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::::::::this is a time sink. Obviously authors who advocate fringe aren’t RS for fringe. The article already duly notes acupuncture’s role in pain relief and palatative care and recommendations pertaining to these. It is also duly comprised in large part of the tectonic slabs of writings from medrs, which say it is a bag of toss. There’s simply nothing more to be done here. This isn’t a conversation about article improvement. ~~~~ [[User:Edaham|Edaham]] ([[User talk:Edaham|talk]]) 13:09, 12 December 2018 (UTC) |
::::::::this is a time sink. Obviously authors who advocate fringe aren’t RS for fringe. The article already duly notes acupuncture’s role in pain relief and palatative care and recommendations pertaining to these. It is also duly comprised in large part of the tectonic slabs of writings from medrs, which say it is a bag of toss. There’s simply nothing more to be done here. This isn’t a conversation about article improvement. ~~~~ [[User:Edaham|Edaham]] ([[User talk:Edaham|talk]]) 13:09, 12 December 2018 (UTC) |
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:::::::::Both time sink and {{red|red herring}} ''par excellence'', because not a single one of the preceding comments under my !vote pertains to Vickers' IPD meta-analysis. (Note, meta-analysis, not opinion piece.) --[[User:Middle 8|Middle 8]] <small>([[User talk:Middle 8|t]] • [[Special:Contributions/Middle_8|c]] | [[User:Middle_8/Privacy|privacy]] • [[User:Middle_8/COI|acupuncture COI?]])</small> 17:43, 12 December 2018 (UTC) |
:::::::::Both time sink and {{red|red herring}} ''par excellence'', because not a single one of the preceding comments under my !vote pertains to Vickers' IPD meta-analysis. (Note, meta-analysis, not opinion piece.) --[[User:Middle 8|Middle 8]] <small>([[User talk:Middle 8|t]] • [[Special:Contributions/Middle_8|c]] | [[User:Middle_8/Privacy|privacy]] • [[User:Middle_8/COI|acupuncture COI?]])</small> 17:43, 12 December 2018 (UTC) |
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:::::::::: We did address that, actually. As stated: we're not including Vickers to "balance" the reality-based consensus that acupuncture is bollocks, regardless of the effect on your income. Sorry. <b>[[User Talk:JzG|Guy]]</b> <small>([[User:JzG/help|Help!]])</small> 19:23, 12 December 2018 (UTC) |
Revision as of 19:23, 12 December 2018
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Removal of a 2017 review
I recently added this 2017 review article to the section on Effectiveness (specifically the subsection thereof "Pain"). But this edit was soon reverted by MPants at work, apparently because it is too recent to have made a significant impact, and is "a little fishy, to boot". MPants further cited WP:DUE to justify his removal of this article. [1] However, there appears to be no reason to believe that the conclusions of this review article, positive though they may be regarding acupuncture, are "fringe" views that thus need to be minimized. It appears that this source, far from being the sort of fringe publication that should be excluded by WP:DUE, is the sort of recently-published review article in a reputable peer-reviewed journal (Current Opinion in Anesthesiology) that we should be trying to include per WP:MEDRS. But if MPants or anyone else wishes to explain why this sources is "fishy" or should be excluded for another reason I'm all ears. IntoThinAir (formerly Everymorning) talk 00:14, 17 July 2018 (UTC)
- Just as a point of fact, by definition, sources that support the efficacy of acupuncture have fringe conclusions. That doesn't make them invalid, but the mainstream view is that acupuncture is not effective, hence the conclusions of this study are fringe. However, that's not so much the problem in this case, per se. The WP:DUE reason here is that there's nothing about this study that makes it at all clear why it was picked. It's just one, random study by a couple of unremarkable researchers claiming to show that acupuncture is effective, tacked on to the end of a paragraph about the effectiveness of accupuncture that, for the most part, clearly disagrees with the results of this study. (That's leaving out the use of language like "growing evidence".) As for the date: It's a 2017 review. It hasn't had a chance to establish an impact in the field. It's just one of the things that make this study unremarkable. We generally prefer studies and surveys that have been around a few years and gathered up a bunch of citations; preferably those which have had their results duplicated.
- Finally the fishiness: the review starts by exclaiming that acupuncture is effective. It then "finds" that acupuncture is effective. <sound of crickets chirping> That's not just a red flag, that's a guy in a red suit with a red face from drinking frantically waving a red flag soaked in his own urine while blathering about aliens and anal probes. Good science never sets out to answer a question by stating that one answer is true in unambiguous terms. Of course, this is actually par for the course with acupuncture research.
- Then there's the usual "Multiple Asian authors and one Westerner", with the Asian contributors clearly the actual authors (Author information says: Acupuncture Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea, yet Buchheit is with The Pain Society of the Carolinas) used to make acupuncture research look more legitimate by making it look less Asian. Then, it's published in a relatively low-impact journal (there's another journal by the same publisher, covering the same field with twice the impact factor). Like I said, it's just fishy. It might turn out to be okay, but I highly doubt that any credible researchers would give this study the time of day. Of course, in a few years, we might see that I was wrong, when this article has hundreds of cites and is referenced as establishing the scientific consen- Oh, wait. I just saw how it concludes. Further studies on its use as an adjunct or alternative to opioids, and in perioperative settings are needed. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 02:59, 17 July 2018 (UTC)
- Do you have a reliable source to support your clearly extraordinary claim that "the mainstream view is that acupuncture is not effective"? Without such a source any claim that "by definition, sources that support the efficacy of acupuncture have fringe conclusions" is clearly untenable. Dismissing the article as being by "unremarkable researchers" is of course an ad hominem that has no bearing on whether or to what extent the conclusions of the article are valid. Notably, you failed to address the point I made regarding the fact that WP:MEDRS (specifically the section WP:MEDDATE) recommends that recent literature reviews be included, meaning the complaint about this article not having had enough time to get a lot of citations is invalid: that it was published recently is a strength, not a weakness. In addition, their statement that more research is needed appears to be with reference not to acupuncture's effectiveness in general, or with respect to chronic pain, but rather with respect to its use "an adjunct or alternative to opioids, and in perioperative settings" (as shown in the quote you yourself cited above). That two of the three authors are of Asian descent seems of little to no relevance to the credibility of the article's conclusions--I am aware of the issue of almost all Chinese studies producing positive results, but none of the authors have any affiliations in China. So I am, in general, skeptical of the argument that this should be excluded. IntoThinAir (formerly Everymorning) talk 03:31, 17 July 2018 (UTC)
- The new review discusses five new human trials (most of the papers reviewed are animal trials, or publications that are not clinical trials). And one of those trials only had 8 people and no control group. And the only of the five with more than 100 subjects wasn't even designed to test efficacy. It contributes literally nothing to the body of knowledge on acupuncture effectiveness, except to point out that people continue to publish studies from which no conclusions can be drawn. Someguy1221 (talk) 03:43, 17 July 2018 (UTC)
Do you have a reliable source to support your clearly extraordinary claim that "the mainstream view is that acupuncture is not effective"?
Ahh, so you were POV pushing with that addition. That explains it. But to answer your question:- Myint Swe Khine (2011) Advances in Nature of Science Research: Concepts and Methodologies Springer Science & Business Media, New York, NY
- Baran G.R., Kiani M.F., Samuel S.P. (2014) Science, Pseudoscience, and Not Science: How Do They Differ?. In: Healthcare and Biomedical Technology in the 21st Century. Springer, New York, NY
- Barrett, Stephen M.D. Be Wary of Acupuncture, Qigong, and "Chinese Medicine" http://www.quackwatch.org/01QuackeryRelatedTopics/acu.html (this one has it's own list of references worth checking out)
- Brian M. Berman, M.D., Helene M. Langevin, M.D., Claudia M. Witt, M.D., M.B.A., and Ronald Dubner, D.D.S., Ph.D. (2010) Acupuncture for Chronic Low Back Pain New England Journal of Medicine 2010; Volume 363, pages 454-461
- Andrew C. Ahn, Agatha P. Colbert, Belinda J. Anderson, Ørjan G. Martinsen, Richard Hammerschlag, Steve Cina, Peter M. Wayne, Helene M. Langevin (2008) Electrical properties of acupuncture points and meridians: A systematic review Bioelectromagnetics Volume 29, Issue 4
- Christopher J. Standaert; Janna Friedly; Mark W. Erwin; Michael J. Lee; Glenn Rechtine; Nora B. Henrikson; Daniel C. Norvell (2011) Comparative Effectiveness of Exercise, Acupuncture, and Spinal Manipulation for Low Back Pain Spine, Volume 36, Pages 120-130
- E. Ernst (2005) Acupuncture – a critical analysis Journal of Internal Medicine Volume 259, Pages 125-137
- Shu-Ming Wang, Zeev N. Kain, Paul F. White (2008) Acupuncture Analgesia: II. Clinical Considerations Anesthesia & Analgesia, Volume 106(2) Pages 611-621
- Ernst, E.; Lee, Myeong Sooa; Choi, Tae-Youngb (2011) Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews Pain, Volume 152(4), Pages 755-764
- Ernst, Edzard (2009) Acupuncture: What Does the Most Reliable Evidence Tell Us? Journal of Pain and Symptom Management, Volume 37(4), Pages 709-714
- There's plenty more where that came from.
Dismissing the article as being by "unremarkable researchers" is of course an ad hominem that has no bearing on whether or to what extent the conclusions of the article are valid.
Cherry picking, are we now? Don't pretend to call out "fallacies" in another editors argument if you can't be bothered to maintain a higher level of integrity, yourself. Either quote me in context or don't quote me at all, thanks.Notably, you failed to address the point I made regarding the fact that WP:MEDRS (specifically the section WP:MEDDATE) recommends that recent literature reviews be included
I thought you had already read WP:RECENTISM, which is explicitly warned against in WP:MEDRS. If I was mistaken in that assumption, I apologize. So let me address your concern now: WP:RECENTISM.In addition, their statement that more research is needed
Using a higher level of specificity only transforms a vague and meaningless statement into a less vague but still meaningless statement.I am aware of the issue of almost all Chinese studies producing positive results, but none of the authors have any affiliations in China.
