Talk:List of diagnoses characterized as pseudoscience
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Title: I believe "List of contested diseases" more accurate and appropriate
editMany in the medical profession question or refute the listed diseases. Titling this list "questionable diseases" takes a non-neutral point of view favoring those in medicine who question or refute the listed diseases. It would be more accurate and much more neutral to title this list "List of contested diseases." I intend to change the title if there are no objections. JustinReilly (talk) 20:23, 18 June 2015 (UTC)
- If you're gonna go that route then "contested diagnoses" could be better. Diseases are contested (treated) every day. :p Please give this some time, I hope someone more savvy than me can give a better opinion. — Jeraphine Gryphon (talk) 07:44, 19 June 2015 (UTC)
- Thanks for your input, Jeraphine! I gave it some time as you asked (almost 3 months) but noone else has chimed in. Your suggestion of "contested diagnoses" is fine with me. However, I looked at some of the relevant guideline pages and the main one: WP:MOVE, suggests that the most commonly used nomenclature for the term should be a title of any article including a list. Thinking about this, I recalled only one term being used in my reading on this topic: "contested illness." I did google searches of the three terms as a rough proxy of how commonly they are used and found the following number of results: for "questionable diseases": 1,230 results; "contested diagnoses": 1,690; "contested illnesses": 8,720. The singular (as opposed to plural) forms of these terms yielded similar results: "contested illness" was the most used term. Also in scanning the google results, it appears that "contested illnesses" is used much more frequently in the academic literature than the other terms. FYI, some more potentially useful guideline pages: naming Lists: WP:LISTNAME; "Stand-alone Lists": WP:SAL; Titles of Articles generally: WP:TITLE. I have "moved" the name of the list to "contested illnesses" and redirected the only two pages that linked/redirected to the list. There was a suggestion on the notice I got to "check if there were any sort keys" but the link had no information on how to figure that out and I have not heard of sort keys; if someone knows how to do this, may I ask that you check and edit the sortkeys, if any. I welcome further comment from anyone of course. Thank you for your consideration! JustinReilly (talk) 04:35, 7 September 2015 (UTC)
Does Chronic Lyme Disease belong on the list?
editI edited the list in June to take off CLD. User 216.54.219.238 reverted my edit. He or she said: "(Undid revision 667539638 by Justito (talk) The majority opinion is still that Chronic Lyme Disease is questionable.)" I posted the following response on his/her talk page: I don't think that is clear at this point; it seems more to be a split in the authorities, with the vast majority of Lyme Disease specialists on the side of "non-questionable" (and with the majority of the scientific evidence being on the side that CLD constitutes at least a minority, but may, or may not, account for the majority of those with PTLDS); and the momentum is very clearly to the "nonquestionable" view; of course the majority medical opinion almost always lags years to decades behind the (1) science and then (2) the majority opinion of experts in the diseases; so I really think it needs to drop off the list at this point. btw, do you have a user name (other than 216.54.219.238)? I will reverse the edit if I don't hear from you; but do welcome your opinion of course. Cheers, Justin JustinReilly (talk) 04:32, 7 September 2015 (UTC)
- Chronic Lyme is the canonical quack diagnosis, yes it absolutely belongs here. Any disease where believers have to pass a law so they aren't disciplined for unethical behaviour in "diagnosing" it and "treating" it (with, it must be noted, quite risky treatments) is definitely not a proper diagnosis. Guy (Help!) 21:46, 8 September 2015 (UTC)
