Wikipedia talk:WikiProject Countering systemic bias/Archive 16

Systemic bias in Eastern Medicine subjects

Hello all, I was just reading the article on acupuncture and noticed an interesting example of systemic bias. Many strong claims are made, sometimes supported by reviews from good peer-reviewed journals. On Western medicine related subjects, articles/studies from such publications are considered the gold standard in sourcing. However, when it comes to a subject like acupuncture, I think they actually fall quite short. There are reporting standards, for instance, such as STRICTA which, if followed, mandate that studies/reviews note things like "who is performing acupuncture? Is it a nurse? Is it an MD? Is it a non-healthcare professional? Or is it an acupuncturist with more than 10 years experience?" or "depth of needle insertion" or "needle retention time". Western journals, because they are ignorant of attributes such as these, often don't care about these details. They can often, perhaps unwittingly, publish low quality studies and reviews because it is not their field of expertise. While we may regard these journals as high-quality on topics ranging from albuterol to zygomycosis, I would suggest editors here to take a look at the page and join my efforts in making corrections to it, as necassary, so as to avoid systemic bias on topics such as these. 166.147.123.168 (talk) 22:07, 15 July 2014 (UTC)

Hey bro, I know quite a bit about eastern medicine. I studied Chinese in college and lived in China for a little over two years, then wandered around in various parts of Asia for several more. Their medicine is legit, it saved my butt on more than one occasion. People in the US live in a tiny bubble and haven't experienced the rest of the world. They have opinions, but don't know what they don't know. I haven't heard of stricta but I'll look into it. I just looked at the acupuncture page you're talking about and it does have a strong western bias. I'll give me my 2 Lincoln's. LesVegas (talk) 18:37, 17 July 2014 (UTC)

Be careful not to conflate bias with correctly dealing with pseudoscience and fringe theories. Reliable scientific journals are what medical articles MUST be based on. Sam Walton (talk) 18:54, 17 July 2014 (UTC)

I think the point was reliable scientific journals aren't reliable at all when it comes to subjects which their editors aren't familiar. If we're not gonna have systemic bias, shouldn't sources meet a better standard for reliability? I was reading about STRICTA today and here is the Stricta checklist which is all common sense. If studies can't meet those standards, they're not reliable. I'll read about this some more before I edit. There's idiots everywhere on wikipedia attached to their opinions, I want to make sure I'm not one of them. LesVegas (talk) 02:56, 18 July 2014 (UTC)

Chinese research tends to be ignored, both by Wikipedia editors and Western journals. --Hildanknight (talk) 03:12, 18 July 2014 (UTC)

On what basis are you assuming that the scientific journals used in, for example, the acupuncture article are not familiar with the subject? Because that's quite a big claim. Sam Walton (talk) 09:11, 18 July 2014 (UTC)

What Sam Walton is saying is quite reasonable from Western common sense, and a part of me agrees with them. However, this is the talk page for the project to fight systemic bias. As such, we need to take a step back and examine if what we take for granted are colored with systemic bias. From this stand point, I support 166.147.123.168, LesVegas and Hildanknight.

Moreover, WP:MEDRS is a guideline, and its first line says "It is a generally accepted standard that editors should attempt to follow, though it is best treated with common sense". (and WP:COMMON says " Wikipedians come from diverse ethnic, religious, political, cultural and ideological backgrounds and have vastly different perceptions") On the other hand, unlike a guideline, WP:NPOV is a policy all editors MUST follow, which requires us to recognize and present minor view points (including Chinese common sense). Japan has over 120Million population, and China has over 10Million English speakers. Yiba (talk | contribs) 07:59, 20 July 2014 (UTC)

Well I've been doing research on the subject of STRICTA and came across this review from the British Medical Journal, who has adopted STRICTA's reporting standards in acupuncture research. It showed how even Cochrane Reviews are sub-par. Not when it comes to Western research, it's the gold standard there. But Eastern medicine, specifically acupuncture, they don't value robustness in reporting. And that's a problem in a field like that. You've got to have some sort of reporting standards, and if you don't then it's clear you don't understand the subject. LesVegas (talk) 20:10, 20 July 2014 (UTC)

Be aware that there has been systematic boosterism of various areas in medicine and science, and some of these we know about but are still picking up the pieces of. All the best: Rich Farmbrough, 20:18, 20 July 2014 (UTC).

May be we should add the subtitle "boost the knocker" to this project, or use it as the slogan :) Yiba (talk | contribs) 04:18, 21 July 2014 (UTC)

Yeah man, boost the knocker! I like it. Now, as for what Rich said, I just noticed how an active editor on the acupuncture pages has just been topic banned. The only real thing I could see he did wrong was to edit war, although other editors were doing this as well and have emerged unscathed. On the one hand, I see many problems on that page and while I want to help, I don't want to be bullied by some of the editors who have seized pages like this and act like they own it. On the other hand, I think bias will only get out of control if we don't stand up to it. Is there another way of proceeding, other than going over there and getting into an edit war and eventually getting topic banned ourselves? That article, and articles like it, need major work to free them from bias, but there has got to be a better way than fighting to go about it.LesVegas (talk) 12:54, 22 July 2014 (UTC)

No evidence for any systematic bias by "western journals" has been presented here. The STRICTA list of participating journals is over 50% published in countries traditionally considered to be "Western" culture. One of which is PLoS, one of the largest "western journals". And editor LesVegas said that British Medical Journal, one of the most respected "western journals", has also adopted STRICTA. It would seem obvious to me that any favoratism of "Eastern Journals" over "Western Journals" would only lead to systematic bias. Dkriegls (talk to me!) 19:12, 22 July 2014 (UTC)

Hey DKriegls! Thanks for contributing to this discussion here bro. I appreciate your comments and you're right about Plos and BMJ. Now, you said no evidence has been presented here, and I can see how you would certainly come to that conclusion if you didn't notice this link I posted previously. And sorry, man, I've probably also talked too abstractly, but anyway the argument I've come to understand here is extremely complex, and it didn't make complete sense to me either at first. But basically it's this: reporting standards exist, for example, for acupuncture. This ensures that we, or the reviewers of studies or of systematic reviews, know exactly what occurred in a study. For instance, some studies don't report how long needles were left in someone's body. Or they don't report who did acupuncture and what their qualifications were. Or they don't report how deep the needles were inserted, or what the retention time was. Or all or even any details about the placebo control. Now, I can certainly forgive some Western journals for publishing studies that don't have this information. They aren't as familiar with acupuncture as western medicine, and to them a study that says, "acupuncture on these points yielded x result versus sham placebo" seems reliable so they publish it. Afterall, that's how Western studies are designed. A drug is a drug is a drug. And we don't need to know if the sugar in the placebo came from refined cane sugar or from beet sugar or was a crop from Cuba or from the Honduras. It doesn't matter. But deeper details matter in something like acupuncture, and they could matter a lot. So anyway, we've got Cochrane Reviews that don't even adopt reporting standards for acupuncture. That's a problem and it's not just us saying it, the BMJ even says Cochrane is publishing subpar information on acupuncture. It stands to reason that we need evidence of the highest quality to make our claims. So Western journals like Plos, BMJ, etc and respected Eastern journals which also subscribe to these reporting standards would be the ones we should use to make our boldest claims, and perhaps most claims. So you're right in a sense, Western journals could be good ones too, we just have to make sure they're reporting with robust evidence. LesVegas (talk) 03:28, 23 July 2014 (UTC)

Thanks, I did actually read that link and as a researcher myself, understood it fine. I don't see where it demonstrates bias, only that there are different (and possibly less rigorous) science standards. Asserting that Western Journals "aren't as familiar with acupuncture as western medicine" is an actual assertion of bias, but you have not provided any evidence of that as there are plenty of "Eastern Journals" that also don't report STRICTA standards with their publications. Since STRICTA standards are not a standard research practice, our Wikipedia NPOV approach would be to include reference to all current research on the topic, but add mention of the difference in STRICTA reporting. As there are no current systematic reviews which only look at STRICTA reporting studies, the best systematic reviews out there are what we report. On a side note, I would think this is a discussion better suited for the Acupuncture talk page where editors are more familiar with STRICTA and Acupuncture; and would only make sense to bring up here after editors at said talk page rejected the inclusion of STRICTA reporting methods due to some apparent bias. Dkriegls (talk to me!) 20:05, 23 July 2014 (UTC)

