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::::Consensus doesn't mean everyone is happy, and everyone but you seems to think including deaths in the lead is appropriate. |
::::Consensus doesn't mean everyone is happy, and everyone but you seems to think including deaths in the lead is appropriate. |
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::::I added my own qualifier about under reporting. [[User:WLU|WLU]] <small>[[User talk:WLU|(t)]] [[Special:Contributions/WLU|(c)]] Wikipedia's rules:</small>[[WP:SIMPLE|<sup><span style='color:#FFA500'>simple</span></sup>]]/[[WP:POL|<sub><span style='color:#008080'>complex</span></sub>]] 14:11, 7 June 2011 (UTC) |
::::I added my own qualifier about under reporting. [[User:WLU|WLU]] <small>[[User talk:WLU|(t)]] [[Special:Contributions/WLU|(c)]] Wikipedia's rules:</small>[[WP:SIMPLE|<sup><span style='color:#FFA500'>simple</span></sup>]]/[[WP:POL|<sub><span style='color:#008080'>complex</span></sub>]] 14:11, 7 June 2011 (UTC) |
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:::::Well, I am not happy. The lead currently says this: "A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy in the treatment of pain and accompanied by serious risks and adverse effects including death." While technically correct, there is a weight problem with this statement as this holds acupuncture to a much higher standard than conventional medicine. The article [[Aspirin]] says ''nothing at all'' about deaths from incorrect use of salicylate, even though it is a significant problem: |
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::::::"Salicylate intoxication remains a common problem in Britain; about 10 percent of adult hospital admissions for deliberate self-poisoning involve these drugs. [...] In the United Kingdom, the annual number of salicylate-related deaths has fallen slightly between 1967 and 1980. [...] The mortality rate from acute salicylate poisoning in hospital-treated adults is about one percent; death is usually preceded by neurologic features and a dominant metabolic acidosis." [http://www.ncbi.nlm.nih.gov/pubmed/6650533] (I am sure there are better sources, this is just a random source I found via Google while avoiding anything that looked remotely like a crackpot site. Given the large number of known problems that can occur with salicylate, it would be astonishing if there were not hundreds or thousands of related deaths worldwide every year.) |
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:::::That's not a weird omission, it's the standard treatment of such topics. Of course every single death is too much, and it makes sense to stress serious complications of unnecessary therapies and practices such as needling (or riding motorcycles, to take a non-medical example) than those of best practice approaches such as the best known medical therapies. But I wouldn't be surprised to learn that more people die from malpractics related to salicylate every year than from acupuncture. After all, it's often prescribed as a placebo – presumably often without checking for contraindications – and has also been implicated in the high mortality of the [[Spanish flu]], for example. [[User:Hans Adler|Hans]] [[User talk:Hans Adler|Adler]] 14:57, 7 June 2011 (UTC) |
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This page has archives. Sections older than 20 days may be automatically archived by Lowercase sigmabot III when more than 5 sections are present. |
page progress and page troubles
@ Snowded (and anyone else who pops in here). I'm open to reasoned discussion about the ongoing changes to the article, but we have had none of that to date - just pithy obstructionism from a single editor. I'd ask you not to revert a reasonable amount of good work simply because one editor has been doggedly obstructing things. If you don't like the changes that have been made, please discuss them here. Do not become part of the problem by engaging in large-scale reverts without considering the issues properly. --Ludwigs2 18:15, 1 May 2011 (UTC)
- Lay out the issues so other editors can look at them. For the moment I've put the article back to where it was before this dispute broke out - WP:BRD and all that. As far as I can see you are as much a part of the problem as other editors. --Snowded TALK 18:16, 1 May 2011 (UTC)
- Snowded, READ THE TALK PAGE. these issues have been laid out as we've gone along, and been regularly reverted by one editor who does nothing except declaim 'POV edit!' You are currently supporting someone who has been tendentiously edit warring against page development. is that what you mean to be doing? --Ludwigs2 18:21, 1 May 2011 (UTC)
- P.s. If you're really going to insist that I spell out all the rationales for changes again, I'll do that: but but I want your word first that if I do so you will behave reasonably and cease edit warring. --Ludwigs2 18:23, 1 May 2011 (UTC)
- Wow, you really enjoy personal attacks on everyone. For someone with 14 blocks to their name, is this a wise course of action? I'm just trying to give you some helpful advice. And yes, your edits were POV. It's upon you to explain your edits to a stable version of an article, not for me to explain why every one of your edits were unacceptable and violations of POV. Again, I'm here to give advice to an editor who is subject to a variety of Pseudoscience article sanctions. OrangeMarlin Talk• Contributions 18:25, 1 May 2011 (UTC)
- (ec) Its far from clear to be honest. I went through the discussion above and some of it relates to the actual edits. Rather than commenting on other editors maybe you would put the same effort into summarising the main changes you want so they can be treated one by one. I also suggest you stop shouting and failing to WP:AGF. I've restored a position per WP:BRD if you think that is edit warring or unreasonable behaviour fine --Snowded TALK 18:27, 1 May 2011 (UTC)
- I don't understand what you're asking for that isn't already there. for instance:
- my edits of yesterday were clearly marked as clean up and rewrite for clarity [1]. mostly they were just rewording for style; some of it was removal of odd ramblings. why didn't you open a discussion and ask about it? I would certainly have been open to that discussion, but since I have no idea what you think is wrong with the edits in particular, how can I justify them?
- you reverted a clarity tag that middle 8 put on - why is that?
- it's easy to revert Snow, but it's really hard to figure out what's bothering you about the edits if you won't explain yourself. So, explain what you think is wrong with the edits, in enough detail so that we can discuss it - how long do you need to make a reasonable explanation? --Ludwigs2 18:40, 1 May 2011 (UTC)
- FYI my id here is snowded. Its very easy to edit war, I reverted to a stable position with the suggestion that you (or some other) involved editor summarises the desired changes. Simple really, if you are not happy with that I will look at it again later, but for the moment I have flights to catch --Snowded TALK 18:44, 1 May 2011 (UTC)
- Ludwigs, once again, it is your responsibility to defend your edits on a fringe article. You haven't. You cannot take your path of editing and think you can "get away with it." You could go the teapot around the moon article, write that it's there, and ask everyone else who tries to revert "well, provide a reliable source that it isn't there." OrangeMarlin Talk• Contributions 18:47, 1 May 2011 (UTC)
- OK, well will you summarise the issues with the changes (which I see have been put back) then maybe we can make progress. --Snowded TALK 18:51, 1 May 2011 (UTC)
- I'm seeing less than ideal behavior from both OM and L2. L2, edits like this [[2]] are simply petty. OM, your snarky WP:TLDR, and references to L2's number of blocks don't contribute to the discussion; if the number of blocks is relevant, what are to make of your 4? (By the way, [zero] here. Don't that make me better or more virtuous than both of you???)Gerardw (talk) 18:56, 1 May 2011 (UTC)
- Gerard - I archived that because it was off-topic and specifically intended to be personal rather than content-related. I'd appreciate it if you'd restore the archive, because it adds nothing to the discussion, and leaving it out there will simply encourage more comments along the same line. If you like, I can do more focused redaction of off-topic personal material, but I do believe it should be obscured. --Ludwigs2 19:01, 1 May 2011 (UTC)
- What possible reason would I have for restoring it? I think it's inappropriate. Gerardw (talk) 19:04, 1 May 2011 (UTC)
- ok, I'll do it myself. If you continue to think it's inappropriate, please bring it up somewhere (not here) where we can discuss the matter with the community and reach a decision on the usefulness of it. Just let me know where. --Ludwigs2 19:17, 1 May 2011 (UTC)
- What possible reason would I have for restoring it? I think it's inappropriate. Gerardw (talk) 19:04, 1 May 2011 (UTC)
- Gerard - I archived that because it was off-topic and specifically intended to be personal rather than content-related. I'd appreciate it if you'd restore the archive, because it adds nothing to the discussion, and leaving it out there will simply encourage more comments along the same line. If you like, I can do more focused redaction of off-topic personal material, but I do believe it should be obscured. --Ludwigs2 19:01, 1 May 2011 (UTC)
- I'm seeing less than ideal behavior from both OM and L2. L2, edits like this [[2]] are simply petty. OM, your snarky WP:TLDR, and references to L2's number of blocks don't contribute to the discussion; if the number of blocks is relevant, what are to make of your 4? (By the way, [zero] here. Don't that make me better or more virtuous than both of you???)Gerardw (talk) 18:56, 1 May 2011 (UTC)
- OK, well will you summarise the issues with the changes (which I see have been put back) then maybe we can make progress. --Snowded TALK 18:51, 1 May 2011 (UTC)
- Ludwigs, once again, it is your responsibility to defend your edits on a fringe article. You haven't. You cannot take your path of editing and think you can "get away with it." You could go the teapot around the moon article, write that it's there, and ask everyone else who tries to revert "well, provide a reliable source that it isn't there." OrangeMarlin Talk• Contributions 18:47, 1 May 2011 (UTC)
- FYI my id here is snowded. Its very easy to edit war, I reverted to a stable position with the suggestion that you (or some other) involved editor summarises the desired changes. Simple really, if you are not happy with that I will look at it again later, but for the moment I have flights to catch --Snowded TALK 18:44, 1 May 2011 (UTC)
- I don't understand what you're asking for that isn't already there. for instance:
- (ec) Its far from clear to be honest. I went through the discussion above and some of it relates to the actual edits. Rather than commenting on other editors maybe you would put the same effort into summarising the main changes you want so they can be treated one by one. I also suggest you stop shouting and failing to WP:AGF. I've restored a position per WP:BRD if you think that is edit warring or unreasonable behaviour fine --Snowded TALK 18:27, 1 May 2011 (UTC)
Ok, well, as I said, they were mainly clarity changes. let's start going through it line by line and try to figure out what to do about each. sorry about shortening your username, by the way; didn't realize that was an issue. --Ludwigs2 18:57, 1 May 2011 (UTC)
first line
old version | my change |
Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body. |
Acupuncture is an alternative medicine in which thin needles are inserted into a the skin and manipulated in various ways, ostensibly to influence the patient's qi for therapeutic benefit. |
what do you object to in this revision? the latter is a clearer description of what acupuncture attempts to do, I think. --Ludwigs2 18:57, 1 May 2011 (UTC)
- Can we have all the suggested changes? That is just a small part of the changes in the first couple of sentences of the lede. --Snowded TALK 19:31, 1 May 2011 (UTC)
- Snowded - it's three paragraphs of copy-editing revisions, involving material that was added, reworded, moved to different places, or removed. If you want to deal with the whole thing at once you can look at the diff and tell me what specifically you found distasteful in it. If it helps any, I had three main goals:
- to clarify specific details (e.g. needles are inserted into the skin, they are not stuck into the body like daggers).
- to organize the paragraphs: first paragraph as overview of topic, second paragraph dealing with medical issues and efficacy.
- to remove redundancies and pithinesses (e.g. removing link to 'evidence-based medicine', which is a POV neologism for western scientific medicine, or combining the three or four separate references to efficacy issues into a single line for easier reading)
- Otherwise I don't understand what you mean by 'all the suggested changes' - we look at it as a block or we look at it in pieces; there doesn't seem to be a middle ground. --Ludwigs2 19:44, 1 May 2011 (UTC)
- Snowded - it's three paragraphs of copy-editing revisions, involving material that was added, reworded, moved to different places, or removed. If you want to deal with the whole thing at once you can look at the diff and tell me what specifically you found distasteful in it. If it helps any, I had three main goals:
- 2 hours, no response from Snowded or Orangemarlin. I'll check back in a bit. --Ludwigs2 21:39, 1 May 2011 (UTC)
- What are you talking about. no one here is full time and I am grabbing spots between hotels and airports over the whole of this evening so don't expect any detailed work in a two hour window - please. Otherwise I don't think its all or nothing. When I looked at it some of the editors improved things, others attempted to reduce any medical criticism. Its going to take a bit of work given this and the article is thanlfully frozen for a few days anyway. --Snowded TALK 23:57, 1 May 2011 (UTC)
- Just marking time, more with respect to Orangemarlin than you. Eventually, the fact that OM does not use the talk page to discuss revisions is going to become significant, and it's worth highlighting it as we go along. For instance, this thread has now been hanging here for 7.5 hours without anyone trying to discuss the reasons for reverting the material. You're busy, valid excuse; Orangemarlin has been working on different pages on project. the longer this thread goes without anyone explaining the reasons for reverting, the more effectively I can assert that we have the established the groundwork for a new consensus. --Ludwigs2 04:12, 2 May 2011 (UTC)
- Nonsense. See wp:NODEADLINE. Certainly nobody seriously believes we operate on a timescale of hours. Give it a few days.LeadSongDog come howl! 06:15, 2 May 2011 (UTC)
- Agreed, its going to be necessary to go through the changes which have been restored by Adler/Ludwig2. The one listed above is fairly inconsequential, other changes appear to attempt to reduce scientific criticism. Making such major changes without consensus was bound to be provocative. --Snowded TALK 06:20, 2 May 2011 (UTC)
- If either of you has concerns with the changes you will have to say what they are. See the 4RR report currently open at WP:EW/N or the discussion on my talk page for some background. OM is a serial abuser of the BRD principle. For him it quite obviously means "bold, revert, leave the regular editors of the article puzzled about what he might be objecting to and why". It's just a technique for producing maximal chaos at an article with minimal effort.
- NODEADLINE refers to imperfections in article space. It doesn't say that you can hold up editors who are doing content work on an article by putting unreasonably long intervals between the BR and the D of BRD. And the point of Ludwigs2's comment was probably not that it's taking too long but that there is a reasonable expectation that OM is not going to get to the D step at all. Which is why it was perfectly proper to revert him. Hans Adler 06:33, 2 May 2011 (UTC)
- You can't use one persons bad behaviour to justify the fact that there was little attempt to argue the changes here on the talk page. As it is its going to be a good hours work to go through the changes and comment. The example given above is cherry picking the least controversial change. Given that its unreasonable to start demanding responses within two hours --Snowded TALK 06:42, 2 May 2011 (UTC)
- This section is about L2's attempt to draw OM into discussion. It's not cherry picked, it's the $%^ first sentence of the lead.
- It's predictable that OM won't bite because it's (almost?) unprecedented that OM engages in discussion at one of his revert-only articles. But I don't see why we need this meta-discussion here in the meantime. For all I know your own content concerns may well be valid. Find out what they are, express them, and start a fresh section.
- This all started with disruptive behaviour by OM (5 unexplained reverts in 24 hours, not acceptable by any standard, with not remotely comparable behaviour on the other side), and you jumping in essentially just supporting OM uncritically. Now it's your turn to stop supporting OM's pure stone walling and take this into a constructive direction. Hans Adler 06:56, 2 May 2011 (UTC)
- The first line is minor, the substantive changes were elsewhere so it is cherry picking. The ne content has all being placed there by Ludwig and one other (and now reverted by you) rather than leaving the previous stable version in place while a discussion takes place. Rather than edit warring after the reversal the case should have been made on the talk page. If after a few days no one objected then the case would have been stronger. However we have a edit war flurry over a day so neither side really comes out well here. Now we have forum shopping on top. I am now going to bed, and I have a very long couple of days on my feet with flights and late night arrivals. I will go through this as a content issue if another editor does not do it first however, but it may take a few days. --Snowded TALK 07:04, 2 May 2011 (UTC)
- Maybe you will understand things better tomorrow. A 3RR report for 5 reverts in 24 hours, with no content discussion and no history of constructive work on the article, cannot possibly be forum shopping unless an admin is already dealing with the problem.
