WikiProject Medicine Newsletter - November 2024
- Issue 23—November 2024
- WikiProject Medicine Newsletter
Hello all. A short edition to get the newsletter going again. As it says at the bottom, if you have thoughts on how the newsletter could be useful/interesting to you, please post at Misplaced Pages talk:WikiProject Medicine/Newsletter:
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WP:MED News
- Help WikiProject Unreferenced articles with their November backlog drive by addressing the 130 medicine articles lacking sources.
- Reminder that you can follow medicine-related deletion discussions, GA nominations, merge requests and more by watchlisting Misplaced Pages:WikiProject_Medicine/Article_alerts. Many of these discussions would benefit from more attention.
Newsletter ideas, comments, and criticisms welcome here.
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Invitation to provide feedback
Inspired by Worm That Turned's re-RfA where he noted administrators don't get a lot of feedback or suggestions for improvement, I have decided to solicit feedback. I'm reaching out to you as you are currently one of the users I've selected as part of my recall process. I hope you will consider taking a few moments to fill out my feedback form. Clicking on the link will load the questions and create a new section on my user talk. Thanks for your consideration. Best, Barkeep49 (talk) 15:43, 2 December 2024 (UTC)
- Hi @Barkeep49. I'm not really active enough in admin activities to be familiar with your work other than when it involves me directly. I have thoughts and opinions on that, of course, but I suspect you're looking for wider feedback that isn't biased from personal consequences of your decisions and actions. Wrt your recall process, if you are looking for someone who might proactively spot when Barkeep has gone off the rails, then I'm probably not your man. On the other hand, if you got into bother and wanted feedback, then I'd try my best to investigate at the time. -- Colin° 08:46, 4 December 2024 (UTC)
- Thanks Colin. I am more looking for general feedback at the moment and my recall list was a good group to message for potential feedback (as I know I have some people on it who are more critical than favorable towards me). I appreciate what you've said here and your offer if that should ever come to pass. Best, Barkeep49 (talk) 21:14, 4 December 2024 (UTC)
A barnstar for you!
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The Teamwork Barnstar |
| I really like what you said, "… it needs both sides to be working under an assumption of good faith and collaborative spirit". Thank you! --Dustfreeworld (talk) 15:41, 5 December 2024 (UTC) |
- Thanks @Dustfreeworld. Unfortunately complaining about lack of teamwork doesn't magically make people collaborate well. -- Colin° 16:48, 5 December 2024 (UTC)
- You are right Colin . --Dustfreeworld (talk) 17:44, 5 December 2024 (UTC)
PANDAS
Colin, as to the approach the AAP has taken culturally, I can send you a very good article on delusional parasitosis once I re-locate it ... dermatologists had to take a particular stance to be able to offer some treatment, even in resistant cases. The approach here seems similar, considering that PANS is related to OCD, which can be familial. SandyGeorgia (Talk) 20:50, 17 December 2024 (UTC)
- From here, I can't recall if it was Campbell or Moriarty -- free full-text is not available, but one of them went into great detail about the language and approach needed to gain the trust of the patients and families, so they could at least have a chance of offering some treatment rather than seeing the patient continue to consult multiple doctors until they got the desired outcome. Telling a delusional patient that they need an antipsychotic will only guarantee they move on to the next doctor, so careful use of language, rather than blunt truth, is the recommended approach for DP. The PANDAS network helps parents lobby state legislatures to force insurance companies to pay for treatment. On one support group message board, PANDAS is included in the same group as Lyme disease. How is MEDRS set to handle the incoming administration in the US? You might recall that from the day of its (MEDRS) inception, I lobbied against elevating sources like NIH, CDC, etc, for the very reasons we are likely to see going forward. I could always point out errors in NIH information; PANDAS was born at the NIH. SandyGeorgia (Talk) 21:03, 17 December 2024 (UTC)
- Perhaps I'm naive but I think the UK legal system and medical system is less prone to political or financial interference. So I'm probably more favourable to bodies linked to government (NHS, NICE). Do we think these bodies are any more or less likely to adopt a controversial POV than something that appears more grassroots like some association of healthcare professionals. I guess anything that attempts to describe a consensus of experts is great. At times it may not always be ideal. -- Colin° 10:05, 18 December 2024 (UTC)
- I can't speak to the UK legal/medical compared to the US, but I suspect we will see issues with sourcing from the incoming NIH, CDC, FDA et al relative to what high-quality peer-reviewed publications say. I think the current MEDRS wording encompasses that eventuality, but I'm not entirely sure whether the wording is sufficient to avoid unnecessary battleground. Recall, for example, that the FDA succumbed to advocacy organization pressures and approved aducanumab, overriding its own advisory panel's recommendation and leading several renowned panel members to resign in protest. And the drug was eventually abandoned by the manufacturer (it never worked and had safety issues as well). There are so many examples of politicization of medical decisions in the US, that I worry if MEDRS wording is up to the task of the coming years. SandyGeorgia (Talk) 14:41, 18 December 2024 (UTC)
- Bodies like NICE and SIGN involve patient groups and a range of medical professionals and so can be influenced by advocacy groups as well as looking at systematic reviews. Perhaps this is a WP:RIGHTGREATWRONGS situation where we get the governments and government institutions we deserve, and have to live with it on Misplaced Pages. Sometimes we win sometimes we lose.
