Talk:Medical uses of silver/Archive 10

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Colloidal silver definition

I think that one of the most useful additions to this article would be a discussion as to what, exactly "colloidal silver" is. Looking through the scientific literature there does not seem to be any clear definition and looking through all of the promotional literature suggests that there is no clear consensus. Has anyone found a relatively recent review that could clear this up? The term "silver nanoparticles" certainly has something to do with it, but even that term seems to have multiple definitions. The issue is complicated by whatever solution the colloid or nanoparticles are in, such as water, saline, non-aqueous media, whatever. Also, the minute one ingests colloidal silver or silver nanoparticles, it is highly likely that the constituents will change based on ionic strength, pH, temperature, enzymes, protein binding, etc. A good scientific review would help a lot but I cannot find one with free access.Desoto10 (talk) 03:23, 6 February 2013 (UTC)

This does seem to be a problem. The term 'colloidal silver' seems to be mostly a marketing term for "products that contain various concentrations of ionic silver, silver colloids, ionic silver compounds or silver proteins in purified water" as one paper put it. We should probably clarify this in the article. Zad68 04:40, 6 February 2013 (UTC)

That's exactly what I'm saying. Colloidal silver has got two meanings. One is the precise meaning.

1) "Colloidal silver" - are two words. One is "silver" - any variation of silver molecule which is silver is a silver. The other one is "colloidal". Colloidal means that the particles of silver are microscopically dispersed evenly throughout another substance (I guess we may call this other substance a "medium"). That's all.

2) The second one is what I call a broad meaning of colloidal silver, or "lay person" meaning of colloidal silver or a marketing term as I second Zad. What is important is that the companies are using this name "colloidal silver" for "silver nanoparticles" because it's a lay person term. (When its said "silver nanoparticles" it sounds scientific, something for research. When its said "colloidal silver" it sounds as something you can buy and use.) However, this second broad meaning is absolutely the same as the first meaning. Ionic silver, metallic particles, nanosilver, silver nanoparticles, particular silver compounds, silver complexes bearing bidentate N-heterocyclic carbene ligands, agnp and the variations zad has mentioned are all silver particles microscopically dispersed evenly throughout another substance.

(An ion is an atom or molecule in which the total number of electrons is not equal to the total number of protons, giving the atom a net positive or negative electrical charge. - This is in reference to ionic silver.)Ryanspir (talk) 15:26, 12 February 2013 (UTC)

I know what the terms mean. What we need is a quality, independent, secondary source that defines the terms, not just uses them.Desoto10 (talk) 18:00, 12 February 2013 (UTC)

Which word should be explained? "Silver" or "colloidal"? In any case, the second "broad" or "layperson" definition of cs is inclusive of all silver-based compounds. Ryanspir (talk) 12:54, 13 February 2013 (UTC)

The term "colloidal silver" needs to be defined. What do you propose to use as the definition and what are the sources?Desoto10 (talk) 21:13, 13 February 2013 (UTC)

A recent 2012 review article

http://www.ncbi.nlm.nih.gov/pubmed/22324439 J Appl Microbiol. 2012 May;112(5):841-52. doi: 10.1111/j.1365-2672.2012.05253.x. Epub 2012 Mar 28. Silver nanoparticles: the powerful nanoweapon against multidrug-resistant bacteria. Rai MK, Deshmukh SD, Ingle AP, Gade AK. Source

Department of Biotechnology, Sant Gadge Baba Amravati University, Amravati, Maharashtra, India. mkrai123@rediffmail.com Abstract

In the present scenario, pharmaceutical and biomedical sectors are facing the challenges of continuous increase in the multidrug-resistant (MDR) human pathogenic microbes. Re-emergence of MDR microbes is facilitated by drug and/or antibiotic resistance, which is acquired way of microbes for their survival and multiplication in uncomfortable environments. MDR bacterial infections lead to significant increase in mortality, morbidity and cost of prolonged treatments. Therefore, development, modification or searching the antimicrobial compounds having bactericidal potential against MDR bacteria is a priority area of research. Silver in the form of various compounds and bhasmas have been used in Ayurveda to treat several bacterial infections since time immemorial. As several pathogenic bacteria are developing antibiotic resistance, silver nanoparticles are the new hope to treat them. This review discusses the bactericidal potential of silver nanoparticles against the MDR bacteria. This multiactional nanoweapon can be used for the treatment and prevention of drug-resistant microbes.

© 2012 The Authors. Journal of Applied Microbiology © 2012 The Society for Applied Microbiology.

Could anyone get the full article please? Ryanspir (talk) 14:33, 12 February 2013 (UTC)

I'm not sure where you are going with this, but this paper is probably not suited for this article as it likely summarizes some of the in vitro work done using silver on MDR bacteria. We already know that silver kills some microbes, but until some clinical work begins to appear in the literature there is no evidence that it will ever be a valid therapy.Desoto10 (talk) 21:42, 12 February 2013 (UTC)

Well, for one thing, this article indicates that currently there is an active research into cs. So it's unlikely that respectable organizations would research 'snake oil', would they? This article also supporting my proposition that silver nanoparticles is a new emerging vector for antimicrobials, not a quack medicine. Ryanspir (talk) 12:21, 13 February 2013 (UTC)

You still don't get it, do you? People can study whatever they want. This is basic research, not drug discovery. If you want to claim medical benefits, then yes, you need to spend a billion dollars to prove that cs is safe and effective. That is the way the system works.Desoto10 (talk) 20:09, 13 February 2013 (UTC)

Fairly large RCT does not find benefit

From silver containing catheters. [1] We will need to update in a year or so when the secondary literature reflects this. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:59, 14 February 2013 (UTC)

Thanks for the heads-up. The same authors also did a cost analysis with the same data. The antibiotic might be cost-effective but it was unlikely that the Ag-coated version was. Free access: http://www.ncbi.nlm.nih.gov/pubmed/23199586

Desoto10 (talk) 01:39, 14 February 2013 (UTC)

Few articles which mention colloidal silver nanoparticles in one phrase

http://pubs.rsc.org/en/content/articlelanding/2013/CS/C2CS35289C - Controlled synthesis of colloidal silver nanoparticles in organic. Controlled synthesis of colloidal nanoparticles in organic solutions is among the most intensely studied topics in nanoscience because of the intrinsic advantages in terms of high yield and high uniformity in comparison with aqueous synthesis. However, systematic studies on the formation mechanism of nanoparticles with precisely tailored physical parameters are barely reported. In this tutorial review, we take the synthesis of different Ag nanoparticles as an example to rule out the general principles for controlling the nucleation process involved in the formation of colloidal Ag nanoparticles in organic solutions, which enables the synthesis of high-quality nanoparticles. solutions: empirical rules for nucleation engineering.

