Talk:German acupuncture trials/Archive 3

Archive 1

Archive 2

Archive 3

Recommend treating Howick source as a pseudoscience proponent

On the basis of this credulous website: [1], I believe that the reliability of his book is fairly well impeached. jps (talk) 17:46, 25 February 2014 (UTC)

OTOH[2] Alexbrn ^{talk|contribs|COI} 17:56, 25 February 2014 (UTC)

Yep, he is at Oxford. Doesn't mean he's not a pseudoscience proponent. There are a lot of pseudoscience proponents infesting various academic institutions, believe me. jps (talk) 18:00, 25 February 2014 (UTC)

Especially at Oxford ;-) But he is well published. Mind you, that photo is now etched on my mind. Alexbrn ^{talk|contribs|COI} 18:12, 25 February 2014 (UTC)

jst you'll need a reliable source calling that book pseudoscience to make that claim; a review in JAMA or the like.Jytdog (talk) 18:35, 25 February 2014 (UTC)

I'm not recommending we call the book pseudoscience in the article. I'm just recommending that we treat it carefully and not use it as an objective source for this page (or any other). jps (talk) 19:48, 25 February 2014 (UTC)

I don't think we should discount an author just because he teaches yoga classes. The reason I've objected to Howick (e.g. [3]) is that his indictment of sham acu is plainly contrary to the consensus of most reviewers, who say sham is a valid control. (Howick used to be used in the lede (2nd para) to dispute the relevance of GERAC's results; ironically, this probably looked to some editors like a strong EBM proponent criticizing weak acu-promoting trials -- hence a lot of the votes to delete in the last AfD.) --Middle 8 (leave me alone • talk to me • COI) 23:43, 27 February 2014 (UTC)

It's really not just that he teaches yoga classes. You should read the entire website for the full effect. Be that as it may, I am fairly appalled at how poor his scholarship is and his work on evidence basis is pretty atrocious. I am dismayed that he is apparently ensconced in the British academic establishment as a legitimate critic of evidence basis (he seems to be a concern troll of the worst sort, actually). I'm glad we agree to remove him as a source, though. jps (talk) 21:58, 5 March 2014 (UTC)

jps and User:Middle 8: in his test edit of today, QuackGuru has reintroduced Howick for this content "A 2011 assessment of the trials judged that since the sham acupuncture was not a well-designed placebo, they were unlikely to have emitted clinically significant findings", without making clear that this is a pseudoscience source, and also put it in, next to Novella as a source for statements about the overall outcome. Jytdog (talk) 17:57, 30 March 2014 (UTC)

Impeaching another source: Focus (de)

[4].

This has got to be one of the worst sources I've read in a long time and really should not be used in this article. The source waxes eloquent about acupuncture topics without actually dealing with the outcomes of the trials. It is a terrible article and should not be used as a source for anything as they obviously don't get the basics of the story right at all and spend most of the rest of the article shilling for acupuncture. This would be the equivalent to a public relations churn. Let's remove it.

jps (talk) 12:11, 26 February 2014 (UTC)

it is indeed fluffy. we can do much better, i would think. Jytdog (talk) 13:38, 26 February 2014 (UTC)

News source

Of possible use: "Fake acupuncture works nearly as well as the real thing for low back pain..."

"Dr. Heinz Endres of Ruhr University Bochum in Bochum, Germany, said... [p]ositive expectations the patients held about acupuncture — or negative expectations about conventional medicine — also could have led to a placebo effect and explain the findings."

[5] jps (talk) 13:23, 26 February 2014 (UTC)

hey jps, would you please sign your comment above. This seems to be cherry-picking of his full quote "'Acupuncture represents a highly promising and effective treatment option for chronic back pain,' study co-author Dr. Heinz Endres of Ruhr University Bochum in Bochum, Germany, said in an e-mail. 'Patients experienced not only reduced pain intensity, but also reported improvements in the disability that often results from back pain and therefore in their quality of life.'... Although the study was not designed to determine how acupuncture works, Endres said, its findings are in line with a theory that pain messages to the brain can be blocked by competing stimuli. Positive expectations the patients held about acupuncture — or negative expectations about conventional medicine — also could have led to a placebo effect and explain the findings, he said." Jytdog (talk) 13:36, 26 February 2014 (UTC)

The full quote is fine too. I just found it interesting that the co-author would point out that the placebo effect can explain the findings -- a perspective that seems to get short shrift in our article. jps (talk) 17:09, 26 February 2014 (UTC)

I hear you on that. As I read the literature, I find there are plenty of scientifically-minded people interested in testing acupuncture who, like good scientists, do not go beyond the evidence in asserting claims about efficacy, and who are frankly acknowledge that there is no known mechanism by which it might even work; there are science-based hypotheses but nothing is known. Jytdog (talk) 13:36, 28 February 2014 (UTC)

Results of RfC are not reflected in current article

Ya'all had an RfC above on the level detail in the article. Here is the version cited by QG when he set up the RfC as his preferred example of containing " fewer low-level details". However the current article lacks the detail found even there. I think the version that QG proposed is reasonable and it was supported in the summary of the RfC. And I don't see any reasoned discussion of why the level of detail was moved yet lower. I intend to restore the RfC-validated level of detail. Objections? If so, they should be based on changes to PAG or new sources that emerged subsequent to the RfC, or somebody should explicitly say "I changed my mind" and give reasons... Jytdog (talk) 13:30, 26 February 2014 (UTC)

I object. First, I don't now what PAG is. Secondly, I don't think that the RfC is binding on content. Thirdly, in comparison, the version cited contains some sources that we've seemed to agree we should remove (He et al., for example). It would be unwise to reintroduce them. Finally, the article as it stands right now includes a lot of problematic sources that I'm still working through. If you are going to go ahead and add more content and (presumably) more sources, I'd like you to explain why they are good additions on the talkpage first. Some additional content may be good, but some of it may not be warranted. The differences between the two versions is too great to be able to tell in one fell swoop. Thanks. jps (talk) 17:10, 26 February 2014 (UTC)

sorry for being too slangy! WP:PAG = policies and guidelines. jps you are absolutely right that RfCs are not binding, but in the process of building consensus (which in all AGF I believe we are all doing), the results of RfCs form milestones that should not be tossed aside without consideration - that is why I asked for solid reasons why we would move away from it. I reviewed the discussion above and didn't find any. btw jps I think the work you are doing evaluating sources is great, and can proceed even if this content is reinstated... thanks for doing it! Jytdog (talk) 17:26, 26 February 2014 (UTC)