Then you should be aware that this tends to apply to Korean studies to a somewhat lesser extent, and to studies from institutes dedicated to promoting acupuncture to a much higher extent. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 12:53, 17 July 2018 (UTC)- MPants at work, I'm curious to know where you heard this about Korean studies. Do you have a link to this information? TylerDurden8823 (talk) 08:31, 6 August 2018 (UTC)
- @TylerDurden8823: I've seen comparisons between Chinese and Korean science wrt acupuncture in numerous places. Off the top of my head, this is one example that actually goes into some detail about what the specific problems with Korean studies are. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 12:31, 13 August 2018 (UTC)
- @MPants at work:, I don't see anything about the state of the medical literature from Korea in the cited article. Are you sure you cited the correct study? It looks like it's an older article examining the state of Korean literature specifically about acupuncture. Granted, it looks like it's mainly lower level evidence (e.g., case reports, series, uncontrolled/suboptimally controlled studies, etc, which still have some value (case reports can be a helpful type of evidence)) but it doesn't necessarily speak to the original question of whether medical literature from Korea suffers from similar questions about its overall integrity when compared to that of China. TylerDurden8823 (talk) 08:02, 21 August 2018 (UTC)
- It's a paper that weighs the results and analyses the methodology of literally every acupuncture study published in all Korean journals, and found the facts that they almost always show a positive result and they are virtually always of low methodological quality notable enough to mention in the abstract (not even saving it for the results). I don't see how that's at all ambiguous. Sure, an analysis of the overall state of Korean literature might not have been the stated goal of the authors, but that doesn't really matter when such an analysis was a part of their methodology, now does it? ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 01:26, 22 August 2018 (UTC)
- Well, I think it matters. I wouldn't necessarily extrapolate the poor quality of the Korean literature in the field of acupuncture to Korean literature in all other medical subjects. The article you provided certainly speaks volumes about the quality of the Korean literature on acupuncture. I'm not suggesting it's ambiguous about that. TylerDurden8823 (talk) 07:19, 22 August 2018 (UTC)
- I was only referring to the qualities of Korean medical science wrt acupuncture. I have no particular problem with, for example, a Korean new drug study. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 12:29, 22 August 2018 (UTC)
- Well, I think it matters. I wouldn't necessarily extrapolate the poor quality of the Korean literature in the field of acupuncture to Korean literature in all other medical subjects. The article you provided certainly speaks volumes about the quality of the Korean literature on acupuncture. I'm not suggesting it's ambiguous about that. TylerDurden8823 (talk) 07:19, 22 August 2018 (UTC)
- It's a paper that weighs the results and analyses the methodology of literally every acupuncture study published in all Korean journals, and found the facts that they almost always show a positive result and they are virtually always of low methodological quality notable enough to mention in the abstract (not even saving it for the results). I don't see how that's at all ambiguous. Sure, an analysis of the overall state of Korean literature might not have been the stated goal of the authors, but that doesn't really matter when such an analysis was a part of their methodology, now does it? ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 01:26, 22 August 2018 (UTC)
- @MPants at work:, I don't see anything about the state of the medical literature from Korea in the cited article. Are you sure you cited the correct study? It looks like it's an older article examining the state of Korean literature specifically about acupuncture. Granted, it looks like it's mainly lower level evidence (e.g., case reports, series, uncontrolled/suboptimally controlled studies, etc, which still have some value (case reports can be a helpful type of evidence)) but it doesn't necessarily speak to the original question of whether medical literature from Korea suffers from similar questions about its overall integrity when compared to that of China. TylerDurden8823 (talk) 08:02, 21 August 2018 (UTC)
- @TylerDurden8823: I've seen comparisons between Chinese and Korean science wrt acupuncture in numerous places. Off the top of my head, this is one example that actually goes into some detail about what the specific problems with Korean studies are. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 12:31, 13 August 2018 (UTC)
- MPants at work, I'm curious to know where you heard this about Korean studies. Do you have a link to this information? TylerDurden8823 (talk) 08:31, 6 August 2018 (UTC)
- Do you have a reliable source to support your clearly extraordinary claim that "the mainstream view is that acupuncture is not effective"? Without such a source any claim that "by definition, sources that support the efficacy of acupuncture have fringe conclusions" is clearly untenable. Dismissing the article as being by "unremarkable researchers" is of course an ad hominem that has no bearing on whether or to what extent the conclusions of the article are valid. Notably, you failed to address the point I made regarding the fact that WP:MEDRS (specifically the section WP:MEDDATE) recommends that recent literature reviews be included, meaning the complaint about this article not having had enough time to get a lot of citations is invalid: that it was published recently is a strength, not a weakness. In addition, their statement that more research is needed appears to be with reference not to acupuncture's effectiveness in general, or with respect to chronic pain, but rather with respect to its use "an adjunct or alternative to opioids, and in perioperative settings" (as shown in the quote you yourself cited above). That two of the three authors are of Asian descent seems of little to no relevance to the credibility of the article's conclusions--I am aware of the issue of almost all Chinese studies producing positive results, but none of the authors have any affiliations in China. So I am, in general, skeptical of the argument that this should be excluded. IntoThinAir (formerly Everymorning) talk 03:31, 17 July 2018 (UTC)
We should evaluate sources based on their quality not their conclusions. Re mainstream: NICE guidelines recommend acupuncture for chronic tension-type headaches and migraines [2]. Harrison's (2015 pdf) recommends it for several conditions including dysmennorhea, knee OA and chronic flank, back, or abdominal pain due to renal enlargement in ADPKD. NICE and Harrison's are as mainstream as it gets last I checked. --Middle 8 (t • c | privacy • acupuncture COI?) 09:03, 1 December 2018 (UTC)
- To be clear i do get that for most other conditions there's "evidence of no efficacy" or "no evidence of efficacy", and caveats re possible false positives, etc etc. --Middle 8 (t • c | privacy • acupuncture COI?) 02:52, 3 December 2018 (UTC) (revised 11:26, 3 December 2018 (UTC))
- And if you look at the history of NICE guidance on acupuncture, the recommendations are being crossed off one by one. Example: https://www.nice.org.uk/news/article/nice-publishes-updated-advice-on-treating-low-back-pain Guy (Help!) 13:13, 3 December 2018 (UTC)
- Yep. Unlike the acupuncturists themselves, at least NICE is slowly recognizing and resolving its green-jelly-bean problem. TenOfAllTrades(talk) 13:28, 3 December 2018 (UTC)
- @JzG: Yes, that is the overall trend for the evidence base. Wikipedia not being a crystal ball, how would you handle what NICE and Harrison's say now, as opposed to what they'll probably say in the future? --Middle 8 (t • c | privacy • acupuncture COI?) 10:21, 4 December 2018 (UTC)
- We ignore it, because there is good reason to think that sources like this are merely behind the trajectory. They are the equivalent of the few sources that continued to publish Heartland-funded industry driven climate change denialism after the publication of Merchants of Doubt. Quackademic medicine is a large and well funded enterprise, but the ability of acupuncture to manipulate nonexistent qi along nonexistent meridians, cherished though it is by the integrative medicine cargo cult, is no longer a matter of serious scientific inquiry, only of marketing studies by true believers. All these continued studies do is prove how hard it is to properly double blind an invasive procedure. Guy (Help!) 12:42, 4 December 2018 (UTC)
- @JzG: Harrison's and NICE are the equivalent of climate change deniers?!? Now there's a fringe view! Acu, like anything else on WP, is to be depicted according to what properly weighted (MED)RS say. Not according to the pejoratives other (lesser!) sources (let alone editors!) fling at such MEDRS. Or what other sources/editors predict they'll say. --Middle 8 (t • c | privacy • acupuncture COI?) 10:40, 10 December 2018 (UTC)
- No, they are the equivalent of the reviews of climate science that noted the positions of climate change deniers before the whole fossil fuel lobby funded fraud was exposed. Guy (Help!) 11:03, 10 December 2018 (UTC)
- Right. An unproven conspiracy to hijack the best MEDRS. Definitely the stuff of mainspace. --Middle 8 (t • c | privacy • acupuncture COI?) 11:12, 10 December 2018 (UTC)
- No, they are the equivalent of the reviews of climate science that noted the positions of climate change deniers before the whole fossil fuel lobby funded fraud was exposed. Guy (Help!) 11:03, 10 December 2018 (UTC)
- @JzG: Harrison's and NICE are the equivalent of climate change deniers?!? Now there's a fringe view! Acu, like anything else on WP, is to be depicted according to what properly weighted (MED)RS say. Not according to the pejoratives other (lesser!) sources (let alone editors!) fling at such MEDRS. Or what other sources/editors predict they'll say. --Middle 8 (t • c | privacy • acupuncture COI?) 10:40, 10 December 2018 (UTC)
- We ignore it, because there is good reason to think that sources like this are merely behind the trajectory. They are the equivalent of the few sources that continued to publish Heartland-funded industry driven climate change denialism after the publication of Merchants of Doubt. Quackademic medicine is a large and well funded enterprise, but the ability of acupuncture to manipulate nonexistent qi along nonexistent meridians, cherished though it is by the integrative medicine cargo cult, is no longer a matter of serious scientific inquiry, only of marketing studies by true believers. All these continued studies do is prove how hard it is to properly double blind an invasive procedure. Guy (Help!) 12:42, 4 December 2018 (UTC)
- And if you look at the history of NICE guidance on acupuncture, the recommendations are being crossed off one by one. Example: https://www.nice.org.uk/news/article/nice-publishes-updated-advice-on-treating-low-back-pain Guy (Help!) 13:13, 3 December 2018 (UTC)