Hey DKriegls! Thank you kindly for giving us your insight as a psychology researcher. That's exactly why I didn't want to take this topic to the acupuncture talk pages just yet. I thought about it, but to me, it's better to get these insightful and broader views first. Now, when I said "Western journals aren't as familiar with acupuncture" I should have qualified it by saying they aren't as familiar if they don't use well accepted reporting standards, which STRICTA clearly is. If a Western journal publishes a study on acupuncture which says x, but it doesn't say how long needles were retained, or if they were stimulated or not, or who inserted them, then our argument is there's a problem with reliability. Or Eastern journal for that matter! To me, what matters most is: is the study or review reporting all the facts or not? If not, I don't see how we could allow the source to make a bold claim. Neutral claims, yes, but bold claims one way or another should only be made with sources using some sort of reporting standards. Since you're an expert in the psychology research field, I'm curious if you value more robust reporting or is it not that important to you? If a bold claim were made about, say cognitive behavioral therapy not yielding any results for patients with, say, anxiety when administered weekly over the course of 1 year, would you be skeptical of the claim if they failed to report whether or not they used psychologists actually trained in the method? If you're busy, I understand, but hopefully you can provide some expert nuance here because now I only see it black and white,(and that's notable since I'm an ENTP to the extreme!) Anywhoo, I thank you again for offering your valuable insight!LesVegas (talk) 23:04, 23 July 2014 (UTC)

Oh,sorry, I just noticed where you said you didn't see the demonstration of bias. This is a specific type of bias we're claiming here, systemic bias, which I'm sure you know is the inherent tendency of a process to support particular outcomes. As Yibal said, MEDRS is a guideline not a policy. By using just peer reviewed journals to support any claim, journals without reporting standards, we create systemic bias. Or at least that's what we're thinking is going on here. LesVegas (talk) 23:25, 23 July 2014 (UTC)

There's a lot to respond to here, not sure I will get to it all. Perhaps your last statement is best addressed first. Yes, there is lots of bias in research. However, citing non-uniform (even poor) standards is not evidence of systemic bias. It makes it harder to prevent bias, but even STRICTA standards are likely to leave room for the type of systemic bias currently found in scientific reporting. Bias in science can be identified in many ways. For instance, STRICTA in no way limits a widely recognized systematic bias currently troubling scientific publican. Called Publication bias, it has wide ranging implications and is the bane of every researcher trying to improve scientific reporting. But it does exist and we identify it through statistical trends like the Decline effect. So for instance, if you were to argue that studies reporting STRICTA (and to be clear, STRICTA is just about reporting and not reporting doesn't mean not using) were more reliable than non-STRICTA reporting studies, you would need to demonstrate that by discovering a difference in outcome between the two groups. This study on publication bias in video game research is an example of what that would look like. In contrast, this study you refer to from PLOS doesn't show anything like that. In fact, it actually shows that randomized controlled trials (RCT) published after 2005 were extremely likely to used STRICTA reporting standards. Your referenced study's critique was that the Cochrane Reviews of those very RCT studies were "16% less likely to report the acupuncture-related items of STRICTA than RCTs". Meaning Cochrane Reviews used STRICTA compliant studies, but 16% of the time didn't report all the STRICTA variables. This is not evidence of any systematic bias and is actually counter evidence to your claim that STRICTA isn't being used as even the Cochrane reviews were only 16% less likely to use it. While I don't see any evidence that a distinction actually exists between "Eastern" and "Western" journals in general, I do know that studies originating in certain countries do have a well know publication bias on the subject. This review of 252 acupuncture studies found that "No trial published in China or Russia/USSR found a test treatment to be ineffective". Statistically speaking, this is an improbability even for a highly effective treatment. Just by chance some studies of very effective treatments statistically vary from the norm. This study suggests similar "highly positive" publishing by Chinese journals in other medical subjects as well, so I assume this is a systemic publication bias, and not just a preference to accept acupuncture as effective. But even given this publication bias, I would not assume systematic bias in research until I had a solid set of higher quality studies that showed significantly different results. Publication bias does not equal research bias. A scientific conclusion is like a brick house that you never finish and can't discard the bricks you start building it with. You only build a stronger base round the weaker base, and you always live in an unfinished house. --Dkriegls (talk to me!) 06:13, 24 July 2014 (UTC)

Now with that said, this list originally think that STRICTA wasn't widely excepted. However, after more closely reading the STRICTA/Cochran review, reading the BMJ uses it even though they weren't on the STRICTA list of users, and inclusion by NIH here, I think you made the case that STRICTA is widely accepted. However, this apparent wide acceptance makes me now doubt if it isn't already included in all the articles cited on the acupuncture page. I think the next step would be to review the studies cited and see if they are not. Unfortunately, after reading the STRICTA/Cochran review study, this isn't guideline they say they have followed, they just follow it and you have to find the data points to see if they have. I could be wrong, but that was the impression I got. Better to ask someone on the Acupuncture page. --Dkriegls (talk to me!) 06:13, 24 July 2014 (UTC)

Thank you again DKriegls! You have given us some excellent things to think about. I have run across some stricta content you might not have been aware of which addresses some of your concerns, it'll just be a matter of me sifting through them. There's a lot of data there! Anyway, I again appreciate you lending us your expertise! LesVegas (talk) 03:57, 25 July 2014 (UTC)

Just read through this thread. Some comments. Please excuse the length. Feel free to ignore, of course. First, overall tone. While it is very true that WP has systemic biases, in my mind it would be a mistake to conflate the general controversy in the field of medicine over the validity of acupuncture, with systemic bias in WP. Those are two separate issues and the relationship & distinctions between the two should be discussed carefully.

I want to say a bit more about controversy in the field of medicine over the validity of acu and what that means in WP. Acu is grounded in traditional, pre-scientific notions of the body. Because those notions of the body (qi, etc) are not grounded in science, the same is true for interventions based on those notions of the body. Specific interventions can be tested using the scientific method for sure, and there is scientific research underway to determine scientific bases for why acu could work. But (and here it comes) the lack of grounding means that in WP, the field is defined as pseudoscience. This is a serious and important thing in WP. Efforts to address systemic bias without acknowledging that, and trying to address the pseudoscience classification in inappropriate venues (article Talk pages are not appropriate for that!) will, in my view, probably lead to failure, frustration and drama all around, and even topic bans. I'll return to this at the end.

Along those lines, LesVegas mentions the editor who was recently topic banned. The description of why Herbxue was topic banned is wrong. The actual AE is here, and you will see that Herbxue was topic banned for more than edit warring - mostly for uncivil behavior, losing his temper.. things like that. If you go and actually study his interactions, you will see that H refused to really grapple with the "pseudoscience" issue and this often led to him getting angry and frustrated. (I was trying to help him grapple with it, when he wrote something here about how "outsiders" choose to interpret things that I still don't understand. (I tried to discuss it with him here)) But in my view, one of the reasons he crashed and burned is that he looked only at bias and didn't deal with the problems with pseudoscience and got frustrated with editors who were dealing with it.

That said, there are editors who work on TCM on the "skeptic" side who are incredibly difficult to work with. For the most part I have stopped working on TCM articles because the POV-pushing from both sides makes it impossible to get nuanced content into WP. Anyway, enough on that.

I also want to discuss STRICTA a bit. If you study the evolution of STRICTA... it came into being in 2002 (see here and it only became an official extension of the overall CONSORT standard in 2010 (see here). It is still fairly new, and there are many published trials that didn't report according to it, and some that still don't report according to it. Here is a published editorial by a guy who led the Cochrane review of acu in fibromyalgia who describes how much work it took to get information required by STRICTA from authors, that they didn't include in their publications, so he could do his review well. Things are messier than LesVegas would make them out to be.

And I want to point out that when LesVegas writes things like "BMJ says X" this is ... unfortunate (more on that in a minute). The corresponding author of the article in BMJ Open (which is not "The" BMJ) is Professor Jae Dong Lee of the Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, South Korea. It is accurate to write that BMJ Open published an analysis of Cochrane reviews written by professors of acupuncture and to later refer to it as "the BMJ Open article". Something like "BMJ says X" would only be accurate if the editors of the actual BMJ wrote and published an editorial and said X (which would indeed be a powerful thing), but is just not the case here. On the "unfortunate" thing - this way of describing published work -- which arises from ignorance, sloppiness, tendentiousness, or a combination thereof, - and deploying the mangled description to make strong rhetorical points -- discredits those who do it and inflames people "on the other side". It is profoundly unhelpful.