Except that the link you mentioned contains some of the sources that we already removed from the article. If you just revert back to that version, all those sources come back. You'll have to do it piecemeal anyway, so why not just justify the reincluded material here? I don't want to abandon previous discussions and decent work of others, but neither do I want to have to redo my own work! jps (talk) 18:05, 26 February 2014 (UTC)

awesome. ok so you are not (in theory) opposed the previously agreed level of detail. I will get to work seeing if any the clearly good sources we have here (not marginal ones) support any of that and will propose re-introducing content and sources in a new section below so we can all be sure we are comfortable... unless somebody else objects theoretically here. i don't want to waste my time. thanks Jytdog (talk) 18:28, 26 February 2014 (UTC)

There was a previous discussion about trimming the individual trials. QuackGuru (talk) 04:25, 27 February 2014 (UTC)

God the threading in this Talk page is horrendous. OK, this is kind of what I meant above. Please give a reason why you changed your mind, QG. You proposed the longer version! I note that in article about a clinical trial it is difficult to see how content actually describing the trial design is undue weight; that claim doesn't really hold water in any case.Jytdog (talk) 07:26, 27 February 2014 (UTC)

You're becoming increasingly volatile in your talkpage discussions. Can you please calm down? QG posted a very short sentence that referenced a previous discussion, and you're accusing him of "changing your mind" on that basis? Perhaps you should consider taking a break from this rather oppressively hot kitchen rather than setting more fires. jps (talk) 17:38, 3 March 2014 (UTC)

I don't see Jytdog becoming volatile here at all... I'm actually impressed how patient he is with QG. --Mallexikon (talk) 02:03, 4 March 2014 (UTC)

I'm happy to wait and see what Jytdog has in mind. jps (talk) 18:37, 4 March 2014 (UTC)

Steven Novella

In Science Based Medicine: "Verum (or true) acupuncture and sham acupuncture treatments are no different in decreasing pain levels," says Steven Novella, referring to GERAC. [6]

jps (talk) 05:47, 27 February 2014 (UTC)

Novella, referencing GERAC in Skeptical Inquirer Volume 35.4, July/August 2011:

"Some trials also control for the variable of needle insertion, using placebo or simulated acupuncture in which opaque sheaths are used and a dull needle is pressed against the skin when the plunger is depressed, but there is no skin penetration. Alternatively, toothpicks have been used to simulate the sensation of acupuncture without going through the skin. Again, when this variable is isolated, it turns out that simulated acupuncture works as well as verum acupuncture. This is true of the largest and best trials of acupuncture for the most common uses, such as reducing back pain (Haake et al. 2007) and treating nausea (Enblom et al. 2011).

"Therefore, if we define acupuncture as using needle insertion to stimulate acupuncture points, and the best scientific evidence shows that acupuncture points do not exist (it doesn’t matter where you stick the needles) and needle insertion has no effect (it doesn’t matter whether or not you stick the needles), then does acupuncture work? I think the only reasonable answer is no; there is no reality to acupuncture or the concepts upon which it is based."

Note that (Haake et al. 2007) is GERAC.

jps (talk) 05:55, 27 February 2014 (UTC) ::Thanks for bringing up this interesting debate. Reading that blog post, it says that "About a year ago the editors of Anesthesia & Analgesia solicited a written debate on whether or not acupuncture is effective or simply an elaborate placebo. Four experienced acupuncture researchers agreed to write the pro-acupuncture article, Wang, Harris, Lin and Gan. They asked David Colquhoun to write the con position, and David asked me to write it with him (which, of course, I enthusiastically agreed to do). The article is fortunately published in open access, and so I can reprint it here (full article is below). What I think David and I convincingly demonstrated is that, according to the usual standards of medicine, acupuncture does not work." So, if we are going to use the Novella article from this journal, then we can also use the Wang, Harris, Lin and Gan article? Jytdog (talk) 10:12, 27 February 2014 (UTC)

Damn it I got sucked into the game. This article is about a specific set of clinical studies, not about acupuncture in general. Your insistence on attacking the intervention being tested, is off-target and disruptive. Please stop. Thanks. Jytdog (talk) 10:39, 27 February 2014 (UTC)

Um, the reference was to the fact that Steven Novella, a subject-matter expert, referenced this study in the above posts. It was not meant as an "attack on the intervention" nor is it off-target since it specifically references this specific set of clinical studies. Please be more careful before flying off the handle. jps (talk) 17:35, 3 March 2014 (UTC)

Birch source and more set-up details

I included material from the Birch source to present the acu-proponents criticism of GERAC: it centers mainly around alleged inadequate training of the participating acupuncturists, and a "too powerful" placebo. In order to put this criticism into perspective, I think it is important to include some information about participating acupuncturists' training and sham acupuncture design in our set-up section. --Mallexikon (talk) 08:31, 27 February 2014 (UTC)

Fringe criticisms are irrelevant and have no weight. This is for the same reason that we do not include astrologers rebuttals of tests of astrology because they have no weight (and they are also an irrational defence of their preconceived beliefs). These "rebuttals" always exist, but the due weight is generally not there for them to be included since they aren't discussed by non-fringe sources. If you want it included, source it to a real journal, WP:FRIND, WP:MEDRS Second Quantization (talk) 13:07, 2 March 2014 (UTC)

Your personal likings are irrelevant here. Before you wield WP:FRINGE around, I recommend you read it more carefully. It emphasizes that "Care should be taken with journals that exist mainly to promote a particular viewpoint. Journals that are not peer reviewed by the wider academic community should not be considered reliable, except to show the views of the groups represented by those journals" and that's the guideline we stick to. An illuminative example of this is given in WP:FRINGE#Quotations. So I've re-added the material in question. If you want to delete it again, please show that you have a real reason to violate WP:Revert only when necessary. --Mallexikon (talk) 04:15, 3 March 2014 (UTC)

stepping back for a sec; mallexikon can you please say briefly why it is important to include this content? Thanks Jytdog (talk) 04:26, 3 March 2014 (UTC)

I don't really understand the added text ("the verum acupuncture suffered"? "inert"?) Alexbrn ^{talk|contribs|COI} 04:31, 3 March 2014 (UTC)

come on alexbrn! the article said that the people giving the true acupuncture were not as competent as they could have been, and that the sham acupuncture equipment really had an effect - the result being that the measured efficacy was lower than it could have been, and the placebo was higher than it should have been - and that is why the treatment looked no better than placebo. that could have been said in more simple english, but i reckon that the acknowledgedly highfallutin language is somewhat a product of the feeling hounded over fringeness. Jytdog (talk) 04:44, 3 March 2014 (UTC)

...or of my English sucking. Sorry. Please feel free to paraphrase.

