19 February 2015 (UTC)
  • COMMENT Claims that "position statements from nationally or internationally reputable expert bodies" are not "secondary sources" per WP:MEDRS are completely and literally incorrect per Misplaced Pages:Identifying_reliable_sources_(medicine)#Definitions which has already been quoted above. Importantly Policies and guidelines cannot be changed locally. What is a MEDRS-acceptable secondary source, is one, be it here or there. Now, someone ~could~ argue that one or both of World Lung Foundation or the World Medical Association are not "nationally or internationally reputable expert bodies". That would be a reasonable argument under WP's policies and guidelines. I have never heard of the World Lung Foundation and based on a quick look wouldn't object to a decision that they are not major. I had never heard of World Medical Association but once I looked into it, it is clear that this is the UN of national medical associations (AMA is a member). This is definitely authoritative. Jytdog (talk) 00:26, 20 February 2015 (UTC)
The WMA might be fairly well-known, but their website says that they're mainly involved in the following non-clinical stuff:
  • Ethics
  • Human Rights
  • Public Health
  • Health Systems
  • Advocacy
  • Campaigns
In fact, I can't find anything on their website that suggests they issue regular medical guidelines, and I doubt this is the case since the WHO has always been the one doing most of it. In any case, the WMA's list of Topics in advocacy includes "Tobacco control" as one of their goals. Are their statements regarding E-cigarettes scientifically neutral? Probably not. -A1candidate 01:11, 20 February 2015 (UTC)
Sources are not required to be "neutral", we as Misplaced Pages editors are. Also, if the only reliable medical sources are those who take no position about the obvious detrimental health effects of tobacco smoking, I suspect we will find it very hard to find any sources to use at all. Yobol (talk) 03:10, 20 February 2015 (UTC)
If there are detrimental health effects of e-cigarettes, they would be mentioned in review articles. Otherwise, there are none. -A1candidate 03:24, 20 February 2015 (UTC)
I think we're cross talking. You mentioned "tobacco control" advocacy as a sign that a source is not "neutral"; my comment is that almost any relevant medical source recognizes that tobacco is detrimental to the health of individuals and would advocate for cessation of tobacco use. To find a source that says tobacco is good for you or not harmful would be a sign of an unreliable medical source. Yobol (talk) 04:00, 20 February 2015 (UTC)
Prevention of patient's tobacco consumption is what most medical organizations aim for. Advocacy for tabacco control is what the WMA does. -A1candidate 04:11, 20 February 2015 (UTC)
Controlling tobacco use is what every responsible medical organization does. I'm afraid we'll have to agree to disagree that advocating people stop smoking is somehow a disqualifying feature of a medical source. Yobol (talk) 04:19, 20 February 2015 (UTC)
That's only because you fail to understand two types of advocacy - Political advocacy, which is what the WMA does, and making clinical recommendations, which is what most medical organizations do. -A1candidate 04:24, 20 February 2015 (UTC)
Oh yes, very political. Cough. Yobol (talk) 04:35, 20 February 2015 (UTC)
  • Include, in segregated section There should be a section with a summary of significant statements, but kept apart from the purely medical sections. We all know research is scrambling to catch up with the growth of e-cigs, and is as yet unable to say anything about the long-term effects, so such statements are more significant here than for many long-established issues (like tobacco use for example). Johnbod (talk) 16:41, 20 February 2015 (UTC)
  • The statements are absolutely relevant. The sources are reliable and no evidence to the contrary has been provided. The argument for excluding them are we must use reviews for e-cig articles. On the contrary, positions of organizations are also reliable. QuackGuru (talk) 23:12, 24 February 2015 (UTC)
  • Include statements Per Doc James. The statements are pertinent to the section. Jim1138 (talk) 23:57, 24 February 2015 (UTC)
  • Comment: Please await the results of the RfC before starting to use this material, otherwise we are not respecting the processes of wikipedia. Status Quo before the RfC was that the material was not included, and to base even more material on this, is premature. --Kim D. Petersen 10:04, 25 February 2015 (UTC)
  • Use secondary reviews If this viewpoint is significant enough then we should have no problems backing it up with secondary reviews that actually systematically analyse the studies that the quotes refer to.Levelledout (talk) 14:38, 26 February 2015 (UTC)
What does "respectable" have to do with the issue at hand? They are very reliable for the context of Positions of medical organizations regarding electronic cigarettes. But here they are used in a context where we should use secondary MEDRS reviews, which are the most reliable sources for this kind of information. It seems though that editors either do not want to use secondary reviews, or alternatively want to double the effect of secondary sources, by duplicating it from tertiary ones,. --Kim D. Petersen 22:51, 27 February 2015 (UTC)
Your concerns are not reflected in the policy. There is nothing in it about context, and we are using position statements by major reputable bodies because they hold strong weight. We do not use them to "double the effect" of a statement, but rather in order to provide proper facts as interpreted by the most influential and authoritative organizations in the world. This entire discussion is merely disruptive and detracts from any possibility of actually improving this article and wastes time that could be spent on other articles. The RfC should be closed as per WP:SNOWBALL. -- CFCF 🍌 (email) 23:03, 27 February 2015 (UTC)
There is no policy that states that just because something is reliable that it then must be included. In fact editing is the process of sorting out what sources should and shouldn't be used, and what weight is attached to them. In this case there is significantly more weight put on secondary MEDRS reviews, which also are the most reliable of MEDRS sources - sources in the category of position statements are tertiary material for medical and safety information, and thus should per WP:MEDRS be used to find secondary sources, not as sources themselves. Why use less reliable material, that only repeats what we can already find in more reliable material? Can you answer me that? --Kim D. Petersen 23:39, 27 February 2015 (UTC)
Health professionals consider the statements of major health bodies as inherently the most reliable, and so does Misplaced Pages. Data that contradicts the statements is valuable but it should be stated as carrying less weight, not more. -- CFCF 🍌 (email) 10:47, 28 February 2015 (UTC)
Oh well if you say that's true then it must be. Of course. Levelledout (talk) 00:02, 1 March 2015 (UTC)
Of course. And can we move forward now? Cloudjpk (talk) 18:50, 27 February 2015 (UTC)
If you think it's such a farce then you should get it struck out at AN, no point in keep complaining about it here.Levelledout (talk) 22:24, 27 February 2015 (UTC)
  • Include statements per Doc James and others. The fact that there are currently a few articles on e-cigs and/or their safety on wiki does not mean that relevant information should be excluded from any of those articles if it applies to the subject matter of the article's title. Softlavender (talk) 06:54, 5 March 2015 (UTC)
  • Include It looks like the organization is wholly legitimate and trusted, and Misplaced Pages policy guidelines suggest that such entities be utilized as legitimate references and citations. Damotclese (talk) 18:30, 26 March 2015 (UTC)

