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Coatrack?

An editor recently indicated in an edit summary that there was a WP:coatrack issue here. Rather than just leaving it rather lazily and not very convincingly in an edit summary, raise it here and let's discuss it properly.DrChrissy ^(talk) 22:35, 28 April 2015 (UTC)

DrChrissy are you talking about this edit? When you're starting a Talk page discussion it'd really be nice if you'd help out your fellow editors by specifying the particular edit you're concerned about (and by dropping unnecessary adverbs like 'lazily'). I'd actually disagree with the characterization of that section as a "coatrack" problem but I'd rather not do a whole lot of typing here if that's not what you're talking about. Zad68 02:05, 29 April 2015 (UTC)

@Zad68 Yes, that is the edit - I will be more specific in the future. Sorry about the use of "lazily". It just seems rather unhelpful for an editor to drive-by, leave the template with a negative edit summary and not even bother to take this to the Talk page. I'll curb my frustration in the future.DrChrissy ^(talk) 09:13, 29 April 2015 (UTC)

What do you think doc? -Roxy the Viking dog™ (resonate) 09:39, 29 April 2015 (UTC)

Are you talking to me? If so, please use my user name or I might be wasting my time replying.DrChrissy ^(talk) 09:54, 29 April 2015 (UTC)

Are there any other docs on this page at the moment? So, what do you think? Genuine question. -Roxy the Viking dog™ (resonate) 10:14, 29 April 2015 (UTC)

Please use my user name so that other readers can follow who you are asking a question of.DrChrissy ^(talk) 10:52, 29 April 2015 (UTC)

Sure Chrissy, thanks... No, the inclusion of a short summary section on Veterinary acupuncture isn't a coatrack problem. A general review of the reliable sourcing on acupuncture in shows that vet. acu. is well-represented. This acupuncture article is really getting to be quite sizeable and comprehensive, so it isn't undue here either. Per WP:SUMMARY there should be a section here summarizing what's at the vet. acu. article, or what should be in that article (it's tiny now and given the sourcing available it really could be expanded quite a bit).

The one thing that needs be done though is to move that section to the end per WP:MEDMOS. Actually generally this article needs to be restructured per MEDMOS. Zad68 13:34, 29 April 2015 (UTC)

It is my intention to work on the Vet Acu article soon and we can then provide a summary of that here. Happy to see the Vet Acu section moved toward (to) the end - I appreciate that is the style of medical pages.DrChrissy ^(talk) 14:16, 29 April 2015 (UTC)

@User:Zad68 I moved the Vet section to the end of the article as both you and I agreed, but another editor has moved it back. I believe I am being goaded into edit warring by this, so I will not revert but thought I should let you know.DrChrissy ^(talk) 17:35, 2 May 2015 (UTC)

@DrChrissy - I've restored it back to where it belongs. Hopefully, the disruption will stop. -A1candidate 18:20, 2 May 2015 (UTC)

You have not explained how your edits were an improvement, especially with restoring the MEDRS violations. This edit added misplaced text that is already in the article,. QuackGuru (talk) 18:23, 2 May 2015 (UTC)

It was a reasonable shortening of the article according to User:Sonicyouth86. We do have a section for related practices. See Acupuncture#Related practices. QuackGuru (talk) 01:20, 4 May 2015 (UTC)

Quick comment: I didn't mean to endorse your edits with my self-revert. I just meant that, on second thought, your deletion of sourced content didn't appear like clear-cut vandalism to me because you did provide edit summaries and participated in discussions, that's why I decided to undo my rollback. I'll let editors with deeper knowledge of the subject decide if your edits were constructive. --SonicY (talk) 01:35, 4 May 2015 (UTC)

Revert of pseudoscience

Regarding this revert: Huh? This is the first time (to my knowledge) the pseudoscience descriptor was removed from that section, so the accusation of edit warring is bizarre.   — Jess· Δ♥ 13:54, 4 May 2015 (UTC)

I was talking about your pattern of editing, not a single revert.DrChrissy ^(talk) 14:27, 4 May 2015 (UTC)

My "pattern of editing"? I reverted you only once prior to that, on an entirely different edit, and I commented on the talk page regarding both reverts. This edit, however, is edit warring; it is a revert of a revert without discussion with the intent of forcing a proposed change into the article despite opposition. You should read WP:EW before citing it. That all said, you undid my change above without providing any rationale. Why did you do that?   — Jess· Δ♥ 15:24, 4 May 2015 (UTC)

And this version was not an improvement. DrChrissy please discuss and get consensus for significant changes before you make them. --NeilN ^{talk to me} 14:02, 4 May 2015 (UTC)

Please see WP:BRD.DrChrissy ^(talk) 14:24, 4 May 2015 (UTC)

TCM based on science

I have found a source that says that "There is a strong scientific basis for traditional chinese medicine" in contrast to the article's current assertion (sourced to Quackwatch) that TCM isn't based on science. The source is this book, page 2, section 1.2. Does it seem reliable, and if so, more reliable than Quackwatch? It was, after all, published by the Royal Society of Chemistry.Everymorning talk 00:57, 27 April 2015 (UTC)

Wow, that is absolutely a very reliable source since it is a textbook published by the Royal Society of Chemistry. FYI, I'm not going to be available to discuss this at length due to real world circumstances right now, but for now I'll just pop in and say that, yes, anything published by the RSC that is specific to the topic of TCM is much more reliable than QuackWatch which is a POV pushing advocacy site. QuackWatch might be reliable for certain claims, but in this article any claim should always be attributed at the very least so that the reader knows where the information is coming from. Is it reliable for this claim, especially in light of this textbook from RSC? Well, I guess that will be for us to decide. Keep in mind, we also say in the lede that acupuncture founded on "pseudoscience" (and we use a pro-acupuncture source out of context to say that, big stretch with out sources!) As I see it, we have several options: option 1 is we use the source next to Quackwatch and others in the lede for parity. Option 2, we delete claims coming from Quackwatch and other one-sided sources because they might not be able to hold their weight next to a source like this. Option 3 we use the source and don't delete claims by Quackwatch and others, but we attribute those to let the reader know where the statements are coming from, in all cases. Option 4 we don't use a high quality source like this and edit war anyone who tries adding it in, yet keep bending sources to make the article appear that all things Chinese medicine are pseudoscience and keep doing this until someone files an RfC. ANywho, those are the options as I see them and I'm not sure which one I'm for yet, three of them seem reasonable, one terrible. LesVegas (talk) 01:43, 27 April 2015 (UTC)

Nobody mentioned Option 5 - we could, you know, examine the source, to um, see if it is any good. I have a small but exciting wager on the outcome. -Roxy the Viking dog™ (resonate) 03:00, 27 April 2015 (UTC)

But wait, Option 5 looks a whole lot like Option 4 especially since you did't even bother to say why a textbook published by RSC would be unreliable. I have a little time this morning to discuss this so if anyone would care to add something, let's hear it before we add the source in. LesVegas (talk) 15:45, 27 April 2015 (UTC)

It's certainly not a preferred source for medical topics. I also note that it includes an internal disclaimer that its contents are not endorsed by the RSC.—Kww(talk) 04:23, 28 April 2015 (UTC)

Sorry, KWW, but it looks like the RSC uses that as a standard disclaimer on all their newer publications. like this one and this one or this one. So perhaps since this source is rock solid after all, the conversation should begin to move towards how and where we add it in and what lower quality sources should be deleted with this taking its place? LesVegas (talk) 19:16, 28 April 2015 (UTC)

If they disclaim it, they disclaim it, so they are not relevant to determining the reliability. Any discussion of reliability can only pertain to the actual author and whether this particular material has survived peer review.—Kww(talk) 05:41, 29 April 2015 (UTC)

They disclaim every book. What is nothing published by RSC reliable now?. MEDRS states that the publisher matters (in cases of a low quality publication) but says nothing about standard legal disclaimers. But if you find something in MEDRS or any policy or guideline that states otherwise, feel free to add that to the discussion before we add this source into the article. LesVegas (talk) 14:06, 29 April 2015 (UTC)

No, but the source has to be evaluated on the merits of the author, not the publisher. If they disclaim it, they disclaim it. Given that it is so clearly a fringe view and not supported by the publisher, it doesn't merit inclusion.—Kww(talk) 18:40, 3 May 2015 (UTC)

KWW, I gave you several examples of RSC using that disclaimer in all their current texts. I could give more, but I have to assume you will ignore those as well. That issue isn't going away. Iff you want to have a discussion as to whether or not anything currently published by RSC is unreliable, we can have that discussion. As I see it, it is your burden to show that standard legal disclaimers are unreliable in Wikilaw. LesVegas (talk) 19:00, 3 May 2015 (UTC)

Just popping in to this discussion. Actually, both of them matter, but even meritorious authors might have published a lot of nonsense that have never passed the scrutinizing eyes of a notable publication. Therefore, we are highly interested in the publisher, but of course, the both have to match. Jayaguru-Shishya (talk) 17:15, 4 May 2015 (UTC)

I'm sorry that you don't understand the meaning of a disclaimer, but it's pretty straightforward: the RSC's reliability is irrelevant to the discussion. Doesn't mean the source is unreliable, but it doesn't mean it's reliable, because they have disclaimed responsibility for the material. If you believe such a ludicrously fringe view to be from a reliable source, you will have to defend its inclusion based on the authors expertise, not the publisher.—Kww(talk) 19:10, 3 May 2015 (UTC)

I have changed it to "Some scientists believe that the theories basis of TCM are poorly understood in the West". Is this a good enough compromise, User:Kww? We are not stating that TCM has a scientific basis whatsoever. User:Mann jess your input here would be helpful too. -A1candidate 19:42, 3 May 2015 (UTC)

I think the basis of TCM is well understood in the West: it's based on folklore and superstition. It isn't science, isn't based on science, and shouldn't be described as being on par with science. Describing it as "poorly understood" implies that it has some unappreciated merit. It doesn't. Your edits leave the reader with the false impression that there is some legitimate scientific controversy about TCM.—Kww(talk) 19:53, 3 May 2015 (UTC)

Well, I live in the West. And I certainly don't understand the theories of TCM. -A1candidate 19:54, 3 May 2015 (UTC)

All you need to understand about them is that they are entertaining folk superstitions at best. The specific details aren't important.—Kww(talk) 19:58, 3 May 2015 (UTC)

I'm afraid we have to disagree, because true skepticism entails understanding the contrary arguments, even if they are demonstrably wrong. -A1candidate 20:07, 3 May 2015 (UTC)

A1, it is my belief that a compromise isn't necessary, but I want to thank you for trying to be a peacemaker. The source is accurate and attributed and reliable according to every guideline I know of, other than the ones being made up on the fly here. At some point this page needs to stop having two sets of rules. I would never suggest a reliable source that criticizes acupuncture is unreliable based on a standard legal disclaimer, even though I have found some in our article. LesVegas (talk) 20:04, 3 May 2015 (UTC)

And, if you read carefully, I haven't suggested that a source is unreliable because it contains a disclaimer either. I've said that you need to make the case for reliability based only upon the parties that haven't issued disclaimers about the contents. You haven't made any effort to do so. As for the page having two sets of rules, it doesn't: sources representing mainstream scientific thought have precedence over mysticism and fringe science. That should be a fairly simple rule to comprehend and abide by. That you persistently wind up on the wrong side of it is a different issue.—Kww(talk) 21:15, 3 May 2015 (UTC)

The content you wish to include is diametrically opposed to the vast majority of the quality sources we have on the topic. Many of those are already cited, including, for example, Ernst. Systematic reviews show, at most, efficacy for reducing certain types of pain, and no results beyond placebo for other conditions. Impartial reviews of TCM indicate it is not science-based or evidence-based, and is almost wholly rejected by the scientific community as a result. Here is a source which sets out explicitly to show that TCM should be seen to have a scientific basis, despite that trend. So, is it reliable? Well, it is a source with a clear agenda: advocating for a minority (or, more likely, fringe) position that I don't see advanced elsewhere. I think the burden on demonstrating its reliability is therefore quite high for it to overturn our MEDRS compliant sources, and even if that were done, it would need to be given due weight, not exclusive weight, when describing the subject.   — Jess· Δ♥ 21:37, 3 May 2015 (UTC)

Acupuncture has "proven efficacy" and scientific backing

I just reverted a series of edits which indicate quite strongly that TCM has scientific backing and is "effective" without qualification. I think this needs significantly more discussion before being inserted into the article, as it turns our coverage of Acupuncture's efficacy on its head. What sources are we referencing when adding this content? Why are we now aiming to exclude our existing sources which say the precise opposite?   — Jess· Δ♥ 19:55, 3 May 2015 (UTC)

We are using Miller's Anesthesia. Which sources are we excluding, User:Mann jess? -A1candidate 19:57, 3 May 2015 (UTC)

It's not that you are attempting to exclude existing sources, it's that you were attempting to provide false parity.—Kww(talk) 20:03, 3 May 2015 (UTC)

Statements of authoritative medical textbooks need to be given due weight. What would both of you suggest as a compromise? -A1candidate 20:11, 3 May 2015 (UTC)

(edit conflict)First of all, you've taken these three sources: [1], [2], [3] and replaced them with just one: [4]. You've not just provided equal weight to this new source, but you've actually given it significantly more weight ("scientists vs quackwatch"). Your edits to later parts of the page are of more concern, but for essentially the same reason.   — Jess· Δ♥ 20:15, 3 May 2015 (UTC)

Well, we can put them back in? I would also appreciate some suggestions from you about how we could give both sources equal weight, User:Mann jess. -A1candidate 20:21, 3 May 2015 (UTC)

In such cases we go with the scientists and omit QuackWatch. Jayaguru-Shishya (talk) 17:20, 4 May 2015 (UTC)

Equal weight? Why should "Traditional Chinese Medicine: Scientific Basis for Its Use" be given equal weight to those three sources? Why is it of that high a quality?   — Jess· Δ♥ 20:28, 3 May 2015 (UTC)

Because it is written by experts in a relevant scientific field (pharmacology) and it is from a respected publisher (Royal Society of Chemistry)? Don't you think this is grounds for a legitimate scientific discussion, User:Kww? -A1candidate 20:32, 3 May 2015 (UTC)

To the extent that it makes claims about pharmacology, I haven't got any objection to its use. There are certainly herbs used in TCM that have legitimate medical value. To the extent that it makes the claim that the underlying concepts of TCM, such as qi, yin, and yang, make scientific sense, I don't see that the expertise in pharmacology is applicable, and the claim itself is clearly a fringe claim. As the publisher has disclaimed responsibility for the contents, the publisher's credentials don't factor into the discussion.—Kww(talk) 21:20, 3 May 2015 (UTC)

The purpose of pointing to the publisher's credentials isn't to imply that they are responsible for contents, but to demonstrate that they are independent of, and unrelated to, the acupuncture community. In any case, we have a prominent medical textbook (Oxford Textbook of Palliative Medicine ) that says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266). This demonstrates the medical community's preference for a modern explanation of acupuncture in lieu of a purely traditional explanation ("vital energy"), User:Kww. Also, what good reason do we have to replace a good medical textbook with QuackWatch, User:Mann jess? -A1candidate 22:10, 3 May 2015 (UTC)

KWW, it is claiming TCM has a strong scientific basis, not that TCM herbalism alone has a strong scientific basis. It is simply suggesting that herbs have a pharmacological method of action under TCM, which it's claiming has a strong basis in science. LesVegas (talk) 22:20, 3 May 2015 (UTC)

Exactly, and that's what makes it a fringe claim. That TCM has identified some valuable herbs is non-controversial. I can't imagine any reputable scientist arguing that an herb couldn't possibly have value because TCM uses it. That TCM has a scientific foundation is controversial (controversial to the point of being ludicrous, in fact) and a background in pharmacology doesn't provide strong support for claiming that qi, yin, and yang are viable approaches to studying chemistry.—Kww(talk) 01:13, 4 May 2015 (UTC)

A1, the quote you've provided does not address the first section you changed. It also does not indicate acceptance of TCM or acupuncture within the scientific community. Why use quackwatch? Because it explicitly addresses the claim we are sourcing without interpretation or synthesis, and its findings are consistent with the plethora of other sources which describe the scientific community's opinion.   — Jess· Δ♥ 22:29, 3 May 2015 (UTC)

I am not arguing that TCM is accepted within the scientific community. I am arguing, however, that medical acupuncture is accepted by a large faction of the medical profession (at least the modern explanations for acupuncture are). QuackWatch should be given less weight because it fails to address this second issue. -A1candidate 22:36, 3 May 2015 (UTC)

Thanks, Mann jess. If the findings of QuackWatch "are consistent with the plethora of other sources which describe the scientific community's opinion", then we will remove QuackWatch on the peculiar instance and replace it with some of those sources describing the scientific consensus. Jayaguru-Shishya (talk) 17:22, 4 May 2015 (UTC)

You're not? Well, you removed content that said TCM was not based on scientific knowledge, and wrote in its place that scientists believe TCM is just misunderstood. Again, your source does not address that topic, but the ones we are using do, and they back up the existing wording. Also, I don't see any part of your edit which discusses the acceptance of modern explanations of acupuncture by medical professionals. All I see are suggestions that acupuncture is efficacious and backed by science, and our MEDRS compliant sources contradict that claim.   — Jess· Δ♥ 01:37, 4 May 2015 (UTC)

Like I said, I have nothing against restoring that content. What I wrote was "poorly understood", not "misunderstood" - Both terms have different meanings. The part on acceptance by the medical profession was removed here. I stand by this addition, firmly, and request an explanation of why this content should be removed. -A1candidate 02:33, 4 May 2015 (UTC)

"Poorly understood" and "misunderstood" have different meanings, but the difference is not significant to what I wrote. As for the diff, I did not remove that content, so I'm not the one to ask why it was taken out. I'd venture a guess that there is an effort to trim the article, since it's become unwieldy to the point of being nearly incomprehensible.   — Jess· Δ♥ 03:02, 4 May 2015 (UTC)

Trimming the article = Reverting the edits of other editors? Since you're not willing to defend the removal, I request that someone else do so. Otherwise I'm going to restore it back to this version. It is not perfect but at least it's something all of us could (hopefully) live with. -A1candidate 06:54, 4 May 2015 (UTC)

This edit is completely inappropriate. It wholly removes the description of Acupuncture's scientific reception from the lead, and on top of that, goes on to summarize it as an opinion from 2007. The edit was made when discussion thus far has shown such changes to be contentious. Please discuss edits like that before instituting them (and reverting to get them in the article!)   — Jess· Δ♥ 13:57, 4 May 2015 (UTC)