As I wrote, I pretty much stopped working on TCM-related articles due to POV-pushing on both sides. There is too little space in the middle for careful, nuanced work that would lead to really good WP articles. It is a great thing to address systemic bias, but beware becoming a POV-pusher for acu. Acknowledge the lack of scientific basis for acu; describe sources and what they say carefully and accurately; deal honestly with the messiness all around - what we know and what we don't know, and overall, with the limitations of any human editor and with all human endeavors, including medicine and TCM. Addressing systemic bias is important and will cause drama. Please don't undermine those efforts by POV-pushing for acu at the same time, in a conflated way. That will doom the efforts to failure and cause confused, unnecessary drama. The last thing we need is more POV-pushing editors who view themselves as righteous and the world as black and white. Anyway, those are my two (really twenty) cents. You can do with them as you will. Jytdog (talk) 11:36, 25 July 2014 (UTC)

Jytdog gives great advice here, and I agree with most of it. A couple things I would like to clarify (and I will bring it back to systemic bias). I was banned for uncivil behavior and failure to AGF. In regards to my failure to grapple with certain issues, my reading of the source used to establish using a pejorative label in WP's voice was supported by several impartial editors at two separate noticeboards. I disagreed with the dominant POV of the culture in those articles, and was actually getting traction with neutral editors at places like project medicine and reliable sources noticeboard. I blew it because I wasn't keeping track of how much snark and anger I had been putting out there, and kept doing it.

To tie it back to systemic bias, I was banned (rightly) for being a jerk, but other editors who added and defended a misrepresentation the conclusions of a systematic review did not get as much as a warning. The literature may be imperfect, but I agree with those that say we cannot privilege, for example, Chinese literature because it will create bias (we cannot exclude that literature either). The real bias we have that could be addressed is the occasional misreading and misapplication of reliable sources, or inflating the message of certain sources, or giving certain sources undue weight to push a POV. I will not comment further, but wanted to clarify why I was banned because you guys brought it up. Herbxue (talk) 15:26, 25 July 2014 (UTC)

LesVegas, I haven't had time to read through all the comments here, but If you are concerned about systemic bias against eastern medicine, I'd think you’d need evidence beyond just acupuncture related. I don’t follow eastern medicine pages closely enough to comment on any potential systemic bias there, but will add a few to my watchlist. However, I do have several noticeboards on watchlist, and seem to recall reports regarding Traditional Chinese Medicine page, so you might want to look into any similar bias issues/concerns there, if you are interested in pursuing this. Also, Technophant was apparently recently blocked indefinitely for what appeared to be relatively minor infraction, so can understand what you say regarding wanting to avoid getting “bullied”. Unfortunately, that might be legit concern. --BoboMeowCat (talk) 16:37, 25 July 2014 (UTC)

A lot of good advice from Jytdog, Herbxue and BoboMeowCat. I have one comment on Jytdog's "the lack of grounding means that in WP, the field is defined as pseudoscience. This is a serious and important thing in WP". I am not disputing the comment as a fact in en.wikipedia, but from the traditional Chinese common sense, or point of view, TCM is validly grounded (as LesVegas stated, "they don't value robustness in reporting" and value other grounds more). The concept of 'science' and 'grounds', etc. have different meanings in different cultures, and the fact en.wikipedia uses English language does not mean it can always apply English meaning or definition on the concepts (as it is often illustrated in the handling of American, Irish or Scottish concepts). It is in violation of WP:NPOV to ignore and not present the relevant point of view (Traditional Chinese point of view in cases of TCM subjects) even if (especially if?) it contradicts Western (or American, Irish, Scottish, or any other country) belief or common sense.

It is this "doubting our own common sense" side that I value in this project to fight against systemic bias. Yiba (talk | contribs) 10:13, 26 July 2014 (UTC)

I am sorry but Yiba, this is a dangerous mythology. Science is science, including in China and other developing countries. China is striving to excel in science. See this article for one tiny example of reporting on this. The mythology is dangerous, as you would have China (and other developing countries that are now emerging) remain in some kind of prescientific backwater drowning in poverty and ignorance, and is basically a form of Orientalism wrapped up in a confused nationalism. Jytdog (talk) 13:47, 26 July 2014 (UTC)

There is no reason why properly referenced Eastern claims should not be included as claims, i.e. not as "the Truth according to Wikipedia." Subject matter should be properly balanced, and since acupuncture came out of the east, the eastern viewpoint should at the very least be summarised in the article. Simon Burchell (talk) 14:44, 26 July 2014 (UTC)

This is accurate yes - describing how things work in various TCM and other traditional modalities is good and appropriate, with inline attribution (e.g. "In TCM, "qi" is ......"), not in WP's voice (e.g. ""Qi" is ..."). Jytdog (talk) 14:58, 26 July 2014 (UTC)

We are not talking about modern day Chinese science or modern day Chinese medicine. Please take a look at Traditional medicine, and hope you'll see it is far away from mythology. As I so stated, I am talking about "Traditional Chinese point of view" in the articles on Traditional Chinese Medicine subjects. What Simon Burchell stated is not only agreeable or 'fine', but is required by WP:NPOV. We need to present views on the subject based on all the relevant points of view with due weight. In my mind, the difficulty in finding good sources aside, traditional Chinese view should carry a considerable weight in the Wiki articles on TCM. Wikipedia article on TCM should not be "TCM as viewed or judged by Western standards, or common sense", but rather it should be "TCM as viewed by traditional Chinese view point, modern day Chinese view point, Western view points and all other relevant view points in a balanced manner." I am not a Chinese speaker, and so I am not claiming that I can do this difficult task on TCM articles (I would guess there are many people in HongKong who could help.) I'd think that this basic NPOV requirement (which carries more weight than any Wiki guideline) is ignored too often, and the ignorance is creating a serious systemic bias. Yiba (talk | contribs) 17:44, 26 July 2014 (UTC)

If you are talking about discussions of TCM or other traditional medicinal practices and theories from an anthropological/historical perspective -- sure those should be discussed as clearly and sympathetically as possible, like any anthropological matter. It is a different story if are talking about claims of actual efficacy of TCM and other traditional medicinal approaches. Those are subject to science, which is the same anywhere you go. Jytdog (talk) 18:06, 26 July 2014 (UTC)

"talking about claims of actual efficacy of TCM" is a very good example of the problem I am talking about. Wikipedia is not a scientific journal or research paper, and as an encyclopedia, we the editors should leave the judgments on efficacy or true/false to reliable sources. So "if the claimed efficacy is valid" is not, and should not be, our primary concern. Instead, we should pay more attention to "are the points of view presented in the claims by reliable sources balanced?".

Meaning of 'science' has evolved over time. The earliest teachings of European universities were monastic, then scholastic science acted as the precursor to modern day science. It is well known that Robert Boyle and Isaac Newton had strong alchemy backgrounds. Some claims of acupuncture efficacy may be proven or disproven in the future, but so are the claims of efficacy on today's modern medical practices in the advancement of technology. "Proven valid" is always within the limitation of the proving methods used. So encyclopedia editors should not be concentrating on right/wrong, but rather on balancing the presentation of claims made by reliable sources, which may or may not be 'valid'. WP:NPOV applies to all Wiki articles regardless of context or perspective. Yiba (talk | contribs) 04:57, 27 July 2014 (UTC)

Yiba, yep, acu may or may not be shown to have a scientific basis in the future. As of 2014, for no lack of trying, there is none. That is what we report here. That is how things work here - what you are describing is not a matter of bias and is indeed not a matter of right/wrong. If you don't want to hear, there is nothing more I can do. Best regards, Jytdog (talk) 05:20, 27 July 2014 (UTC)

Yiba, Jytdog is correct. Wikipedia is not a crystal ball. We depend on RS, not on speculations about the future. We are, and must be, "behind the ball" at all times. We report after the fact. -- Brangifer (talk) 05:31, 27 July 2014 (UTC)

I am saying we should stay behind the ball. Judging everything according to the currently accepted common sense is refusing to accept that the ball has been, and will be showing new things at all times, and that common sense has been and will be evolving, and that there are and has been many versions of common sense in the world. We need to accept the fact what we believe in will change in the future, especially in discussing topics based on the past or foreign points of view. Refusal to accept that is taking the future in our own hands, and is like placing ourselves above the ball, or history. Wikipedia:Systemic bias#The nature of Wikipedia's bias says "Notability is more difficult to establish in non-Anglophone topics because of a lack of English sources and no incentive among anglophone participants to find sources in the native language of the topic." We need to take that statement to the heart. Choosing to ignore the entire Wikipedia:Systemic bias may be left to the freedom of Wiki editors, but not to those of us who participate in the discussions on this talk page for Wikipedia:WikiProject Countering systemic bias. Wikipedia is not in the business of making judgments. Yiba (talk | contribs) 07:41, 27 July 2014 (UTC)

How is the quote you provide above relevant to the discussion about TCM and science? Jytdog (talk) 09:24, 27 July 2014 (UTC)

A1candidate's observations

I have been closely following this thread for the past few days, and I think now is the time to drop some observations since the discussion above appears to have gone off course.

