→Medical Research Rewrite: Fix some typos, add more comments, ask for a wider variety of people to weigh in. |
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:::You must also remember that the difference between Alt Med and Integretive Med is just Altmed trying to get mainstream acceptance and inclusion into mainstream use for their unproven therapies. I look forward to any reliable sources that you have showing any alternative practises turning into real medicine. --[[User:Roxy the dog|Roxy the dog]] ([[User talk:Roxy the dog|resonate]]) 17:52, 11 February 2014 (UTC) |
:::You must also remember that the difference between Alt Med and Integretive Med is just Altmed trying to get mainstream acceptance and inclusion into mainstream use for their unproven therapies. I look forward to any reliable sources that you have showing any alternative practises turning into real medicine. --[[User:Roxy the dog|Roxy the dog]] ([[User talk:Roxy the dog|resonate]]) 17:52, 11 February 2014 (UTC) |
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== |
== Evidence and Support Rewrite == |
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I would like to start a more directed discussion on |
I would like to start a more directed discussion on the medical evidence and support for Qigong in the talk pages before making changes. I've been talking with several people and some suggested the following change, which I think we should implement. |
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''Old text:'' |
''Old text:'' |
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:If by "unbiased" you mean that it ''must'' say that qigong is effective, we cannot do it. There are widespread claims made about many many things ([[magnet therapy]], [[echinacea]], drugs in clinical trials) and wikipedia does not parrot them. Unless something is proven to be safe and effective and there is a solid scientific consensus behind that, we cannot say that it is. Let me repeat that - unless something is proven safe and effective and there is a solid scientific consensus behind it, we cannot say that it is. If we did, Wikipedia goes to the dogs, both on the alt med (or integrative) side and the corporate side. In this case, the first half of the second sentence needs to go. I am very uncertain about the first sentence. [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 17:26, 11 February 2014 (UTC) |
:If by "unbiased" you mean that it ''must'' say that qigong is effective, we cannot do it. There are widespread claims made about many many things ([[magnet therapy]], [[echinacea]], drugs in clinical trials) and wikipedia does not parrot them. Unless something is proven to be safe and effective and there is a solid scientific consensus behind that, we cannot say that it is. Let me repeat that - unless something is proven safe and effective and there is a solid scientific consensus behind it, we cannot say that it is. If we did, Wikipedia goes to the dogs, both on the alt med (or integrative) side and the corporate side. In this case, the first half of the second sentence needs to go. I am very uncertain about the first sentence. [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 17:26, 11 February 2014 (UTC) |
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:: Of course I don't mean to indicate that it "must" say that qigong is effective. That has not yet been proven, so I agree with you. What I am saying is that, unlike magnet therapy and echinacea, qigong and other integrative health practices are beginning to demonstrate, in solid clinical trials, that it is |
::: Of course I don't mean to indicate that it "must" say that qigong is effective. That has not yet been proven, so I agree with you. What I am saying is that, unlike magnet therapy and echinacea, qigong and other integrative health practices are beginning to demonstrate, in solid clinical trials, that it is safe, effective, and beneficial as an integrative health practice. (Not alternative, not even complimentary, but as part of a whole integrative medical perspective, taking into account the wellbeing of the whole person.) [[User:Cjrhoads|CJ]] ([[User talk:Cjrhoads|talk]]) 15:31, 13 February 2014 (UTC) |
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::My initial thoughts. I've never heard of Paul Rich, or Penny Klein. Arguments from authority will not cut the mustard here, we need reliable sources. Your proposed edit is interesting, and could be used for any other forum of exercise. Consider ... |
::My initial thoughts. I've never heard of Paul Rich, or Penny Klein. Arguments from authority will not cut the mustard here, we need reliable sources. Your proposed edit is interesting, and could be used for any other forum of exercise. Consider ... |
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::Nobody disputes that exercise is a good thing, but equally, there is nothing to suggest that Qigong has anything over and above walking the dog, or any other form of structured or ad hoc exercise. I would not support your changes to current text. When there is some scientific explanation for the more extreme parts of this fringe pseudoscience as detailed in your Harvard quote I would be prepared to reconsider. We shouldn't say any more than the equivalent of "Exercise is good for you" in Wikipedia's voice. --[[User:Roxy the dog|Roxy the dog]] ([[User talk:Roxy the dog|resonate]]) 19:55, 11 February 2014 (UTC) |
::Nobody disputes that exercise is a good thing, but equally, there is nothing to suggest that Qigong has anything over and above walking the dog, or any other form of structured or ad hoc exercise. I would not support your changes to current text. When there is some scientific explanation for the more extreme parts of this fringe pseudoscience as detailed in your Harvard quote I would be prepared to reconsider. We shouldn't say any more than the equivalent of "Exercise is good for you" in Wikipedia's voice. --[[User:Roxy the dog|Roxy the dog]] ([[User talk:Roxy the dog|resonate]]) 19:55, 11 February 2014 (UTC) |
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::: I've removed references to the specific people with whom I spoke - it is irrelevent. However, I do disagree with your statement that there is nothing to suggest that Qigong has anything over and above walking the dog. What I'm saying is that recently a body of research is developing that says |
::: I've removed references to the specific people with whom I spoke - it is irrelevent. However, I do disagree with your statement that there is nothing to suggest that Qigong has anything over and above walking the dog. What I'm saying is that recently a body of research is developing that says there is growing evidence that Qigong has additional benefits over exercise, and can be applied in more situations than just plain exercise (for example, with people who are bedridden, as there is are many Lying Down Qigong practices). Again, more research is needed. But the evidence is growing, and Harvard Medical School, Mayo Clinic, Vanderbilt Medical and hundreds of other highly regarded well-established medical communities are beginning to endorse Qigong and Tai Chi. [[User:Cjrhoads|CJ]] ([[User talk:Cjrhoads|talk]]) 15:31, 13 February 2014 (UTC) |