Scientific basis section

I have been trying to bring a little stability and order to this article. I have tried to take details (not the subject) about adverse effects from the lede to the main body of the article. Result - disruptive edit warring! I have tried to take the scientifc basis of acupuncture to its own section so that the lead can remain stable for at least 24 hrs. Result - more disruptive edit warring! I even chose to place this scientific basis above the section on clinical practice. I think everybody would agree that the scientific basis of acupuncture is contentious, so why do those doing the edit warring not want such a section. We can all have our say and leave the lede alone!DrChrissy ^(talk) 14:10, 4 May 2015 (UTC)

You wanted the lead to be stable for 24 hours, so you made significant changes to it? That's a strange rationale. The lead must summarize the body, so there are two problems with your edit: 1) Moving the scientific reception of acupuncture out of the lead means it no longer summarizes the body, and indicates that acupuncture's scientific reception is not a significant part of the topic. 2) Since this detail is already covered in the body, moving the lead into the body means it is now covered twice in two different places (but still not in the lead).   — Jess· Δ♥ 14:14, 4 May 2015 (UTC)

As I stated in the edit summary I was trying to make the first para neutral so we could all leave it alone. Yes, the lead must summarize the body of the article, at the moment, there is little, if any, discussion of the scientific basis in the body of the article. This should be discussed in the body, not the lead, and the lead should only summarize it. I believe it's importance justifies its own heading.DrChrissy ^(talk) 14:21, 4 May 2015 (UTC)

1) We don't have sections in leads. 2) If your intent was to move that entire section out of the lead, it would remove all indication that the mainstream medical community regards acupuncture as a fringe treatment. --NeilN ^{talk to me} 14:40, 4 May 2015 (UTC)

My intent was/is to move it out of the lead, discuss the section, then when consensus is clear, make a summary in the lead. At the moment, we appear to be having the discussion in the lead which is probably why several editors have already commented it is too long and complicated. My sole intention is to improve the article.DrChrissy ^(talk) 14:53, 4 May 2015 (UTC)

There really are two issues here, and let's not conflate them. The benefits of acupuncture are contentious to the extent that there is legitimate research that shows that it may have some small actual effect through mechanisms that have not been properly isolated. Because of that, we cannot flatly state that acupuncture itself is pseudoscience or quackery. The underlying theories of TCM, however, with yin, yang, qi, meridians, and the like are obvious pseudoscience to the point that they should be unequivocally and decisively described as such in Wikipedia's voice and the smattering of contradictory studies dismissed as either erroneous or intentional fringe science. As for moving it "out of the lead": absolutely not. The lead serves as the summary and takeway for readers that skim, and the important takeaway on acupuncture is that it is a practice with dubious benefits that are not certain to exist, and that the theoretical underpinnings on which it was founded are superstition and folklore. Someone that reads the lead should not come away with the impression that it is a widely accepted medical treatment or that there is some kind of controversy over its origin.—Kww(talk) 15:04, 4 May 2015 (UTC)

Wikipedia is WP:NOTFORUM. Less personal opinions, more sources. Thank you Kww. Jayaguru-Shishya (talk) 17:24, 4 May 2015 (UTC)

Less interruptions of discussion flow, please. I have provided a reasonable summary of scientific opinion and your implication that I have not is completely unwelcome.—Kww(talk) 17:45, 4 May 2015 (UTC)

• Kww really highlights the issue here, it's the conflation of the TCM ideas (qi, meridians) and the evidence for effectiveness (RCT results). We have to be careful to cover these as separate topics. If there is some evidence for effectiveness beyond placebo, we cannot allow the article to imply that TCM has an accepted basis as the cause of it. Zad68 17:54, 4 May 2015 (UTC)

Full protection...

...for three days. Let's try and continue this here, rather than on the article please. --kelapstick^(bainuu) 18:48, 4 May 2015 (UTC)

Cochrane reviews on acupuncture

The words "pseudoscience", "quackery" and the like seem to be thrown at acupuncture without a second thought. My second thought was to check whether these terms really do apply. So, I turned to WP:MEDRS to find out which would be the best way to research this. WP:MEDRS states "Cochrane Library reviews are generally of high-quality...", so I went to the Cochrane Collaboration site and typed "acupuncture" into their reviews search engine. I got 248 hits. I went through the first 20 of these and found the following -

"There is low to moderate-level evidence that compared with no treatment and standard therapy, acupuncture improves pain and stiffness in people with fibromyalgia."[5]

"Limited evidence suggests that acupuncture may have some antipsychotic effects as measured on global and mental state with few adverse effects."[6]

"In the previous version of this review, evidence in support of acupuncture for tension-type headache was considered insufficient. Now, with six additional trials, the authors conclude that acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches."[7]

"In the previous version of this review, evidence in support of acupuncture for migraine prophylaxis was considered promising but insufficient. Now, with 12 additional trials, there is consistent evidence that acupuncture provides additional benefit to treatment of acute migraine attacks only or to routine care."[8]

"Acupuncture may reduce period pain, however there is a need for further well-designed randomised controlled trials."[9]

"There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment."[10]

I only looked at the first 20 hits of the search, but if this is a representative sample, it means that approximately 25% of Cochrane reviews find a positive effect of acupuncture. Pseudoscience? Quackery? hmmmm....DrChrissy ^(talk) 20:31, 2 May 2015 (UTC)

Talk pages are not a forum to bring up topics to discuss in general, but are here to improve the article. What specific suggestions do you have to change the text of this article, citing which source? Yobol (talk) 20:36, 2 May 2015 (UTC)

@Yobol Perhaps you missed it but in the opening paragraph it states "TCM theory and practice are not based upon scientific knowledge,[7] and acupuncture is described as a type of pseudoscience.[8][9] Many within the scientific community consider it to be quackery[10]"....that to me seems to be undue weight.DrChrissy ^(talk) 20:53, 2 May 2015 (UTC)

The rules for lead indicate that that content should be mentioned. That's about as short a mention as is possible, and it's properly sourced, so those words are obviously not "thrown at acupuncture without a second thought." -- BullRangifer (talk) 21:53, 2 May 2015 (UTC)

@DrChrissy - What do you think of the following sources:

1. Harrison's Principles of Internal Medicine: "In addition, new research is shedding light on the effects of meditation and acupuncture on central mechanisms of pain processing and perception and regulation of emotion and attention. Although many unanswered questions remain about these effects, findings are pointing to scientifically plausible mechanisms by which these modalities might yield benefit." (pg. 14e-3)
2. Essentials of Small Animal Anesthesia and Analgesia: "Basic research on acupuncture's mechanisms in Western societies started in 1976 after the endorphin hypothesis of acupuncture's mechanism of action was introduced. Further advancement of acupuncture research was prompted by the introduction of functional magnetic resonance imaging (fMRI) and positron emission tomographic scanning, which revealed the relation between acupuncture stimulation and activation of certain brain structures" (pg. 132)
3. Miller's Anesthesia: "A scientific basis may exist for acupuncture. Acupuncture stimulates high-threshold, small-diameter nerves that activate the spinal cord, brainstem (i.e., periaqueductal gray area), and hypothalamic (i.e., arcuate) neurons, which trigger endogenous opioid mechanisms. The effect of acupuncture analgesia can be reversed by administration of naloxone." (pg. 1235)

I'm particularly interested in your opinion about source #2, since it relates to veterinary medicine. -A1candidate 20:49, 2 May 2015 (UTC

I think all three are excellent sources. I came across the second a few days ago and it is something that we really need to incorporate. It's probably not worth discussing in detail here because a member of the WP:MEDRS police will step in and say because it is veterinary it should not be discussed here. Funny how different factions of the medical profession can have such open or closed minds.DrChrissy ^(talk) 20:59, 2 May 2015 (UTC)

@DrChrissy, I don't think WP:MEDRS forbids the use of veterinary medical textbooks in topics on veterinary medicine. If there are no objections, I'll incorporate the text into the article. -A1candidate 21:07, 2 May 2015 (UTC)

No it does not forbid it because WP:MEDRS does not apply to veterinary science or to animals. I have already incorporated the reference into Veterinary acupuncture - I'll expand a little bit tomorrow. Thank you very much for the reference. Much appreciated.DrChrissy ^(talk) 21:26, 2 May 2015 (UTC)

I beg to differ. MEDRS applies to direct medical claims, even veterinary. If it doesn't say so in the policy, it should. -- BullRangifer (talk) 21:46, 2 May 2015 (UTC)

There is an ongoing discussion on Wikipedia talk:Identifying reliable sources (medicine) regarding the possible inclusion of vet medicine into MEDRS - surprised you have missed it. There are not really any strong arguments for it. I seem to remember somewhere that even Jtydog suggested it should not apply to animal articles.DrChrissy ^(talk) 22:11, 2 May 2015 (UTC)

-This section is a jumble, and my attempt to make it legible was reverted. I will not be participating further. Yobol (talk) 21:17, 2 May 2015 (UTC)

At the significance 0.05, 1 in 20 papers will produce a false positive. See WP:EXTRAORDINARY. Tgeorgescu (talk) 21:34, 2 May 2015 (UTC)

Nah - that is pseudoreplication. Each study is independent of all the others. Besides which, they look at the effects of acupuncture on different dysfunctions - totally wrong to lump them together like that. In any case, you are talking about 1 in 20 papers as being a Type I error - how do you explain the findings of the other 5 studies?DrChrissy ^(talk) 21:46, 2 May 2015 (UTC)

Just in response to this comment, you can't make a conclusion on that because you need to know the numbers of both positive and negative results, not just the number of positives. There are also plenty of ways for bias to occur - independence is a pretty big assumption! Sunrise (talk) 02:18, 3 May 2015 (UTC)

User:Sunrise, these issues were obviously taken into account by the Cochrane reviewers, haven't they? -A1candidate 09:03, 3 May 2015 (UTC):::

Your ping didn't work, by the way. In any case, I was responding in the abstract to an abstract statement, without referring to specifics, so that would be a different subject. Sunrise (talk) 08:40, 4 May 2015 (UTC)

Let's not get diverted by this. The 25% which I stated above is probably OR on my part. It was meant as a throw-away comment and not to taken as ststistical evidence trying to convince a reader about any "fact" or trend. My point of the OP was to indentify that there are multiple Cochrane reports out there which have a positive finding with regard to acupuncture. In my mind, the medical dogmatists are wanting it both ways. They are quoting extremely loaded words such as "quackery" and "Pseudoscience" (without quotes by the way!), and then playing down the findings of sources which they normally defend as being amongst the most reliable possible.DrChrissy ^(talk) 10:25, 3 May 2015 (UTC)

Scientific publications have a bias for publishing significant results only; so for every published significant result for it, there could be 19 results which never get published, due to such bias. Tgeorgescu (talk) 10:42, 3 May 2015 (UTC)

Yes, I agree. The Cochrane reviews seem to be different than other branches of science in that they do take into account "no significant difference". I would be the first to say that because I found 6 of 20 reviews had a positive conclusion for acupuncture, this means 14 did not.DrChrissy ^(talk) 10:49, 3 May 2015 (UTC)

Not our job to speculate on such matters. There are statistical methods to evaluate the publication bias, so let's leave that for the scientists. Jayaguru-Shishya (talk) 13:19, 3 May 2015 (UTC)

Our job is also to be careful not to represent pseudoscience as having merit. That a minority of studies on a treatment with such a notably strong placebo effect show weak results of positive impact, using such weak language as "low to moderate-level evidence" and "limited evidence shows that acupuncture may", is unsurprising and unpersuasive.—Kww(talk) 18:48, 3 May 2015 (UTC)

Leave that to the scientists. For you, I'd recommend to WP:STICKTOSOURCES. Ps. Don't you worry about disclaimers, doesn't affect our position in anyway. Jayaguru-Shishya (talk) 17:18, 4 May 2015 (UTC)

Disclaimers don't affect things? I'm sorry that you don't understand their meaning or purpose, Jayaguru-Shishya.—Kww(talk) 18:59, 4 May 2015 (UTC)

Not being verifiable?

DrChrissy, what are you talking about? Have you actually clicked the link and read the web page? --NeilN ^{talk to me} 19:03, 4 May 2015 (UTC)

Stop being so patronising. The link has been changed very recently. When I made my comments, I was being directed to an older version of the Quackwatch article that did not include the statement. The current source now does. The lack of stability in this web-site/blog is another reason we should not be using Quackwatch.DrChrissy ^(talk) 19:19, 4 May 2015 (UTC)

I went back to a 2013 version of the article. Same quote, same link, so your explanation does not make sense to me. --NeilN ^{talk to me} 19:25, 4 May 2015 (UTC)

The version of the article here[11] directs to this source.[12] I was unable to verify the statement from that source.DrChrissy ^(talk)

Chrissy, the bit of the Quackwatch article we quote here has been on the source web page since April 2011. I'm not seeing support for the idea that the content suffers from "lack of stability". Zad68 19:28, 4 May 2015 (UTC)

Actually, I was talking about the stability of the source, Quackwatch. It is clear that articles are updated - I have no idea how frequently or infrequently, but I wonder if editors are careful enough to keep WP updated with Quackwatch.DrChrissy ^(talk) 19:51, 4 May 2015 (UTC)

Yes I understood you correctly. Quackwatch does indeed update their articles, which many would consider to be a pro and not a con, in that they keep their articles up-to-date. You can use archive.org to see how many updates are made over time. But I get your point, and we probably shouldn't be using a big direct quote like we're using currently, I'd prefer if we summarized it (with attribution). Zad68 19:56, 4 May 2015 (UTC)

Thanks for that and the helpful advice on archive.org. I would agree totally with a summary with attribution, rather than a quote which seems to be a little Wp:Undue.DrChrissy ^(talk) 20:13, 4 May 2015 (UTC)

POV on Lede

I added a POV tag to the lede since its neutrality is under dispute by several editors. Here are the two versions being disputed. I'm contending additional reliable sources are needed for parity. Furthermore, one source is being misrepresented since it's used out of context for a strong claim. Let's hear any ideas on how we can resolve this dispute. LesVegas (talk) 22:04, 3 May 2015 (UTC)

Is anyone disputing it that doesn't have a COI in relationship to TCM? Or is it just people that rely financially on people misunderstanding its status as folklore and superstition that object?—Kww(talk) 03:13, 4 May 2015 (UTC)

I don't make a living in relationship to TCM, and I don't appreciate the accusation nor the implication of COI. Kww, I've always tried being cordial with you and yet I feel like you are cotinually being very uncivil towards me. Why? LesVegas (talk) 16:01, 4 May 2015 (UTC)

Because you insistently and persistently portray TCM as having validity. Either you know better, which means your edits fall under one category of problem, or you do not, which means your editing falls under another category of problem.—Kww(talk) 17:42, 4 May 2015 (UTC)

For the record, I don't think TCM is very valid. But it's not what I believe, we are going to rely on what sources say. We're not going to delete reliable sources just because they don't correspond to our point-of-view. Regardless, your justification doesn't excuse your constant incivility, and I'm going to ask that you stop right now and start treating myself and others with more respect. I would not accuse you of working for an industry that is threatened by acupuncture in order to justify edit warring, disruption and other bad behavior. You are an administrator and seem to be intelligent so I shouldn't have to be telling you any of this, but please stop. LesVegas (talk) 18:37, 4 May 2015 (UTC)

I too have absolutely no COI or relationship to TCM. I dislike that you may be lumping me into that. I had not realised until the posting above that you were an administrator. TuT TuT - I would have expected a much more measured posting.DrChrissy ^(talk) 19:24, 4 May 2015 (UTC)

My response was quite measured and not uncivil. I admit that there is a third form of problem that plagues the article: the occasional well-meaning editor that believes that we gullibly parrot sources without evaluating them for fringe science and pseudoscience. Regardless of the motivation, editors that consistently and intentionally make this article misrepresent acupuncture are a problem.—Kww(talk) 19:36, 4 May 2015 (UTC)

We had this discussion about the tag before. We don't need a tag at the top of the page again. Do you remember the previous discussion on this? The result was no consensus to restore the tag. QuackGuru (talk) 20:37, 4 May 2015 (UTC)

How nice of you to finally post here over a day later to justify your removal of the template. Of course, the dispute then was never resolved so you're disrupting again and regardless, this is a new dispute with many new sources being contended. Can you please explain why you ignored the sentence on the template that says, "Please do not remove this message until the dispute is resolved"? Why do you constantly remove POV templates? Also, why did you ignore the rules about removal which say,

Remove this template whenever:

There is consensus on the talkpage or the NPOV Noticeboard that the issue has been resolved

It is not clear what the neutrality issue is, and no satisfactory explanation has been given

Since there was no consensus that it was resolved, and since I made it very clear what the neutrality issue was, what again made you think you could quickly remove the tag? LesVegas (talk) 20:54, 4 May 2015 (UTC)

Editors disagree with making the lede longer. QuackGuru (talk) 21:35, 4 May 2015 (UTC)

Expansion of lead

Where are the extensive talk page discussions for this? --NeilN ^{talk to me} 17:26, 4 May 2015 (UTC)

See Talk:Acupuncture#Acupuncture_has_.22proven_efficacy.22_and_scientific_backing -A1candidate 17:28, 4 May 2015 (UTC)

@NeilN - Are you going to provide an explanation for your removal? -A1candidate 17:31, 4 May 2015 (UTC)

Yes, please use a less misleading edit summary next time. A discussion that's less than one day old, begins with "I think this needs significantly more discussion before being inserted into the article", and was not even about moving content into the lead is not "extensive talk page discussions". You should know that. --NeilN ^{talk to me} 17:37, 4 May 2015 (UTC)

You still have not provided a policy-based explanation for removing MEDRS sources. -A1candidate 17:43, 4 May 2015 (UTC)

Because your laundry list was misleading and undue. Look at your very first source - (weak recommendation, moderate-quality evidence). The only recommendation classified as "weak". --NeilN ^{talk to me} 18:00, 4 May 2015 (UTC)

So what do you suggest to make it less misleading, without deleting the views of medical organizations? -A1candidate 18:03, 4 May 2015 (UTC)

What about a section called "National reception" or "Reception by national medical organisations" (or something like that), with a summary in the lead? We alraedy have one section on Scientific reception and another section that could easily be called "Popular reception".DrChrissy ^(talk) 18:13, 4 May 2015 (UTC)

Why would we worry about "popular reception" of an activity that purports to be medicine?—Kww(talk) 18:37, 4 May 2015 (UTC)

• The actual discussion history (started yesterday) cannot be reasonably used to "restore" something that never had consensus for inclusion in the lead in the first place, so per WP:BRD we restore the status quo ante and discuss the proposed change.

