Wikipedia talk:Identifying reliable sources (medicine)

Steps towards consensus

Kim Bruning (talk · contribs) suggested on Wikipedia talk:Consensus that those editors discussing contentious issues at WP:MEDRS answer four questions:

1. Your current position as to how MEDRS should be formulated (and reasoning why)
2. Some idea of where you're willing and able to compromise on that position.
3. Your current view/ best estimate of where each of the other participants stand, singly and as a group (and reasoning why).
4. Your current best estimate of where other participants are willing to compromise.

The idea hasn't been followed-through but may be worth exploring. Colin°^Talk 12:38, 25 September 2008 (UTC)

Colin's answers

My position

1. MEDRS should be in agreement with WP:PRIMARY in regarding secondary sources as the foundation of an article, and to use primary sources only with care. This policy is manifest in this guideline where we prefer to cite literature or systematic reviews rather than research papers. I note that some people have commented that there is a different definition of "primary source" within science (logbooks and database records); I'm using the definition on WP which is concerned solely with published material.
2. MEDRS should be in agreement with WP:V, which places peer-reviewed journals and academic books at the top of the quality tree, and mainstream newspapers at the bottom. ("In general, the most reliable sources are peer-reviewed journals and books published in university presses; usually followed by university-level textbooks; then by magazines, journals, and books published by respected publishing houses; then by mainstream newspapers."). WP:RS (or its example page) have long said that "popular newspaper and magazine sources are generally not reliable sources for science and medicine articles".
3. MEDRS does not need to spell out where editors should use common sense, judgement or talk pages. We have WP:IAR and other editor-behaviour guidelines for that. The whole guideline should be read in the context that it is merely a guideline, and is a part of a set of guidelines and policies that work as a whole. Colin°^Talk 12:38, 25 September 2008 (UTC)
4. The use of reviews (expert opinion and analysis of the primary literature) enables editors to write better and more encyclopaedic articles. Both experts and POV pushers tend to write articles that mention study after study (the former because that's the style they read in the science journals, the latter because one can find a study somewhere to backup almost any claim). Mention of a study may be interesting and it may be necessary to constrain our certainty of the facts, but by-and-large an encyclopaedia should assert facts, not prove them. Colin°^Talk 22:05, 1 October 2008 (UTC)

My compromise

I'm not sure how the core of the first two points can be changed without bringing MEDRS into conflict with policy. A few editors have expressed support for the New York Times but since I don't read it, I can't judge. I don't believe any British newspaper has shown itself capable of reporting medical information reliably. Even if judged reliable, other aspects of a newspaper article make it a poor choice for anything but the most trivial medical fact. The exact wording used to express these guidelines is, of course, open to discussion. The third point can be compromised if there is consensus that MEDRS needs to spell out what some regard as obvious or repetitive. Colin°^Talk 12:38, 25 September 2008 (UTC)

I'm less keen now, to accept the inclusion of the "common sense" clause immediately following the preference of reviews over primary studies. I believe it may be misused, cited and wikilawyered over. If challenged, editors should have a better reason for deviating from the general guideline than "I'm just using common sense" (the implication being the challenger is not being sensible). Colin°^Talk 22:05, 1 October 2008 (UTC)

Others' position

Paul regards the preference for reviews over original publications as "batty" because they are "written by the same people who do the original research, and they are subject to the same personal prejudices and biases". Therefore they should not be favoured. In addition, he would like the choice of secondary vs primary to emphasise the need for common sense, editorial judgement and discussion on talk pages.

Nbauman objected to how newspapers were regarded, though did not participate in the poll. Some effort was made to find a compromise wording that would be acceptable. A debate ensued where Nbauman believed this guideline's statements needed to be sourced per WP:V rather than be the collective opinion of WP editors. It was established that this requirement does not exist, but even if it did, sources could be found to support the idea that newspapers are not a good choice for medical facts. A compromise was reached with Nbauman where this statement was explicitly sourced in the guideline, even though such sourcing is not required. Ludwigs2 was another editor who objected to the anti-newspaper stance. Colin°^Talk 12:38, 25 September 2008 (UTC)

Mattisse has contributed opinions based on his experiences and we seem to be in agreement. Colin°^Talk 22:05, 1 October 2008 (UTC)

Others' compromises

Paul has suggested (on my talk page) highlighting the danger in using reviews written by authors with a COI over the original research they are citing. I responded that this sounds like a valid concern, but very difficult to detect or enforce, and only necessary where the subject is controversial. Perhaps this idea can be explored by other editors. I have encouraged Paul to make this suggestion to a wider audience; he has not done so yet.

I get the impression that most examples given for valid use of newspapers involve some kind of scandal (e.g., Vioxx). Newspaper journalists can do investigative reporting, and medical journals generally do not. Perhaps those editors would be happier if the scope of "avoid newspapers" was clarified and restricted. For example, there seems little problem citing newspapers for historical events, current affairs, social and political issues (e.g., that a drug isn't available on the NHS due to a ruling by NICE), etc.

Please add your own subsection and we can then discuss the opportunities for compromise or changing-of-minds that arise. Colin°^Talk 12:38, 25 September 2008 (UTC)

Excellent. Could Paul, Ludwigs2 and WhatamIdoing also reply? (Eusebus, Nbauman and others who would also like to post a similar text may do so too of course, it's still a wiki ;-) . Don't worry if your version is substantially shorter or longer than Colin's version. As long as each of the 4 key questions are answered as best you can.) --Kim Bruning (talk) 16:45, 25 September 2008 (UTC)

Colin: your answer to 1 lists requirements, but I'm not sure what to do with them. Can you explain what you would like to change about the page right now? --Kim Bruning (talk) 21:30, 25 September 2008 (UTC)

I'm happy with the current text and it meets those requirements and my present understanding of medical sources. That doesn't mean I'm not open to being educated further or that I think the text is perfect. Colin°^Talk 21:39, 25 September 2008 (UTC)

Ok, noted! :-) --Kim Bruning (talk) 22:40, 25 September 2008 (UTC)

Right. If Eubulides made the changes he proposes below, which of those changes would you *not* agree with, and why? Would you update your answers to the questions (especially 3 and 4) based on the data from Eublides? --Kim Bruning (talk) 21:23, 26 September 2008 (UTC)

Kim, the idea that you're trying to mediate between me and Eubulides is really funny. Colin°^Talk 21:40, 26 September 2008 (UTC)

Meh, there's discrepancies between his position and yours right now. If you agree with his position entirely, that's fine, and all I need to know. :) --Kim Bruning (talk) 22:05, 26 September 2008 (UTC)

You said you'd support improvements. :-) Are some of the changes that Paul Gene proposes actual improvements? If so, can you specify which? --Kim Bruning (talk) 19:05, 30 September 2008 (UTC)

No. Nothing Paul has suggested here improves the guideline. Colin°^Talk 17:36, 1 October 2008 (UTC)

Eubulides' answers

1. MEDRS should supplement WP:RS, WP:OR, and WP:V with advice specific to biomedical articles, advice that is in agreement with the mainstream scientific consensus on medicine and biology. MEDRS should not unduly repeat the policy pages, nor restrict itself to merely saying what the policy pages say. Nor should it emphasize parts of the policy that we like and deemphasize the parts we don't like.
2. It's OK to have brief summaries of what the policy pages say, to establish context.
3. There are two overlapping sets of disagreements. One set disagrees with the current standing of newspapers in WP:MEDRS, and would like newspapers to be viewed more highly as a source. Another set disagrees with WP:MEDRS's strong position on favoring secondary over primary sources.
4. #Common sense above explores one way to compromise over the secondary-versus-primary dispute, by briefly summarizing the policy page in question. It's possible a compromise may be found there. For newspapers, it may be helpful to give another example or two where citing newspapers is OK.

Eubulides (talk) 17:12, 25 September 2008 (UTC)

Ok, also wondering about your #1, which changes should be made to the current page to meet your requirements? (answers to all 4 questions should be about concrete actions, but let's start at #1). --Kim Bruning (talk) 21:32, 25 September 2008 (UTC)

For #1, it's not so much a question of meeting requirements, as it is of improving the article so that it's more useful, particularly to editors new to Wikipedia's medical articles. Here are a few suggestions off the top of my head:

• Remove the dispute tags.
• Give advice that's specific to the section of the medical article. Sources for an Epidemiology section will have different characteristics than sources for a Classification section.
• Give more examples.
• Make the section headers shorter. Use fewer section headers.
• Article type is out of place; it should be combined with the secondary sources bullet of Definitions somehow.
• Periodicals, Books, and Online should be combined into a single top-level section, with duplicative material removed. Almost everything's online now, for starters.
• Assess the quality of evidence available contains too much detail about evidence ranking schemes. It should summarize the point and give pointers to the details.