http://pubs.acs.org/doi/abs/10.1021/nn301724z?mi=z48nb4&af=R&pageSize=20&searchText=aging - Formation Mechanism of Colloidal Silver Nanoparticles: Analogies and Differences to the Growth of Gold Nanoparticles.

http://iopscience.iop.org/2043-6262/3/4/045007 - Powerful colloidal silver nanoparticles for the prevention of gastrointestinal bacterial infections

http://www.sciencedirect.com/science/article/pii/S0956566312002412 - Robust one pot synthesis of colloidal silver nanoparticles by simple redox method and absorbance recovered sensing Ryanspir (talk) 15:54, 12 February 2013 (UTC)

We need secondary sources that explicitly address the definitions of "colloidal silver" and nanosilver.Desoto10 (talk) 21:33, 12 February 2013 (UTC)

Why? Colloidal silver is not such a difficult term. Both "silver" and "colloidal" are explained on wikipedia already in the respective articles. Regarding Secondary vs Primary consider reading WP:USEPRIMARY "Primary" is not another way to spell "bad".Ryanspir (talk) 12:14, 13 February 2013 (UTC)

Why? Because colloidal silver is used to mean a variety of things, both in the scientific literature and in the alt med market. We need a secondary source to define the term.Desoto10 (talk) 20:02, 13 February 2013 (UTC)

Here is how I see it.

"Colloidal" doesn't define a form or structure of silver atoms or molecules. It only specifies that the silver which is used is equally dispersed through another substance.

An example would be, if there would be tablets of silver and we would call them tabletable silver, it would mean just as much. It would just mean that the silver we are referring to is in the form of a tablet. It wouldn't specify by itself what kind of silver, in what way the atoms or molecules are arranged or anything else. It would be a collective name, same as "colloidal" is not a specification, but a collective name. Ryanspir (talk) 14:10, 18 February 2013 (UTC)

Balance between a drug's benefits and its risks

"Blakebeau, your final two questions are based on a false dichotomy. Both established medical sources and Consumer Reports view colloidal silver as ineffective and potentially dangerous. I think you're also fundamentally misunderstanding the concept of safety, as it applies to medications. Safety is a relative concept which encapsulates the balance between a drug's benefits and its risks. If a substance (like colloidal silver) has absolutely no known medical benefits, then any degree of risk renders it "unsafe". You're applying an unreasonable and unscientific standard here, and I'd prefer we simply defer to the numerous reliable medical and consumer-safety sources rather than try to editorially undermine or soften them.< p>Desoto, I'm able to view the article you linked. It dates from 1997 and outlines a number of what are perceived as modern-day versions of snake oil, from chromium picolinate and cyclic AMP to emu oil and colloidal silver. The focus is on the misleading or dishonest ways in which these substances are marketed to the public via the Internet. I'll think about whether there's anything in the source that would be directly relevant/useful for this article; I think we've already covered the fact that colloidal silver is often promoted in a highly dubious fashion. MastCell ^Talk 19:05, 1 February 2013 (UTC)"

This is a good analysis and I agree with MastCell. However, cs has known medical benefits. To have medical benefits and to be approved by a regulatory authority for oral ingestion isn't the same thing. Sometimes it's simply a question of money. Have you got 100 million to get it approved? Then it's approved in 10 years time. You haven't? Sorry. The second point, I think it's in the past that colloidal silver could have been "often promoted in a highly dubious fashion. But FDA did a good job by sending warning letters and now days virtually all internet sites which are selling cs have a proper FDA approved disclaimer and maintain adherence to the established rules for selling food supplements.

Another point is a dosage. Medical benefits and "risks" should be viewed also in relation to the dosage and over-dosage. I'll explain what I mean. Ciprofloxacin for example has a standard dose of 500mg two times a day. Would you exceed this by 100% you are much more likely to experience the "risks". Exceeding this dosage by 300% and more are HIGHLY likely in you feeling very bad within one hour (even if otherwise the normal dosage is tolerable by you without adverse effects). Exceeding this dose by 1000% and taking it for several months, even if possible would likely result in death or feeling very, very ill.

However, taking cs two teaspoons a day which is a normal dosage for maintenance or two tablespoons which is considered a normal dosage for treatment ever for prolonged periods of time are highly unlike to induce any adverse effects. Upping the dose to 300% and even 1000% isn't resulting in any side-effects either, even if taken for months and is still below of the EPA's threshold for a risk of agryria. And, generally people who take 1000% of the dosage of cs are experiencing no adverse side-effects, whatsoever. Not even a headache. Ryanspir (talk) 12:48, 13 February 2013 (UTC)

This great and we can put it in the article as soon as you can locate WP:MEDRS-compliant reliable secondary sources supporting the ideas that ingested CS is a "treatment" for anything at all with a recommended "dosage", what ailments it might be a treatment for, and what the tested effectiveness of ingested CS is in treating those ailments. WP:MEDRS-compliant reliable secondary sources please? Zad68 13:47, 13 February 2013 (UTC)

Why are you always insisting on secondary sources? Per http://en.wikipedia.org/wiki/Wikipedia:Identifying_and_using_primary_and_secondary_sources

""Primary" is not another way to spell "bad" "Primary" is not, and should not be, a bit of jargon used by Wikipedians to mean "bad" or "unreliable" or "unusable". While some primary sources are not fully independent, they can be authoritative, high-quality, accurate, fact-checked, expert-approved, subject to editorial control and published by a reputable publisher. Primary sources can be reliable, and they can be used. Sometimes, a primary source is even the best possible source, such as when you are supporting a direct quotation. In such cases, the original document is the best source because the original document will be free of any errors or misquotations introduced by subsequent sources."

I have already quoted it several time. It's even said that sometimes its even "the best possible source". Ryanspir (talk) 13:58, 18 February 2013 (UTC)

Why do people come to this article?