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: I think the old text is more neutral in tone. I agreed with the comments of [[User:Jytdog|Jytdog]] and [[User:Roxy the dog|Roxy the dog]], the scientific consensus is just not there to make a more positive statement about qigong. The listed authority did not contribute any new information to change my opinion. I suggest we leave the tone of the article as is. [[User:Ottawakungfu|ottawakungfu]] ([[User talk:Ottawakungfu|talk]]) 03:02, 12 February 2014 (UTC) |
: I think the old text is more neutral in tone. I agreed with the comments of [[User:Jytdog|Jytdog]] and [[User:Roxy the dog|Roxy the dog]], the scientific consensus is just not there to make a more positive statement about qigong. The listed authority did not contribute any new information to change my opinion. I suggest we leave the tone of the article as is. [[User:Ottawakungfu|ottawakungfu]] ([[User talk:Ottawakungfu|talk]]) 03:02, 12 February 2014 (UTC) |
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:I'm sorry, but I completely disagree. The old text is not neutral, in my opinion. It is biased and negative, and gives the wrong impression regarding how the medical community views Qigong and Tai Chi. [[User:Cjrhoads|CJ]] ([[User talk:Cjrhoads|talk]]) 16:03, 13 February 2014 (UTC) |
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: The new text is clearly better and more neutral. Based on solid references, the lead statement concerning health should clearly state that claims of health benefits are widespread, that clinical studies consistently show benefits, but that systematic reviews cannot reach a definitive conclusions because of limitations of controlled trials. Please, let's be supportive of earnest efforts to improve the article. The language and tone of this discussion seems rather aggressive and biased, including labeling qigong as "fringe pseudoscience", and using unnecessarily challenging and cynical statements. First, indeed there are widespread claims about health benefits of qigong that are reviewed repeatedly in popular books about qigong as well as in the peer-reviewed medical literature, and most peer-reviewed papers start with a review of these claims, and the list "improving cardiovascular function, healing specific acute diseases, and increasing longevity" is representative and taken from a valid reference. Second, there is a substantial body of peer-reviewed literature in reputable journals that consistently finds positive benefits, and this is born out in a comprehensive review of randomized controlled trials. Third, the three quotes are taken directly from the conclusion of the overview of systematic reviews and the current wording is a paraphrase that gives a different tone than the reference. Note there is not a similar literature about walking dogs; no there is not a literature that equates qigong with exercise (though that may be a good opinion); and no it is not neutral to exclude a balance of the main view of references (even if you believe this is pseudoscience). Fourth, the reasons why “it would be unwise to draw firm conclusions at this stage” should be explicit, in particular lack of funding for research, impracticality of double blinding, and difficulty of standardized controls and treatment dosing (frequency, duration, and intensity of treatment). Fifth, many references emphasize advantages of low cost, low risk, and high accessibility. Yes, it could be good to extract conclusions and quotes from Peter Wayne's ''Harvard Medical School Guide to Tai Chi''. [[User:TheProfessor|TheProfessor]] ([[User talk:TheProfessor|talk]]) 08:50, 12 February 2014 (UTC) |
: The new text is clearly better and more neutral. Based on solid references, the lead statement concerning health should clearly state that claims of health benefits are widespread, that clinical studies consistently show benefits, but that systematic reviews cannot reach a definitive conclusions because of limitations of controlled trials. Please, let's be supportive of earnest efforts to improve the article. The language and tone of this discussion seems rather aggressive and biased, including labeling qigong as "fringe pseudoscience", and using unnecessarily challenging and cynical statements. First, indeed there are widespread claims about health benefits of qigong that are reviewed repeatedly in popular books about qigong as well as in the peer-reviewed medical literature, and most peer-reviewed papers start with a review of these claims, and the list "improving cardiovascular function, healing specific acute diseases, and increasing longevity" is representative and taken from a valid reference. Second, there is a substantial body of peer-reviewed literature in reputable journals that consistently finds positive benefits, and this is born out in a comprehensive review of randomized controlled trials. Third, the three quotes are taken directly from the conclusion of the overview of systematic reviews and the current wording is a paraphrase that gives a different tone than the reference. Note there is not a similar literature about walking dogs; no there is not a literature that equates qigong with exercise (though that may be a good opinion); and no it is not neutral to exclude a balance of the main view of references (even if you believe this is pseudoscience). Fourth, the reasons why “it would be unwise to draw firm conclusions at this stage” should be explicit, in particular lack of funding for research, impracticality of double blinding, and difficulty of standardized controls and treatment dosing (frequency, duration, and intensity of treatment). Fifth, many references emphasize advantages of low cost, low risk, and high accessibility. Yes, it could be good to extract conclusions and quotes from Peter Wayne's ''Harvard Medical School Guide to Tai Chi''. [[User:TheProfessor|TheProfessor]] ([[User talk:TheProfessor|talk]]) 08:50, 12 February 2014 (UTC) |
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:: *I have already commented on the proposed text, saying why I find it unacceptable. You did too and I have been trying to understand your argument in favor of it. So far I have not understood your arguments.[[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 15:26, 13 February 2014 (UTC) |
:: *I have already commented on the proposed text, saying why I find it unacceptable. You did too and I have been trying to understand your argument in favor of it. So far I have not understood your arguments.[[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 15:26, 13 February 2014 (UTC) |
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: Whoaaa - seems to be a lot of nastiness getting thrown around here!! Can we tone it down and focus just on improving the article with more recent information available? Perhaps it would be better/easier to go down into the details and modify that before we start changing the introductory paragraph. I'm going to jump down into the evidence and support area that will give more specific references for the summarization we'd like to modify. |