- Author affiliation: "Acupuncture Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul". That ends the conversation. Korean acupuncture studies are as biased as Chinese ones. Everyone is familiar with the acupuncture anaesthesia hoax, I hope? Guy (Help!) 13:10, 3 December 2018 (UTC)
- Ends which conversation exactly? --Middle 8 (t • c | privacy • acupuncture COI?) 10:21, 4 December 2018 (UTC)
- An unfounded derogatory assertion aimed at the author of a paper is not a valid critique of a source. I agree with Middle 8. Both NICE and Harrisons currently recommend acupuncture. They are reliable sources. Let's avoid crystal ball gazing and cite what they say now instead of wondering what they might say in the future. Morgan Leigh | Talk 22:15, 10 December 2018 (UTC)
Removal of cited information
@SkepticalRaptor: Please explain why you have removed cited information from the page. How can a direct quote from a cited source constitute a POV comment? Morgan Leigh | Talk 07:55, 21 November 2018 (UTC)
- @Morgan Leigh: You've been told before of WP:STICK. Tgeorgescu (talk) 02:01, 23 November 2018 (UTC)
- Um no. Not OK to remove a properly-weighted Vickers. It should be among the very first mentioned because it's about the highest-quality meta-analysis there is -- AFAIK the only IPD one, which Cochrane calls the "gold standard" of systematic review. (pings @SkepticalRaptor: @Tgeorgescu: @Morgan Leigh:) --Middle 8 (t • c | privacy • acupuncture COI?) 08:44, 1 December 2018 (UTC)
There is a discussion about this at the Reliable sources noticeboard here. Morgan Leigh | Talk 04:29, 2 December 2018 (UTC)
Removal of Category 'Medicine'
@Roxy the dog: Please explain why you have removed the category Medicine from this article. I refer you to the lead of the article that says that "Acupuncture is a form of alternative medicine". Morgan Leigh | Talk 01:54, 27 November 2018 (UTC)
- Yes, and the article is in the "Alternative Medecine" category. So all is good. --McSly (talk) 02:00, 27 November 2018 (UTC)
- What McSly said. -Roxy, the naughty dog. wooF 08:30, 27 November 2018 (UTC)
- I'd like to refer interested editors in general and @Coffee.sleep.repeat: in particular to this page where I explain that a correct understanding of how categories work is the root of this issue. Morgan Leigh | Talk 07:06, 3 December 2018 (UTC)
- So, now that you understand, are you going to stop adding spurious categories, or not? -Roxy, the naughty dog. wooF 08:42, 3 December 2018 (UTC)
- Actually for those who insist that alt-med be defined as what doesn't work, and medicine as what does, acu should be in both categories because it works for a few things. --Middle 8 (t • c | privacy • acupuncture COI?) 11:04, 3 December 2018 (UTC)
- No it doesn't. It doesn't matter where you put the needles or even whether you put them in or not, any "effects" are small, transient, and only affect subjective outcomes self-reported by the patients. It is an absolutely classic fake treatment. Guy (Help!) 13:07, 3 December 2018 (UTC)
- Can we have a source that supports that text? Morgan Leigh | Talk 22:58, 3 December 2018 (UTC)
- No it doesn't. It doesn't matter where you put the needles or even whether you put them in or not, any "effects" are small, transient, and only affect subjective outcomes self-reported by the patients. It is an absolutely classic fake treatment. Guy (Help!) 13:07, 3 December 2018 (UTC)
- Actually for those who insist that alt-med be defined as what doesn't work, and medicine as what does, acu should be in both categories because it works for a few things. --Middle 8 (t • c | privacy • acupuncture COI?) 11:04, 3 December 2018 (UTC)
- So, now that you understand, are you going to stop adding spurious categories, or not? -Roxy, the naughty dog. wooF 08:42, 3 December 2018 (UTC)
- I'd like to refer interested editors in general and @Coffee.sleep.repeat: in particular to this page where I explain that a correct understanding of how categories work is the root of this issue. Morgan Leigh | Talk 07:06, 3 December 2018 (UTC)
- What McSly said. -Roxy, the naughty dog. wooF 08:30, 27 November 2018 (UTC)
Perhaps you could start by reading the sources for the article. You will find that Guy has summarized the results of years of studies and reviews including the latest conclusions. I actually find that summary the best I have seen on acupuncture research in some time.MrBill3 (talk) 23:21, 3 December 2018 (UTC)
- I always consider the 'effect' the acu equivalent of going "Pat, Pat, - 'There There'." -Roxy, the dog. wooF 00:55, 4 December 2018 (UTC)
- @Roxy the dog: FWIW: WP:TALK 1st 2 sentences. Just sayin'. --Middle 8 (t • c | privacy • acupuncture COI?) 11:04, 4 December 2018 (UTC)
- @Middle 8:Hi M8, I've missed you. Have you seen our Sealioning article? -Roxy, the dog. wooF 14:10, 4 December 2018 (UTC)
- @Roxy the dog: FWIW: WP:TALK 1st 2 sentences. Just sayin'. --Middle 8 (t • c | privacy • acupuncture COI?) 11:04, 4 December 2018 (UTC)
- @JzG: Yes, I've read the blogs where that opinion is expressed. Are those the sources you'd use to answer Morgan Leigh's question? NICE and Harrison's (better sources) say differently. Remember scientists use blogs for opinions and peer review for findings, and here peer review hasn't "caught up" with opinions/predictions (however prescient they may be). @MrBill3: Did you read that diff I used just above? (Better link for NICE/NHS scroll to "Uses of acupuncture" here.) Any summary excluding such sources is inadequate (MEDRS don't get better/more mainstream). --Middle 8 (t • c | privacy • acupuncture COI?) 11:04, 4 December 2018 (UTC)
- The function of science communicators is to succinctly summarise the research in lay terms. And as a lay summary that is hard to beat. Ernst's stage dagger needles conclusively demonstrated that insertion or not makes no difference, backing a number of other studies using other methods; there are a large number of studies showing that position is unimportant, and this is indeed obvious from the existence of multiple acupuncture traditions with different dogmas. The conclusion that acupuncture "affects" only subjective symptoms is also well-supported, as is the existence of adverse events up to and including death. I know you are a believer, but your belief is misplaced and that succinct lay summary of the evidence shows exactly why. Guy (Help!) 12:50, 4 December 2018 (UTC)
- This is not about any editor's opinion as to the efficacy of Acupuncture. It is about the sources, using good ones and representing them accurately. The above comment sounds as if you are advocating using a blog rather than using peer reviewed sources. Morgan Leigh | Talk 22:15, 4 December 2018 (UTC)
- This is a talk page. It is perfectly reasonable to use a lay summary from a expert sources (in this case both Edzard Ernst and Steve Novella, both of whom have a stellar reputation for critiquing alternatives to medicine). Guy (Help!) 22:49, 4 December 2018 (UTC).
- We are not discussing the subject. We are discussing which sources are good to go in the article. In response to my post at the reliable sources noticeboard here you stated that acupuncture doesn't work but when asked there for a source to support your statement by @Slatersteven: you have offered nothing. I subsequently reiterated that question here when you said the same thing, using almost exactly the same words, to wit, "It doesn't matter where you put the needles or even whether you put them in or not, any "effects" are small, transient, and only affect subjective outcomes self-reported by the patients. It is an absolutely classic fake treatment."? You offered a blog in support of your proposition. I have provided three peer reviewed meta analyses that provide evidence of the efficacy of acupuncture for certain conditions. All three have been removed from the article with a claim that they are POV. I suggest that a blog is not a more reliable source than three peer reviewed meta analyses. Do you agree?
- This is a talk page. It is perfectly reasonable to use a lay summary from a expert sources (in this case both Edzard Ernst and Steve Novella, both of whom have a stellar reputation for critiquing alternatives to medicine). Guy (Help!) 22:49, 4 December 2018 (UTC).
- This is not about any editor's opinion as to the efficacy of Acupuncture. It is about the sources, using good ones and representing them accurately. The above comment sounds as if you are advocating using a blog rather than using peer reviewed sources. Morgan Leigh | Talk 22:15, 4 December 2018 (UTC)
- The function of science communicators is to succinctly summarise the research in lay terms. And as a lay summary that is hard to beat. Ernst's stage dagger needles conclusively demonstrated that insertion or not makes no difference, backing a number of other studies using other methods; there are a large number of studies showing that position is unimportant, and this is indeed obvious from the existence of multiple acupuncture traditions with different dogmas. The conclusion that acupuncture "affects" only subjective symptoms is also well-supported, as is the existence of adverse events up to and including death. I know you are a believer, but your belief is misplaced and that succinct lay summary of the evidence shows exactly why. Guy (Help!) 12:50, 4 December 2018 (UTC)
- As a reminder there are two changes to be considered.
- 1)The article currently says;
- "The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits." Citing this source Wang SM, Kain ZN, White PF (February 2008). "Acupuncture analgesia: II. Clinical considerations". Anesthesia and Analgesia. 106 (2): 611–21 doi:10.1213/ane.0b013e318160644d
- I suggest changing it to;
- "One systematic review found little evidence of acupuncture's effectiveness in treating pain(sourced to Ernst E, Lee MS, Choi TY (April 2011). "Acupuncture: does it alleviate pain and are there serious risks? A review of reviews" (PDF). Pain. 152 (4): 755–64), while others have found it to be effective.
- The sources I suggest citing for this change are;
- Vickers, Cronin, Maschino, et al, (2012), Acupuncture for Chronic Pain:Individual Patient Data Meta-analysis, Arch Intern Med. 2012;172(19):1444-1453. doi:10.1001/archinternmed.2012.3654
- Hopton, MacPherson, (2010), Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta‐analyses, Pain Practice, Volume 10, Issue 2, March/April 2010, Pages 94-102
- Kwon, Pittler, Ernst, (2006), Acupuncture for peripheral joint osteoarthritis: A systematic review and meta-analysis, Rheumatology, Volume 45, Issue 11, 1 November 2006, Pages 1331–1337, https://doi.org/10.1093/rheumatology/kel207
- 2)The article currently says;
- "The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits." and cited this source Wang SM, Kain ZN, White PF (February 2008). "Acupuncture analgesia: II. Clinical considerations". Anesthesia and Analgesia. 106 (2): 611–21 doi:10.1213/ane.0b013e318160644d
- I propose we change it to more accurately represent the source to;
- "A review of randomized, sham-controlled clinical investigations found that treatment with acupuncture is "effective in the short-term management of low back pain, neck pain, and osteoarthritis involving the knee" but that it does not produce long-term benefits."