Is there any way to find out what keywords people use to find this article? I'd suggest that very few people are investigating endotrachael tubes or silver dressings. I'd suggest the main search term by a mile is 'colloidal silver'. I'd go further and suggest they specifically want to learn about the type of colloidal silver they see in health food stores or might make at home. Well they sure aren't learning anything here. Just read the alternative medicine section. Its totally devoid of information. Apart from all the warnings, a reader would be just as in the dark as when he started. Wheres the info about how its made? Whats in it? How big is the retail market? How much do people drink? How is it used? Who are the pioneers of this alternative product? What is the in-vitro research proving? Colloidal silver has an interesting story quite apart from the (understandably) contentious medical aspect but you wouldn't know it from this article/section. Something is wrong here. Its just too hard to contribute. Submissions are just totally removed rather than beaten into shape. Editors are discouraged not encouraged. (In fact they are almost beaten into submission). The emptiness of the section about the key search term (colloidal silver) proves that something is not working here. (And don't tell me to submit something and see how it goes. I'm not falling for that one again.)Blakebeau (talk) 03:08, 15 February 2013 (UTC)

That's exactly what I have felt. Cannot disagree with Blakebeau. Ryanspir (talk) 14:14, 18 February 2013 (UTC)

Sure so 6248 out of 74678 people came to this article via the term colloidal silver in Jan 2013 per [2] Have you tried to add content about the size of the retail market and had it rejected? Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:23, 15 February 2013 (UTC)

Thanks for the numbers but these are just described as 'page views' not search terms. Would I be correct in thinking these figures don't account for people who type 'colloidal silver' into Google then see this Wikipedia article (Medical uses) as the first result, then click it? The stats come from a Squid cluster whatever that is but it sounds purely internal. Possibly it only counts people who typed colloidal silver into the Wiki search box.Blakebeau (talk) 07:46, 16 February 2013 (UTC)

Good analysis, thumbs up! One thing though, in my opinion you could change your reasoning a bit. To simply reason that its a known fact without referring to the Google hits. As for example saying that "people drink water every day" is so well known fact, that in order to write that in the wikipedia there is no need to provide a published research which would explicitly elaborate that people drink water everyday. Ryanspir (talk) 13:38, 18 February 2013 (UTC)

I am sorry that you feel so put-upon. We have a section on History. Why don't you work on that? There could be a good story about the potential for the use of antiseptics like silver to lessen the risk of developing resistant strains of bacteria. Why don't you work on that? Keep in mind that the title of the article is Medical uses of silver. The medical uses of silver are wound dressings, catheters, and a few minor uses. Drinking silver is not a medical use currently (banned by the FDA, Australia, and EU soon). I would argue that silver disinfectant sprays and water disinfectants are also not medical uses, but nobody else agrees, so there we are. In any case, you don't really have many choices: you can contribute, or not.Desoto10 (talk) 03:42, 15 February 2013 (UTC)

Desotho, this statement is indeed sounding discouraging. Ryanspir (talk) 14:14, 18 February 2013 (UTC)

Ha! I cant even get "Colloidal silver is usually consumed orally" into the article. You think I'd even attempt a history or content about the 'industry'?Blakebeau (talk) 04:03, 15 February 2013 (UTC)

OK then. As far as I can see, you are 1 for 3 in your contribution history. Not a bad record and certainly nothing to get upset about. But contributing or not is up to you.Desoto10 (talk) 04:28, 15 February 2013 (UTC)

Archived material restored

Material archived in the last few days has been restored on request, after all, it's just a robot. Comments removed by restoration have been restored to their original locations. User:Fred Bauder Talk 13:53, 18 February 2013 (UTC)

Safe and effective

"FDA’s statutory mandate includes protection and promotion of the public health by ensuring that drugs are not only safe but also effective for their intended use. The Commissioner of Food and Drugs’ decision on the status of Laetrile, published in the Federal Register of August 5, 1977 (42 FR 39788), expresses the agency’s position on freedom of choice with respect to ensuring that drugs are not only safe, but also effective. That statement reads in part: In passing the 1962 Amendments to the act—the amendments that require that a drug be proved effective before it may be marketed—Congress indicated its conclusions that the absolute freedom to choose an ineffective drug was properly surrendered in exchange for the freedom from the danger to each person’s health and well-being from the sale and use of worthless drugs" from http://www.gpo.gov/fdsys/pkg/FR-1999-08-17/pdf/99-21253.pdf User:Fred Bauder Talk 18:53, 18 February 2013 (UTC)

This is true for drugs, but not so much for devices such as the silver-containing dressings. In any case, this kind of information might be better placed in FDA article, assuming that there is one, or drug regulations.Desoto10 (talk) 04:45, 19 February 2013 (UTC)

Homemade CS

Blake put in some unsourced text about DYI CS via electrolysis. I removed it because there were no references and because we need to define what CS is first and then we could comment on what is made in these DYI CS generators. The deletion was reverted with a statement to the effect that it would be easy to source via a google search. I then reverted the reversion to give the original poster the opportunity to provide those easily available sources.Desoto10 (talk) 00:18, 14 February 2013 (UTC)

I think you are just being churlish. These weren't controversial claims or vague statements about dosages for example. These were basic details. Do we really need a source for the statement that colloidal silver is usually 'consumed orally'. What do you want? An 'RS' medical source for that fact? And just type 'How to make colloidal silver' into google. You'll get a thousand responses including Youtube videos showing how its made. And why do we now need a definition of colloidal silver before an edit can be made? We didn't need one to put all those warnings into the article. Quite obviously, in this alternative medicine section, colloidal silver is simply a generic term for the stuff that that people buy in health food stores or make themselves. Blakebeau (talk) 02:45, 14 February 2013 (UTC)

I tried that and found Colloidal Silver Alternate Cancer Treatment. Obscene! User:Fred Bauder Talk 14:04, 18 February 2013 (UTC)

You might be right, however referring to the cancer research that is being conducted by University of Leeds, it was mentioned that cs is thought to or known to have effect on cancer; and it seems to be the initial basis for their research, with positive results I shall say. Ryanspir (talk) 13:37, 20 February 2013 (UTC)

So you don't have sources?Desoto10 (talk) 04:29, 14 February 2013 (UTC)

OK, maybe I am being churlish, but look, I am having a hard enough time myself trying to find reliable sources for some definitions of "colloidal silver", let alone sources for how it is used and made. Sure, google gives you a million hits for colloidal silver but how do you pick through them to find reliable sources? I am pretty sure that the truth is that nobody knows what comes in those little blue glass bottles at CVS labeled CS, or what various researchers are using, but I cannot just put that in the article without some kind of reference.Desoto10 (talk) 04:50, 14 February 2013 (UTC)

This is absurd. The FDA, NCCAM and TGA warn people against consuming colloidal silver but I have to provide a reference that they really do consume it! Heres a link to the silverlist.http://silverlist.org/ and its archives http://silverlist.org/ This is the oldest and largest discussion group I know of. Its been going for about 20 years and has thousands of users and tens of thousands of posts. These people drink, inhale, and use the stuff topically. Are they a reliable source for the fact that people actually drink, inhale, and use the stuff topically? Furthermore, about half the discussions here are about making the stuff with electrolysis. Are they a reliable source for how its made? I could also link to dozens of commercial sites that sell electrolytic colloidal silver makers. Are they a reliable reference for how home-made colloidal silver is made? If not, then I guess Westinghouse isn't a reliable source for how to wash your clothes. (Note that I'm not using these links as references for efficacy or safely I'm simply presenting them as references that the stuff IS made and IS consumed. Thats all my edit was about.