: Whoaaa - seems to be a lot of nastiness getting thrown around here!! Can we tone it down and focus just on improving the article with more recent information available? Perhaps it would be better/easier to go down into the details and modify that before we start changing the introductory paragraph. Next week, I'm going to jump down into the evidence and support area that will give more specific references for the summarization we'd like to modify. Quite frankly, I have done a ton of research on this topic, and can cite chapter and verse - I just need the time to put it into a format that matches Wikipedia's requirements, which I'm just now learning about. Please give me some time, and hold off on squashing the newby, please. |
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: As I noted, my goal is to have the article accurately reflect the current state of medical opinion about Qigong and Tai Chi, which is more positive than negative. Additionally, the comments about the reasons why there are few ramdomly controlled studies is certainly relevent. You made the case yourself, Jytdog. You said: |
: As I noted, my goal is to have the article accurately reflect the current state of medical opinion about Qigong and Tai Chi, which is more positive than negative. Additionally, the comments about the reasons why there are few ramdomly controlled studies is certainly relevent. You made the case yourself, Jytdog. You said: |
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:'' As pointed out by me and others above, there are many many things that "people say" have wonderful effects. Heck at one point "people said" smoking was good for you. Wikipedia should not repeat what "people say" in a section on health effects '' |
::'' As pointed out by me and others above, there are many many things that "people say" have wonderful effects. Heck at one point "people said" smoking was good for you. Wikipedia should not repeat what "people say" in a section on health effects '' |
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:The reason it took so long for the medical community to finally recognize how bad smoking is for humans is because it was impossible to do a randomly controlled scientific study; they only had correlational regression studies, which do not prove causation. There are still no quantifiable, well-designed scientific studies that prove that smoking is bad for you. But the evidence finally piled up even without that golden-certification of RCT, and the medical community now has gone 180 in recognition of the dangers of smoking. |
:The reason it took so long for the medical community to finally recognize how bad smoking is for humans is because it was impossible to do a randomly controlled scientific study; they only had correlational regression studies, which do not prove causation. There are still no quantifiable, well-designed scientific studies that prove that smoking is bad for you. But the evidence finally piled up even without that golden-certification of RCT, and the medical community now has gone 180 in recognition of the dangers of smoking. |
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: I suspect the same is happening for Qigong and Tai Chi. I know that there are many skeptics. We need skeptics to reign in the unwarranted "claims" of thousands of bad, dangerous, and unhealthy practices. But let's not be blinded to the actual evidence and support that is growing for some health practices that are becoming part of integrative medicine. |
: I suspect the same is happening for Qigong and Tai Chi. I know that there are many skeptics. We need skeptics to reign in the unwarranted "claims" of thousands of bad, dangerous, and unhealthy practices. Nothing bothers me more than Qigong Advocates making completely unfounded claims about miraculous faith-based healings due to some magical mystery force they call "qi". But let's not be blinded to the actual evidence and support that is growing for some health practices that are becoming part of integrative medicine. There is growing evidence of the benefits of the combination of deep breathing, focused intention, and slow purposeful movements which is the basis for Qigong. I'd like to focus on what the evidence shows, and doesn't show, about this healthful practice. |
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:I'm in the middle of another project right now, so I can't add the information this week - besides, I'd like to hear from some other people - perhaps some new people - on their opinions of making changes to the Qigong article. Anyone? [[User:Cjrhoads|CJ]] ([[User talk:Cjrhoads|talk]]) 15:49, 13 February 2014 (UTC) |
:I'm in the middle of another project right now, so I can't add the information this week - besides, I'd like to hear from some other people - perhaps some new people - on their opinions of making changes to the Qigong article. Anyone? [[User:Cjrhoads|CJ]] ([[User talk:Cjrhoads|talk]]) 15:49, 13 February 2014 (UTC) |
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Revision as of 16:03, 13 February 2014
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Health Benefit
Agree that the statement "Possible health benefits of qigong have been studied in various medical conditions. Evidence of effectiveness is inconclusive due to the poor quality of the clinical trials." in the summary section is a scientific one. But it is just one of the points for "The main arguments from the view of skeptics against the correlation between qigong practices and health-related results are:". It should be grouped under the same section. So1308 (talk) 16:46, 20 October 2013 (UTC)
- Thanks for starting a conversation, So1308.
- Here is the blow by blow. You removed the brief statement of the medical consensus from the lead, in this dif and an IP address (you?) deleted again after I reverted you, in this dif. The first edit note said "not appropriate to highlight just one point of the controversy in a summary" and the second said "rephrase reason for moving the paragraph to the controversy section - this is just one of the points from skeptics.".
- I reverted twice, first in this dif and then in this dif with edit notes reading "statements of the scientific consensus are not part of a controversy. we state those in wikipedia's voice, and prominently" and "No, this is not a "statement by skeptics" It is a statement of the medical consensus. Please see Talk and please read WP:MEDRS."
- The sentence is "Possible health benefits of qigong have been studied in various medical conditions. Evidence of effectiveness is inconclusive due to the poor quality of the clinical trials." with the source being " Lee MS, Oh B, Ernst E (2011). "Qigong for healthcare: an overview of systematic reviews". JRSM Short Rep. 2 (2): 7. doi:10.1258/shorts.2010.010091. PMC 3046559. PMID 21369525.