Eubulides (talk) 23:30, 25 September 2008 (UTC)

Ok, compare what you've written with the objectives written by Colin above (answers 1 and 2). Do you foresee Colin objecting to any of your changes? If so, why, and where do you believe you can reach a compromise? --Kim Bruning (talk) 21:25, 26 September 2008 (UTC)

Colin might object to some of those proposals; if so, I'd almost surely withdraw them, as Colin has more experience in this area and is a topflight editor. But I must say that it sounds like there's some confusion here, as Colin and I weren't disagreeing with each other. We were disagreeing with other editors, notably with User:Paul gene. Eubulides (talk) 21:39, 26 September 2008 (UTC)

Sure, noted. I guess you can tell I'm a neutral outsider here, since I'm just doing this systematically :-) --Kim Bruning (talk) 22:07, 26 September 2008 (UTC)

Alright, Paul Gene has pointed out his views now. Can you point out which changes that he proposes that you agree with? --Kim Bruning (talk) 19:04, 30 September 2008 (UTC) hopefully there's at least 1 :-)

I don't agree with the changes Paul gene proposes. The "compromise" in #Paul Gene's answers is not a compromise: it simply restates Paul gene's position, which is to remove guideline status from this page. The "compromise" also restates Paul gene's position to duplicate large chunks of text from a policy page, even though this would introduce redundancy and makes this page unbalanced. Paul gene has proposed these two changes many times, without anything remotely approaching consensus. In #Common sense, I attempted a compromise on the second issue, involving a WP:SUMMARY of the policy-page text, but so far this compromise has been rejected. Eubulides (talk) 20:13, 30 September 2008 (UTC)

Ok, noted. So there is no change proposed so far, (however small), that you agree with?

Alright. based on Pauls position, is there any (small) change you could propose that you could both agree on? --Kim Bruning (talk) 20:21, 30 September 2008 (UTC)

I have already done that, by proposing a change at the top of #Common sense that attempted to put text prominently at the start of a section, text that summarizes policy text that Paul gene wants to insert. This is indeed a small change: it's only 14 words, namely "Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages." Eubulides (talk) 20:36, 30 September 2008 (UTC)

Cool. I'll ask Paul about that. --Kim Bruning (talk) 20:38, 30 September 2008 (UTC)

I've got the following text back: "Sometimes choosing between reviews and original research papers is complicated and requires editorial judgment and discussion on article's talk pages." . Do you have any issues with this particular phrasing that would preclude placing it on the MEDRS page? Does it require further changes? --Kim Bruning (talk) 22:36, 2 October 2008 (UTC)

(outdent) That text wouldn't work as well, as it uses terms like "reviews" and "original research papers" before they are discussed. Furthermore, the "is complicated" and "requires" unduly scares the reader. We shouldn't start off the guideline with a sentence that puts off naive readers; we should start it off with a friendly sentence. How about the following rewording instead? "Editorial judgment and talk-page discussion can help when choosing sources." Eubulides (talk) 23:23, 2 October 2008 (UTC)

Ok, Well, let's see where that gets us. --Kim Bruning (talk) 16:05, 3 October 2008 (UTC)

Paul Gene's answers

(long by necessity as I tried to represent the points of views of all of the editors, and most of them are burned out)

My position

1 This page is not sufficiently developed to be a guideline and may actually be harmful in some aspects.(see two different views on how it is inadequate: [1] and [2]) Several editors mention that this page is good for helping new editors. The same editors appear to agree that for an experienced editor this page adds almost nothing to the existing guidelines.[3][4][5] Helping newbies is a good reason to exist for an assay, but the guideline should also be useful for others.

2 In particular, the definitions of primary and secondary sources are confusing.[6][7]. They should be explained along the lines outlined by WhatIamdoing [8] : “Lab records=primary source for a given fact. Original paper reporting lab results=secondary source, but primary literature. Review paper (say, comparing half a dozen similar original papers)=tertiary source, but secondary literature.”

3 Since primary literature in medicine is actually secondary sources, it is generally reliable, and appeals to WP:NOR and WP:V to support the exclusion of research papers are without merits. Moreover, the idea to exclude original research publications is contrary to the community practice. Most of the references for the WP:MED featured articles are to original research papers not to the reviews. The exclusion of research publications may help newbies but it will make the life of experts (such as myself) miserable. This deficiency of the current page has been discussed by multiple contributors over the years and the compromise has never been reached. See for example [9][10][11][12]

4 A procedural point, but only to answer the often raised argument that this page has been around for 22 months so it deserves to be a guideline. This page was set up as a proposed guideline 22 months(!) ago [13]. Despite the continuous re-submission of this page as proposed guideline, the consensus could not have been reached for 22 months. According to normal WP process, it should have been labeled rejected or historical long time ago. Indeed it was labeled historical in January 2007[14] and reverted by Sandygeorgia[15]. It was rejected in May 2007 (see [16] [17] and [18] and related discussions). This rejection was reverted over the insistence by Sandygeorgia and Colin, who is the page owner. In June 2007 it was downgraded to just a project page [19] Any work on the page then essentially stopped till June 2008. The page was again restored as a proposed guideline in August 2008 by WhatIamdoing.[20] Now the story is being repeated again.

The existence of this "walking dead" page itself is an abuse of Wikipedia process. This Frankenstein monster is killed and revived again, unchanged, and it just never dies. To remind all involved the relevant policy WP:PG: “A failed proposal is one for which consensus for acceptance has not developed after a reasonable time period. Consensus need not be fully opposed; if consensus is neutral or unclear on the issue and unlikely to improve, the proposal has likewise failed. It is considered bad form to hide this fact, e.g. by removing the tag. Making small changes will not change this fact, nor will repetitive arguments. Generally it is wiser to rewrite a failed proposal from scratch and start in a different direction.”

My compromise

The opposed points of view on this page are - this is a rejected guideline vs. this is an accepted guideline. The compromise would be to return to the page's status as a project page. Then the disputed tags could be removed from the parts of this article. As a project page, this page would be still helpful for newbies while not hindering the work of experienced editors.

In this new project page we should insert the full quotation from WP:NOR to make it unbiased: “Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment”t (see this discussion for the background: Wikipedia_talk:Reliable_sources_(medicine-related_articles)#Common_sense).

The topic of reliability of sources is covered rather well in WP:NOR, WP:V and WP:RS. The new proposed guideline could be started, though, devoted to the question of what sources are the most useful for medical articles. It could be called MED:Sources, and incorporate the practical advice from this page.

Others' positions

Colin is happy with the current text and it meets his present understanding of medical sources, although it can be improved. [21]

Eubulides thinks the page unquestionably meets the requirements for a guideline, although could be improved. [22] He would defer to Colin who is “a topflight editor”. Eubulides would almost surely withdraw any proposal Colin disagrees with.[23]

WhatIamdoing has “no interest in pushing cutting-edge research into Wikipedia. In fact, one of the goals of MEDRS's version of WP:PRIMARY is to keep unconfirmed, cutting-edge research out of Wikipedia by strongly preferring proper secondary literature (which takes months, if not years, to appear) to primary literature.” [24]

Sandygeogia thinks that “in a content dispute, WP:V suffices to cover the content at MEDRS anyway, and the additional info there was only intended to provide specifics about medical sources. Whether the page is or isn't a guideline will not change good, policy-based editing on medical articles in practice; the absence of the page as a guideline will, however, make editing harder for new editors.” [25]

Eversince – the page should not be a guideline because it will prevent the inclusion of the reputable views from the other fields (Philosophy, Psychology, History, Literature, etc) on medical topics. The current policies (WP:NOR, WP:V) are sufficient. [26][27][28]

NBauman would like to see more nuance in the definition of the popular press coverage. The scientific evaluations of the accuracy of popular press should be used in the guidelines, not just simple assertions by the editors.[29]

UnaSmith – this proposal is contrary to the intent of Wikipedia by being far too prescriptive, and trying to prescribe something which should be a matter of editorial judgment. For example, she has read far too many mediocre review articles that are a giant step backward from the original research literature they cite.[30][31] In her opinion, this page is not an improvement on Wikipedia:Reliable sources. [32]

Mihai Cartoaje is concerned with the conflict of interest, which permeates the medical research. [33] (IMHO a very valid point, see [34] [35][36])

Ludwigs2 – Although the news media can be wrong, it often “can and does present decent, effective, readable reports that can sometimes have distinct advantages over academic journal articles from the perspective of wikipedia”, for example, by being more readable and when medical researchers have a conflict of interest.[37]

Others' compromises

Colin can compromise on the addition of the caveat from WP:NOR. He would not compromise on the definition of Primary and Secondary sources as he believes that his understanding of the issue reflects WP policies.