  The existing wording in the lead is "Clinical practice varies depending on the country." sourced to Ernst. I can support a small expansion of that one sentence, sourced to a high quality secondary source (note that statements from the individual medical organizations would be primary sources for this purpose). Zad68 18:16, 4 May 2015 (UTC)

Zad, if the medical organizations state their view is based on scientific evidence, doesn't this make them secondary sources?DrChrissy ^(talk) 19:58, 4 May 2015 (UTC)

This is a subtlety in that the same source can be primary or secondary depending on what it's used for. For example, this practice guideline from the American College of Physicians contains some discussion of acupuncture that might be used as a secondary source for "Acupuncture may be helpful for those with chronic back pain that does not respond to other treatment." (However I rush to point out that the guideline is from 2007 and there are plenty of more up-to-date sources.) But that practice guideline itself would be a primary source for "The American College of Physicians has suggested the use of acupuncture for some groups of patients" (to use the wording from the edit that started this discussion). Make sense? Zad68 20:17, 4 May 2015 (UTC)

Yes, I know what you mean. (You may be interested to look here[Wikipedia:Identifying primary and secondary sources for biology articles] at an essay I wrote on the subject.) I was actually thinking about the UK site [13] which states "NICE makes these recommendations on the basis of scientific evidence."DrChrissy ^(talk) 20:30, 4 May 2015 (UTC)

Off-topic

A1candidate, your edit summaries are beginning to approach active deceit. Here you described the reintroduction of contentious material that had been reverted multiple times as "format", and in "extensive talk page discussions" you implied that there was some indication that your edits were acceptable and had gained some level of consensus. If you insist on participating in this article, please do so honestly.—Kww(talk) 18:23, 4 May 2015 (UTC) I have no intention of deceiving anyone, User:Kww. -A1candidate 18:27, 4 May 2015 (UTC) Then why are you providing edit summaries that serve to disguise the content and intent of your edits?—Kww(talk) 18:35, 4 May 2015 (UTC) @ Kww. We Do Not accuse other editors of being deceitful – period. They may suffer from ambidextrousness, perfidiousness, double-dealing, etc., (on the one hand you may say this but my other hand says... ). That is not in my book deceitful. Rather a lack of knowledge how science works. WP is a Encyclopedia that anyone can edit and we should expect these poorly reasoned comments.--Aspro (talk) 18:51, 4 May 2015 (UTC)

If we have reliable sources that offer parity, we have to expand the lede for neutrality purposes. If we are worried about the lede being too long, then we have to delete parts of it. But what we cannot do is have it full of one-sided sourcing only. Hence the tag I added. LesVegas (talk) 21:35, 4 May 2015 (UTC)

This information was about effectiveness but we already have information about effectiveness to summarise the body. See "Evidence on the effectiveness of acupuncture is "variable and inconsistent, even for single conditions".[15] An overview of high-quality Cochrane reviews found evidence suggesting that acupuncture may alleviate certain kinds of pain.[16]" QuackGuru (talk) 21:40, 4 May 2015 (UTC)

That information serves as parity against Quackwatch calling its basis pseudoscience. Oh, and Quackwatch doesn't hold much weight against a plethora of sources like that so it needs to be replaced by something with equal weight to those national scientific bodies, or be deleted altogether. LesVegas (talk) 21:47, 4 May 2015 (UTC)

Why do you insist on providing "parity"? What parts of our policies and guidelines about pseudoscience do you misinterpret as requiring us to provide equal time to the notion that TCM isn't pseudoscience?—Kww(talk) 21:49, 4 May 2015 (UTC)

Just popping in. If we have more reliable sources than QuackWatch, we can replace it by the more reliable ones. Jayaguru-Shishya (talk) 21:54, 4 May 2015 (UTC)

Effectiveness and pseudoscience are two separate issues. QuackGuru (talk) 21:59, 4 May 2015 (UTC)

@ Kww, I don't mean Wikipedia:PARITY when I say parity, I mean Wikipedia:BALANCE. All the edits A1 Candidate and DrChrissy and I made in the lede's expansion were towards providing a counter argument to Quackwatch's claims. I didn't delete Quackwatch, even though it really fails the test on Wikipedia:GEVAL if you stand Quackwatch up next to notable textbooks, multiple government health organizations, and notable scientific books that disagree with Quackwatch. Really, if we are going to use the claim, we need to find a source that has equal weight to the many acupuncture-positive ones that were deleted. LesVegas (talk) 23:11, 4 May 2015 (UTC)

But the scientific consensus is that TCM is claptrap. I agree that the lead can't describe acupuncture itself as pseudoscience directly and without attribution, but that doesn't apply to TCM. Sources that describe TCM as having a foundation are WP:FRINGE, and cannot be included as being on par and are not necessary (or even desirable) for balance. We don't balance science with pseudoscience, nor present fringe claims as being on par with accepted science.—Kww(talk) 23:19, 4 May 2015 (UTC)

Scientific consensus? Where are you getting your information about scientific consensus saying TCM is a claptrap? Don't tell me the Wikipedia article! Kww, don't you know that editors there only pretend there is a consensus amongst scientists by deleting all scientific sources that suggest otherwise? They do, I promise you. These editors actually delete scientific sources and statements that come from the NIH, the NHS, the Routeledge Encyclopedia of Science, texts published by the Royal Society of Chemistry, anesthesia textbooks, and then they claim there is scientific consensus all because Quackwatch says so. They can't ever seem to find anyone else who says exactly what Quackwatch says, but they merely repeat words like "scientific consensus says" which confuses editors just passing by, and making them think the folks trying to add statements by the NHS and NIH are fringe kooks who are just trying to push another strange theory into the encyclopedia. And they also don't want Quackwatch attributed when it says something about TCM, even though an RfC on TCM suggested otherwise. Seriously, if you want good information on TCM or Acupuncture, I'll show you some sources by scientific bodies. Don't read Wikipedia for your information anymore. LesVegas (talk) 00:13, 5 May 2015 (UTC)

No, I'm afraid it's people pushing superstition and fraud that are pretending.—Kww(talk) 01:55, 5 May 2015 (UTC)

Deletion of Quackwatch sourced statement

The lead paragraph contains the following statement "TCM theory and practice are not based upon scientific knowledge,<ref name=Barrett2007/>" I propose to delete this statement for the following reasons:

1)The source is outdated - how can this source represent present consensus when it is 7-8 years old.

2)The source is not/may not be peer-reviewed.

3)The source is from a web site with a blog-like approach

4)The source is a partisan site - not NPOV

5)The source is an opinion piece of just a single person and therefore the statement is WP:UNDUE

DrChrissy ^(talk) 10:56, 2 May 2015 (UTC)

Still reliable for our use, as explained to you multiple times by multiple users. Any more of this will be disruptive. -Roxy the Viking dog™ (resonate) 11:09, 2 May 2015 (UTC)

• Support - In addition to what DrChrissy said, we have much better sources including prominent medical textbooks such as Miller's Anesthesia, which says "A scientific basis may exist for acupuncture" (pg. 1235) and "When compared with placebo, acupuncture treatment has proven efficacy for relieving pain" (pg. 1235) or Oxford Textbook of Palliative Medicine , which says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266). This is the mainstream medical consensus, as stated in the NHS's description of acupuncture: "It is based on scientific evidence that shows the treatment can stimulate nerves" and in Chapter 14e of the latest edition of Harrison's Principles of Internal Medicine: "In addition, new research is shedding light on the effects of meditation and acupuncture on central mechanisms of pain processing and perception and regulation of emotion and attention. Although many unanswered questions remain about these effects, findings are pointing to scientifically plausible mechanisms by which these modalities might yield benefit." (pg. 14e-3) -A1candidate 11:11, 2 May 2015 (UTC)

Still reliable for our use, as explained to you multiple times by multiple users. Any more of this will be disruptive. -Roxy the Viking dog™ (resonate) 11:36, 2 May 2015 (UTC)

How can opening a discussion on a Talk page be disruptive! If you don't want to join in, simply walk away - the article content has not been changed!DrChrissy ^(talk) 11:40, 2 May 2015 (UTC)

Nothing wrong with a new discussion Doc, and I encourage you to open discussions on any topic you wish. But please stop opening new discussions on the same subject over and over and over again, especially when you already know the answer. That's disruptive -Roxy the Viking dog™ (resonate) 11:50, 2 May 2015 (UTC)

Firstly, as I have requested on several occassions before, please use my correct user name. Second, it has been suggested several times that the reliability of QW as a source needs to judged on a case-by-case basis. This is what I am doing. Neither you nor I know the "answer" as to whether the source is reliable in this particular case, therefore it can not be disruptive. Perhaps you would like to comment on any one of the 5 points I raised above, rather than trying to disrupt this thread.DrChrissy ^(talk) 11:58, 2 May 2015 (UTC)

QuackWatch is not reliable per se, and there's a firm consensus that it should be used only on a case-by-case basis. I think we could proceed by endorsing the steps of 1) paraphrasing the text in such a manner that there are no longer block quotes, and 2) considering whether acupuncture is a subject that hasn't attracted enough scientific research. If there's a rich variety of scientific research on the subject, then we don't want to include any claims so poor that haven't been even able to make their way through some notable peer-reviewed journal. Jayaguru-Shishya (talk) 12:39, 2 May 2015 (UTC)

• Oppose removal. Came here from posting on WT:MEDRS by DrChrissy. Quackwatch is reliable for its own opinion, and is generally considered reliable on alt med topics of which Acupuncture is one.Use of Quackwatch is appropriate here, but should not be overemphasized if better sources are available. I should caution against the cherry-picking of specific sources that may be "positive" or "negative" towards acupuncture, but to give the full spectrum of opinion by reliable sources per WP:WEIGHT, of which Quackwatch is one. Yobol (talk) 13:38, 2 May 2015 (UTC)

If and I quote: Quackwatch is reliable for its own opinion then using the same logic, DrChrissy opinion, that it is not, -nullifies QW's opinion. Oh come on folks- if my grand children came out with this muddled thinking I'd be on the phone to my lawyer to reclaim back their education fees!--Aspro (talk) 16:07, 2 May 2015 (UTC)

Yobol, just to clarify, are you supporting the use of QW for the particular sentence I indicated in my original posting?DrChrissy ^(talk) 14:19, 2 May 2015 (UTC)

Yes. As far as I know, the underlying principles of TCM (Qi, meridians, etc) is not based on scientific knowledge (based instead on traditional pre-scientific hypotheses/superstition) and therefore appropriate for QW to be used in this context. Yobol (talk) 14:23, 2 May 2015 (UTC)

Is there a more reliable source to confirm this, or is this a marginal position outside the scientific mainstream? Jayaguru-Shishya (talk) 13:02, 3 May 2015 (UTC)

It's an easily falsifiable statement. History confirms that the statement is correct, and since there is no evidence to the contrary, it's a good one and properly sourced. -- BullRangifer (talk) 18:59, 3 May 2015 (UTC)

QW is sufficiently reliable for this statement.—Kww(talk) 14:36, 2 May 2015 (UTC)

Good, that is a real problem solver. Maybe we can include the sources to the article? After all, we don't include claims of marginal position outside the scientific mainstream. Jayaguru-Shishya (talk) 17:19, 4 May 2015 (UTC)

Do we not have a more recent, secondary or tertiary source for this? Surely the medical scientists have published something more reliable in the past decade or so.DrChrissy ^(talk) 14:52, 2 May 2015 (UTC)

Scientists generally don't publish about pre-scientific hypotheses/superstitions which have no basis in human physiology and is generally considered nonsensical in modern terms. This is why we have WP:PARITY. Yobol (talk) 15:25, 2 May 2015 (UTC)

So why is it that when I go to Cochrane Collaboration and type in "Acupuncture" I get 134 hits for systematic reviews?DrChrissy ^(talk) 15:48, 2 May 2015 (UTC)

The content in question is the proposed mechanism of how acupuncture has been traditionally considered to work by acupuncturists/TCM practitioners (Chi, meridians, etc). There is, to my knowledge, no high quality medical source that says any such entities actually exists in the human body. The studies you are seeing are studies as to whether or not acupuncture has an effect, which is a separate question as to whether or not the traditionally proposed mechanisms are correct. Yobol (talk) 15:55, 2 May 2015 (UTC)

You may be correct that there is no high quality medical source to say this, so instead, let's fall back on the opinions of just a single person and forget about how we say that only the highest quality evidence should be used in medical articles. I trust my incredulity comes through.DrChrissy ^(talk) 16:16, 2 May 2015 (UTC)

Um, what? We should be using the highest quality sourcing for this; in this case, Quackwatch fits the bill. Insisting that we have peer-reviewed studies for things that medicine views as nonsense is of course not reasonable and is precisely why we have WP:PARITY, because high quality peer-reviewed sources usually do not talk about what is generally considered nonsense. If you have high quality sourcing saying that Meridians or Chi or whatever actually exists, present them. Otherwise, Quackwatch is perfectly reliable for saying such nonsense does not exist. Yobol (talk) 16:21, 2 May 2015 (UTC)

Well if you don't mind me for saying so that is Pseudoskepticism. Can't argue against a pseudo-skeptic because they can't be proved wrong (and when they are, they just move the goal posts). So its turtles all the way down and no one can disprove it – so they are always right – even when wrong. Lets move on and not waste our time arguing about if QW might sometimes, have something of merit. Over all, we (the bulk of editors) acknowledge that QW is not to be viewed as a reliable source.--Aspro (talk) 16:51, 2 May 2015 (UTC)

Please stop the nonsense of claiming "the bulk of editors" agree with you when you have no evidence of this. Thanks. Yobol (talk) 18:32, 2 May 2015 (UTC)

The talk pages on WP gives evidence to this. Jimmy Wales said and I quote: Zero information is preferred to misleading or false information. So stop inundating us with pseudo arguments. Scientist are naturally skeptic but they don't grasp at stuff just because it gives their prejudices a warm feeling inside. Thanks.--Aspro (talk) 14:47, 3 May 2015 (UTC)

Well, this article is about acupuncture, not about traditional Chinese medicine, but both of the subjects have attracted significant amount of scientific research. So I have to disagree with Yobol here: yes, scientists do publish a great deal of research concerning acupuncture and traditional Chinese medicine. And what those studies don't say, well it obviously cannot be called part of "scientific mainstream". QuackWatch may be considered as a reliable source in such cases where the subject is so marginal that it hasn't been able to attract scientific attention (e.g. reiki healing). Just imagine, how many researchers are ready to waste their time on such nonsense? On such cases, QuackWatch fits the bill. But that's not the case at acupuncture, I am afraid. We should bear in mind the ArbCom conclusion, labeling QuackWatch as a partisan site. Anyway, the first step is to paraphrase the source so we don't have to use block quotes anymore. The second step is to think about if there are better sources available, or if we are dealing with claims not presented by the scientific consensus. Jayaguru-Shishya (talk) 13:06, 3 May 2015 (UTC)

Please note that I have proposed a specific sentence for deletion. It would help if users !voted and left a clear indication of this in bold at the beginning of one of their posts. This will avoid arguments about "bulk of editors" etc.DrChrissy ^(talk) 18:46, 2 May 2015 (UTC)

• Support as the OP.DrChrissy ^(talk) 18:47, 2 May 2015 (UTC)
• Oppose as the source is reliable for the claim. QuackGuru (talk) 18:49, 2 May 2015 (UTC)
• Oppose per WP:PARITY QW is valid source for discussion of FRINGE notions like modern claims that qi exists and flows along meridians Jytdog (talk) 19:20, 2 May 2015 (UTC)

• User:Jytdog, we have a prominent medical textbook (Oxford Textbook of Palliative Medicine ) which says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266), thereby refuting the notion of vital energy. Why promote QW when there are better sources? -A1candidate 19:26, 2 May 2015 (UTC)

oxford press does not have WP:PSCI and WP:FRINGE governing its content; wikipedia does, and here we call pseudoscience, pseudoscience. we don't just skip over the first part of that sentence you quoted. we pause and say the equivalent of "which is complete bullshit" albeit in a nicer way. we don't "promote" QW, we use it. Jytdog (talk) 19:34, 2 May 2015 (UTC)

I don't see anything useful that isn't already covered by the Oxford textbook. -A1candidate 19:40, 2 May 2015 (UTC)

I don't see anything relevant to this statement covered by the Oxford textbook. — Arthur Rubin (talk) 19:43, 2 May 2015 (UTC)

IT REFUTES THE VALIDITY OF VITAL ENERGY. Did you not read? -A1candidate 19:47, 2 May 2015 (UTC)

That's not what the quote says, and, even if that is elsewhere in the book, it wouldn't support the statement in the article, as it doesn't even imply that there aren't other (potential) bases for acupuncture, accepted by acupuncturists, which are not incompatible with scientific research. 04:38, 3 May 2015 (UTC)

Yes, that is a quadruple negative. Those without an advanced knowledge of English might misinterpret it. — Arthur Rubin (talk) 04:43, 3 May 2015 (UTC)

You obviously speak a different type of English, because the source does imply that it is compatible with neuroscientific research. Whether it is accepted by acupuncturists or not is of peripheral importance. Acceptance by the medical community is what matters. -A1candidate 09:08, 3 May 2015 (UTC)

• Oppose per WP:PARITY and WP:DEADHORSE. — Arthur Rubin (talk) 19:43, 2 May 2015 (UTC)
• Oppose Quackwatch has repeatedly been shown to be reliable at RSN, and WP:PARITY indicates we can use non-MEDRS sources on articles such as these. Further, even if that weren't true, the statement is sourceable elsewhere. This has been discussed to death already.   — Jess· Δ♥ 05:26, 3 May 2015 (UTC)
• Comment Not quite, Jess. There is a firm consensus that QuackWatch is not relaible per se, and it may be only used on a case-by-case basis. So better not say: Quackwatch has repeatedly been shown to be reliable. Actually, we have an ArbCom ruling labeling QuackWatch as a partisan source that should be used with caution. Well, that's not a surprise since not even QuackWatch itself claims to be a peer-reviewed source. QuackWatch sure has its place on some few articles, but acupuncture has been studied relatively lot, and therefore we don't have a compulsive need to include QuackWatch. Jayaguru-Shishya (talk) 13:19, 3 May 2015 (UTC)
  • Not quite, Jayaguru-Shishya. You are overreaching yourself. Three quotes from the amendment: "It is not the job of this committee to determine whether sources are reliable.", "There is an observation that Quackwatch tends to be partisan, and should not be a preferred or exclusive source, but not that it is not a reliable source as is generally understood." "Deeming a source to be reliable or unreliable is almost always going to be a content decision and as such beyond our remit." Most sources can be deemed reliable for certain things and unreliable in others. When I say the NY Times is a RS in reference to a biography it is foolish to say, "better not say: NY Times has repeatedly been shown to be reliable" because it's not a WP:MEDRS. --NeilN ^{talk to me} 15:18, 3 May 2015 (UTC)
  • NeilN, my comment wasn't addressed to you nor did I say anything about the NYT. I agree with the quotations you gave, however. I've also been emphasizing strongly that the reliability is a matter of context. I guess there was a misunderstanding there. It's also been voiced out by many editors that QuackWatch is reliable in such topics that haven't attracted sufficient scientific interest. And this is exactly the problem we are tackling with many fringe articles. Jayaguru-Shishya (talk) 15:43, 3 May 2015 (UTC)