- The first sentence of an article is the most important. This is the one position that most edit wars are about, and there was a substantial change there. If OM is fine with that change, nothing objectively prevents him from saying so. Even saying it in a nasty way would have advanced the discussion. But he has just run away. Hans Adler 07:13, 2 May 2011 (UTC)
- The first line is minor, the substantive changes were elsewhere so it is cherry picking. The ne content has all being placed there by Ludwig and one other (and now reverted by you) rather than leaving the previous stable version in place while a discussion takes place. Rather than edit warring after the reversal the case should have been made on the talk page. If after a few days no one objected then the case would have been stronger. However we have a edit war flurry over a day so neither side really comes out well here. Now we have forum shopping on top. I am now going to bed, and I have a very long couple of days on my feet with flights and late night arrivals. I will go through this as a content issue if another editor does not do it first however, but it may take a few days. --Snowded TALK 07:04, 2 May 2011 (UTC)
- You can't use one persons bad behaviour to justify the fact that there was little attempt to argue the changes here on the talk page. As it is its going to be a good hours work to go through the changes and comment. The example given above is cherry picking the least controversial change. Given that its unreasonable to start demanding responses within two hours --Snowded TALK 06:42, 2 May 2011 (UTC)
- Agreed, its going to be necessary to go through the changes which have been restored by Adler/Ludwig2. The one listed above is fairly inconsequential, other changes appear to attempt to reduce scientific criticism. Making such major changes without consensus was bound to be provocative. --Snowded TALK 06:20, 2 May 2011 (UTC)
- Nonsense. See wp:NODEADLINE. Certainly nobody seriously believes we operate on a timescale of hours. Give it a few days.LeadSongDog come howl! 06:15, 2 May 2011 (UTC)
- Just marking time, more with respect to Orangemarlin than you. Eventually, the fact that OM does not use the talk page to discuss revisions is going to become significant, and it's worth highlighting it as we go along. For instance, this thread has now been hanging here for 7.5 hours without anyone trying to discuss the reasons for reverting the material. You're busy, valid excuse; Orangemarlin has been working on different pages on project. the longer this thread goes without anyone explaining the reasons for reverting, the more effectively I can assert that we have the established the groundwork for a new consensus. --Ludwigs2 04:12, 2 May 2011 (UTC)
- What are you talking about. no one here is full time and I am grabbing spots between hotels and airports over the whole of this evening so don't expect any detailed work in a two hour window - please. Otherwise I don't think its all or nothing. When I looked at it some of the editors improved things, others attempted to reduce any medical criticism. Its going to take a bit of work given this and the article is thanlfully frozen for a few days anyway. --Snowded TALK 23:57, 1 May 2011 (UTC)
- 2 hours, no response from Snowded or Orangemarlin. I'll check back in a bit. --Ludwigs2 21:39, 1 May 2011 (UTC)
@ Snowded: as far as I'm concerned what I did was inconsequential copyediting. You throw around words like 'controversial changes' and 'attempts to reduce scientific criticism' but I have no idea what you are referring to and you're not explaining it. I told you above precisely what I was trying to do (see the three bullet points above). So note well: You have a problem with this edit; I don't. You need to express what your problem is - in words - so that we can address it properly. If you cannot express what your problem is in words, then how can we possibly credit your problem as being valid? wp:IDONTLIKEIT is not a valid argument.
and 'cherry-picking' refers to quoting sources, not discussing content. If you're not averse to this particular change, just say so and we'll move on to the next. easy as sinning, if not as much fun. --Ludwigs2 07:36, 2 May 2011 (UTC)
@ LeadSongDog: the fact that there's no deadline doesn't mean that we can't assert a new consensus has been formed. we have the opportunity to discuss any objections now, which is great if that's what you want to do. If you choose not to raise or discuss objections at this point, then you can certainly raise them at some later point (because there's NODEADLINE), but in the meantime we will take this new revision as the new consensus. As far as I can see it was a reasonable edit that I am more than willing to discuss and explain; you need to tell me what you see wrong with it.
I understand the 'temporizing' tactic - block changes to the article, toss out a few vague policy worries in talk, refuse to explain much of anything all the while accusing everyone else of haste and impropriety, and then sit on your heels and temporize in the hopes the issue will melt away without further ado. It's a common enough tactic on wikipedia, and not necessarily an unreasonable approach in many cases, though it is a bit on the passive-agressive side (particularly when used against reasonable editors). Just be aware that this is not the first time that I've had to address this particular tactic on project - not by far - and it certainly won't be the last. If this is the approach to be used here, then I will take it as an opportunity for practice and experimentation; it's good to have the chance to discover more reasonable, civil, and effective approaches to dealing with it. --Ludwigs2 07:36, 2 May 2011 (UTC)
- For all this talk of how OM is dodging discussion, has anyone actually tried contacting him to let him know there's a discussion taking place? Apparently not, so I have. I get that editing can get tense around here sometimes, but all this talking about a specific editor on an article talk page when he's not even involved in the discussion is a little out of line. Watchlists get clogged up sometimes, and I very often find myself reverting changes with which I disagree and not seeing the subsequent discussion until a bit later. If there are specific complains with a specific editor, they should be taken to their talk page, not here. As for the article changes, I'll lodge my disagreement with the provided diff as well. The previous version properly contextualized Acupuncture as variously claiming efficacy in a broad range of areas, for which there isn't currently scientific support. The new proposal reduces that weight substantially, further adding undue weight to the concept that Acupuncture is effective for some treatments. This doesn't properly reflect the article, or the weight of the sources. The previous version needs work, but this largely isn't a step in the right direction. — Jess· Δ♥ 15:58, 3 May 2011 (UTC)
- Mann_jess: OM made five (5) reverts in one day, and has seen fit to make multiple comments here on my putative POV, logical fallacies, personal character, and etc. It's safe to assume that he's following the conversation and choosing not to participate for unknown reasons. I applaud your adherence to AGF, but will suggest kindly that the principle should generally not be extended to the point where one has to ignore a whole range of behavior in order to make it make sense.
- With respect to your substantive comments... This is an article about acupuncture, not an article about the scientific criticism of acupuncture. while I agree that the scientific criticism needs to be there, we do not need to pack the lead with multiple separate claims about the same weakness; one line is sufficient for framing, and we can draw out the specifics in the body more extensively as appropriate. Please remember that it is not the purpose of wikipedia to make an argument that acupuncture is flawed. We simply describe acupuncture, including its flaws and critiques, in a way that makes the subject clear to readers. Filling out the lead with excessive critiques is an effort to make an argument; balance is needed. right? --Ludwigs2 17:56, 3 May 2011 (UTC)
- Criticisms of an editor should still be kept on the editor's talk page (or a noticeboard). Having a whole section practically devoted to that editor, particularly when he isn't even participating, isn't what article talk pages are intended for. Regarding content: I agree fully that the article shouldn't focus on criticism, and I'm not claiming anything of the sort. I'm simply objecting on the grounds that the new revision doesn't properly convey the scientific standing of acupuncture on the claims being made. The last version did that, so while it may have had problems, this revision is still not forward progress. — Jess· Δ♥ 18:37, 3 May 2011 (UTC)
- I think it's generally accepted that normally a lead should have no more than 3 paragraphs. (Ludwigs2 reduced the number of paragraphs from 4 to 3.) How many of these 3 paragraphs need to say that acupuncture doesn't work all that well? This is a serious question, and I expect a number as an answer. Hans Adler 19:09, 3 May 2011 (UTC)
- Jess, cool, I'm actually glad to hear you say that abut "Criticisms of an editor should still be kept on the editor's talk page (or a noticeboard)". could you please take a look at these diffs - [3], [4], [5], [6], [7] - and remind Orangemarlin of this principle? That's just the ones from the last few days, excluding the edit summaries on his article page reversions; I can find more, if you like. And yes, I do actually expect to see you remind him, otherwise your comments to us here lose whatever moral authority they might have. --Ludwigs2 20:13, 3 May 2011 (UTC)
- @Ludwigs, the argument "he did it first" isn't a good one. I'm in no way lodging support for OM's editing. I'm simply saying that, as you and Hans are experienced editors, you should adhere to policy regarding article talk pages, namely by keeping discussion of other editors on their talk page or a noticeboard. Your irritation at OM in this thread appeared to be that he wasn't participating, so reminding him to stay on topic in a conversation he's not a part of seems a little silly. That said, consider this a reminder for him too, since it equally applies to everyone.
- @Hans There's no one number which answers that question absent discussion of actual content (and along side a decent proposal). Again, I've made it clear that 1) I don't think the article should be driven by criticism, and 2) the previous version needs work. The answer to your question is "however many is necessary to describe the criticism well". I imagine that would probably be one or less, but it needs to be done well, and the current proposal doesn't. I'm objecting on those grounds. Weight was removed from criticism and added to efficacy for nausea. That doesn't reflect the article or the sources properly. — Jess· Δ♥ 20:37, 3 May 2011 (UTC)
- Jess, I wasn't using a he did it first argument - I was suggesting that you be equal and fair in your condemnation of he practice. But let me point out that you and I talking about each other isn't productive either, so let's drop this.
- With respect to your disagreement. I actually welcome disagreement and discussion. I don't welcome a "let's go back to square one" approach. Overall the writing in my version is an improvement. if you think I've gone too far in organizing the material, then you're welcome to suggest new adjustments, but neither you nor anyone else has given a pressing rationale for blanket reversion. what criticism do you want to add to the criticism that's already in the article that you think is important? --Ludwigs2 21:50, 3 May 2011 (UTC)
Jess, it's very difficult to edit here with Ludwigs' constant personal attacks. It makes for a very troubling and hostile editing environment. I'm assuming that Ludwigs will get his 15th block sooner or later, which will make this area much more civil and prone to agreement. I thought Ludwigs was on a fringe article restriction? If not, I'd rather work on articles with a more collegial environment. I'm not sure why he hasn't been blocked for all of his hounding of me and of his constant personal attacks. OrangeMarlin Talk• Contributions 22:50, 3 May 2011 (UTC)
- @ Jess: so much for idealism... --Ludwigs2 23:04, 3 May 2011 (UTC)
- I can't take these personal attacks from Ludwigs. It's clear he hasn't learned anything from his prior 14 blocks. OrangeMarlin Talk• Contributions 23:21, 3 May 2011 (UTC)
- He has a few problems with basic math, as well - only about half of those items are block entries, the rest are unblock entries. I've wracked up a number of 20 minute deals, where someone makes a hasty block and it gets quickly overturned. but it's no never mind. stuff like this is so obvious it's actually kind of funny. --Ludwigs2 00:31, 4 May 2011 (UTC)
- Guys, take this to talk. If anyone has an issue with another editor's behavior, it should be handled on a noticeboard. We now have multiple sections devoted to attacking others. That's not ok. No response to this is needed... just concentrate on article improvement from here on out, please. Thanks. — Jess· Δ♥ 00:48, 4 May 2011 (UTC)
Comment re: Jess and Ludwig Ludwig seems fair & reasonable. I quote him below, indented.. His purpose is entirely reasonable, fair & appropriate. This is the intent of Wikipedia. Jess -- while it is nice to discourage argument, you reveal an inappropriate inherent bias -- tolerating one editor's disruptive & abusive behaviour, while essentially telling another more-reasonable & fair-minded editor that they should both 'settle down'. Ludwig is entirely fair and reasonable, and not try to push some particular philosophical point of view. The atmosphere in this article is extremely toxic & unpleasant, has driven off most genuine contributors, and you are contributing to this by permitting & validating abusive & inappropriate behaviour. See Ludwig's quote, below.202.37.64.48 (talk) 01:14, 4 June 2011 (UTC)
- With respect to your substantive comments... This is an article about acupuncture, not an article about the scientific criticism of acupuncture. while I agree that the scientific criticism needs to be there, we do not need to pack the lead with multiple separate claims about the same weakness; one line is sufficient for framing, and we can draw out the specifics in the body more extensively as appropriate. Please remember that it is not the purpose of wikipedia to make an argument that acupuncture is flawed. We simply describe acupuncture, including its flaws and critiques, in a way that makes the subject clear to readers. Filling out the lead with excessive critiques is an effort to make an argument; balance is needed. right? [Ludwig, quoted by TW.]
Comment from a non-editor Although I do not edit articles of this kind, I requested that the article be fully protected for a short period while the disputed changes to the lede were discussed. The whole form of the lede was changed in a single edit, described as a "copy-edit". Given that, discussing such major changes sentence by sentence does not seem to be a helpful way to move forward. My suggestion is that the previous lede be restored and that arguments for the proposed new lede should be presented and discussed here (per WP:BRD). Thanks, Mathsci (talk) 08:16, 4 May 2011 (UTC)
- Now that we have entered actual discussions about the content (for the record: OrangeMarlin has so far not been involved in this at all), I support this proposal undere the optimistic assumption that there will be an actual constructive discussion rather than all the sceptics running away because it's been reverted back to a version in which a third of the lead is made up by the following and blocking any improvements ensures that it stays that way:
Template:Blockquotetop
Acupuncture being effective beyond the placebo effect has never been proven, except some pain relieving applications, though the latter results are somewhat inconsistent as well.
[...] and there is no anatomical or scientific evidence for the existence of qi or meridians; concepts central to acupuncture theory.
The evidence for acupuncture's effectiveness for anything but the relief of some types of pain and nausea has not been established. Systematic reviews have concluded that acupuncture is no more effective than nonpenetrating stimulation of one point to reduce some types of nausea. Evidence for the treatment of other conditions is equivocal. Although evidence exists for a very small and short-lived effect on some types of pain, several review articles discussing the effectiveness of acupuncture have concluded it is possible to explain this as a placebo effect.
A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including 38 cases of infection, 42 cases of trauma and 5 cases of death. The authors considered the adverse events to be statistically significant. Publication bias is a significant concern when evaluating the literature.
Template:Blockquotebottom
- In case someone still doesn't see the problem, while every single sentence is probably correct, a large part of this is not the kind of high-level summarising that we normally expect in a lead. There is some obvious redundancy, such as the first and third sentence saying almost exactly the same thing. I am not seeing this phenomenon for the first time; it appears to be caused by a perceived necessity that every single lead paragraph debunks the subject of the article to some extent, and that at least one paragraph is fully devoted to debunking the subject. Of course this technique of hitting the reader with 16 ton weight right at the start ensures that (1) they stop reading, and (2) if for whatever reason they do continue reading, they take everything negative said in the article about acupuncture with a pound of salt. Unless they are already subscribed to the Skeptical Inquirer and are used to this amateur debunking style.
- As a very minor observation, the previous version of the lead had "that treats patients by insertion and manipulation of needles" in the first sentence. At homeopathy there was once extreme opposition against using "treat" in this non-technical sense. Having seen Middle8 use the word in its technical sense of treating effectively, I am now more inclined to believe that this is a legitimate point. Ludwigs2's edit solved this problem. Hans Adler 08:47, 4 May 2011 (UTC)
- Mathsci:
- Can you document where you made this request? it's not at the edit-warring thread I opened.
- It was a copy edit and rewrite for clarification (as I explicitly said), and no one has pointed out anything actually problematic with the revision (it's all vague, unsubstantiated worries about POVitude).
- Given what's happened at the page in the last few days, I suggest that any attempt to undo the revision again without thorough talk page discussion can be viewed as an effort to resume edit warring on the page, and I will treat it as such. It's not going to harm anything for the version of the page you dislike to remain in place for a few days while you explain (clearly and succinctly) why you dislike it.
- That being said, I will set up the side-by-side comparison you asked for below, in a separate section. --Ludwigs2 17:24, 4 May 2011 (UTC)
- I second MathSci's proposal. This is in accord with WP:BRD, and is how this dispute should be handled. The appropriate route is not to "keep the new proposal until there's consensus to revert it", it's to revert the proposal and discuss the reason to add it. Once again, if there are issues with an individual editor being disruptive, that's no reason to treat all objections from other editors as disruptive as well. I raised valid concerns above regarding weight which must be addressed. Regarding Hans' comment, I agree that we should avoid using "treat" in the previous first sentence, and as such, I'm in agreement with the first sentence change. That said, the entire "copy edit" change should be undone, with individual changes applied which are either non-contentious or with consensus support. Policy is BRD, not "BDR". — Jess· Δ♥ 17:41, 4 May 2011 (UTC)
- Mathsci:
- Jess, nothing needs to be or should be undone until the issue is discussed. --Ludwigs2 23:30, 4 May 2011 (UTC)
- I disagree, and per the support here and in the variety of editors initially reverting, I think it's reasonable to adhere to the BRD cycle. I've reverted to the stable version on those grounds. We can discuss individual changes here, and incorporate those as consensus allows. Thanks. — Jess· Δ♥ 23:49, 4 May 2011 (UTC)
- and I'm reverting back, because no valid reason has yet been given in talk for reverting the material. --Ludwigs2 00:59, 5 May 2011 (UTC)
- Ludwigs, you've been reverted by myself, Orangemarlin and Snowded, and restoration of the previous version has been supported on this talk page by myself, MathSci, Hans Adler, and LSD (below). I see no one besides yourself supporting your proposal stay while the issue is discussed. Furthermore, guideline dictates that the proposal be reverted followed by discussion, not the other way around. Per policy, and consensus support, I'm going to revert to the stable version again. This is the last time I'll do this. Considering your 9 blocks (5 for edit warring), I'd highly suggest working collaboratively rather than combatively on this issue, and avoid edit warring until consensus for the inclusion of your proposal is reached. If you continue to institute your version against consensus, I will take the issue to AN3. Furthermore, your assertion that "no valid reason has been given" is incorrect, as multiple editors have lodged objections, myself included. I'd very much appreciate if you worked with other editors, rather than against them, on this issue. All the best, — Jess· Δ♥ 01:38, 5 May 2011 (UTC)
- Jess, I don't regard this as satisfactory in the slightest. Just a few weeks ago, I was discussing this introduction with WLU and the (extremely hostile, irrational editor) who is unable to consider logical balance of his worldview. We -- me and WLU -- reached a reasonable agreement, with a well-written introduction text. What is the sudden need to change things? Other than to push a POV.