Eubulides tried to unsuccessfully find a compromise with me on the inclusion of the caveat from WP:NOR (see Wikipedia_talk:Reliable_sources_(medicine-related_articles)#Common_sense)

Paul Gene (talk) 14:50, 27 September 2008 (UTC)

Alright, can you point out some things that Eublides would like to change that you agree with (partially or entirely)? --Kim Bruning (talk) 19:03, 30 September 2008 (UTC)

Eublides proposes adding the words: ""Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages." , which he thinks/hopes you'll agree with. Do you indeed agree with that? --Kim Bruning (talk) 20:39, 30 September 2008 (UTC)

I agree with this statement the same way agree with the statement "The Earth is round". The Eubulides proposal is a platitude, does not add anything to the article, and there is no need to include it. Why not address the controversy directly: "Sometimes choosing between reviews and original research papers is complicated and requires editorial judgment and discussion on article's talk pages." Paul Gene (talk) 07:53, 2 October 2008 (UTC)

The wording of this principle, isn't it a matter for the core policy document Wikipedia:Reliable sources? EverSince (talk) 08:40, 2 October 2008 (UTC)

@Eversince: Basically. We can sync both documents, if you like. Incidentally, can you provide a reference for the term "core policy"? --Kim Bruning (talk) 22:34, 2 October 2008 (UTC)

Kim, what I meant really was Wikipedia:Verifiability: "Wikipedia:Verifiability is one of Wikipedia's core content policies...these policies determine the type and quality of material that is acceptable in Wikipedia articles" and its reliable sources section feeds into Wikipedia:Reliable sources of course. Don't know about sync'ing. EverSince (talk) 09:41, 3 October 2008 (UTC)

@Paul Gene. I take it that's a yes then. Would you actually be opposed to putting Eublides' wording on the MEDRS page? In the mean time, let me approach Eublides. --Kim Bruning (talk) 22:34, 2 October 2008 (UTC)

Yes, he can put that wording on the page, and 2+2=4, too. Unfortunately, that does not solve the problem. Paul Gene (talk) 12:38, 3 October 2008 (UTC)

I got back "Editorial judgment and talk-page discussion can help when choosing sources." . Is that any good? --Kim Bruning (talk) 16:07, 3 October 2008 (UTC) (Ok, this is a tad slow... I'm going to actually turn on my brain now. O:-) )

This wording is the same as 2+1=3. Let me outline the problem as I see it. Contrary to the WP:PG policy, the proposed guideline does not reflect the best community practice in writing medical articles. The best community practice is embodied in WP:MED Featured Articles[38]. It is to use reviews and original research papers in approximately equal numbers. Examples: Chagas disease refers to 17 reviews and guidelines that are cited 29 times. It refers to 33 original research articles that are cited 39 times. Keratoconus refers to 19 reviews, guidelines and textbooks that are cited 41 times. It refers to 33 original research articles that are cited 47 times.Paul Gene (talk) 20:40, 3 October 2008 (UTC)(Ok, trying to move gears a bit. Feel free to tell me that I overstepped and I will scratch my reply.) )

• These numbers do not contradict the WP:MEDRS guidelines. WP:MEDRS says "medical articles should be based upon published, reliable secondary sources whenever possible" (my emphasis). Perhaps it wasn't possible in the cited articles.
• The cited articles are reasonably old. Chagas disease became featured in July 2005, and Keratoconus in March 2006. Both these dates are before the first version of WP:MEDRS. It's not clear these older articles would still pass; FA standards have gone up since then. WP:MEDRS attempts to document current guidelines, not past guidelines.

Eubulides (talk) 23:08, 3 October 2008 (UTC)

Eublides: "medical articles should be based on secondary sources" is confusing to me. Can you clarify for me: does it mean the wikipedia definition of secondary source, or do you mean the biomedical definition of secondary article? <scratching head> --Kim Bruning (talk) 23:13, 3 October 2008 (UTC)

It means the definition of secondary sources given in WP:MEDRS #Definitions, the section that contains the sentence "In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible." that I was referring to above. Eubulides (talk) 23:18, 3 October 2008 (UTC)

%-/ <pulls hair out> No wonder there's confusion on that front! This is yet another, 3rd set of definitions. On the plus side, that explains a lot to me! :-) --Kim Bruning (talk) 23:28, 3 October 2008 (UTC) And it even links to PSTS, just to add to the confusion! <sigh>

Ok, having grabbed a cup of tea and thinking about it: Is it a consequence of the current wording that we should be avoiding the majority of texts published on pubmed ? --Kim Bruning (talk) 23:37, 3 October 2008 (UTC)

After some toast and some more reading, the wording appears to be VERY careful on this point, apparently some negotiation already happened there. I'm going to think about this and ask some more questions in the morning I think. (feel free to answer the question about avoiding pubmed though) --Kim Bruning (talk) 23:42, 3 October 2008 (UTC)

It's hard to say, but I'd guess that more than half of Pubmed should be avoided for medical articles. That is because more than half of Pubmed is over 10 years old, and older sources are likely supplanted by newer and more-reliable sources. Of course there are exceptions; please see WP:MEDRS #Use up-to-date evidence for details. And again, this is just a guess. Eubulides (talk) 00:56, 4 October 2008 (UTC)

Importantly, it's not just the source. No source is universally reliable. No source is universally appropriate. Whether a source is appropriate or reliable depends very much on how the source is used. Primary sources should not form the basis of the article. That's why MEDRS says that "medical articles should be based upon secondary sources", not "medical articles should only cite secondary sources". WhatamIdoing (talk) 01:10, 4 October 2008 (UTC)

Cool! WhatIamdoing, you may have found the source of the confusion. Some people may understand "should be based upon secondary" as "should always cite secondary". Let me see if I interpret you correctly. You are saying that reviews and textbooks do not have to be the numerically main part of the article, rather they should lay the groundwork or form the framework for it. That is something we could agree on. StevenFruitsmaak also expressed a similar sentiment here[39] Paul Gene (talk) 03:20, 4 October 2008 (UTC) Jumping up and down at the chance to have a meaningful agreement.

Yes, goodness me! The reason why PSTS is discussed at NOR is because it concerns how you use a source. If it mattered to whether you can use a source, it would be at WP:V. Nobody is banning primary sources. One reason we prefer reviews is because you can say more (with confidence, without OR, and having some assurance of WP:WEIGHT). Sure, for the details (especially if one needs to discuss the details of studies) the primary literature may be required. There are also allowances in this guideline for when the secondary literature isn't substantial enough to build on. So, yes, the groundwork and framework, the major points/facts and the contentious facts. This is how I worked on the ketogenic diet: it was written from a handful of reviews and then fleshed out with a mix of reviews and primary studies. I recently analysed the text and 76% of the words are based on secondary sources. The 24% is mostly uncontentious supplementary detail. I would have thought a big subject like epilepsy could easily be 100% sourced to secondary sources. On other articles, the figures may be much, much less. Colin°^Talk 08:32, 4 October 2008 (UTC)

Kim, in the archive you will find a list of online sources that define PSTS for science and medicine. I haven't found support for "the biomedical definition" you mention. Colin°^Talk 08:32, 4 October 2008 (UTC)

Drat. I had some sources lined up... but... no mind for now though, as it'd just get in the way of your conversation with Paul. I'll reserve the option to come back to this topic later in case things somehow get stuck, but I'm entertaining the hope that that won't be necessary at all! :-). --Kim Bruning (talk) 03:14, 5 October 2008 (UTC) (Turning brain back off)

Yes, Paul, you seem to understand. Perhaps you now also understand why so many of us were confused by your opposition. WhatamIdoing (talk) 16:44, 4 October 2008 (UTC) (who promises that if she ever intends for a guideline to require that something "always and only" be done in a single way, then the guideline will say so with an absolutely unambiguous phrase, like "always and only")

(undent) Would this wording be acceptable? Removal of the current wording is shown as the strike through. New wording is italics. - "In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible. The best practice is to use reliable secondary sources, such as reviews and textbooks, to form the framework of the medical article. This framework can then be fleshed out by adding information from reliable primary sources, such as research articles. Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse. Use primary sources with care to avoid engaging into original research. For that reason, eEdits that rely on primary sources should only make descriptive claims that can be checked by anyone without specialist knowledge." etc Paul Gene (talk) 19:23, 4 October 2008 (UTC)

I'm so glad we're no longer fighting over the definition of secondary. We say "based upon"; NOR says "rely mainly on"; neither say "always cited to", but I do feel it is more than just a "framework", which makes it sound like a review might do little more than supply the section headings (rather than be the foundation or even the main building blocks). Plus it seems to actually advise that the fleshing out be with primary sources. And the "use with care because of the potential for misuse" is a very important statement I'm reluctant to lose. Original research is not the only danger; WP:NPOV is hard to get right without consulting/citing the opinion of experts, which is where secondary sources come in. I am a little frustrated that we've wasted a month partly because "based upon" was misinterpreted, but it is a carefully chosen phrase. But to avoid accusations of WP:OWN, I'm not killing your suggestion and am open to other opinions and, of course, other suggestions.