Regarding why I think it is important to include this text: to give a balanced view of the subject. GERAC attracted a lot of commentary; both by acu-opponents and acu-proponents (and the acu-proponents' criticism IMO is BS). --Mallexikon (talk) 04:57, 3 March 2014 (UTC) --Mallexikon (talk) 04:57, 3 March 2014 (UTC)

Can you workshop here what your proposed inclusion would look like? If it is properly weighted so we it's clear that it's the opinion of pseudoscientists, then we might be able to move forward. Is there any evidence that the competency level of acupuncturists affects outcomes? I haven't seen any independent evidence to that effect, just complaining that is done in WP:FRINGE sources and so not admissible as anything but pseudoscientific protestations. jps (talk) 14:20, 3 March 2014 (UTC)

I tried to word it better [7]. Regarding evidence that the competency level of acupuncturists affect outcomes... no, haven't seen any study about this. We couldn't discuss it in this article anyway, though. --Mallexikon (talk) 01:58, 4 March 2014 (UTC)

(refactor: moved discussion of another journal below to own section)

• Mallexikon, WP:FRIND clearly states that independent sources are required to establish weight. There is no onus on the article to provide the opinions of acupuncturists outside of reliable sources, particularly when they aren't being portrayed as such in the text. Second Quantization (talk)

this is on point. I think the perspective given in JCM is interesting but I too am curious about the weight it deserves, but from a different angle. The Birch article is remarkably tendentious (and almost offensively so! ) - the idea that only Chinese acupuncturists have the proper training and approach really underlines how esoteric and almost magical acu must be to Birch et al ... But one thing i am curious about is how mainstream the view of Birch et al is, even among acu-proponents. I can't imagine it is very common among western-trained acupuncturists! Jytdog (talk) 12:15, 4 March 2014 (UTC)

Determining what is the prevalent viewpoint is generally difficult amongst pseudoscientists. They tend to view their own approaches as the dominant way. A good example is in astrology where some groups declare it a religion and find claims that it acts like science to be offensive, while another group declares it to be a science and find it offensive if it's compared to a religion or divination. It's also a good part of why we look to external sources, Second Quantization (talk) 16:20, 4 March 2014 (UTC

@Second Quantization: Wikipedia:FRINGE#Peer-reviewed sources says "Journals that are not peer reviewed by the wider academic community should not be considered reliable, except to show the views of the groups represented by those journals". An illuminative example of this is given in WP:FRINGE#Quotations. However, if you think that the acupuncturists' views are not being portrayed as such in our text, I'll be happy to change the text accordingly.

@Jytdog: I also think Birch's article is tendentious, however, to his defense, I think you misunderstood him... I don't find him calling for Chinese acupuncturists. He just compares the German requirements (regarding hours of study) for acupuncture-practicing physicians with the requirements in UK, NZ, Australia etc. (who seem to have higher requirements) and the WHO guidelines (which seem to be met by German requirements). --Mallexikon (talk) 02:58, 5 March 2014 (UTC)

yep, my bad. i was thinking about the He article. stupid me. birch is much more even-handed than He. yes. Jytdog (talk) 12:52, 5 March 2014 (UTC)

I think this is controversial text not from a mainstream journal. How about this text? QuackGuru (talk) 04:18, 5 March 2014 (UTC)

I frankly don't get it why you think that the Birch source should be used to comment on the Federal Joint Committee's decision (to reimburse acupuncture), but at the same time shouldn't be used to comment on the GERAC trials (which happen to be the nominal subject of this article). What kind of rationale is that? --Mallexikon (talk) 04:27, 5 March 2014 (UTC)

pls see below on the rationale.. let's discuss that separately. Please note that QG did end up proposing quite good language here, which was great. Said the exact thing that Mallexikon wanted to say but tighter and cleaner. Thanks for that QG! I think we have some straight-up horse trading going on... see below.Jytdog (talk) 12:52, 5 March 2014 (UTC)

Maybe this could work but other editors would have to agree. I was reading the summary.QuackGuru (talk) 04:52, 5 March 2014 (UTC)

Mallexikon, you are selectively reading WP:FRINGE, as I've already mentioned, WP:FRIND says "Points that are not discussed in independent sources should not be given any space in articles. Independent sources are also necessary to determine the relationship of a fringe theory to mainstream scholarly discourse." You need independent sources to say that this fringe opinion has weight, Second Quantization (talk) 11:15, 5 March 2014 (UTC)

Thanks for replying to my question above, 2Q, about whether the view in Birch is mainstream among acu-proponents. Mallexikon and Middle8, 2 questions. 1) In your opinions as experts in this field, is the view in Birch questioning the validity of the skills of the german acupuncturists mainstream in the field? (not valid for supporting content, just trying to get a sense) 2) If so, I would think there would be other sources that say the same thing -- can you bring any? I do note that the He source we already excluded, also states that. Thanks! Jytdog (talk) 12:52, 5 March 2014 (UTC)

Of those others if they exist, it is the non-pseudoscientific which are required for WP:FRIND. Independent means independent of fringe proponents. Second Quantization (talk) 21:17, 5 March 2014 (UTC)

@Jytdog: Thanks for flattering me, but I wouldn't call myself an expert in this field. And no, I don't know if Birch's criticism is mainstream in the field. Regarding point 2.) I don't know what you mean. I try to include an acu-proponent's view on GERAC here. That would naturally come from a fringe journal, no?

@2ndQ: Sure, "points that are not discussed in independent sources should not be given any space in article", but the point here is assessment/criticism of GERAC. We have several independent sources discussing this point. The Birch source would only be used to show the specific assessment of the acu-proponents. I can't see how I would be selectively reading WP:FRINGE. Your point seems to be that the views of proponents of pseudoscience (in the case of acupuncture, it's actually questionable science, to be correct) should never and under no circumstances be mentioned at WP. Am I right? --Mallexikon (talk) 09:11, 6 March 2014 (UTC)

No, you are completely wrong as should be self evident from what I wrote. Re-read what I wrote. Second Quantization (talk) 11:59, 6 March 2014 (UTC)

Acupunct. Med. a fringe journal?