As for your desire to find a physical definition of colloidal silver. I think you are heading down a black hole there. The NCCAM, FDA, and TGA don't define what colloidal silver is. If you define that home-made colloidal silver is not really colloidal silver at all then you'll have to remove all the warnings from the FDA, NCCAM, TGA because they specifically apply to colloidal silver.Blakebeau (talk) 05:34, 14 February 2013 (UTC)

None of the sources that you list are reliable. Random posts on an anonymous listserver don't really provide much information and manufacturers websites are worse. If you want to put the text back in without sources, then get some editors to agree with that and I will go with the consensus.Desoto10 (talk) 06:11, 14 February 2013 (UTC)

'Reliable sources' for my edits already exist in the article but I refuse to use them because I have previously argued that they should not be acceptable. But my edits were not medical claims anyway, or extraordinary claims that require extraordinary evidence. My edits were very, very basic: People drink colloidal silver. People make colloidal silver with electrolysis. I included them as something of a test to see what would happen. Frankly I haven't been surprised by your actions.Blakebeau (talk) 09:49, 14 February 2013 (UTC)

So you have sources that are already in the article but won't use them? Is this another test?Desoto10 (talk) 18:34, 14 February 2013 (UTC)

Quackwatch supports my statement that colloidal silver is made with electrolysis and is consumed orally, but I've said before that I think its a crap reference and shouldn't be accepted. I refuse to use it in this situation. Its stupid to have to use such a site when 1,590,000 google search results ('How to make colloidal silver') will verify my edit.

Saying the edit was 'a test' was poorly worded on my part. I didn't just add the statement as a test but I did wonder how an anti colloidal silver editor would respond. Totally predictably, as it turned out. My edit was a genuine attempt to satisfy an obvious deficiency in the article. Surely many people come to this section to answer the question "Where does colloidal silver come from and what do people physically do with it?" I answered the question as uncontroversially as possible. Zad asked for a citation, fair enough, but you removed my edit totally even though I think you know it to be true. You might not have liked it but I was trying to improve the article. What were you trying to do?

In case you've forgotten, heres the edit in dispute. Perhaps you could be more specific about which particular details you have a problem with.

Colloidal silver is often made at home using a simple electrolysis system comprising little more than a battery or low voltage DC wall adaptor directly connected to two silver wires suspended in a glass of pure water. More sophisticated systems may have circuitry to limit the current at the electrodes, and have some form of stirring apparatus such as an aquarium bubbler or rotating paddle.

Methods of consumption: Liquid colloidal silver is usually consumed orally, but is sometimes inhaled using a nebulizer or ultrasonic humidifier. It may also be applied topically.

Blakebeau (talk) 00:35, 15 February 2013 (UTC)

Let's be clear about what we are arguing about. I have no problems with your text, although I am not aware of nebulizers or ultrasonic humidifiers, as long as you cite references. You seem to be arguing that you should be able to enter the text without sourcing it. OK. I think that the onus is on you to gain consensus for your entry and lack of sources. Since these are not medical claims I think that you can use any reliable sources, such as magazine articles, newspapers, science-news type websites, etc. I am still waiting for input from other editors. A consensus will solve this.Desoto10 (talk) 02:15, 15 February 2013 (UTC)

OK, we agree these are not medical claims. So I've reinstated the edit with a non commercial website that I think should be considered a reliable source on how its made and what people do with it. Blakebeau (talk) 02:29, 16 February 2013 (UTC)

Well you can probably see for yourself that my edit has been removed again even though I sourced it. http://www.silvermedicine.org/ What do you reckon? Is it a fair source for a non-medical edit? All I'm trying to prove is that people make it and drink it. Blakebeau (talk) 04:59, 16 February 2013 (UTC)

I agree with this. It's indeed factually correct. Some people are making cs in their homes for the purpose of drinking it and applying externally. Ryanspir (talk) 13:40, 18 February 2013 (UTC)

The FDA's final rule on colloidal silver contains the language "The dosage form of these colloidal silver products is usually oral, but product labeling also contains directions for topical ... use." User:Fred Bauder Talk 14:28, 18 February 2013 (UTC)

That's right. The 'ruling' however is outdated and in my opinion no reference shall be given at all to say what Blakebeau is trying to say. Perhaps I'm wrong about this one? Ryanspir (talk) 13:40, 20 February 2013 (UTC)

Once and for all---Definition of "colloid silver"

I would like to propose that we provide a sourced definition of the term "colloid silver". Yes, I know that a colloid is a particulate suspended in a liquid with the particles so small that Browninan motion is sufficient to keep them suspended for a long time (or eternally). A colloid can be identified by shining a light beam through it. I also know what silver is. However, I feel that it would be a synthesis to say that "colloidal silver" (the stuff that is distributed as a supplement or home made) is, in fact, a colloidal suspension of silver in water. My case is bolstered by the variety of claims and counterclaims from manufacturers and distributers of "colloidal silver". Each one contends that they have the "real" stuff and the others have junk. I suspect that most "colloidal silver" contains silver, water, silver ions, silver oxide, and probably other things. I also suspect that colloidal silver often contains small elemental silver particles, and/or small silver oxide particles, often called nanoparticles (or nanosilver) because of their dimensions.

The problem is that I can't find a suitable definition that refers specifically to the colloidal silver that is on the market. The FDA contends that it is an unknown formulation of silver particles, but it is not clear that they have even looked into anything other than labeling. NCCAM has nothing. FTC has nothing. I can't find any review articles that actually look at what is on the market and tell us what is in it. For sure we cannot trust what the manufacturers put on the labels or in their advertising.

I would like to get a consensus on what to do so that we don't continue to argue over it.