Paul, I'm interested to know if you can "live with" the current text, and interpret "based upon" to whatever extent you feel comfortable with (saying yes, doesn't diminish your argument that your proposed text is better). You see, if we know you are no longer at war with the guideline, it will help us all relax and take our time over polishing the text. Colin°^Talk 20:33, 4 October 2008 (UTC)

Hmm. I'm considering your "best practice" statement. I think there is value in describing an approach to article building that describes using core secondary sources as a foundation and adding a mix of primary and secondary material to flesh it out. Maybe this could go under "Basic advice". Perhaps we need input from a variety of our best editors to see how they've gone about the process. Then we can document the collective wisdom. Colin°^Talk 20:44, 4 October 2008 (UTC)

Excellent! --Kim Bruning (talk) 03:14, 5 October 2008 (UTC)

I note that a subsection on NOR was recently created within WP:Reliable Sources, linking to Wikipedia:No original research#Primary, secondary, and tertiary sources. And in it the phrase about secondary sources has become "based around", and the phrase about primary sources become "with extreme caution", while the relevant policy WP:NOR still says "with care" (as currently does MEDRS).

Can I also just note that MEDRS leads with "These guidelines supplement the general guidelines at Wikipedia:Reliable sources", but in fact (and as per above discussion) seems to also be about supplementing Wikipedia:No Original Research and Wikipedia:Neutral Point of View. And supplementing seems to involve rewording. EverSince (talk) 09:54, 5 October 2008 (UTC)

Colin, what do you propose to fix the ambiguous wording of the paragraph in question? And why cannot we refer to best actual practice in the beginning? It is not a legal document we are writing, where all the definitions should be verbatim or very close to some official statute, but a helpful guide. Paul Gene (talk) 11:56, 5 October 2008 (UTC)

I think it may be worth starting a new section (if that's allowed, Kim) because these proposals are getting lost in among the position-statements of each participant. You can open it with e.g. "I found the following passage ambiguous ... and propose this replacement". If you want, I'll wait for others to comment/refine rather than put my views in first. I didn't find it ambiguous and think it provides enough wiggle room. Eubulides is pretty good with words, perhaps he can come up with something.

Wrt documenting best practice vs giving rules and guidelines: I think we need both. Sometimes when you just describe "how we do it", people find it hard to apply that to their situation. If first, you outline the principles you are working to, and then describe how we do it, they can come up with their own variation that still obeys the principles. Also, before describing a "do this then this" approach, I'd like to know if that's how people work or have found effective. What I'm trying to say is I'd like to get other input rather than play prose-tennis with you until we're happy but everybody else feels left out. Colin°^Talk 13:04, 5 October 2008 (UTC)

If you both promise to proceed carefully, we could actually unprotect the page and try things out directly (possibly we could agree to let Eubulides do the typing for now? :-) ). If you're not entirely sure, or would like to discuss at the same time, feel free to open a new section; I propose we set the condition that every post in that section must suggest an edit for Eublides to carry out. A post in that section may discuss anything else too, including the weather in far off places, but must also include at least one instruction to Eubulides as well, however trivial. (if Eubulides thinks that this would be a fun and interesting thing for him/her to do? ) I have no problem solving the issues between Colin and Paul first. Often I first make a consensus of two, then add in number three, then four, etc... one at a time. --Kim Bruning (talk) 17:07, 5 October 2008 (UTC) The condition is designed so that each participant must propose progress of some sort, no matter what else they would like to discuss. Besides, discussing with restrictions is interesting. @Paul: Obviously I'll be monitoring such a section, so feel free to post there. :-)

Hmm. I was kind of hoping to tap Eubulides' brain for some suggested phrasings, rather than demote him to typist. Regardless of who the typist is, are you saying that each time we propose something, the page changes? Or only if we're both happy? What if Eubulides can, if he wants, suggest things to Paul and me, but then one of us has to propose it back (or similar) before it goes? Colin°^Talk 17:52, 5 October 2008 (UTC)

A procedure that I've found helpful is that someone thinks out loud about what changes should be made; for example, I did this in #Eubulides' answers above. Then someone (maybe the same person) builds on that to propose a specific change (down to each word that would be changed); I did this in #Section header cleanup below. Then, this gets discussed and the proposal gets modified as discussion goes on. Then, assuming there's consensus, the change gets installed. In such cases, it's often helpful for one editor to do all the typing for the particular proposal (usually it's the editor that made the specific proposal). Obviously any changes that get installed should reflect overall consensus; it wouldn't suffice to get agreement only among Colin, Paul gene, and me. Eubulides (talk) 21:27, 5 October 2008 (UTC)

Mattisse's answers

My position

• The New York Times is no more reliable than, for example, BBCNews in providing accurate, medical summaries of data. It should be used only in combination with other reliable sources of medical information to present the "popular press" view and never as a sole source of medical information.
• Agree with WhatIamdoing on the issue of pushing cutting-edge research into Wikipedia. Specifically, in Psychology this is very risky as cutting-edge research can seem to support all sorts of "wacko" theories that are then presented as valid on Wikipedia.
• The use of editorial "common sense" likewise is risky for the general editor writing in the field of Psychology. Witness the recent inclusion of Parapsychology by a sophisticated editor in the category of Psychology in FAC. With expert writers, the use of "common sense" is somewhat less risky although it is still subject to the bias of that expert editor. WP:IAR is used to cover a multitude of sins. Again, this is especially true in Psychology, where the misuse of sources is rampant, to the point that it is almost impossible to maintain a respectable article.
• Agree that the use of primary sources should be undertaken only with great care and evaluation of the merits of the primary source. This includes primary sources in peer-reviewed journals also. Research articles are essentially OR, even if peer-reviewed since the researcher is reporting his observations (although a peer-reviewed journal is definitely superior to one that is not, as methodology is reviewed presumably). However, peer-reviewed journals contain articles on case studies, studies with low Ns, meta analyzes combining studies with widely varying methodologies, etc. Also, witness a peer-reviewed journal of the American Psychological Association apologizing, because of public pressure, for a research paper that was methodologically sound but had a politically-incorrect outcome. I strongly support the preference for citing literature or systematic reviews rather than research papers.
• I do not agree that WP:V and WP:NOR cover the sourcing problems that arise in medicine-related or science-related articles and that WP:MEDRS guideline is unneeded. Evaluation of sourcing is more rigorous for these articles and the application of rules for establishing reliabilty are somewhat different. Some of the information in WP:V, for example, can be seen as simplistic, misleading or inaccurate when used for this purpose.

—Mattisse (Talk) 17:13, 1 October 2008 (UTC)

Mattisse, thanks for joining the discussion. The above points look to be close to answering question 1 from Kim's four questions. Would you consider moving this section up to a sub-section of "Steps towards consensus"? It would also help if you could indicate what changes you would like to make to MEDRS. If you can answer questions 2-4 also, that would be great. Colin°^Talk 17:24, 1 October 2008 (UTC)

The positions of others

• I have no outstanding problem with the MEDRS guideline the way it is.
• I am not opposed to having MEDRS supplement WP:RS, WP:OR, and WP:V with advice specific to biomedical articles, as I do think the latter are misleading to the uninitiated editor which leads these editors to use inappropriate sourcing and therefore to (sometime wildly) inappropriate conclusions and even whole articles. In fact, I am inclined to support the primacy of MEDRS as a guideline for medicine-related articles.
• I agree that the use of common sense does not need to be specifically addressed in the MEDRS guidelines. In fact, I do not think it should be.
• I would be concerned about elevating the role of the popular press. As stated above, it can appropriately report on scandals and other issues not directly related to scientific evidence. Scientific American I would consider a tertiary source, useful for some purposes perhaps but not appropriate as a reference source to an article to support scientific findings.
• I do not agree with the statement, "primary literature in medicine is actually secondary sources." I believe strongly in the distinction between the two, having seen misleading information in articles when this distinction is not observed.
• I do not agree that the MEDRS page is not helpful to the experienced editor. I find it helpful and I consider myself experienced.
• I do not agree with Paul gene's statements on the differentiation and ranking of sources nor on the usefulness of the MEDRS page, so I would have difficulty in agreeing to the demotion or mass altering of the page along the lines he seems to be suggesting.
• I agree that MEDRS should be a guideline.

My compromises

I would have difficulty greatly compromising my views regarding the MEDRS page, but I am willing to be open to the opinions of others if they present practical reasons for not agreeing with me. —Mattisse (Talk) 20:16, 1 October 2008 (UTC)

Ok, this actually looks like it might be useful as part of an answer to question 2. If you have time, could you research the positions of other parties in more depth, and provide answers to 3 and/or 4 as well? --Kim Bruning (talk) 16:18, 3 October 2008 (UTC)

Apparently you might have the same misunderstanding as Orangemarlin below? I'm actually asking what you know about other people's opinions, rather than your opinion on their opinions. :-) See my answer to Orangemarlin, and see if it helps you. If you're still confused, tap me on the shoulder! :-) --Kim Bruning (talk) 23:44, 3 October 2008 (UTC)

As explained below, I am unwilling to make further comments. Since my own simple question was completely misinterpreted and therefore provoked a negative reaction, I am totally unwilling to make comments or guesses about what I think other editors might think or do beyond what they have stated. I would base any conclusions on what they have said and nothing else. I am unwilling to hypothesize. —Mattisse (Talk) 00:59, 4 October 2008 (UTC)

Well, everything you do on wikipedia is by necessity going to be based on some underlying hypothesis as to the position of others/the community. As you yourself point out, it's very easy to make mistakes! I'd very much prefer for people to explicitly state their underlying hypotheses, so that we can all work together to systematically review and test them, and thus deduce a viable "theory of consensus" ;-) on this topic. This approach should yield the optimal course of action (or something close to it).