{{cite journal}}
: CS1 maint: multiple names: authors list (link)
- This article is discussing health matters, so WP:MEDRS applies. MEDRS states that "Wikipedia's articles, while not intended to provide medical advice, are nonetheless an important and widely used source of health information.[1] Therefore, it is vital that the biomedical information in all types of articles be based on reliable, third-party, published sources and accurately reflect current medical knowledge. Ideal sources for such content includes literature reviews or systematic reviews published in reputable medical journals, academic and professional books written by experts in the relevant field and from a respected publisher, and medical guidelines or position statements from nationally or internationally recognised expert bodies."
- The source for this statement, is as excellent as it gets under MEDRS - it is not just a review, but a review of reviews. This sentence states the medical consensus on what we know about the health benefits of Qigong with a neutral point of view (please see WP:NPOV). And yes, it belongs in the lead as per WP:LEAD, which says "The lead section (also known as the lead, introduction or intro) of a Wikipedia article is the section before the table of contents and the first heading. The lead serves as an introduction to the article and a summary of its most important aspects." The medical consensus on what we know about health benefits is definitely among the "most important aspects" of an article that spends so much space discussing effects on health.
- Please explain, based on Wikipedia's policies and guidelines, why the sentence does not belong in the lead. This is not a "statement by skeptics" - it is a consensus statement on the science. Thanks! Jytdog (talk) 16:50, 20 October 2013 (UTC)
- A skeptic is just a person who questions the validity, authenticity, or truth of something. Being a scientist and a skeptic has no conflict. The conclusion from the review is just "inconclusive due to the poor quality of the clinical trials" (as of 2011). The subject is still open and there are many new studies by the medical community. The point is still just one point from the skeptics. The other four points from skeptics are equally strong and valid. So1308 (talk) 18:34, 20 October 2013 (UTC)
- Thanks for continuing to talk! I am not sure what "other four points" you are talking about, sorry. The scientific perspective is inherently skeptical - I agree with you. If someone makes a health claim, that X is good for Y, that has to be backed up with data; if there is currently insufficient data to make a judgement as to whether the claim is true, a scientist acknowledges that. And this is exactly what the subject sentence says - "evidence of effectiveness is inconclusive". As long as this article makes health claims, the scientific perspective (what you call "the skeptics") must be front and center. That is what WP:MEDRS says... right? Jytdog (talk) 21:24, 20 October 2013 (UTC)
Please discuss
Twice now my addition has been reverted, and I would like to discuss it before filing a dispute. I feel that erasing my additional quote is allowing an incorrect and biased quote taken out of context to remain, while erasing my quote from the same article. When Yobol undid one of my edits because I "cherry picked" a quote from a journal article that contradicted the conclusion. However, I read the entire article, not just the abstract summary, and in my opinion the other quote was the one that was "cherry picked". Rather than erase the misleading quote, I added another quote from the conclusion of the article that more fairly represented the overall views of the investigators. With both quotes, I felt there was a much more balanced representation of the conclusion of the article. Please undo you revert and allow the more accurate portrayal of the article to stand. CJ (talk) 01:38, 9 January 2014 (UTC)
- It appears you are misreading the "Conclusions" section, which states, in full, "Due to limited number of RCTs in the field and methodological problems and high risk of bias in the included studies, it is still too early to reach a conclusion about the efficacy and the effectiveness of qigong exercise as a form of health practice adopted by the cancer patients during their curative, palliative, and rehabilitative phases of the cancer journey. Since qigong exercise is preferred and widely practiced among patients with various cancers in China and Asia, further well designed large-scale placebo-controlled, randomized studies with validated outcome measures are particularly needed." The sentence you added is not from the conclusions section, but from the discussion. Your additional sentence seems to suggest that the studies on immune function were not covered by the limitations stated (methodological flaws, high risk of bias), which they most definitely are. Taking one sentence out of the "Discussion" section and trying to use it to debunk a sentence from the "Conclusions" is a definite no-no. Yobol (talk) 04:44, 9 January 2014 (UTC)
- Yobol's reasoning is solid.Jytdog (talk) 13:49, 9 January 2014 (UTC)
- Indeed. --Roxy the dog (resonate) 15:32, 9 January 2014 (UTC)
- Yobol's reasoning is solid.Jytdog (talk) 13:49, 9 January 2014 (UTC)
- But if you read the entire article, it is much more "positive" about the likelihood that there actually is a positive health benefit to daily Qigong practice, there just hasn't (yet) been enough well designed large-scale placebo-controlled randomized studies to make that conclusion. Since funding for such studies has some inherent difficulty (as I've reported in my own article published in a peer reviewed medical journal, which I'd like to discuss with you in the Integrative Medicine talk page) I'd like to find a way to, not "debunk", but rather put the statement quoted in perspective. I thought adding the statement I did was a non-controversial way of doing that, but you obviously disagree. I'm open to other suggestions.
- Within the last year several really high quality, well-designed placebo-controlled randomized studies have been published in major medical journals identifying significant positive benefits for specific practices that many people call Qigong or Tai Chi. I plan on adding references to those when I have time, and quoting from those articles. I'll put the info here first, however, if you think there should be discussion on it.
- The other change I'd like to make (but thought I would discuss it here first), is to change the sentence:
- "with almost all evidence based on poor quality data, making any firm conclusions impossible to reach"
- While this statement was true five years ago, it is no longer true. There are now several firm conclusions that can be stated about Tai Chi and its impact on the immune system, systolic blood pressure, Fibromyalgia, and shingles. Until I get time to compile the list of well-designed studies, however, I'd still like to change this sentence to read:
- "until recently, most studies were poorly designed and therefore it was impossible to reach any firm conclusions. However, as evidence-based tai chi forms are being well-documented and used in research more often, studies are beginning to appear with strong indications of a positive effect."