• Comment: Some editors here may be unwittingly be putting words in the the mouth of The Journal of the American Medical Association (JAMA) by suggesting they uphold QW to be a reliable medical source. Should we not ask them for an official statement? As it could effect their reputation- what with WP being so widely read. WP editors should not speak on the behalf of another organization as it is not professional behaviour. If I worked for The Journal of the American Medical Association I would be on to the lawyers quickly, to make it very clear that mention of QW does not mean that we accept that QW as a reliable source and any mention is solely down to the writer of such an article -and we 'expect' s/he to have performed due diligence in this respect. We cannot be held responsible for any contributors lapses. We have nothing to comment upon the reliability or otherwise of this site known as QW. Period . Just asking.--Aspro (talk) 15:20, 3 May 2015 (UTC)

• Your hypothetical life is of no interest here. --NeilN ^{talk to me} 15:26, 3 May 2015 (UTC)

• And you comment is just trying to deflect! Lets be civil OK. It is to improve the quality of WP that is important here, please remember that.--Aspro (talk) 15:35, 3 May 2015 (UTC)

• Articles aren't improved by putting your words in the mouth of a source. I mean, you even say, "WP editors should not speak on the behalf of another organization" and then you blatantly go ahead and do it. Is there anything here that can't be directly surmised by JAMA statements? --NeilN ^{talk to me} 15:53, 3 May 2015 (UTC)

• You know very well that I was not blatantly putting words into The Journal of the American Medical Association's mouth. Then you go on to ask "Is there anything here that can't be directly surmised by JAMA statements?" Yes there is: all of the above. Is there anything on the the Journal of the American Medical Association site to say that they uphold QW? Think you keep getting your premises mixed up. Take deep breath and stand back, so as to take a fresh look. --Aspro (talk) 17:04, 3 May 2015 (UTC)

@Aspro Is there anything on the the Journal of the American Medical Association site to say that they uphold QW? You mean besides their publication, in their journal, that specifically says Quackwatch is a resource that provides "reliable health information"? Yobol (talk) 23:46, 3 May 2015 (UTC)

@ Yobol The Journal of the American Medical Association does not accept anything ether way. The Journal of the American Medical Association publishes topical articles. Were do you think in their choice of published articles, suggests that they adopt everything their contributors write about? As intimated to -NeilN above, you should keep premises separate. To suggest that the Journal of the American Medical Association support and accept everything they publish is a misunderstanding of the work of journals. So it is absolutely wrong for some editors here to claim that the Journal of the American Medical Association considers QW as a reliable source of medical information based on the articles that they publish. Can I say that any clearer. We (some of us) provide guidance which some editors prefer to ignore (Think to yourself: what is the root of the word ignorant. Step back and look at the bigger picture.) But maybe, I am just trying to catch the wind.--Aspro (talk) 13:28, 4 May 2015 (UTC)

@Yobol (or anybody else) If you have evidence that JAMA supports Quackwatch, please would you provide this evidence - I have looked and I can't find it.DrChrissy ^(talk) 13:10, 4 May 2015 (UTC)

@Aspro, @DrChrissy, have you all not read the Quackwatch article, which references JAMA's specifically citing Quackwatch as a reliable source for medical information? Sigh. Yobol (talk) 13:48, 4 May 2015 (UTC)

That is interesting. Wonder if the executives are aware that their lower down minions in their organization upholds QW. As I said before, we need a qualified statement from the Journal of the American Medical Association to save them from embarrassment. And believe you me, when your read through that QW site it, it is hardly a reliable medial source. The Journal of the American Medical Association's PR may refuse to reply and take the risk that it will not put the journal's reputation into question, based on that link provided, in the short term. Yet what of the future, when WP, being the first port of call for many a medical researcher, who find the Journal of the American Medical Association supports QW as reliable. Is s/he going to add included JAMA in his thesis. Think not. The argument is swaying to the Journal of the American Medical Association to officially state their position on QW as to remove all doubt. Get it from the horses mouth, rather than just guesstimate. For those that are familiar with this sort of things - it don't mean nothing unless it is a policy statement from the executive. Yobol should understand this. — Preceding unsigned comment added by Aspro (talk • contribs)

So you read the statement made by JAMA, published in JAMA, explicitly calling Quackwatch a reliable source for medical information and you call that a "guesstimate"? Now I remember why replying to you is an incredible waste of time. Yobol (talk) 15:52, 4 May 2015 (UTC)

Repeating the sentiment from above, we're not interested in what you think organizations should do to "save them from embarrassment." Focus on what they're actually stating, not on what you would like them to state. --NeilN ^{talk to me} 15:54, 4 May 2015 (UTC)

Again I ask and point out: Do the executive know about this? Is this what the executive supports. If you have left high skool and worked for a large organisation you should be aware that much of what ends up on a company web-site is not kosher. i.e. just because it is written in black and white it is not gospel – it is just stuff put up on their web-site – which you take to be gospel - can I explain that any more simply? Come on folks, use your brain cells here, If you can edit WP you must have more than two. What is the third one doing? --Aspro (talk) 17:10, 4 May 2015 (UTC)

They have apparently not checked JAMA, so this is just IDHT behavior. On a "JAMA Patient Page", under the heading "How to find reliable online health information and resources," they list Quackwatch, among other sources. JAMA clearly recommends QW as "reliable". This is good enough for us to continue using it on a case by case basis. -- BullRangifer (talk) 14:53, 4 May 2015 (UTC)

Both BullRangifer and Yobol directed us to [14] as evidence that JAMA supports Quackwatch. I am unable to open this article fully, but I can open the previous and subsequent articles. Seems rather odd. Perhaps the article [15] has been removed/redacted? I am able to see the date of publication was 1998. Perhaps in the subsequent 17 years(!) JAMA have seen fit to update their reputable sources?DrChrissy ^(talk) 16:04, 4 May 2015 (UTC)

We can use QuackWatch on a case-by-case basis when the topic is so marginal that it hasn't attracted enough scientific attention. If plenty of sources exist, however, we will use those instead of QuackWatch. Jayaguru-Shishya (talk) 17:23, 4 May 2015 (UTC)

I can open the article just fine, it is still available on the website. Do you have any reason, other than your own apparent dislike for Quackwatch itself, to think JAMA no longer thinks Quackwatch is reliable? If and when you find a similar publication by JAMA saying Quackwatch is no longer reliable, please bring it forward. All I see here are editors who do not like Quackwatch trying their hardest to not acknowledge what high quality sources have said about it. Yobol (talk) 16:09, 4 May 2015 (UTC)

What I am trying to do at the moment is verify statements made by other users. At the moment, I am unable to do this, but I am happy to watch for comments that it can be verified. FYI, I do not dislike Quackwatch, I just intensely dislike its use by some editors when they are too lazy to go and find other peer-reviewed, NPOV secondary sources.DrChrissy ^(talk) 16:24, 4 May 2015 (UTC)

Boys, boys... For claims on medical efficiency we need peer-reviewed MEDRS compliant sources, no matter whom JAMA cites. If the topic is well covered by scientific research, then we don't need QuackWatch. There are subject though, that have been left in the shadows of mainstream science, and therefore QuackWatch is a decent source until better ones pop up. Jayaguru-Shishya (talk) 17:25, 4 May 2015 (UTC)

First, I already verified it and downloaded it. It has not been retracted. Second, sources are not required to conform to the Wikipedia policy WP:NPOV, so the term "NPOV source" is meaningless; the proper application of WP:NPOV is whether or not we (as editors) are using the sources in a manner consistent with NPOV. We use partisan/biased sources all the time and they are often necessary to have a fully NPOV compliant article that establishes all significant points of view. Now that it is clear that you and Aspro are showing clear WP:IDHT behavior, I won't waste any more of my time here. Cheers. Yobol (talk) 16:45, 4 May 2015 (UTC)

That page on that site : the Journal of the American Medical Association (that only quacks like I and Yobol can accesses apparently) , (ie not publicly assessable and thus not open to public scrutiny) has small print. That gets the the Journal of the American Medical Association off the hook regarding QW don't you think. Unless the Journal of the American Medical Association makes a official statement upon QW, then there is no substance as to why we should use it. That page referred to (not an article) but just a page – it is just that! How do we put this to you (and et al) that hidden information is not Verifiability. Otherwise people could hid information a splatter WP with nonsense. Cheers--Aspro (talk) 20:31, 4 May 2015 (UTC)

Oppose removal. Perfectly accurate statement, backed up by history. -- BullRangifer (talk) 19:06, 3 May 2015 (UTC)

• Attribute to Stephen Barrett per WP:ATTRIBUTEPOV if it's going to be kept in the lead. Zad68 16:03, 4 May 2015 (UTC)
• Support the removal and the removal of most Quackwatch sources. There are better sources out there to make the claims it makes, and if there aren't, then what does that tell us? Quackwatch is also diametrically opposed to a textbook source I added and doesn't hold weight to it even for parity, so there's that. I do think we should still have Quackwatch on the article to back up what skeptics think about acupuncture, but maybe only one or two cites at most, per weight, and the it should be attributed as Zad says. But I would attribute to Quackwatch or Quackwatch and Stephen Barrett and not Stephen Barrett alone. LesVegas (talk) 17:10, 4 May 2015 (UTC)

And yet another reason not to use QuackwatchI have been editing the Acupuncture article to remove a statement attributed to Quackwatch. I simply could not find the statement in the source provided. I challenged this. The content was re-introduced and suddenly the Quackwatch source provided the content! It appears the source I was originally following was an archive. After my challenge, this was suddenly cleaned up here[16]. How misleading this can be and what a complete waste of my time. It is so dangerous to be using Quackwatch as a source when it is so dynamic! It is a Blog and should be treated as such!DrChrissy ^(talk) 18:57, 4 May 2015 (UTC)

• Do you have any reason to believe that this was anything different than the normal case of an archive and the current text falling out of sync? That's a pretty common phenomenon across all internet sources.—Kww(talk) 19:01, 4 May 2015 (UTC)

(edit conflict)You're upset that the website changed in the last 5 years? Websites tend to do that. Your opinion of quackwatch is, however, not one shared by the editors at RSN, nor by the other reputable sources which reference it.   — Jess· Δ♥ 19:02, 4 May 2015 (UTC)

Chrissy before you started working with that quote from Quackwatch it was quoting the website accurately and the website's most recent version of the content matched what we had in our article. I don't understand what you're saying here, but it probably doesn't matter: the article and the source are now in sync. Zad68 19:03, 4 May 2015 (UTC)

I am wondering whether we are talking about the same quote. I am referring to the quote in the "Scientific reception" section in the version here [17] which states

"Quackwatch states that:[7] TCM theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. TCM practitioners disagree among themselves about how to diagnose patients and which treatments should go with which diagnoses. Even if they could agree, the TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care.

If you click on the [7], then click on the hyperlink of the title of the article, it takes you here[18]. This does not contain the quote, it does not even contain the section "The bottom line is". Try searching for the word "nebulous".

DrChrissy ^(talk)

See "TCM theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. TCM practitioners disagree among themselves about how to diagnose patients and which treatments should go with which diagnoses. Even if they could agree, the TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care. "[19] QuackGuru (talk) 21:25, 4 May 2015 (UTC)

Wow! The POV editing regarding Quackwatch is just incredible. I have just edited Quackwatch to indicate that the website does not always contain peer-reviewed articles (which it admits on its own FAQs) only to have this reverted twice. Surely this is a fundamental characteristic of Quackwatch which readers need to know. What is wrong with stating what a web-site says about itself?DrChrissy ^(talk) 23:53, 4 May 2015 (UTC)

• Oppose removal By definition, traditional Chinese medicine ("based on a tradition of more than 2,000 years") is not based on scientific knowledge, unless the word "science" is redefined to include what anyone thinks. After the event, it may turn out that some traditional remedies involve components with useful medicinal properties, but TCM is based on chi and meridians and the source is fine (WP:PARITY) for pointing out that TCM is something quite different from medicine based on science. Johnuniq (talk) 01:29, 5 May 2015 (UTC)
• Remove source...keep statement As all can see quackwatch is not seen by all here as the best source (lets assume the same can be said for our readers)....so lets find sources that have a better overall rep....thus readers and edtors will have more confidence in the article overall. I suggest we keep the sentence and just source it with something newer that mentions both TCM and Acupuncture.... like - James M. Humber; Robert F. Almeder (2013). Alternative Medicine and Ethics. Springer Science & Business Media. p. 10. ISBN 978-1-4757-2774-6. -- Moxy (talk) 01:58, 5 May 2015 (UTC)

"Although minimally invasive"

The lede currently contains the text:

Although minimally invasive, the puncturing of the skin with acupuncture needles poses problems when designing trials that adequately control for placebo effects.

The difficulty of designing trials is adequately sourced, but as far as I can tell "although minimally invasive" is editorial and appears to violate WP:SYN. It is invasive enough to result in numeorus case histories of cardiac tamponade, infection and other adverse events, after all. I can't find a robust source for the implicit claim that acupuncture is a member of the class of minimally invasive procedures (see Invasiveness of surgical procedures § Minimally invasive procedure for a description of the normal use of the term). Minimally invasive is a term normally reserved for techniques that reduce the invasiveness of an established procedure; pain management is normally not invasive at all, whereas acupuncture is, so I think this text is misleading and incorrect. Guy (Help!) 22:54, 5 May 2015 (UTC)

The body says "Due to acupuncture's invasive nature, one of the major challenges in efficacy research is in the design of an appropriate placebo control group.[18][19]" I wonder who made the changes to the lede or the body. QuackGuru (talk) 23:02, 5 May 2015 (UTC)

Edit protected request

Please add the {{content}} tag to the article. There is absolutely no disagreement that there is and has been a content dispute, and that either some content not in the article belongs there, or that some content in the article does not belong there. I see no chance that the dispute will be resolved in the near future, but some of the disputes are being discussed, so I believe the tag is appropriate, even while the article is protected. — Arthur Rubin (talk) 20:02, 4 May 2015 (UTC)

I don't see how a tag will improve the article. It solves nothing. QuackGuru (talk) 20:09, 4 May 2015 (UTC)

Yeah, I can support the addition of such a tag in this case. — {{U|Technical 13}} (e • t • c) 22:58, 4 May 2015 (UTC)

 Administrator note awaiting further comments — Martin (MSGJ · talk) 08:02, 5 May 2015 (UTC)

• Support along with Arthur if this is the tag he's talking about, and I've added one or two similar ones myself. I really believe they'll help attract new editors. But how do we keep the war zone away? Well, what I really think will do the trick there is to dramatically lower the threshold for topic bans. Make a couple of disruptive edits, you're automatically topic banned. Go over the 3RR twice, you're topic banned. Act uncivil towards editors, topic banned. Administrators should also not feel impervious to the possibility of being banned either. People need to stop feeling like they are entitled to grossly violate rules here. That'll prevent this battleground editing for good. LesVegas (talk) 12:29, 5 May 2015 (UTC)

great idea Les, but what will you do after you get indeffed from fringe topics, broadly construed. -Roxy the Viking dog™ (resonate) 12:34, 5 May 2015 (UTC)

Good question. I guess I'll start editing bumblebee and Disney articles with you! LesVegas (talk) 12:45, 5 May 2015 (UTC)

• Oppose - We don't need a tag again. According to previous discussion there was no consensus to have the tag. What is the purpose for the tag when there are many editors currently discussing this article? How will the tag improve the article? QuackGuru (talk) 16:06, 5 May 2015 (UTC)

• Support - I see no harm with including the tag, especially since the tag is closely linked to many of the questions discussed here at the Talk Page. Hopefully it will attract more editors to the article. Jayaguru-Shishya (talk) 19:36, 5 May 2015 (UTC)

• How will the tag attract more editors to the article? What would be the purpose of attracting more editors? I think we need less editors not more. QuackGuru (talk) 19:41, 5 May 2015 (UTC)

What the article needs is people who can talk things out...not article owners. -- Moxy (talk) 19:52, 5 May 2015 (UTC)

To talk about what things exactly? Should we talk about the format change? Should we talk about things like what happening to the lede? Or is this a waste of time? QuackGuru (talk) 20:10, 5 May 2015 (UTC)

So far those talks are a good step...but no need for all the edit wars (thus why the page is locked). If people are not aware of the editing habit problems here then they need to step-back and look at what's going on again. All should follow our basic expectations on how to deal with content and sourcing arguments. I understand that this article has had a long history of problems....but this does not mean the basics should not be followed. Perhaps the community should impose a 1 revert for this topic....this may help. -- Moxy (talk) 20:39, 5 May 2015 (UTC)

Why would it be a good step to talk about a format change? Why would it be a good step to talk about a what happening to the lede? Maybe it would help if ArbCom would accept the case rather that talk things out. Talk things out about for what? The edits don't improve anything. QuackGuru (talk) 20:48, 5 May 2015 (UTC)

There are many editors here with different POV's ...thus we have a talk page to talk things out ...this falls under common sense. You may believe all is perfect and nothing should change.. but this is not how it works here.....others may voice opinions or edit the page at will. If they or even you are reverted after a bold edit then a talk should take place...not an editwar. All should try to propose solutions ...not kick each-other in the nuts. If this is beyond peoples capability then they should think about editng other topics that are not as controversial. -- Moxy (talk) 22:22, 5 May 2015 (UTC)

Okay. Who supports this change to the lede? Anyone? QuackGuru (talk) 22:37, 5 May 2015 (UTC)

Hell no. That attributes the mainstream view, widely held, to a single individual, which gives an entirely false impression. Guy (Help!) 22:45, 5 May 2015 (UTC)

We had this before A1candidate's edits of 19:36, 3 May 2015:

Some believe that TCM has a strong scientific basis, but according to Quackwatch, it is not based upon scientific knowledge, and others describe acupuncture as a type of pseudoscience.The claim that acupuncture is medically effective has in the past been declared a pseudoscientific claim, but there is now plausible scientific evidence for acupuncture's effectiveness. However, Massimo Pigliucci and Maarten Boudry describe it as a "borderlands science" lying between normal science and pseudoscience.