- Just because a drug is approved, for example, doesn't mean clinical guidelines recommend it, or maybe it is third-line. And maybe a lot of first-line drugs are so because of big pharma lobbying and not because they really are so much better than the generics. And maybe a drug is prescribed/taken more than it should be. And so on. We know that so-called peer review isn't perfect either. Your US gov bodies may have their flaws, but maybe on balance they are right more often than the alternative. At least for now.
- If we are conflicted between one set of guidelines and another government report, which disagree, maybe that's not such a terrible problem. Compare that to the gensex mess, where activist editors think random PDFs, the contents of which change with the wind, and are written to win US legal battles rather than inform medical professionals, stand higher than six systematic reviews and an health service report that was enthusiastically accepted by the health service it was for. Or where talk pages mention articles in lifestyle magazines to spread conspiracy theories or editors face xenophobic comments on talk pages. I can live with "one set of grown ups disagree with another set of grown ups". -- Colin° 14:58, 18 December 2024 (UTC)
- I 'spose if you aren't worried, then I won't be :) On aducanumab, "Just because a drug is approved, for example, doesn't mean clinical guidelines recommend it", was the approach I took when it was speedily added in the Treatment section at Alzheimer's after the FDA approved it, although no guidelines or peer-reviewed articles recommended it. No one challenged me when I removed it from the Treatment section to the Research directions section, but I can imagine scenarios where a battleground will develop. The NIH has long advocated for PANDAS and the related hypotheses, which were born at the NIH. In the longrun, will the peer-reviewed literature on the topic go the way of peer-reviewed literature in the GENSEX area, which is supplanted by blogs and random PDFs. I am concerned we'll see more of this. SandyGeorgia (Talk) 15:21, 18 December 2024 (UTC)
- I can't speak to the UK legal/medical compared to the US, but I suspect we will see issues with sourcing from the incoming NIH, CDC, FDA et al relative to what high-quality peer-reviewed publications say. I think the current MEDRS wording encompasses that eventuality, but I'm not entirely sure whether the wording is sufficient to avoid unnecessary battleground. Recall, for example, that the FDA succumbed to advocacy organization pressures and approved aducanumab, overriding its own advisory panel's recommendation and leading several renowned panel members to resign in protest. And the drug was eventually abandoned by the manufacturer (it never worked and had safety issues as well). There are so many examples of politicization of medical decisions in the US, that I worry if MEDRS wording is up to the task of the coming years. SandyGeorgia (Talk) 14:41, 18 December 2024 (UTC)
- I've seen several comments about insurance companies, but the very much pro-PANDAS group https://www.pandasppn.org/flowchart/ and https://www.liebertpub.com/doi/10.1089/cap.2016.0148#T5 (which it links to) indicate that the recommended first-line drugs are cheap: a couple of weeks of ordinary amoxicillin and over-the-counter Aleve, with the option of adding some ordinary prednisone. IVIG is pricey (though not compared to hospitalization), but even if you assume PANDAS exists and is moderately common, it looks like most kids would get treated cheaply. There would be no financial incentive for an insurance company to deny such a cheap treatment. Even if it only worked as a placebo, it might save them money by preventing a second office visit. WhatamIdoing (talk) 01:21, 19 December 2024 (UTC)
- If what WAID says is true, why the battle to get insurance companies on board. It seems relatively few states mandate treatment for PANS/PANDAS and we see posts on the talk page complaining about Misplaced Pages encouraging insurance companies to say no. The article does describe what WAID suggests, that people are giving out antibiotics like Smarties in the belief that this cheap and usually harmless treatment might help. But that makes me wonder: antibiotics are as close to miracle drugs as we have. You can cure an infection in 10 days. You can't cure depression or TS or epilepsy in 10 days. So if that approach had merit, surely the effectiveness of treatment would be pretty easy to demonstrate in a trial.