I would like to request that CLD be removed from this list. It is not a "canonical quack diagnosis" as many well trained and well respected doctors and researchers diagnose and treat for this disease. Chronic Lyme Disease exists when treatment is not successful (for many reasons - but that doesn't matter) and treatment options are varied and questionable (but that doesn't matter either). I invite those who disagree to review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102277/. Another issue is that current testing cannot indicate if the infection is cured after a treatment protocol, https://jcm.asm.org/content/40/2/319 and therefore Lyme Disease is a disease diagnosed based on symptoms not tests. If the symptoms still exist Wikipedia should not be the place to define this two sided issue. Cheers Andrew Sharky905 (talk) 03:10, 14 September 2018 (UTC)
- Thanks for your note, but "chronic lyme disease" is not a thing. Post-Treatment Lyme Disease Syndrome is a thing. Jytdog (talk) 03:31, 14 September 2018 (UTC)
Moved back
editJustito (talk · contribs · deleted contribs · logs · filter log · block user · block log) doesn't seem to have much editing experience, these are not "contested" diagnoses they are questionable - chronic Lyme, Mogellons and so on, do not exist, and are used by quacks to sell worthless treatments. That's the focus of the article. Guy (Help!) 17:43, 8 September 2015 (UTC)
- The move was explained in the first section here. (I'm not saying I agree with it necessarily but I hope you didn't just gloss over it because the editor doesn't have experience.) "Questionable diseases" just sounds kind of funny to me. — Jeraphine Gryphon (talk) 18:03, 8 September 2015 (UTC)
- The explanation parses as not liking the fact that these are not real. I also looked at some of his few other contributions, which include agenda-driven edits to a BLP that has been under savage attack for a decade. Guy (Help!) 21:43, 8 September 2015 (UTC)
Empty nose syndrome
editDoes Empty nose syndrome belong here? I'm trying to clean up that page because it was written as an anti-turbinectomy diatribe. It's certainly a controversial condition but I am not an ENT surgeon. What's the cutoff for controversial v questionable? [Signed in retrospect] Dubbinu | t | c 14:36, 10 June 2016 (UTC)
I'm pretty sure Fibromyalgia is real.
editI am almost certain that fibromyalgia is real, yet I see an unsourced statement on this page saying that it is not. Am I wrong, and if I am, could someone find me a source? --RafChem (talk) 23:54, 1 March 2017 (UTC)
- On second thought, this seems to have been removed and re-added. I'll just be bold instead.--RafChem (talk) 00:05, 2 March 2017 (UTC)
Consider to delist Non-coeliac gluten sensitivity
editBasically questionable needs to be properly defined. Non-coeliac gluten sensitivity is not exactly "fake" like Morgellons. Something really happens, cause may be some gluten related product or some different thing if not gluten. The condition is not fake.— Preceding unsigned comment added by MozzieINbangla (talk • contribs) 13:06, 5 April 2017 (UTC)
A mess
editThis article is very problematic. Some of it fails WP:V, which is unacceptable for a controversial medical article. Most of it fails WP:MEDRS, the higher standard we expect of material pertaining to medicine.
Moreover, it looks like WP:SYNTH. It lumps together quite different things. You've got fan death, an urban myth of note as a cultural phenomenon, but not something a patient ever believes themself to have. You've got functional disorders, where you have real people with real symptoms, but controversy over whether there is a unifying syndrome or cause. You've got something largely rejected by medical orthodoxy like vertebral subluxation to those which have some support (fibromyalgia has only just been removed from this list). Then you have non-coeliac gluten sensitivity, which is broadly accepted in the literature, but which is also massively over-(self-)diagnosed, a cultural fad.
While there is something interesting to say about all these, while there is, in a sense, something questionable about them all, they are quite different and listing them without discussion in this manner is bad medicine and bad Wikipedia-ing. This article needs some MEDRS-suitable articles giving a broader context. As it stands, I'd support WP:TNT. Bondegezou (talk) 10:37, 8 February 2018 (UTC)
The title: "List of disputed diseases"?