My first observation has got to do with the remarks of Simon Burchell, who says that:

"Acupuncture came out of the east, the eastern viewpoint should at the very least be summarised in the article."

This is an entirely reasonable position and it is what Wikipedia's policy of WP:NPOV requires us to do. However, the Eastern viewpoint is extremely difficult to represent because there are often conflicting views even among Eastern researchers themselves. Nevertheless, there is no doubt that the main philosophical theories behind Traditional Chinese medicine are inadequately summarized in our TCM articles. If you compare the difference in length and content between official Chinese sources on TCM philosophy such as this one and our main article on Traditional Chinese medicine, there are indeed remarkable differences as well as many instances of crucial philosophical theories being left out completely and ignored.

So, the question is why is this happening to our TCM articles? Are Western sources doing a poor job of objectively investigating the field of TCM? Is Yiba correct to make such a statement as shown below:

""Wikipedia article on TCM should not be "TCM as viewed or judged by Western standards, or common sense", but rather it should be "TCM as viewed by traditional Chinese view point""

The simple answer to this is a straightforward "No". I deal with Western medical literature everyday and I can honestly tell you that a perceived "bias" against TCM in Western sources is much less common than you would like to think. In fact, the mainstream scientific consensus in the Western world is actually for, not against, the traditional medical beliefs of the Eastern world.

It's difficult to present the most widely accepted Western viewpoint on a topic that still remains controversial, but the Journal of the American Medical Association (one of the most highly regarded medical journals) recently made a very good observation about the general attitudes in the in the United States towards non-Western medical therapies:

"For some mind-body approaches, however, there is mounting evidence of usefulness and safety, particularly in relieving chronic pain. A few examples include acupuncture for osteoarthritis pain; tai chi for fibromyalgia pain; and massage, spinal manipulation, and yoga for chronic back pain.

Increasing comfort with this emerging evidence is reflected in practice guidelines from the American College of Physicians, the American Pain Society, and the Department of Defense. (link)"

Outside the United States, the mainstream scientific consensus is just as strong, if not even stronger. In Great Britain, you can literally see the scientific consensus changing when it comes to the empirical validity acupuncture, as demonstrated by the country's National Health Service (NHS):

How the NHS viewed acupuncture before 15 July 2014

What is acupuncture?

"Acupuncture is a form of ancient Chinese medicine"

Can acupuncture be considered a part of mainstream Western medicine?

"It is a complementary or alternative medicine (CAM). This means that acupuncture is different in important ways from treatments that are part of conventional western medicine."

Is there a mechanism for acupuncture?

Some scientists and acupuncturists believe that acupuncture may stimulate nerves and muscle tissue, and that this may be responsible for any beneficial effects.

What are the indications for acupuncture treatment?

"Currently, the National Institute for Health and Clinical Excellence (NICE) recommends acupuncture as a treatment option only for lower back pain."

Source: (Archived link)

How the NHS views acupuncture after 15 July 2014

What is acupuncture?

"Acupuncture is a treatment derived from ancient Chinese medicine"

Can acupuncture be considered a part of mainstream Western medicine?

"It is often seen as a form of complementary or alternative medicine (CAM), although it is used in many NHS general practices, as well as the majority of pain clinics and hospices in the UK."

Is there a mechanism for acupuncture?

"Western medical acupuncture is the use of acupuncture after a proper medical diagnosis. It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue."

What are the indications for acupuncture treatment?

"Currently, the National Institute for Health and Care Excellence (NICE) only recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migraines."

Source: NHS

These guidelines are also supported by the text of many authoritative medical textbooks, such as Harrison's Principles of Internal Medicine and Practical Management of Pain. (In fact, health authorities must stick to scientific consensus otherwise there will be a horrifying publish backlash if they issue a statement that turns out to be quackery)

And finally, the scientific theories of acupuncture discussed by the NHS have been discussed in numerous mainstream medical journals, including the The New England Journal of Medicine (link), but surprisingly, none of these findings can be found on Wikipedia, so we finally come to the crux of the problem: The true source of systemic bias are not "biased" Western sources, but those who despise the process of scientific inquiry and adhere to pseudoskeptic beliefs.

There are people who have spent their entire careers fighting quackery (or what was once perceived as quackery), and they have every incentive to disprove what they originally fought against. If you write a book claiming that acupuncture is a fradulent treatment, your entire reputation is at stake when you fail to persuade mainstream scientific consensus to agree with you.

And these are the people that are the true cause of what OP incorrectly describes as "systemic bias in Eastern Medicine subjects". It is not about "Western" medicine against "Eastern" medicine. It is about mainstream science being usurped by WP:FRINGE blogs and self-published sources such as Quackwatch and the personal website of Steven Novella, as well as those who view themselves as quack fighters and quack experts.

The fact that meta-analyses and reviews in high impact factor journals are repeatedly removed by Wikipedia editors who cite the lowest quality, self-published sources speaks volumes. If there are systematic biases to be found in Eastern medicine, they are certainly not caused by Western sources but rather those who oppose the process of scientific inquiry and have an utter disdain for mainstream scientific consensus. -A1candidate (talk) 18:18, 27 July 2014 (UTC)

Above you make a claim about JAMA, but it's not the AMA who made what you call "good observations", but two people expressing their POV in a "viewpoint" article. Those two people are very strongly invested (their income is dependent on promoting AM) in alternative medicine (AM):

Viewpoint | August 21, 2013

Perspectives on Complementary and Alternative Medicine Research

Josephine P. Briggs, MD1; Jack Killen, MD1

Author Affiliations

1National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Maryland

So, we have an unsurprising opinion. Big deal. -- Brangifer (talk) 22:07, 27 July 2014 (UTC)

Sigh, what a weak argument... NCCAM is a part of NIH. Every researcher's income is dependent upon their research. -A1candidate (talk) 00:17, 28 July 2014 (UTC)

A1, just as LesVegas did above when he cited "the BMJ" and attempted to leverage the prestige of the journal itself for his argument, you did the same thing with "JAMA" (and you do the same thing with NEJM). That is not valid, and Brangifer rightly called that out. I think your main point is very worthy of discussion, but you shoot yourself in the foot when you overstate things like this. It is unfortunate. Generally the best thing to do to is acknowledge mis-steps, strike the bad bits and turn the focus back to your main point. Your choice to give a dismissive response to a valid critique undercuts your effort yet further. Unwise. I am also not sure that you can support your claim (which is a strong one) that "meta-analyses and reviews in high impact factor journals are repeatedly removed by Wikipedia editors who cite the lowest quality, self-published sources speaks volumes." (I am pretty sure that if high-impact meta-analyses or reviews have been removed, it has been with justification such as WP:INDY and isn't completely arbitrary as you make it seem) I am also pretty confident that your claim that acupuncture, broadly speaking, is now within "mainstream scientific consensus" is unsupportable. (the quotes from Harrison's being discussed at the acu article do not support this claim, for sure, and neither do the NHS quotes above, which support limited use only) And really, is this, which pops up in the first page of a google search for "cancer acupuncture", mainstream medicine in your eyes? (that is a real question)

Both statements (removal of good sources, acu is within mainstream consensus) are too starkly black and white and will collapse when dug into. Again, I think your main argument is important... but to the extent you distract from it with unsupportable claims that put a pro-TCM advocacy dress on it, you are 1) distracting your key audience - your opponents - from your main argument and 2) being part of the problem, not part of the solution. The terrible irony is, that the harder pro-TCM advocates push in an advocate-like way, the more they justify the stance of quack-fighters and support for them (even the most abusive of them! see the last paragraph here). These quack-fighters are committed to remaining on the front lines to keep quackery out.