- I ask my fellow editors to please address these two proposed changes by answering these two questions, are these changes supported by these sources? Are these sources reliable for this text? Morgan Leigh | Talk 05:27, 5 December 2018 (UTC)
- Sure, I'll address them. No, and no.
- No because it replaces a factual summary with weasel words that make it sound as if only one or a few sources finds these facts. That's not true. There is no long term benefit from sticking needles into people, and it can cause adverse events up to and including death, so we don't give undue weight to the beliefs of those who fervently wish otherwise.
- A reminder: acupuncture is an alternative to medicine based on the idea that all diseases are caused by disturbances in the flow of qi through meridians that can be rebalanced by inserting needles at specific points in the body. Qi does not exist, meridians do not exist, competing schools of acupuncture have different acupoints, assiduous research shows that it doesn't matter where you put the needles or even whether you stick them in at all, there is no credible evidence of any long-term effect and no credible evidence of objective effect.
- It has taken a long time to design studies that properly blind and control, due to the invasive nature of acupuncture. The development of more sophisticated blinding and controls has fatally undermined the claims of acupuncture proponents. Acupuncture fans have spent years at this article trying to "balance" this with studies showing positive outcomes which virtually all share the same trifecta: 1. They deal with subjective outcomes; 2. they use self-reporting; 3. they are produced by people with a vested interest in acupuncture. Guy (Help!) 08:17, 5 December 2018 (UTC)
- I ask my fellow editors to please address these two proposed changes by answering these two questions, are these changes supported by these sources? Are these sources reliable for this text? Morgan Leigh | Talk 05:27, 5 December 2018 (UTC)
- Which words exactly do you contend are weasel words?
- If you are objecting to the use of the word one in the proposed sentence, "One systematic review found little evidence of acupuncture's effectiveness in treating pain, while others have found it to be effective." The word one is there because one review is cited for that statement whereas three are cited for the other statement. I note that the existing version says "The evidence suggests that..." which sounds as if all the evidence suggests, whereas in fact the statement is supported by one review. If you have more sources to cite for that finding I encourage you to add them and then it can say "Some reviews have found... while others..." which is super balanced. Morgan Leigh | Talk 08:51, 5 December 2018 (UTC)
- I think it's obvious to those of us who are not True Believers. Casting this as "this one review said X" when the one review actually reflects the reality-based consensus is weaselly. It's also worth remembering that when the Cochrane study said "there is moderate-level evidence that the effect of acupuncture does not differ from sham acupuncture", the reality-based community recognised that this means it doesn't work whereas the True Believers claimed it as validating acupuncture because it's so great that even fake acupuncture works. That is the perfect exemplar of how the SCAM community reviews evidence. Guy (Help!) 12:17, 7 December 2018 (UTC)
- If you are objecting to the use of the word one in the proposed sentence, "One systematic review found little evidence of acupuncture's effectiveness in treating pain, while others have found it to be effective." The word one is there because one review is cited for that statement whereas three are cited for the other statement. I note that the existing version says "The evidence suggests that..." which sounds as if all the evidence suggests, whereas in fact the statement is supported by one review. If you have more sources to cite for that finding I encourage you to add them and then it can say "Some reviews have found... while others..." which is super balanced. Morgan Leigh | Talk 08:51, 5 December 2018 (UTC)
There have been studies of acupuncture for decades. A very few studies have shown any effect and those results are evaporating as methodology evolves. There is what is called a preponderance of evidence that acupuncture has no long term benefit and that the short term benefits are slight and quite probably statistical anomalies or confounding factors. There is zero support for the theoretical underpinnings. There is zero evidence that the mechanisms proposed exist at all. There are significant risks and harm has resulted. The article must clearly represent that. Perhaps it is time to WP:Drop the stick. Take some time to read the archives and try not to rehash. Really this has been gone over. MrBill3 (talk) 10:22, 5 December 2018 (UTC)
- Instead of expressions of personal opinions can we please answer the question at hand? i.e. Are the specific sources I mentioned reliable and do they accurately represent the text proposed? Morgan Leigh | Talk 03:12, 7 December 2018 (UTC)
- As I see it, much of the problem is down to the plethora of studies carried out on acupuncture which say very little. In the past a problem that has plagued this article is having huge lists of citations yet conveying little or no knowledge to the reader. So I agree, this is one of those occasions where we need decent tertiary commentary (or a review of reviews) in order to build a coherent article. Most of the scholarly tertiary sources are quite old now, so it's reasonable to use something from Ernst etc. I think. More recently, I think this piece[3] done for the NHS offers a reasonable overview of the current situations ... executive summary: evidence for acupuncture helping pain is weak, and even then there is doubt whether it's useful and/or cost-effective. Alexbrn (talk) 10:32, 5 December 2018 (UTC)
- Not sure this has been posted already but here is a summary of all Cochrane reviews on acupuncture until Nov 2017: https://www.scienceinmedicine.org.au/wp-content/uploads/2018/01/Cochrane-acupuncture-2017.pdf. Says it all really... Lucleon (talk) 10:41, 5 December 2018 (UTC)
- What that list of reviews actually says is that you are presenting an incomplete list framed to a skeptical POV, complied by a renowned skeptic. That is not a complete list of all Cochrane reviews on acupuncture. If you go to the Cochrane site you will see that there are 122 Cochrane reviews about acupuncture while that list has only 42. The URL indicates the list you mentioned is from the Institute for Science in Medicine, which was founded by renowned skeptic David Gorski.
- Bearing this in mind it is unsurprising to note the summaries on that list are framed to be a negative as possible. For example this study on fibromyalgia is summarized on that list as
whereas the conclusions of the author's of the review say in full,The small sample size, scarcity of studies for each compassion, lack of an ideal sham acupuncture weaken the level of evidence and its clinical implication
There is low to moderate-level evidence that compared with no treatment and standard therapy, acupuncture improves pain and stiffness in people with fibromyalgia. There is moderate-level evidence that the effect of acupuncture does not differ from sham acupuncture in reducing pain or fatigue, or improving sleep or global well-being. EA is probably better than MA for pain and stiffness reduction and improvement of global well-being, sleep and fatigue. The effect lasts up to one month, but is not maintained at six months follow-up. MA probably does not improve pain or physical functioning. Acupuncture appears safe. People with fibromyalgia may consider using EA alone or with exercise and medication. The small sample size, scarcity of studies for each comparison, lack of an ideal sham acupuncture weaken the level of evidence and its clinical implications. Larger studies are warranted.
- Not sure this has been posted already but here is a summary of all Cochrane reviews on acupuncture until Nov 2017: https://www.scienceinmedicine.org.au/wp-content/uploads/2018/01/Cochrane-acupuncture-2017.pdf. Says it all really... Lucleon (talk) 10:41, 5 December 2018 (UTC)
- This exemplifies what is going on in this article at present. Evidence is being skewed to a skeptical POV. Morgan Leigh | Talk 03:12, 7 December 2018 (UTC)
- Yes, the list is from a website made be renowned people, which makes the list only better in my opinion. Which Cochrane review on acupuncture are you missing? The 1-line summary from the website you single out is consistent with the complete summary: low to moderate-level evidence from studies with small sample size and a scarcity of studies for comparison.Lucleon (talk) 07:35, 7 December 2018 (UTC)
- A renowned skeptic. There are 80 reviews missing from that list. It is not consistent with the summary because the summary doesn't make any mention that "acupuncture improves pain and stiffness in people with fibromyalgia". Morgan Leigh | Talk 08:23, 7 December 2018 (UTC)
- "Scientific skepticism ... is a practical, epistemological position in which one questions the veracity of claims lacking empirical evidence." (Quote from Skeptical movement). I don't see what could be wrong with having such a position when we are discussing potential medical treatments. You are referring to 80 missing Cochrane reviews but it's not clear where this number comes from. Can you mention some of Cochrane reviews you are missing? Regarding the review you mentioned above: the point is that low to moderate-level evidence from a small number of studies with small sample size and a lack of an ideal sham acupuncture is not a basis to claim that "acupuncture improves pain and stiffness in people with fibromyalgia" without further elaboration. Lucleon (talk) 09:50, 7 December 2018 (UTC)
- If you go to the Cochrane reviews site and search for acupuncture you will find 122 reviews either specifically about acupuncture only or that mention acupuncture. Yes, I can mention them, see below. Re the fibromyalgia review, you seem to be arguing that a Cochrane review is not good enough to justify its findings. Is this the case? A skeptic who was true to the principles of science wouldn't need to present an abbreviated list as if it were a full list and wouldn't need to summarise the results omitting any mention of positive results. They also wouldn't need to try to discredit scholars based solely on the field in which they study. They wouldn't find it necessary to disparage other by labeling them "true believers' and claiming they weren't "reality based". That looks like an undesirable POV to me. Morgan Leigh | Talk 02:55, 8 December 2018 (UTC)
- "Scientific skepticism ... is a practical, epistemological position in which one questions the veracity of claims lacking empirical evidence." (Quote from Skeptical movement). I don't see what could be wrong with having such a position when we are discussing potential medical treatments. You are referring to 80 missing Cochrane reviews but it's not clear where this number comes from. Can you mention some of Cochrane reviews you are missing? Regarding the review you mentioned above: the point is that low to moderate-level evidence from a small number of studies with small sample size and a lack of an ideal sham acupuncture is not a basis to claim that "acupuncture improves pain and stiffness in people with fibromyalgia" without further elaboration. Lucleon (talk) 09:50, 7 December 2018 (UTC)
- Close. A scientific POV, which, in Wikipedia articles on science and medicine, is the same thing as the neutral POV. You know the old saying: extraordinary claims require extraordinary evidence. The claims of acupuncture are absolutely extraordinary: a 19th Century reworking of bloodletting, based on folk superstitions about life energy originated long before the modern science of anatomy, somehow resulted in a profound method of healing even though all the premises on which it is based are now definitively refuted. The evidence is not in the least bit extraordinary: True Believers conducting endless poorly controlled, poorly blinded studies measuring usually self-reported effects on subjective outcomes, contradicted by much more carefully designed studies by more skeptical researchers. If you believe in the thing and don't try too hard to disprove it, you end up "proving" the thing every time. These tactics kept homeopathy from the scrapheap for half a century, and it's only recently that publicly funded health bodies have started addressing that particular form of health fraud. The trajectory for acupuncture is the same. Guy (Help!) 12:12, 7 December 2018 (UTC)
- Once again you are expressing your own opinions and not addressing the specific sources. Morgan Leigh | Talk 02:55, 8 December 2018 (UTC)