(refactor: journal in question unrelated to above discussion; moved to own section)

Is Acupuncture In Medicine really a fringe journal just because of its subject matter? The "independent sources" part of WP:FRINGE has been construed more narrowly than in academia. See Independent sources & refs therein. Dependence isn't a function of a journal's topic in the real world; it actually has to do with external relationships (e.g., a reviewer being the parent of an author). No important conflicts -- according to prevailing standards in academia -- are declared by its editorial board (most/all of whom practice acu, not surprising given the subject matter, and have additional qualifications as well). The journal appears to fulfill WP's other tests for sources, such as peer review and indexing; furthermore, studies published in it have been used by Cochrane and in other accepted MEDRS's, and MD's and PhD's publish in it (e.g. Ernst). "Dependence" seems to have been misinterpreted by editors unfamiliar with what it actually means. Why should WP have different standards than academia -- are we supposed to be more prestigious or something? Sounds like pretension to me. --Middle 8 (leave me alone • talk to me • COI) 02:38, 4 March 2014 (UTC)

I am with Middle8 on this one (although i could do without the unproductive editorializing in the last 2 sentences - please AGF for those who see the journal as questionable). If there is really a dispute over this, I would be happy to bring this journal to the MEDRS Talk page and get more input on the question... Jytdog (talk) 03:00, 4 March 2014 (UTC)

If it really is a peer-reviewed source, it's reliable. WP:Fringe theories#Reliable sources is very specific about this: "Reliable sources on Wikipedia include peer-reviewed journals; books published by university presses; university-level textbooks; magazines, journals, and books published by respected publishing houses; and mainstream newspapers. Academic and peer-reviewed publications are usually the most reliable sources in areas where they are available, but material from reliable non-academic sources may also be used in these areas." Also cf. WP:Fringe theories#Peer-reviewed sources.

But why are we having this discussion? Even if this source was not peer-reviewed, it still should be used in order to present the acu-proponents' point of view here. --Mallexikon (talk) 05:00, 4 March 2014 (UTC)

The question is whether the articles in the journal are considered reliable; if so review articles in this journal could be MEDRS-compliant and more broadly useful. Jytdog (talk) 05:12, 4 March 2014 (UTC)

Agreed (and struck; sorry, just venting about the idea; nothing personal intended, but it sounds wrong). --Middle 8 (leave me alone • talk to me • COI) 05:44, 4 March 2014 (UTC)

Do we have any evidence that this journal is peer-reviewed? I couldn't find any. --Mallexikon (talk) 06:00, 4 March 2014 (UTC)

Look right under the title that's in the big blue box at aim.bmj.com (assuming that they are a valid source about themselves :-) --Middle 8 (leave me alone • talk to me • COI) 07:21, 4 March 2014 (UTC)

Why are you talking about the wrong journal? Did you even read the edits under discussion? Second Quantization (talk) 10:45, 4 March 2014 (UTC)

yes 2Q, this is not on topic for the Birch source - that's been bothering me a bit but i didn't make a fuss over it. but it should be in a separate section. thanks for making this explicit - birch was published in Journal of Chinese Medicine not Acupuncture In Medicine.Jytdog (talk) 12:15, 4 March 2014 (UTC)

Fixed, sorry. --Middle 8 (leave me alone • talk to me • COI) 06:28, 5 March 2014 (UTC)

I don't think a journal published by BMJ Group can be dismissed as fringe. TimidGuy (talk) 11:27, 5 March 2014 (UTC)

Who publishes it hardly matters. What matters is its editorial policy and it is clear that this one does not promote independent review. Therefore, it is only reliable for the opinions of acupuncturists. jps (talk) 12:11, 5 March 2014 (UTC)

Whoever publishes also determines editorial policy -A1candidate (talk) 12:26, 5 March 2014 (UTC)

Do you have evidence of that for this journal? jps (talk) 12:34, 5 March 2014 (UTC)

Hey all quick note. I posted a question on this on the MEDRS talk page, here. If you choose to participate there, please don't battle each other there as it will bore the pants off third parties and drive them away, and it would be useful to get independent input. Please just make your own argument on the question and let others chime in. (That's what I want, but ya'all will of course do as you will do!) Jytdog (talk) 13:28, 5 March 2014 (UTC)

"decision was made in part on the results of the trials and in part for socio-political reasons"

Let's talk about this separately: "The Journal of Chinese Medicine found that this decision was made in part on the results of the trials and in part for socio-political reasons". Note that "this decision" refers to the decision to reimburse acu. QG has been pushing for this language for a while - however the earlier version of it stated it in Wikipedia's voice: "This decision was made in part on the results of the trials and in part for socio-political reasons". I can see how this language is very useful for the acu-skeptics; it says explicitly that Germany decided to reimburse acu not just based on the science, and so provides a very useful block to acu-proponents who want to point to the Germany approvals and say "see? it works!", which I understand has been happening. I see how this is very useful. The double-irony is that Mallexikon has been the main one wanting to include this source in the article, albeit for the narrowly stated purpose of giving the acu-proponents' view on the outcome, so that we cover the whole range of reactions. The triple irony is that other acu-skeptics here have wanted to exclude the source altogether for being fringe. The quadruple irony, is that as I discuss below in b), Birch is trying to use the "socio-political" angle to argue that acu should be more widely reimbursed. So there are just layers and layers here, making this all very difficult. So here are some points. i am signing each separately to invite interposed comments. Jytdog (talk) 12:52, 5 March 2014 (UTC)

• a) my sense is that QG is offering some horse-trading here in what I see as an effort to try to reach consensus. The deal is: QG offers support for using this source to describe acu-proponents' critique of the trials' design, execution and results, in exchange for Mallexikon accepting this content about why reimbursement really happened. Above Malllexikon rejected the implicitly offered deal. I am not sure Mallexikon was aware there was a deal on the table. I am also not sure that horse-trading is the best way to get the most excellent content, but sausage gets made in many ways. I also am not sure that the deal can survive other editors' scrutiny, as the source itself is being contested altogether. Jytdog (talk) 12:52, 5 March 2014 (UTC)

• b) What the Birch text has to say about these "socio-political" reasons is interesting. Mostly Birch focuses the socio-political analysis on the the trial design (including the selection of indications to be tested). (see right column of page 12 to left column of page 13). He seems to think that the trial design was a dog's breakfast because "They tried to address scientific and socio-political questions at the same time" and his subsequent discussion of results and reactions, is based on his judgement of which kind of question (scientific or socio-political) was being asked, and which question those reacting to the trial cared about. In my opinion (I am owning that this is my opinion) Birch's discussion, especially on page 13, is fringe-y and ditto his restatement of it in the penultimate sentence of the article. ( to borrow from SNL: really? including a placebo/sham is not scientific? really??) I think that where Birch is coming from, is that he believes that acu should be much more widely reimbursed. His purpose in writing this article is to try to argue that sham/placebo should not be included in future designs, and that it was the inclusion of this feature that led to acu being less reimbursed than it should have been. Jytdog (talk) 12:52, 5 March 2014 (UTC)