I am grateful for the handful of editors who man the front lines. The amount of quackery that people push into WP every day is mind-blowing - a key problem we have to deal with in this "encyclopedia that anyone can edit". In my view, project medicine takes its responsibility (created by huge readership of health-related articles) seriously, and generally is conservative and cautious, and the underlying consensus there seems (to me) to be that it is better to have a crappy health-related article with a cautious, pro-science bias than a crappy article that pitches health woo. To the extent that you, A1, and other TCM advocates refuse to deal with that larger picture and refuse to acknowledge that wider problem, and again - to the extent that you make unsupportable arguments and advocacy-like claims - you make it way more convenient for project medicine to pick the low-hanging fruit off your statements, discredit them and thus the whole argument, and move on to deal with the next advocate pushing woo, of which there is an exhaustingly endless supply. Can you not see that? (real question!!) If you want to be taken seriously and open space for a different kind of coverage for TCM related topics, your argument needs to be conservative, limited, and reasonable, and you must deal with the bigger picture of keeping quackery out of WP, including TCM-based quackery, of which (I hope you can acknowledge) there are mountains. You must show you are here to build an encyclopedia, not just to push your POV, and your solution cannot open WP to buckets of woo (acu as an actual treatment for cancer, magnet therapy, homeopathy, "detoxification", etc etc infinity). Jytdog (talk) 12:30, 28 July 2014 (UTC)

You appear to have a strong point of view against non-western medicine but perhaps it might help to consider that it would be pretty easy for a group of editors with a POV against western medicine to use reliable sources to present it unfairly as "Quackery". Consider that it is not uncommon for the mechanism by which a pharmaceutical product works in the body to be unknown. Additionally, off label non-researched use of pharmaceutical products are currently common practice by physicians. Also, there are instances where Western medical research is corrupted by conflict of interest. Safety studies of medications tend to be funded by the corporations that manufacture those medications and concerns have been raised regarding the practice of publishing studies with favorable results in terms of medication safety and efficacy while not publishing the unfavorable studies. Additionally, Western medicine is often described as an art not a science. If someone with a POV against western medicine were to cherry-pick these facts out of reliable sources they could produce an article very biased against western medicine and the concern appears to be that something similar might be happening with respect to eastern medicine due to groups of biased editors.--BoboMeowCat (talk) 19:15, 29 July 2014 (UTC)

I disagree BoboMeowCat and I think it will be impossible for you to support your assertion that I have a "strong point of view against non-western medicine". I reject the notion that "non-western medicine" even exists (as I reject that there is "non-western science") and that is not a phrase I have ever used, or would use. Please provide difs or strike that. Thanks. There are lots of pre-scientific "traditional medicine" practices and notions of the body from around the world, some of which have survived to our time (TCM among them). Some of the interventions that arose from them have been transformed by science into medicine (willow bark for pain became aspirin) or into pretty broadly accepted complementary medicine practices (acupuncture for some kinds of pain); the rest is pretty much pseudoscience/quackery today in the developed world. In places that are underdeveloped and these traditional prescientific "medicines" are still all people have to rely on... well that is part of the broader tragedy of problems in the developing world. As for the rest of what you write, not sure what your point is. You will find content like that in WP. Some of it sticks, some of it doesn't, depending on how it is stated and sourced. Jytdog (talk) 10:27, 30 July 2014 (UTC)

Western medical companies send people to less developed countries to obtain medical knowledge from the natives. Then they patent this knowledge for profit, with no compensation to the natives. If traditional medicines were useless, would the Western medical companies be able to do this? You can "reject the notion that non-Western medicine even exists" due to such exploitation. According to Wikipedia, quackery is the "promotion of fradulent medical practices" and a quack is "a person who pretends to have medical skill, knowledge or qualifications that he does not". There are valid doubts whether TCM is effective, but calling it "quackery" (based on the above definition) would be deemed racist by many Chinese, including myself. Unlike fake cures invented one day by someone to cheat others, TCM has over two thousand years of history and is associated with the largest racial group in the world. TCM is recognised and regulated in many countries, even Western countries where Chinese are a tiny minority. --Hildanknight (talk) 13:13, 30 July 2014 (UTC)

I hear your opinion. It is not how WP works, as has been explained above. Health claims that are not based on sound science have no place here. If you want to try to lock China into some pre-scientific era and way of thinking, you are free to try, but China has broken hard toward science and the modern world, and is investing more money in its people, their education, and its medical infrastructure more than any country on the planet. It is not racist for me to say any of that, nor for me to say that interventions based on pre-scientific notions of the body and disease, are quackery. I am sorry you are offended, but I cannot help that. I do understand that every culture has its Luddites. Jytdog (talk) 22:11, 30 July 2014 (UTC)

@Jytdog - You asked a question that deserves an honest response, so here it is:

And really, is this, which pops up in the first page of a google search for "cancer acupuncture", mainstream medicine in your eyes? (that is a real question)

Ultimately, whether this article is mainstream or fringe depends on which part of it you're referring to. I would say that the article is largely promotional, based on anecdotal evidence, and certainly not good enough for MEDRS, but some of the things it says aren't entirely inaccurate.

After all, the fact that "cancer thrives when the immune system's defensive action can't or won't react effectively" isn't that far off. See immunoediting for more details. And it's also true that some integrative therapies do modulate the immune system. There's a recent meta-analysis about this in PLOS ONE.

As for acupuncture in cancer care, see what the National Cancer Institute says about using acupuncture to manage cancer-related symptoms. For a recent review, see PMID 23868190 in Supportive Care in Cancer. -A1candidate (talk) 14:05, 8 August 2014 (UTC)

thanks for replying, i really appreciate it. the article you cite and the NCI page are clear about using acu in CAM as per Mayo, etc (to help manage pain and nausea). that is the mainstream use which has nothing to do with the article i cited. to the extent that you cannot come out and say something like "that article suggests patients should use acu instead of medicine to treat cancer, and to the extent it goes there, it is dangerous quackery ("While some patients elect to move on to chemotherapy and radiation therapy, Fuda says these patients are often much harder to treat successfully with acupuncture." and other comments throughout, that suggest that acu is better than medicine at treating cancer and attempts to persuade patients to choose acu over medicine to treat cancer).... as long as you will not draw that bright line between mainstream uses and quackery, you are going to continue being part of the problem, and more importantly, your own worst enemy; quack-watching editors will never trust your edits and will remain hyper-vigilant and concerned that opening the door a little, will lead to dangerous ideas like those in that article, getting into WP. I know I said that somewhat harshly, but do you see what I mean? Jytdog (talk) 15:30, 8 August 2014 (UTC)

I hear you loud and clear - The article unduly promotes acupuncture as a fringe treatment for cancer, based on anecdotal evidence alone, but:

1.The part of the article that says "Our body's immune system routinely quells renegade cells and would-be malignancies before they ever take hold" is correct. See article on immunoediting.

2. The part of the article that says "Some scientists theorize that cancer thrives when the immune system's defensive action can't or won't react effectively." is correct. In fact, this was proposed more than a century ago by Nobel Prize winner Paul Ehrlich. For a recent review, see PMID 21436444.

3. The part of the article that says "Dr. Fuda believes that acupuncture, employed correctly, can retrain the body's immune system to defeat cancer" is supported by some experimental evidence, but it is too early to make a definite conclusion. See NCI page, which makes reference to the "the anticancer effect of acupuncture" under a section titled "Effect of Acupuncture on Immune Function".

4. The part of the article that says "Yet even as an adjunctive therapy, acupuncture also can help cancer patients endure and recover from the ravages of cancer treatment." is correct. See NCI page and review article at PMID 23868190.

I want to repeat myself so that this is crystal clear to you - Acupuncture as an anti-cancer treatment is not part of mainstream medicine. It is also not pseudoscientific quackery, at least not until multiple lines of evidence for acupuncture's immunomodulatory effects (see NCI page) are outweighed by any evidence suggesting otherwise.