Occasional misunderstandings and problems are to be expected when you work like this. But with this approach, misunderstandings and negative reactions are not failures: they merely serve to disprove the working hypothesis. One can simply formulate a new hypothesis and try again.

If you don't quite feel up to doing that kind of thing^xkcd quite yet, you can always choose to just answer questions I ask you in this section. I'll then talk with others and take the heat, if any is forthcoming. I have a similar arrangement with Paul Gene at the moment; he seems to be making progress! :-) --Kim Bruning (talk) 03:01, 5 October 2008 (UTC)

I do not mind disagreements. I dislike comments meant to intimidate my participation made with out even taking time to understand my question. My question was neutral. Mastcell choose to react negatively to me personally, making assumptions about my position, without addressing the question. If Mastcell is no longer a participant here, or if he is willing to cease making such responses, then I am willing to continue in the discussion. —Mattisse (Talk) 14:26, 5 October 2008 (UTC)

Jfdwolff's answers

My current position is that MEDRS was about to become an widely endorsed guideline if not for the vocal protests of two contributors. I am of the opinion that the last stable version should be kept at guideline status, as such a guideline was long overdue.

I am not willing to compromise on the basic tenets behind this guideline, namely that secondary sources are out of necessity to be preferred over primary sources. I have always held, however, that editorial judgment should be exercised when selecting secondary sources, and if a secondary source seems poor-quality, unreliable or biased there are usually alternative secondary sources to choose from.

I am not going to guess others' perspectives. We have heard enough. Neither am I going to speculate on their willingness to compromise. JFW | T@lk 22:11, 1 October 2008 (UTC)

Ok. However, if you wish to participate in a consensus process, or wish to form a consensus, you should nevertheless be taking those steps, be it implicitly or explicitly.

1. If you do not know your own aims, you can never reach consensus, because there is nothing to reach consensus over.
2. If you are unable to compromise, it is very hard to reach consensus, because you have no flexibility to negotiate with others.
3. If you are unaware of the aims of others, you can never reach consensus, because you have no information to build a consensus on.
4. If you are unable to gauge the ability of others to compromise, you are severely handicapped, because you cannot take advantage of the flexibility offered to you by others.

I'll gladly hear back from you anytime if/when you change your mind, and wish to participate in consensus formation. :-) --Kim Bruning (talk) 16:27, 3 October 2008 (UTC)

My brusque response above reflects my frustration with the fact that we cannot get this vital policy off the ground. Please bear with me.

You misunderstood my response in the sense that I know my aims very well: a working policy that gives primacy to reliable secondary sources for medical content. As this is basically a consequence of core Wikipedia policies such as NOR, V and CITE I don't think there's much to compromise over, because it is not mine to compromise (to paraphrase the late Lord Jakobovits). However, I can accept (and will concede) that newspaper articles are on rare occasions useful as secondary sources, but there needs to be clear consensus between an article's contributors that a particular newspaper article is a reliable source for the information quoted from it. Hence, in most situations I find newspaper articles unsatisfactory (e.g. see the recent fracas at number needed to treat over an article from Business Week that made possibly valid points but badly lacked context). Primary studies are occasionally good sources of information, especially where there are no comparable secondary sources (e.g. on central core disease), where secondary sources have not yet included the information in question, or where there is other information (e.g. from a major newspaper article) that suggests that a primary study has been disregarded in reviews. Editorial judgement trumps any policy, and requires consensus on a case-by-case basis.

I am only partially aware of the agendas of other editors, but I know that Paul gene wants greater liberty at citing primary studies because he feels they are selectively quoted or misrepresented in reviews written by drug company shills. This is an understandable frustration but borders on a stated intent to violate WP:NOR/WP:SYNTH, which I why I have opposed this. I am unsure if there is any strong desire to compromise from Paul or from other editors (such as ImperfectlyInformed) who have opposed this policy. JFW | T@lk 19:53, 4 October 2008 (UTC)

Cool! Thank you for taking the time to formulate such a well thought out answer.

I'm going to think about your answer for a bit. In the mean time, would you be willing to invite ImperfectlyInformed to try to answer the 4 questions too? I hope they might be able to provide some of the information you feel is missing. --Kim Bruning (talk) 04:22, 5 October 2008 (UTC)

All editors who have previously opposed this guideline presumably have this talkpage on their watchlist, and have now had ample time to offer their perspectives. If, on reviewing previous discussions, you feel that a particular editor is going to be of importance in achieving consensus you might wish to contact any such contributor yourself. I my mind, adding even more voices to this debate is going to increase noise and decrease the likelihood of any form of consensus emerging. JFW | T@lk 09:04, 5 October 2008 (UTC)

EverSince Comment

My feeling is that, rather than just an exposition of technical issues specific to medical sourcing, MEDRS is asserting reworded versions of core policies, in a way that reflects a point of view (medical or medical establishment) based on Wikipedia:Ownership. Its basis in concepts of "medical articles" or "related to medicine" is problematic. I think there needs to be discussion somewhere of the need for guidance across different areas and how to develop and coordinate it in a way that doesn't potentially undermine NPOV. EverSince (talk) 07:33, 2 October 2008 (UTC)

Examples of rewording of core policies? SandyGeorgia (Talk) 07:43, 2 October 2008 (UTC)

WP:NPOV mandates that we express ideas in proportion to their representation among experts in the field. You may, if you wish, refer to these experts as the "medical establishment". This project's fundamental goal is to create a serious, respectable reference work. This guideline is intended to give specific advice to implement those objectives on medical topics. I'm not seeing a problem. MastCell ^Talk 19:38, 2 October 2008 (UTC)

There is Wikipedia:Scientific citation guidelines. Is this Wikipedia:Ownership and undermine WP:NPOV? —Mattisse (Talk) 22:56, 2 October 2008 (UTC)

The scientific citation guideline addresses different issues. Obviously, I do not believe this guideline violates NPOV. Having re-read WP:OWN, I don't see what that policy has to do with this issue. MastCell ^Talk 17:19, 3 October 2008 (UTC)

I was merely making a somewhat frivolous reference to the comment of EverSince, pointing out that there are accepted guidelines for special areas other than MEDRS and that these are not considered to violate Wikipedia:Ownership or undermine WP:NPOV. However, you are free to disagree with it if you like and to feel my comment was ridiculous and inappropriate if you like. —Mattisse (Talk) 18:22, 3 October 2008 (UTC)

In fact, I am perfectly willing to withdraw from this discussion, if you like. —Mattisse (Talk) 18:22, 3 October 2008 (UTC)

Ah, well, I misunderstood your comment. I'm sorry; it sounds like we're in agreement. Don't feel the need to leave on my account. MastCell ^Talk 18:43, 3 October 2008 (UTC)

I do feel the need to leave on MastCell's account. I'm unwilling to participate in a discussion where an editor's comment (or short question, in this case) about content is treated with ridicule and condescension by another editor who decides he does not like the point of view he thinks the question expresses. Mastcell's apology is given only because he decides he agrees with me after all. A discussion where I cannot ask a simple question without being treated dismissively is not one where I feel comfortable in expressing myself further. —Mattisse (Talk) 00:42, 4 October 2008 (UTC)

I feel badly that you've taken offense; it was not my intention to be dismissive, but rather to concisely explain my opinion as it relates to the topic under discussion. MastCell ^Talk 06:30, 5 October 2008 (UTC)

Re. details of examples, think better to address in another section (if do at all). Re. NPOV, it doesn't say "experts in the field", but "reliable sources on the subject". It also says "A balanced selection of sources is also critical for producing articles with a neutral point of view.". Re. WP:SCICITE, I did previously wonder that, but ultimately it's much more narrowly framed, "about specific details of inline citation" to help editors on scientific projects. EverSince (talk) 22:51, 5 October 2008 (UTC)

:-) --Kim Bruning (talk) 19:54, 3 October 2008 (UTC)

Ok noted for future reference. Eversince, If you'd like to have changes made to this page, please answer the 4 questions at the top of the talk page, and let's see what we can do. --Kim Bruning (talk) 16:16, 3 October 2008 (UTC)

SandyGeorgia comment

Because I haven't followed this page (which has enjoyed broad support for several years now) closely enough since it was elevated to a guideline, I can't speculate on the position of other editors or their willingness to compromise. I do know that only two vocal opponents have held up some elements of the page with ideas about sourcing that are at variance with WP:V.