Thanks, Desoto10 (talk) 05:19, 19 February 2013 (UTC)

Well, this edit is not productive if that is your goal. I suppose an example is in order: whole milk is a colloid with butterfat particles suspended in skim milk, itself a colloid. The thing that is undefined, and concerned the FDA, and what should give pause to anyone buying, making, or using colloidal silver is the amount of silver present. Below a minimum the solution does not even have the antiseptic property expected and is useless for topical application. If it has a lot, and it is being ingested there is a danger of sunlight breaking up the compound near the skin and depositing metallic silver. So it is not that the current products are not colloids which might not even contain silver, but there is no reliable information about the concentration of silver or what be an appropriate dose, assuming anyone would ingest such a substance. User:Fred Bauder Talk 14:03, 19 February 2013 (UTC)

It's not only the amount of silver that may matter. It's the structure of the silver atoms and molecules (example is a cancer research by univ of leeds), particle size and other variables. However, 'colloidal silver' is just a generic collective term as I have said already and carries no specific information by itself. You are generally right regarding the issue - too much can theoretically make a person become blue (though it's over-hyped) and too little may have no effect. Ryanspir (talk) 13:33, 20 February 2013 (UTC)

Thanks for the editorial, but do you have an opinion on the topic at hand?Desoto10 (talk) 18:20, 19 February 2013 (UTC)

The referenced FDA document says "Colloidal silver is a suspension of silver particles in a colloidal base." Is that an adequate definition? —BarrelProof (talk) 18:55, 19 February 2013 (UTC)

In the next sentence they say

In recent years, colloidal silver preparations of unknown formulation have been appearing in retail outlets. These products are labeled for numerous disease conditions, many of which are serious diseases.

I agree that the common description of colloidal silver is silver particles in a colloidal base, but that is the regulatory definition, not the scientific one.Desoto10 (talk) 21:44, 19 February 2013 (UTC)

Desoto, you are trying to find something which doesn't exist. So how much you can be successful at that? "Colloidal silver" is a layperson generic collective term. It doesn't include any specification regarding the silver, so you cannot find any specification. Ryanspir (talk) 12:56, 20 February 2013 (UTC)

A water based 'matrix'? Where did you get that from? I'd like a reference please. Why not just call it a liquid?Blakebeau (talk) 12:23, 26 February 2013 (UTC)

I have been begging for a reference, to no avail. I would support you reverting the definition due to lack of a reference. I agree that liquid is much better than what I had in there so I changed it.Desoto10 (talk) 17:12, 26 February 2013 (UTC)

Silver

I have started the process to make the information in the Silver article section on Medical uses match what we have here. Any help would be appreciated. Desoto10 (talk) 01:56, 5 March 2013 (UTC)

"Cancer research from the University of Leeds" is not relevant to Quackwatch and colloidal silver

The findings of the following preliminary in vitro preliminary research study are being quoted many times now in support of the idea that colloidal silver is not "quackery": PMID 22327273 "Enhanced cytotoxicity of silver complexes bearing bidentate N-heterocyclic carbene ligands" and here is the U of Leeds' press release about it. The argument being repeated here goes like:

1. There is a legitimate cancer study that shows a promising use of silver
2. There is no clear definition of colloidal silver that would necessarily exclude what Leeds studied
3. Ingested colloidal silver contains silver
4. Therefore, colloidal silver shouldn't be labelled "quackery" and we should reject Quackwatch's characterization of ingesting colloidal silver

This argument fails because per WP:BURDEN it is up to the editor bringing the argument for the content change to demonstrate that the sources brought clearly support the proposed content change. Saying that the definition of colloidal silver is too vague to exclude what was studied at Leeds is not sufficient. A reliable source would need to be found that clearly states that ingesting colloidal silver has any kind of health benefit at all in humans; this Leeds study does not do that. Leeds did not study ingested colloidal silver in humans and the study abstract makes no mention of colloidal silver or ingesting it. Zad68 13:56, 20 February 2013 (UTC)

I think you wanted to say 'in my opinion this argument fails'.

"There is no clear definition of colloidal silver that would necessarily exclude what Leeds studied". This is absolutely not what I have said. Kindly correct it.

"There is a legitimate cancer study that shows a promising use of silver", I agree here.

"Ingested colloidal silver contains silver", agree. And "Therefore..", agree.

"Saying that the definition of colloidal silver is too vague to exclude what was studied at Leeds is not sufficient." This is not correct. Who has said that definition of colloidal silver is too vague? I didn't say that. I have said it's a collective general term, but it's not vague. Kindly don't misquote me.

"A reliable source would need to be found that clearly states that ingesting colloidal silver has any kind of health benefit at all in humans; this Leeds study does not do that." - In that case it would be enough to state that cs has been proven beneficial for ingesting, but I'm not saying that. So this argument doesn't apply here.

"Leeds did not study ingested colloidal silver in humans and the study abstract makes no mention of colloidal silver or ingesting it." It's clearly a study of ingesting colloidal silver in order to treat cancer with positive results in phase 1. An abstract may not say that, but the whole article does. The author of the news article has obviously read the whole publication and explained it in layterms has written it clearly. Ryanspir (talk) 15:09, 20 February 2013 (UTC)

No, the Leeds researchers did not study ingestion of anything. This was an in vitro study. The press release directly from Leeds says "lab tests". Zad68 15:34, 20 February 2013 (UTC)

Neither the press release nor the paper mention colloidal silver or any variation on that term. As Zad68 notes, the paper has nothing to do with ingestion of anything, being a purely in vitro study. (And a study that didn't even attempt to measure or test cytoxicity of these compounds non-malignant cells, at that.) The paper used specific, well-characterized organometallic complexes of known chemical composition, molecular structure, and concentration—in stark contrast to 'colloidal silver' snake oil.

Even in the simplified system offered by this in vitro study, the authors note explicitly that the silver ion by itself is of limited effect, and that the contextualization of the silver atom by appropriate ligands is required for cytotoxicity. This point is reiterated (in more layman-friendly language) in the press release.

Finally, I suspect that you're confusing the press release's casual use of the phrase "...still the first phase of drug development..." (meaning basic biochemical and in vitro studies) with the very different concept of a Phase I clinical trial (which means administration of a real drug to a small number of actual human beings). The distance between those two points in terms of time, money, and clinical significance is vast. I think you would be very well served by reading the actual paper, instead of relying on the (sometimes a bit vague, and always hyperbolic) claims in a press release. TenOfAllTrades(talk) 17:15, 20 February 2013 (UTC)

As Zad and tenofalltrades have pointed out, this is not even an animal in vivo study, but rather a study of the effects of bidentate liganded silver complex on two types of cancer cell lines in tissue culture. They find that their silver-liganded complex works better, under these conditions than a platinum-liganded complex. A cool result, but irrelevant to whether or not Quackwatch is a reliable source.Desoto10 (talk) 23:02, 20 February 2013 (UTC)

Sorry to say, but all of you are wrong. And, I have tried to change the topic of this section to: "== "Cancer research from the University of Leeds" relevancy to Quackwatch and colloidal silver ==", for it being more balanced, neutral and in good faith. Why would we discuss something if it's already decided? That would render the discussion moot, won't it? So I'll change the topic one more time, and if someone will change it back, I won't change it again.