• c) Although Birch spends most of this "socio-political" analysis on trial design he has a very brief discussion of the decision to reimburse or not, and near the end of the article he states: "Will the fact that specific German socio-political factors influenced the choice of study, their design and the interpretation of results be taken into account by scientists and health care analysts in other countries?" So, importantly, there is literal support in this source, for the specific content that QB wants to include in the article. That is important.Jytdog (talk) 12:52, 5 March 2014 (UTC)

• d) It would be great if there was discussion of non-scientific factors related to the decision to reimburse or not, in sources acceptable to everybody. If such sources do not exist, discussion of the idea cannot rise to the lead of the article but need to remain isolated with the rest of what Birch has to say. QG are there sources really acceptable to you for non-scientific influences on the decision to reimburse? Jytdog (talk) 12:52, 5 March 2014 (UTC)

• e) here is my take. If we keep the source and the language being discussed above, I think it is reasonable to include in the same block of text being discussed above, something like this "Birch found that the the design of the trial and decisions about reimbursement were shaped in part by socio-political reasons" But it should stay isolated to the this "acu-proponent" block of content, and should not rise to the lead.Jytdog (talk) 12:52, 5 March 2014 (UTC)

• 1. The text does not make it obvious that this is by proponents 2. Sources independent of the proponents do not draw attention to this paper. 3. There is no obvious evidence that this is a common position amongst Acupuncturists. Second Quantization (talk) 12:08, 6 March 2014 (UTC)

Thanks, 2Q. I think that naming the journal from which the content comes was a good faith effort to signal that it is from proponents, but I agree it should be more explicit (if we keep it). I agree with your 2) and 3) which is why I say "if" and why I asked Mallexikon and Middle8 if they are aware of any sources that also say this (any sources at all - we can then look at their quality). Jytdog (talk) 13:42, 6 March 2014 (UTC)

1.) I think Jytdog's proposal (e) is a good solution, and I agree that we could change the text to emphasize that this is an acu-proponents' view.

2.) True, but why do you demand that? This is a non-independent source that would only be used to demonstrate an acu-proponents' view on GERAC.

3.) True, but why do you demand that? And what kind of evidence could that possibly be? The result of a world-wide poll among acupuncturists? --Mallexikon (talk) 01:31, 11 March 2014 (UTC)

On 2) and 3) - not demanding anything... really 2Q is assuming, as i am, that if this view is common, it should be in other sources. not just this one. do you know of any? Jytdog (talk) 04:12, 11 March 2014 (UTC)

Well, the He at al. source similar focused its criticism on the sham concept. This acu-proponents' online article is less sophisticated than Birch; it simply states that "Acupuncturists have noted that the success of sham acupuncture noted in that particular study of 1,162 patients in Germany reveals that poorly placed acupuncture needles also derive benefit for the patient." Which in my understanding amounts to criticism on the sham concept as well (i.e., they're not too surprised by this being an active treatment. Interestingly). --Mallexikon (talk) 06:37, 11 March 2014 (UTC)

It is specifically in the guidelines that a non-independent source should not be used when there are no independent reliable sources highlighting the same thing WP:FRIND. This is because what an acupuncturists thinks is important isn't the same as what the mainstream does, and wikipedia highlights what is in the mainstream interest. Using other dodgy websites is irrelevant. Second Quantization (talk) 08:16, 11 March 2014 (UTC)

You are misinterpreting WP:FRIND. It says: "In particular, the relative space that an article devotes to different aspects of a fringe theory should follow from consideration primarily of the independent sources. Points that are not discussed in independent sources should not be given any space in articles."

1. This is not an article about a fringe theory, but about a medical trial. So WP:FRIND doesn't really apply.
2. Even if this was an article about a fringe theory, you'd still be misusing this guideline. "Points that are not discussed..." clearly refers to "different aspects of a fringe theory". That doesn't mean we have to have an independent source saying exactly the same as an unreliable one. It just has to cover the same aspects (in this case, criticism about GERAC's set-up). If we would have an independent source saying the same as an unreliable one, what would be point in using the unreliable one in the first place? We use unreliable sources "to show the views of the groups represented" by these sources. WP:FRINGE uses this example: "in the article about Bigfoot, a verifiably attributed and accurate quote might take the following form:

   The Bigfoot Field Researchers Association has stated, 'Scientists from various disciplines put the most compelling sasquatch evidence to the test. Collectively their conclusions are ground-breaking. There is now scientific proof for the existence of a giant primate species in North America – a species fitting the descriptions of sasquatches (bigfoots).'"

   --Mallexikon (talk) 04:02, 12 March 2014 (UTC)

WP:FRIND applies to all aspects of a fringe theory. A guideline that only applied to material in the main article would make zero sense and would be illogical. Read WP:FRINGE. It is not talking about the main article of a fringe theory. WP:FRINGE applies in any article where a fringe theory is involved (I have over 20,000 edits to fringe theories articles. I have poured over the wording of sections in WP:FRINGE on an almost daily basis for 2 years (as any editor of the fringe must). I'm fairly sure I have not consistently misunderstood this basic aspect of the guidelines for several years and without someone telling me so). I said " Sources independent of the proponents do not draw attention to this paper." That is my text, somehow you convert that into a strawman that I think independent sources should exactly duplicate the pseudoscience sources. Read what I write, don't fill in the gaps with things I have not said. Find those independent sources. You also cherry picked the text about bigfoot that sutied you, without reading the wider context of that section: "the quote should only be included if it can be contextualized in a verifiable and neutral sense as a point of view of the Bigfoot Field Researchers Association and not necessarily a factual statement. The consensus of editors may even be to not include the quote at all." (emphasis mine). Second Quantization (talk) 00:00, 13 March 2014 (UTC)

Hi 2Q, I value your experience very much! But I think you might be mixing apples and oranges a bit and I would appreciate if you would clarify. This section is discussing a statement in a source, the statement being: "decision was made in part on the results of the trials and in part for socio-political reasons", and the source for it, a journal that I think we can claim with reasonable certainty fails FRIND, namely The Journal of Chinese Medicine. I think by now we can probably all agree on that. Correct? Now there is also a 2nd matter - namely that this article is about a clinical trial of acupuncture, not about acupuncture itself. I am sorry to belabor this and ask you to teach more, but I am going to open a separate section on this question, so that this section can remain focused on the issue of whether we keep the statement and its source. Jytdog (talk) 01:33, 13 March 2014 (UTC)