editThere was discussion of moving this page to "List of contested diseases" a few years ago, a move that was subsequently undone by JzG (a change that I agree with myself). However, I still believe the current use of the adjective "questionable" is too vague. Would "List of disputed diseases" work better? I would be WP:BOLD and move it anyway, but since there was already discussion and disagreement about this topic, I decided to come here. Nanophosis (talk) 22:52, 9 June 2018 (UTC)
- I'm happy to consider alternatives, up to and including "fake". Guy (Help!) 23:20, 9 June 2018 (UTC)
- I still favour WP:TNT. The article arbitrarily sticks together very different things and mostly fails WP:MEDRS. It omits lots of things it might include. We have good articles across Wikipedia on pseudoscience etc. I see no value in this article. Bondegezou (talk) 14:33, 10 June 2018 (UTC)
- I would agree that the article should be entirely rewritten, but I don't usually edit medical-related articles and thus don't feel comfortable trying to rewrite this one; that's why I chose to work on the title instead. Nanophosis (talk) 18:01, 10 June 2018 (UTC)
- I still favour WP:TNT. The article arbitrarily sticks together very different things and mostly fails WP:MEDRS. It omits lots of things it might include. We have good articles across Wikipedia on pseudoscience etc. I see no value in this article. Bondegezou (talk) 14:33, 10 June 2018 (UTC)
"Renaming is advisable"
editI proposed deleting this article, but that proposal was not supported by the community: see Wikipedia:Articles for deletion/List of questionable diseases. There was a lot of useful discussion there that could help improve this article. In particular, the AfD was closed with, "The result was kept, but renaming is advisable." The question is to what, and what that means for what articles are included here. GreenMeansGo pointed out that WP:LISTCRITERIA requires the criteria for inclusion in a list article to "be unambiguous, objective, and supported by reliable sources", which they don't seem to be at present.
In the AfD, different people were interpreting what this article should be differently. These interpretations imply different possible names and different content. Edison summed it up as "diseases which are popular but which may lack a scientific basis". JzG called it a list of "fake diseases". Only in death described it as "wingnuttery".
I thought Little pob had an interesting suggestion, writing, "The only way I can see a list such as this working is to rename; to remove the ambiguity around questionable (contested/disputed/unproven could work). Then separate the different types of "questionable" diagnoses into contextual subheadings. The sections could cover alternative medicine (e.g. adrenal fatigue), disproved conditions (e.g. morgellions), urban myths (e.g. fan death (if it were readded)), historically contested but gaining (e.g. non-celiac gluten sensitivity) etc."
There was some discussion around moving to "discredited" rather than "questionable", or to "diagnoses" rather than "diseases". JzG pointed out that, "The best title depends on the scope of the article. It might be considered legitimate to include real but rare diagnoses that are massively over-hyped by quacks".
My main concern remains the vagueness of "questionable", so renaming can help. However, I'm also concerned about sourcing. I could remove items that fail WP:MEDRS, but that's not going to leave very much! Bondegezou (talk) 10:02, 4 July 2018 (UTC)
Sourcing
editLooking through the article, the only two that remotely meet WP:MEDRS as far as I can see are Autistic enterocolitis and Vertebral subluxation, and even then it depends what we're actually claiming the list inclusion criteria to be. Bondegezou (talk) 10:09, 4 July 2018 (UTC)
- I honestly have no idea what the proper medical/scientific terminology for a disputed disease would be. "Questionable" is colloquial and nebulous and gives us no clear inclusion criteria. May as well be List of shady diseases or List of fishy diseases (not to be confused with Fish disease and parasites). GMGtalk 11:07, 4 July 2018 (UTC)
- I'm not certain there is a proper medical/scientific terminology for a disputed disease, which is why I don't think this article works. There is a literature around particular categories of contested illnesses. So, Mass psychogenic illness and Functional disorder covers two types of phenomena. (The Functional disorder article is very poor, but there's a large, established literature on the topic.) A lot of this is about alternative medicine and the orthodox medicine literature just talks about that under the umbrella of "alternative medicine". Bondegezou (talk) 11:15, 4 July 2018 (UTC)
- Possible alternatives:
- Fake diseases
- Fake diagnoses
- Questionable diagnoses (yes, I know you hate the word questionable, but it is 100% technically accurate)
- Diagnoses that lack medical acceptance
- Quack diagnoses
- I'm sure there are more. The current title is the least bad I could think of at the time.
- Step 1, though, is to ensure that everyone agrees on scope. So, for example, would MTHFR polymorphisms be included, on the basis that the vast majority of people diagnosed with them don't actually have any medical condition, and are merely marks for charlatans? Would we include PANDAS, where again it's a real but extremely rare thing, with vastly larger numbers of fake diagnoses made by quacks using bogus diagnostics?