1. "No, the Leeds researchers did not study ingestion of anything. This was an in vitro study. The press release directly from Leeds says "lab tests". Zad68"

At the best you could say it was a result of a in-vitro phase. However, the whole study is regarding ingestion of cs, as I have already said.

"The research, still the first phase of drug development" - its clearly states that this research is about drug development.

Then what kind of silver do they refer to in the following quote? We have to ask, with what kind of silver the internet is awash with stories of? Obviously it's cs.

"The internet is awash with stories of how silver can be used to treat cancer. Now, lab tests have shown that it is as effective as the leading chemotherapy drug - and may have fewer side-effects. Results from the study at the University of Leeds, published in Dalton Transactions, show that particular silver compounds are as toxic to cancer cells as the platinum-based drug Cisplatin, which is widely used to treat a range of cancers.

But the crucial difference is that silver is thought to be much less toxic to healthy human cells, and in some cases, can be beneficial. Silver is currently used for its antiseptic and antibiotic properties, in bandages, wound dressings and water purification filters in the third world. "

It's clear from this paragraph that the intention of this research is to replace platinum-based drug with silver based drug. So I'll say it again, to summarize, while the current phase of the development is about in-vitro, the research is about ingestion of silver by mouth in order to treat cancer.

2."Neither the press release nor the paper mention colloidal silver or any variation on that term." - I have already said, that saying silver and colloidal silver is almost the same, and in this article it is the same. With what stories the internet awash? Nobody tried to consume chunks of silver, right? The only form people have been consuming is cs. The word "colloidal" is generally a confusing one for the majority of the people. But it takes just one minute to read the wiki article on "colloidal" to understand that it doesn't make much difference. It is still makes a general definition. By saying "colloidal" you don't define what kind of silver, what molecule or atoms or any configuration of silver. So you may as well not to say it at all, as they have choosen to do in the article.

3. "Even in the simplified system offered by this in vitro study, the authors note explicitly that the silver ion by itself is of limited effect, and that the contextualization of the silver atom by appropriate ligands is required for cytotoxicity. This point is reiterated (in more layman-friendly language) in the press release." - May I point you being inconsistent? You are mentioning cs to be a snake oil. Yet here, you agree and even use it as a proof of your position. May I point you to the fact that 'snake oil' has no effect? However, if there is a limited effect, it cannot be called a snake oil or a quack, in my opinion. I'll try to address the other points later. Ryanspir (talk) 15:25, 26 February 2013 (UTC)

Ryan, regarding "the current phase of the development is about in-vitro" -- Yes, glad everyone here agrees this was an in vitro study, we are unanimous on that.

You are asserting the Leeds study is relevant to the use of ingested colloidal silver; three experienced editors disagree with you. Per WP:BURDEN is it up to you to provide more, better, convincing proof that this study, which we all agree was in vitro, was relevant in any way to ingested colloidal silver. You need to provide something more than your interpretation of the press release. At this point you'd need to actually obtain the full, complete study and quote directly from it where it discusses ingested colloidal silver (if it does); consider using WP:RX for this. As it stands, although your viewpoint is noted, there is not consensus support for it and therefore there is no consensus to change article content based on it. Zad68 15:56, 26 February 2013 (UTC)

I actually went ahead and asked this at WP:RX, discussion is here, here it is:

Does PMID 22327273 mention ingesting colloidal silver? The abstract does not, but we'd like someone with access to the full article content to see if it's mentioned anywhere. Thanks... Zad68 12:14 pm, Today (UTC−5)

I just checked, and there isn't even mention of "colloidal". Chris857 (talk) 12:52 pm, Today (UTC−5)

So the study does not mention colloidal anything. I think this resolves the question of whether this study is useful to support the idea that it relevant to ingesting colloidal anything. Zad68 18:09, 26 February 2013 (UTC)

I had skimmed the original paper (as well as the press release, which seems to be the only thing that Ryanspir has read) before I commented here the first time. I specifically searched for any mention of colloids or colloidal mixtures. TenOfAllTrades(talk) 19:12, 26 February 2013 (UTC)

Do you and Zad actually read my reply? I have said that any silver that is intended for ingestion is a colloidal one. If there is no second substance in which it would be dispersed it would just be a piece of silver. If you don't like it, please re-read the definition of "colloidal". If you are still not sure, you may decide to ask the researchers at Leeds, if I remember rights their emails have been listed.

Thanks Ten, I wasn't sure if you had said you were looking at the full study article or maybe the abstract. But, it's now confirmed from two different sources, including the WP:RX volunteer who wasn't even involved in this discussion. Zad68 20:42, 26 February 2013 (UTC)

And so it appears as if we have a consensus of zad, ten, desoto, and a volunteer (Chris857) that the Leeds research does not specify ingestion nor colloidal silver and that it is irrelevant to the issue of quackery and quackwatch. Can we put this to bed?Desoto10 (talk) 21:58, 26 February 2013 (UTC)

I didn't say the research literally spells "colloidal silver". But I have said that "colloidal" is a word that can be omitted or changed, it isn't a word that must be stated. Example is Mesosilver. It is a colloidal silver, but they don't use this word. Any silver intended for ingestion is going to be colloidal, otherwise it would be a small invinsible to the eye piece of silver, impossible to ingest as you cannot see it. Small, microscopic particles of silver need another medium in which it will be suspended, most commonly water. It's similar to Ciprofloxacin vs Ciprofloxacin Hydrochloride. Its up to the writer which wording to choose, but in both cases it will be the same substance mentioned. Ryanspir (talk) 15:59, 28 February 2013 (UTC)

"Finally, I suspect that you're confusing the press release's casual use of the phrase "...still the first phase of drug development..." (meaning basic biochemical and in vitro studies) with the very different concept of a Phase I clinical trial (which means administration of a real drug to a small number of actual human beings). The distance between those two points in terms of time, money, and clinical significance is vast. I think you would be very well served by reading the actual paper, instead of relying on the (sometimes a bit vague, and always hyperbolic) claims in a press release."

I'm not confusing. Regarding the claims in the press release, http://www.sciencedaily.com/releases/2012/02/120202094700.htm. (I would like to point to "Story Source: The above story is reprinted from materials provided by University of Leeds.) So they are not vague. However if someone made his mind that cs is a "snake oil" than he would probably think that by simply saying "silver" they refer to "pieces of ordinary silver"?