- The problem here, is that you are trying to adjust the summary of the sources to fit your perception of what this article should say. This, of course, is opposite of what we as editors ought to be doing; our jobs is to summarize the highest quality sources (in this case, WP:MEDRS compliant sources) as best we can, regardless of what our personal feelings are. In this context, I would object to any changes that are not neutral summaries of the conclusions of WP:MEDRS compliant sourcing (noting now that any primary papers such as individual RCT that have not been evaluated in secondary sources would be premature to include here), and therefore object to the proposals mentioned above. Yobol (talk) 22:47, 9 January 2014 (UTC)
- CJ, you are trying to put the cart before the horse, as Yobol has eloquently explained. You cannot change the article in this way without sources to back up your assertions. I personally doubt you have such sources, so to agree to a change of the article in this way in anticipation that you will bring such sources, but can't be bothered to find them at the moment, is not the way to go about it. --Roxy the dog (resonate) 23:59, 9 January 2014 (UTC)
- Cjrhoads,you write: "But if you read the entire article, it is much more "positive" about the likelihood that there actually is a positive health benefit to daily Qigong practice there just hasn't (yet) been enough well designed large-scale placebo-controlled randomized studies to make that conclusion." We don't do "crystal ball" here; there is either evidence to make health claims, or there is not. As you acknowledge, currently we don't have evidence to say much about Qigong good or bad. If there is never money for studies, we will never know which means the wikipedia article will need to remain equally silent. Jytdog (talk) 05:45, 10 January 2014 (UTC)
- I tend to agreed with Yobol , Roxy the dog, and Jytdog and try to maintain a more neutral tone for the health benefits of qigong. There is no scientific consensus on the benefits of qigong and this extends to almost any topic relating to alternative medicine. The current article provided a delicate balance providing information from both advocates and skeptics. ottawakungfu (talk) 21:23, 11 January 2014 (UTC)
- I agree we should maintain a neutral tone - but the current tone is not neutral, but leans toward the negative. Keep in mind that Qigong is more specifically aligned with Integrative Medicine, which is not Alternative Medicine. Since there has been quite a bit of activity surrounding Integrative Medicine recently, including scientific evidence of the effectiveness of mind-body practices, I believe it is to everyone's benefit to review the impression the articles gives. I'll start a new section to discuss some changes (below) CJ (talk) 16:59, 11 February 2014 (UTC)
- A couple of points CJ. The current tone is neutral enough, and certainly doesn't lean towards the negative. What we have is Wikipedia taking the mainstream view on an exercise program which proponents want to turn into a medical modality. Taking this mainstream POV is what Wikipedia obliges us to do. It becomes fringe or Alt med when you make claims for the modality that cannot be substantiated by good evidence. You have not as yet presented any good evidence in the form of sources that show real beneficial results for quigong beyond the obvious benefits of any kind of exercise.
- You must also remember that the difference between Alt Med and Integretive Med is just Altmed trying to get mainstream acceptance and inclusion into mainstream use for their unproven therapies. I look forward to any reliable sources that you have showing any alternative practises turning into real medicine. --Roxy the dog (resonate) 17:52, 11 February 2014 (UTC)
Evidence and Support Rewrite
I would like to start a more directed discussion on the medical evidence and support for Qigong in the talk pages before making changes. I've been talking with several people and some suggested the following change, which I think we should implement.
Old text: Possible health benefits of qigong have been studied in various medical conditions. Evidence of effectiveness is inconclusive due to the poor quality of the clinical trials.[1]
New text: Claims about heath benefits of qigong practice are widespread and include improving cardiovascular function, healing specific acute diseases, and increasing longevity.[2][3][4] While a comprehensive review of random controlled trials shows that almost all studies showed positive benefits of qigong practice[5], an overview of systematic reviews concludes that “effectiveness of qigong is based on poor quality research”, that “it would be unwise to draw firm conclusions at this stage” and that "this area merits further rigorous research”[1]
Would this change be acceptable to everyone? If not, what specifically is the problem with it, and how can we come to consensus on a more unbiased and balanced view of the Qigong research which, though not yet definitive, is highly supportive and provides some evidence.
I look forward to hearing your thoughts. CJ (talk) 16:55, 11 February 2014 (UTC)
On another note, we might want to consider the following:
I do believe that we might find something useful in Peter Wayne's recent book - Harvard Medical school Guide to Tai chi.
Conventional medical science on the Chinese art of Tai Chi now shows what Tai Chi masters have known for centuries: regular practice leads to more vigor and flexibility, better balance and mobility, and a sense of well-being. Cutting-edge research from Harvard Medical School also supports the long-standing claims that Tai Chi also has a beneficial impact on the health of the heart, bones, nerves and muscles, immune system, and the mind. This research provides fascinating insight into the underlying physiological mechanisms that explain how Tai Chi actually works. [6]
However, nomenclature is a problem. We accept that qigong is a group of modalities: quiet meditation, moving meditation, self massage, external applications including a number of additional modalities such as cupping, tapping, 'sword finger' , even diet and herbal remedies. The vast majority of recent research is limited to moving meditation using tai chi postures. We can assume the premise that tai chi forms can cultivate qi and use the current research to our advantage to promote qigong with the caveat that this is a very limited inquiry.