References

Any thoughts on this? Jayaguru-Shishya (talk) 17:35, 6 May 2015 (UTC)

This was rejected. QuackGuru (talk) 20:30, 6 May 2015 (UTC)

You seem to be in danger of the fallacy of false equivalency. Some people's POV is that disease is caused by imbalance of yin and yang and can be cured by balancing the flow of qi through meridians using acupuncture. That is a POV, just as the age of Earth being 6,000 years is a POV, but both are based on superstition and dogma, and both are wrong.

This is not a matter of balancing POVs of equal validity. It is a matter for making specific, actionable edit requests, and seeing if there is consensus for them. Science is not a POV, it's a method for separating truth from falsehood.

It is also a matter for controlling long-term civil POV-pushing by acupuncture advocates. We do this on articles like Homeopathy (edit | talk | history | protect | delete | links | watch | logs | views) all the time. Guy (Help!) 22:43, 5 May 2015 (UTC)

All great points....so what to do...we show many sources for what many may seem as contentions ...that is we have both MED sources and textbook source....why textbook source??? Because they go into details about topics and this will let others see the reasons behind the conventional thinking. So do you think a one revert option on this article would help? -- Moxy (talk) 23:03, 5 May 2015 (UTC)

Editors can review all the changes or lack of changes with the recent edits. After over 235 edits little has changed. QuackGuru (talk) 22:48, 5 May 2015 (UTC)

•  Added the maintenance tag — Martin (MSGJ · talk) 08:31, 6 May 2015 (UTC)

"Western Medical Acupuncture"

[20] Western medical acupuncture <> acupuncture. Per the first source given, "it is an adaptation of Chinese acupuncture..." --NeilN ^{talk to me} 16:30, 8 May 2015 (UTC)

Recent edits to the article by DrChrissy are looking to expand a bit on the term "Western medical acupuncture". The edits were made to the lead and were (in my judgment) rightly reverted by Roxy the dog and NeilN because as they were made they were a problem per WP:LEAD (first edit) and then incorrectly equated TCM acupuncture with Western acupuncture. I think the concept of Western medical acupuncture (which is mentioned only in passing right now) should be expanded, largely to hit on the issues the Kww has been raising -- that acupuncture is done, but there's a distinction between whether it's TCM-based or Western based. This needs to be developed using good-quality sourcing in the body before it's added to the lead, however. Zad68 16:36, 8 May 2015 (UTC)

Agreed, it appears to be undue for the WP:LEAD now, and as written equates the two, which seems to be a misrepresentation of the source. Yobol (talk) 16:39, 8 May 2015 (UTC)

Zad, where is the best place in the article to expand on this where I can avoid being automatically reverted?DrChrissy ^(talk) 16:41, 8 May 2015 (UTC)

I don't see that you were "automatically" reverted, reasons were provided for every revert.

Why not expand the section where "Western medical acupuncture" is already mentioned? Zad68 16:46, 8 May 2015 (UTC)

You should also avoid describing the claims made as facts. The source you are using is a publication by a charity dedicated to the cause of promoting acupuncture as a legitimate medical technique, but the claims they make fall afoul of WP:FRINGE.—Kww(talk) 16:53, 8 May 2015 (UTC)

Which source are you talking about? I trimmed the original posting so it was simply related to use of the term, to avoid what you are saying. However, even this was reverted rather than being discussed. Does this term not exist?DrChrissy ^(talk) 17:05, 8 May 2015 (UTC)

Again please take care to represent the concerns of others accurately. That wasn't the reason the second edit was reverted, it was reverted because it incorrectly implied that TCM and Western were equivalent, and it was a problem per WP:LEAD. Zad68 17:07, 8 May 2015 (UTC)

And by the way, the "new" content added to the body said that it "acts by stimulating the nervous system" and listed several "known modes of action". If you are going to contribute content to the article, please make some effort to present it neutrally. To my knowledge, there is not any consensus that western acupuncture stimulates the nervous system nor are there identified modes of action supporting its efficacy. I cleaned that up, and we're now left with a description of western acupuncture without any discussion of its reception. I don't know if this is the proper weight, but if we're going to discuss it, the blurb should ultimately be expanded.   — Jess· Δ♥ 17:22, 8 May 2015 (UTC)

I did attempt to be neutral. I placed it in quotes. If I had not done that, I would have been in copyvio. If I changed the words and paraphrased, I imagine there would have been accusations of "misrepresentation". Thankyou for cleaning it up. Maybe you would care to help in the expansion that is clearly needed.DrChrissy ^(talk) 17:29, 8 May 2015 (UTC)

Avoiding a copyvio and using neutral wording are two different things. Yes, you did one of them. Please try to also do the other one in the future.   — Jess· Δ♥ 17:38, 8 May 2015 (UTC)

I removed the fringe journals per WP:MEDRS and WP:OVERCITE. QuackGuru (talk) 18:24, 8 May 2015 (UTC)

Deletion of information from this talk page

I recently posted a thread here that involved a question regarding the removal of material from this Talk page. Another editor has seen fit to remove my thread without discussing this first. Please re-instate my posting.DrChrissy ^(talk) 00:25, 9 May 2015 (UTC)

I already explained in an edit summary and on your talk page. Discussion of editor conduct does not belong on an article talk page, per the talk page guidelines. Go to that user's talk page, or try WP:ANI if you feel it is particularly egregious.   — Jess· Δ♥ 00:28, 9 May 2015 (UTC)

I will take the behaviour of the editor to ANI or another forum, I have no problem with that, but you should re-instate my posting so that others are aware of the undiscussed removal of material from this Talk page.DrChrissy ^(talk) 00:32, 9 May 2015 (UTC)

No. Discussion of editor conduct does not belong here. That's the whole point. And just to be clear, no material was removed from the talk page except a section heading you apparently found objectionable. I'm having a seriously hard time characterizing your behavior as anything but disruptive. Please keep discussion focused on article improvement. Thanks.   — Jess· Δ♥ 00:36, 9 May 2015 (UTC)

The hatting and the original removal were both overly aggressive. These aren't BLP violations or WP:FORUM violations, they were were complaints about behaviour on a talk page on the talk page where the behaviour occurred. Those are normally granted some leniency. As for the complaint itself, "clumsy" probably wasn't the best word. "Misleading", "inappropriate", "unacceptable", "unwarranted", or similar would have been accurate without running the risk of insulting the person that put it there.—Kww(talk) 02:27, 9 May 2015 (UTC)

Eye of the beholder. I think your first three adjectives are worse than "clumsy". I'd further explain why clumsy was appropriate but of course, that would risk further offense. --NeilN ^{talk to me} 02:45, 9 May 2015 (UTC)

@Kww, I disagree, but fair enough. We have 33 sections on this talk in just over a month, which isn't helped by the increasing amount of behavioral discussion lately. The original complaint was about an edit by NeilN that he had already removed. I stand by that being an inappropriate discussion for this page (it can't possibly concern the article), and I left a reasonably unconfrontational message on the OPs talk to explain further. But, reasonable editors can disagree at times, so I appreciate your input, and it turns out my edit didn't end up serving its purpose of staying on-topic anyway. Oh well.   — Jess· Δ♥ 03:08, 9 May 2015 (UTC)

Content removal

It now seems that there is an approximate 30 minute time limit to providing information or edits will be deleted - see here[21]. I disagree with this removal of content, expecially with such aggressive editing.DrChrissy ^(talk) 17:13, 9 May 2015 (UTC)

I requested the page number and none was provided. You still have not provided the page number. The text was too complicated for the general reader, anyhow. QuackGuru (talk) 17:17, 9 May 2015 (UTC)

Ermmmm...where am I supposed to provide the page number now that you have deleted the content?DrChrissy ^(talk) 17:21, 9 May 2015 (UTC)

Adrian White, Mike Cummings and Jacqueline Filshie, ed. (2008). An Introduction to Western Medical Acupuncture. Elsevier. ISBN 978-0-443-07177-5.

Please provide the page number on the talk page and a proposal for a rewrite on the talk page. QuackGuru (talk) 17:24, 9 May 2015 (UTC)

I will do in time - but too busy doing other things at the moment. By the way, the diff of the paraphrase you have labelled as "too complicated" can be found here[22]. I am not responsible for this.DrChrissy ^(talk) 17:28, 9 May 2015 (UTC)

I had the time and fixed the wording myself. QuackGuru (talk) 18:00, 9 May 2015 (UTC)

Cancer-related pain

User:Arthur Rubin, you deleted a statement from the American College of Chest Physicians which says "in patients with cancer related pain". How is this not part of "cancer-related conditions"? -A1candidate 11:02, 4 May 2015 (UTC)

The same statement in the same article is being paraphrased differently in two different sections. It should only be there once, or it should be explicitly noted that it is the same statement in the same article. The first use refers to "nausea and vomiting from either chemotherapy or radiation therapy", and the second use refers to "cancer-related pain" (and something not relevant and not in the article). Although it's not a fringe article, both references are outside of the medical specialty that the organization and journal normally represent. In other words, both clearly fail WP:MEDRS, unless the authors are expert in the field of the article, not just the field of the journal. I'm beginning to think that both statements should go. — Arthur Rubin (talk) 19:54, 4 May 2015 (UTC)

@A1candidate: — Arthur Rubin (talk) 19:55, 4 May 2015 (UTC)

If that item is listed, it should be under "pain", rather than under "cancer-related conditions". It might be still better to paraphrase the statements together under "Cancer-related conditions", rather than separately under "pain" and "nausea". I still have doubts about it being appropriate at all, though. — Arthur Rubin (talk) 20:12, 4 May 2015 (UTC)

Both are weak sources. These are political opinions rather than scientific evidence. We are using many reviews. We don't need to reach down to lower-quality sources to argue with better sources. QuackGuru (talk) 23:58, 5 May 2015 (UTC)

The clinical practice guidelines is poor evidence and only suggestions. The solid evidence is Cochrane reviews. QuackGuru (talk) 08:23, 8 May 2015 (UTC)

Yes, but they're not perfect. That is why WP:MEDORG must not be ignored. -A1candidate 08:51, 8 May 2015 (UTC)

We have WP:WEIGHT too. This page has over 300 references and is very long. For a mature topic with many reviews we should use better sources. QuackGuru (talk) 09:24, 8 May 2015 (UTC)

I would suggest deleting the blog of David Gorski and remove his polemical statements -A1candidate 09:58, 8 May 2015 (UTC)

I did remove the source David Gorski from a long section. See Talk:Acupuncture/Archive 23#Long section. If you want to remove more specific information I suggest starting a new section. QuackGuru (talk) 18:36, 8 May 2015 (UTC)

The sources are opinions not solid evidence. The sources do not summarise the body. QuackGuru (talk) 20:38, 9 May 2015 (UTC)

Last time I checked, Gorski's name is still there. Then add it to the body instead of removing. -A1candidate 20:51, 9 May 2015 (UTC)

It is where exactly. We have more precise wording using a high-quality review in the body. QuackGuru (talk) 20:54, 9 May 2015 (UTC)

Under section on "ethics" -A1candidate 21:01, 9 May 2015 (UTC)

You have not given a reason to remove it from Acupuncture#Ethics. QuackGuru (talk) 21:04, 9 May 2015 (UTC)

How about failing WP:MEDRS? -A1candidate 21:06, 9 May 2015 (UTC)

The source was discussed before. See WP:FRINGE. QuackGuru (talk) 21:08, 9 May 2015 (UTC)

Listen, I agree with Arthur that the American College of Chest Physicians talking about acupuncture and cancer isn't the same as the American Cancer Society, but it's wrong to outright delete things like this without discussion. There can be a perfectly reasonable argument for its inclusion that is worth examining. For instance, chest physicians like pulmonolgists often see patients undergoing cancer treatment and might give referrals for acupuncture. Based on their expertise, it may be relevant. If we want to have a strict enforcement of the specialization clause in MEDRS, we could absolutely start deleting claims from all non-acupuncture specific journals since it's not within their field of expertise. LesVegas (talk) 21:33, 9 May 2015 (UTC)

Possible source

• Acupuncture: What Does the Most Reliable Evidence Tell Us?

Given that this is an overview of systematic reviews, it seems like a very reliable source. It covered 32 Cochrane reviews, and concluded that 25 had negative conclusions, 5 positive, and two inconclusive. The abstract states: "The conditions that are most solidly backed up by evidence are chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache." Everymorning talk 21:40, 9 May 2015 (UTC)

Thank you Everymorning for your tireless contributions of good material! This source might be high quality for some things but it is 7 years old and MEDDATE tells us to refresh sources 5 years old. So what I think we would have to do is go through it condition by condition and compare it to the current Cochrane information to see what has changed and what hasn't and we could use this source to back up the information that's current. LesVegas (talk) 22:35, 9 May 2015 (UTC)

In point of fact, five were positive or tentatively positive. In other words, the conclusion from Cochrane reviews is overhwelmingly negative, much as we say in the lede.

It's amusing that people don't realise the message behind this analysis. Acupuncture is claimed by proponents to treat all kinds of things. It turns out that most of the research is junk and on balance negative, and the areas where outcomes are positive are basically random, indicating that, as per Ioannidis, they are simply islands of false positives. Guy (Help!) 22:41, 9 May 2015 (UTC)

Guy, if you compare this data with Cochrane's newest data DocChrissy has pulled up, it has changed significantly. LesVegas (talk) 22:52, 9 May 2015 (UTC)

Guy, your analysis of the report is extremely misleading. 5 of the reports were positive. These are 5 independent, stand-alone reports that have been assessed by the same authors who analysed and accepted there was no effect for 25 others. It is the height of scientific naivety to simply then disregard the 5 with the positive effects. It is not a game of numbers and to suggest 'more were negative therefore there is no effect', is just scientifically baffling.DrChrissy ^(talk) 23:11, 9 May 2015 (UTC)

And that's correct too. And that's why we have to quote statements directly. If the source says the glass is half full, we cannot say it's half-empty, lest we commit OR. LesVegas (talk) 23:23, 9 May 2015 (UTC)

When introducing material from Cochrane reviews, I have used the conclusions, often quoting these direct. My edits have often been removed with edit summaries such as "methodological flaws", "low number of patients" when these comments are about trials not leading to the conclusions. If a conclusion in a Cochrane review states "There was an effect of X.", we should accept this....we are editors, not researchers).DrChrissy ^(talk) 23:50, 9 May 2015 (UTC)

Quote mining is a way of misrepresenting sources. If the Cochrane review says its own evidence is weak or unreliable, stating that Cochrane found definitive proof of efficacy of acupuncture is misleading. Tgeorgescu (talk) 01:25, 10 May 2015 (UTC)

I am amused that you accuse me of being misleading, and then say "five of the studies were positive". What is actually says is: Thirty-two reviews were found, covering a wide range of conditions. Twenty-five of them failed to demonstrate the effectiveness of acupuncture. Five reviews arrived at positive or tentatively positive conclusions and two were inconclusive. I think that is exactly in line with what I said, but five being "positive or tentaively positive" is certainly not the same thing as five being positive. Still, you did nicely illustrate my point that SCAM proponents misrepresenting weak or equivocal evidence as being unambiguously positive. Well done for that. at least. Guy (Help!) 21:20, 10 May 2015 (UTC)

I added the conclusion to the lede. See "Cochrane reviews found acupuncture is not effective for a wide range of conditions.[10]" QuackGuru (talk) 06:10, 11 May 2015 (UTC)

I just read a copy of the PDF file. Please read the conclusions not the abstract. QuackGuru (talk) 02:09, 10 May 2015 (UTC)

Outside perspective

I haven't read the entire article yet, but the Lead gave me the impression of repeating over and over again, often with extreme and editorialized language, that acupuncture is not considered an acceptable medical practice by traditional medicine.

Certainly that warrants inclusion in a neutral and balanced way, but I would think as an encyclopedia, our principle objective with the article should not be to provide medical advice, but to document the history of the practice - the scientific investigation of it being only one element of the article that is primarily relevant to recent history.