- I'd also like to raise the fact that the claimed Cochrane 'review of reviews', omits, according to my understanding, every single piece of Asian research into acupuncture. Doesn't assign it a partial weight, doesn't consider it with a reduced-weight Bayesian algorithm.. it gives it a zero weight.
- In terms of 'information analysis', in the professional field (signal-processing, document-processing, opinion- or intelligence-gathering, building a radar system) this would be considered a FAIL.
- And if this counts as legitimate science, then the Church should have just 'omitted' Galileo's research in their 'review' of theories they didn't like. (Yep, I know you guys are skeptics -- and you will damn well need to learn to consider both sides equally, not just exercise some pack of assumptions on what you assume not to work.)
- You guys would be busy shouting down continental drift, if it was a hundred years ago. No?
- Twhitmore.nz (talk) 03:54, 1 June 2011 (UTC)
Thanks for bringing this up. The left-hand one, is the correct form for an Introduction section. Introductions, are meant to be a summary of the *primary* nature of the topic. Weasel words and negative phrasing such as "ostensibly" and "purports", should not be used to inappropriately cast doubt & introduce negative aspertions; this would be a negative POV.
Describing "into the skin" and "manipulated in various ways", detracts from the directness & clarity of the explanation; and in the right-hand example, is primarily used as prelude to introducing negative "ostensibly" phrasing.
Read my examples:
- Toothpaste ostensibly does not cause cancer. [Mid-to-strong negative perception]
- Apples are ostensibly free of pesticide. [Highly negative perception]
- Colin offers a purported investment. [Highly negative]
For those with a genuine interest in writing & style: I recommend 'The Economist' Style Guide. This is the leading style guide, for the English language. Twhitmore.nz (talk) 03:32, 1 June 2011 (UTC)
side-by-side comparison of ledes
old version | revised version |
Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body. Its proponents variously claim that it relieves pain, treats infertility, treats disease, prevents disease, promotes general health, or can be used for therapeutic purposes.[1] Acupuncture being effective beyond the placebo effect has never been proven, except some pain relieving applications, though the latter results are somewhat inconsistent as well. Acupuncture typically incorporates traditional Chinese medicine as an integral part of its practice and theory. However, many practitioners consider 'Traditional Chinese Medicine' (TCM) to narrowly refer to modern mainland Chinese practice.[2] Acupuncture in Japan and Korea, and to a certain extent Taiwan, diverged from mainland China in theory and practice. In European countries such as the UK almost half the practitioners follow these non-TCM practices.[3] The most notable difference is that these other approaches often are primarily acupuncture, and do not incorporate Chinese herbal medicine. The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in acupuncture points.[4][5] Acupuncture dates back to prehistoric times, with written records from the second century BCE.[6] Different variations of acupuncture are practiced and taught throughout the world.[7] Ideas of what constitutes health and healing differ from concepts used in modern scientific, evidence based medicine.[8][9][10] Traditional acupuncture was developed prior to the understanding of human anatomy and cell theory upon which modern biology is based, and there is no anatomical or scientific evidence for the existence of qi or meridians; concepts central to acupuncture theory.[11][12][13][14][15] The evidence for acupuncture's effectiveness for anything but the relief of some types of pain and nausea has not been established.[16][17][18][19] Systematic reviews have concluded that acupuncture is no more effective than nonpenetrating stimulation of one point to reduce some types of nausea.[20] Evidence for the treatment of other conditions is equivocal.[21] Although evidence exists for a very small and short-lived effect on some types of pain, several review articles discussing the effectiveness of acupuncture have concluded it is possible to explain this as a placebo effect.[16][22][23] A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including death.[19] Publication bias is a significant concern when evaluating the literature. Reports from the US National Center for Complementary and Alternative Medicine In America (NCCAM), the American Medical Association (AMA) and various US government reports have studied and commented on the efficacy of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles.[12][24][25][26] |
Acupuncture is an alternative medicine in which thin needles are inserted into the skin and manipulated in various ways, ostensibly to influence the patient's qi for therapeutic benefit. It is closely related to Traditional Chinese Medicine (TCM), sharing the same core philosophy and often being used in combination with TCM herbal preparations, but many acupuncturists construe TCM narrowly as the modern mainland Chinese practice and see acupuncture as a distinct concept,[2] particularly in Korea, Japan, Taiwan, and prominent European practices derived from those, where acupuncture has diverged significantly from Chinese theory and practice.[3] The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in acupuncture points.[4][5] Acupuncture dates back to prehistoric times, with written records from the second century BCE.[6] Different variations of acupuncture are practiced and taught throughout the world.[7] Traditional acupuncture was developed prior to and independently of western advances in medicine and is based on a different conception of the human body. Many of its presuppositions - such as qi or meridians - have no identifiable correlates in western medicine, and even its conceptions of bodily organs is different, treating them as interrelated systems rather than discrete objects in the body.[11][12][13][14][15] Acupuncture is a general system of medicine which claims to address a broad range of physical concerns. It may be used by practitioners as a tool to promote general health, for relief of symptoms, or for therapeutic purposes.[1] Acupuncture's effectiveness for anything beyond the relief of some types of pain and nausea has not been established,[16][17][27][19][21] and its effectiveness with pain is often cast as a placebo effect.[16][22][23] A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including 38 cases of infection, 42 cases of trauma and 5 cases of death. The authors considered the adverse events to be statistically significant.[clarification needed][19] Publication bias is a significant concern when evaluating the literature. Reports from the US National Center for Complementary and Alternative Medicine In America (NCCAM), the American Medical Association (AMA) and various US government reports have studied and commented on the efficacy of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles.[12][24][25][26] |
the revised version isn't missing anything significant, is better written and more focused, and more clearly describes both the practice and the critiques of acupuncture? Can anyone point to specific problems or general trends in it that are troubling?
Note further that I didn't actually get to the last paragraph (before the edit warring started, but it will have to be revised as well. The revision I intend to make there is this:
current version of last paragraph | intended revision |
A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including 38 cases of infection, 42 cases of trauma and 5 cases of death. The authors considered the adverse events to be statistically significant.[clarification needed][19] Publication bias is a significant concern when evaluating the literature. Reports from the US National Center for Complementary and Alternative Medicine In America (NCCAM), the American Medical Association (AMA) and various US government reports have studied and commented on the efficacy of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles.[12][24][25][26] |
A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles.[12][24][25][26] |
This does the following:
- removes numerical referents that have no statistical baseline, as discussed above.
- removes a comment about 'statistical significance' which is statistically meaningless as written
- removes an off-topic statement about publication bias (probably true in general, but not specific enough to acupuncture to appear in the lead)
- removes a vague statement that various organizations have 'studied and commented on' acupuncture (the line adds nothing meaningful that I can see).
are any of these changes problematic? --Ludwigs2 17:43, 4 May 2011 (UTC)
- Clearly the latter change, which whitewashes the discussion of the adverse effects, will not fly. The existence of those effects can easily be cited to high quality review sources, e.g. PMID 21440191. For editors who are interested, the historic inconsistency in reporting adverse events is discussed at PMID 20026952, though I don't suggest that discussion belongs in the lede. The point is that asserting the absence based on analysis of old data is not diligent. LeadSongDog come howl! 18:59, 4 May 2011 (UTC)
- 'Whitewashing'? What absolute nonsense. Ill-effects of acupuncture are exceedingly minimal, and almost certainly insignificant comapred to Western medicine. Aspirin and paracetamol both have complication/fatality rates between 1 in 3,000 and 1 in 8,000.. it's completely illogical (and outright false) to decry acupuncture ill-effects, at rates of 1 per 100,000, 1 per million or less. Twhitmore.nz (talk) 01:38, 3 June 2011 (UTC)
- I'm sorry, I'm not sure what you're referring to by 'whitewashing'. I explained quite clearly why I removed the bits I did, and all the explanations had to do with sourcing and relevance issues. any of these points might be redeemable with better sourcing or clearer explanation, but as they stand they are senseless and irrelevant to the topic. Just to take the first point (which is what you linked to) - 95 cases of severe adverse effects out of what number examined? 95 cases out of 100 would be horrific; 95 cases out of 1000 would be bad; 95 cases out of a million would not be worth mentioning.
- LSD, the problem you're having is that you're pointing to abstracts rather than articles. you need to go to the actual article to substantiate this claim, because the abstract does not present a clear picture of what the authors were doing. find a copy of the article that we can all see, so that we can examine the study properly, or face the fact that we need to limit how we reference this study in order not to misrepresent it. --Ludwigs2 20:52, 4 May 2011 (UTC)
- I agree with LSD, and oppose the proposal to the last section. However, I do think the sentence quoting specific numbers can be omitted. Citing so much from this individual study in the lead doesn't properly summarize the weight of the study presented in the article, and Ludwigs is correct about the statistical significance, at least in part; Saying "the authors found it to be significant" is okay, per se, but unnecessary. I do think a list of adverse effects in the lead is warranted, but perhaps we could sum up those effects as a list with no numbers, instead combining all the reports from various studies we're already presenting within the article. — Jess· Δ♥ 00:07, 5 May 2011 (UTC)
- You agree with LSD on what? Neither of you has said anything meaningful enough to agree with.
- Also, 'significance' has a particular meaning in statistics, and it should never, never be confused with the colloquial meaning of he word (it means 'likely not due to random chance', not 'meaningful and important'). we cannot simple state 'the authors claim it was significant' without clarifying which of those meanings is being used. --Ludwigs2 00:58, 5 May 2011 (UTC)
- I've reread both LSD's and my response, and I'm having trouble understanding your confusion. Both seem to be fairly clear. Perhaps I can summarize them in a different way. LSD is saying that your proposal removes the list of adverse effects from the lead, which is unwarranted given that they can be cited to high quality sources. I agree that this is unjustified, given that the sources are present and that the information is being presented in the article, and is pertinent to be summarized within the lead. Furthermore, I provided an alternate suggestion, taking into account your concerns, suggesting that the numbers and statement of significance should be removed as they are unnecessary and provide undue weight to a single study. In other words, I object to the proposal on a high level, but I think the individual concerns might be addressed through alternate changes. Is that clearer? All the best, — Jess· Δ♥ 01:55, 5 May 2011 (UTC)
- perhaps I am being unclear. Let me sum this up in three points:
- the list of adverse affects can be discussed in talk - I'm not averse to including it - but it is currently sourced to an abstract, not an article. we need to see the article itself to understand the claim properly
- we agree on the numbers and significance points, so that's not a cause to revert my changes whole cloth
- nothing has been said whatsoever about the remainder of my edits, so reverting everything in bulk to address one discussed issue is entirely uncalled for.
- You have in no way made an effective justification of broad-scale reversion. I'm going to take a short break and consider my options for moving forward on this - I suggest you take that time to undo your revert and make a more effective argument for your position here in talk. Up to you, however... --Ludwigs2 02:11, 5 May 2011 (UTC)
- perhaps I am being unclear. Let me sum this up in three points:
- If you want to keep arguing about the edit war, that's up to you I guess... but I just gave you solid criticisms of your proposal, and your response to me was effectively "We can talk about it". I know we can talk about it... that's what I'm trying to do, as clearly as I can. Regarding sourcing, your objection that you can only see the abstract is a weak one, since it doesn't address the content which is summarized in the abstract, nor does it imply that the paper is wholly unavailable to you or other editors. I also see a variety of other sources regarding adverse effects already present in the article. Quickly skimming the criticism section, I'm finding cite 19, 25, 143, 145, 146, 147, 148 and 149 cover the topic. To be clear, is your contention with this content that it is not properly sourced? — Jess· Δ♥ 02:23, 5 May 2011 (UTC)
- Jess, the problem with using the abstract is that the abstract is not making clear statements - it's impossible to determine what the authors are referring to without reading the full article, and therefore the material cannot be used carelessly. Abstracts are intended to be teasers, not analytical statements in their own right.
- If you want to keep arguing about the edit war, that's up to you I guess... but I just gave you solid criticisms of your proposal, and your response to me was effectively "We can talk about it". I know we can talk about it... that's what I'm trying to do, as clearly as I can. Regarding sourcing, your objection that you can only see the abstract is a weak one, since it doesn't address the content which is summarized in the abstract, nor does it imply that the paper is wholly unavailable to you or other editors. I also see a variety of other sources regarding adverse effects already present in the article. Quickly skimming the criticism section, I'm finding cite 19, 25, 143, 145, 146, 147, 148 and 149 cover the topic. To be clear, is your contention with this content that it is not properly sourced? — Jess· Δ♥ 02:23, 5 May 2011 (UTC)
- So here's what I'm going to do: I'm going to recover the revision I made, modify it to address these concerns (meaning that I'll re-add in the bits that you're commenting on, with verification tags until we get access to the full article), and then reinsert it in the lead. I'll also remove the numbers that you seem to agree with me about deleting from the third paragraph. ok with you? --Ludwigs2 01:04, 6 May 2011 (UTC)
The third paragraph is a solid whitewash per both Jess and LSD. This is why I reverted originally. I won't spend an hour rewriting, when, per WP:BRD, the editor that adds POV must defend his or her edits, so it's easier with one click to keep the better version. Luddie has not defended it to the point where it receives a strong consensus to change. And this is why I cannot stand the hostile editing environment pushed by Luddie and his pals. OrangeMarlin Talk• Contributions
- There's a certain group here, pushing an aggressive partisan POV onto other people's articles. You've been angry, irration, hostile & aggressive in your comments and interaction -- both with me & others. Don't accuse others, of your sins.
- I made a sound, logical & reasonable proposal, to address the excessively negative & biased tone which had been introduced into the article.
- You attacked this attempt to seek reasonable neutrality, as "POV pushing" and "soapbox" -- without being able to at all address the major logical points.
- 1) Acupuncture is not within Western science; and is not yet fully understood or encompassed, by such a framework;
- 2) Primary scientific investigation & research, has yielded significant results, and is more likely to be on the basis of "understanding" rather than "debunking";
- 3) Much-touted reviews, manage to find negatives by omitting *all* Asian research results;
- 4) Issues of complications, are probably much lower than Western medicine.
Twhitmore.nz (talk) 01:38, 3 June 2011 (UTC)
- I would support removing the numbers, phrasing it as something like "it is generally recognized as low-risk, though infection, trauma and death have occurred due to acupuncture treatments." I don't think the numbers are that meaningful but it is worth noting these serious direct outcomes.
- I'm not sure why publication bias would be removed, as it is indeed a concern regarding acupuncture research. WLU (t) (c) Wikipedia's rules:simple/complex 14:18, 5 May 2011 (UTC)
- WLU, I added those numbers because Luddie was hostile towards my original changes. I think they're kind of silly, because, as the article states, the adverse reactions are statistically significant. It's always nice to have access to the full article. I wish they would be linkable to Wikipedia, instead of costing. OrangeMarlin Talk• Contributions 18:30, 5 May 2011 (UTC)
- OM, it's Ludwids2, not Luddie (or else you're going to be Marliebaby from now on; I'm good either way. )--Ludwigs2 01:06, 6 May 2011 (UTC)
- @Ludwigs2 Regarding your comment above (01:04, May 6), I've made a number of criticisms of your proposal which should be addressed. There are others, but I'd have to address those after seeing how the content is affected your updated revision. Given the opposition to this recent edit, reinserting it into the lead without discussion first would be preemptive. The most appropriate course of action at this point would appear to be revising the content to address the concerns listed here, and then proposing the change on the talk page. If it gains consensus, then it should be okay to reinsert. All the best, — Jess· Δ♥ 01:42, 6 May 2011 (UTC)
- I am new here. Not sure if my opinion counts for much. For what it is worth, I think there is too much detailed business going on in what you people refer to as the "lede". (Or is that the Wikipedia spelling for "lead".) I prefer the edits suggested above as it is more succinct and has less specific details. I am purely about aesthetics, but giving specific numbers and details in that third paragraph particular looks clunky and is not what I consider to be a good "introduction" or lead or lede to an article. —Preceding unsigned comment added by 67.127.100.144 (talk) 02:43, 6 May 2011 (UTC)
- WLU: I see no reason to edit on a subpage. the proposed edits have been presented here, they are largely non-contentious (except for a couple of points that are open to discussion), and moreover no one offered any meaningful objections to the revision as a whole, so there's really nothing to stop me from going ahead with them. offer suggestions or objections with respect to what I have written here already if you like, but please don't obstruct page development for no readily apparent reason. thanks. --Ludwigs2 02:50, 6 May 2011 (UTC)
- If "non-contentious" means two large sections devoted to editors lodging objections, then I think we're using very different definitions. Asking you to seek the input of other editors before making changes which have been the subject of this much discussion seems quite reasonable, and ignoring those requests would appear to be erring on the disruptive side. Please just propose the change you'd like to make, and see if it garners support. I'd be happy to provide input once you've revised your proposal. — Jess· Δ♥ 03:14, 6 May 2011 (UTC)
Subpages offer a distinct advantage over both mainspace and talk space - you won't get auto-reverted, yet people feel free to edit over other people's work much like a mainspace page and allows for a diff-by-diff comparison which is often much easier to parse, particularly across multiple differences. I can't help but agree with Mann jess that your interpretation of "noncontentious" may be idiosyncratic, at least as far as this page goes. My suggestion would be, use a subpage and if I think the section has merit but needs improving, I will edit that. It's often easier to incrementally improve a proposed lead in a subpage simply because it can be incremental. WLU (t) (c) Wikipedia's rules:simple/complex 04:03, 6 May 2011 (UTC)
- Collaborative editing works by different editors making revisions to the article and discussing differences of opinion in talk. The changes I edited in - despite the extreme over-reaction of some editors here - are relatively minor, and any problems with them can easily be fixed with short discussions, assuming that the other editors here choose to discuss them. So far, almost no one has shown any interest in discussing the changes. That's fine. However, none of you are entitled to stop me from editing the article simply because you have some vague, inexpressible fear about the outcome, and I am not inclined to go out of my way making subpages and etc over what amounts to (again) relatively minor revisions. So, I am going to be editing the article. your choices are (as always):
- you can make clear and reasonable objections or clarifications to specific revisions I make in the article, so that we can discuss them and improve them after I've edited them into the article
- you can read over my proposals here and make clear and specific objections or clarifications to the proposals I've made, so that we can discuss them and improve them before I edit them into the article
- you can continue to revert me as I make changes, and continue failing to give clear and specific explanations for doing so, in which case we will quickly end up at ArbCom enforcement.