Again - I'd like to hear your thoughts. CJ (talk) 17:21, 11 February 2014 (UTC)
- If by "unbiased" you mean that it must say that qigong is effective, we cannot do it. There are widespread claims made about many many things (magnet therapy, echinacea, drugs in clinical trials) and wikipedia does not parrot them. Unless something is proven to be safe and effective and there is a solid scientific consensus behind that, we cannot say that it is. Let me repeat that - unless something is proven safe and effective and there is a solid scientific consensus behind it, we cannot say that it is. If we did, Wikipedia goes to the dogs, both on the alt med (or integrative) side and the corporate side. In this case, the first half of the second sentence needs to go. I am very uncertain about the first sentence. Jytdog (talk) 17:26, 11 February 2014 (UTC)
- Of course I don't mean to indicate that it "must" say that qigong is effective. That has not yet been proven, so I agree with you. What I am saying is that, unlike magnet therapy and echinacea, qigong and other integrative health practices are beginning to demonstrate, in solid clinical trials, that it is safe, effective, and beneficial as an integrative health practice. (Not alternative, not even complimentary, but as part of a whole integrative medical perspective, taking into account the wellbeing of the whole person.) CJ (talk) 15:31, 13 February 2014 (UTC)
- My initial thoughts. I've never heard of Paul Rich, or Penny Klein. Arguments from authority will not cut the mustard here, we need reliable sources. Your proposed edit is interesting, and could be used for any other forum of exercise. Consider ...
- "Claims about heath benefits of walking the dog are widespread and include improving cardiovascular function, healing specific acute diseases, and increasing longevity. While a comprehensive review of random controlled trials shows that almost all studies showed positive benefits of walking the dog, an overview of systematic reviews concludes that “effectiveness of walking the dog is based on poor quality research”, that “it would be unwise to draw firm conclusions at this stage” and that "this area merits further rigorous research”
- Nobody disputes that exercise is a good thing, but equally, there is nothing to suggest that Qigong has anything over and above walking the dog, or any other form of structured or ad hoc exercise. I would not support your changes to current text. When there is some scientific explanation for the more extreme parts of this fringe pseudoscience as detailed in your Harvard quote I would be prepared to reconsider. We shouldn't say any more than the equivalent of "Exercise is good for you" in Wikipedia's voice. --Roxy the dog (resonate) 19:55, 11 February 2014 (UTC)
- I've removed references to the specific people with whom I spoke - it is irrelevent. However, I do disagree with your statement that there is nothing to suggest that Qigong has anything over and above walking the dog. What I'm saying is that recently a body of research is developing that says there is growing evidence that Qigong has additional benefits over exercise, and can be applied in more situations than just plain exercise (for example, with people who are bedridden, as there is are many Lying Down Qigong practices). Again, more research is needed. But the evidence is growing, and Harvard Medical School, Mayo Clinic, Vanderbilt Medical and hundreds of other highly regarded well-established medical communities are beginning to endorse Qigong and Tai Chi. CJ (talk) 15:31, 13 February 2014 (UTC)
- I think the old text is more neutral in tone. I agreed with the comments of Jytdog and Roxy the dog, the scientific consensus is just not there to make a more positive statement about qigong. The listed authority did not contribute any new information to change my opinion. I suggest we leave the tone of the article as is. ottawakungfu (talk) 03:02, 12 February 2014 (UTC)
- I'm sorry, but I completely disagree. The old text is not neutral, in my opinion. It is biased and negative, and gives the wrong impression regarding how the medical community views Qigong and Tai Chi. CJ (talk) 16:03, 13 February 2014 (UTC)
- The new text is clearly better and more neutral. Based on solid references, the lead statement concerning health should clearly state that claims of health benefits are widespread, that clinical studies consistently show benefits, but that systematic reviews cannot reach a definitive conclusions because of limitations of controlled trials. Please, let's be supportive of earnest efforts to improve the article. The language and tone of this discussion seems rather aggressive and biased, including labeling qigong as "fringe pseudoscience", and using unnecessarily challenging and cynical statements. First, indeed there are widespread claims about health benefits of qigong that are reviewed repeatedly in popular books about qigong as well as in the peer-reviewed medical literature, and most peer-reviewed papers start with a review of these claims, and the list "improving cardiovascular function, healing specific acute diseases, and increasing longevity" is representative and taken from a valid reference. Second, there is a substantial body of peer-reviewed literature in reputable journals that consistently finds positive benefits, and this is born out in a comprehensive review of randomized controlled trials. Third, the three quotes are taken directly from the conclusion of the overview of systematic reviews and the current wording is a paraphrase that gives a different tone than the reference. Note there is not a similar literature about walking dogs; no there is not a literature that equates qigong with exercise (though that may be a good opinion); and no it is not neutral to exclude a balance of the main view of references (even if you believe this is pseudoscience). Fourth, the reasons why “it would be unwise to draw firm conclusions at this stage” should be explicit, in particular lack of funding for research, impracticality of double blinding, and difficulty of standardized controls and treatment dosing (frequency, duration, and intensity of treatment). Fifth, many references emphasize advantages of low cost, low risk, and high accessibility. Yes, it could be good to extract conclusions and quotes from Peter Wayne's Harvard Medical School Guide to Tai Chi. TheProfessor (talk) 08:50, 12 February 2014 (UTC)
- Dear Professor: much of the literature compares qigong with excercise; it is often used as the intervention in one of the arms in clinical trials. You don't seem to be aware of what the literature actually says.... so it in unclear on what basis you are making any arguments here. Jytdog (talk) 13:19, 12 February 2014 (UTC)
- Hi Jytdog, greetings to you. Let's be specific about the substance of the article and what is being discussed, and not resort to trying to discredit me based on unsound and unfounded comments. Yes, I am aware of the literature, and no it is not fair of you to try to dismiss all I wrote with a sweeping statement like "it is unclear on what basis you are making any arguments here". Yes, many RTCs have an "exercise" group and often show similar beneficial effects. Rather, let's focus in on the proposed new text. The first sentence establishes that there are many claims about health benefits and provides a concise referenced list ("improving cardiovascular function, healing specific acute diseases, and increasing longevity"). Do you have a better list? In their short communication Qigong for healthcare: an overview of systematic reviews Lee et al. 2011 begin with a statement that "Proponents of qigong recommend it for a wide range of conditions, symptoms and situations, including stress management, hypertension, chronic pain, depression, insomnia, cardiac rehabilitation, immune function and for enhancing the quality of life (QOL) of cancer patients." and reference Sancier KM. Medical applications of qigong. Altern Ther Health Med 1996;2:40–6. Claims or beliefs concerning health benefits need to be introduced up front using similar neutral language. Second, there needs to be a clear statement about what medical literature exists (the comprehensive review is appropriate). Third, there needs to be a clear statement of medical conclusions (quotes from the systematic reviews and overview of systematic reviews are appropriate). TheProfessor (talk) 18:01, 12 February 2014 (UTC)