Discussion on positions

There never was a consensus to use only using reviews for medical claims on e-cig pages. We don't have different rules for e-cig pages. There is a long standing WP:CON to include other sources including WHO, the US Food and Drug Administration, and the World Lung Foundation. See Electronic_cigarette#Position_of_medical_organizations. Also see Electronic_cigarette#Harm_reduction for other sources such as the Centers for Disease Control and Prevention (CDC) that are not reviews. Claiming that only reviews can be used for medical claims runs against WP:MEDORG. This RfC has apparently turned into WP:SNOW. User:AlbinoFerret also deleted other sources including a formal policy statement. After User:AlbinoFerret could not delete the reliable source you then added context that was inappropriate. The inappropriate content smacked WP:POINT. See Talk:Safety_of_electronic_cigarettes/Archive_1#Original_research_2. User:AlbinoFerret, User:KimDabelsteinPetersen, and User:Levelledout appeared to be against using the formal policy statement written in a peer-reviewed journal for medical claims. See Talk:Electronic_cigarette/Archive_21#Policy_Statement_from_the_American_Association_for_Cancer_Research_and_the_American_Society_of_Clinical_Oncology. User:AlbinoFerret last edit to the safety page deleted even more sources including a number of reviews. So what is your reason to make a full revert back to an old version while deleting a number of sources including reviews? User:AlbinoFerret, you were asked "Are there issues with the sources or the summary of said sources?" So far you have not specifically explained which new sources are a concern to justify your blanket revert. See Talk:Safety_of_electronic_cigarettes#Removal_of_mammoth_edit.

Let's review according to the start of this page: https://en.wikipedia.org/search/?title=Safety_of_electronic_cigarettes&oldid=634900625 See WHO: https://en.wikipedia.org/search/?title=Safety_of_electronic_cigarettes&oldid=634900625#cite_ref-WHOPosition2014_8-0 See US Food and Drug Administration (FDA): https://en.wikipedia.org/search/?title=Safety_of_electronic_cigarettes&oldid=634900625#cite_ref-FDA_nitrosamines_13-0 See The UK National Health Service https://en.wikipedia.org/search/?title=Safety_of_electronic_cigarettes&oldid=634900625#cite_ref-nhs_17-0 These sources are not reviews or formal policy statements written in a peer-reviewed journal but they are reliable according to WP:MEDORG. This confirms that there is a long standing WP:CON to include other reliable sources rather than just reviews or formal policy statements. QuackGuru (talk) 17:03, 9 March 2015 (UTC)