- Wrt Sandy's comment above. It isn't that I'm not worried about the US government healthcare situation. It is that I don't see demoting a whole class of sources as a solution to situations where editors believe they have an example of where it goes wrong. In the gensex area, we have activist editors demoting three sources: Anything British, The Guardian and the BBC. You can find sources and issues with all three if you go looking. And those issues are then cited as a reason to demote that entire class of source, whenever anyone wants to push that source to say something you don't want to say (but conveniently forgotten about if the source says something you do want to say). And I find it surprising since the US is much worse than the UK, and the Guardian and BBC generally news-report these issues with neutrality, and are much better than the alternatives (Pink News might say what you want to say, but nobody argues it is neutral. The Telegraph and Times don't say what you want to say, but are paywalled). So generally I'm nervous about demoting eg NIH or CDC because Sandy can find examples of where they fall down. But maybe we are right to be concerned that in 2025 these bodies might start promoting quack theories and discouraging good medicine. -- Colin° 09:32, 19 December 2024 (UTC)
- I have a very full day ... doctors plus dentist plus church board meeting and budget ... will catch up tomorrow if I can. SandyGeorgia (Talk) 13:57, 19 December 2024 (UTC)
- Perhaps I'm naive but I think the UK legal system and medical system is less prone to political or financial interference. So I'm probably more favourable to bodies linked to government (NHS, NICE). Do we think these bodies are any more or less likely to adopt a controversial POV than something that appears more grassroots like some association of healthcare professionals. I guess anything that attempts to describe a consensus of experts is great. At times it may not always be ideal. -- Colin° 10:05, 18 December 2024 (UTC)
Greetings of the season
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- Thank you @Dustfreeworld. Hope you have a merry Christmas too. -- Colin° 17:23, 24 December 2024 (UTC)
Happy Holidays
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Merry Christmas and a Prosperous 2025! |
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Hello Colin, may you be surrounded by peace, success and happiness on this seasonal occasion. Spread the WikiLove by wishing another user a Merry Christmas and a Happy New Year, whether it be someone you have had disagreements with in the past, a good friend, or just some random person. Sending you heartfelt and warm greetings for Christmas and New Year 2025. Spread the love by adding {{subst:Seasonal Greetings}} to other user talk pages. |
Abishe (talk) 23:45, 24 December 2024 (UTC)
Readability tools
In honor of our discussions in years past: Misplaced Pages:Readability tools. WhatamIdoing (talk) 05:29, 5 January 2025 (UTC)
- There's a medical student editing course using the Hemingway app to make articles into the short, choppy gibberish we've encountered elsewhere:
- SandyGeorgia (Talk) 13:02, 5 January 2025 (UTC)
- Eg, from Colin's area of editing: . SandyGeorgia (Talk) 13:38, 5 January 2025 (UTC)
- Thanks @SandyGeorgia and @WhatamIdoing. That's a good essay (though it is hard to beat the original source article for explaining things well). It has provoked me to have a rant at Misplaced Pages talk:Make technical articles understandable#Readability score pseudo-science.
- Sandy, I took the epilepsy-related articles off my watchlist years ago when you-know-who took ownership of them. I wouldn't advise anyone get epilepsy-related information from Misplaced Pages. There are plenty better websites today. Looking at one section:
The first line medication for an actively seizing person is a benzodiazepine, with most guidelines recommending lorazepam. Diazepam and midazolam are alternatives. It may be given in IV if emergency services is present. Rectal and intranasal forms also exist if a child has had seizures previously and was prescribed the rescue medication.
- It is a mix of in-hospital advice (IV lorazepam) or child-only community advice. The "It" in the third sentence is a good example of a chop introducing ambiguity. The "it" refers to lorazepam but you can't figure this out. The rectal form refers to diazepam. The intranasal form to midazolam though in some countries that might be buccal instead. Which is another problem, as this advice isn't necessarily the same in all countries and depends what is licenced. And the treatment protocol for one person might be different to another and different for adults vs children or convulsive seizures vs other kinds. And apparently if the child has not previously had seizures or not prescribed rescue medication, these forms cease to exist in the known universe. Colin° 19:19, 5 January 2025 (UTC)
- That course is making messes everywhere. I had a go at cleaning up Airway obstruction, but it's more of a job than I have time for. SandyGeorgia (Talk) 00:27, 6 January 2025 (UTC)
- In climate change related articles we've had the same: people misusing these tools to create awkward text without flow.