- Hi professor. When you mention "unsound and unfounded comments", are you referring to your statement that "no there is not a literature that equates qigong with exercise"? If so, I am willing to ignore that statement and move on. If you are referring to my calling that out, I don't understand; my question was reasonable - if you make such an error, so strongly, have you even read the literature, and if not, on what basis are you making any arguments at all? Confusing. Anyway let's do move on. Addressing the new matter. First. As pointed out by me and others above, there are many many things that "people say" have wonderful effects. Heck at one point "people said" smoking was good for you. Wikipedia should not repeat what "people say" in a section on health effects. That is why there is nothing like sentence 1 in the article; these things do not "need" to be stated at all. Second. The current 2nd sentence does not make "a clear statement about what medical literature exists"; instead, of describing the literature, it makes health claims. And I do not agree that a Wikipedia should even provide "a clear statement about what medical literature exists" - that is not typical Wikipedia article content. Third, indeed, this is what Wikipedia should do -- provide "a clear statement of medical conclusions". Yes to that! Jytdog (talk) 18:45, 12 February 2014 (UTC)
- Hi Jytdog, thanks for your input. I will consider further your perspective concerning CJ's suggestions, and add a bit more discussion that clarifies my perspective later. In the meantime, could you please supply us with the specific reference(s) and quoted text that in a medically sound way equates qigong with exercise? Thanks. TheProfessor (talk) 03:52, 13 February 2014 (UTC)
- So now you are showing that you have not even read our own article carefully nor looked at the sources that are already presented. Jytdog (talk) 11:09, 13 February 2014 (UTC)
- Nothing of the sort, Jytdog. Of course I have read our own article carefully, and yes I have done more than just look at the sources presented. Actually, if you look back over the past several years of my contributions I have been a major contributor to the Qigong article and have worked hard to ensure that it is clearly written, properly referenced, and neutral. This is not the question. I was only asking if you could supply us with specific reference(s) and quoted text that in a medically sound way equates qigong with exercise. Is that not a simple and civil request? TheProfessor (talk) 11:34, 13 February 2014 (UTC)
- Professor, I don't understand why you are asking me as though I am trying to introduce something new, that is not already clearly cited and discussed in the article and has been there a long time. If you want to make a point about this content and its sources please make it directly. Thanks. Jytdog (talk) 12:35, 13 February 2014 (UTC)
- If you need sources, Prof, I think you should find them yourself, rather than asking Jytdog to find them for you !! --Roxy the dog (resonate) 12:04, 13 February 2014 (UTC)
- Professor, I don't understand why you are asking me as though I am trying to introduce something new, that is not already clearly cited and discussed in the article and has been there a long time. If you want to make a point about this content and its sources please make it directly. Thanks. Jytdog (talk) 12:35, 13 February 2014 (UTC)
- Jytdog, I encourage us to keep the discussion focused on CJ's proposed new text, and I'll offer more input after we hear from others. To clarify, in a strict sense I know of no references that explicitly equate exercise and qigong, though as the Qigong article states "Studies that compared qigong and tai chi with other physical exercises found similar effects, and greatest effects were found in studies that compared qigong and tai chi to effects in low activity or inactive participants". We certainly could revisit whether this borders on OR in that it was extracted from a review and not the conclusions of the source, per se. So I genuinely would appreciate it if you have a medically sound reference that explicitly equates exercise and qigong. As you know, statistical equivalence of two treatments in an RTC does not necessarily mean that two treatments are the same, just that they have indistinguishable effects (possibly real, or possibly artifact, for example of small sample size or poor experimental design). In my own perspective, part of qigong/exercise equivalence is definitional, in that qigong could be called a special kind of exercise, and, according to what is taught by many qigong teachers, exercise and other activities can be performed as a kind of qigong. Another part involves a more sophisticated understanding that translates what is practiced to the language of science and medicine. Specifically, qigong could be viewed as different from "ordinary exercise" because it combines slow physical movement (or stillness), coordinated with controlled breathing, a meditative state, and mental focus that builds proprioception, new neural connections, and enhanced circulation. On the other hand, there is a lot of sophisticated exercise out there. And yes, there is a lot of hot air, belief, misinformation, hopeful thinking, investment in outcome, and sloppy thinking. New literature is emerging that emphasizes perspectives of other scientific approaches, and while double-blind RCTs are not necessarily practical, much of accepted scientific understanding is based on other kinds of "proof" (e.g., gravity, evolution, greenhouse effect...). Perhaps with time we will find conclusive health benefits or lack of benefits from qigong. Of course from a Wikipedia perspective we need to be careful to stay with what is verifiable. Please assume good faith. And please be supportive of new (and old) editors. I myself prefer a gentle and friendly tone. Thanks for your contributions. Hi Roxy the dog. TheProfessor (talk) 14:25, 13 February 2014 (UTC)
- Nothing of the sort, Jytdog. Of course I have read our own article carefully, and yes I have done more than just look at the sources presented. Actually, if you look back over the past several years of my contributions I have been a major contributor to the Qigong article and have worked hard to ensure that it is clearly written, properly referenced, and neutral. This is not the question. I was only asking if you could supply us with specific reference(s) and quoted text that in a medically sound way equates qigong with exercise. Is that not a simple and civil request? TheProfessor (talk) 11:34, 13 February 2014 (UTC)
- Four comments:
- *So you have been pulling a bill clinton and you are using "equate" with unsignalled formal precision. oy. OK a) the current article does not "equate" qigong with exercise and b) I know of no source that "equates" qigong with exercise either. So why are you bringing up this whole "equating" thing at all? (real question)
- *With respect to why there is not great RCT data - this is not relevant. We either have such data and can make definitive positive statements about health benefits, or we do not have it, and we cannot make definitive positive statements. In this case it is the latter, and it will continue being the latter until somebody who cares enough makes it happen.