I don't have any background in acupuncture and have never tried it; but the first thing that comes to mind for me is its role in Asian culture, whereas the Lead depicts it as a scam, which I don't think is representative of the total body of literature. In comparison, certainly Christianity has been debunked by scientists and you can see how different the Lead is in that article. CorporateM (Talk) 14:14, 11 May 2015 (UTC)

Welcome! It is good to see a fresh editor here. I have been looking at other articles on contentious subjects such as Ghost, Loch ness monster, Creationism and they seem to have managed to get a neutral Lead, even including criticism. I hope we can achieve that here.DrChrissy ^(talk) 14:25, 11 May 2015 (UTC)

CorporateM, present day mainstream Christianity doesn't make scientific/medical claims. --NeilN ^{talk to me} 14:28, 11 May 2015 (UTC)

That's correct. This article is guided by different policies than religious articles - for example WP:MEDRS and WP:FRINGE, and even falls under special arbcom rulings. The topics are really not comparable, and we need to take that into account when assessing content. That said, the lead was recently reworked considerably, which I think may have addressed some of those concerns (before they were even raised).   — Jess· Δ♥ 14:43, 11 May 2015 (UTC)

Creationists do make scientific claims, so to that degree we have Christians engaged in pseudoscience. They are powerful and influential enough to get their politicians to ban some books and force the teaching of young earth creationism in public schools in the USA. -- BullRangifer (talk) 14:47, 11 May 2015 (UTC)

One cannot really disprove that Jesus is God or that God exists. Science and historical scholarship cannot tell if those are true or false, since those are not falsifiable statements. There are philosophical arguments for atheism and against it, but science is neutral in this respect. All historians have done is debunk specific falsifiable claims (like biblical inerrancy or the historicity of the book of Genesis), but there are Christians who accept such results and still are Christians. There is no contradiction between accepting evolution and being a Christian. Tgeorgescu (talk) 14:52, 11 May 2015 (UTC)

(edit conflict)@BullRangifer True. So a more comparable example might be creation science or Intelligent design, which would hit on WP:FRINGE but not WP:MEDRS. The point, though, is that we can't model our lead on Acupuncture after Christianity, because different policies apply.   — Jess· Δ♥ 14:53, 11 May 2015 (UTC)

(edit conflict) That's Creation science, which isn't exactly mainstream Christianity. --NeilN ^{talk to me} 14:56, 11 May 2015 (UTC)

I don't see the content being medical in nature as good justification for a contentious writing style and I disagree that the article should focus so heavily on medicine. Things like resurrection, conception without intercourse, and wine containing the holy spirit are scientific claims made by christianity that are all just as bogus as traditional Asian beliefs like yin/yang, qi, meridians, etc., which I would say are closer to religion or culture than medicine. I don't think it is big of us to write attack-style content about the practices of Eastern cultures and glowing articles about our own society's equally bogus beliefs. I also don't believe acupuncture is actually a fringe topic, except when it comes to the element of reception among the medical field, which is just one part of the subject. Rather, the current article contains a Reception section that shows that support of acupuncture is wide-spread and a popularly held belief, not a fringe one. Fringe is often just what we label concepts we do not ourselves believe. CorporateM (Talk) 15:03, 11 May 2015 (UTC)

Except that not all Christians consider that wine contains Holy Spirit or that Jesus was born without sex. Christianity is an umbrella concept, it means a lot of different things to different people. And we don't offer it special status, you might want to check how WP:RNPOV is applied in articles pertaining to the history of Christianity: they do not flatter Christian prejudices or pander to piety. Tgeorgescu (talk) 15:07, 11 May 2015 (UTC)

CorporateM, please show me modern day research on "conception without intercourse" or "wine containing the holy spirit". --NeilN ^{talk to me} 15:08, 11 May 2015 (UTC)

(edit conflict)@CorporateM Acupuncture is a medical intervention, and it is fringe within the medical community. WP:FRINGE certainly applies, whether or not is has a historical or religious following as well.   — Jess· Δ♥ 15:10, 11 May 2015 (UTC)

Yes, it applies to the aspect of it as a medical treatment, but that is only one part of the subject and a very western view only relevant to recent history. Just doing some quick Google searches on the history of acupuncture turns up how it was seen as a method of attaining harmony between the living and the dead, has some tie-in with the Asian superstitious belief about the number 5, and gaining "harmony" with the natural world. This is all cultural and religious history important to Asian culture. We are not a WebMD or digital doctor. Our main goal should be to document the history of the practice. CorporateM (Talk) 15:26, 11 May 2015 (UTC)

Sorry, I'm not buying that acupuncture is not predominantly a medical intervention, and I don't see our sourcing backing that claim up.   — Jess· Δ♥ 15:34, 11 May 2015 (UTC)

User:CorporateM One thought I had a short while ago was to split the article into 2 separate articles - Traditional acupuncture and Western medical acupuncture. This would make science editors such as myself, more comfortable editing the latter, whilst leaving the Traditionalists to edit the former. I'm just throwing this out - I will probably not spend time defending this, but I thought you might like to know.DrChrissy ^(talk) 16:24, 11 May 2015 (UTC)

Each article should document the debate and represent multiple viewpoints fairly; we don't split articles to allow POV camps to each have their own page. However, just as there is an article on Regulation of acupuncture, in a perfect world we would have neutral, high quality sub-pages on History of acupuncture and maybe something on ancient Chinese medical practices. It is large enough of a topic to warrant multiple sub-articles. CorporateM (Talk) 18:03, 11 May 2015 (UTC)

Chinese authors or Chinese studies

According to a discussion in another thread there may be bias studies in this article.

{{SAFESUBST:#invoke:Unsubst||date=__DATE__|$B=

Maybe this tag will help. QuackGuru (talk) 01:38, 11 May 2015 (UTC)

It's a delicate enough topic that I can't imagine that tag doing anything positive.—Kww(talk) 01:44, 11 May 2015 (UTC)

Maybe we can replace the current tag with this tag. QuackGuru (talk) 01:46, 11 May 2015 (UTC)

You'd need to slap another POV tag on top for that one.--TMCk (talk) 02:00, 11 May 2015 (UTC)

Sure, but please present the studies first. Publication bias is not an opinion, it's tested by statistic methods. Cheers! Jayaguru-Shishya (talk) 18:27, 11 May 2015 (UTC)

Impact factor and reliability of sources

The subject of journal impact factors and their relation to the reliability of sources for this article has been raised. I have searched various WP pages (below) for statements regarding the impact factor of journals.

Policy articles

Wikipedia:Verifiability - No relevant statement

Wikipedia:Neutral point of view - No relevant statement

Wikipedia:No original research - No relevant statement

Content Guideline

Wikipedia:Identifying reliable sources - No relevant statement

Wikipedia:Offline sources - No relevant statement

Wikipedia:Fringe theories - No relevant statement

Wikipedia:Non-free content - No relevant statement

Notability Guideline

Wikipedia:Notability - No relevant statement

Essays

Wikipedia:Offline sources - No relevant statement

The only article I have found (possibly) mentioning impact factor is WP:MEDRS which states - To access the full text, the editor may need to visit a medical library or ask someone at the WikiProject Resource Exchange or WikiProject Medicine's talk page to either provide an electronic copy or read the source and summarize what it says; if neither is possible, the editor may need to settle for using a lower-impact source. Note this states "lower-impact source", not "lower-impact factor source".

In summary, I suggest there is nothing on Wikipedia to support the argument that the reliability of a source can be judged by its impact factor.

DrChrissy ^(talk) 11:32, 11 May 2015 (UTC)

Other than years of precedent, you mean? You are inexperienced in this area. Several of those with whom you disagree, are very experienced in medical and pseudomedical subjects on Wikipedia. Journal impact factor is of huge importance. A new study in Nature is likely to merit inclusion, a new study in the Journal of Acupuncture and Meridian Studies is extremely unlikely to merit inclusion. The impact factor is a measure (we can argue about how accurate later) of how trusted a journal is. Journals such as NEJM, The Lancet and the like, have a very high threshold for inclusion: a paper must be not only well written and well argued, but its subject must usually be of genuine and provable significance, to make it into these journals. In particular, it would be very unusual to reference a claim in a low-impact journal that contradicts a finding in a much higher impact journal. Guy (Help!) 12:27, 11 May 2015 (UTC)

Whether I am inexperienced or not, I believe my review of the WP policy articles was sufficiently thorough and my summary posted for WP accurate. After all, we are dealing with WP editing here, not how outside journals conduct their affairs. I strongly suggest you read Impact factor. I was amazed to see that approximately 50% of this article is about criticism of impact factors and the way they are used. For example, "The Higher Education Funding Council for England was urged by the House of Commons Science and Technology Select Committee to remind Research Assessment Exercise panels that they are obliged to assess the quality of the content of individual articles, not the reputation of the journal in which they are published".DrChrissy ^(talk) 12:45, 11 May 2015 (UTC)

Wikipedia guidelines are descriptive not prescriptive. They lag practice and sometimes don't reflect it at all when something is obvious, as this is. Incidentally, you also reverted my moving of an overall summary form a book tot he head of a para. I did that because the para is currently confusing in a way that it is not with the framing statement at the head of the para. It started out reading "some studies show it works for this, other say it doesn't, it might work, it might not" and so on - in fact the conclusion is that it doesn't work, and if you start by establishing that, the rest makes a lot more sense. Guy (Help!) 13:06, 11 May 2015 (UTC)

I don't think there is anything "obvious" with the impact factor issue, and it probably explains why it's been discussed so many times earlier. Jayaguru-Shishya (talk) 18:31, 11 May 2015 (UTC)

I think this is such a basic part of the source evaluation process that nobody added it to the guideline. Unlike the RAE panels, we are discouraged from directly analyzing the research quality in the paper and are restricted to analyzing the overall reliability of the source in which it is published relative to the statement we wish to make based on the source. Can I suggest that you take this up in a more general venue? It's certainly not an acupuncture-specific topic: nobody is suggesting that impact factors be either used or ignored only for acupuncture-related articles, and that way you can feel comfortable that you are receiving an answer that isn't specifically designed to attack acupuncture. My access to computers will be spotty today, so my participation will be low.—Kww(talk) 12:56, 11 May 2015 (UTC)

I suspect if you read Impact factor you might not have the opnion of it being such a basic part of source evaluation. Anyway, I have raised the issue on Wikipedia talk:Identifying reliable sources.DrChrissy ^(talk) 13:17, 11 May 2015 (UTC)

The policy page that is relevant to looking at the impact factor is WP:V, where it says "must be attributed to a reliable, published source". Looking at the impact factor is one of many attributes that can be of value in determining whether the source is reliable for the use proposed. It is neither possible nor desirable for the general policy pages to attempt to be prescriptive about every factor that might go into determining "reliable," so noting that they don't mention it is really of no value. It might be of value to add a mention of it at WP:MEDRS. Zad68 15:18, 11 May 2015 (UTC)

There are other ways of attributing to a reliable, published source - for example ISBN and ISSN numbers.DrChrissy ^(talk) 16:32, 11 May 2015 (UTC)

The point I was making was regarding the word reliable and not attributed. Zad68 16:34, 11 May 2015 (UTC)

Could someone please provide a recent (< 5yrs old) source indicating that impact factors are a recommended way of assessing the quality of a journal.DrChrissy ^(talk) 17:08, 11 May 2015 (UTC)

Why would it be necessary that the source < 5 years old? Do you have evidence that the utility of impact factors has changed significantly in the past 5 years as opposed to the years before then? Zad68 17:18, 11 May 2015 (UTC)

It is not "necessary" to be <5 years old - I suggested that so the source would be WP:MEDRS compliant. There are many articles > 5 yrs old which identify the problems with impact factors, but I was hoping to get a more recent perspective.DrChrissy ^(talk) 18:27, 11 May 2015 (UTC)

I think user DrChrissy is pertaining to WP:MEDDATE. Anyway, there's been pretty good discussion over the subject at least here[23]. I think user Sunrise put it pretty well:[24] "Again, the point is not that lower IF journals are unreliable, but rather that we cannot use IF to support their reliability" User Famousdog also made a valid point by stating:[25] "There has historically been some absolutely brilliant science published in journals with a very low impact factor for a variety of reasons: because the field is so specialized that the readership is small, or because the research has few (if any) commercial applications, or because certain scientists are sentimentally attached to certain journals" User Roxy the dog has said the same:[26] "I don't believe there is a hard and fast rule on impact factor/reliable sources.", which in turn has been supported by user BullRangifer:[27] "Correct. There isn't any." What user LesVegas has said is also consistent with the statements above:[28] "BTW, journal impact factor has no bearing on whether or not a source can be used."

I hope this serves as a small summary for the earlier discussions in regards to the impact factor. Jayaguru-Shishya (talk) 18:33, 11 May 2015 (UTC)

Review article

A meta-analysis has just been published that might warrant inclusion here. "Acupuncture therapy can significantly improve the hearing of patients with nerve deafness, and the efficacy of acupuncture in combination with medication is superior to medication alone." [29] I am leaving it here for regular editors to decide if it is worth including. — Preceding unsigned comment added by 108.181.201.237 (talk) 19:32, 6 May 2015 (UTC)

• This is a low-impact journal, so I personally think it should probably be left out. Everymorning talk 20:13, 6 May 2015 (UTC)
• The authors are Jiang Y, Shi X, and Tang Y. They might have a COI. QuackGuru (talk) 20:16, 6 May 2015 (UTC)
• The journal is not MEDLINE indexed. Zad68 20:26, 6 May 2015 (UTC)
• Looks great to me! WP:MEDRS states "The best evidence comes primarily from meta-analyses of randomized controlled trials (RCTs)" Authors sometimes choose for their own reasons to publish in low impact journals - that does not mean the article itself is poor quality. Not being Medline indexed does not necessarily mean it is poor quality. Perhaps we could have some evidence of the COI accusation?DrChrissy ^(talk) 21:10, 6 May 2015 (UTC)
• Leave it out, not MEDLINE indexed, in a low impact journal. Yobol (talk) 21:17, 6 May 2015 (UTC)
• Please provide the impact factor of the journal as evidence it should not be used.DrChrissy ^(talk) 21:25, 6 May 2015 (UTC)
  • Before sticking your neck out on this one, why not read the paper's own discussion section, and note carefully the drawbacks the authors bring up... Also read WP:EXCEPTIONAL. Zad68 21:30, 6 May 2015 (UTC)
• I am not sticking my neck out, I am simply asking another editor to provide evidence to back up their arguments that 1) there is a potential COI, and 2) the impact factor of the journal.DrChrissy ^(talk) 21:36, 6 May 2015 (UTC)
  • The impact factor is on their website: 1.422. As a comparison to some of the top general medical journals NEJM has a impact factor >50, JAMA ~30, Annals of Internal Medicine ~16. Compared to 2013 impact factors, this would place it #72 in the general medicine category, slightly ahead of the Croatian Medical Journal and the Libyan Journal of Medicine. Yobol (talk) 21:37, 6 May 2015 (UTC)

  • "Looks great to me!" seems like sticking your neck out... Zad68 21:38, 6 May 2015 (UTC)

Interesting discussion! I honestly thought it would be ok to include, but thought I should let you guys decide. A question though, as I clearly do not have a good grip on policies regarding sources in medical articles...why would you exclude this peer-reviewed meta-analysis when in the sections above it seems many of you accept inclusion of the non-peer-reviewed sources from blog sites like Quackwatch? Isn't this review a better source than a non-peer-reviewed blog, despite that it might not be medline indexed? — Preceding unsigned comment added by 108.181.201.237 (talk) 21:53, 6 May 2015 (UTC)

It is a better source, but stand back and wait for the replies you are about to get!DrChrissy ^(talk) 22:01, 6 May 2015 (UTC)

Here come the replies.... Because some people (and everybody can join in the chorus here . It goes like this): Nah-nah-nah – can't hear you? Because it offends my- un-examin-ed- beliefs! nah-nah-nah – can't hear you – nah-nah-nah. Its not on Quack Watch, not on Quack Watch, so nah-nah—nah nah an a nah.--Aspro (talk) 22:36, 6 May 2015 (UTC)

@IP 108: It is important to note that how reliable a source is depends on the context of what text it is being used as a source to support. For instance, Quackwatch is not just your run of the mill blog, but is a highly praised website (praised by medical sources and general media alike); it is also being used to source content in this article that is generally difficult to find in peer reviewed sources, such as discussion of the conceptual basis of acutpuncture. It is not being used to describe the efficacy of acutpuncture in individual diagnoses. This is an important mistake that many editors make, in that they forget that different types of sources can be reliable for different types of text they are used to support. Your suggested source is not a high quality source compared to the others used in this article to describe the efficacy of acupuncture for individual diagnoses, and should therefore not be used for this purpose. Yobol (talk) 22:18, 6 May 2015 (UTC)

@IP 108. You have raised a question that has been raised many, many times, simply because it is such an obvious one to ask. I myself raised the same question on the Talk page of this article just a few days ago. I suggest you have look to see the type of answers you might get here. It is some of the most mis-contrived logic I have ever read.DrChrissy ^(talk) 22:43, 6 May 2015 (UTC)

@DrChrissy, @Aspro, please stop poisoning the well. It is disruptive. Yobol (talk) 22:45, 6 May 2015 (UTC)

Then stop owning this article! It is as simple as that.--Aspro (talk) 22:52, 6 May 2015 (UTC)

@User talk:Yobol How can I possibly be poisoning the well. The IP asked a question and I am answering them. Sorry if my answers disagree with yours but that is life! I am requesting that you strike the accusation about me being disruptive.DrChrissy ^(talk) 22:59, 6 May 2015 (UTC)

• A low-impact journal with a surprising result? In general, for all medical topics, if there's an isolated report in a low-impact journal with a result that isn't reported by in more widely accepted journals, we shouldn't include it. If acupuncture actually cures deafness, it will be eventually reported more widely and we can report it then.—Kww(talk) 23:45, 6 May 2015 (UTC)

1.42 is actually fairly good. In my experience looking at impact factors, it would put the journal in the top half in a medical category. TimidGuy (talk) 17:53, 8 May 2015 (UTC)

It is not MEDLINE indexed. That's not good. QuackGuru (talk) 18:01, 8 May 2015 (UTC)

@TimidGuy: 1.422 may be "ok" in certain very specialized topics, but not in this context. Their impact factor puts them in the bottom 30% of their respective category (87th out of 124). It is not MEDLINE indexed, it has a low impact factor and all signs point to it not being a high quality journal, and therefore should not be used. Yobol (talk) 18:28, 8 May 2015 (UTC)

The review itself admits that not a single one of the studies they looked at had any placebo control. --sciencewatcher (talk) 00:41, 12 May 2015 (UTC)

A sense of proportion II

Jess, please try to understand what I am geting at. Your edit undid everything that the discussion accomplished. QuackGuru, please think about what you want to do before you do it, so we don't have 15 edits to get one word right. It would be appreciated Rui ''Gabriel'' Correia (talk) 20:16, 12 May 2015 (UTC)

"A review of reports from a number of countries covering the period 2000 to 2009 pointed to at least ninety-five cases of serious adverse events, including five deaths resulting from acupuncture."[30]

The wording starts off with 'A review of reports". You don't need to say it was a review. A word to avoid is "pointed". The previous wording is better written with less words. The part "a number of countries" is ambiguous (original research). QuackGuru (talk) 20:21, 12 May 2015 (UTC)

I restored the original wording until we can come to agreement over which version to use. Will comment more in a moment.   — Jess· Δ♥ 20:24, 12 May 2015 (UTC)

Here was my edit, which used your wording but made it a little shorter. I changed "covering the period" to "between" and removed "from a number of countries". As I expressed above, I'd like to avoid saying "international", "worldwide", "from X,Y,Z countries", etc, because it could misleadingly imply that the reports are representative of that area. "Only 5 deaths in a decade, worldwide? No, only one report on the topic which listed 5 deaths." Your edit wasn't misleading in that way, but as worded it was superfluous. By not listing a country, we're not constraining the data geographically already. I just don't see how "from a number of countries" is helpful. We can still ask the same question: "Which ones?"   — Jess· Δ♥ 20:30, 12 May 2015 (UTC)

Also, I am marginally concerned about saying "a review of reports". Is that the correct weight? We're saying "just one review" says this, but it's actually reported widely, and this "review" is a high quality systematic review, not just some miscellaneous compilation of data. "Were reported" seems more vague, but it's the right weight. Is there another option?   — Jess· Δ♥ 20:33, 12 May 2015 (UTC)

Yes, "review of reports from a number of countries" is incorrect, because it implies that specific countries were chosen, when this is not the case. I also think the shifts in emphasis would need to be discussed. Sunrise (talk) 20:37, 12 May 2015 (UTC)

"Between 2000 and 2009, at least ninety-five cases of serious adverse events, including five deaths, were reported to have resulted from acupuncture internationally." I think we can include the word "internationally" because the text makes it clear that was what was reported. It does not mean only five deaths resulted from acupuncture. QuackGuru (talk) 20:38, 12 May 2015 (UTC)

Allergies

We have:

A 2015 meta-analysis suggests that acupuncture might be a good option for people with allergic rhinitis (AR). Several randomized clinical trials (RCTs) support the use of acupuncture for AR and itch. Experimental studies refer to a specific effect of acupuncture in atopic eczema and asthma, but large RCTs are lacking. Using acupuncture to treat other allergic conditions such as contact eczema, drug rashes, or anaphylaxis is not recommended. Additional research is required to clearly determine any effects of allergic disease therapy above placebo. There is insufficient evidence that acupuncture has specific effects on seasonal allergic rhinitis (SAR). There is some evidence that acupuncture might have specific effects on perennial allergic rhinitis (PAR), though all of the efficacy studies were small and conclusions should be made with caution. There is mixed evidence for the symptomatic treatment or prevention of AR. For seasonal AR, the evidence failed to demonstrate specific effects for acupuncture. For perennial AR, there was suggestive evidence for the effectiveness of acupuncture. Acupuncture is an unproven treatment for allergic-immunologic conditions.