I broadly agree with the answers from Colin, Eubulides, Jfdwolff and Mattisse, although I'm unaware of the "Common sense" compromise they reference. I would be wary of any relaxing of acceptance of primary sources and lesser quality sources than peer reviewed journals because they are the means by which fringe theories are inserted into medical articles, and any common sense compromise in that area would be susceptible to wikilawyering. Paul Gene's answers are too long to read: if a position on sourcing can't be summarized concisely, a position unsupported by Wiki policy may be present; Wiki policy is clear on primary and secondary sources, and delving into dictionaries for alternate definitions isn't relevant. I did note that he has somewhat misrepresented me twice on this page, and I see he neglected to mention that Una Smith opposes the guideline because she disagrees with other Wiki policy pages.

Most of the basics of this page aren't open to compromise without bringing them in to conflict with WP:V policy; the page is useful as a guideline to explain how policy is applied and interpreted in a specific group of articles. Secondary sources are preferable to primary sources, and that will prevail per policy, with or without this guideline.

On the newspaper issue, I have never, ever, once in 20 years of research, encountered a single newspaper or magazine account of Tourette syndrome that didn't have basic, fundamental errors. Here's a simple example from a 2005 article in The New York Times. No, GTS did not first describe TS in 1885; Itard did in 1825. This is the kind of inaccuracy one often finds in the laypress. And that's not even a medical fact; that's basic history, and the NYT didn't even get that right. They do worse on the medical; there are a few significant and numerous subtle medical inaccuracies in the article as well. (Side note, Eubulides, note the 750,000 children; I found this article just now on Google.) Even in the NYT, except for their quotes of Zinner, it's fluff at best, inaccurate at worst. Newspapers are not reliable for reporting medical information, but I agree with Eubulides that we could expand the examples of when newspaper, magazine and other sources can be used.

I apologize for not having followed closely, and that I can't add much more to the discussion, but I will try to stay better tuned in from here forward. SandyGeorgia (Talk) 09:19, 2 October 2008 (UTC)

Agree with the above. FYI, the "Common sense" compromise is at Wikipedia talk:Reliable sources (medicine-related articles)/Archive 2 #Common sense. It proposed prepending "Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages." to WP:MEDRS #Definitions. Nobody else supported the compromise. Eubulides (talk) 17:58, 2 October 2008 (UTC)

Thank you. You sort of answer the 4 "question essential to consensus" that I posed, but the answers are intermingled. If at some point you find time to organize your thoughts further, that would be appreciated. :-)

It is to be understood that answers to question 3 and 4 will always contain inaccuracies. That's one of the reasons I'm asking for those answers explicitly, so that we can root out misconceptions between people. Can you point out where Paul Gene's perceptions need correction? Thank you so far for the information on Una Smith. I hope Una Smith shows up themselves, and provides more information on that. --Kim Bruning (talk) 16:12, 3 October 2008 (UTC)

OrangeMarlin comments

I'm deeply troubled that we're engaging in this long discussion because two editors, one of whom has a long history of disrupting medical articles, have complained loudly about this guideline. Consensus does not mean two editors can stand in the way of progress. If this were true, the long history of any article in this project is doomed to failure. However, setting aside the personalities of two dissenters, details of my thinking are below:

My position

1. MEDRS should be in agreement with WP:VERIFY, WP:RS and WP:PRIMARY. Because medical articles must have a slightly higher standard than articles in other fields (using as an example, an article about recent politics), it should be clearly described. In other words, as others have stated, this guideline is specific to medical articles, and sets standards, though based on other guidelines, has got to take it to another level. When I write an article, I never use popular press (i.e., newspapers, magazines, etc) to support a statement. When I see a popular press citation, I remove it and replace it with a peer reviewed article. It takes very little time to do so. The popular press, because it's journalism and not peer reviewed, has a tendency to position information to the requests of its readers, rather than to state what has been researched.
2. I really have no concerns with the guideline as it is. It will useful in establishing what can be used as citations for articles. I can't be happier, so that I quit seeing cruft being thrown into articles with the support being some off-hand statement in the New York Times. OrangeMarlin ^{Talk• Contributions} 19:17, 2 October 2008 (UTC)

The positions of others

1. I disagree that this guideline is only useful to new editors. I completely disagree. Not only will this be a good guideline for me when I'm unsure, but it can be used in content disputes in articles.
2. I do not agree that this guideline is just a repeat of other guidelines that I've mentioned above. It's not. It's an improvement specifically for medical articles. For example, a New York Times article is fine for discussing Sarah Palin, but not very useful for Alzheimer's disease.
3. I agree with SandyGeorgia's comments about newspaper articles. They're more often inaccurate rather than useful.
4. I disagree with the comments about primary sources that are published in peer-reviewed journals as being the equivalent of secondary sources. In fact, some individuals use "letters to the editors", which are very primary sources, as citations, when they have no usefulness. Secondary sources are the best.

Compromise

1. None. Two editors complaining loudly is not a reason to have these issues with a guideline endorsed by a large number of editors. OrangeMarlin ^{Talk• Contributions} 19:27, 2 October 2008 (UTC)

Ok, this answers question 1, and refutes the need for a question 2 (which is your prerogative) . Could you also answer questions 3 and 4? (to wit 3. what *are* the positions of others, as accurately as you can ascertain, and 4. where are others willing to compromise?) --Kim Bruning (talk) 16:30, 3 October 2008 (UTC)

Kim, I think I stated what I see as what others are saying. I happen to agree with the reasonable editors like Colin et al. There are no compromises. MEDRS should stay a guideline, and Paul should find another project for wasting people's time. OrangeMarlin ^{Talk• Contributions} 17:45, 3 October 2008 (UTC)

Alright. Feel free to come back any time, when you are willing/able to answer the 4 questions as posed. --Kim Bruning (talk) 18:16, 3 October 2008 (UTC)

Dude, no need to be rude. I thought I had answered the four questions above. I just thought 1&2 were combined, as you surmised. My viewpoint of the positions of others is up there. My compromise, which is NONE, is up there. Not sure what you're asking, but either I'm totally misunderstanding you, or you're intentionally being a pain in my butt. OrangeMarlin ^{Talk• Contributions} 19:59, 3 October 2008 (UTC)

Dude! I'm not trying to be a pain in your butt. Well... not too much of a pain in your butt. I'll assume you're doing the same.

I think see I the misunderstanding. You gave your opinions and views *about* the positions of others. However, those are based on a set of premises we haven't quite checked yet, which is whether everyone actually understands *what* those positions really are. Does that make (logical) sense to you?

So my actual question is ₍₃₎ what are (/do you know about) other peoples views, and ₍₄₎ what compromises do you think they are willing/able to make?

So far, from diverse answers, I've already learned that there are at least 2 different definitions of secondary sources, and (elsewhere) I've learned that sociologists treat sources in one way and biomedical researchers treat them in another way.

I wonder what kind of things you might be able to pick up yourself?

Finally, ₍₂₎ are you really that absolutely certain of yourself that you could never be wrong, and no compromise is ever possible? It could be true in this case, of course, but think and see if there may yet be some way you could show some amount of flexibility to someone? Just to be sure!

--Kim Bruning (talk) 20:38, 3 October 2008 (UTC) The four questions are basically an intelligence-gathering exercise wrt consensus. ₍₁₎ Know your own position and ₍₃₎ those of the other community members, and _{(2 and 4)} find out where compromises are possible between those two positions. Potential uncontroversial edits and potential pitfalls become obvious very quickly, that way. It also quickly becomes obvious if someone is acting in good faith or not.

I really want to engage in this conversation, but I just don't get what you want me to do. I keep thinking I'm answering the questions at the top of this thread. As for compromise? How can there be one if two editors, without a real understanding of consensus, have caused this massive discussion. And from what I've read, several regular editors agree. So, please bullet point what you want me to say, and I'll respond. OrangeMarlin ^{Talk• Contributions} 03:21, 5 October 2008 (UTC)

I think the massive discussion happened because no-one bothered to take the time to properly educate said 2 editors early on, at the first signs of trouble. A stitch in time saves nine. Why do I always manage to get called in so late, I wonder? ^^;;

Actually, there's at least 4 editors we may want to consider. You've mentioned 3 of them yourself, right?