@Jytdog Correct. The Journal of Chinese Medicine clearly is not an independent source. --Mallexikon (talk) 02:55, 13 March 2014 (UTC)

@Second Quantization: The text in question (the allegation that GERAC's verum acupuncture performed worse than usual because of lack of training of the participating acupuncturists while the sham treatment performed better than placebo because it somehow constitutes a highly effective treatment) of course should, and would, be contextualized as an acu-proponent's POV. And yes, we might even have consensus here to not include it at all. I just don't understand why we should leave it out. Let me repeat: WP:FRIND doesn't want us to cover aspects of a fringe theory that are not discussed by independent sources. But I don't see how we might be in danger of doing this by adding acu-proponents' criticism of a medical trial. As Jytdog said, apples and oranges. --Mallexikon (talk) 02:55, 13 March 2014 (UTC)

Do you not see the mental contortions you are doing? You agree the paper you want to use is not independent. You agree that WP:FRIND doesn't allow non-independent material to be mentioned without an independent source drawing attention to it. How can you then say its ok to put in the criticism from a pseudoscientific journal when you lack that independent source. No, clearly it's not ok. Clearly you require the independent source. You also say its the acupuncturists viewpoint, I don't believe you. Get me an independent source that says it is indicative of their viewpoint. It's quite simple, find the secondary source which is not a fringe one which draws attention to this paper. Second Quantization (talk) 08:45, 13 March 2014 (UTC)

You basically don't seem to understand that WP:FRIND doesn't apply here. Please read my argumentation again before accusing me of mental contortions. I agree that Birch is not an independent source but that just doesn't matter here. --Mallexikon (talk) 02:15, 18 March 2014 (UTC)

I don't know what you are talking about. Second Quantization (talk) 08:45, 13 March 2014 (UTC)

I'd like to sum up and close this section. No support from other sources has been brought for the criticism of GERAC stated by Birch, so we have no idea if that criticism is idiosyncratic or widespread among the pro-acu community, so the criticism should not come in even as a representative of the or even a "pro-acu view". The source itself has also been dismissed. So nothing from Birch should be in the article. Jytdog (talk) 10:56, 13 March 2014 (UTC)

Agreed, Second Quantization (talk) 11:07, 13 March 2014 (UTC)

No, I don't agree at all. There will never be the pro-acu view (since we're not talking to a unified "scene" here; acupuncture is quite diverse). This is a view from an acupuncturist (probably one of the few who work in scientific research), it's published in a TCM journal, and one of its two main points - attacking the sham design - was repeated in the He et al source. That's enough reason to include it as an pro-acu point of view. To demand that "I get you" an independent source drawing attention to this article is Kafkaesk: why should a reliable source waste time to discuss this fringe view? And to stay with the example above: do you really think that the Bigfoot Field Researchers Association's statement was mirrored in a reliable source?

I frankly don't understand your opposition to include Birch's (and maybe also He et. al's) criticism here. What danger do you see in representing the pro-acu view on GERAC? Since it obviously exists. --Mallexikon (talk) 02:15, 18 March 2014 (UTC)

Mallexikon, we have said several times that we need other sources that show that these views are actually representative of something wider than He's and Birch's individual perspectives - that the views they state actually represent some substantial view in the pro-acu community and are not idiosyncratic. Nobody has brought anything. Jytdog (talk) 05:08, 30 March 2014 (UTC)

Mallexikon, you are correct. The Journal of Chinese Medicine is usable for non-medical claims. Perhaps I was a bit hasty in deleting the text. I could of reworded it. QuackGuru (talk) 05:33, 30 March 2014 (UTC)

Is this article a FRINGE topic?

In a few places above, the claim has been made that this article is not about a FRINGE topic, but instead, is about a mainstream scientific topic - namely, a clinical trial. My sense, is that the preceding statement is true. MEDRS applies to any health-related content, since the topic is decidedly health related. And all policies and guidelines about sourcing of course apply as well (ie, sources must not fail FRIND). And any claims about any underlying theories of acupuncture within the article, of course fall within FRINGE. But descriptions of the clinical protocol, and description of results, are all standard health-related content that are not FRINGE. I think this is pretty clear -- the trial design seems to have been carefully done to make it a good placebo-controlled RCT, and the results were decidedly negative for two indications, and borderline negative for two others - this was far from a rah-rah-acupuncture outcome. I would be interested to hear thoughts on this, based of course as much as possible on policies and guidelines (no big hand-wavy claims, please!!). Thanks. Jytdog (talk) 01:41, 13 March 2014 (UTC)

I think you're dead-on. --Mallexikon (talk) 05:42, 13 March 2014 (UTC)

Jytdog, it clearly is a fringe topic since it's about acupuncture. astrology and science is a fringe topic even though its about the scientific view of astrology. The distinction you are making makes no difference in policy. WP:FRINGE is still followed in mainstream articles and some parts are directly aimed at mainstream articles: WP:ONEWAY, so this is a distinction without a difference. The only slight difference is that the onus is greater to justify fringe views if you claim its a mainstream article due to ONEWAY. Second Quantization (talk) 08:39, 13 March 2014 (UTC)

That is kind of hand-wavy. Is that grounded directly in policy or guideline or is that your more 10,000 foot level interpretation? Thanks. Jytdog (talk) 10:00, 13 March 2014 (UTC)

Don't take my word for it, read it! You'll notice wording like "When discussing topics that reliable sources say are pseudoscientific or fringe theories, editors should ..." Nothing says it only applies to articles about fringe subjects, it talks about when fringe content appears. That is because WP:FRINGE is primarily an extension of NPOV. Second Quantization (talk) 10:10, 13 March 2014 (UTC)

Incorrect semantics.

1.) This article is not about acupuncture. It's about a scientific trial.

2.) Whether the therapeutic method "acupuncture" itself is pseudoscience is actually debatable; according to WP:FRINGE/PS's definition, acupuncture constitutes "questionable science" (as "a reasonable amount of academic debate still exists on this point").