- Now, as I said, I am going to reinsert my improvements to the lead, making adjustments for the valid complaints that were raised above (which is the way collaborative editing should work). Please read over the boxes above and offer any further suggestions that you care to. With luck, we'll find that we quickly resolve this issue to everyone's satisfaction. --Ludwigs2 05:34, 6 May 2011 (UTC)
- Forgive me, but it is still very clunky, sloppy and redundant. For instance, that there is a lack of scientific support for acupuncture is mentioned in all three paragraphs. I think the reader gets it after the first mention. Then the first paragraph jumps from a basic definition to the lack of scientific evidence to some detailed information about how the practice varies from country to country to a basic definition to a brief bit about its ancient history to once again describing how practices vary around the world. What a mess! And that's just the first paragraph. How about a little organization?
- The second paragraph begins with a very vague statement which doesn't seem to be about acupuncture specifically and then talks about the lack of scientific evidence again. That there is a lack of scientific evidence is quite obvious now that this opening has stated it twice.
- And yet the third paragraph is devoted entirely to the lack of scientific evidence and risk. It contains such esoteric details that it cannot be proper for an introduction to this encyclopedia entry. Save the point-by-point for the rest of the entry. Just a concise overview should serve the opening. There's nothing wrong with discussing the scientific invalidity of acupuncture, but the degree at which this invalidity is addressed in the opening comes off as argumentatively skewed and combative in nature. The way I read this, I would think that the entire entry - or at least about eighty percent of it - would be about this lack of scientific support. However, reading through the rest of this entry, I know this not to be true. Thus, this opening does not provide the reader with a very accurate depiction of how the rest of the entry reads. "Scientific basis" is just one of the eight main headings of the article
- Reading through this hostile discussion, I confess that as neophyte I am somewhat timid about doing what I know needs to be done. That would be gutting this whole "lede" entirely and converting it to something with a logical structure which works with the flow of the rest of this page's entry, and a more economical writing style. My gut estimation is that this opening should be about half the size of how it stands now. —Preceding unsigned comment added by 67.127.100.144 (talk) 08:26, 6 May 2011 (UTC)
- IP I fixed the indents on your post. are you talking about the current lead, or the revised version presented at the top of this thread? Sorry, it's not clear from what you wrote. --Ludwigs2 15:17, 6 May 2011 (UTC)
- @67.127 Please don't feel put off by the current climate. Some editors are having trouble communicating with one another, but it seems we all recognize that changes should be made to the article, and we're working to implement those changes. If you see something that should be fixed, please either propose it here, or (if you expect it won't be controversial) make a bold edit to the article, and see if it's accepted. WLU's suggestion to make a subpage with a new proposed lead is a good one. If you're timid about editing the article directly, making a subpage for your proposal would be a great way to get your ideas out there without butting any heads. All the best, — Jess· Δ♥ 16:38, 6 May 2011 (UTC)
- I don't know how to make a subpage. Though I just figured out how not to lose my prior comment to an edit conflict.
- Ludwigs, your assessment that these are minor changes has been opposed by every editor who has weighed in, as far as I can tell. I'd just like to point out that you've been given large criticisms from a variety of editors, and you've been asked to proceed in a specific way to collaborate with those editors. That is a reasonable request. Your response thus far has been to dismiss the criticisms as "not meaningful", and state that you intend to proceed in opposition to that request, saying things like "none of you are entitled to stop me from editing the article". This is not going down a good road. I'd like to work with you on cleaning up the lead, but if you reinsert content into the article which either fails to address the concerns discussed here, or which introduces new problems, that content will (rightly) be reverted. I'm just noting that here, largely repeating what's already been said above; Your stated approach is combative, not collaborative, and is not likely to get us anywhere good. — Jess· Δ♥ 16:33, 6 May 2011 (UTC)
- @67.127 Please don't feel put off by the current climate. Some editors are having trouble communicating with one another, but it seems we all recognize that changes should be made to the article, and we're working to implement those changes. If you see something that should be fixed, please either propose it here, or (if you expect it won't be controversial) make a bold edit to the article, and see if it's accepted. WLU's suggestion to make a subpage with a new proposed lead is a good one. If you're timid about editing the article directly, making a subpage for your proposal would be a great way to get your ideas out there without butting any heads. All the best, — Jess· Δ♥ 16:38, 6 May 2011 (UTC)
- Thank you for the indentation. I think I have figured that out better now. I was referring to the "lede" currently in place on this article entry. It's a mess. The revised version above is much improved. Though the first paragraph is still a bit jumbled. You need to organize the bit about the history and the various regional practice styles slightly better. The second paragraph is fine, but the third is too specific for an introduction. There is a "intended revision" version which is better but its first sentence is redundant with the second paragraph of the proposed revision version. Though, the second sentence of that "intend revision" is all well and good. Here would be my simple solution, which still could be improved upon:
- Acupuncture is an alternative medicine in which thin needles are inserted into the skin and manipulated in various ways, ostensibly to influence the patient's qi for therapeutic benefit. It is closely related to Traditional Chinese Medicine (TCM), sharing the same core philosophy and often being used in combination with TCM herbal preparations. However, many acupuncturists construe TCM narrowly as the modern mainland Chinese practice and see acupuncture as a distinct concept,[2] particularly in Korea, Japan, Taiwan, and prominent European practices derived from those where acupuncture has diverged significantly from Chinese theory and practice.[3]
- Acupuncture dates back to prehistoric times, with written records from the second century BCE.[6] Traditional acupuncture was developed prior to and independently of Western advances in medicine. Many of its presuppositions - such as qi or meridians - have no identifiable correlation in Western medicine, and even its conceptions of bodily organs is different, treating them as interrelated systems rather than discrete objects in the body.[11][12][13][14][15]
- Acupuncture may be used by practitioners as a tool to promote general health, for relief of symptoms, or for therapeutic purposes.[1] However, acupuncture's effectiveness for anything beyond the relief of some types of pain and nausea has not been established,[16][17][28][19][21] and its effectiveness with pain is often cast as a placebo effect.[16][22][23]
- I removed some sentences and phrases for reasons of flow, redundancy and relevance. For instance, the bit about how it is sometimes used with electrical currents -- that was too specific for an introduction and should rather be mentioned somewhere in the rest of the article entry. It isn't mentioned anywhere else currently, so why mention something so specific in this introduction? I won't presume that my version is perfect, just better than what is in place right now. — Preceding unsigned comment added by 67.127.100.144 (talk • contribs)
- @67.127: Thanks for the proposal. Unfortunately, this leans heavily upon Ludwig's proposal, which he's in the process of revising to address various concerns discussed on the talk page, and consequently, this proposal has those same problems. One, for instance, is that it reduces the weight of acupuncture's efficacy and adverse effects too drastically, and adherence to WP:Weight is a major concern. You are correct, however, that the organization and wording of the lead should be cleaned up, and hopefully as Ludwigs is able to revise his proposal, we can look at what pieces of these suggestions we can incorporate. I've created a subpage with the current lead in place, here: Talk:Acupuncture/Proposed lead. Feel free to edit that with any ideas you have. Making them smaller incremental changes (if possible) might be helpful to follow the progress of edits. All the best, — Jess· Δ♥ 17:29, 6 May 2011 (UTC)
- Just because it relies on Ludwig's proposal doesn't make it bad. Perhaps there is bad blood here which prevents the rest of you from accepting this. Ludwig has provided a better starting point than what is currently in place in the introduction. It is not perfect though. It has the problems which I enumerated above. Also, the statement I kept in tact about efficacy is this: "However, acupuncture's effectiveness for anything beyond the relief of some types of pain and nausea has not been established, and its effectiveness with pain is often cast as a placebo effect." That really says it all succinctly. What more needs to be said in the "lede" that this statement doesn't already say? I am not sure what you mean by "weight", but the rest of the efficacy statements in the current lead all go to support the statement which I retained. If they are only supportive - they don't add anything new except specific details of why acupuncture's effectiveness has not been established beyond that of placebo - then these statements don't belong in the "lede". The reader doesn't need more in the introductory statement. Just a cursory overview of the main points of the rest of the entry is sufficient. Save the details for the body of the entry. —Preceding unsigned comment added by 67.127.100.144 (talk) 19:51, 6 May 2011 (UTC)
- Jess: I'm really not concerned about the numbers of editors who object; I an interested in the reasons editors give for objecting. A thousand editors could come by and say "I don't like it" and I wouldn't care. one editor who comes by and says "I don't like it because..." gets my attention. Thank you for making the subpage, feel free to use, but I'll be discussing things here and editing the article.
- Now, thank you for raising the weight concern (which you probably should have done prior to the first revert you made on the page). I think you're right that the IPs edit goes a little far on removing critiques of acupuncture, but I don't think you can honestly make the same claim about my revision - since in fact I didn't remove very much, but mostly reorganized what was there. can you point to something in my version that you see as problematic in terms of weight? bet you can't... --Ludwigs2 17:44, 6 May 2011 (UTC)
- Your "reorganizations" oftentimes give undue weight to unsupportable information. OrangeMarlin Talk• Contributions 17:48, 6 May 2011 (UTC)
- Ludwigs, my very first edit to this page was on May 3rd, where I said "The new proposal reduces that weight substantially, further adding undue weight to the concept that Acupuncture is effective for some treatments. This doesn't properly reflect the article, or the weight of the sources." This was a full day before my first revert to the article, which was suggested and supported by editors on the talk page. Not to be missed, I referenced concerns with weight again, including on the 4th, immediately before reverting to the last stable version. I subsequently clarified and gave specific examples, in addition to other editors, including my May 4th 9:55 reply, which said "your proposal removes the list of adverse effects from the lead, which is unwarranted". You repeatedly responded that these concerns were "not meaningful". Goading me by saying things like "bet you can't" is out of line. — Jess· Δ♥ 18:13, 6 May 2011 (UTC)
- Jess, these concerns - as you have expressed them - are not meaningful. Anyone can say the words 'undue weight' with reference to anything. Honestly, I have no idea whether you are right or wrong in your assertion that there is undue weight on something, because you steadfastly refuse (with the one notable exception above) to explain what you mean by it. I simply cannot credit your opinion as valid because I could easily train a parrot to give the arguments you've given so far ("undue weight, undue weight, *squawk*, undue weight"). Please give me some better discussion than the mere fact that you have learned how to type the words 'undue weight' on your computer keyboard. If you can't do better than that, then... sorry!
- @Ludwigs (I assume), you asked me to provide a specific example of WP:Weight concerns, and told me I should have cited them prior to reverting you. I provided exact diffs showing I've already done just that. As far as "meaningfulness", your objection to my criticisms broadly fails to address the content of my reply, or provide any indication that you've so much as understood what I've said; Your objection that my reply is "not meaningful" is itself not meaningful. Rejecting large amounts of criticism from a variety of editors all under the vague notion that it's "not meaningful" doesn't get us anywhere. — Jess· Δ♥ 05:26, 7 May 2011 (UTC)
- I have no problem keeping scientific criticism in the lede but insomuch as it isn't redundant or stating something specific from one specific study which only goes to support the general statement that there is a lack of evidence supporting acupuncture's efficacy beyond that of placebo. The lede doesn't need to be more specific than that. The rest of the article entry is for getting so specific.67.127.100.144 (talk) 22:20, 6 May 2011 (UTC)
- I like the first two-thirds of the the proposed revised first paragraph. The first sentence is a better summary of the topic, in particular I think the adjective "ostensibly" is well-chosen and neutral. Moving the list of claimed effects and accompanying questions of efficacy to the second paragraph seems a good choice to tighten the focus of the paragraph, though removing it from the lead altogether would be a mistake. Better agreement on how to present this information in later paragraphs may be needed before it's actually removed from the first. The copyedit of the next few sentences is an improvement.
- However, the final two sentences of the proposed first paragraph are seriously problematic, as they introduce incorrect comparisons to western medicine. "Traditional acupuncture was developed prior to and independently of western advances in medicine" is nonsense. The Ancient Egyptian medicine that was the foundation for western medicine was far more advanced than Chinese medicine in the second and third millennia BCE- heck, Hippocrates himself lived centuries prior to the earliest written records of Acupuncture as mentioned in this article. (For a sufficiently broad definition of medicine both traditions could be said to date back to the stone age, so while perhaps one could argue they have equal age on this basis, the 'prior' claim on behalf of eastern versus western medicine is still nonsense.) This false comparison appears to be a non-neutral exaggeration of its relative age to give an incorrectly positive impression of the practice to the reader. The final sentence of the proposed first paragraph is also nonsense - the claim that western medicine never treats the body organs as interrelated systems is obviously false, and again not neutral. --Noren (talk) 19:17, 6 May 2011 (UTC)
- Noren, I kind of agree with your first points, but I'm really supportive of your second paragraph. This Western Medicine bullshit is just frustrating, especially when Chinese, Indian, Japanese, Singaporeans, and whomever else lives on the Asian continent, use "western medicine," such as surgery, cardiac stenting, beta blockers, plastic surgery, organ transplants....oh, I could create a list that would rival the long treatises of some other editors. There is medicine, backed by evidence, science, clinical trials, peer reviewed studies, and success.....and there's stuff that isn't anything. This eastern vs. western medicine is some sort of strawman argument that fails logic quickly. Anyways, I agree with what you're saying. NPOV matters, and the proposed edits aren't. OrangeMarlin Talk• Contributions 22:38, 6 May 2011 (UTC)
- Okay, how's this then? If it doesn't work, don't criticize it without proposing your own version. Let's see how much we all agree on at the same time and maybe a compromise wil become all too obvious. All we know now is that we all agree that this lede needs to be rewritten. So let's go for it!
- Acupuncture is an alternative medicine in which thin needles are inserted into the skin and manipulated in various ways, ostensibly to influence the patient's qi for therapeutic benefit. Acupuncture dates back to prehistoric times, with written records from the second century BCE,[6] and is closely related to Traditional Chinese Medicine (TCM), sharing the same core philosophy and often being used in combination with TCM herbal preparations. However, many acupuncturists construe TCM narrowly as the modern mainland Chinese practice and see acupuncture as a distinct concept,[2] particularly in Korea, Japan, Taiwan, and prominent European practices derived from those where acupuncture has diverged significantly from Chinese theory and practice.[3]
- Acupuncture may be used by practitioners as a tool to promote general health, for relief of symptoms, or for therapeutic purposes.[1] However, acupuncture's effectiveness for anything beyond the relief of some types of pain and nausea has not been established,[16][17][29][19][21] and its effectiveness with pain is often cast as a placebo effect.[16][22][23]
- 67.127.100.144 (talk) 00:12, 7 May 2011 (UTC)
- @ IP: that's short and sweet, I'll give you that. I'd be ok with it, though I'd like to think on it a bit, because I have a dim and unformed feeling that it's missing something.