Taking things step by step in wiki-time will be slow going, but let's try. This also means I need to expand questions quite a bit, to come to the following long-form. (and I'm not even being exhaustive yet, I'm sure ^^;;)

• (2) Identify a number of flaws with the current state of the page, where's room for improvement?
• (2) Rules by necessity sometimes have an arbitrary element (eg. some countries say you must drive on the left, some say drive on the right, it's arbitrary, but as long as everyone does the same thing, there won't be any accidents). Identify arbitrary elements in the page.
• (2) Divide aspects of the page into those that are essential to you and those that are less essential. Which aspects of the page could be deleted or altered, without essentially harming (your intent for) the page? You may have already partially answered this question with the 2 points above. If there is a lot to consider, list aspects in order of priority.
• (2) Summarize some low priority aspects that could be altered, in as few words as possible (to prevent TLDR ;-) )
• The answer to question 2 tells you how much room you have to maneuver. You may be able to sacrifice something with a low priority to gain consensus on something with a higher priority.
• (3) Name all the participants who have edited the page. Separately, name those who participate on the talk page.
• (3) Examine the opinion of each participant. What would this person write if they were editing the page by themselves? summarize it. (Do not discard the opinion of any participant!)
• (3) Note which participants tend to work together and/or agree with each other
• (3) Using the data from the above two points, cluster the participants into groups. (the less groups, the better you can summarize, but beware of overgeneralization! IMPORTANT: This particular clustering is a means to summarize data and reduce work -for your convenience only-, it is not indicative of actual cliques or cabals.)
• (3) for each group, determine their primary course of action. How would they write the page if no other group was present? Summarize
• The answer to question 3 is -by necessity- imperfect, as you are basing yourself on external information. It is best considered a hypothesis. Later steps will test this hypothesis (the most obvious approach being to simply ask people if your hypothesis is correct or not :-), though other approaches exist as well )
• (4) The answer to question 3 provides you with a number of groups and their objectives. Like yourself, these groups are attempting to reach consensus, and are maneuvering for position. Like yourself they'll be trying to find answers to question 2. For each group: what will the members of that group answer for question 2?
• If you have trouble finding a single answer for each group, perhaps you need to revisit question 3
• The answer to question 4 is -by necessity- even less perfect than the answer to question 3. Not only must you base yourself on external information, but you may also need to speculate more about other people's motives. As discussion progresses, you may find yourself updating the answers to question 4 often.

Perhaps it's a good idea to answer just a few points at a time, so we can go over each step? Let's take our time :-) --Kim Bruning (talk) 04:57, 5 October 2008 (UTC)

I wonder if there's a better way in this case? --Kim Bruning (talk) 05:35, 5 October 2008 (UTC)

LeeVanJackson comments

1. As an jackson of all trades I was trying to make sense of numerous seemingly out-of-place facts on a medical article and spent hours(years even) trawling around primary papers, I was referred here as part of a GA review, suddenly the penny clicked, some of the references were out of place, some put there in good faith - others promoting so and so research or institutes, readdressing using reviews to double check and leaving primary papers for specific facts and whola article starts making sense :) My position is as long as editors reading this guide ( note no _line / essay / policy - since it's exact status doesn't matter as long as it's helpful ;) can be saved the same time and confusion, it's ok by me!
2. I have not contributed to the actual guide, but anything that moves confrontation to collaboration ( in keeping with 1.) and let's these good editors get on with their admirable passtime(s:).
3. I think misunderstandings of the complicated business of consensus has caused some editor's to dig their heels in.
4. .. but as long as everyone feels their views have been heard respectively and fairly should be ok.
5. I think you may have stumbled on a cross-disciplinary problem, with different emphasis, respect and commercial bias of sources. Kim's pointer to a strange map of the sciences [40] also seems to back this fact up. This would explain vehement sticking to principles - since one discipline might not see eye-to-eye and the difficulty finding happiness. I would suggest that we may need an ancillary essay exploring the differences between disciplines, that way editors from different arenas of science could directly address the relevant sections and we'd have a collaborative - who know's might help solve some of the world's problems at the same time :) LeeVJ (talk) 22:19, 2 October 2008 (UTC)

You're seeing the same things I am! \o/

If you see a (partial) solution, try and see if you can answer the 4 questions wrt that solution? If you're careful and smart, you might be able to boil down your answer to just a few sentences per question. If you can, you're almost certain to gain consensus on that. :-)

--Kim Bruning (talk) 16:36, 3 October 2008 (UTC)

Fvasconcellos comments (not answers)

It seems everyone has left their two cents already, so I guess I should follow suit :)

• I have no major problem with the current state of this page. It could do with a little copy editing, and maybe some rewording (leaving content mostly unchanged) here and there, but that's it. It does reflect current practice (more on that later), it does not conflict in any perceivable way with WP:V, WP:NOR, or WP:RS, and it is not the same page that was rejected last year. It has grown and improved substantially—compare [41] and [42].
• I agree with Sandy and LeeVJ that the status of this page is actually of little consequence. Sure, being a guideline would (a) lend it greater credence and (2) make it known to a wider audience, but it would be no less useful (or less reliable) as a subpage of WP:MED or whatnot. WP:CHEMSTYLE (though fundamentally different in purpose) has always been in WikiProject space and that's not a problem.
• I respectfully disagree with Paul that this page is a "Frankenstein monster", is somehow owned by Colin, and has an "anti-research paper bias". The current wording is actually abundantly clear in that respect: Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse. That's it. This page in no way forbids the use of research papers or limits their use beyond "gold-standard" current practice. Paul's experiment of counting citations to primary and secondary literature in FAs is very interesting, and I'd like to see it taken one step further: note which statements are being supported by which type of literature. I believe you'll find most (if not all) recent FAs, and even one recently saved from FAR such as Chagas disease, do not conflict with the current wording of this page.
  I disagree with the consideration that "Since primary literature in medicine is actually secondary sources, it is generally reliable". In Wikipedia, the wording "primary/ secondary/ tertiary source" always refers to primary/ secondary/ tertiary literature, making this a moot point (and I mean "moot point" in the U.S. sense of the word—please, no misunderstandings :).
  I also disagree (not with Paul specifically, of course) that this page is not useful for experienced editors. Have a look at Wikipedia:Reliable sources/Noticeboard—you'll find that experienced editors and even administrators (who should, in a perfect incarnation of Wikipedia, know policies and guidelines backwards while blindfolded and sedated) need help with referencing practices.

I think the intelligence-gathering exercise proposed by Kim is quite helpful, but we also need to think about how we're going to move forward once people have presented their views, so we can actually build consensus—whether for the first or the umpteenth time—and decide on the status of this page. Let's make a dance and call it "the Compromise". Fvasconcellos (t·c) 12:19, 4 October 2008 (UTC)

I haven't followed the whole discussion here, but I fully agree with Fvasconcellos' opinion stated here. --WS (talk) 12:54, 4 October 2008 (UTC)

The intelligence gathering is a first step - it's what I always do before I hit 'edit' or 'submit'. The next steps depend on the answers provided. There are many pages that describe what steps to use for different situations. We'll be getting to those steps soon, I think :-) --Kim Bruning (talk) 05:07, 5 October 2008 (UTC)

In the mean time, feel free to answer the 4 questions for yourself, if you'd like to participate in consensus formation! Of course your own opinion is important, but by itself it is not actually sufficient for us to establish a consensus with you. (normally this fact is hidden and implicit, I'm just making it explicit today, for the sake of informal mediation ) --Kim Bruning (talk) 05:14, 5 October 2008 (UTC)

Section header cleanup

The table of contents is a bit scraggly. I propose shortening some section headers and removing some others (for very-short sections), as follows:

• 'Do not use primary sources to "debunk" the conclusions of secondary sources' → 'Respect secondary sources'
• 'Cite peer-reviewed scientific publications and check community consensus' → 'Summarize scientific consensus'
• 'Assess the quality of evidence available' → 'Assess evidence quality'
• 'Medical textbooks'. Remove this section header (keeping the contents).
• 'Popular science and medicine books'. Remove this section header. Replace the following 'These' with 'Popular science and medicine books'.
• 'Online'. Rename to 'External links', and move to the end of the page.

Eubulides (talk) 16:24, 1 October 2008 (UTC)

This is the TOC for the archive page? (I don't see a problem on *this* page?) --Kim Bruning (talk) 16:31, 1 October 2008 (UTC)

Sorry, I meant the table of contents for WP:MEDRS, the project page. Eubulides (talk) 16:36, 1 October 2008 (UTC)

Eubulides, I'm not sure I agree with the change to "Online". These aren't proposed "External links" for medical articles. The first set are proposed online reliable sources. We can, of course, discuss whether the set is a good one. I'm not sure we need to keep the "Background reading" section at all as they aren't proposed sources. Colin°^Talk 17:16, 1 October 2008 (UTC)

OK, thanks, I struck the 'Online' suggestion. The other ideas are reasonable but let's make them part of a later proposal. Eubulides (talk) 17:46, 1 October 2008 (UTC)

Agree with the shorter titles; as I recall, we inherited them from WP:RS during the ATT debacle, and they are clunky. SandyGeorgia (Talk) 07:48, 2 October 2008 (UTC)

That's probably not a problem. :-) Give me a bit of time to get the page unprotected? --Kim Bruning (talk) 16:46, 1 October 2008 (UTC) This would require ensuring there won't be an edit war. Might take 24-48 hours at a guesstimate

Unprotection would be a seriously bad idea. Just ask an admin to make any consensual changes for now. Colin°^Talk 17:16, 1 October 2008 (UTC)

That's a very tempting course of action, yes. It would make it seem like I'd personally (with a little admin help) "solved" the situation quickly and easily, and I can go about showing off as Kim The Great Mediator, or some such, I suppose. :-P

Unfortunately, the approach of "let an admin do it" fails to encourage mutual trust, doesn't restore an equitable situation, fails to teach people how to find consensus by themselves, leaves people too dependent on administrators and/or mediators, and forces an administrator into a role they were never chosen for. All these are things we really Do Not Want.