3.) Be that as it may, traditional acupuncture has a pseudoscientific theory behind it (qi, meridians etc.), which constitutes a strong rationale to sum it up under pseudoscience. The emphasis here lies on theory because that's what WP:FRINGE deals with: fringe/pseudoscience theories. There's no theory behind a clinical trial like GERAC other than the scientific method. WP:Fringe theories clearly doesn't apply here. --Mallexikon (talk) 10:26, 13 March 2014 (UTC)

So you claim it's actually an entirely mainstream topic (I don't accept this logic, WP:FRINGE would still apply to an article about Shawn Carlson's test of astrology). Therefore, according to your stated position, we shouldn't mention the views from unreliable sources, like the one mentioned in the topic further above, per WP:RS. It's not reliable, and it's a fringe view by an acupuncturist which does not satisfy WP:ONEWAY to be in this ostensibly mainstream topic. Second Quantization (talk) 11:10, 13 March 2014 (UTC)

I am finding it a bit difficult to follow Mallexikon's logic, but I think he agrees to exclude Birch. But let's try to stay on the topic of this thread, if we can... Jytdog (talk) 11:38, 13 March 2014 (UTC)

mmm 2Q that is a hand-wavy too. The article is about a set of clinical trials, organized by mainstream insurance companies. It shouldn't be used as a WP:COATRACK for pro-acu views, for sure. But what I have seen going on here is that instead of the background being simply stated (that acu itself is FRINGE), quack-fighters (generally awesome and hard working wikipedians) have been treating this article as though it is about acupuncture itself, and basically disrupting it. It has, topsy-turvy, become WP:COATRACK for relentlessly stating that acu is quack. There must be some background to that, but I don't understand it. It seems entirely possible to simply describe the experiment and the bizarre outcome and the consequences, framing before and after with simple statements that there is no reason to expect acu to work. (and we can cite for example this 2009 systematic review to support that) This is such a great story about how difficult clinical research is and it is such a shame that the story cannot be told clearly. It is bizarre to me that the clinical protocol is not stated here, in an article about a clinical trial! Mallexikon I would ask you to be careful on your point 2. Point 3 is strong though. Jytdog (talk) 10:53, 13 March 2014 (UTC)

This is well stated. I'd like to see the article as you describe. TimidGuy (talk) 11:04, 13 March 2014 (UTC)

forgot to add - there should be a section on the intervention being tested, and that section should be written as per FRINGE, for sure. Jytdog (talk) 11:51, 13 March 2014 (UTC)

A section generally about acupuncture is a WP:COATRACK. QuackGuru (talk) 17:23, 13 March 2014 (UTC)

The section on the intervention should be basically a copy/paste condensed version of the lead of the acupuncture article, already written to FRINGE and MEDRS standards. WP:AGF for pete's sake.17:53, 13 March 2014 (UTC)

According to the closing of RfC done by User:Gaijin42: RFC sample size could be greater, but only 1 real !vote for the greater information. The lesser level of information avoids getting into WP:MEDRS violating WP:COATRACK. If the trials themselves are notable the article should be about the trials, not the acupuncture results. QuackGuru (talk) 18:19, 13 March 2014 (UTC)

I am going to make a draft in my sandbox and when it is ready, will post a link. Jytdog (talk) 18:25, 13 March 2014 (UTC)

Proposal

Now there is is another source in the article about the insurance corporations we can include this too. QuackGuru (talk) 01:14, 28 March 2014 (UTC)

I would say that now that we have a reliable source, there is even less need and a weaker argument, for including He, than before. It is still FRINGE. It is bizarre that you keep pushing to include a FRINGE source! Jytdog (talk) 05:12, 28 March 2014 (UTC)

See WP:MEDDATE: Many medical claims lack reliable research about the efficacy and safety of proposed treatments or about the legitimacy of statements made by proponents. In such cases, reliable sources may be difficult to find while unreliable sources are readily available. Whenever writing about medical claims not supported by mainstream research, it is vital that third-party, independent sources be used. Sources written and reviewed by the advocates of such marginal ideas can be used to describe personal opinions, but extreme care should be taken when using such sources lest the more controversial aspects of their opinions be taken at face value or, worse, asserted as fact. If the independent sources discussing a medical subject are of low quality, then it is likely that the subject itself is not notable enough to have its own article or relevant enough to be mentioned in other articles.

We can also include it per MEDDATE since there are not many sources on the topic. I don't see how FRINGE applies in this case when it is about a historical event. There's no theory behind the GERAC clinical trials. FRINGE can't trump MEDDATE even if this is a fringe topic. QuackGuru (talk) 05:31, 28 March 2014 (UTC)

jps, mallexikon, 2Q and I all do not find this source reliable. you are the only one who thinks it is. please drop the stick already. Jytdog (talk) 11:37, 28 March 2014 (UTC)

According to the original discussion the source was reliable. See Talk:German acupuncture trials/Archive 1#Insurance companies in Germany have stopped reimbursement for acupuncture treatment. I posted a review for this source at Wikipedia talk:WikiProject Medicine#German acupuncture trials. I think the 2013 review is reliable for the claim. QuackGuru (talk) 18:47, 28 March 2014 (UTC)

You are the only one who thinks it is reliable. really. Talk:German_acupuncture_trials/Archive_2#Fringe_journals But hey if you can get jps, User:Alexbrn, me, User:Second Quantization AND WP:Mallexikon (and how often do all of those agree on anything?) you may have something. Until then, there is consensus that is not reliable. Please drop the stick.Jytdog (talk) 22:21, 28 March 2014 (UTC)

The review [8] is pubmed indexed. What is wrong with the source in question? Has anyone tried a RfC to get in more opinions and if not what not? Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:02, 29 March 2014 (UTC)

Hi DocJames, we had an intricate discussion of this source and others as per my comment above (Talk:German_acupuncture_trials/Archive_2#Fringe_journals), which a branch of, led to an interesting discussion on MEDRS on a different but similar source, which is here. Quackguru didn't participate in much of that. He has been working to include this source, which jps and alexbrn - also quackfighters - have said repeatedly fails WP:FRIND.... The content that QG wants to pull out of this source has to with some insurance companies stopping coverage for acupuncture because of GERAC. It is just tendentious IDHT on the part of quackguru to keep pushing for this source and that content now, especially as he has another source that he can use to support it now. But really, please see the thread above02:29, 29 March 2014 (UTC)

I don't have another source that specifically says some insurance companies stopping coverage for acupuncture because of GERAC. I discussed the source recently with jps privately and he did not have a problem with me restoring it. Alexbrn thought the source for statement that are not in the fringe space, it is however usable. I don't see consensus to delete the statement or the source from the article. QuackGuru (talk) 04:03, 29 March 2014 (UTC)

Look, above in the fringe section jps and alexbrn argued adamantly that this source fails WP:FRIND and they convinced me; I at first too thought it was fine. Their reasoning was upheld in the discussion at Talk:MEDRS on the J Acu Med source. If jps has changed his mind he needs to come here are refute his own arguments. 2Q also was very clear that this source is fringe. I will say to you again, QG- if you can find some other source that says this, then sure, that statement can come in. As you wrote above, you don't have one, so this statement should be considered as FRINGE as everything else in that source. I don't understand why you didn't present these arguments when we were actually discussing this source - you were editing this article at the time . Again please drop the stick. This source is gone. This is exactly the kind of behavior that exasperated Mallexikon and Middle8 and led to you being brought to RFCU. Jytdog (talk) 12:05, 29 March 2014 (UTC)

3. Journal of traditional Chinese medicine was being used to claim acceptance of acupuncture by the international community, that no significant differences between acupuncture and sham acupuncture were found, that the reimbursement procedures were made for unstated "socio-political reasons", and that some insurance corporations in Germany no longer reimbursed acupuncture. See Talk:German acupuncture trials/Archive 2#Fringe journals.