- @ Noren and OM: I understand your objections, and even agree with you that it's badly stated. The thing that I was reaching for there was the obvious observation that TCM and modern medicine are largely incommensurate - one cannot map effectively or meaningfully from one to the other without creating nonsense statements. just for example, the bit about equating acupuncture's effectiveness with pain as equivalent to a placebo effect: What does that mean? The placebo effect (scientifically speaking) refers to an effect whose cause is unknown. e.g. if you give someone a sugar pill and they get better, there's obviously some unknown reason they got better, but it's assumedly not the sugar pill that did it, right? Now if Ernst (I think it was Ernst) is saying that acupuncture is no more effective than a placebo statistically that would a powerful statement that acupuncture doesn't work (show the statistics for that and the discussion's over). However, if Ernst is saying that the 'mechanism' of acupuncture is similar to the 'mechanism' of a placebo... well, that's just nonsense: obviously, should acupuncture actually have an effect it would be an effect whose cause is currently unknown. I suspect Ernst is making the latter claim (mostly because acupuncture does no lend itself to placebo-controlled testing at all) and we need to be careful to contextualize statements like that properly to avoid presenting the science of the issue badly.
- Note that this isn't really a worry about acupuncture at all. This is a worry about misrepresenting science on wikipedia. Science gets its power by being clear, rational, and definitive with respect to well-defined evidentiary claims. The more we misuse scientific sources to support ill-defined or exaggerated claims, the more we inadvertently convince readers that science is mostly politics - where scientists 'win' by making other theories look bad - and that just plays into the hands of people who advocate pseudoscience. We don't want to win a battle against pseudoscience in article space just to lose the pedogogical war in the real world. --Ludwigs2 01:00, 7 May 2011 (UTC)
- Thank you for your thoughtful response, Ludwig. I think short and sweet is exactly appropriate for a lede. Please let me know of any critiques after you've sat with it for awhile, and please do so by presenting a version with your changes. When should I expect a response from other participants on this entry?67.127.100.144 (talk) 02:11, 8 May 2011 (UTC)
- Note that this isn't really a worry about acupuncture at all. This is a worry about misrepresenting science on wikipedia. Science gets its power by being clear, rational, and definitive with respect to well-defined evidentiary claims. The more we misuse scientific sources to support ill-defined or exaggerated claims, the more we inadvertently convince readers that science is mostly politics - where scientists 'win' by making other theories look bad - and that just plays into the hands of people who advocate pseudoscience. We don't want to win a battle against pseudoscience in article space just to lose the pedogogical war in the real world. --Ludwigs2 01:00, 7 May 2011 (UTC)
- I would really like to continue this discussion but I cannot keep returning just to check this thread where no one is attempting to work with each other. It seems to me as an outsider that there are a lot of personality conflicts occurring behind-the-scenes to the point where people are less interested in bettering this article entry; more interested in disparaging each other. If this is what WIkipedia is then no-thank-you. So what I am going to do is insert my version into the entry. That might get changed back right away but at least it could restart the discussions here about substance rather than personal grudges. Again if you have a critique of this version please respond with your critique and a version of the lede with your changes. This will better illustrate our differences in opinions and facilitate a compromise.67.127.100.144 (talk) 15:59, 9 May 2011 (UTC)
- Hi 67.127. Again, there are a couple concerns with the revision which have been discussed (in part) above. Right now, I think we're waiting on Ludwigs to provide an improved version of his proposal which addresses those concerns. If you can do that too, that would be great... but I think the best course of action is to propose your change here, and garner support first, before inserting it. Putting it into the article without support, when there's been this much discussion, probably won't do much good, or instill good faith for editors who are contributing. All the best, — Jess· Δ♥ 16:35, 9 May 2011 (UTC)
- Jess, thank you for the response. As I said, I am okay with my edit be changes back (as it was), but why did the editor (Orangemarlin) accuse me of edit warring? That seems rather extreme and is the kind of thing that leads to these personality clashes that have graffiti'd this page. Maybe I am misinterpretting what accusing someone of edit warring means. But why didn't this editor or you propose a revised version as I requested? I know you don't have to comply with my reasonable request, but it occurs to me that this discussion would run smoother if instead of just saying what we don't like about each other's version, we also respond with a version incorporating our critiques. It would feel like we are all interested in putting in the work to make this article better; making contributions rather than just criticisms. As for your comments above, please see that I responded to each of them but received no response back from you. I apologize if I am missing some Wikipedia custom of how to get someone to continue with a conversation. I am trying to learn. In any regard, my response to your main criticism remains: A lede should not contain such narrow specifics that just go to support a broad idea which is already stated quite clearly in the lede. So (for example) it's good enough to write that acupuncture dates back to prehistoric times. We don't have to talk about Shiji and Huangdi Neijing in the lede. The existence of these ancient texts support the idea that indeed acupuncture dates back to prehistoric times, discussion of these texts should be reserved for the body of the article entry. It's unneeded in the lede. The same goes for all of the other topics discussed in the lede and this includes the lack of scientific support for efficacy. It is enough to say acupuncture lacks scientific support; it is unneeded to go into an explanation of clinical science and specific systematic reviews which support the statement. These specifics belongs in the body of the article entry, not in the lede.67.127.100.144 (talk) 17:50, 9 May 2011 (UTC)
- The placebo effect isn't "an effectiveness whose cause is unknown", it's an effect unrelated to the specific effects of the physiological activity of the compound or intervention. We may not understand precisely what is happening in terms of biochemistry - we just know that the results aren't being caused by the medication or anatomical changes brought about by surgery.
- I don't like the proposed lead for a couple reasons - it's TCM first, alt medicine second and the proposed version places emphasis on its modern practice before its historical roots. The use of "ostensibly" casts doubt on the practice, which is warranted, but acupuncture should be described in terms of the TCM explanation (i.e. "Acupuncture's effectiveness is explained in TCM as the result of the manipulation of qi...") followed by the modern explanations, including placebo. The proposed version places emphasis on it's use as a general tonic, rather than going straight into its lack of effectiveness - in other words, it gives undue weight to the claims of practitioners rather than the scientific evidence. It also emphasizes its "safety" when "safety" is a relative measure. Driving isn't as safe as sitting in a steel room with an independent supply of sterile oxygen, water and food, but gets you where you're going faster than continental drift. Emphasis should be placed on the existence of adverse effects (with examples) that are rare in the hands of trained practitioners with sterile needles. WLU (t) (c) Wikipedia's rules:simple/complex 20:12, 9 May 2011 (UTC)
- Thank you for your thoughtful response. My goal was not to give undue weight to the claims of acupuncturists. My goal was to remove the fat. All of the superfluous information and specific supportive facts unnecessary for a proper introduction. My goal was also to make the lede concise and to have some logical flow structurally. WLU, please share with us how you would like to see the lede written so we can see what you have in mind.67.127.100.144 (talk) 20:30, 9 May 2011 (UTC)
@67.127. The problem is that removing details about acupuncture's criticisms has the effect of removing weight from the statement, which in turn places undue weight on the statements regarding its efficacy. That turns out to be a violation of WP:NPOV, since the statements regarding scientific support are well sourced to high quality sources. So, while it may shorten the lead, it's a line that we have to trot carefully to avoid changing emphasis without proper cause. To answer your question about other editors making proposals, it's great when an editor can do that, but we can't expect every editor who lodges an objection to a proposal to provide one of his own. There are a variety of reasons for this, above all else that the editor may not have time to rewrite the content now. If so, this doesn't dampen his objections to the new content, which must stand on its own. Some editors here may also not think that the lead needs a rewrite at all, and if so, asking for a new proposal when they object to yours would defeat the point. All in all, the new proposal has to be an improvement over the existing one, and cannot introduce new problems to the article, or be a violation of policy. Until it meets that criteria, it has to be kept out while it's being worked on. You're welcome to continue doing that, of course! I would recommend not reintroducing it to the article again, however, until you have some support on this page. All the best, — Jess· Δ♥ 21:44, 9 May 2011 (UTC)
- Thanks again for the response. Can I ask if you specifically have the time or interest in writing up a proposal for the lede? I think you are among those who agree that the current lede is a mess and needs help. And in fact, I don 't see anyone above arguing that we leave it as is.
- I don't quite yet have a grasp on the concepts of NPOV and undue weight, so I apologize right off the bat for that. I have read a lot about these Wikipedian concepts but am still not quite comfortable with them in practice. I appreciate your continued patience and guidance here. And I don't have plans to re-insert my version of lede. My stated goal was to restart this stalled conversation. And it has! So yay for that. :-)
- So please help me out here. By removing from the lede all of the specific scientific reviews that state that acupuncture is not effective for this or that ailment specifically, how am I putting too much "weight" on the general statement that acupuncture has not been shown to be scientifically effective for much of anything at all? I thought that was a pretty faithful summary for the entire "Scientific basis and research on efficacy" entry. Are you saying that a faithful summary cannot stand on its own in the lede without including supporting details from that section? By not including the specific supportive statements am I making the weight for the general statement stronger or weaker? And how should it be if not just a neutral summarization of what is presented in the rest of the article? It seems redundant and "non-lede-like" to include a statement like "A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy" in the lede when we are already stating "The evidence for acupuncture's effectiveness for anything but the relief of some types of pain and nausea has not been established." 67.127.100.144 (talk) 22:58, 9 May 2011 (UTC)
- I've been hoping to propose a change at some point, but I don't have the time now. As of now, all I can really do is participate in the discussion. Regarding WP:NPOV and WP:Weight - these can be tricky policies to get a handle on right off the bat... they apply differently in different cases, largely dependent on what type of sourcing we have available. I would suggest, as you're becoming acclimated with everything now, that you create an account, and place {{[[WP:Adoption|adoptme]]}} on your user page. This will request that an experienced user helps answer questions and get you acclimated with some of our policies. Many new users find this helpful to adjusting to the site. In this case specifically, we need a neutral way to say "Acupuncture claims efficacy in a broad range of areas (including X, Y, Z), but these claims lack scientific support. Clinical trials have concluded that acupuncture is not effective treatment for ailments besides nausea, and has serious risks (including U, V, W)." Ultimately, all of that needs to be said, and needs to be presented with proper emphasis. The current proposal (based on Ludwig's) pushes emphasis from the end of that content to the beginning (i.e. from 'criticisms' to 'claims'), which gives the reader a greater impression of the claims being made over its actual efficacy as concluded by the scientific community. Based on the sources we have available, and per WP:Weight, that's an unwarranted shift of emphasis. We should probably trim the lead, sure, but not at the risk of compromising policy. Does that make more sense? — Jess· Δ♥ 23:50, 9 May 2011 (UTC)
- It does help, Jess. It is appreciated. So you are saying that the problem you have with Ludwig's proposal is that it puts statement A before statement B when you think it should be B before A. I think what's important here is that you both this A and B belong in the lede, but you are only disputed the order in which they are presented. It's this kind of common ground which becomes apparent when we start being more specific with what we want to see done in the lede rather than just critique what others are suggesting. I bet we are all pretty close to agreement. Closer than we think. When you do have time, please do propose a change to the lede as I think it will reveal more about what yours has in common with Ludwig's and my proposals. And that will bring us to an agreement much quicker and more painlessly than merely providing a criticism, which so often is taken personally whether intended or not. It is easy to criticise; harder to contribute. So if we all put in a little bit more effort to contribute, I think we will all reach an accord much faster. Thanks again, and know that I am very close to pulling the trigger on setting up my own account. I appreciate your advice.67.127.100.144 (talk) 00:07, 10 May 2011 (UTC)
- I've been hoping to propose a change at some point, but I don't have the time now. As of now, all I can really do is participate in the discussion. Regarding WP:NPOV and WP:Weight - these can be tricky policies to get a handle on right off the bat... they apply differently in different cases, largely dependent on what type of sourcing we have available. I would suggest, as you're becoming acclimated with everything now, that you create an account, and place {{[[WP:Adoption|adoptme]]}} on your user page. This will request that an experienced user helps answer questions and get you acclimated with some of our policies. Many new users find this helpful to adjusting to the site. In this case specifically, we need a neutral way to say "Acupuncture claims efficacy in a broad range of areas (including X, Y, Z), but these claims lack scientific support. Clinical trials have concluded that acupuncture is not effective treatment for ailments besides nausea, and has serious risks (including U, V, W)." Ultimately, all of that needs to be said, and needs to be presented with proper emphasis. The current proposal (based on Ludwig's) pushes emphasis from the end of that content to the beginning (i.e. from 'criticisms' to 'claims'), which gives the reader a greater impression of the claims being made over its actual efficacy as concluded by the scientific community. Based on the sources we have available, and per WP:Weight, that's an unwarranted shift of emphasis. We should probably trim the lead, sure, but not at the risk of compromising policy. Does that make more sense? — Jess· Δ♥ 23:50, 9 May 2011 (UTC)
Possible draft lead
See Talk:Acupuncture/Proposed lead. It's essentially a hybrid of this lead and the current. It needs sources to be filled out, but for every ref tag there is a citation and it should be a good one - the old lead was one I worked on personally and I tend to be a stickler for scholarly publications. WLU (t) (c) Wikipedia's rules:simple/complex 10:39, 10 May 2011 (UTC)
- I give it thumbs up on my first reading and I give you a well-deserve thank-you. I will look at it closer and let you know if I have any comments and will offer specific revisions if I do. But it does seem succinct and well-organized. Great work!67.127.100.144 (talk) 15:35, 10 May 2011 (UTC)
- Okay, looking at the first paragraph only, I wonder if we can't shorten it a bit by cutting out some of the specificities.
- WLU's first paragraph:
- Acupuncture is a form of traditional Chinese medicine that involves inserting and manipulating filiform needles into various acupuncture points on the body to relieve pain or for therapeutic purposes. The earliest written record of acupuncture is the Chinese text Shiji (史記, English: Records of the Grand Historian) with elaboration of its history in the 2nd century BCE medical text Huangdi Neijing (黃帝內經, English: Yellow Emperor's Inner Canon). Though thought to originate in China, variations in theory and practice are taught throughout the world mainly differing in their use of Chinese herbology,[citation needed] selecting different points to needle, or in modern applications, applying an electric current to the needles. A related traditional practice is moxibustion (灸), the burning of cone-shaped preparations of Artemisia vulgaris (mugwort) on or near the skin often in proximity to acupuncture points.
- Compared to:
- Acupuncture is a form of traditional Chinese medicine that involves inserting and manipulating filiform needles into various acupuncture points on the body to relieve pain or for therapeutic purposes. Though thought to originate in ancient China, variations in theory and practice are taught throughout the world mainly differing in their use of Chinese herbology,[citation needed] selecting different points to needle, or in modern applications, applying an electric current to the needles.
- Essentially, I got rid of second sentence which spoke about specific written records which tell specifically how old acupuncture could be and instead just added "ancient" to describe "China" in the following sentence. I think that suffices for a lede without getting so specific. Also, I removed the last sentence about "moxibustion". I don't think that is important enough to the rest of the article to qualify for the lede. These thoughts of mine aren't make-it-or-break-it issues for me in terms of finding a compromise. I just want to make you fully aware of how I look at a lede in terms of writing style. It should be broad, succinct, and well-written. Before I analyze the next paragraph, I would like to hear from WLU and the others here to see if this penchant for brevity by way of lack of specificity is a good Wikipedian practice.67.127.100.144 (talk) 16:42, 10 May 2011 (UTC)
- I like the inclusion of brief mentions of specific texts. Keep in mind the entire history section is essentially summarized in that single line, it's worth keeping. Moxibustion almost always accompanied acupuncture historically, this should be reflected in the lead and in the body. The two were considered mutually supporting and complementary, it would be like a history of the internet without mentioning the telephone. WLU (t) (c) Wikipedia's rules:simple/complex 18:39, 10 May 2011 (UTC)
- Okay. I guess I have a lot to learn about how ledes are written here at Wikipedia as opposed to the academic world. I just want to make it clear, because there seems to be some confusion, I am not for reducing the amount of words dedicated to discussing the lack of scientific support of acupuncture because I have a pro-acupuncture agenda. I don't think any of my edits should suggest that. I am for reducing the overall amount of words in the entire lede because I believe ledes should be concise. There were some assumptions made here about who I am and what I stand for and that was really troublesome. I came to Wikipedia last week simply because I wanted to learn something about Acupuncture. I read the article, got confused about one section and decided to make my first edit ever. I joined in the conversation here because I found the entire article to be well-written except for the lede. My goal was to make it more streamlined and I think WLU's proposal - while it does not completely satisfy me - it is without a doubt a hell of a lot closer to that than the jumble, overwritten mess that's in place now. I'd be all for implementing it and then seeing where it goes from there.67.127.100.144 (talk) 19:37, 10 May 2011 (UTC)
- I like the inclusion of brief mentions of specific texts. Keep in mind the entire history section is essentially summarized in that single line, it's worth keeping. Moxibustion almost always accompanied acupuncture historically, this should be reflected in the lead and in the body. The two were considered mutually supporting and complementary, it would be like a history of the internet without mentioning the telephone. WLU (t) (c) Wikipedia's rules:simple/complex 18:39, 10 May 2011 (UTC)
This article is inappropriately negative. It's meant to be about Acupuncture, not 'Acupuncture Skepticism'.