-A1candidate (talk) 19:23, 9 August 2014 (UTC)

happy that you recognize that it is not mainstream. we disagree, pretty violently, on that article. the author is speaking to people who have cancer and their families. i think it is evil to try The author tries to persuade cancer patients that they should forego medical treatment for something that has no mechanism of action we can explain and no evidence that it works to treat cancer. the clinical persuading, is what makes it quackery. (did you notice the heartbreaking comment at the bottom of that article? it is exactly because of people like that - desperate and in a terrible situation, wide open to anybody who says they can help - that I say, evil that this bothers me so much). I called attention to this persuasive element twice now. to the extent you cannot see that huge, glaring thing - the evil of trying how terrible it seems to me and others, to try to pull people away from the best that science can offer them when they are most in need of it -- we are not in same building, much less on the same page. (it is a very different conversation from kicking around possible avenues for research.. in general I'd be happy to talk about research and preliminary findings -- outside of the context of discussing how to treat cancer now) i was hoping you might join me in a reasonable middle to get the acu article put on a more reasonable middle ground. i have no hope, and will no longer try. like WAID, I am outta there. Jytdog (talk) 01:44, 11 August 2014 (UTC) (toning down language Jytdog (talk) 14:05, 11 August 2014 (UTC))

Wikipedia is not a scientific journal. If it is, then I'd agree with the opinion "Health claims that are not based on sound science have no place here." Encyclopedia should not make judgments if something is Quackery, Fringe, Unsound or Evil, but instead should report with neutral and balanced point of view, and on the grounds if not insignificant number of reliable sources exist. So no matter how much something is quackery, unbelievable, unsound, fringe or evil in my (or someone else's) mind, the subject/claim/concept deserves a place on wikipedia as long as there are significant reliable sources behind it. This is why there are Wiki articles on breatharianism (which lacks the presentation from believers' point of view, so is short of meeing WP:NPOV yet) and many other articles like Smoking, which appropriately presents the description "a form of drug intake" from the then-major view. This is how Wikipedia works. We do not promote a notion, push or pull people into/away from/to concepts/belief/practice. The reasonable middle ground in someone's mind is not reasonable for Wikipedia if it clings to one belief (I believe in science, but that doesn't matter) without recognizing other view points. Significant sources say "Jesus walked on water", then we should say "OK, let's find a way to present it in a neutral and balanced manner", not "That's BS, it has no place here." Wikipedia is not in the business of making judgments if accupuncture is effective for something or not. Yiba (talk | contribs) 05:23, 11 August 2014 (UTC)

As described in the preface to WP:MEDRS, millions of people look to WP for health-related information. While we are very careful to provide no guarantee that our information is accurate, this means we have a responsibility to provide reliable information to the public about health matters and we have to keep quackery out. It is our responsibility. Working with your example... it is indeed to fine to say that "the Bible describes Jesus walking on water" or "some christians believe Jesus was able to perform miracles" but I very much doubt that anywhere WP says, in its own voice, "Jesus walked on water." Likewise, on health related matters we need to be very careful to describe reality as defined in MEDRS-defined sources; it is more-or-less OK to ascribe altmed beliefs to altmed practitioners "Some acupuncturists believe they can cure cancer" but statements about reality and best practices need to carefully and responsibly made - we would have to follow that up with "But there is no evidence that this is true" (with reliable sources) - and unlike religious topics, in health topics, if the topic is so "out there" that we cannot provide a reality based statement, then we say nothing. Most importantly, as I wrote above, we cannot work to create a reasonable article if there are not boundaries, if we cannot say what is "in" and what is "out". Right now the articles are dominated by quack-fighters who believe (and apparently rightly so) that if they give an inch, acu-proponents will take a mile and will fill the article with speculative and unvalidated uses of acupuncture. I don't have a sense that A1 and others would draw a bright line in describing what are valid uses of acu in medicine, but instead, would keep pushing to include uses that are not validated today. I can't see a way forward.Jytdog (talk) 14:05, 11 August 2014 (UTC)

I understand the logic, and am sympathetic to the position. However, when the average Wiki editor (college kids or slightly older) thinks the well-intended notion "It is our responsibility" justifies taking main/fringe, good/evil, definition of altmed, etc. judgments into his own hands, the article steps out of encyclopedic into editorial, thereby violates the Wikipedia policy. These editors cannot work to create a 'reasonable' article without a boundary may be, but the boundary is set within Wiki policies to be 'verifiability' to judge 'in' or 'out'. Within the boundary, editors do need to make judgments on weighting and balance, not main/fringe, reality/fantasy, reasonable/unreasonable, quackery/legitimate, good/evil or any such judgments. So may be it is not the way forward after stepping out of the boundary we should seek, but rather the way back to these basics. If quackery or alternative medicine article gives someone the impression that what's written is Wikipedia's position on the topics described in its "own voice", then there are problems in the articles, and/or problems in the way the reader perceives Wikipedia articles to be, because they are not meant to be editorials. If WP:MEDRS gives the impression that editors can violate WP:NOTJOURNAL on health topics, then there may be a conflict. And in conflict situations, Wikipedia policy is clear on the priority (core policies on top, then other policies, and then guidelines and others) that WP:NOTJOURNAL as a policy wins over WP:MEDRS as a guideline. Editors may be "very carefully" violating Wiki policies without recognizing it, without ill intentions. Yiba (talk | contribs) 14:34, 12 August 2014 (UTC)

Though it is of course core policy that any treatment of notions that have been established as fringe needs to make plain those notions are indeed fringe by relaying the reliably-sourced mainstream counter-view: "Any inclusion of pseudoscientific views should not give them undue weight. The pseudoscientific view should be clearly described as such. An explanation of how scientists have received pseudoscientific theories should be prominently included. This helps us to describe differing views fairly. This also applies to other fringe subjects ...". So if some treatment (e.g. squirting coffee up your backside in an attempt to cure cancer) has a following, but is discredited by mainstream science & medicine, WP has (yes) a "responsibility" to make that plain. Alexbrn ^{talk|contribs|COI} 14:57, 12 August 2014 (UTC)

Copernicus' theory was banned by the Catholic Church in 1616 because it was deemed to be 'pseudoscientific' and many reputable 'scientists' supported the decision. The ban was then removed in 1820 because the church accepted that facts have proven the theory and therefore it became 'scientific'. By that time, the reputable scientists were long gone. More recently, scientists believing in Inductive logic once insisted that "inductive probalility" defines the difference between science and pseudoscience before refuted by David Hume and much later by Karl Popper. (See Problem of induction for details.) And the question of science vs. pseudoscience still remains to be answered after Thomas Kuhn's respected work that concluded that science can never reach full objectivity (due in part to limit in knowledge). So a blank belief in a statement by a 'scientist' that something is pseudoscience is naive. I state it again, let's go back to basics. Let's fight the urge to impose our own common sense onto others. Yiba (talk | contribs) 17:56, 12 August 2014 (UTC)

At the time, Wikipedia would have aligned its view with that of the Catholic Church. We reflect the mainstream view as reflected in the best reliable sources, anything else opens the floodgates to editorializing and OR. WP:VNT is an interesting essay that touches on this topic: "... before Pasteur everybody considered the spontaneous generation theory to be true, and they were mistaken. Even so, if Wikipedia had existed before Pasteur, it should have treated it as an accepted theory." (And WP:FLAT is another interesting essay that ellucidates how our WP:NPOV policy interacts with fringey things.) Alexbrn ^{talk|contribs|COI} 18:07, 12 August 2014 (UTC)

I am so glad the tone of this discussion is becoming much more civilized. I agree with "Wikipedia should have treated spontaneous generation as an accepted theory at the time." Thank you for pointing out WP:FLAT. It is a well written piece, I agree with many points raised in it, and I feel I could be friends with the authors, and might even think about doing a counter essay (or a parody) if I find a good counter example by inheriting most, if not all, of its arguments applied in opposite direction. Come to think of it, "Why Wikipedia cannot claim the earth is round" could work for this discussion. If Wikipedia claims the earth is round in an article, then the article becomes an editorial. "Wikipedia claims the earth is round" is completely different from "'Earth is round' has become widely accepted since the 17th century" and the former violates WP:NOTADVOCATE whereas the latter could become a part of a good article depending on how it is balanced, sourced, styled, etc. The core of the issue may have become clear as "Wikipedia's voice" and "Wikipedia's view" have come up several times. Wikipedia articles are not written with Wikipedia's voice (Wikipedia editors should not and can not represent Wikipedia unless your name appears on Wikimedia Foundation, or you're in a contractual relationship with it to do so), and Wikipedia's views, while being expressed by Jimmy Wales et al. on other venues, are not expressed in regular articles (as opposed to essays or policy/principle articles with the title starting with 'Wikipedia:') with few exceptions (e.g.User:Andrewa/creed). Wikipedia's views reflected on regular articles are (or, should be) those described on policy pages, such as on verifiability, balance, style, etc. and not on issues, ideas, practices, beliefs, or topics. As to Copernicus and Wikipedia, I feel that his views would be treated and presented as a minority view by Wikipedia at the time, and I strongly disagree that his views would be excluded from Wikipedia articles if 'aligned' means to have gone along with the ban. His controversial book was published in 1543 (276 copies remain today), and by the time Catholic Church banned it, it had become so popular that the second edition (325 copies remain) was already out, and three more editions followed despite (because of?) the ban. It was one of the earliest examples of best seller. Yiba (talk | contribs) 11:14, 13 August 2014 (UTC)