- To me, this does speak to the need of creating guidelines that do work. It's quite silly that WP:readability now points to an obscure user essay that's not really about that at all... —Femke 🐦 (talk) 19:58, 6 January 2025 (UTC)
- I thought about taking that to Misplaced Pages:Redirects for discussion, but I'm not sure where else to point it to, and there are several links in. WhatamIdoing (talk) 02:31, 7 January 2025 (UTC)
- I don't think it's ripe for pointing elsewhere yet, we'd need to do some reorganisation in WP:MTAU or WP:writing better articles to point it somewhere. Interestingly, quite a few of the links pointing to that user essay assume they're linking to a P&G, probably not following the redirect to check if this is even a guideline. Not sure how WP:RfD works, but it shouldn't be too much work to change these historical links if there is consensus to do so, where sensible. —Femke 🐦 (talk) 08:25, 7 January 2025 (UTC)
- I agree something needs to be done with that essay and the shortcut pointing to it ... not a good situation. SandyGeorgia (Talk) 14:43, 7 January 2025 (UTC)
- I don't think it's ripe for pointing elsewhere yet, we'd need to do some reorganisation in WP:MTAU or WP:writing better articles to point it somewhere. Interestingly, quite a few of the links pointing to that user essay assume they're linking to a P&G, probably not following the redirect to check if this is even a guideline. Not sure how WP:RfD works, but it shouldn't be too much work to change these historical links if there is consensus to do so, where sensible. —Femke 🐦 (talk) 08:25, 7 January 2025 (UTC)
- I thought about taking that to Misplaced Pages:Redirects for discussion, but I'm not sure where else to point it to, and there are several links in. WhatamIdoing (talk) 02:31, 7 January 2025 (UTC)
- User:Ian (Wiki Ed) do you think you can make any progress by speaking with the prof of this medical student course? They aren't doing great work medically, but they are also turning articles unreadable by using the Hemingway app to create choppy prose that doesn't flow. I wonder if the prof is checking their work, medically, and I wonder if the prof is encouraging them to use these apps, which have issues. I did what cleanup I had time for at one article, Airway obstruction, but it still needs attention, as I suspect most of their other work does. SandyGeorgia (Talk) 14:48, 7 January 2025 (UTC)
- PS, some of the issues are ... not adding page numbers on book sources (while students have access to medical libraries, they should provide the page nos so others don't have to later search them out), giving medical advice and otherwise not adhering to WP:MEDMOS, not being aware of general advice on section headings (see duplicates at Airway obstruction, adding images to articles without concern to MOS:SANDWICH and whether those images are better suited to sub-articles, and generally disrupting flow and understanding by applying readability apps and other algorithms (perhaps a look at the new page Misplaced Pages:Readability tools would help guide them. In addition to that, the actual medical content warrants closer review. SandyGeorgia (Talk) 14:53, 7 January 2025 (UTC)
- @SandyGeorgia Just looking at that Readability tools page now. It's great to see. I made myself a note yesterday about working on something like that, which was specifically inspired by one of the medical classes from last semester - actually it was probably the one you linked to here. Ian (Wiki Ed) (talk) 14:56, 7 January 2025 (UTC)
- Thx Ian! SandyGeorgia (Talk) 15:00, 7 January 2025 (UTC)
- @SandyGeorgia Just looking at that Readability tools page now. It's great to see. I made myself a note yesterday about working on something like that, which was specifically inspired by one of the medical classes from last semester - actually it was probably the one you linked to here. Ian (Wiki Ed) (talk) 14:56, 7 January 2025 (UTC)
- @SandyGeorgia - WhatamIdoing just pinged me about this. That class is done, but they have a new class that started yesterday. I will definitely reach out to them - I think they should be responsive. Ian (Wiki Ed) (talk) 14:54, 7 January 2025 (UTC)
- @Ian (Wiki Ed), I would suggest the class use each others brains, rather than a tool based on 1950's technology. One student makes a note on the talk page or whereever about things they found hard to understand or confusing. Then a group of students brainstorm how they might rewrite the sentence to make it clearer. This might involve researching the current and new sources so they themselves understand what the article is trying to say (assuming it is correct to say). Then ideally an expert (teacher?) could check their rewrite hasn't made it worse. -- Colin° 15:06, 7 January 2025 (UTC)
- PS, some of the issues are ... not adding page numbers on book sources (while students have access to medical libraries, they should provide the page nos so others don't have to later search them out), giving medical advice and otherwise not adhering to WP:MEDMOS, not being aware of general advice on section headings (see duplicates at Airway obstruction, adding images to articles without concern to MOS:SANDWICH and whether those images are better suited to sub-articles, and generally disrupting flow and understanding by applying readability apps and other algorithms (perhaps a look at the new page Misplaced Pages:Readability tools would help guide them. In addition to that, the actual medical content warrants closer review. SandyGeorgia (Talk) 14:53, 7 January 2025 (UTC)
- That course is making messes everywhere. I had a go at cleaning up Airway obstruction, but it's more of a job than I have time for. SandyGeorgia (Talk) 00:27, 6 January 2025 (UTC)