References

This is confusing.

1. It might be a good option for AR
2. Several trials support it
3. There's no evidence it works for SAR
4. There's limited evidence for AR
5. The studies are bad
6. For SAR the evidence fails to demonstrate a specific effect
7. For AR there is suggestive evidence
8. Acupuncture is an unproven treatment for allergies.

Actually that last point is the most significant, and makes sense of the rest. IMO the para should be:

Acupuncture is an unproven treatment for allergic-immunologic conditions. A 2015 meta-analysis suggests that acupuncture might be a good option for people with allergic rhinitis (AR), and a number of randomized clinical trials (RCTs) support the use of acupuncture for AR and itch. There is some evidence that acupuncture might have specific effects on perennial allergic rhinitis (PAR), though all of the efficacy studies were small and conclusions should be made with caution. There is mixed evidence for the symptomatic treatment or prevention of AR. For seasonal AR, the evidence failed to demonstrate specific effects for acupuncture. There is insufficient evidence that acupuncture has specific effects on seasonal allergic rhinitis (SAR). Using acupuncture to treat other allergic conditions such as contact eczema, drug rashes, or anaphylaxis is not recommended.

References

I think that is offers a more logical progression. Note that this removes two WP:WEASEL phrases endemic in studies where the evidence is crap. Discuss. Guy (Help!) 15:16, 11 May 2015 (UTC)

This is better and makes the text more readable. The key is the the first sentence. QuackGuru (talk) 16:20, 11 May 2015 (UTC)

Alternatively

As a compromise, we could try this:

A 2015 meta-analysis suggests that acupuncture might be a good option for people with allergic rhinitis (AR). Several randomized clinical trials (RCTs) support the use of acupuncture for AR and itch. Experimental studies refer to a specific effect of acupuncture in atopic eczema and asthma, but large RCTs are lacking. Using acupuncture to treat other allergic conditions such as contact eczema, drug rashes, or anaphylaxis is not recommended. Additional research is required to clearly determine any effects of allergic disease therapy above placebo. There is insufficient evidence that acupuncture has specific effects on seasonal allergic rhinitis (SAR). There is some evidence that acupuncture might have specific effects on perennial allergic rhinitis (PAR), though all of the efficacy studies were small and conclusions should be made with caution. There is mixed evidence for the symptomatic treatment or prevention of AR. For seasonal AR, the evidence failed to demonstrate specific effects for acupuncture. For perennial AR, there was suggestive evidence for the effectiveness of acupuncture. A 2015 clinical practice guideline released by the American Academy of Otolaryngology – Head and Neck Surgery stated that clinicians may offer acupuncture as a treatment for allergic rhinitis to patients interested in non-pharmacologic treatments. According to Middleton's Allergy, "although preliminary clinical reports suggest potential benefits, there is insufficient reliable evidence to rate acupuncture as an effective therapy".

References

The solution to your apparent dilemna/confusion is to stick to the words and statements of authoritative medical textbooks such as Middleton's Allergy. -A1candidate 16:11, 11 May 2015 (UTC)

This is not an improvement and makes the text less readable and the section too long. The proposal by Guy is much better. QuackGuru (talk) 16:20, 11 May 2015 (UTC)

I also think it's too long. The solution is to cut away most (or all) of the reviews, leaving the WP:MEDORG and the authoritative textbook alone. -A1candidate 16:24, 11 May 2015 (UTC)

That's a "compromise"? Not hardly. I also draw to your attention the words of Stephan Schultz at the top of my Talk page: "In science, any compromise between a correct statement and a wrong statement is a wrong statement". Guy (Help!) 21:25, 11 May 2015 (UTC)

• I need to review the sourcing and conclusions, I think this is a matter of emphasis. Depending on which source you look at or weight you can shade the representation of the sources in one direction or the other. I have a feeling Guy's content represents the overall state of the best-quality sources better. Zad68 16:25, 11 May 2015 (UTC)

The sources and content have not, you will note, changed, other than to remove two short sentences, one of which appears in more or less identical form in literally thousands of poorly constructed SCAM trials. All I did was rearrange the text to read more logically. Guy (Help!) 21:25, 11 May 2015 (UTC)

I went ahead and tried to improve the wording and organise the text. QuackGuru (talk) 19:18, 12 May 2015 (UTC)

It seems odd that Guy and QG's proposed wording would place the oldest secondary source first in the section? There is a clear difference between the wording of the conclusions of sources older than 2013 and those newer than 2013. I think this is because the newer reviews (after 2013) include 2-3 recently published RCTs that are not included in the older reviews.70.65.253.158 (talk) 19:38, 12 May 2015 (UTC)

See WP:RECENTISM. It is not about which source came first. It is about an overview of the section. QuackGuru (talk) 19:48, 12 May 2015 (UTC)

Hmmm, I read the essay on recentism; it does not say that the best summaries result from using the oldest reviews first? As such, I am not sure what your point is QG. We have 4-5 secondary sources and the newer one include RCT studies that the older ones do not. The newer reviews also seem to have more favourable conclusions. The recentism essay suggests that we should not exclude the older reviews just because there are newer reviews, but it certainly does not suggest that it is better to give older reviews more weight.70.65.253.158 (talk) 20:26, 12 May 2015 (UTC)

[[User:QuackGuru], didn't you earlier argue and organize the sources from the most recent to the oldest? Jayaguru-Shishya (talk) 21:13, 12 May 2015 (UTC)

Why don't you log into your account? It is not about older versus newer. It was about placement for a general summary of the section. QuackGuru (talk) 20:34, 12 May 2015 (UTC)

What does logging in to an account have to do with acupuncture for allergies? If your arguments are cogent then that is all that should matter; try not to get distracted. So your opinion is that the oldest review that fits within MEDRS timeframe on this subject makes the best start to a section on the topic? Even though it is not consistent with newer reviews in mainstream journals? My opinion is that when there is a bunch of reviews that are mentioned in a section in the body of the article then they should be in chronological order unless there is some clear reason why older reviews should be given ore weight than the newer reviews. Do you have any good reason why the oldest review is the best to start the section on allergies?70.65.253.158 (talk) 20:49, 12 May 2015 (UTC)

A sense of proportion

The bit about "Between 2000 and 2009, at least ninety-five cases of serious adverse events, including five deaths, were reported to have resulted from acupuncture" is meaningless unless we know against what it is being measured. A mention of a country help (eg. tiny San Marino or huge China), but not really scientific. Better would be something like x number of deaths in y number of treatments or some other formula. This is the standard for any treatment vs deaths, whether we are talking about a powerful drug or aspirin. Rui ''Gabriel'' Correia (talk) 02:38, 12 May 2015 (UTC)

It's a meta-analysis, not a primary study, so asking "where?" isn't really a meaningful question. To a first approximation, the best answer would be "everywhere someone collected data." A complete answer would be a list of about 25 countries with some type of frequency distribution (this information can be found in the paper). The paper goes into detail on exactly what the inclusion criteria were. Sunrise (talk) 04:37, 12 May 2015 (UTC)

The number is so marginal that it shouldn't be included at all. There's been discussion about the topic earlier here: Talk:Acupuncture#Safety and weight. I am not quite sure why we didn't go ahead and remove the source already back then, but I find it good that the topic has been brought up for newer inspection. Jayaguru-Shishya (talk) 21:25, 12 May 2015 (UTC)

Yes, this is the number of reports, which is going to be representative of some areas and perhaps not of others. We don't always know and can't anticipate which areas fall into which of those categories. We would have to delve into each study to get a better idea, and then the list will probably be quite large. To say "worldwide" is misleading, because this isn't reports to police in every country during that period, just studies published. Before reverting, I spent some time trying to imagine what wording we could use that would be appropriate, and I came up dry. The closest I can imagine would be "In peer reviewed studies published between X and Y...", which is 1) already implied and 2) not really answering the question "where".   — Jess· Δ♥ 05:54, 12 May 2015 (UTC)

The major problem is that SCAM practitioners typically have no systematic reporting of adverse events at all. Chiropractic is the worst example, but acupuncture and TCM generally are no better really. Guy (Help!) 07:58, 12 May 2015 (UTC)

That's very true. This is one of the major characteristics of alternative medicine. It's a very disparate group of practices and professions without any oversight or control. They make mutually exclusive claims, and there is no system for reporting side effects or any follow up. The one thing they agree on is that mainstream medicine, pharmaceuticals, and MDs are evil. They also don't criticize each other. -- BullRangifer (talk) 14:48, 12 May 2015 (UTC)

One of the other things Acupuncture shares with other alt-med systems is the universal feature, always present ... it doesn't work. Worth remembering when reading all the desperate hand-waving denial here. -Roxy the Viking dog™ (resonate) 15:04, 12 May 2015 (UTC).

JzG, BullRangiger, that might be the case indeed. I don't doubt about that. The talk page is, however, running a risk to turn into a forum instead of discussion about the article content. Anyway, you seem to have a lot of opinions, but mostly you are not supporting them by any sources and there is a risk that someone might mistake those as given facts. Please remember that Wikipedia is WP:NOTFORUM. Thanks. Jayaguru-Shishya (talk) 21:35, 12 May 2015 (UTC)

Hi guys, I agree 100% that "where" is not the best tag, as pointed out by Jess and Sunrise, but we are rather limited in suitable tags, unless there are some that I don't know of. Maybe the technical guys will come up with something better. At any rate, the idea was to draw attention to the issue and in that it produced the expected results. Based on your posts and information on the page I have tweaked the text. Perhaps it is my inner/ former journalist that always reads looking for the "when and where" part. By analogy, if an article said "Seventy people were killed in tornados in the past decade", a reader would immediately sense that the information is incomplete. Thanks for your inputs, appreciated. Rui ''Gabriel'' Correia (talk) 16:29, 12 May 2015 (UTC)

I found a similar claim in this book on page 50:

In addition, in a worldwide literature search reported by the World Health Organization in 2002, 193 adverse events following acupuncture (including relatively minor events such as bruising and dizziness) were identified over a 15-year period.

This does not provide a ratio of out of how many treatments, but I think provides a sufficient amount of context. WHO seems like a good place to get for this information, especially because it is global in nature. CorporateM (Talk)

The current source in the lede is more reliable and it is internationally and without language restrictions. QuackGuru (talk) 18:38, 12 May 2015 (UTC)

QuackGuru, I'm not sure I have the investment to dig into this topic at this moment, but I think it needs a closer look. The current source you mentioned looks fine to me at a glance, but its primary conclusion is that there has not been any "truly convincing evidence that acupuncture is effective in reducing pain" with the caveat that many studies that met their standard of rigor had positive results for neck pain. The 95 adverse effects is different than WHO's measurement, because they only documented severe adverse effects, while WHO documented even minor ones; both sources appear to be stating a number of side-effects out of a specific, discrete data-set of evaluated studies and not as an estimate of adverse effects world-wide or as a ratio of treatments. I don't have a specific solution to propose, except that ideally someone will eventually find a source that's a little different. I'm not sure the current number is actually useful without knowing out of how many treatments they occurred out of and neither source appears to state this. It also comes across as too detailed for the Lead, since it already states that it is safe if done properly, and not if done improperly. Perhaps a topic for another day, as I'm still trying to get to the Regulation section. CorporateM (Talk) 19:47, 12 May 2015 (UTC)

2002 is a bit dated. I went ahead and added it to the adverse events sections though.

Current wording: "In 2002, WHO reported 193 adverse events resulted from acupuncture worldwide over a 15-year period.[216]" This is from 2002. QuackGuru (talk) 20:48, 12 May 2015 (UTC)

If I understand it correctly, it's reporting that there were 193 adverse effects reported in the studies it analyzed, whereas the text seems to imply this is an estimate for all adverse effects that occurred in the real-world, in total. I'll see if I come across something better. CorporateM (Talk) 21:32, 12 May 2015 (UTC)

If you can't find anything newer than I suggest the 2002 sentence can be deleted. QuackGuru (talk) 21:41, 12 May 2015 (UTC)

@QuackGuru: I'm going to trim it for now. This source I came across says in a single incident in Canada in 2004, almost 1,200 patients may have been exposed to HIV from re-used needles. That would blow these numbers way out of proportion, because these numbers are based on sample sizes from the data used for individual studies. I think the data is misleading to readers, because it sounds as if these are the total number of cases. I will keep my eyes peeled for something better. CorporateM (Talk) 23:48, 12 May 2015 (UTC)

Another new discussion on Quackwatch

Didn't spot this advertised here: Wikipedia_talk:Identifying_reliable_sources_(medicine)#Proposal_to_address_Quackwatch_by_name_in_this_guideline The proposer explicitly says Quackwatch should not be used in this article. --NeilN ^{talk to me} 14:00, 12 May 2015 (UTC)

This is pretty tiring and classic IDHT behavior. It's also venue shopping. We have editors who favor fringe subjects, and they often complain about MEDRS as a hindrance to their efforts to promote these subjects using shoddy sources with a systemic bias for these subjects. This is yet another attempt to misuse MEDRS to their ends of defeating the use of QW, a source which consistently exposes this bias. They should be topic banned from MEDRS, as their efforts there invariably seek to weaken and not strengthen our use of mainstream sources. Their efforts aren't just detrimental to QW, they are detrimental to the encyclopedia's goals. -- BullRangifer (talk) 14:32, 12 May 2015 (UTC)

I don't think anyone is trying to "defeat the use of QuackWatch". Indeed, QuackWatch stands for its place on certain articles that have missed the eye of mainstream scientific medicine. There is a strong consensus that QuackWatch is not reliable per se, and I think it'll be good to have some of inclusion about that. The fundamental mistake some editors seem to make, is that some sources would be "reliable independent from the context", but as been voiced out by a dozen of editors, the reliability of a source should be evaluated always on a case-by-case basis. Therefore, no source is reliable per se. Jayaguru-Shishya (talk) 21:36, 12 May 2015 (UTC)

It is quite noticeable that the majority of those supporting reduced usage are long-time editors of alt-med articles with a history of primarily supportive material and arguing against inclusion of reality-based sources. Guy (Help!) 22:42, 12 May 2015 (UTC)

the statement "There is a strong consensus that QuackWatch is not reliable per se," is false. Jytdog (talk) 05:31, 13 May 2015 (UTC)

Why did this happen? QuackGuru (talk) 22:44, 12 May 2015 (UTC)

Notes

@QuackGuru:, somewhere on this Talk page you mentioned that Western journals consider Chinese journals on acupuncture to be unreliable and have results that conflict with their own. I came across this book on the history of acupuncture, written by the head of an acupuncture trade association in the UK. On page 18, he also says that most research on the topic is not of good quality and praises "the West" as having produced better research. This source probably should not actually be used for this, but it was reassuring to see someone outside the US confirm the statement. CorporateM (Talk) 04:45, 13 May 2015 (UTC)

see PMID 25256890 and note the authors. Jytdog (talk) 05:27, 13 May 2015 (UTC)

I have looked at the article and it does not discuss acupuncture per se, it discusses TCM. Sure the individual trials may have studied acupuncture, but I think we need to be careful about the distinction.DrChrissy ^(talk) 10:43, 13 May 2015 (UTC)

Yup, appears to be an actual thing, and not ethnocentrism as I initially presumed. Of course people contributing to that aspect of the page have the difficult task of balancing studies from different areas of the world while only relying on the most high quality studies - I do not envy anyone with that task. CorporateM (Talk) 18:05, 13 May 2015 (UTC)

"The study also found that trials published in non-Chinese journals tended to be of higher quality.[74] Chinese authors use more Chinese studies, which have been demonstrated to be uniformly positive.[75]" I got it covered in the article. I recently added the bit about Chinese authors and Chinese studies. QuackGuru (talk) 18:56, 13 May 2015 (UTC)

Hmm...The difference between a scientific, statistical analysis and an insulting stereotype is a matter of whether you say "most" or "9 out of 10" versus "all". I haven't looked at the sources, but I have to imagine there are at least some skeptics even in China and at least some high-quality studies. Unless it meets the requirements at WP:EXCEPTIONAL of a strong consensus among multiple exceptional sources, I would think we should adopt something closer to a generalization, like "most" or "tend to be" but I don't know what is representative of the total body of literature on the subject. CorporateM (Talk) 19:03, 13 May 2015 (UTC)

There are concerns regarding positive bias in publications from China on traditional chinese medicine. The issue also includes the peer review system in China.