Acupuncture is a long-established form of treatment, coming from a pre-scientific background. The fact of this background does not in way, prove it is not effective or does not work -- that is a logical fallacy. It is inappropriate for this page, intended to be about Acupuncture, to be hijacked to convey a clear skeptical POV. This page should be removed from the purview of the 'Skepticism Project'. They can write a counter-page if they want.
Acupuncture has been of significant scientific interest, for a long time. With many studies ongoing. It is unlikely it would be of such interest, in finding the means, if there were no effect.
Many current studies, appear to find it useful for Cardiology, Anaesthesia as well as Musculo-Skeletal and other conditions.
Here are just a very few studies:
There are dozens or hundreds more, searching PubMed alone. (Published under auspices of the US Government NIH).
If acupuncture were any empty phenomenon, there would not be this level of scientific investigation (16,457 published papers). This is a subject, which is receiving genuine & substantial amounts of investigation -- to uncover why it appears to be efefctive.
However, acupuncture is the primary phenomenon -- not the partial and limited understanding of it, yet gleaned by science. *That* should not be the topic, or focus, of this article.
I also challenge the objectivity & neutrality of skeptics -- very few surgical procedures have been validated by double-blind trials, and 'medical error' is a leading cause of death in industrialized countries.
195,000 deaths from errors in hospitals, per year in US: [13] [14]
up to 780,000 deaths from wider medical errors, per year in US: [15]
[Iatrogenesis] [26] $19.5 billion cost per year, from medical errors in US [16]
Where are the skeptics defacing pages, on surgery & Western medicine? I'm a supporter myself, but this a clear embedded bias which the skeptics seem too irrational & uninformed to acknowledge.
It is unnecessary -- and outright incorrect -- to garnish every single statement about acupuncture, with criticisms or negatives based on a limited & skeptical understanding and 'selective viewing' of evidence.
By comparison with Western medicine, acupuncture is safe. Article on gardening, do not immediately focus on legionella deaths from planting mix -- articles on rocketry, do not immediately focus on rocket explosions -- articles on Western medicine, cover the 'positive purpose & benefit' with little mention of the 20% - 33% rate of hospital complications and 250,000 deaths per year (in the US).
Yet the supposed 'rationalism' of skeptics -- actually, a *logically false* and erroneously argumentative form of criticism -- comes from a weak & limited understanding of their own 'embedded mindset' and accepted background. Things considered to be 'normal' or 'accustomed' practice, by them, are not equally considered or subjected to such criticism.
Such 'skepticism' is logically false, and should not be the major feature in this article. This is exceptionally hostile, exceptionally POV, and both exceptionally weak & arrogant -- to assume that a raft of selective minor criticisms, should assume first-class status & take over the article.
I call upon the editor to remove this page from the purview of the skeptic's group -- and to edit the page, so it provides a genuine neutral view of Acupuncture rather than this negatively biased POV.
Furthermore, I'd like and expect this discussion of 'purpose', 'bias' and 'criticism' to REMAIN IN THIS TALK PAGE -- until such time as it becomes unnecessary, or a better and more comprehensive NEUTRAL DISCUSSION succeeds it.
Thankyou.
Twhitmore.nz (talk) 02:52, 15 May 2011 (UTC)
- I'm not going to spend an hour countering your rant. First of all, see WP:NOTAFORUM. The talk space of articles is not a place to rant about what you believe in. Your logical fallacies abound. You choose articles in support of your POV that are primary sources, unconfirmed, or barely rate as a reliable source. Acupuncture cannot cure a cancer, and if you claim it, you better bring some pretty amazing sources. Yes people die in hospitals because they are sick. They die of cancer, which none of your alternative medicine can cure. NONE. They don't go to a hospital because they're in perfect health. So, if you're going to play with the big boys here, please read the following: WP:NPOV, WP:VERIFY, WP:FRINGE and WP:MEDRS. Because you misconstrue NPOV as being not negative. The vast wealth of clinical trials, evidence, and science make it clear that the best you can ever expect from acupuncture is a placebo effect. BTW, most research shows that for no benefit whatsoever, acupuncture has a relatively high rate of adverse events. You got your facts wrong. Good luck with your search for reliable sources. Because we've looked, and there aren't any. OrangeMarlin Talk• Contributions 03:34, 15 May 2011 (UTC)
- WP:TLDR. WLU (t) (c) Wikipedia's rules:simple/complex 13:02, 15 May 2011 (UTC)
- Harumph! I hardly qualify for TLDR...do you want to talk about the moon and cheese???? LOL I'm guessing that was meant for the soapboxing friend. OrangeMarlin Talk• Contributions 02:25, 16 May 2011 (UTC)
- It's not a rant -- it's a statement of what neutrality, and neutral POV, consists of. Your stating that you won't bother countering, is both a rant -- and an admission that you are pushing a highly biased POV, and can't support that.
- WP:TLDR. WLU (t) (c) Wikipedia's rules:simple/complex 13:02, 15 May 2011 (UTC)
- For example, emphasis on acupuncture "risks/ deaths" is extremely biased -- compared to rates of medical error, death, drug side-effects, and painkiller addiction in Western medicine. And you mention logical fallacies?
- I didn't bring up the subject of cancer, you did. See the WHO recognition of acupuncture, for a reasonable list of conditions considered treatable. Chronic/internal illnesses -- such as digestive & metabolic illness, as well as pain -- may be suitable for acupuncture. As far as I am aware, cancer is not suitable for treatment by acupuncture, and you should see your GP or oncologist.
- It sounds like you have a personal, highly emotive, and reactive issue with regard to cancer. As this was entirely off-topic. Please conduct these discussions, in the interests of Wikipedia rather than in reaction to any personal circumstances. My condolences anyway, despite your poor manner.
- "Yes people die in hospitals because they are sick." -- this is widely accepted, not to be an acceptable excuse for *medical error*. Practices in the field of aviation, are widely recognized to be far superior in reliability/ error avoidance, to those in the medical field.
- "Playing with the big boys"? I am disappointed by your tone & attempted superiority. Perhaps if you could give a balanced discussion, and not a ranting list of logical fallacy, then we might be able to discuss this more sensibly.
- I've referred this to NPOV Arbitration.
- Twhitmore.nz (talk) 02:16, 16 May 2011 (UTC)
- What's your point?OrangeMarlin Talk• Contributions 02:25, 16 May 2011 (UTC)
Because I'm bored, let me respond to your bogus theories:
- It is a rant. See WP:SOAPBOX. All that matters is verification and reliable sources, not your opinion. No one cares about your opinion, from a Wikipedia standpoint.
- Accupuncture risks is verified by reliable sources.
- WHO is a political organization and doesn't qualify for a reliable source. You have none to support acupuncture's usefulness in anything, including digestive and metabolic illness. Lacking any reliable source to support your fringe theory is, once again, precisely what NPOV is all about. When you bring a reliable source, and not your opinion, then let's talk. We'll wait, since we looked at this again and again and again and again.
- Wrong. I don't care about anything about medicine but evidence based verifications. You're the emotional one, because Wikipedia, in its goal to protect neutrality, refuses to give you the means to push a POV that acupuncture actually does anything. When it does.
- With regards to hospitals. You make me laugh. You have no idea, and apparently, no reliable sources to support your soapboxing. Logical failure of the extreme.
- I'm not superior to anyone. I am, however, well versed on this topic.
- Do you not think this has been to NPOV "arbitration" (can't even get the terms right) before? This will WP:BOOMERANG on you badly.
- Remember. Verification counts. OrangeMarlin Talk• Contributions 02:33, 16 May 2011 (UTC)
- OK, I ended up reading it. It's the same standard talking points you always see - acupuncture is popular, it's old, it doesn't have adverse effects, etc. There's nothing new here and no sources worth integrating. In particular, Twhitmore should realize that acupuncture is proven effective or not based on studies of acupuncture, not on the adverse effects of unrelated treatments. Doubly-particular, Twhitmore needs to read WP:NPOV carefully, particularly WP:UNDUE. "Neutral" does not mean "from the perspective of believers". The article does need a re-work though, and I'm reading towards that goal. WLU (t) (c) Wikipedia's rules:simple/complex 18:39, 16 May 2011 (UTC)
Thanks for your comments. Removing the interspersed flow from my original, to preserve it clearly, and so I can reply to them:
- It's "long history" (which is actually rather debatable, see Taylor, 2005) also does not prove it is effective. WLU (t) (c) Wikipedia's rules:simple/complex
- Long history, establishes it as outside & pre-established before the emergence of scientific method. Being competent at logic, this establishes it as at least 'partly independent' of that domain. Long-established existence, also implies social acceptance & shared understanding, (possibly due to successful effect), continuing that existence.
- So why would you expect science to support it? Science is a method for testing, and acupuncture has consistently failed those tests. It is data that matters, and it is data that determines the truth of the claim made. Social acceptance, pre-scientific understanding, continued existence, these are all logical fallacies; popularity, tradition and a bit of nature. It was long accepted the earth was flat and the sun rotated about it. It was long accepted that bleeding cured. It was long accepted that white men were superior to white women who were in turn superior to all black people. None of which is supported by data, therefore none of which is true. Acupuncture isn't all science, but all of its factual claims are - claims about healing, biology and method. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- Long history, establishes it as outside & pre-established before the emergence of scientific method. Being competent at logic, this establishes it as at least 'partly independent' of that domain. Long-established existence, also implies social acceptance & shared understanding, (possibly due to successful effect), continuing that existence.
- See WP:NPOV. "Neutral" does not mean "uncritical", it is appropriate to lay out the best evidence for acupuncture's efficacy as a medical treatment. We also don't create POV forks. An appropriate page on acupuncture deals with its history, uses, variations, rationale, and the evidence for or against it. WLU (t) (c) Wikipedia's rules:simple/complex
- Neutral does not mean "excessively critical" either, which is exactly what it was. Biased use of the very few acupuncture injuries, to denigrate it versus Western medicine which has huge problems, is completely intellectually unacceptable.
- It's not biased to point out that acupuncture itself has adverse effects, that it is not risk-free. Particularly given arguments, like the ones you've made, that it's both risk-free and effective. Acupuncture is not risk-free despite being promoted as such, and given that it's effectiveness is borderline at best, that make the ratio of risk to benefit a bad one. That's the point made by Ernst, and it's an important one. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- It's biased to give undue weight, to low-or-minimal levels of risk compared to Western medicine. This writing appears to completely mis-state the relative risks -- Western medicine, with surgery, small-molecule drug sideeffects, and painkiller addiction is *substantially* risky. Acupuncture appears to have a very low risk.
- Aspirin and paracetamol, for example, both have complication/death rates between 1 in 3,000 and 1 in 10,000. The cited 100-odd acupuncture complications; is that per million, 10-million, or 100-million treatments. — Preceding unsigned comment added by Twhitmore.nz (talk • contribs) 01:49, 3 June 2011 (UTC)
- It's not biased to point out that acupuncture itself has adverse effects, that it is not risk-free. Particularly given arguments, like the ones you've made, that it's both risk-free and effective. Acupuncture is not risk-free despite being promoted as such, and given that it's effectiveness is borderline at best, that make the ratio of risk to benefit a bad one. That's the point made by Ernst, and it's an important one. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- Neutral does not mean "excessively critical" either, which is exactly what it was. Biased use of the very few acupuncture injuries, to denigrate it versus Western medicine which has huge problems, is completely intellectually unacceptable.
- See Trick or Treatment, the evidence base for acupuncture got significantly worse once adequate placebos were developed. There is no evidence for acupuncture points with specific effects, meridians, or effectiveness for much beyond pain and nausea. The reason there is so much research is because acupuncture is popular, it is purported to treat nearly any disease, and it's extremely difficult to create an adequate placebo. However, we've now managed to do such a thing, with the resulting erosion of the evidence base. WLU (t) (c) Wikipedia's rules:simple/complex
- I'm aware of the placebo effect already. "The reason" is an assumption -- the best & most probable reason for a scientist to do research, is because something works & they want to know why. A less profitable reason, for a scientist's career & for scientific value, is to debunk something. It is a suprising assumption, that you assume the less profitable & negative reason by default. Not logically sound, either.
- Acupuncturists have much greater motivation to deny negative studies and claim it is effective because they directly make their living from it, while researchers get grants irrespective the results of their studies. The placebo effect is discussed regarding acupuncture because it makes much more sense than qi and because the evidence supports it - acupuncture is dramatic, portrayed as old and mystical, requires a lengthy "diagnosis" and a pseudo-sensible explanation, all of which enhance the placebo effect. Control for them and acupuncture's effectiveness disappears. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- Scientists have greater motivation to research & investigate useful and existent phenomena, than to debunk non-existent ones. Productive activities are always more valuable than unproductive ones, both to society, and in research kudos, grant money & citations. The presumption of scientific investigation being most likely for "debunking" purposes, is logically unsound & actually completely inverted.202.37.64.48 (talk) 01:37, 4 June 2011 (UTC)
- Acupuncturists have much greater motivation to deny negative studies and claim it is effective because they directly make their living from it, while researchers get grants irrespective the results of their studies. The placebo effect is discussed regarding acupuncture because it makes much more sense than qi and because the evidence supports it - acupuncture is dramatic, portrayed as old and mystical, requires a lengthy "diagnosis" and a pseudo-sensible explanation, all of which enhance the placebo effect. Control for them and acupuncture's effectiveness disappears. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- I'm aware of the placebo effect already. "The reason" is an assumption -- the best & most probable reason for a scientist to do research, is because something works & they want to know why. A less profitable reason, for a scientist's career & for scientific value, is to debunk something. It is a suprising assumption, that you assume the less profitable & negative reason by default. Not logically sound, either.
- Regarding anasthesia, search for "anesthesia" in this document. WLU (t) (c) Wikipedia's rules:simple/complex
- Thanks for your suggestions.
- I have now read/ skimmed through the article, and found it interesting.
- We reference pubmed here frequently, there's a citation template for it: {{cite pmid}}. You are doing what is referred to as "cherry picking" - selecting studies that support your hypothesis, rather the totality of the literature. See WP:MEDRS. What you actually need are review articles and meta-analyses, such as this one, and this one, and this one, and this one. Note the trend is ultimately negative. There's no evidence, there's negative evidence, there's calls for more research, but rarely is there anything positive. Again read Trick or Treatment, and you'll find that as the quality of the trial increases (control groups, a large sample size, publication in high-quality journals, replication, etc.) the evidence base again shrinks. Anyone can cite primary sources that support a conclusion, but we must cite secondary sources on wikipedia pages that summarize whole bodies of research rather than just the parts we like. WLU (t) (c) Wikipedia's rules:simple/complex
- "Cherry picking" could be used to describe studies, which reject the majority of Chinese & Asian research -- who are the experts -- yet elevate Western medicine as "scientific" and "researched", despite the huge funding biases & major publication biases known to exist in the research/publication system.
- Look up the Cochrane Collaboration and search for it in WP:MEDRS. There's a reason we insist in high-quality sources that aggregate the data for us, so we can't cherry-pick. The best sources, published in the best venues, are negative. Again, read Trick or Treatment's chapter on acupuncture. The results for acupuncture in non-Asian high-quality research are mixed, some positive, some negative. By contrast, there are zero negative results from China. Ernst and Singh point this out as a reason why to distrust Asian research, particularly given political motivation to portray the culture and its learning in a positive light. The results point to systematic bias. Read the book. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- "Cherry picking" could be used to describe studies, which reject the majority of Chinese & Asian research -- who are the experts -- yet elevate Western medicine as "scientific" and "researched", despite the huge funding biases & major publication biases known to exist in the research/publication system.
- Wikipedia is an encyclopedia. It is not a soapbox, nor a publisher of original thought nor a place to predict the future. We discuss what history, medicine, anthropology and sociology have uncovered about acupuncture, we don't assume it works and promote it. Also, acupuncture is effective, but the research is aimed at discovering why. The results suggest much of the effectiveness stems from nonspecific effects - that is to say, placebo. WLU (t) (c) Wikipedia's rules:simple/complex
- Precisely. Wikipedia is not a soapbox for skeptics. This article is meant to be about Acupuncture, not about "Skeptics assume Acupuncture couldn't work". Acupuncture has been around for let's say 2000 years -- I'd say in the next 50 years, biological sciences will have advanced far enough to get a good understanding of what acupuncture does, or doesn't do.
- But for now, biological & medical science do not understand many major systems, nor subtle patterns in many other systems. For example: cell-wall sugar-molecule signalling, immune system, cognition & consciousness, gene control & expression, RNA computation & effects, cellular operation, growth & development control, repair mechanisms, or the peripheral nervous system.
- So -- assuming it's all cut-and-dried already, is entirely & spectacularly incorrect. Go read a science magazine -- every month they're making spectacular discoveries.