- Close. A scientific POV, which, in Wikipedia articles on science and medicine, is the same thing as the neutral POV. You know the old saying: extraordinary claims require extraordinary evidence. The claims of acupuncture are absolutely extraordinary: a 19th Century reworking of bloodletting, based on folk superstitions about life energy originated long before the modern science of anatomy, somehow resulted in a profound method of healing even though all the premises on which it is based are now definitively refuted. The evidence is not in the least bit extraordinary: True Believers conducting endless poorly controlled, poorly blinded studies measuring usually self-reported effects on subjective outcomes, contradicted by much more carefully designed studies by more skeptical researchers. If you believe in the thing and don't try too hard to disprove it, you end up "proving" the thing every time. These tactics kept homeopathy from the scrapheap for half a century, and it's only recently that publicly funded health bodies have started addressing that particular form of health fraud. The trajectory for acupuncture is the same. Guy (Help!) 12:12, 7 December 2018 (UTC)
MY response was to a specific question about a specific source, not sources as a whole (nor is it a comment on acupuncture+.Slatersteven (talk) 10:43, 5 December 2018 (UTC)
@Alexbrn: That NHS piece is a balanced piece, but instead of citing it why don't we cite the paper it was based on? The paper is Cummings, Hróbjartsson & Ernst, (2018), BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k970. It's a recent paper reviewing the evidence that covers both sides of the debate. I note that I am trying to cite three recent meta reviews...Morgan Leigh | Talk 03:12, 7 December 2018 (UTC)
- The trouble with that is that it's got stuff from a acupuncture advocate which is bonkers. Although the BMJ can do this kind of "two sides" thing, we are prohibited from doing it by WP:GEVAL policy. We need to make sure that the pseudoscience is kept in its box. Alexbrn (talk) 04:23, 7 December 2018 (UTC)
- So the trouble with that paper is that it shows both sides? POV much. We are most certainly not prevented from explaining both side of any given position. By your usage of "bonkers" I am presuming that you feel the source might be biased. WP:BIASED says, "However, reliable sources are not required to be neutral, unbiased, or objective. Sometimes non-neutral sources are the best possible sources for supporting information about the different viewpoints held on a subject.". It is hard to see how a peer reviewed paper that presents both sides of a position is biased though... Moreover WP:GEVAL says "While it is important to account for all significant viewpoints on any topic, Wikipedia policy does not state or imply that every minority view or extraordinary claim needs to be presented along with commonly accepted mainstream scholarship as if they were of equal validity." That acupuncture has some level of effectiveness for some conditions is hardly a minority view nor an extraordinary claim. "The Earth is flat" is a minority view and an extraordinary claim. There is scientific evidence from reliable sources that acupuncture has some degree of efficacy for some conditions. Like the ones I am proposing to cite. Which takes me back to the actual question here, are the aforementioned changes supported by the sources? Are these sources reliable for this text? Morgan Leigh | Talk 05:25, 7 December 2018 (UTC)
- It's very fringey to argue that doctors "should" prescribe acupuncture for pain yes, so we're not going to frame that as just one side of "the debate" - it's not a debate being had in the real world. The situation is that whereas acupuncturists have historically made claims that it works for pretty much everything, today they have retreated to the last patch of ground, pain (notoriously difficult to assess via EBM) but even here as the source I mentioned states, the evidence - for a small effect - is weak. So the summary is that acupuncture doesn't work for anything except maybe pain relief, and there isn't even good evidence it works for that. I have already said how this could be sourced. Alexbrn (talk) 05:43, 7 December 2018 (UTC)
- Considering that it is a debate going on in the BMJ it is most certainly (a) a debate going on in the real world and (b) not fringey, the BMJ is as unfringey as it gets. I have offered peer reviewed papers that demonstrate some evidence of some effect for acupuncture for some conditions. You have suggested we only cite people with a particular view and that people who don't agree with that view are "bonkers". Science doesn't proceed with the assumption that people with a certain view are bonkers and so we should ignore their research. It tests claims and produces papers. I suggest we approach this as science does, one paper at a time. Starting with accurately representing what the papers already in the article say. Once again I ask, are the aforementioned changes supported by the sources? Are these sources reliable for this text? Morgan Leigh | Talk 08:23, 7 December 2018 (UTC)
- Well, if you're going to misrepresent my words there seems no point in continuing this discussion. I have suggested a way forward. Alexbrn (talk) 08:28, 7 December 2018 (UTC)
- Exactly how have I misrepresented your words? I sincerely hope I have misunderstood you, but it seems your way forward is to not cite evidence that supports the use of acupuncture. You suggested the NHS article. I suggested citing the paper it is based on and you said you couldn't do that because it contained information from someone who is bonkers. If this is not the case please explain what your way forward is. If its citing the NHS article, ok let's do that. How about we cite this quote from the NHS article "To summarise, evidence outlining the benefits of acupuncture does exist, but it is not strong evidence. There are also concerns the positive effects found in acupuncture research are only small and, arguably, due to a placebo effect.".Morgan Leigh | Talk 08:53, 7 December 2018 (UTC)
- @Alexbrn: Re GEVAL: Read GEVAL in the context of WP:NPOV of which it's a part, e.g. the first sentence of UNDUE. To the extent an RS GEVAL's, we GEVAL, when citing that source and according to its weight. Basic NPOV. --Middle 8 (t • c | privacy • acupuncture COI?) 09:56, 10 December 2018 (UTC)
- I'm sure we can spawn all kinds of alternatives to Wikipedia's WP:PAGs by creative invocations of "context"! Unfortunately for the acupuncturists here, GEVAL is explicit: even "plausible" but currently unaccepted theories should not be legitimized through comparison to accepted academic scholarship. So the fringe assertions of an acupuncturist (backed by their equally fringe publications) that acupuncture is in line with science are not going to be used to counterpoint basic scientific reality. This is doubly so when we have rock solid RS informing us that acupucture is pseudoscience. Alexbrn (talk) 10:12, 10 December 2018 (UTC)
- Yes, reading WP:NPOV all the way through, what a rad concept. Read right above GEVAL,
An article should not give undue weight to minor aspects of its subject, but should strive to treat each aspect with a weight proportional to its treatment in the body of reliable, published material on the subject.
BMJ is part of that body of material -- in fact the idea that acu is a powerful tool in pain management turns out to be a very mainstream view. --Middle 8 (t • c | privacy • acupuncture COI?) 10:39, 10 December 2018 (UTC)
- Yes, reading WP:NPOV all the way through, what a rad concept. Read right above GEVAL,
- I'm sure we can spawn all kinds of alternatives to Wikipedia's WP:PAGs by creative invocations of "context"! Unfortunately for the acupuncturists here, GEVAL is explicit: even "plausible" but currently unaccepted theories should not be legitimized through comparison to accepted academic scholarship. So the fringe assertions of an acupuncturist (backed by their equally fringe publications) that acupuncture is in line with science are not going to be used to counterpoint basic scientific reality. This is doubly so when we have rock solid RS informing us that acupucture is pseudoscience. Alexbrn (talk) 10:12, 10 December 2018 (UTC)
- Well, if you're going to misrepresent my words there seems no point in continuing this discussion. I have suggested a way forward. Alexbrn (talk) 08:28, 7 December 2018 (UTC)
- Considering that it is a debate going on in the BMJ it is most certainly (a) a debate going on in the real world and (b) not fringey, the BMJ is as unfringey as it gets. I have offered peer reviewed papers that demonstrate some evidence of some effect for acupuncture for some conditions. You have suggested we only cite people with a particular view and that people who don't agree with that view are "bonkers". Science doesn't proceed with the assumption that people with a certain view are bonkers and so we should ignore their research. It tests claims and produces papers. I suggest we approach this as science does, one paper at a time. Starting with accurately representing what the papers already in the article say. Once again I ask, are the aforementioned changes supported by the sources? Are these sources reliable for this text? Morgan Leigh | Talk 08:23, 7 December 2018 (UTC)
- It's very fringey to argue that doctors "should" prescribe acupuncture for pain yes, so we're not going to frame that as just one side of "the debate" - it's not a debate being had in the real world. The situation is that whereas acupuncturists have historically made claims that it works for pretty much everything, today they have retreated to the last patch of ground, pain (notoriously difficult to assess via EBM) but even here as the source I mentioned states, the evidence - for a small effect - is weak. So the summary is that acupuncture doesn't work for anything except maybe pain relief, and there isn't even good evidence it works for that. I have already said how this could be sourced. Alexbrn (talk) 05:43, 7 December 2018 (UTC)
- So the trouble with that paper is that it shows both sides? POV much. We are most certainly not prevented from explaining both side of any given position. By your usage of "bonkers" I am presuming that you feel the source might be biased. WP:BIASED says, "However, reliable sources are not required to be neutral, unbiased, or objective. Sometimes non-neutral sources are the best possible sources for supporting information about the different viewpoints held on a subject.". It is hard to see how a peer reviewed paper that presents both sides of a position is biased though... Moreover WP:GEVAL says "While it is important to account for all significant viewpoints on any topic, Wikipedia policy does not state or imply that every minority view or extraordinary claim needs to be presented along with commonly accepted mainstream scholarship as if they were of equal validity." That acupuncture has some level of effectiveness for some conditions is hardly a minority view nor an extraordinary claim. "The Earth is flat" is a minority view and an extraordinary claim. There is scientific evidence from reliable sources that acupuncture has some degree of efficacy for some conditions. Like the ones I am proposing to cite. Which takes me back to the actual question here, are the aforementioned changes supported by the sources? Are these sources reliable for this text? Morgan Leigh | Talk 05:25, 7 December 2018 (UTC)
"It’s a safe alternative to drugs that is under-researched because it lacks commercial interest, writes Mike Cummings, but Asbjørn Hróbjartsson and Edzard Ernst argue there is no convincing evidence of clinical benefit and that the potential risks and health service costs are unjustified" So I am not sure the paper can be used, as it seems to not be that clear cut. At best if could be used to show that Dr Mike Cummings think s it is medical useful, not that this represents any kind of consensus that it is. As such it could not be used toi show that the wider medical community thinks this is a valid form of medicine As opposed to alternative medicine)Slatersteven (talk) 15:31, 7 December 2018 (UTC)
- Yes. "Acupuncture advocate advocates for acupuncture" doesn't really help enlighten our readers. My favourite bit of the article is where Cummings asserts acupuncture is supported by basic science and cites in support – his own book! But again, "acupuncturist asserts acupuncture is scientificially sound" doesn't help our readers either. The whole Cummings side of this paper is not WP:FRINDependent. Alexbrn (talk) 15:40, 7 December 2018 (UTC)
- Cummings doesn't cite a book by him in this article. He cites a paper he published in the BMJ. [BMJ 2017. http://www.bmj.com/content/356/bmj.i6748/rr-6 Low back pain and sciatica: summary of NICE guidance] And Hróbjartsson cites himself and so does Ernst. A paper doesn't need to be clear cut to be cited. Such a paper is useful because it shows both side of an issue. I am familiar with the argument that people who study things skeptics don't agree with can't be cited because they are obviously biased. It gets reeled out a lot here lately. It akin to saying you can't cite a neurologist about neurology.