The World Lung Foundation, in particular, appears to be a relatively new society founded in 2004 and may be of questionable notability (and reliability). Anyone can issue health statements, but not all are widely recognized and even fewer are considered to be authoritative. -A1candidate 21:44, 13 March 2015 (UTC)
Founded in 2004 about ten years ago does not mean it is questionable. Where in WP:MEDORG supports your argument that a source founded about 10 years ago may be unreliable? QuackGuru (talk) 22:13, 13 March 2015 (UTC)
It is found in the phrase "reputable major medical and scientific bodies". -A1candidate 22:38, 13 March 2015 (UTC)
It is a reputable organisation according to the Global Health Workforce Alliance. QuackGuru (talk) 22:44, 13 March 2015 (UTC)
Reputable for providing "assistance to governments and non-government organizations", but not reputable for issuing medical guidelines. -A1candidate 22:51, 13 March 2015 (UTC)
Since the World Lung Foundation is a reputable organisation it is reliable for the medical claims.QuackGuru (talk) 23:01, 13 March 2015 (UTC)
Which part of this article indicates that it is reliable or reputable? -A1candidate 23:03, 13 March 2015 (UTC)
Here is another ref. "WLF is one of five coordinating partners of the Bloomberg Initiative to Reduce Tobacco Use, which focuses on low and middle income countries, where more than two-thirds of the world’s smokers live." QuackGuru (talk) 23:19, 13 March 2015 (UTC)
What you've just showed me is a job offer in a WordPress blog. Can I consider that an indicator of reliability or notability? No. -A1candidate 23:25, 13 March 2015 (UTC)
We are not using a WordPress blog. We are using a statement made by the World Lung Foundation that has a good reputation to help prevent and manage lung disease. QuackGuru (talk) 23:29, 13 March 2015 (UTC)
Being a member of the GHWA simply means that the WLF does a lot of good work in developing countries. It does not automatically make it an authoritative organization for medical guidelines. -A1candidate 23:34, 13 March 2015 (UTC)
Since they do a lot of good work in developing countries regarding tobacco control it makes them an expert on the topic. See "Essentially e-cigarette companies are selling nicotine addiction," said Dr. Neil Schluger, chief scientific officer for the World Lung Foundation, which advocates for tobacco control." QuackGuru (talk) 17:43, 14 March 2015 (UTC)
No. Reliability does not depend on the amount of good work one does. -A1candidate 20:02, 14 March 2015 (UTC)
They do a lot of good work around the world on the topic of tobacco control, which makes them a major organisation. QuackGuru (talk) 20:40, 14 March 2015 (UTC)
Where do these sources indicate that it is a major organization? -A1candidate 22:29, 14 March 2015 (UTC)
The American Cancer Society and World Lung Foundation jointly released the The Tobacco Atlas, third edition, which is currently available worldwide in several languages. That is as major as it gets on tobacco control. QuackGuru (talk) 23:55, 14 March 2015 (UTC)
Tobacco control is more of a sociopolitical than a biomedical issue. -A1candidate 08:10, 15 March 2015 (UTC)
The website and 2012 financial statements are informative. It has about 30 staff and income/spend in the $20 miilions annually, mostly grants in and out. It was founded mainly for efforts in mid and low income countries on TB, but then got a big slug of Bloomberg & Gates Foundation money for tobacco control. I'm not sure that does make it "major" in terms of policy statements. But they have a particular interest in the 3rd world, which most statement-making bodies don't, so perhaps they are. Certainly they are WP notable. Johnbod (talk) 13:10, 15 March 2015 (UTC)
What I'm interested to know is whether they issue medical guidelines on a regular basis, particular those related to pulmonary health in general, just like what the American Heart Association does for cardiology topics. Their financial standing and sources of income are of less importance here. -A1candidate 13:22, 15 March 2015 (UTC)
I doubt it. Sources of income are always very important in these circumstances. Johnbod (talk) 13:58, 15 March 2015 (UTC)
What about a staff size of 30? Consensus statements like these often involve at least 10 to 15 healthcare experts. -A1candidate 17:57, 15 March 2015 (UTC)
Who normally will all, or nearly all, have other jobs elsewhere. Johnbod (talk) 18:43, 15 March 2015 (UTC)
So which medical experts are associated with the WLF - a supposedly major and reputable medical organization? -A1candidate 18:49, 15 March 2015 (UTC)
I don't know, Mr District Attorney. Why don't you look at their website & try to find out? Johnbod (talk) 20:25, 15 March 2015 (UTC)
Because I've looked and found none so far. At least none are listed on their staff page. -A1candidate 20:43, 15 March 2015 (UTC)
No, they wouldn't be - nor would the AHA statement's authors be staff there. I don't disagree with your point here btw, but medical guidelines covering treatment are a somewhat different thing. Johnbod (talk) 11:06, 18 March 2015 (UTC)
You wanted global and I gave you the World Lung Foundation and the World Medical Association. Thanks for your suggestion. QuackGuru (talk) 07:05, 18 March 2015 (UTC)
None of these institutions issue medical guidelines on a regular basis. How about the World Wildlife Fund instead?. -A1candidate 08:51, 18 March 2015 (UTC)
Do you have a source for World Wildlife Fund? QuackGuru (talk) 00:29, 12 April 2015 (UTC)
The above discussion is preserved as an archive of the debate. Please do not modify it. No further edits should be made to this discussion.