- Again I point to sources - the best sources are critical and the literature reviews are critical. Citing their results accurately is not skepticism, it's accurate summary. If you can find positive literature reviews whose results are not contradicted by later work, then by all means cite them.
- Egyptian medicine has been around a lot longer than Chinese and lasted longer than the entire civilization, shall we start digging into the Egyptian medical papyri for modern treatment? Shall we use crocodile dung instead of condoms? For that matter, bloodletting goes back to about the same time, shall we start using lancets again? Age doesn't mean anything, evidence does. Merely because new scientific discoveries are made on a regular basis doesn't mean they support acupuncture. Until you have specific evidence that explicitly supports acupuncture, you're not saying anything worth including on the page. Are you convinced if I say "they're making new scientific discoveries every day, so therefore all healing is due to tiny gnomes who heal your wounds in your sleep"? But they're making new scientific discoveries every day! Speculation about future evidence is useless without specific evidence for or against acupuncture. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- I assume if you investigated crocodile dung, you might find it had some degree of effect. (Perhaps a 70% probability of that outcome?). But, Egyptian contraceptives are not the point. I posted links to some number of studies, by reputable Western research departments, finding benefits from acupuncture. Suprisingly -- cardiology was one hot area. So, there is specific evidence. Your straw-man about "tiny gnomes" is really, not necessary.202.37.64.48 (talk) 01:37, 4 June 2011 (UTC)
- So -- assuming it's all cut-and-dried already, is entirely & spectacularly incorrect. Go read a science magazine -- every month they're making spectacular discoveries.
- [Iatrogenesis] So what? The two phenomena are unrelated. It's not like the failings of medicine mean acupuncture works. If an experiment fails to support string theory, does that mean loop quantum gravity is the correct theory? If the theory of evolution has flaws, does that mean creationism is right? You're creating a false dilemma here - acupuncture's effectiveness stands or falls on its own merit and evidence base like all of science. If evidence supports or refutes acupuncture, that is only meaningful to acupuncture, not to any other branch of medicine or science. WLU (t) (c) Wikipedia's rules:simple/complex
- The what is, that the "Skeptical Acupuncture" page was being written to entirely different standards -- negative, critical, unproductive -- than those applied to pages of Western medicine.
- Science is meant to be about discovery & intellectual honesty. Double-standards & pre-judgement are not what science is about, yet these were a previous & severe problem with the Acupuncture article.
- That's fantastic, so go find negative studies about "western" medicine and add it to medicine. It's irrelevant here. I wouldn't cite peer reviewed articles about the failures of homeopathy on this page, despite their obvious vitalistic commonalities. I would cite articles about acupuncture because this is the acupuncture page. Please stop bringing up "western" medicine's alleged failings. It's both a red herring and a false dilemma. Acupuncture stands and falls on its own merits, nothing else. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- No, it's not fantastic. It's an instruction to apply the same neutral & constructive writing style to articles about Acupuncture, as is used for surgery, prescription drugs & Western medicine. This is an issue of NPOV, non-bias and having a productive/informative writing style, meeting Wikipedia's guidelines. Equality, fair comparison & avoidance of unconscious bias ('Western medicine is fine & health risks are non-existent, acupuncture is a fraud therefore absolutely minimal levels of acupuncture complication should be written up like a huge accusation') are not a red herring, nor a false dilemma. But they should be fixed.202.37.64.48 (talk) 01:37, 4 June 2011 (UTC)
- Returning to my earlier comment, if a peer reviewed trial supports surgery, does that mean acupuncture suddenly becomes less effective?
- Anyway, your comments here are irrelevant, if you're so concerned about the failings of "western" medicine and surgery, you should seek out reliable sources and expand those pages, not try to debate them here. WLU (t) (c) Wikipedia's rules:simple/complex
- Obviously nonsensical. My points are about 1) slanted Evidence bases in the comparison of Western medicine to acupuncture, 2) false standard of comparison between Surgery and Acupuncture, despite surgery being relatively effective; and 3) expectation the Acupuncture page be written & discussed in a useful, positive & constructive way -- not driving all the actual domain experts off.
- I regard most pages on Wikipedia as good exemplars; focusing on the productive topic, rather than nitpicking caveats. This same standard, is the one which I am happy to apply to Acupuncture.
- [Re: unnecessary -- and outright incorrect -- to garnish every single statement about acupuncture, with criticisms or negatives based on a limited & skeptical understanding and 'selective viewing' of evidence].
- It is if we're discussing effectiveness. The history section shouldn't talk about how meridians and acupuncture points are unsupported by any evidence, but the "theory" and "effectiveness" sections should. WLU (t) (c) Wikipedia's rules:simple/complex
- Primary purpose of the page & introduction, should be the topic -- not skeptics attacking the topic. WLU's version now provides is an appropriate and balanced intro.
- If acupuncture is ineffective, then it's not safe no matter how many adverse effects there are. If accupuncture is truly effective, we should be able to demonstrate this using scientific evidence instead of talking points - in which case it will be adopted as actual medicine. It hasn't, because unlike most drugs and many surgeries its effectiveness is still debatable. WLU (t) (c) Wikipedia's rules:simple/complex
- Actually, this is the only logically sound & correct statement you've made. Thanks for pointing out something that is actually correct.
- It is posited on an multiplier of zero, though -- for the statement to have any effective value, acupuncture has to be completely or (very significantly) absent of effectiveness. Probably even placebo effect, would render this approach unfruitful.
- Thanks for attending Logic 101.
- Yes, but without you citing positive, medically appropriate sources, you're wasting everyone's time. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- Thanks for attending Logic 101.
- I don't think "skepticism" can be "logically false". It's an approach, a desire for empirical evidence rather than rhetoric, not a syllogism. WLU (t) (c) Wikipedia's rules:simple/complex
- Skeptical bias in this page, has displayed *enormous* double-standards, assumptions of in-effect, and negative/unproductive writing style. If I say logical error, or logically unsound, I mean it. Read my disproof of Noam Chomsky using variant form of Occam's Razor.
- Again, sources over logic. Your opinion is original research and is worthless. Without sources, you're wasting everyone's time. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- Skeptical bias in this page, has displayed *enormous* double-standards, assumptions of in-effect, and negative/unproductive writing style. If I say logical error, or logically unsound, I mean it. Read my disproof of Noam Chomsky using variant form of Occam's Razor.
- Again, neutral doesn't mean favourable. See WP:NPOV. WLU (t) (c) Wikipedia's rules:simple/complex
- When I say neutral, I mean neutral. I don't need somebody to tell me that; especially as "slanted wallpaper" to cover blatant, highly biased, extremely slanted & aggressive & rude (to the point of driving off genuine contributors) skeptic community.
- We appear to have reached an improved state of affairs, and (thanks for your input & contributions) a much more coherent & reasoned discussion. Thanks again for your comments & input!
- Neutral is demonstrated, not asserted. You call us rude, we have to deal with the same bullshit whining every couple months and we get sick of it - "this article is too negative, modern medicine isn't perfect, science supports acupuncture" all without any real work or heavy lifting done by any of the whiners. I'm reading a lengthy book on acupuncture, one of several, so I can contribute meaningfully. I will use these books to neutrally expand and rewrite the page. I won't bitch about how unfair it is on the talk page and throw up a pile of fallacies. If "being rude" (i.e. insisting on wikipedia's policies being followed) drives of credulous believers unwilling to actually hunt down sources and read the polices, it saves everyone some time. WLU (t) (c) Wikipedia's rules:simple/complex 03:21, 17 May 2011 (UTC)
- We appear to have reached an improved state of affairs, and (thanks for your input & contributions) a much more coherent & reasoned discussion. Thanks again for your comments & input!
Thanks to recent editing and WLU, the introduction is now much improved -- substantially neutral, with primary discussion of Acupuncture and appropriate minor mention of negatives, among the scientific.
Thanks to the editors & contributors, who have taken the time to politely comment. Twhitmore.nz (talk) 02:29, 17 May 2011 (UTC)
Important post
I love ScienceBasedMedicine (really deserves its own article!) in large part because it addresses in plain language many of the flaws of alternative medicine, including acupuncture. The latest post by Harriet A. Hall addresses acupuncture in part, but mostly it contains a list of why it can be expected to have a huge placebo effect to boost any specific effects it may have.
[17], the section titled "acupuncture's makeover" contains the list. It's a must-read for anyone who argues for the effectiveness of acupuncture's specific effects. WLU (t) (c) Wikipedia's rules:simple/complex 14:43, 17 May 2011 (UTC)
- I read it all the time. Two of the authors are Facebook friends of whom I ask questions when I run into some odd statements here. We can't use them as a reliable source, but they analyze and use reliable sources, so I find them very useful in editing alternative medicine articles. I'll be reading it with my coffee this morning! OrangeMarlin Talk• Contributions 15:23, 17 May 2011 (UTC)
"ScienceBasedMedicine" is a great idea. Unfortunately, the reality is substantially different. Massive funding & publication biases, ensure that dangerous pharmaceuticals like COX-2 inhibitors (Vioxx) get promoted -- while diet & exercise, being far more cost-effective & far less profitable, are ignored.
Also, the enormous numbers of injuries/fatalities caused by medical error, and the vast negative effects (across the population) of prescription-pharmaceutical side-effects, toxicity, and addiction, are very often not included/or considered in comparison.
Statements, for example, that "acupuncture is risky" are almost certainly factually incorrect -- acupuncture would appear to be about 10,000 times safer than surgical procedures, 100s of times safer than taking (say) mid-strength opiate or synthetic opiate painkillers.
As WLB says, the above does require that acupuncture have some effect -- I don't know for sure, but enough Chinese & scientists are trying to find out why it works, for me at least to keep an open mind. Twhitmore.nz (talk) 04:03, 1 June 2011 (UTC)
- And once again, you're just sitting here preaching and not providing any actual, you know, verification for your claims. Try citing some reliable sources to back up your claims sometime, per wikipedia policy. SuperAtheist (talk) 19:55, 1 June 2011 (UTC)
- Twitmore, Not sure where to start. Let's see, there's that old logical fallacy of appeals to conspiracy. One of my favorites. Oh, and that surgical procedures, which actually work, compared to something that doesn't work. A strawman argument of massive failure. Oh, and keeping an open mind does not mean you should keep an uncritical mind. Openmindedness does not mean anyone should accept any crap without evidence. Openmindedness, in fact, is attempting to determine the accuracy or substantivity of a statement. You are so closed minded because you refuse to listen to the real clinical science which shows that acupuncture is slightly unsafe for NO benefit at all. There is a risk of surgery, but you get a good chance of actually curing a disease. You see, the best you can offer for acupuncture is that it might suppress some pain. It can't cure cancer, or mend a broken bone, or do anything useful. Twitmore, logic is so useful. OrangeMarlin Talk• Contributions 01:45, 3 June 2011 (UTC)
- I'm going to be cruel, because these are all pet peeves of mine. BlahblahblahconspiracytheoryblahblahblahBigPharmablahblahblah is not an argument, nor is it a source, and is completely useless for the purposes of adjusting any page on wikipedia. The claim that doctors ignore diet and exercise is the worst sort of bullshit CAM talking point - good luck finding a doctor who doesn't promote diet and exercise. The fact that patients don't follow this advice is not the fault of primary practitioners. Claiming that medicine is bad because it is dangerous and acupuncture is good because it is safe is the rankest nonsense since it is a requirement that medication be demonstrated safe and effective before it is used, while acupuncture is simply assumed to be effective. As SBM itself says - any risk is excessive when the effectiveness of an intervention has not been established. The fact that Chinese scientists are the only ones who consistently find positive effects is actually a flaw, not a strength - as is discussed in Trick or Treatment and the page proper. Twhitmore, you are repeating empty talking points that have been spoonfed to you by health freedom advocates and CAM proponents who willfully ignore results they don't like. We're familiar with and have already dismissed this sort of rank nonsense, please don't bother repeating it again. WLU (t) (c) Wikipedia's rules:simple/complex 16:19, 3 June 2011 (UTC)
- I want some cheese. Moon certified cheese. OrangeMarlin Talk• Contributions 02:29, 4 June 2011 (UTC)
- I'm going to be cruel, because these are all pet peeves of mine. BlahblahblahconspiracytheoryblahblahblahBigPharmablahblahblah is not an argument, nor is it a source, and is completely useless for the purposes of adjusting any page on wikipedia. The claim that doctors ignore diet and exercise is the worst sort of bullshit CAM talking point - good luck finding a doctor who doesn't promote diet and exercise. The fact that patients don't follow this advice is not the fault of primary practitioners. Claiming that medicine is bad because it is dangerous and acupuncture is good because it is safe is the rankest nonsense since it is a requirement that medication be demonstrated safe and effective before it is used, while acupuncture is simply assumed to be effective. As SBM itself says - any risk is excessive when the effectiveness of an intervention has not been established. The fact that Chinese scientists are the only ones who consistently find positive effects is actually a flaw, not a strength - as is discussed in Trick or Treatment and the page proper. Twhitmore, you are repeating empty talking points that have been spoonfed to you by health freedom advocates and CAM proponents who willfully ignore results they don't like. We're familiar with and have already dismissed this sort of rank nonsense, please don't bother repeating it again. WLU (t) (c) Wikipedia's rules:simple/complex 16:19, 3 June 2011 (UTC)
Funding & publication biases in Western medicine:
No hidden conspiracy -- just an outright weighting of vested interest, producing outcomes that favour those multi-billion-dollar interests.
I've already posted some number of links to clinical studies on PubMed. So, with reputable evidence *for* and possible reviews *against* -- my position is, to hold an open mind. That's not uncritical. What I'm really critical of, is attempts to drive a POV.
'Claiming that medicine is bad because it is dangerous'? That's not a claim I made, and have been clear that my goal is *not* to reduce Western medicine pages to the (poor) standard & combatative nature, of this page.
'Acupuncture is good'? No, that's not my intent either. Mainly I am interested in reading an acupuncture about *acupuncture*, not *skepticism*. I don't regard the existence of a page about Chinese this-and-that as requiring me to believe in it -- I just have an open mind. 'Because it is safe'? I believe that statement, is actually fairly much correct. If I try acupuncture, which I have no intention in the forseeable future of doing, I'll have some more data-points with which I can form my own opinion.
'Medication be demonstrated safe and effective before it is used'? Demonstrate how this statement works, in respect of Vioxx. Three of you have used plenty of words replying -- why have you been unable to address reasonably clear points, in a concise or logically sound manner? T.whitmore 202.37.64.48 (talk) 01:57, 4 June 2011 (UTC)
- You do realize that this doesn't prove any point with regards to acupuncture. In fact, I would use it to debunk any positive result for acupuncture. Well, if there were any of note. OrangeMarlin Talk• Contributions 02:34, 4 June 2011 (UTC)
- Once again you conflate openmindedness with believing in fringe theories. Openmindedness is willingness to accept new ideas. It does not mean a willingness to accept invalid causal connections or to reject evidence. You have not brought one tiny bit of evidence of not only the efficacy of acupuncture, but you fail miserably to explain how it might work. You are making us accept a supernatural explanation for how acupuncture works, which is simply unrealistic. So, acupuncture fails on two levels. No evidence of efficacy and no proposal of a mechanism for it that can be falsified. You can't. And what fuck does Vioxx have to do with the stupidity of Acupuncture? It has nothing to do with it. By the way, given that you are totally unknowledgeable about pharmaceuticals, I propose that the simpler answer to Vioxx is that lawyers want to make money. But then again, I don't want to go down that conspiracy road that many use. OrangeMarlin Talk• Contributions 02:43, 4 June 2011 (UTC)
- By "western medicine" you mean "medicine", I assume? Because medicine simply works, it doesn't just work in "the West", a stupid term since the earth is a sphere and China is "west" of North America.
- Do any of those links have anything to do with acupuncture? If so, please separate them out and suggest an improvement to the page based upon them. This page isn't about how "western medicine" is allegedly flawed and "eastern medicine" is awesome. It's about acupuncture, which has been tested by science and found wanting in the best quality studies. Vioxx for all of its flaws, is an effective pain reliever, and an independent panel concluded it should be returned to the public. Not to mention it was voluntarily withdrawn by Merck, not by the FDA. Not to mention it's side effects are about equivalent to other NSAIDS. So how was Vioxx demonstrated safe and effective? Well, they tested it and it reduced pain. They continued testing it and found that a small number of people had more heart attacks. So small, it was not immediately obvious in the smaller trials. But again, this has fuck all to do with acupuncture, so why are we talking about it? I wonder if your open mind is sufficiently open to the possibility that it may simply be an elaborate placebo? WLU (t) (c) Wikipedia's rules:simple/complex 01:01, 5 June 2011 (UTC)
Tag: Questionable statement about deaths in lead section
I am challenging the following two sentences and suggesting that they do not belong in the lead, and that the second ("statistically significant") sentence is probably false and does not belong in the article at all:
- "A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including (since 2000) 38 cases of infection, 42 cases of trauma and 5 cases of death. The authors considered the adverse events to be statistically significant."[24][25]
Note: To attract editorial attention, I've tagged the statement with {{clarify}}. Per WP:TAGGING, since an adequate explanation for the tag has been made, please leave the tag until the issue is resolved.