- If only there was more evidence that said acupuncture might be effective...
- Deare, Zheng etal. (2013) Acupuncture for fibromyalgia "There is low to moderate-level evidence that compared with no treatment and standard therapy, acupuncture improves pain and stiffness in people with fibromyalgia."
- Linde, Allais etal (2016) Acupuncture for preventing migraine attacks "The available evidence suggests that a course of acupuncture consisting of at least six treatment sessions can be a valuable option for people with migraine". "The available evidence suggests that adding acupuncture to symptomatic treatment of attacks reduces the frequency of headaches. Contrary to the previous findings, the updated evidence also suggests that there is an effect over sham, but this effect is small."
- Vickers, Cronin, Maschino, et al, (2012), Acupuncture for Chronic Pain:Individual Patient Data Meta-analysis, Arch Intern Med. 2012;172(19):1444-1453. doi:10.1001/archinternmed.2012.3654 - "Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo."
- Hopton, MacPherson, (2010), Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta‐analyses, Pain Practice, Volume 10, Issue 2, March/April 2010, Pages 94-102 - "...evidence from pooled data from recent meta analyses of acupuncture for chronic pain shows that there is accumulating evidence to support the contention that acupuncture has specific effects beyond the placebo."
- Kwon, Pittler, Ernst, (2006), Acupuncture for peripheral joint osteoarthritis: A systematic review and meta-analysis, Rheumatology, Volume 45, Issue 11, 1 November 2006, Pages 1331–1337, https://doi.org/10.1093/rheumatology/kel207 - " "... sham controlled RCTs suggest specific effects of accupuncture for pain control in paitens with peripheral joint OA. Considering its favourable safety profile, acupuncture seems an options worthy of consideration particularily for knee OA".
- Furlan, van Tulder et al. (2005) Acupuncture and dry‐needling for low back pain - "For chronic low‐back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment immediately after treatment and in the short‐term only"
- Shen, Xia et al (2014) Acupuncture for schizophrenia - "Limited evidence suggests that acupuncture may have some antipsychotic effects as measured on global and mental state with few adverse effects."
- Armour, Ee et al. (2018) Acupuncture and acupressure for premenstrual syndrome "The limited evidence available suggests that acupuncture and acupressure may improve both physical and psychological symptoms of PMS when compared to a sham control."
- Smith, Collins et al. (2011) Acupuncture or acupressure for pain management in labour - "Acupuncture and acupressure may have a role with reducing pain, increasing satisfaction with pain management and reduced use of pharmacological management.
- Lee, Chan et al. (2015) Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting "There is low‐quality evidence supporting the use of PC6 acupoint stimulation over sham."
- White, Foster et al. (2007) Acupuncture treatment for chronic knee pain: a systematic review - "Acupuncture that meets criteria for adequate treatment is significantly superior to sham acupuncture and to no additional intervention in improving pain and function in patients with chronic knee pain."
- Belivani, Dimitroula et al. Acupuncture in the treatment of obesity: a narrative review of the literature "Both experimental and current clinical data suggest that acupuncture (in different forms) exerts beneficial effects on obesity."
- I suggest we cite these papers for the quotes provided and ask, are these sources reliable for this text?Morgan Leigh | Talk 02:55, 8 December 2018 (UTC)
- Which text? -Roxy, the dog. wooF 06:05, 8 December 2018 (UTC)
- @Morgan Leigh: citing neurology to a neurologist is generally fine, but it's not fine citing acupuncutre material to an acupuncturist any more than it is citing astrology explanations to an astrologer, or history to a 9/11 Truther. That's rather the whole point of WP:FRIND. If there really were an accepted scientific basis for acupuncture, it would be easy to find it in stated in independent sources. Alexbrn (talk) 11:20, 8 December 2018 (UTC)
- So you assert that acupuncture is WP:FRINGE? Science is about examining the evidence. Suppressing information about whole subject areas because one has decided are dodgy is not science. There is a name for it though. It is a witch hunt. Morgan Leigh | Talk 01:39, 9 December 2018 (UTC)
- I am asking for agreement that the sources mentioned are reliable for the quotation following each citation. Should we arrive at some kind of consensus then explicit changes can be made. But if you want an explicit edit to start with then we might consider changing the present text,
- I suggest we cite these papers for the quotes provided and ask, are these sources reliable for this text?Morgan Leigh | Talk 02:55, 8 December 2018 (UTC)
- "A systematic review found little evidence of acupuncture's effectiveness in treating pain."
- which cites this source Ernst E, Lee MS, Choi TY (April 2011). "Acupuncture: does it alleviate pain and are there serious risks? A review of reviews" (PDF). Pain. 152 (4): 755–64. doi:10.1016/j.pain.2010.11.004.
- to,
- "A 2011 systematic review found little evidence of acupuncture's effectiveness in treating pain (Citing Ernst E, Lee MS, Choi TY (April 2011). "Acupuncture: does it alleviate pain and are there serious risks? A review of reviews" (PDF). Pain. 152 (4): 755–64), while others have found it to be effective. (Citing Vickers, Cronin, Maschino, et al, (2012), Acupuncture for Chronic Pain:Individual Patient Data Meta-analysis, Arch Intern Med. 2012;172(19):1444-1453. doi:10.1001/archinternmed.2012.3654
- Hopton, MacPherson, (2010), Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta‐analyses, Pain Practice, Volume 10, Issue 2, March/April 2010, Pages 94-102
- Kwon, Pittler, Ernst, (2006), Acupuncture for peripheral joint osteoarthritis: A systematic review and meta-analysis, Rheumatology, Volume 45, Issue 11, 1 November 2006, Pages 1331–1337) Morgan Leigh | Talk 09:56, 8 December 2018 (UTC)
- A lot of old, and some fringe, sources there. The science has moved on. We should really be up-to-date by saying something along the lines of the (recent) piece for the NHS I've linked above. Something like (per the source): acupuncture doesn't work for anything except maybe pain, and even there the evidence of effect isn't good enough to be sure it's useful. That's the current knowledge, saying anything else strikes me as in danger of being WP:PROFRINGE especially since we know acupuncure is a pseudoscience, so per WP:REDFLAG any claim of effectiveness for any condition would require multiple sources of the very hightest quality. Alexbrn (talk) 10:59, 8 December 2018 (UTC)
- Opinion. Again. Please address the sources. Which ones do you contend are fringe? The oldest one is 2005. How is this too old? Morgan Leigh | Talk 01:39, 9 December 2018 (UTC)
- I have to agree with Alexbrn. And I oppose changing the wording of the article to equivocating. The evidence has been building for years and it is now widely accepted that with all the studies there just isn't any quality evidence that demonstrates any genuine effect. This overly long discussion is not related to the subject header. A new section with a concrete proposal for improving the encyclopedia is called for, or a dropping of the stick. FRIND, PROFINGE, DUE, MEDRS these guidelines and policies have been pointed to and correctly referred to. We really don't need to say they are planning to check past the edge of the flat earth to see if the proof acupuncture is an efficacious and beneficial thing to do to people. MrBill3 (talk) 12:22, 8 December 2018 (UTC)
- Opinion. Again. Please address the sources. Can you source your claim that it is "widely accepted"? How do you reconcile this asserting with the numerous peer reviewed sources I have mentioned?Morgan Leigh | Talk 01:39, 9 December 2018 (UTC)
- Yup. It doesn't matter where you put the needles, it doesn't matter whether you stick them in or not, the basis of claimed action was refuted over a century ago, there are no objective effects, subjective effects are short-lived and usually clinically irrelevant, and the difficulty of properly blinding makes it impossible to rule out bias and confounding in any of the positive studies. Any drug sold on this basis, and showing evidence of adverse effects, as acupuncture does, would be withdrawn. Guy (Help!) 15:35, 8 December 2018 (UTC)
- Opinion. Again. You have expressed this opinion three times now, in almost exactly the same words and each time you have been asked to provided sources that substantiate it and you have offered nothing. Morgan Leigh | Talk 01:39, 9 December 2018 (UTC)
- A lot of old, and some fringe, sources there. The science has moved on. We should really be up-to-date by saying something along the lines of the (recent) piece for the NHS I've linked above. Something like (per the source): acupuncture doesn't work for anything except maybe pain, and even there the evidence of effect isn't good enough to be sure it's useful. That's the current knowledge, saying anything else strikes me as in danger of being WP:PROFRINGE especially since we know acupuncure is a pseudoscience, so per WP:REDFLAG any claim of effectiveness for any condition would require multiple sources of the very hightest quality. Alexbrn (talk) 10:59, 8 December 2018 (UTC)
- That BMJ link is to a Rapid Response, i.e. a letter. By Mike Cummings. Guy (Help!) 15:35, 8 December 2018 (UTC)
- As it says in the paper, that BMJ link is a peer reviewed head to head commissioned by the BMJ and authored by Cummings, Hróbjartsson and Ernst.Morgan Leigh | Talk 01:39, 9 December 2018 (UTC)
- Science is not done by panel discussion. Guy (Help!) 11:02, 10 December 2018 (UTC)
- Is that your entire rebuttal of the inclusion of this peer reviewed paper, commissioned by and published in the BMJ?Morgan Leigh | Talk 22:04, 10 December 2018 (UTC)
- Acupuncture in Medicine (in which PMID 23153472 appears) is not the BMJ. BMJ Group publish many journals, some of them fringe journals we we do not use per WP:FRIND: like Acupuncture in Medicine. Per WP:MEDRS we should generally not be using any source more than 5 years old if newer pertinent material is available. We do not use weak primary sources (e.g. letters even in the real BMJ) for assertions about WP:Biomedical information. All of this is pretty basic. Alexbrn (talk) 08:18, 11 December 2018 (UTC)
- The paper to which you refer is "Acupuncture in the treatment of obesity: a narrative review of the literature.". No one has claimed it was in the BMJ. However I do contest your assertion that Acupuncture in Medicine is a fringe journal. Most importantly though we are referring here to "Should doctors recommend acupuncture for pain? BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k970 (Published 07 March 2018) BMJ 2018;360:k970".
