Wikipedia:Citations in medical articles

For the related guideline, see Wikipedia:Identifying reliable sources (medicine).

Most editors want a higher density of citations in articles about medical conditions and drugs than is typical for articles about less technical subjects, such as books and films.

Special needs for medical articles

Wikipedia has general rules which apply by default to its millions of articles. The Wikipedia community keeps those rules strict enough to maintain a high level of article quality but also relaxed enough to encourage people of all backgrounds to improve Wikipedia with content contributions from reliable publications in all fields. There is a well loved concept in the Wikipedia community that "WP:Local consensus" should be avoided. This means that whenever possible, Wikipedia's rules should be set by a global consensus which applies to all articles. By default, attempts to establish "local consensus" to create new and specialized editing guidelines which only apply to a certain set of articles should fail. Anyone who seeks a local consensus to create an exception to a rule should instead change their own expectations, or seek to re-write the global rule in a way that benefits everyone, or somehow seek to encourage the best editing practices which are most intuitive to most people and encourage the best contributions to Wikipedia.

Editors to medical articles on Wikipedia, and the WikiProject Medicine community in particular, tend to advocate for specialized rules for medicine more than other groups of typical Wikipedia contributors. This happens because medicine has a more centralized culture around it than many other fields of publication. As Wikipedia seeks to mirror and summarize the best available medical information, Wikipedia adopts for its medical articles the standards of quality which expert consensus in medicine has established outside Wikipedia. Points of conflict between editors of medical articles and the general Wikipedia editing community include the following:

1. Editors of medical content typically want Wikipedia to reflect published sources of a higher quality standard than anyone expects for non-medical Wikipedia articles. Those sources are described at WP:MEDRS.
2. Editors of medical content often look beyond English Wikipedia, and try to anticipate that the information they share must be in a form which can be translated to other language Wikipedias or reused off-wiki. One consequence of this is advocacy for a publishing style which works cross-wiki, and not just on English Wikipedia. This goal conflicts with editors who participate in English Wikipedia but do not prioritize following the continual developments in translation from English to other languages.
3. Editors of medical content often act with urgency beyond what is normal elsewhere. While in some fields there is tolerance for making mistakes in editing Wikipedia then correcting those mistakes over a period of hours or days, in medicine, there is an expectation that all content has to maintain an above-average quality standard and be readable immediately on publishing. This conflicts with a tendency to permit individual editors to experiment with live Wikipedia articles, even if that permits mistakes to be published while editors are fixing them.
4. Editors of medical content have a goal of responding to external media scrutiny more often than Wikipedians editing in other spaces. Wikipedia's medical content is the subject or academic review and criticism more often than any other field of Wikipedia content. Through publication in off-wiki channels, non-Wikipedian journalists and researchers who publish about Wikipedia are contributors to Wikipedia also, even if they never have Wikipedia accounts or engage on-wiki. Medical editors seek to gain the support of those off-wiki critics, including medical researchers, health care providers, and university faculty, in ways that less commonly arise in other areas of Wikipedia publication. Engaging in Wikipedia discussion in academic review of Wikipedia's medical content is important to Wikipedia's medical editors but sometimes seems irrelevant to editors who see the development of Wikipedia as more of an internal, closed-community conversation.

These pressures and others lead to editors to Wikipedia's medical content having expectations about medical content on Wikipedia that differ from the global rules which generally apply to Wikipedia editing.

Citations in the lead

Medical articles in particular are quite often translated into many other languages, and are generally recognised as reliable sources on health issues. In many cases, the lead alone may be translated as part of the effort to make the top-importance medical articles available in as many languages as possible. For this reason, editors of medical articles generally make an exception to the Wikipedia meme of keeping references out of the lead (as explained in WP:LEADCITE, part of the Manual of Style.

A problem that affects regular medical editors is the drive-by citation remover. Because it is common practice not to placing citations in the lead in other types of articles, it is not unusual for the deliberate task of providing references in the lead to be undone, simply because of a lack of understanding of the other issues at play. The same effect occurs when using the same citation for consecutive sentences.

Citations for almost every sentence

This concept should not be confused with Wikipedia:Citation overkill, which is concerned with the practice of providing a large number of consecutive references to support a single claim. There is rarely any need to cite more than one or two sources for any given fact, but attempts are sometimes made to bolster weakly sourced content by adding multiple weak sources in the hope that quantity makes up for the lack of quality in the sourcing.

Given that it is not obvious that a single reference at the end of a paragraph supports each sentence in the paragraph, there is some weight in the suggestion that each sentence should be referenced. This is a real consideration because as articles age, content changes and is rearranged. Sometimes text can be added that is not supported by the terminal reference and it requires constant vigilance to catch such changes.

Edwardx summarises the concern quite well: "We should aim to cite every sentence, especially for articles that might be more contentious, or those that are more likely to be expanded over time, such as BLPs. Articles get rearranged and sometimes paragraphs are combined or split into two. Thinking long-term, the sentence is the key unit, not the paragraph. If we also consider the increasing role of Wikidata in supporting and creating articles, then its role in supporting discrete facts (ie sentences), favours such an approach. One citation per sentence should be enough, unless something is particularly contentious, or perhaps where each source supports a different element of the sentence."

There is a suggestion that multiple sentences can be supported by the same citation as a work-around by placing the citation inside an html comment after each sentence except the last. That means the repeated references are visible to an editor, but not seen by a reader. It used to work fairly well. A small number of editors at the English Wikipedia are using the Visual Editor, where these hidden comments are now displayed in their entirety, highlighted in a different color, and marked with a (!) icon, but we have one (so far) example of one sourced sentences being removed by a logged-out on the grounds that it was contradicted the body of the article.

Overciting content

Further information: Wikipedia:Citation underkill

For simple claims one inline citation is usually the most that is needed for content that is likely to be challenged. More than three inline citations for each claim is usually excessive for non-controversial claims. An editor may consider picking the top one or two sources. This is done on a case-by-case basis.