Now, as to why the two sentences don't belong in the lead, the answer is simple: talking about death in the lead for something as safe as acupuncture is undue weight. The article reports 5 deaths in the literature from 2000 till 2010. One death every two years. That makes acupuncture very safe compared to other medical interventions as well as most other activities. There are articles on far riskier activities where we don't talk about deaths in the lead section, and undue weight is the reason.
Finally, I don't believe that the second sentence is at all an accurate summary of the article. I ask for unambiguous proof that it is, in the form of a quote, with ample context, from the article. The reason I doubt that this sentence accurately reflects the source is that there is no such thing as statistical significance when the sample size is unknown. A survey of adverse events reported in the literature by definition does not have a sample size. No sample size, no statistical significance. At best, one might say something like "the authors saw fit to bring attention to the issue of adverse effects in light of their conclusion that there is little evidence that acupuncture effectively treats pain".
(sidebar: It's odd that the authors, in purporting to compare risk vs. benefit, addressed only pain. Doesn't the alleviation of other types of suffering count for something? The best MEDRS on the planet states unambiguously that "P6 acupoint stimulation prevented PONV" (post-operative nausea and vomiting) as well as antiemetic drugs, and "There was no evidence of publication bias".[26] I'll add these statements to the article later.) --Middle 8 (talk) 09:23, 5 June 2011 (UTC)
- I'm not surprised at this revert without discussion, a more accurate edit summary for which would have been "I reverted this before[27][28][29] without serious discussion[30], and I'm doing it again." In other words, the editor ignored WP:DR before, and is doing so again (see also WP:IDHT). Also, no reason was given for removing this simple and accurate edit[31]. I'm restoring the tag. --Middle 8 (talk) 19:58, 5 June 2011 (UTC)
- Acupuncture is portrayed as safe, risk-free and adverse affects - a point made in the meta-analysis itself. Hence, the meta-analysis makes the counter-point that this is not the case, hence the lead does since that sort of source is the best one available for medical information. For any medical intervention, an inclusion of adverse effects is something that would appear in the lead, even rare ones. Acupuncture is not 100% safe and one of the adverse effects is death. We aren't comparing the "effectiveness" of acupuncture versus adverse effects to real medicine, we're just talking about acupuncture. I'm pretty sure any intervention that has "death" as a regular side effect would have that information in the lead.
- If you want the proof from the article, perhaps you should request it from a library or find it in paper form and read through it yourself.
- I support the inclusion of the "from 2000" if we are including the raw numbers - it underscores that those figures are from only a decade of research, suggesting a large number of unrecorded side effects from before that time. The "statistically significant" part I also fail to see the point of and would support removing it unless I can be convinced otherwise.
- The Ernst, Lee & Choi article is about acupuncture and pain, not nausea. That's why they don't talk about nausea. You'd have to see the detailed Cochrane Review to see why there was no evidence of publication bias - it's possible that there is no bias because the selection methodology excluded a large number of results from China for quality reasons. WLU (t) (c) Wikipedia's rules:simple/complex 21:22, 5 June 2011 (UTC)
- Hi WLU -- regarding the source, I just discovered that I can check at WP:LIBRARY. OTOH, it would take you less than five minutes to copy, paste and email me the source. Why not help a fellow editor? I've done the same.
- Also, is there any good reason not to have the tag there, given that more editorial eyes are generally good for an article that generaly has very few active editors? If so, would you mind restoring the tag?
- Acupuncture is not portrayed as "risk-free and (free of) adverse affects". Rather, it is said that these are relatively low (just read the sources). Ernst's raw number doesn't change that.
- Glad you agree with adding the time frame to the and removing "statistical significance".
- You're quite wrong about how deaths are handled in lead sections on Wikipedia, but I assume you'd agree that standards should be consistent. For example, see Serotonin_syndrome#Cause, and click on any of the compounds listed: the large majority do not mention the deadly serotonin syndrome in the lead. There are plenty of similar examples. Apparently, this article is failing to follow standards that are widespread in articles on medicine. I'll ask about it at Wikiproject Medicine, and we can follow the guidelines (de facto or not) that they use. Sound good?
- In any case, whether in the lead or note, we need to mention that deaths are due to practitioner-error (pneumothorax, dirty needles), just as, e.g., we note that fatalities for a given compound are caused by overdose.
- Regarding Ernst, efficacy for pain and deaths: the point is that the comparison, which he insinuates to be somehow meaningful, is a half-truth because it doesn't include other benefits in the equation. Risk-benefit doesn't mean jack-squat if you ignore any important risks or benefits. On top of that, the risk is a meaningless raw number. Students learn not to make such errors in college. What a foolish thing for Ernst to say.
- Re nausea, my only point was that it's a strong and pretty much unequivocal source. regards, Middle 8 (talk) 03:28, 6 June 2011 (UTC)
- I don't have a copy. I could get one if I need it, and you probably could to. Normally I request sources from specific editors so I can't help you with WP:LIB.
- Tags are not badges of shame. If there is a genuine reason to question whether the authors actually consider these adverse events statistically significant, tag it. If there's not (and I don't see any reason to suspect such a basic thing is not true but only checking the actual source will make it clear) then don't bother tagging it.
- In the absence of specific guidance, we use common sense. Common sense to me suggests we include serious adverse effects in the lead, particularly when a major review article makes a point of highlighting these adverse effects. If you think adverse effects including death should be included in the lead of other articles, feel free to include them. When I rewrote natalizumab, I included death in the lead. Certainly, pages like Celecoxib, Tylenol and probably many other pages should have it included in their too-short leads. Aspirin, a featured article, does mention it. WP:MEDMOS doesn't provide much guidance, but WP:LEAD does, and it indicates including prominent controversies which would include information on effectiveness and adverse effects in my opinion.
- Ernst's whole point is that while we can't be sure of acupuncture's benefits (i.e. it's still equivocal whether inserting needles into the skin has specific effects or if it's due to non-specific effects) we can be sure of its adverse effects like death. The lead also closes with a note that acupuncture is safe when administered by well-trained professionals using sterile needles. Beyond the modifications I have already suggested, I see no need to further alter the lead. WLU (t) (c) Wikipedia's rules:simple/complex 15:22, 6 June 2011 (UTC)
- Re nausea, my only point was that it's a strong and pretty much unequivocal source. regards, Middle 8 (talk) 03:28, 6 June 2011 (UTC)
- Hi WLU - since you agree that the tag is acceptable, I'll ask again: would you mind restoring it (along with my other edit adding "since 2000")? Another editor has been removing it without discussion. But it does no harm, and in fact does good.
- You say "Ernst's whole point is that while we can't be sure of acupuncture's benefits...", but he's not including all of the benefits in the equation. Nor are risk numbers meaningful.
- As for the lead section's treatment of adverse effects, let's wait to see what global consensus is. Given the the vast majority of medical articles don't include death in the lead (perhaps because it's rare in so many cases), I suspect it may differ from your position. TBD. regards, Middle 8 (talk) 17:25, 6 June 2011 (UTC)
- I don't think the tag is acceptable, I think it's stupid and unnecessary. I don't support restoring it. Is this an acceptable wording to you?
- Again, Ernst is talking about pain. His point is acupuncture hasn't been conclusively proven for pain, thus presenting uncertain benefits with certain, and possibly completely unnecessary risks. If benefit to risk is expressed by a ratio of one over the other, if the top number is a zero, it doesn't matter what the bottom number is - the net result is a zero.
- Again again, because other articles don't discuss deaths in the lead doesn't mean this one should or shouldn't. The only way you can really compare articles is if you are comparing featured articles, and even then it's not necessarily a good idea. WLU (t) (c) Wikipedia's rules:simple/complex 18:16, 6 June 2011 (UTC)
- Hi WLU -- good news, an editor at WP:LIBRARY came through with the source[32]. Grab it if you like, but do it soon; the link will expire.
- Re the tag, what could be wrong with attracting more editors, which is all a tag does? Anyway, I think your edit is an improvement. I still have problems with not quantifying risk, even in a ballpark way -- readers should know that these events are rare and caused by poorly-trained practitioners. Readers should also know that many sources consider acupuncture to be relatively safe (see other sentences in the lead), and I'd prefer to tie into those somehow. The lead is kind of fragmented and repetitive. I'll suggest changes when time allows.
- And I still think it's undue weight to mention deaths in the lead. As I mentioned before, I don't think global consensus supports the idea that every adverse effect, including death, belongs in the lead. Among featured articles in health and medicine, only one --Treatment of multiple sclerosis -- includes death as an adverse effect, and it's not mentioned in the lead. So we're zero for one in that small sample set. WP policies and guidelines evolve with the whole encyclopedia, not just featured articles, so non-featured articles still weigh in global consenus. As I said, I'll ask at Wikiproject Medicine.
- Regarding Ernst and the risk-benefit ratio, I think we're talking past each other. I understand what you're saying, but I don't know if you grok my point. Ernst is implying that his benefit/risk ratio is somehow meaningful, but it's flawed top and bottom. The numerator includes only pain and is therefore incomplete (and acu's efficacy in treating nausea is unequivocally real per the most recent Cochrane review; this would go in any serious assessment). His denominator is of course a raw number, not indicating frequency of adverse effects, and not very informative. The source is flawed and its implication that acupuncture is relatively unsafe is contradicted by several other sources in the article. So including deaths in the lead is doubly undue weight: other articles don't use Ernst's dubious "logic", and other articles estimate a relatively low frequency of adverse events. regards, Middle 8 (talk) 21:34, 6 June 2011 (UTC)
- @WLU -- I just tweaked your edit. If we're going to mention death in the lead for now, we need to say something about why they occur and how often. Ernst said "minute" (which is true, relatively) and then went on to say that even one avoidable adverse event is one too many (also true). Nothing in there about "statistical significance", though, from my reading so far. --Middle 8 (talk) 21:57, 6 June 2011 (UTC)
- Regarding Ernst and the risk-benefit ratio, I think we're talking past each other. I understand what you're saying, but I don't know if you grok my point. Ernst is implying that his benefit/risk ratio is somehow meaningful, but it's flawed top and bottom. The numerator includes only pain and is therefore incomplete (and acu's efficacy in treating nausea is unequivocally real per the most recent Cochrane review; this would go in any serious assessment). His denominator is of course a raw number, not indicating frequency of adverse effects, and not very informative. The source is flawed and its implication that acupuncture is relatively unsafe is contradicted by several other sources in the article. So including deaths in the lead is doubly undue weight: other articles don't use Ernst's dubious "logic", and other articles estimate a relatively low frequency of adverse events. regards, Middle 8 (talk) 21:34, 6 June 2011 (UTC)
- Did you understand the meaning of "not badges of shame" above? Template:POV/doc elaborates, but the same principle is broadly applicable to other templates indicating a dispute. Their utility rests in attracting more editors to a hitherto-neglected page for discussion. Using them on page such as this, which is broadly watchlisted, is unnecessary and unproductive. Simply discuss the issue on the talkpage, there's no need for tagging it. LeadSongDog come howl! 18:37, 6 June 2011 (UTC
- Hi LeadSongDog - yes, I understand what tags are for. How do you know this article is broadly watchlisted? All I know is that at any given time, the article usually has a very small number of editors -- often as little as two. So it does no harm to have the tag, and attracting more editors is good. At the same time, the editor who keeps removing the tag is abstaining from any discussion here, and when I mentioned this on his talk page, he was rude and said I should take it up on this page, which he is ignoring. Seems like we could use some fresh editorial input, no? regards, Middle 8 (talk) 21:34, 6 June 2011 (UTC)
- Middle8, good job. Now you've actually produced an edit I can like. My job in mentoring you in writing to NPOV has been fruitful. OrangeMarlin Talk• Contributions 22:48, 6 June 2011 (UTC)
FYI: I partially undid the most recent edit by Middle 8 here, and have proposed a new structure incorporating his wording in the same edit. I'm uncomfortable with Middle's proposal because it changes the wording from presenting the risks to solely downplaying them; Instead of saying "there are risks including X", it says "any risks (even X) are improbable". My new wording bypasses that issue by presenting the risks, and then incorporating his wording discussing their frequency. However, it's worth noting that I don't have access to any of these sources (or really, the time to check them anyway), and as such, I'm not fully comfortable supporting even my proposal. If we have any sources which discuss risks without emphasizing their infrequency, that should be reflected better in the wording. I don't know if we do. Any input on this would be great. — Jess· Δ♥ 23:43, 6 June 2011 (UTC)
- I'm fine with the current version. I have copies of the articles, and right now they're available at WP:LIB for a limited time only. I've tagged the section with {{resolved}} because I'm sick of discussing it. WLU (t) (c) Wikipedia's rules:simple/complex 00:59, 7 June 2011 (UTC)
- Hi Jess -- actually, per the source, the risks overall are low -- "minute" was a term used (one death every two years from a literature survey -- compare that with other medical interventions). The thing is that a large number, possibly the majority, of these risks are due to malpractice. Acupuncturists needle in places where they are taught (over and over again) not to needles, or (again against training) they use dirty needles (more often in 3rd-world countries; in the Western(-ized) world, needles are disposable). Therefore, properly training acupuncturists is vital and should reduce risk even more. (The original wording, especially the "statistically significant" bit, wasn't that close to the source.) How about this? regards, Middle 8 (talk) 03:55, 7 June 2011 (UTC)
- To summarize, it looks like we're at or very close to agreement on the current discussion of wording in the lead. I still have serious reservations about putting extremely rare deaths in lead. We should be able to resolve this with additional editorial eyes and investigation of global consensus. regards, Middle 8 (talk) 08:43, 7 June 2011 (UTC)
- Consensus doesn't mean everyone is happy, and everyone but you seems to think including deaths in the lead is appropriate.
- I added my own qualifier about under reporting. WLU (t) (c) Wikipedia's rules:simple/complex 14:11, 7 June 2011 (UTC)
- Well, I am not happy. The lead currently says this: "A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy in the treatment of pain and accompanied by serious risks and adverse effects including death." While technically correct, there is a weight problem with this statement as this holds acupuncture to a much higher standard than conventional medicine. The article Aspirin says nothing at all about deaths from incorrect use of salicylate, even though it is a significant problem:
- "Salicylate intoxication remains a common problem in Britain; about 10 percent of adult hospital admissions for deliberate self-poisoning involve these drugs. [...] In the United Kingdom, the annual number of salicylate-related deaths has fallen slightly between 1967 and 1980. [...] The mortality rate from acute salicylate poisoning in hospital-treated adults is about one percent; death is usually preceded by neurologic features and a dominant metabolic acidosis." [33] (I am sure there are better sources, this is just a random source I found via Google while avoiding anything that looked remotely like a crackpot site. Given the large number of known problems that can occur with salicylate, it would be astonishing if there were not hundreds or thousands of related deaths worldwide every year.)
- That's not a weird omission, it's the standard treatment of such topics. Of course every single death is too much, and it makes sense to stress serious complications of unnecessary therapies and practices such as needling (or riding motorcycles, to take a non-medical example) than those of best practice approaches such as the best known medical therapies. But I wouldn't be surprised to learn that more people die from malpractics related to salicylate every year than from acupuncture. After all, it's often prescribed as a placebo – presumably often without checking for contraindications – and has also been implicated in the high mortality of the Spanish flu, for example. Hans Adler 14:57, 7 June 2011 (UTC)
- Well, I am not happy. The lead currently says this: "A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy in the treatment of pain and accompanied by serious risks and adverse effects including death." While technically correct, there is a weight problem with this statement as this holds acupuncture to a much higher standard than conventional medicine. The article Aspirin says nothing at all about deaths from incorrect use of salicylate, even though it is a significant problem:
- To summarize, it looks like we're at or very close to agreement on the current discussion of wording in the lead. I still have serious reservations about putting extremely rare deaths in lead. We should be able to resolve this with additional editorial eyes and investigation of global consensus. regards, Middle 8 (talk) 08:43, 7 June 2011 (UTC)
- ^ a b c d Novak, Patricia D.; Dorland, Norman W.; Dorland, William Alexander Newman (1995). Dorland's Pocket Medical Dictionary (25th ed.). Philadelphia: W.B. Saunders. ISBN 0-7216-5738-9. OCLC 33123537.
- ^ a b c d Fruehauf: TCM in Crisis
- ^ a b c d Hicks, Angela; Hicks, John; Mole, Peter (2004). Five Element Constitutional Acupuncture (1st ed.). London: Churchill Livingstone. pp. ix. ISBN o443071705.
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- ^ Singh & Ernst, 2008, Chapter 2, pg. 39–90.
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