- Acupuncture in Medicine (in which PMID 23153472 appears) is not the BMJ. BMJ Group publish many journals, some of them fringe journals we we do not use per WP:FRIND: like Acupuncture in Medicine. Per WP:MEDRS we should generally not be using any source more than 5 years old if newer pertinent material is available. We do not use weak primary sources (e.g. letters even in the real BMJ) for assertions about WP:Biomedical information. All of this is pretty basic. Alexbrn (talk) 08:18, 11 December 2018 (UTC)
- Is that your entire rebuttal of the inclusion of this peer reviewed paper, commissioned by and published in the BMJ?Morgan Leigh | Talk 22:04, 10 December 2018 (UTC)
- Science is not done by panel discussion. Guy (Help!) 11:02, 10 December 2018 (UTC)
- As it says in the paper, that BMJ link is a peer reviewed head to head commissioned by the BMJ and authored by Cummings, Hróbjartsson and Ernst.Morgan Leigh | Talk 01:39, 9 December 2018 (UTC)
- I note that WP:MEDRS says "Cochrane Library reviews are generally of high quality and are routinely maintained even if their initial publication dates fall outside the 5-year window". The 2005 source is a Cochrane review. WP:MEDRS doesn't say not to use sources older than five years but rather to "try to find those newer sources". I note that more than half the sources in the article are older than five years. One is 1987. Morgan Leigh | Talk 09:05, 11 December 2018 (UTC)
- "No one has claimed it was in the BMJ" Really? No one has asked "Is that your entire rebuttal of the inclusion of this peer reviewed paper, commissioned by and published in the BMJ?" --Hob Gadling (talk) 09:32, 11 December 2018 (UTC)
- Please read my post above more carefully. The not in the BMJ remark is in relation to Belivani, Dimitroula et al., "Acupuncture in the treatment of obesity: a narrative review of the literature.". The "peer reviewed paper, commissioned by and published in the BMJ?" remark is in relation to Cummings, Hróbjartsson & Ernst, (2018), "Should doctors recommend acupuncture for pain?", BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k970.Morgan Leigh | Talk 04:05, 12 December 2018 (UTC)
- Sorry, the whole thing was a bit confusing. --Hob Gadling (talk) 06:53, 12 December 2018 (UTC)
- Please read my post above more carefully. The not in the BMJ remark is in relation to Belivani, Dimitroula et al., "Acupuncture in the treatment of obesity: a narrative review of the literature.". The "peer reviewed paper, commissioned by and published in the BMJ?" remark is in relation to Cummings, Hróbjartsson & Ernst, (2018), "Should doctors recommend acupuncture for pain?", BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k970.Morgan Leigh | Talk 04:05, 12 December 2018 (UTC)
- "No one has claimed it was in the BMJ" Really? No one has asked "Is that your entire rebuttal of the inclusion of this peer reviewed paper, commissioned by and published in the BMJ?" --Hob Gadling (talk) 09:32, 11 December 2018 (UTC)
- I note that WP:MEDRS says "Cochrane Library reviews are generally of high quality and are routinely maintained even if their initial publication dates fall outside the 5-year window". The 2005 source is a Cochrane review. WP:MEDRS doesn't say not to use sources older than five years but rather to "try to find those newer sources". I note that more than half the sources in the article are older than five years. One is 1987. Morgan Leigh | Talk 09:05, 11 December 2018 (UTC)
A proposed edit with recent sources
I agree that the section above has gotten off topic. Here is a discrete proposal for an edit to the article with recent sources that no one has yet actually addressed, except @Middle 8: who described the Vickers paper as "the highest-quality meta-analysis there is ". I'm putting here again because I notice I made a transposition error in when posting it above. It's odd no one noticed that. It's almost as if no one read it...
I suggest we change the present text from;
- "A systematic review found little evidence of acupuncture's effectiveness in treating pain."
- which cites this source Ernst E, Lee MS, Choi TY (April 2011). "Acupuncture: does it alleviate pain and are there serious risks? A review of reviews" (PDF). Pain. 152 (4): 755–64. doi:10.1016/j.pain.2010.11.004.
- to,
- "A 2011 systematic review found little evidence of acupuncture's effectiveness in treating pain (Citing Ernst E, Lee MS, Choi TY (April 2011). "Acupuncture: does it alleviate pain and are there serious risks? A review of reviews" (PDF). Pain. 152 (4): 755–64), while others have found it to be effective. (Citing Vickers, Cronin, Maschino, et al, (2012), Acupuncture for Chronic Pain:Individual Patient Data Meta-analysis, Arch Intern Med. 2012;172(19):1444-1453. doi:10.1001/archinternmed.2012.3654
- Hopton, MacPherson, (2010), Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta‐analyses, Pain Practice, Volume 10, Issue 2, March/April 2010, Pages 94-102
- Kwon, Pittler, Ernst, (2006), Acupuncture for peripheral joint osteoarthritis: A systematic review and meta-analysis, Rheumatology, Volume 45, Issue 11, 1 November 2006, Pages 1331–1337)Morgan Leigh | Talk 01:39, 9 December 2018 (UTC)
- WP:BLUDGEON applies. Alexbrn (talk) 04:36, 9 December 2018 (UTC)
- Yes I think so too, but I wasn't going to bandy around labels just because people keep repeating their personal opinions, ofttimes using the exact same words, without addressing the sources. Morgan Leigh | Talk 05:50, 9 December 2018 (UTC)
- Nope. For the reasons cited above, and multiple times in the past. We don't "balance" pragmatic, reality-based views with the optimistic findings of True Believers. Guy (Help!) 10:45, 10 December 2018 (UTC)
- Please confine your remarks to directly addressing the sources at issue @JzG: rather than, once again, expressing your personal opinion and deriding those with a view you don't agree with by labeling them "true believers" and implying they aren't in touch with reality. Morgan Leigh | Talk 21:59, 10 December 2018 (UTC)
- Stop sealioning. Guy (Help!) 22:28, 10 December 2018 (UTC)
- Instead of making personal attacks please address the sources. Morgan Leigh | Talk 00:13, 11 December 2018 (UTC)
- Stop sealioning. Guy (Help!) 00:35, 11 December 2018 (UTC)
- Morgan Leigh's objection (repeated because the objectionable behavior is repeated) is reasonable. See 2nd sentence in lede of WP:TPG, and WP:TPNO last bullet point. It's not sealioning to ask an editor to stop that. Nor to point out misunderstandings of WP:WEIGHT. --Middle 8 (t • c | privacy • acupuncture COI?) 02:34, 11 December 2018 (UTC); add to cmt 03:25, 11 December 2018 (UTC)
- Stop sealioning. Guy (Help!) 00:35, 11 December 2018 (UTC)
- Instead of making personal attacks please address the sources. Morgan Leigh | Talk 00:13, 11 December 2018 (UTC)
- Stop sealioning. Guy (Help!) 22:28, 10 December 2018 (UTC)
- @ Guy Re Vickers: WP:WEIGHT doesn't mean discounting MEDRS because some other source criticized it. Most crits of Vickers aren't peer-reviewed anyway and thus aren't very good MEDRS (if they're MEDRS at all) or even very good RS. Hence using them de-weight and discount an IPD meta-analysis is absurd. --Middle 8 (t • c | privacy • acupuncture COI?) 02:34, 11 December 2018 (UTC)
- Please confine your remarks to directly addressing the sources at issue @JzG: rather than, once again, expressing your personal opinion and deriding those with a view you don't agree with by labeling them "true believers" and implying they aren't in touch with reality. Morgan Leigh | Talk 21:59, 10 December 2018 (UTC)
- Not really, for a start I doubt this is the only review that has found it ineffective. But I do not agree the other sources can be rejected if they are recognized and qualified medical professionals or professors.Slatersteven (talk) 11:21, 10 December 2018 (UTC)
- Indeed there are many. I draw your attention to the 12 citations in the above section, seven of which are Cochrane reviews. Morgan Leigh | Talk 21:59, 10 December 2018 (UTC)
- One Cochrane review you cite above is about "Acupuncture for schizophrenia": All results of this review are categorised as 'very low quality' or 'low quality evidence', except for 'time spent in hospital' which was 'moderate level' but that was just 1 RCT. "Very low quality evidence" in GRADE (https://bestpractice.bmj.com/info/us/toolkit/learn-ebm/what-is-grade/) means "The true effect is probably markedly different from the estimated effect"; "low quality evidence" means "The true effect might be markedly different from the estimated effect". In other words, this review provides no support for the clinical application of acupuncture in Schizophrenia.