Regarding cs being a snake oil, this is just for the editor who said that, do you mean in relation to ingestion, or to relation to everything? Including external application and disinfection of surfaces? Ryanspir (talk) 15:50, 27 February 2013 (UTC)

Ryan, what specific article content change are you proposing using PMID 22327273? Zad68 15:51, 27 February 2013 (UTC)

I would like this article to portrait cs neither as proven effective for ingestion nor a quack substance. I would like this article to be structured in a way that shows cs - silver to be in a state of active research. Ryanspir (talk) 15:35, 28 February 2013 (UTC)

Every other editor that has examined the source you have brought, PMID 22327273, has observed that the document does not mention "colloidal" anything and per WP:V cannot be used in support of your proposed changes. Unless you have a new, different source you'd like to consider, this discussion is concluded. Zad68 15:48, 28 February 2013 (UTC)

Ok, if no other editor will take the initiative, I may contact the researchers who are doing this cancer research regarding this point and if they will be kind to reply I'll post it. But at this time, let me ask you: What silver do they mean in saying the internet awash with stories of silver being effective for cancer? You are saying it's not colloidal silver. Can you please provide an alternative interpretation? Ryanspir (talk) 16:03, 28 February 2013 (UTC)

You are correct in concluding that it is your initiative to take because per WP:BURDEN it is up to you to provide support for your proposed changes. It is not up to other editors to come up with explanations as to why your interpretation might be right, so there is no reason for other editors to speculate about alternate interpretations. Please be aware that per WP:V, your personal correspondence cannot be used to support article content changes. Zad68 16:08, 28 February 2013 (UTC)

I assume you mean that if the researchers will reply that they indeed investigating cs it will have no any significance to the position of the editors who consider that they are not investigating cs, even if it being a clarification? Other editors agree with zad's position? Ryanspir (talk) 12:49, 6 March 2013 (UTC)

If there are no specific changes proposed for the article, can we just drop this?Desoto10 (talk) 17:35, 28 February 2013 (UTC)

That would be great. One of the biggest researches of nanosilver by a respectable UK university for development of a new cancer drug will not be reflected in the article "Medical_uses_of_silver" and their preliminary results won't be reflected either. I would propose instead of dropping it, some editors will come forward and propose a specific change(s). I personally won't do that at this time. Ryanspir (talk) 13:22, 6 March 2013 (UTC)

OK, great! We will not use the Leeds article by unanimous consensus. We will not bring this up again (or at least in the near future). Desoto10 (talk) 19:34, 6 March 2013 (UTC)

"Quackwatch" dispute resolution outcome implemented

Per the unanimous agreement and successful result of this WP:DRN discussion, I have updated the reference to Quackwatch from using the older Colloidal Silver article to the statement found in the newer Lyme Disease article. Zad68 18:45, 6 March 2013 (UTC)

That's exactly what I have said in the beginning and it was *absolutely* clear that the previous reference fails wp:medrs. In my opinion the whole discussion was quite redundant and was a waste of time for at least five involved editors. If I would sum all the time that I and other editors have used for it reaching in the end the same result that was obvious from the very beginning I would estimate the waste to be more than one thousand dollars. Anyway, I'm glad that I alone won against 3 experienced editors. However, I would rather go beyond personal opinions and work in a friendly and collaborative way. For in such a way there wouldn't be a need for dispute resolution and the article would be more balanced. Ryanspir (talk) 13:24, 8 March 2013 (UTC)

Topical application

zad, so you are saying that colloidal silver per the available information to us at this moment is an effective substance in relation to topical application and is a quack medicine in relation to ingestion. Did I get you absolutely right? Please be precise in the answer so we won't have misunderstanding. If i got you right, please write: yes ryan, you got me right. If i got you wrong kindly clarify. Ryanspir (talk) 19:24, 6 March 2013 (UTC)

If Zad is saying that, then it would be incorrect. The current consensus among editors is that the ingestion of cs is quackery and that the use of silver-containing wound dressings, while not overwhelmingly supported by EBM, is not quackery. Desoto10 (talk) 19:38, 6 March 2013 (UTC)

I moved this from my Talk to here:

topical application

Aren't you saying the same thing as zad? When i said effective i meant merely having any kind of proven effect. Ryanspir (talk) 20:29, 6 March 2013 (UTC)

I am going to start to ignore your comments unless you suggest changes to the article. If you have no changes to make, then it is not clear why you are here. Desoto10 (talk) 21:39, 6 March 2013 (UTC)

Our personal opinions do not matter. This Talk page is for discussion of article improvements only. Do you have a particular article content change and source you'd like to discuss? Zad68 19:47, 6 March 2013 (UTC)

I would ask Desoto out of courtesy to kindly remove his comments. Especially "then it is not clear why you are here." As I find them not relevant and uncivil. Thank you. Ryanspir (talk) 13:33, 8 March 2013 (UTC)

merge sections?

Are there good grounds for having separate sections called "antibacterial cream" and "antiseptic use"? Are these terms not much the same thing? Wdford (talk) 09:45, 21 March 2013 (UTC)

Many of the uses are not antiseptic so changed the heading. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:14, 21 March 2013 (UTC)

Tentative to substantial?

In this series of edits, why was the word tentative changed to substantial? Was it based upon Beattie2011 or other sources? Biosthmors (talk) 22:36, 21 March 2013 (UTC)

Might have been a confusion between central venous catherters and urinary catherters. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:54, 21 March 2013 (UTC)

Primary research being added

In these edits primary research was added [3] such as this paper here [4] and this paper here [5]. This was done while removing the conclusions of a more recent review from 2012 [6]. Consensus is that we do not replace secondary source by primary sources or refute secondary sources with primary sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:50, 21 March 2013 (UTC)

Lede efficacy of Ag dressings

We had:

While wound dressings containing silver sulfadiazine or silver nanomaterials may be used to treat external infections, there is little evidence to support their use.

Wdford changed this to:

Wound dressings containing silver sulfadiazine or silver nanomaterials are used to treat external infections,although the evidence suggests that some non-silver dressings are equally effective.

The actual conclusion from the Cochrane review that is the source for both of these versions is:

"There is not enough evidence to recommend the use of silver-containing dressings or topical agents for treating infected or contaminated chronic wounds."

I suggest that we change to "...there is not enough evidence to support their use."