User:Alexbrn thinks the source For statement that are not in the fringe space, it is however usable.

'I think (3) would be okay for any non-controversial & non-fringe claims. Alexbrn talk|contribs|COI 18:31, 24 February 2014 UTC Number 3 is referring to the The Journal of traditional Chinese medicine. Three is okay according to Alexbrn.

WP:FRINGE guides us to use independent sources. The Journal of traditional Chinese medicine is not independent (of TCM). Any significant claims made there which have permeated the mainstream will be easy to source independently. The claims jps mentions aren't primarily biomedical ones, so how would MEDRS apply in any case? Alexbrn talk|contribs|COI 18:42, 24 February 2014 UTC Alexbrn supports including the text and the source for non-medical claims. For non-medical claims MEDRS does not apply. I cautiously used the source without making any medical claims. QuackGuru (talk) 18:43, 29 March 2014 (UTC)

the article is FRINGE out the wazoo. Have you even read it? And the claim they make there, about reimbursement, is itself unsourced, based only on the authors own authority, which has been found invalid. It is a controversial and FRINGE statement, especially since you have not found any other source that says it. If any of alexbrn or 2Q or jps want to revert their position and support you, they can certainly do that here - they have all been pinged plenty. If they do not speak up, the consensus to not use this source stands. You are the only one who wants to use it. Let it go. Drop the stick. Jytdog (talk) 19:39, 29 March 2014 (UTC)

Alexbrn did support the source. You don't have consensus to leave it out. QuackGuru (talk) 19:44, 29 March 2014 (UTC)

as i said, if alexbrn wants to come here and support your use of it, he is free to do that. if he and all the others who rejected it do not, we already decided not to use this source. As it is, nobody agrees with you. Please wait til others have a chance to weigh in and agree with you or disagree with you. Jytdog (talk)

The source in question could be okay for non-fringe content. But the claims about insurance seem to be exceptional (one might even say, "fringe"), so best to use a more solid, non-fringe journal. Alexbrn ^{talk|contribs|COI} 10:12, 30 March 2014 (UTC)

User:Alexbrn, I made this change with non-fringe content. Editors can review this change without the addition of the insurance claim. QuackGuru (talk) 16:57, 30 March 2014 (UTC)

Archive error

User:Jinkinson noticed a problem with the archives. The archive is malformed. See Talk:German acupuncture trials 1. It should start with /Archive 1. The bot is archiving to the wrong page again. QuackGuru (talk) 05:36, 29 March 2014 (UTC)

Birch came back in, deleted again

So although the Birch source was thoroughly discussed here and at Talk:MEDRS, User:QuackGuru continued trying to push it into the text with his "propose and delete" edits - first adding it here and then deleting right away here and then right away again adding it here and immediately again deleting it here, right after which User:Simonm223. an editor not involved with, and probably ignorant of, the discussions accepted one of those versions here. I didn't notice in this in the flurry of small edits until today, and just took the Birch source back out. Ugly. Jytdog (talk) 19:33, 29 March 2014 (UTC)

You don't have consensus to delete the text for non-medical claims. QuackGuru (talk) 19:45, 29 March 2014 (UTC)

you didn't have consensus to use it for anything. Again, if all the people who already agreed to keep this FRINGE article out, change their minds and agree with you, they are totally free to speak up here. Please wait til others have a chance to weigh in and agree with you or disagree with you. Jytdog (talk) 19:53, 29 March 2014 (UTC)

with respect to QG's test edit, the claim about "the decision about reimbursement were shaped in part by socio-political reasons." appears only in Birch. It was discussed above and is part of a bizarre, FRINGEy argument about why the GERAC trials were invalid. Please find a different source for this. Again, this claim appears nowhere but Birch - it is like the statement from He that you want to add. Jytdog (talk) 17:14, 30 March 2014 (UTC)

Discussion on FRINGE noticeboard

Note that WP:QuackGuru started a discussion about the Birch and He sources on the FRINGE noticeboard, here. sigh. Nice move, not participating in the long discussion we had here already, then re-opening it elsewhere. Talk about WP:FORUMSHOPPING. Jytdog (talk) 22:25, 29 March 2014 (UTC)

• The same discussion is also being raised at WikiProject Medicine, just to let everyone know. -A1candidate (talk) 22:41, 29 March 2014 (UTC)

thanks for pointing that out. ugh. Jytdog (talk) 23:18, 29 March 2014 (UTC)

editorial from Spine?

In a series of edits today, A1candidate introduced a source - an editorial from Spine (PMID 21217438 and indexed by MEDLINE as an editorial). The content based on the source, is about the outcome of GERAC for chronic low back pain. Do folks here find the source acceptable for that content? If so, why or why not? Thanks Jytdog (talk) 21:24, 30 March 2014 (UTC)

If I may ask, is there a MEDRS guideline that specifically forbids the inclusion of peer-reviewed editorials by experts in a mainstream journal? -A1candidate (talk)

Editorials are not peer reviewed as far as I know. To answer your question, if you go to MEDRS and search for "editorial" you will find it near the top of this section where MEDRS makes it clear that editorials are not preferred sources. It is good to discuss marginal sources. Jytdog (talk) 21:35, 30 March 2014 (UTC)

Thank you for the clairification. I agree that we should use better sources, such as the meta-analysis I included. However, I disagree with your edit summary that "really great sources are actually hard to find on this". Actually, they exist. I just don't have the time to include them yet, but there is a Cochrane review that we could use. -A1candidate (talk) 21:50, 30 March 2014 (UTC)

The editorial source was not a review. Your latest edit was a only repeating the results of the original study. QuackGuru (talk) 03:42, 31 March 2014 (UTC)