- Another Cochrane review you cite is "Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting". Again, all comparisons between acupuncture and sham were categorised as "low quality evidence".
- Low quality evidence is still evidence, it's not no evidence, nor is it evidence that it doesn't work. And I'm totally good with mentioning the quality of any given piece of evidence that in the article. I'm not trying to say that acupuncture is a panacea, because it clearly isn't. What I am saying is, if you have a whole lot of studies with some evidence it is a thing worth investigating further. Not a thing that is "bonkers" and can be put in a box labelled 'pseudoscience, do not ever look inside'. Rather it should be investigated further, and that is why more research has been done and the Vickers paper is one result of that. Do you agree that Vickers is a good quality paper that should be cited?Morgan Leigh | Talk 23:53, 11 December 2018 (UTC)
- It is very easy to concoct a low-quality study with low-quality evidence for anything you wish. All you need is money and time; randomness does the rest. Therefore, mentioning such trash in the article would be misleading. Saying that there is low-quality evidence is okay, but one does not have to mention what it is. --Hob Gadling (talk) 06:53, 12 December 2018 (UTC)
- Low quality evidence means that the results are unreliable. Reported treatment effects based on low quality evidence may be due to statistical fluctuations, bias (e.g. lack of sufficient blinding) etc. instead of the treatment actually working; further explanations in the BMJ article I linked in my previous post. As Hob Gadling said, it's not worth reporting and can be misleading.
- Low quality evidence is still evidence, it's not no evidence, nor is it evidence that it doesn't work. And I'm totally good with mentioning the quality of any given piece of evidence that in the article. I'm not trying to say that acupuncture is a panacea, because it clearly isn't. What I am saying is, if you have a whole lot of studies with some evidence it is a thing worth investigating further. Not a thing that is "bonkers" and can be put in a box labelled 'pseudoscience, do not ever look inside'. Rather it should be investigated further, and that is why more research has been done and the Vickers paper is one result of that. Do you agree that Vickers is a good quality paper that should be cited?Morgan Leigh | Talk 23:53, 11 December 2018 (UTC)
- Re Vickers et al 2012 (cited above): effect sizes against sham are 0.23 SD, 0.16 SD and 0.15 SD for back and neck pain, osteoarthritis, and chronic headache. Firstly, these effect size are too small to be clinically relevant. In fact, already Madsen, Gøtzsche PC, Hróbjartsson A. (BMJ. 2009 Jan 27;338:a3115. doi: 10.1136/bmj.a3115. Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. https://www.ncbi.nlm.nih.gov/pubmed/19174438) found a very similar effect size and concluded "A small analgesic effect of acupuncture was found, which seems to lack clinical relevance and cannot be clearly distinguished from bias". Secondly, the small effect size may well be due to bias. Vickers et al results are based on trials which were not double blinded and in the included GERAC trials even the single blinding is questionable. I therefore do not support the change you suggest.Lucleon (talk) 08:16, 12 December 2018 (UTC)
- What Lucleon says. Plus, per WP:MEDRS we shouldn't be using sources older than 5 years old, when we have newer better sources that are relevant (in this case from NICE). Alexbrn (talk) 08:25, 12 December 2018 (UTC)
- @Alexbrn: Vickers was updated last year.[4] @Lucleon: Read it; they addressed both blinding and effect size. Blinding: Vickers found essentially the same results, blinded or not. Effect size: still statistically significant, and they concluded more than a placebo and a reasonable referral option -- because efficacy, which is w.r.t. control, isn't the same as effectiveness, which is w.r.t. no treatment (which is what the clinical decision is: whether to treat. Pragmatic trials look at that all the time). As for Madsen's conclusion about bias: of course we cite that (and I think Vickers addressed bias too), but there's this thing called NPOV that explains very clearly how to handle RS when they disagree. Hint: it doesn't mean citing just one side. --Middle 8 (t • c | privacy • acupuncture COI?) 10:55, 12 December 2018 (UTC)
- Yes, obviously. Vickers is AFAIK acupuncture's only IPD meta-analysis (the "gold standard" of systematic review), cited all over the place and used to help guide practice recommendations. Of course it weighs, at least as heavily as the 2011 Ernst review, which is getting pretty outdated. --Middle 8 (t • c | privacy • acupuncture COI?) 02:34, 11 December 2018 (UTC); copy-edit 02:39, 11 December 2018 (UTC)
- In your opinion, as someone whose livelihood depends on acupuncture being portrayed as valid. Guy (Help!) 09:30, 11 December 2018 (UTC)
- It speaks well of Middle 8 that they have stated that they are an acupuncturist up front. And we have been down this road before, with IIRC a 2:1 weighting against experts having a COI in their subject area. If every MD couldn't write about medicine, if every lawyer couldn't write about the law, if every acupuncturist couldn't write about acupuncture we would soon be getting bombarded with information from whichever ignorant individual 1 who could shout fake news the loudest. Oh, wait... Morgan Leigh | Talk 23:53, 11 December 2018 (UTC)
- MDs can change the medicine they presribe; for acupuncturists the answer must always be Moar Acupunture. So it is with homeopath writing about homeopathy, Scientologists writing about Hubbard and so on. Policy is clear for fringe topics like acu (a pseudoscience) WP:FRIND applies. BTW, Ernst is very good on this topic.[5] Alexbrn (talk) 07:31, 12 December 2018 (UTC)
- You seem to be suggesting that there is no acupuncturist who is an MD and vice versa. This is absolutely not the case. The BMA has recommend for several years that information on acupuncture and its possible benefits should be included in both undergraduate and postgraduate medical education (See British Medical Association Board of Science and Education. Acupuncture: Efficacy, Safety and Practice. London: Harwood Academic, 2000, p96) and there are a growing number of MDs who are also trained acupuncturists. MDs can change the treatments they prescribe, and they sometimes prescribe acupuncture, and vice versa. Morgan Leigh | Talk 08:23, 12 December 2018 (UTC)
- Nice straw man. My point was that fringe adherents are not reliable sources of information about their pet fringe topic. Here we have WP:FRIND, so we're not - per our WP:PAGs - going to be using acupuncturists on acupuncture any more than we're going to be using 9/11 truthers on what happened to the World Trade Center. Alexbrn (talk) 08:31, 12 December 2018 (UTC)
- This. It's remarkable how often the "good" positive studies turn out to hae the same authors. Many, such as Witt, Lewith and so on, also appear on articles spruiking homeopathy and other quack cures. Guy (Help!) 11:01, 12 December 2018 (UTC)
- this is a time sink. Obviously authors who advocate fringe aren’t RS for fringe. The article already duly notes acupuncture’s role in pain relief and palatative care and recommendations pertaining to these. It is also duly comprised in large part of the tectonic slabs of writings from medrs, which say it is a bag of toss. There’s simply nothing more to be done here. This isn’t a conversation about article improvement. ~~~~ Edaham (talk) 13:09, 12 December 2018 (UTC)
- Both time sink and red herring par excellence, because not a single one of the preceding comments under my !vote pertains to Vickers' IPD meta-analysis. (Note, meta-analysis, not opinion piece.) --Middle 8 (t • c | privacy • acupuncture COI?) 17:43, 12 December 2018 (UTC)
- this is a time sink. Obviously authors who advocate fringe aren’t RS for fringe. The article already duly notes acupuncture’s role in pain relief and palatative care and recommendations pertaining to these. It is also duly comprised in large part of the tectonic slabs of writings from medrs, which say it is a bag of toss. There’s simply nothing more to be done here. This isn’t a conversation about article improvement. ~~~~ Edaham (talk) 13:09, 12 December 2018 (UTC)
- This. It's remarkable how often the "good" positive studies turn out to hae the same authors. Many, such as Witt, Lewith and so on, also appear on articles spruiking homeopathy and other quack cures. Guy (Help!) 11:01, 12 December 2018 (UTC)
- Nice straw man. My point was that fringe adherents are not reliable sources of information about their pet fringe topic. Here we have WP:FRIND, so we're not - per our WP:PAGs - going to be using acupuncturists on acupuncture any more than we're going to be using 9/11 truthers on what happened to the World Trade Center. Alexbrn (talk) 08:31, 12 December 2018 (UTC)
- You seem to be suggesting that there is no acupuncturist who is an MD and vice versa. This is absolutely not the case. The BMA has recommend for several years that information on acupuncture and its possible benefits should be included in both undergraduate and postgraduate medical education (See British Medical Association Board of Science and Education. Acupuncture: Efficacy, Safety and Practice. London: Harwood Academic, 2000, p96) and there are a growing number of MDs who are also trained acupuncturists. MDs can change the treatments they prescribe, and they sometimes prescribe acupuncture, and vice versa. Morgan Leigh | Talk 08:23, 12 December 2018 (UTC)
- MDs can change the medicine they presribe; for acupuncturists the answer must always be Moar Acupunture. So it is with homeopath writing about homeopathy, Scientologists writing about Hubbard and so on. Policy is clear for fringe topics like acu (a pseudoscience) WP:FRIND applies. BTW, Ernst is very good on this topic.[5] Alexbrn (talk) 07:31, 12 December 2018 (UTC)
- It speaks well of Middle 8 that they have stated that they are an acupuncturist up front. And we have been down this road before, with IIRC a 2:1 weighting against experts having a COI in their subject area. If every MD couldn't write about medicine, if every lawyer couldn't write about the law, if every acupuncturist couldn't write about acupuncture we would soon be getting bombarded with information from whichever ignorant individual 1 who could shout fake news the loudest. Oh, wait... Morgan Leigh | Talk 23:53, 11 December 2018 (UTC)
- In your opinion, as someone whose livelihood depends on acupuncture being portrayed as valid. Guy (Help!) 09:30, 11 December 2018 (UTC)