-or maybe- "...there is not enough evidence to recommend their use." Desoto10 (talk) 17:25, 14 March 2013 (UTC) Desoto10 (talk) 17:23, 14 March 2013 (UTC)

Still too biased. The two reviews you are referring too actually state clearly that they are not reliable sources either way, due to the poor quality of the tests being reviewed. However a more recent (2012) Cochrane review here [7] - also quoted in the article - says that "Our review suggests that silver-containing dressings and topical silver were either no better or worse than control dressings in preventing wound infection and promoting healing of burn wounds." That says the silver dressings are effective, but no more so or less so than other dressings. Please let's be a bit more neutral here. Wdford (talk) 15:18, 15 March 2013 (UTC)

I am not sure that we are interpreting the Aziz (2012) paper correctly. I only have the abstract and if someone has the actual paper that would be great. It states:

"One small trial of a silver-containing dressing showed significantly better healing time compared to the control [MD -3.6; 95% CI -4.94 to -2.26 for partial thickness burns and MD -3.9; 95% CI -4.54 to -3.26 for superficial burns]. Topical silver showed significantly worse healing time compared to the non-silver group [WMD 3.96; 95% CI 2.41-5.51] and showed no evidence of effectiveness in preventing wounds infection [WMD 2.48; 95% CI 0.39-15.73]. Our review suggests that silver-containing dressings and topical silver were either no better or worse than control dressings in preventing wound infection and promoting healing of burn wounds."

To me that sounds like the last sentence means silver-containing dressings were no better than control and that topical silver was worse than control. They say that topical silver had worse healing time and no evidence in preventing infection when compared to control. That means that topical silver was worse than control. Desoto10 (talk) 04:19, 19 March 2013 (UTC)

Wikipedia should not usually include wording such as "recommend (or support) their use" because wikipedia should not be providing a medical advise, recommend or not to use or not use something or even imply such recomendation or not recomendation. Ryanspir (talk) 15:47, 18 March 2013 (UTC)

Agree with Desoto10 and have reverted to the previous version until consensus is obtained. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:27, 19 March 2013 (UTC)

I revised the main body text as well to reflect this interpretation which, incidentally, is validated in later paper by the authors. Incidentally, ref 4 and 16 refer to the same paper, but I am not smart enough to fix it.Desoto10 (talk) 18:31, 19 March 2013 (UTC)

I read this "either no better or worse" as they were either no better or they were worse. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:58, 21 March 2013 (UTC)

I agree with Doc James about the fact that it was indicated in the way he says. While the conclusion itself might have been erroneous, the read is as he has stated. Ryanspir (talk) 14:13, 22 March 2013 (UTC)

FDA approval

Have moved this content lower in the article "A number of wound dressings containing silver as an anti-bacterial have been approved by theFDA." as the FDA approval is country specific and is legislative more than a comment on effectiveness. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:18, 21 March 2013 (UTC)

Just as long as we are consistent. Wdford (talk) 06:30, 21 March 2013 (UTC)

I absolutely disagree with the position of Doc James. I would really like to put in mild words, but isn't it hypocritical to include all warning by US regulating authorities such as FDA, NCCAM regarding silver and give them a lot of weight *even though those doesn't say silver is ineffective, but they say it's not proven enough to be effective* and at the same time don't include approval/clearances of FDA regarding silver all while by sidelining them on account that they are US specific? I would like to bring you to three main points:

1. FDA final letters didn't mean that silver is ineffective, they were simply meant to say that the products didn't get FDA approval to be sold with treatment claims.

2. FDA advisories say that silver has not been proven to be effective for ingestion, not that it was proven to be ineffective.

3. FDA approval/clearance is a lengthy process. In this case it is not country-specific and such clearances/approvals should be given more weight than FDA advisories for example. Why? Because of how this clearances are obtained. For a certain product, lets say silver dressing, to get FDA approval for external use, the manufacturer has to submit it to 3rd party biomedical facility that will independently verify the claims. FDA won't approve anything for wound healing that is not healing wounds. So for any FDA approval there is a biomedical evidence certified by 3rd party biomedical facility approved by FDA. There will be actual patients with actual wounds applying this actual treatment product. In this case FDA approval constitutes scientific approval that the product is actually works. If the same product will be used anywhere in the world it will treat the wounds in the same fashion it has been found to treat them in USA. Ryanspir (talk) 13:45, 22 March 2013 (UTC)

So due to the above mentioned I view that it's more than "comment on effectiveness." In my humble option it's a very prove of the real products being effective. Ryanspir (talk) 13:55, 22 March 2013 (UTC)

Non pubmed index article

This article is not pubmed indexed and should IMO not be used to refute a more recent Cochrane review "A 2011 systemic review concluded that silver dressings and topical agents are promising as safe and effective wound care treatments." Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:12, 21 March 2013 (UTC)

I disagree with the basis. While Cochrane review maybe not included on other accounts, but the fact that it's Pubmed indexed or not should not play a role. As long as it's Cochrane review - it's a Cochrane review. 2011 is not outdated, so not fais wp:medrs IMHO. Ryanspir (talk) 14:11, 22 March 2013 (UTC)

Primary vs Secondary

Many times I was pointed by Zad and one-two times by Doc James about the issue of primary and secondary sources, in the context of:

a. "Consensus is that we do not replace secondary source by primary sources or refute secondary sources with primary sources." James

b. "Sure you are required to use secondary sources for most details pertaining to health care." James

c. Please provide secondary sources that will show your position. Zad

I have extensively read [wp:medrs] and the relevant wiki policies and I have found that 80-90% of the sources used on wikipedia are primary sources, and that the secondary sources are interpretations of the primary sources. No interpretation can be 100% accurate. So the wiki policies give us a hint, it's the quality and reliability of the sources that matters most. A primary reliable source of good quality counts a lot and should be given due weight. Here is what wiki policies say about that: "Secondary" is not another way to spell "good" Shortcut:

  WP:NOTGOODSOURCE

Further information: Wikipedia:Secondary does not mean independent "Secondary" is not, and should not be, a bit of jargon used by Wikipedians to mean "good" or "reliable" or "usable". Secondary does not mean that the source is independent, authoritative, high-quality, accurate, fact-checked, expert-approved, subject to editorial control, or published by a reputable publisher. Secondary sources can be unreliable, biased, self-serving and self-published. "Primary" is not another way to spell "bad" Shortcut:

  WP:PRIMARYNOTBAD

"Primary" is not, and should not be, a bit of jargon used by Wikipedians to mean "bad" or "unreliable" or "unusable". While some primary sources are not fully independent, they can be authoritative, high-quality, accurate, fact-checked, expert-approved, subject to editorial control and published by a reputable publisher. Primary sources can be reliable, and they can be used. Sometimes, a primary source is even the best possible source, such as when you are supporting a direct quotation. In such cases, the original document is the best source because the original document will be free of any errors or misquotations introduced by subsequent sources." Ryanspir (talk) 14:20, 22 March 2013 (UTC)