- As to MEDRS, by definition you won't get any. That would be like asking for authoritative refutations of flat earth theory in the geophysical literature. The medical world is only rarely concerned with fake diseases, and then largely when the treatments cause harm (e.g. "chronic Lyme", where long-term antibiotics have caused serious harm including death or "vertebral subluxation" where chiropractors have caused stroke and again death). Guy (Help!) 11:30, 4 July 2018 (UTC)
- Well, part of the problem with "questionable" is that we're using it in a figurative sense, meaning dubious or doubtful, rather than a literal sense, meaning "amenable to investigation"...e.g., not something like...the existence of Thomas Paine's deist God, or the existence of Qualia, which are literally constructed in such a way so as to be unquestionable, meaning outside the realm of empirical, evidence based inquiry. GMGtalk 11:47, 4 July 2018 (UTC)
"[List of] diagnoses that lack medical acceptance"
+1 for this suggestion. It's probably the most accurate and neutral title possible for the topic. Little pob (talk) 13:08, 4 July 2018 (UTC)- Thanks for raising this discussion point. There is a similar list under List of topics characterized as pseudoscience#Health_and_medicine. How should we differentiate these two lists? The pseudoscience category has explicit inclusion rules. Should this list essentially capture Category:Alternative diagnoses? T0mpr1c3 (talk) 18:56, 4 July 2018 (UTC)
- The two are not synonymous, this article allows for things that are real but massively abused by quacks, whereas the alternative diagnoses category only allows for fake diseases. Guy (Help!) 22:02, 4 July 2018 (UTC)
- Thanks for raising this discussion point. There is a similar list under List of topics characterized as pseudoscience#Health_and_medicine. How should we differentiate these two lists? The pseudoscience category has explicit inclusion rules. Should this list essentially capture Category:Alternative diagnoses? T0mpr1c3 (talk) 18:56, 4 July 2018 (UTC)
- Well, part of the problem with "questionable" is that we're using it in a figurative sense, meaning dubious or doubtful, rather than a literal sense, meaning "amenable to investigation"...e.g., not something like...the existence of Thomas Paine's deist God, or the existence of Qualia, which are literally constructed in such a way so as to be unquestionable, meaning outside the realm of empirical, evidence based inquiry. GMGtalk 11:47, 4 July 2018 (UTC)
- Possible alternatives:
- I'm not certain there is a proper medical/scientific terminology for a disputed disease, which is why I don't think this article works. There is a literature around particular categories of contested illnesses. So, Mass psychogenic illness and Functional disorder covers two types of phenomena. (The Functional disorder article is very poor, but there's a large, established literature on the topic.) A lot of this is about alternative medicine and the orthodox medicine literature just talks about that under the umbrella of "alternative medicine". Bondegezou (talk) 11:15, 4 July 2018 (UTC)
- I edit a few medical-type pages and would be happy to volunteer to try to get this one in better shape. T0mpr1c3 (talk) 14:27, 4 July 2018 (UTC)
- I think there are a number of distinctions one can make. One can distinguish between:
- things that are definitely nonsense like Morgellons, Autistic enterocolitis and the sort of stuff under List of topics characterized as pseudoscience#Health_and_medicine; and
- things that are (as I would use the word) questionable, where there is debate, where there is faddishness, but something is also going on, which would include JzG's category of things like MTHFR polymorphisms.
- One can also distinguish between different sorts of fakes:
- what are close to scams, like Reward Deficiency Syndrome;
- what might've have been popular once but basically no-one believes now, like Morgellons; and
- very widely accepted in alternative medicine, but rejected by orthodox medicine.
- But lumping very different things together is misleading, and can end up being too positive in its portrayal of some things. Bondegezou (talk) 16:42, 4 July 2018 (UTC)
- I do agree, and while your original suggestion of WP:TNT has the merit of boldness but not the consensus of Wikipedians, I suggest pruning down is an excellent strategy. I do not think there needs to be zero overlap with List of topics characterized as pseudoscience#Health_and_medicine but can we come up with a list of flaky diagnoses that would be better off there? For example, I have transferred Morgellons, Vertebral subluxation, Adrenal fatigue, Wilson's syndrome, Wind turbine syndrome and Autistic enterocolitis to the other list, and removed Leaky gut and Electromagnetic hypersensitivity which were already there. There is also a category for Fringe theories for the really oddball stuff. T0mpr1c3 (talk) 20:36, 4 July 2018 (UTC)
- I think you've created a somewhat more homogeneous list, which is good. However, you've also created something that's further away from how many editors appeared to perceive this article (which was to focus on the clear pseudoscience). What we need is a better name + criteria against which to judge what goes in or out.