- *Your statement "New literature is emerging that emphasizes perspectives of other scientific approaches, and while double-blind RCTs are not necessarily practical, much of accepted scientific understanding is based on other kinds of "proof" (e.g., gravity, evolution, greenhouse effect...)" is so so crazy. The scientific method involves doing repeatable experiments to verify hypotheses. The scientific method has been used, for example, to identify and understand gravity, evolution, and the greenhouse effect. The entire point of evidence-based medicine, which is the basis for health-related content in Wikipedia, is to bring the rigor of the scientific method more clearly to bear on medicine. The field of medicine is exactly trying to move away from "other ways of knowing" and toward the scientific method - the way that gravity was discovered. So again I don't understand where you are coming from.
- *I have already commented on the proposed text, saying why I find it unacceptable. You did too and I have been trying to understand your argument in favor of it. So far I have not understood your arguments.Jytdog (talk) 15:26, 13 February 2014 (UTC)
- So now you are showing that you have not even read our own article carefully nor looked at the sources that are already presented. Jytdog (talk) 11:09, 13 February 2014 (UTC)
- Whoaaa - seems to be a lot of nastiness getting thrown around here!! Can we tone it down and focus just on improving the article with more recent information available? Perhaps it would be better/easier to go down into the details and modify that before we start changing the introductory paragraph. Next week, I'm going to jump down into the evidence and support area that will give more specific references for the summarization we'd like to modify. Quite frankly, I have done a ton of research on this topic, and can cite chapter and verse - I just need the time to put it into a format that matches Wikipedia's requirements, which I'm just now learning about. Please give me some time, and hold off on squashing the newby, please.
- As I noted, my goal is to have the article accurately reflect the current state of medical opinion about Qigong and Tai Chi, which is more positive than negative. Additionally, the comments about the reasons why there are few ramdomly controlled studies is certainly relevent. You made the case yourself, Jytdog. You said:
- As pointed out by me and others above, there are many many things that "people say" have wonderful effects. Heck at one point "people said" smoking was good for you. Wikipedia should not repeat what "people say" in a section on health effects
- The reason it took so long for the medical community to finally recognize how bad smoking is for humans is because it was impossible to do a randomly controlled scientific study; they only had correlational regression studies, which do not prove causation. There are still no quantifiable, well-designed scientific studies that prove that smoking is bad for you. But the evidence finally piled up even without that golden-certification of RCT, and the medical community now has gone 180 in recognition of the dangers of smoking.
- I suspect the same is happening for Qigong and Tai Chi. I know that there are many skeptics. We need skeptics to reign in the unwarranted "claims" of thousands of bad, dangerous, and unhealthy practices. Nothing bothers me more than Qigong Advocates making completely unfounded claims about miraculous faith-based healings due to some magical mystery force they call "qi". But let's not be blinded to the actual evidence and support that is growing for some health practices that are becoming part of integrative medicine. There is growing evidence of the benefits of the combination of deep breathing, focused intention, and slow purposeful movements which is the basis for Qigong. I'd like to focus on what the evidence shows, and doesn't show, about this healthful practice.
- I'm in the middle of another project right now, so I can't add the information this week - besides, I'd like to hear from some other people - perhaps some new people - on their opinions of making changes to the Qigong article. Anyone? CJ (talk) 15:49, 13 February 2014 (UTC)
Qigong general description
It is generally accepted that Qigong exercises have three components: a posture (whether moving or stationary) 調身, breathing techniques 調息, and mental focus on guiding qi through the body 調心. It is generally accepted that Qigong exercises have three components: a posture (whether moving or stationary) 調身, breathing techniques 調息, and mental intent on guiding qi through the body 調心 and possibly external to it.
The word focus is static, while the word intent is active. Most all literature about using Qigong techniques requires intent rather than focus to guide qi. Also, qi can be moved outside the body when it is directed to do so. There are many masters who refer to the existence of a Qi ball that can surround the body to provide both awareness and protection. There is also the whole topic of Qi healing that utilizes the qi from one person to affect the body of a patient. (SequimTao (talk) 06:37, 13 February 2014 (UTC))
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