Publish or Perish in China, Nature

Rampant Fraud Threat to China’s Brisk Ascent, New York Times

Research Fraud Rampant in China, Christian Science Monitor

Fraud fighter: 'Faked research is endemic in China', New Scientist

Looks good on paper, The Economist

There are several sources that demonstrate a concern about research originating from China. QuackGuru (talk) 19:19, 13 May 2015 (UTC)

"Publication bias is a possible explanation". In other words, it hasn't been studied, has it? We still need a study on publication bias - which is quite basics - before being able to proceed. Cheers! Jayaguru-Shishya (talk) 20:29, 13 May 2015 (UTC)

I would say: Down with the qualitative research, long live the quantitative one! Jayaguru-Shishya (talk) 20:33, 13 May 2015 (UTC)

"The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent,[11] and publication bias is cited as a concern in the reviews of randomized controlled trials (RCTs) of acupuncture.[54][71][72]" This has been studied. QuackGuru (talk) 20:35, 13 May 2015 (UTC)

That's the Wikipedia article you are quoting. So, has there been any studies on publication bias or not? Please report. Thanks. Jayaguru-Shishya (talk) 21:02, 13 May 2015 (UTC)

The studies that refer to publication bias are in the article. Click on the sources if you want to know more about it. QuackGuru (talk) 22:13, 13 May 2015 (UTC)

History

Does anyone have a way to access this source and/or have thoughts on its reliability? The author is the International Research Center for Japanese Studies, which appears to be an "inter-university research institute". I noticed it was cited in a blog post written by a university professor and I'm trying to chase down his sources. CorporateM (Talk) 05:38, 13 May 2015 (UTC)

Isn't that a series on mysticism and philosophy? Guy (Help!) 10:16, 13 May 2015 (UTC)

Regulation

I think I'm almost done with this section as a summary of the main article. The most important country to include is probably China, where the practice originated and is most popular, but search results for regulation of acupuncture in China are polluted, since China is mentioned in every article about acupuncture. Does anyone know what the regulatory body is in China for acupuncture? CorporateM (Talk) 18:41, 13 May 2015 (UTC)

http://www.scmp.com/topics/regulation-acupuncture

http://www.scmp.com/article/601500/hong-kongs-traditional-chinese-medicine-laws-putting-public-risk

Maybe these might help. QuackGuru (talk) 19:06, 13 May 2015 (UTC)

Thanks so much @QuackGuru:!! I think I found what I was looking for. Would have never known to look there myself. CorporateM (Talk) 04:36, 14 May 2015 (UTC)

Lede

"In Chinese history the introduction of acupuncture is attributed to the emperor Shennong.[31]" This text should also be in the body under history. QuackGuru (talk) 21:49, 13 May 2015 (UTC)

I disagree. Historians and academics offer dramatically conflicting narratives on when and by who acupuncture was founded. It is misleading to simplify this in the Lead in a way to suggest there is more certainty than there is actually. Also, the source is extremely weak compared to the sources used in the body. It is a list of short one-paragraph biographies and I have not seen Shennong mentioned in much stronger sources. CorporateM (Talk) 05:05, 14 May 2015 (UTC)

You make a fair point. Acupuncture as currently practiced owes at least as much to Mao as it does to Shennong. Acupuncture back then was, according to at least some of the preserved instruments, actually bloodletting, and in any case the appeal to tradition is a fallacy. I don't think this belongs in the lede at all, as it is questionable. Guy (Help!) 11:58, 14 May 2015 (UTC)

I agree with Guy. TCM is a twentieth century creation. However, the practice of acupuncture goes back several thousand years. The historical information QuackGuru is suggesting is not exactly accurate either. In short, historical scholars do not know how long acupuncture has been practiced, but we know it's two thousand years at least, five thousand years likely, ten thousand years possibly. I will see if I can find a reference to this somewhere. Perhaps we could include information on both the historical context and ancient practice of acupuncture as well as the modern creation known as TCM? Or maybe this is all too complex for the lede and we should only briefly summarize it in the lede? LesVegas (talk) 12:46, 14 May 2015 (UTC)

I deleted it from the lede. The 4th paragraph in the lede is now way too short. QuackGuru (talk) 18:55, 14 May 2015 (UTC)

Dated information

"A 2006 review described the 2003 World Health Organization (WHO) report as "[p]erhaps the most obviously over-optimistic overview [of acupuncture]", noting that of the 35 conditions that the WHO stated acupuncture was effective for, 27 of the systematic reviews that the WHO report was based on found that acupuncture was not effective for treating the specified condition.[7]" This does not add much to the article. At the time it was notable but we now have more current information on effectiveness. QuackGuru (talk) 21:55, 13 May 2015 (UTC)

I note that the Quackwatch article used in the lede is only 1 year younger - can we make the same argument for replacing this?DrChrissy ^(talk) 09:54, 14 May 2015 (UTC)

I'm not persuaded. The WHO report (in reality a crowbar job by true believers that should never have been signed off) is still cited by other true believers as "evidence" that acupuncture is valid because the WHO says so. This is less so now than it was ten years ago, obviously, but it is still a current issue. As currently positioned int he article, I don't think this adds undue weight. Guy (Help!) 11:56, 14 May 2015 (UTC)

I moved it back to the ethics section and included some context. QuackGuru (talk) 18:02, 14 May 2015 (UTC)

Hahaha, according to whom? A Wikipedia editor? :-D JzG, I have notified you a multiple times that Wikipedia is WP:NOTFORUM. You editing is becoming disruptive. What's next? You'll get intervened with articles on Economics and claim that the material by World Bank is mere propaganda? Jayaguru-Shishya (talk) 18:41, 14 May 2015 (UTC)

According to V and RS. Please read the article and the sources. Simon Singh; Edzard Ernst (17 August 2008). Trick Or Treatment: The Undeniable Facts about Alternative Medicine. W. W. Norton. pp. 277–278. ISBN 978-0-393-06661-6. QuackGuru (talk) 18:45, 14 May 2015 (UTC)

QuackGuru, if you want your Talk Page posts to be considered when concluding the discussion, please learn to express yourself. For example, you could try to articulate yourself by saying: "I think X is inappropriate because the guideline Y says blablabla". Just ambiguously referring to some policy or source won't bring any weight to your post ever so far. Instead, please give a quote to support your claim. Cheers! Jayaguru-Shishya (talk) 20:45, 14 May 2015 (UTC)

I suggest you read the source above and the text in the article. Did you read it yet? QuackGuru (talk) 02:26, 15 May 2015 (UTC)

Removed material

Hello, I had restored this material to the lede and it was removed. Are these associations not notable enough or reliable enough for the article? Is American College of Physicians or the American Pain Society not nearly notable enough to be listed in the lede alongside the words of Quackwatch, per Wikipedia:Weight? LesVegas (talk) 20:57, 13 May 2015 (UTC)

Your recent edit was discussed in another thread. See Talk:Acupuncture#Recent changes. The part "have suggested the use of acupuncture for some groups of patients." is possibly SYN. We are using high-quality evidence for effectiveness. Recommendations are poor evidence. QuackGuru (talk) 21:04, 13 May 2015 (UTC)

But I have read through their recommendations and they are based on meta-analyses and systematic reviews. Can you show me where recommendations from societies and groups such as these are poor evidence? Specifically, somewhere in our policies and guidelines? Thank you in advance. LesVegas (talk) 21:17, 13 May 2015 (UTC)

I have read them. They are poor evidence according to MEDRS. We have better sources on the topic. The part "have suggested the use of acupuncture for some groups of patients." is unsourced. Thank you for your collaboration. QuackGuru (talk) 21:24, 13 May 2015 (UTC)

Specifically where in our policies and guidelines does it say they are poor sources? I hope you can be specific and point me to where in MEDRS or elsewhere these are considered poor sources, at least poorer than Quackwatch which we are apparently still using in the lede. LesVegas (talk) 21:31, 13 May 2015 (UTC)

The removed material is appropriate to include. It is the summary of input from experts and is therefore secondary, although not a scientific source.DrChrissy ^(talk) 21:34, 13 May 2015 (UTC)

See WP:MEDRS under WP:MEDASSESS. QuackGuru (talk) 21:36, 13 May 2015 (UTC)

It is not appropriate to include OR in the lede or anywhere. QuackGuru (talk) 21:36, 13 May 2015 (UTC)

Secondary sources are not OR. LesVegas (talk) 21:39, 13 May 2015 (UTC)

I too do not understand what you are referring to as OR.DrChrissy ^(talk) 21:41, 13 May 2015 (UTC)

It is irrelevant the type of source. The text itself "have suggested the use of acupuncture for some groups of patients." is OR. QuackGuru (talk) 21:42, 13 May 2015 (UTC)

Maybe I can help explain. Unless the content is specifically cited in a source it is, in an encyclopedia context, a form of OR. Best is to have a source that says what the text added to the article says, although not in the exact words of course This is a major and possibly boring difference between a research paper for example and an encyclopedia. All we can do is ref the sources. We can't comment on or summarize what we find in multiple sources. I know this can be frustrating and confusing.(Littleolive oil (talk) 21:56, 13 May 2015 (UTC))

Perhaps we can solve this by making direct quotes - dull and boring for readers, but there is information here which readers should be made aware of.DrChrissy ^(talk) 22:02, 13 May 2015 (UTC)

The sources are poor evidence according to MEDRS. Therefore, quotes won't solve the underlining problem. QuackGuru (talk) 22:05, 13 May 2015 (UTC)

edit conflict

Direct quotes are possible if from a specific source per content and if WP:RS/MEDRS and Weight are satisfied. What readers need is not so much an issue for us as WP editors. We have to deal with the sources and what they say. Sometimes that leaves the article short in our minds, but readers are not stupid and are capable of following sources to look further. If multiple MEDRS compliant sources say the same thing we can add that and weight would probably be satisfied. (Littleolive oil (talk) 22:13, 13 May 2015 (UTC))

Might be a good idea to look at the sources per MEDRS and per the content you want to add. Whether they are compliant or not is something that should be discussed among all editors active here.(Littleolive oil (talk) 22:13, 13 May 2015 (UTC))

This content that was proposed recently has no consensus to include again.[31][32][33][34] See Talk:Acupuncture#Recent changes. QuackGuru (talk) 22:21, 13 May 2015 (UTC)

Discussion preceeds consensus. I didn't look at the sources when I added to this thread but was speaking in generalities. However, what's wrong with these sources? Just curious.(Littleolive oil (talk) 22:41, 13 May 2015 (UTC))

This article seems to have "the blink of an eye" as defining the time for consensus to be reached. Some of us live in different time zones - how about waiting a couple of days, listening to discussion, before making such swathing edits.DrChrissy ^(talk) 22:56, 13 May 2015 (UTC)

Swathing edits. Sorry not sure what you mean.(Littleolive oil (talk) 23:34, 13 May 2015 (UTC))

Large scale edits such as this.[35]DrChrissy ^(talk) 09:52, 14 May 2015 (UTC)

• As I explained to Les earlier, it was first added here just 9 days ago, and then within minutes it was challenged and removed, added back, removed (by me), added back, removed again, added back, removed in a subsequent series of edits, added back again, removed again. Restoring it again without a consensus developing for it here on the Talk page can't be described as anything but (relatively slow-motion) edit-warring and it will be treated as such.

  As QG pointed out, this proposed change was brought to the Talk page here Talk:Acupuncture#Recent changes two days ago. One issue raised is that it's too much detail for the lead, Les your comment "Are these associations not notable enough or reliable enough for the article?" or comparisons with the uses of other sources don't address these points and so aren't convincing arguments. Zad68 01:58, 14 May 2015 (UTC)

Thank you for providing those diffs Zad. I was not aware that you removed this material multiple times. If the material is too detailed for the lede, perhaps we could make it less detailed? Do you have any suggestions along those lines? LesVegas (talk) 02:18, 14 May 2015 (UTC)

And it appears as though some editors feel that it adds balance to the lede which heavily relies on critical reviews from Edzard Ernst and statements from Quackwatch. If editors feel that it adds too much detail to the lede, perhaps we could trim other details? We need to achieve balance here. Addition or subtraction are the only ways I know to do it. LesVegas (talk) 02:35, 14 May 2015 (UTC)

I don't see any suggestion that anyone wants to readd the content, but I've only made few cmts here and not sure of all of the discussions. I stopped by to try and help explain OR in this situation. OR can be confusing. IRR is always useful for everyone in this kind of situation. (Littleolive oil (talk) 03:33, 14 May 2015 (UTC))

A1 Candidate wanted to re-add the content and Jayaguru Shishya wanted to as well. They mentioned it in other places. Here, both DrChrissy and I wanted it back in. What are your thoughts about the content Littleoliveoil? LesVegas (talk) 03:45, 14 May 2015 (UTC)

I'll look tomorrow. No opinion at this point. I haven't been keeping up so would have to look at the sources - context, weight carefully. My cmts here were more general.(Littleolive oil (talk) 04:05, 14 May 2015 (UTC))

We do not need to have a "balance" here, LesVegas. We need to clearly state what the mainstream scientific and medical communities think, and acknowledge the existence of fringe, mystical, and philosophical views. We should never, under any circumstances, portray the fringe and mystical views as having equivalence to the mainstream scientific and medical views.—Kww(talk) 10:49, 14 May 2015 (UTC)

• The inclusion of this material is self-evidently disputed. If LesVegas (or anyone else) wants to include it, then start an RfC and let an independent editor judge whether consensus exists. Guy (Help!) 12:03, 14 May 2015 (UTC)

I see a lot of objection from User:QuackGuru, but after all, it all comes to the quality of arguments. And unless you can express yourself well enough, any of your objections carry no weight, I'm afraid. Anyway, this is not the place to learn argumentation skills. Cheers! Jayaguru-Shishya (talk) 18:38, 14 May 2015 (UTC)

The text is clearly original research and does not summarise the body. QuackGuru (talk) 18:56, 14 May 2015 (UTC)

User:QuackGuru, if you want your comment to have any weight, please articulate yourself better. For example: "Recommendations are poor evidence", why they are poor evidence? "I have read them. They are poor evidence according to MEDRS.", why are they poor evidence according to MEDRS? "See WP:MEDRS under WP:MEDASSESS.", what are you exactly trying to say? "The sources are poor evidence according to MEDRS.", why? "The text is clearly original research", why is it clearly original research?

Please learn to express yourself first. Meanwhile, I am afraid, we have to ignore all your null objections. Once you have done that, we can continue the discussion again. Cheers! Jayaguru-Shishya (talk) 20:52, 14 May 2015 (UTC)

They are poor evidence because they are opinions not scientific evidence. It clearly original research because the text is unsourced. QuackGuru (talk) 02:29, 15 May 2015 (UTC)

Bibliography

• Aung, SKH; Chen WPD (2007). Clinical Introduction to Medical Acupuncture. Thieme Medical Publishers. ISBN 9781588902214.
• Barnes, LL (2005). Needles, Herbs, Gods, and Ghosts: China, Healing, and the West to 1848. Harvard University Press. ISBN 0674018729.
• Cheng, X (1987). Chinese Acupuncture and Moxibustion (1st ed.). Foreign Languages Press. ISBN 711900378X.
• Cheng, X (2010). Chinese Acupuncture and Moxibustion (3rd ed.). Foreign Languages Press. ISBN 9787119059945. OCLC 624373192.
• Needham, J; Lu GD (2002). Celestial Lancets: A History and Rationale of Acupuncture and Moxa. Routledge. ISBN 0700714588.
• Singh, S; Ernst, E (2008). Trick or Treatment: Alternative Medicine on Trial. London: Bantam. ISBN 9780593061299.
• Stux, G; Pomeranz B (1988). Basics of Acupuncture. Berlin: Springer-Verlag. ISBN 354053072X.
• Stux, G; Pomeranz B (2012). Basics of Acupuncture. Springer-Verlag. ISBN 9783642491139. OCLC 878966679.
• Wiseman, N; Ellis, A (1996). Fundamentals of Chinese medicine. Paradigm Publications. ISBN 9780912111445.
• Madsen, M. V.; Gøtzsche, P. C; Hróbjartsson, A. (2009). "Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups". BMJ. 338: a3115. doi:10.1136/bmj.a3115. PMC 2769056. PMID 19174438.

I did not restore all of these. I only restored the ones that were interlinked with the references in the reference section. There are the full citations for the short citations. Is there anymore that should be restored? QuackGuru (talk) 19:51, 13 May 2015 (UTC)

I disagree with the need to have a bibliography. Ideally sources included in a Further Reading section are just 1-3 that are the most reputable works on the subject. I have found none so far that would truly qualify. CorporateM (Talk) 04:32, 14 May 2015 (UTC)

This discussion is not about having a bibliography in general. This is about linking the short citations with the full citations. The short citations in the references section link to the long citations in the bibliography section. See Acupuncture#cite_note-21 and see Acupuncture#cite_ref-21 and see Acupuncture#CITEREFSingh_.26_Ernst2008 for examples. QuackGuru (talk) 02:44, 15 May 2015 (UTC)

German acupuncture trials

Just something I came across while looking at the Reception section. If our Wikipedia article on the topic is to be believed, it is one of the largest investigations into the efficacy debate ever done at a cost of 7.5 million Euros. Yet I do not see it anywhere in the article (given the size of the page, it's possible I missed it). It apparently found it to be effective for back pain and knee osteoarthritis (whatever that is), but not for headaches or migraines.

I do not myself even understand the concept/argument for how sticking needles in your skin is suppose to reduce pain (sounds painful itself to me). But maybe someone with greater interest/expertise may want to consider adding it using the sources already collected on the corresponding Wikipedia page. Alternatively, I may get to it eventually. CorporateM (Talk) 18:39, 14 May 2015 (UTC)

Hi. Are you referring to reference #295?DrChrissy ^(talk) 20:36, 14 May 2015 (UTC)

These are individual studies, so they are excluded per WP:MEDRS. Reviews discussing these trials are perfectly welcome, however. Everymorning talk 23:06, 14 May 2015 (UTC)

Reviews discussing the effectiveness of acupuncture based on these trials belong at the German acupuncture trials page. QuackGuru (talk) 02:22, 15 May 2015 (UTC)

Yes, citation 295, but it's only currently used to state that the trials caused a 20% increase in acupuncture use; it is very awkward that the actual results of the study are not included, considering they caused a country to change their insurance practices and was one of the largest studies ever done on the efficacy debate. We begin to state its impact, but not explain its results, as if we're dancing around the issue. It has its own article, but I see no reason not to summarize it here. I'm sure there are plenty of sources independent of the study itself that could be used and if not for medical claims, it is important historically. CorporateM (Talk) 08:27, 15 May 2015 (UTC)

Related practice

Recent (i.e. post-2011) reviews in both veterinary text books[2][17][18][19] and scientific journals[20][21][22][23][24] indicate that acupuncture can be used for therapeutic or homeostatic effects in animals, especially in the three areas of pain management, geriatric medicine and sports medicine.[improper synthesis?]

This is poorly written. See Veterinary acupuncture#Efficacy. QuackGuru (talk) 02:33, 15 May 2015 (UTC)

I think the tag should stay until the text is rewritten. QuackGuru (talk) 19:16, 15 May 2015 (UTC)