- Here's another bold suggestion! Why don't we just do a redirect to List of topics characterized as pseudoscience#Health_and_medicine? That appears to be the list that a lot of editors (Edison, JzG, Only in death ??) wanted. Bondegezou (talk) 20:17, 4 July 2018 (UTC)
- I don't think there was much of a consensus about anything, to be honest. I am hoping that by whittling away the overlap with better developed categories there will be a core list that is more easily described. T0mpr1c3 (talk) 20:39, 4 July 2018 (UTC)
- I concur there wasn't much consensus. Something close to List of topics characterized as pseudoscience#Health_and_medicine seems to be how many see the list and can be more easily defined and sourced... but if we want something like that, why don't we just have that (i.e. redirect there)? Or would this be somehow different? Something more like my "things that are (as I would use the word) questionable, where there is debate, where there is faddishness, but something is also going on" fits the current name better, but seems to me dangerously vague and harder to source. Bondegezou (talk) 20:48, 4 July 2018 (UTC)
- I would like to get down to a list of diseases that are not pseudoscience, in that there is no scientific basis at all, but rather a contested body of evidence such that the diagnosis is currently not integrated with mainstream medicine. This was formerly the case, I think, with the diagnosis of chronic fatigue syndrome, which is now generally recognized as a real phenomenon rather than a purely psychosomatic illness, even if its causes remain obscure. The reverse also happens, for example the diagnosis of neurasthenia is now not recognized in the way that it was 100 years ago -- but doctors in places like the Far East still might prefer to diagnose a nonspecific "nerve disorder" rather than more recognized psychiatric illness due to the stigma attached to psychiatric treatment in some populations. Some disorders it still depends who you ask -- perhaps Restless Leg Syndrome falls into this category. I think this would be a useful change of purpose for the page. I doubt there is consensus for that though. T0mpr1c3 (talk) 21:29, 4 July 2018 (UTC)
- The original purpose of this list was to identify well known diagnoses widely used by charlatans to exploit people. Chronic Lyme, electromagnetic hypersensitivity, non-coeliac gluten sensistivity, candidasis, chronic Lyme, and other fake diagnoses whose symptoms are symptoms of life. Some are based on real diseases, some are based on real but exceptionally rare conditions that are massively overdiagnosed by quacks. That was the purpose. Valid sources for such an article include Quackwatch, Science Based Medicine, Skeptical Inquirer and so on, as well as any medical sources, most of which would be primary (e.g. papers by Edzard Ernst, if such existed for any of them). A few people seem to have decided to write a different article with different sourcing criteria instead. That's... mildly irritating. Guy (Help!) 22:12, 4 July 2018 (UTC)
- In that case, the original purpose of the list is redundant with the pseudoscience list. T0mpr1c3 (talk) 00:07, 5 July 2018 (UTC)
- The original purpose of this list was to identify well known diagnoses widely used by charlatans to exploit people. Chronic Lyme, electromagnetic hypersensitivity, non-coeliac gluten sensistivity, candidasis, chronic Lyme, and other fake diagnoses whose symptoms are symptoms of life. Some are based on real diseases, some are based on real but exceptionally rare conditions that are massively overdiagnosed by quacks. That was the purpose. Valid sources for such an article include Quackwatch, Science Based Medicine, Skeptical Inquirer and so on, as well as any medical sources, most of which would be primary (e.g. papers by Edzard Ernst, if such existed for any of them). A few people seem to have decided to write a different article with different sourcing criteria instead. That's... mildly irritating. Guy (Help!) 22:12, 4 July 2018 (UTC)