Schraufnage not a MEDLINE journal

The recent addition does not originate from a MEDLINE indexed journal, and seems to be tangent to the article. Nicotine should be handled in its own article, and only summarized here where relevant and pointed out by reviews. --Kim D. Petersen 06:51, 3 April 2015 (UTC)

Electronic Cigarettes: Vulnerability of Youth.
Schraufnagel DE.
Pediatr Allergy Immunol Pulmonol. 2015 Mar 1;28(1):2-6. Review.
PMID: 25830075
See https://www.ncbi.nlm.nih.gov/pubmed?linkname=pubmed_pubmed_reviews&from_uid=25830075 QuackGuru (talk) 06:55, 3 April 2015 (UTC)
Doesn't change that it isn't a MEDLINE journal - does it? --Kim D. Petersen 06:59, 3 April 2015 (UTC)
It is still a reliable source according to WP:MEDRS. QuackGuru (talk) 07:01, 3 April 2015 (UTC)
Quote from WP:MEDRS:
An integral part of finding high quality sources is avoiding articles from journals without a reputation for fact-checking and accuracy. A red flag that a journal article is probably not reliable for health claims might be publication by a publisher that has a reputation for exhibiting "predatory" behavior, which includes questionable business practices and/or peer-review processes that raise concerns about the reliability of their journal articles. (See "References" section below for examples of such publishers.) Other indications that a biomedical journal article may not be reliable are its publication in a journal that is not indexed in the bibliographic database MEDLINE, or its content being outside the journal's normal scope (for instance, an article on the efficacy of a new cancer treatment in a psychiatric journal or the surgical techniques for hip replacement in a urology journal). Determining the reliability of any individual journal article may also take into account whether the article has garnered significant positive citations in sources of undisputed reliability, suggesting wider acceptance in the medical literature despite any red flags suggested here.
We have had this discussion several times earlier, and general consensus was to rely on MEDLINE journals. --Kim D. Petersen 07:04, 3 April 2015 (UTC)
Where was the discussion several times earlier for a "general consensus" to use only certain types of journals?
I think the source is reliable for the mundane claim. See the link for more information on the source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269219/ QuackGuru (talk) 07:16, 3 April 2015 (UTC)
It's not MEDLINE indexed but it's peer reviewed, collected in NLM, provided online by NIH, and indexed/abstracted in: PubMed Central; Current Contents/Clinical Medicine; Science Citation Index Expanded; Biological Abstracts; BIOSIS Previews; Journal Citation Reports/Science Edition; International Pharmaceutical Abstracts; EMBASE/Excerpta Medica; Scopus; CAB Abstracts; Global Health; CINAHL database as per publisher Cloudjpk (talk) 19:20, 9 April 2015 (UTC)
It's one of a number of journals where selected cites are included in PubMed. This is one of those so included. The paper clearly meets WP:MEDRS. Guy (Help!) 10:59, 17 April 2015 (UTC)
KDP, I do't think the claim that nicotine has an impact on practically every tissue in the body is that controversial so even if this source isn't perfect it's more than good enough. The second half of your objection I do agree with. I think that paragraph needs quite a bit of rewording, both for the dodgy english and the lack of idea flow in it.
Something like the below as a first dab at the spoon (this should really be directly followed by a paragraph on PG and VG info).