Wikipedia most certainly would say the earth is round, and in her own voice, for the reasons set out in WP:ASSERT. As is explained there, couching it as merely as today's point of view would not be neutral, as it would unduly imply there was some doubt about it. Ideally, we'd also add a citation even for simple facts like this. Alexbrn ^{talk|contribs|COI} 11:56, 13 August 2014 (UTC)

You might feel being tricked into this, if so my apologies. As explained in WP:ASSERT, a statement is an opinion when the matter is subject to dispute. So according to WP:ASSERT, fringe/mainstream, legit/quackery, etc. judgments on controversial topics are not assertions but are opinions, correct? Yiba (talk | contribs) 13:54, 13 August 2014 (UTC)

As it says in the definition of fact: "serious dispute". There is no reasonable dispute over the roundness of the earth or that homeopathy doesn't work: consequently Wikipedia should (and indeed does) simply assert these as facts. Alexbrn ^{talk|contribs|COI} 14:04, 13 August 2014 (UTC)

Homeopathy was subject to serious disputes for over 100 years. 'Serious' and 'reasonable' are both subjective, and are totally different concepts. I don't know how many people make living in homeopathy field (whom we can't exclude as Wikipedia readers), but to many of them, I'm sure it still is subject to serious dispute. Well, we digressed.

The concept "Earth is round" was 'proven' by Juan Sebastián Elcano(see this article for details) on September 6, 1522, before the publishing of Copernicus book in 1543. Many scientists studied the book hard and collected additional 'evidences' first mostly to question, then scrutinize, and finally to support the theory. The theory became somewhat 'mainstream' sometime around 1600, and then became almost 'undisputable' around mid-1600s with small number of scientists still having 'serious' reservations (The Copernican Question is a good place to start, if anybody is interested). The acceptance of the theory that said the Earth is spherical except for bulges of land/mountains led to 'disproving' previously accepted 'facts', and the height of Mount Everest became 29,028ft(8,848m) in 1954, from 29,002ft(8,840m) that had been accepted for 98 years. 21 years later in 1975, it became 29,029.24ft, and then it is "currently accepted" to be 29,035ft(8,850m) from 1999.

During the mean time, the generally accepted shape of the Earth became from sphere to oblate spheroid (flattened top and bottom), then the GPS became available and equator (sea surface, not land) was 'proven' not to be circular, and it was suggested that the shape is triaxial ellipsoid with ellipse equator, which became an accepted theory for a while (See Figure of the Earth for details). Then, the Northern half was found to be flatter than the triaxial ellipsoid, and the Southern half is bulged for about the same degree (i.e. a Pear shape). Today, in line with the improvement in GPS accuracy, it is 'proven' (again) that the shape is more complicated than the calculations based on the "Pear shape" theory, and the description Geoid is used in generally accepted scientific 'fact' that says "Earth is not round" (http://www.scientificamerican.com/article/earth-is-not-round/). It took much longer than I thought, but this shows what 'facts' and 'proven' mean in science, that 'facts' evolve, that 'proven' is always "within the limits of the proving methods available", which has become the common sense among mainstream scientists with Thomas Kuhn's work as the theoretical backbone.

This is why seemingly mundane 'facts' are stated with references (i.e. being treated as 'opinions') on scientific papers, because they are more difficult for scientists to assert than for ordinary people. This is also why Wikipedia should not assert the Earth is round (if it does in articles on topics in science, those articles should be corrected. I can see the view they are OK in non-scientific context, but then those articles are editorials perhaps without the authors being aware of it.). This is also why the scientist is not mainstream, has personal interest invested against the subject, is second-rate showing the lack of common sense in science, or combination thereof, if he/she describes something controversial to be pseudo-science. Yiba (talk | contribs) 13:08, 14 August 2014 (UTC)

Here's why Copernicus is both a good and a bad example. It's a good example because his theory was considered maverick by mainstream science at the time. It's a bad example because at the time there was no such thing as science, it was natural philosophy, people had not got close to working out what was real and what was religious dogma. Hooke and Boyle had not published the first experiments with real versus expected results tabulated. The Baconian and the Cartesian school were both seen as potentially valid, there was no calculus, no epidemiology, no understanding of the atomic nature of matter, very little anatomy by dissection. Phlogiston theory was still considered valid, Harvey had not yet documented the circulation system, Hooke had not yet demonstrated tot he Royal Society that candles went out in a vacuum. So in that respect it's like saying a theory of magic carpets is valid because in the early days of powered flight, nobody knew how to build an aerofoil.

Today, we know a vast amount more than we knew back then. We know there is no such thing as qi. We know there are no such things as meridians. We know that it makes no real difference where acupuncture needles are placed. It's pretty likely it doesn't even matter whether they are inserted or not. We know that there are a steady stream of adverse events form acupuncture (pneumothorax etc) based on the fact that practitioners have been taught a belief system rather than a proper empoirically-founded understanding of anatomy.

Acupuncture is a belief system. Poeple believe it does this, that and the other. There is some evidence for some of this, but it's weak. Science is a system of knowing and understanding. Science understands the numerous biases, counfounders and other factors which can cause an intervention to appear to work even when it doesn't. Homeopathy survives only because of these, and there is no reason to think acupuncture is uniquely immune to them.

The problem is that people take the positive studies and the studies form China whihc start by assuming acupuncture works and go on to prove that based on this assumption, it works - and use these to assert that the entire field of acupuncture is valid. In reality there is no reason to believe in qi, meridians or acupoints, and in terms of needling itself the jury is still out but leaning towards it, too, having no particular effect. Consider chiropractic: it is entirely plausible that this has real and specific effects for musculoskeletal pain, but chiros insist that if you accept that then you must also accept the baggage: claims to heal based on nonexistent "chiropractic subluxations" disturbing a nonexistent "innate", implausible claims to cure organic disease unrelated to the mulsculoskeletal system, assertions of safety based on denial rather than systematic recording of adverse events.

The response of Wikipedia is and should be the response of science: "no". We accept that which is robustly supportable, and we document scientifically implausible and unsupportable beliefs as just that. We have long articles on creationism, we still document evolution as fact.

As an electrical engineer I am comfortable with the concept of complex numbers, and that is absolutely what's going on here. Medical claims are like complex numbers: they have a real component and an imaginary component. Proponents view them as scalars and ignore the fact that in some cases the vast majority of the scalar value is in the imaginary plane. Guy (Help!) 08:06, 15 August 2014 (UTC)

"Although considerable controversy surrounds the legitimacy of acupuncture as a treatment, a growing literature on the physiological effects of acupuncture needling in animals and humans is providing new insights into basic cellular mechanisms including connective tissue mechanotransduction and purinergic signaling"

Acupuncture, Connective Tissue, and Peripheral Sensory Modulation (2014) in Critical Reviews in Eukaryotic Gene Expression

-A1candidate (talk) 10:55, 15 August 2014 (UTC)

Guy, for keeping the discussion on track, could you tell me what part of my argument is "like saying a theory of magic carpets is valid ... build an aerofoil"? I know you're using magic carpet as a metaphor, err, simile, so I'm not being insulted or anything like that, but I can't tell what part of my argument you meant it to apply. Yiba (talk | contribs) 14:23, 15 August 2014 (UTC)

@A1candidate You appear to believe that the "growing literature" represents actual progress towards validating acupuncture. It does not. The "growing literature" is exploring the small subset of acupuncture whicih might have a core of validity. Until acupuncturists as a body corporate drop the concepts of qi and meridians form their training and practice, and focus solely on those conditions for which there is robust and specific evidence, (see Ioannidis for why the occasional positive Western clinical trial result can be ignored in this case, all Chinese sources are worthless on this subject sadly) then you are engaged in POV-pushing. You have done this consistently, in fact, asserting that acupuncture as a whole is valid based on studies that validate, often only tentatively, a tiny subset of acupuncture practice.

@Yiba, I already explained that. I suggest you go and read the article on cognitive dissonance, this will explain why you are unable to put it in context.