So let's resist the "let an admin do it" siren song as much as possible. Does that make sense? :)

The next step here is to get multiple people to agree to a way of working that hypothetically precludes edit-warring, and then we take things step by step from there.

We can then test our hypothesis by unprotecting. If people immediately grasp a new way of thinking, sing Kumbayah, and work in perfect harmony (unusual - but possible :-P), then great! If there's hiccups, we smooth them over. But even if people immediately revert or even edit war, that provides useful information, and we can work from there. Depending on what happens, we can draw conclusions, invite people to participate in discussion, block people, or do something else entirely.

If something strange does happen, I'm known to be very creative. But so far, things have mostly happened the same way they always do, and there haven't been any surprises. Alright? --Kim Bruning (talk) 19:19, 1 October 2008 (UTC)

I see what you are trying to do. I'm just not convinced we're ready to take the stabilisers off yet. Go on. Test your hypothesis. Colin°^Talk 20:19, 1 October 2008 (UTC)

:-) *nod*. Before we do that, we're still waiting for some feedback from Paul Gene, and it might be wise to contact Ludwigs2 too? *goes off to check* --Kim Bruning (talk) 20:34, 1 October 2008 (UTC)

Mostly Paul Gene at this point, I guess, though I see Matisse has a slightly different position from Colin and Eublides? I'll also wait to see if SandyGeorgia has anything to add. :-) --Kim Bruning (talk) 20:40, 1 October 2008 (UTC)

Well, I had great intentions many hours ago that I would make it here today, but FAC, FAR and the moon had other plans for my day. Tomorrow should be better. SandyGeorgia (Talk) 07:48, 2 October 2008 (UTC)

So once again, instead of relying upon the vast opinions of numerous reliable editors, Kim Bruning decides to get the opinions of two disruptive editors. Great. OrangeMarlin ^{Talk• Contributions} 19:29, 2 October 2008 (UTC)

Shorter titles are good. Is that what we're talking about here, content-wise? MastCell ^Talk 19:34, 2 October 2008 (UTC)

Yup. :-) --Kim Bruning (talk) 22:50, 2 October 2008 (UTC)

Orangemarlin: First off, please don't call less experienced people "disruptive editors". It's labeling, and not a very productive approach to conflicts.

But that said; *duh* I'm going to spend most of my time on the less experienced people. If I ask a more experienced person (like Jimbo Wales) to be civil and follow consensus, I'm not going to get much of a return on investment on that, because the experienced person will know to do that on their own. On the other hand, if I explain things to a less experienced participant in a discussion, the gain is much higher, since it adds a noticeable amount of clue to the discussion.

In short, I'm relying on the regulars to play nice, not make trouble, and cover my back while I work on talking with people who are not-so-regular. I'm not going to get any trouble from any particular regular person, am I? :-) --Kim Bruning (talk) 22:50, 2 October 2008 (UTC)

Well, I disagree. And my comment wasn't because they were inexperienced, but because they had an odd definition of consensus, which is disruptive. Ludwigs2 has been blocked for edit warring about 4 or 5 times. Not sure why we require his opinion on anything useful. OrangeMarlin ^{Talk• Contributions} 00:44, 3 October 2008 (UTC)

Well, let's find out, shall we? You may be surprised! --Kim Bruning (talk) 16:39, 3 October 2008 (UTC)

Kim, people don't change. Ludwigs has been blocked 5 times. He will be blocked 5 more. I don't AGF disruptive editors. OrangeMarlin ^{Talk• Contributions} 17:41, 3 October 2008 (UTC)

Some people learn. Some don't. Those that don't are rightly banned. Those that do often become our better contributors. --Kim Bruning (talk) 18:15, 3 October 2008 (UTC)

I'm much more realistic and cynical. We balance out each other. OrangeMarlin ^{Talk• Contributions} 19:57, 3 October 2008 (UTC)

As these changes are unrelated to the dispute and there seems to be clear consensus, I went ahead and made the changes. --WS (talk) 11:49, 4 October 2008 (UTC)

Dang! I'd been saving those for when we unprotect the page as a set of easy edits to establish trust. O:-) No matter, I'm sure We'll find something else. In the mean time, thank you very much for taking the initiative, that's worth quite a lot by itself. Will you be around in the coming days? :-) --Kim Bruning (talk) 02:43, 5 October 2008 (UTC)

RfC Archive

An active RfC was evidently archived to /Archive 2#Rfc Promotion of MEDRS to guideline. I'm not sure if there was discussion about this, but I would recommend either unarchiving it, or turning it off (removing the template). These things generally run 30 days and then automatically turn themselves off, but in less time than that, premature archiving ends up with the odd situation of a "live" RfC in the archive, and a link from the RfC page that sends interested editors to an archive page (not a good idea): Template:RFCpolicy list. If no one else has a preference, I'll go ahead and unarchive it, but I wanted to check first. --Elonka 22:27, 1 October 2008 (UTC)

No additional comments in the last 10 days. Colin°^Talk 22:43, 1 October 2008 (UTC)

The discussion and consensus about archiving the RfC is in the same linked page as the archived RfC. (I looked in the archive and can't decipher what is needed to "turn it off".) SandyGeorgia (Talk) 22:49, 1 October 2008 (UTC)

Okay, I got it (I nowiki-ed the template). The bot should notice within the next hour or so, and automatically update the RfC list. I'll keep an eye on it and tweak as needed if that wasn't enough. --Elonka 23:24, 1 October 2008 (UTC)

An example of the problem

As an example of one of the areas where this guideline is essential, I invite your attention to our article on colloidal silver. This product is marketed as the cure to whatever-ails-ya. There are no data indicating its effectiveness, and it has the unfortunate tendency to turn people blue, usually permanently, if they use too much. Numerous secondary sources note the ineffectiveness and potential toxicity of this product:

• Review from the M. D. Anderson Cancer Center.
• Review from the Memorial Sloan-Kettering Cancer Center.
• The U.S. Food and Drug Administration: PMID 10558603 (see also here)
• The Australian Therapeutic Goods Administration: see here

This is supported by numerous primary sources (articles in the peer-reviewed medical literature) attesting to complications of colloidal silver use. Now view this edit. It cites a handful of long-outdated, unrelated, or cherry-picked primary sources to counter the clear and unanimous opinion of medical experts as expressed by the secondary sources above. MastCell ^Talk 22:48, 5 October 2008 (UTC)

My problem regarding this discussion

My problem is that much of my graduate education in my field consisted of indoctrination in the use of the "scientific method" and the associated rules and methodologies for evaluating data. This has served me well in my professional life. (I won't wikilink to the Wikipedia article on the scientific method because I have no faith in the accuracy of the Wikipedia article on the subject.) Because of the ethics in my field, I cannot compromise on this subject personally. This is why, long ago, I learned to avoid editing, or being involved in any way, in articles in my field. I am willing to avoid editing articles that do not respect the scientific method. I believe, however, that the lack of respect for the scientific method is responsible for the deplorable state of the articles in my field. There is one FA on a fairly limited subject in my field that is very large in number of Wikipedia articles.

Bottom line: I have very little room to compromise. Consensus on Wikipedia and scientific consensus in the real world are unrelated. —Mattisse (Talk) 00:04, 6 October 2008 (UTC)

Mattisse, I understand that this topic may be too close to your heart for you to feel able to endorse a compromise you are uncomfortable with, and therefore feel you can't participate in consensual editing if this leads away from your principles [am I interpreting this correctly?]. However, I encourage you to stick around here as there is certainly room for editors to impart wisdom from their (real world) experiences, without fully joining in the editing process. Colin°^Talk 08:51, 6 October 2008 (UTC)

Taking a back seat

I'm going to take a back seat for a while. I've been involved in most discussions at MEDMOS and MEDRS since their creation. This last month has been exhausing and I need a break from it. With MEDRS especially, I always hoped that more experienced editors (both on Wiki and in real life) would come on board and push it forward. Well, there's loads of experienced editors on this talk page and I want to read you guys for a while rather than staring at my own words in the preview window.

For those who haven't spotted, this edit by WhatamIdoing seemed to be the turning point, leading to this reply by Paul. Note that WhatamIdoing repeated the guideline's exact words, followed by a clarification on what it does not say. Please read the discussion that followed in Paul's section. Currently, I see no pressing need to alter the following two sentences:

In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible. Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse.

since "in general"; "based upon"; "can" and "be used" all indicate we do not mean "should always cite secondary" as Paul suggests "some people" may take it.

Kim has asked Paul and I to play at consensual editing here but I don't have the heart for it right now, to be honest. No offence to Paul -- another topic and another time, perhaps. I don't believe consensus is to be found in a straight line halfway between me and Paul. Consensus is a team game in three dimensions. Over to you [plural]. Colin°^Talk 12:30, 6 October 2008 (UTC)