The long term impact of the main constituents in the vapor is not fully understood. Nicotine exposure risks causing addiction and other adverse events including high blood pressure, abnormal heart rhythms, low estrogen and early menopause. In May 2014, Cancer Research UK stated that there were, "preliminary results that suggest that e-cigarettes promote tumour growth in human cells." In Adolescents, nicotine use may damage brain development, including areas connected with higher cognitive function. The health effects of nicotine in infants and children are unclear. In August 2014 the American Heart Association released a policy statement which noted that "e-cigarettes could fuel and promote nicotine addiction, especially in children, and their acceptance has the potential to renormalize smoking behavior."

SPACKlick (talk) 11:23, 17 April 2015 (UTC)

I cleaned up the section. QuackGuru (talk) 22:58, 17 April 2015 (UTC)
Quack, please use DISCUSSION before this kind of wholesale edit. There's no rush for these edits in sections where the content is accurate and the issue is how it's presented. Your opinion on presentation is just one of many. Given this article is contentious a little caution would be prudent.SPACKlick (talk) 01:19, 18 April 2015 (UTC)
I disagree with deleting the other sentences in the same paragraph if that is part of the proposal. I disagree with putting together different sentences from different sources together into one sentence because different sources say different things. QuackGuru (talk) 03:41, 18 April 2015 (UTC)
@SPACKlick:, that paragraph reads very well to me as a statement of the current reservations of professional bodies over e-cigs. I'd support its inclusion if nobody can provide a good counter-argument. Guy (Help!) 08:30, 18 April 2015 (UTC)
  • Without meaning to provide comment on anything other than QG's specific edit (since I was asked to do so): I don't see it as a too outlandish change to make without first establishing consensus. To me at least, QG's version is likely to be more readable to the average reader. It can certainly be improved further, and it wouldn't be a bad idea to do so through collaboratively on this talk page or even a draft subpage, but I do not view QG's edit here as a violation of the sanctions. Kevin Gorman (talk) 05:14, 19 April 2015 (UTC)

Are sources now considered to be flawed to be removed?

Case in point https://en.wikipedia.org/Safety_of_electronic_cigarettes#cite_note-Bekki2014-19 This study has been proven to be flawed in it's methodology, reviews by Dr Farsalinos here and here show that the conditions of the testing were in no way indicative of actual use. In short the devices were not used as intended and were in fact used at settings far beyond what the components would normally operate at.

Similar studies have also been found to produce flawed results that are in no way indicative of actual use. One recent study by Jensen et al. has been critised as being flawed for the same reason as the study referenced in the first line.

Edit: In addition to the first reference mentioned above there is this ( full text ) reference in which the authors seem to be confused about the difference between a liquid aerosol and particulate matter from combustion suggesting that the so called particulates could be as damaging as that of tobacco smoke. Further he references the Schober et al study upon which their assumption is based, this study has since been found to be flawed here (PDF)

Lancer2K (talk) 02:10, 21 April 2015 (UTC)

Hi Lancer2K, ecigarette-research.com and .org are the personal self-published blog websites of Dr. Farsalinos, who describes himself here as someone who "clearly supports that electronic cigarettes should be used as smoking substitutes, by smokers unwilling or unable to quit smoking with currently approved medications." This is absolutely fine, and it his prerogative to have that opinion and publish his opinions on his own websites. But per Misplaced Pages policy WP:SELFPUBLISH and guideline like WP:MEDASSESS such sources are generally not acceptable and are considered lowest-tier quality. Of the other sources you'd listed
You should take a look at WP:MEDRS and how it emphasizes what the best-quality evidence sourcing is, which are generally recent secondary sources like reviews and meta-analyses published in high-quality, authoritative journals in their areas of expertise. Zad68 19:40, 23 April 2015 (UTC)
Hello Zad68 Thanks for that, the reason I posted the links to Dr. Farsalinos site was the examination and explanation of the flaws of the study I mentioned, he explained it far better than I could. I was not suggesting that editorial responses be used as sources for the article it self but rather as contributary evidence that the cited sources may not be as sturdy as we would wish. Lancer2K (talk) 22:25, 23 April 2015 (UTC)

Propylene Oxide

Propylene glycol degrades at sustained temperatures in excess of 500c. Whereas e-cigarette coils are at worst only about 300c and operate for a brief period. Perhaps more pertinently, the vapor at approximately 1mm from the coil of a cartomizer has been measured to be about 56c. So the propylene oxide thing is just one of the dozens of highly suspect items in this article.

And no i am not citing sources, you people hash it out yourselves i'm just pointing out that your credibility here is nearing the ridiculously low standards of your reputation for credibility.

This article is an incomprehensible he-said/she-said mess. That is all.

71.221.67.253 (talk) 09:21, 24 April 2015 (UTC)joe

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