To both of you: I do not believe in acupuncture. That is a neutral position, whereas your belief is not. In science, neutrality is not some midpoint between belief and skepticism, skepticism is neutrality. In science, any compromise between a correct statement and a false statement, is a false statement. I am agnostic, prepared to be persuaded by evidence, you are the faithful, seeking evidence to support your belief and bringing it here in the apparent belief that any evidence that supports any claim related to acupuncture, validates it in its entirety. Neither science nor Wikipedia work that way. You need to stick within the narrow limits of what is supported by robust evidence replicated by those without a vested interest in the practice, and in the case of acupuncture that is a very small body of literature as almost all studies are written by believers.

This is not systemic bias. It is just a milestone on the road from the mediaeval to the modern approach. Medicine uses whatever can be proven to work; by proven, that means it has to be specific, repeatable and to be inconsistent with the null hypothesis, which includes placebo effects, expectation effects, regression to the mean and natural course of disease. The world of medical science does not care if a treatment comes from Eastern mysticism or the bleeding edge of gene therapy, all that matters is whether it repeatably works, or whether it offers only weak and nonspecific results that are not consistent with other knowledge. You want your claims to stand above those of homeopathy, which is completely bogus, so you need to do it by following the proper standards of proof and evidence, rather than by wailing that all those horrible materialists are biased against you. We aren't. We're biased against woo. Show that you're not peddling woo. Guy (Help!) 16:59, 15 August 2014 (UTC)

I can only be persuaded by hard evidence, the strongest of which are reviews and meta-analyses. For example:

• This meta-analysis found that "acupuncture is more than a placebo"

• This meta-analysis confirmed that "acupuncture is more than a placebo"

• This review found biological differences exist between a placebo response and an analgesic response during acupunture

If you want to convince me otherwise, may I respectfully ask that you show me meta-analyses that conclude that acupuncture is a placebo (not just sham needling) treatment? Thanks. -A1candidate (talk) 20:52, 15 August 2014 (UTC)

Guy, you already explained that where? cognitive dissonance does not explain why, and further it seems to me to suggest why you can't, or reluctant to, tell me what part of my argument your statement was meant to apply. Could you be more specific? To both of you part says "your belief is not", and now what belief of mine is not? Belief in science? Yiba (talk | contribs) 00:53, 16 August 2014 (UTC)

Another article to watch

LesVegas, another article to watch to see if there is such a trend with respect to Eastern medicine might be Naturopathy, which is a western discipline which incorporates eastern disciplines such as acupuncture in a science based model. http://www.bridgeport.edu/academics/graduate/naturopathic-medicine-nd/curriculum-and-program-requirements/ The current article appears biased.--BoboMeowCat (talk) 18:48, 29 July 2014 (UTC)

Actual systemic bias in "Eastern medicine" articles

There is a tendency to peddle the false notion that "Eastern medicine" is being "suppressed" by the evil materialists. This is based on the false idea that medicine is different in the East. It's not. There is no such thing as Western medicine or Eastern medicine, there's only medicine. And there's no such thing as alternative medicine, there's medicine (which has been proven to work) and the rest (which either hasn't been proven to work, or has been convincingly shown not to).

This much is common knowledge.

However, there is a definite systemic bias in terms of subjects like acupuncture and Chinese herbalism. It's not in Wikipedia, it;s in the journals published in China especially. Chinese journals publish virtually no disconfirming results. It is hard to find any examples in Chinese journals of studies that show things not to work. This is cultural, and it's a form of systemic bias, as a result of which we have to be very careful in assessing a source per WP:MEDRS. In essence, a Chinese journal that claims efficacy for a biologically implausible therapy, is not reliable unless confirmed by studies in journals with no ideological investment in the subject.

Wikipedia is not biased against acupuncture or TCM as a matter of systemic or cultural bias, we are biased towards robust scientifically supportable fact. We treat acupuncture with exactly the same critical judgement that we use on statins, aspirin, homeopathy or anything else.

If people want Wikipedia to say that acupuncture works by releasing endorphins or whatever, then they first have to go out and do the science that provides robust and repeatable evidence that this is so. If they want to assert that meridians or acupoints are anything other than delusional then they need to provide robust scientific proof, along with the associated anatomy, and they have to show in the literature where the large number of studies showing needle placement to be irrelevant, have been contradicted, and provide competent unbiased review articles that document the new consensus.

Skepticism is not bias, it is the default position in the scientific method. As Feynman said, in science, the first principle is that you must not fool yourself and you are the easiest person to fool. A skeptic is your friend because a skeptic questions your assumptions and forces you to review your beliefs against fact.

In science it often happens that scientists say, 'You know that's a really good argument; my position is mistaken,' and then they would actually change their minds and you never hear that old view from them again. They really do it. It doesn't happen as often as it should, because scientists are human and change is sometimes painful. But it happens every day. I cannot recall the last time something like that happened in politics or religion

— Carl Sagan

If you want to demonstrate that a field is scientific, one great way is to show examples of ideas it has discarded as wrong. Some chiropractors have ditched the idea of subluxation, many others have not. Chiropractic is not a scientific field because the evidence has not resulted in a consensus against the non-existent subluxation. Show us where practitioners of Eastern medicine have formed a consensus that the humours are not a valid medical concept, that yin and yang do not exist, that qi is a metaphor and not a reality, that there are no meridians. Show us progress towards these things, and we'll accept that the systemic bias in "Eastern medicine" is breaking down and it's moving away from a quasi-religious movement and towards being a science. Guy (Help!) 16:15, 15 August 2014 (UTC)

What is systemic bias and what is not

@Yiba: @LasVegas: @Dkriegls: @Jytdog: @A1candidate: @BoboMeowCat: @Alexbrn: @JzG: For context, I am an ethnic Chinese, but have lived in Singapore for my entire life. Having used TCM, I do know a fair bit, but am not a licensed practitioner, expert or researcher on TCM. Other than ethnic pride, I have no personal or financial conflict of interest regarding TCM.

• Stating that the TCM model of the body and disease is incompatible with modern scientific knowledge is accurate and is not systemic bias. TCM practitioners themselves do not claim that TCM is based on modern science.
• Stating the findings of scientific studies on specific TCM treatments is not systemic bias, unless the article misrepresents the findings or its selection of studies is not representative of studies on TCM treatments.
• We should point out potential sources of systemic bias in scientific studies of TCM done in the West. Are such studies done by researchers with adequate knowledge of TCM, practising it as TCM experts would? Of course, discussion of these should be reliably sourced and kept relevant.
• The exclusion of Chinese studies, whether due to accessibility barriers (including language) or the points Guy raised above, is indeed systemic bias. Include them and mention their conflicts of interest, per my third point.
• Perhaps we are putting too much focus on the efficacy of TCM. Poor explanations of core concepts and treatments is indeed systemic bias. Inaccurate or inadequate coverage of the history, adoption, regulation and cultural impact of TCM is indeed systemic bias.
• Mentioning relevant negative issues, such as the environmental impact of certain remedies, is not systemic bias, unless such details are given undue weight or the coverage is slanted.

Systemic bias against Chinese topics is a real and serious issue on Wikipedia. For example, we have a grand total of three articles (all stubs) about Xiangqi players, compared to ten good articles about chess players. My fifth point above similarly applies to the lack of other articles about TCM, such as notable practitioners and institutions. We do have to question our assumptions and be aware of issues such as lack of Chinese representation in the "mainstream scientific community". However, we have to be careful about developing a siege mentality that leads to misuse of the "systemic bias card".

--Hildanknight (talk) 15:08, 17 August 2014 (UTC)

Thanks for this post. Much of it, I agree with. Some caveats:

• "should point out potential sources of systemic bias", if those sources are described in reliable, independent sources, yes. In a way consistent with WP:VERIFY and not WP:OR

* "too much focus on the efficacy of TCM. " - this is really great. but what happens is that advocates for TCM and other altmed approaches push to include this content (relelentllessly) and as a result a culture of fringe-fighting has arisen in Wikipedia, that is now unfortunately really ingrained in WP now. This is the exact issue that makes these articles hellish to work on. I see no way to resolve this problem. What it would take, is a committed core of editors friendly to TCM (!) to watch the articles and fight to keep advocates from putting strong claims for efficacy in. The way it stands now, there is almost no one like that, and certainly no community of dedicated middle-grounders, so the quack-fighters act as though they are the only ones keeping quackery out of WP (and get support for that!) -- there is no middle ground. Jytdog (talk) 14:05, 3 November 2014 (UTC)