- I would like to get down to a list of diseases that are not pseudoscience, in that there is no scientific basis at all, but rather a contested body of evidence such that the diagnosis is currently not integrated with mainstream medicine. This was formerly the case, I think, with the diagnosis of chronic fatigue syndrome, which is now generally recognized as a real phenomenon rather than a purely psychosomatic illness, even if its causes remain obscure. The reverse also happens, for example the diagnosis of neurasthenia is now not recognized in the way that it was 100 years ago -- but doctors in places like the Far East still might prefer to diagnose a nonspecific "nerve disorder" rather than more recognized psychiatric illness due to the stigma attached to psychiatric treatment in some populations. Some disorders it still depends who you ask -- perhaps Restless Leg Syndrome falls into this category. I think this would be a useful change of purpose for the page. I doubt there is consensus for that though. T0mpr1c3 (talk) 21:29, 4 July 2018 (UTC)
- I concur there wasn't much consensus. Something close to List of topics characterized as pseudoscience#Health_and_medicine seems to be how many see the list and can be more easily defined and sourced... but if we want something like that, why don't we just have that (i.e. redirect there)? Or would this be somehow different? Something more like my "things that are (as I would use the word) questionable, where there is debate, where there is faddishness, but something is also going on" fits the current name better, but seems to me dangerously vague and harder to source. Bondegezou (talk) 20:48, 4 July 2018 (UTC)
- I don't think there was much of a consensus about anything, to be honest. I am hoping that by whittling away the overlap with better developed categories there will be a core list that is more easily described. T0mpr1c3 (talk) 20:39, 4 July 2018 (UTC)
- I do agree, and while your original suggestion of WP:TNT has the merit of boldness but not the consensus of Wikipedians, I suggest pruning down is an excellent strategy. I do not think there needs to be zero overlap with List of topics characterized as pseudoscience#Health_and_medicine but can we come up with a list of flaky diagnoses that would be better off there? For example, I have transferred Morgellons, Vertebral subluxation, Adrenal fatigue, Wilson's syndrome, Wind turbine syndrome and Autistic enterocolitis to the other list, and removed Leaky gut and Electromagnetic hypersensitivity which were already there. There is also a category for Fringe theories for the really oddball stuff. T0mpr1c3 (talk) 20:36, 4 July 2018 (UTC)
- This is a red herring. We don't require MEDRS for non-medical topics, and these are by definition non-medical You won't find an article in the NEJM saying that wind turbine syndrome is still bollocks. You appear to be trying to write a different article. Guy (Help!) 22:07, 4 July 2018 (UTC)
- If you are saying that questionable or contested diagnoses are necessarily non-medical, and only discussed on non-medical contexts, then I disagree and am happy to let you know why. T0mpr1c3 (talk) 00:48, 5 July 2018 (UTC)
- Maybe not NEJM specifically, but wind turbine syndrome is reviewed in the core clinical journals, e.g., PMID 23331380. Whether these people experience symptoms (answer: yes) and what the cause of those symptoms are (answer: most sources think it's stress-related) are legitimately medical questions. WhatamIdoing (talk) 19:35, 5 July 2018 (UTC)
- If you are saying that questionable or contested diagnoses are necessarily non-medical, and only discussed on non-medical contexts, then I disagree and am happy to let you know why. T0mpr1c3 (talk) 00:48, 5 July 2018 (UTC)
- Yeah, I think all these things that were removed need to be restored. Natureium (talk) 22:08, 4 July 2018 (UTC)
- They are all still on Wikipedia under List_of_topics_characterized_as_pseudoscience#Health_and_medicine, with expanded and better referenced listings. T0mpr1c3 (talk) 00:08, 5 July 2018 (UTC)
- There has been some bold editing, but maybe we need to walk before we run. We were asked to rename this article: a name helps define inclusion criteria, or deciding on criteria will help define the name. It seems to me that a plurality of editors want a "wingnuttery" list, something approximating what JzG argues for. Perhaps that could be renamed List of pseudoscientific diagnoses? T0mpr1c3 wants something different, but I'm less clear on what would be a suitable name: perhaps List of contested diagnoses? Are either of these able to achieve consensus? Bondegezou (talk) 08:34, 5 July 2018 (UTC)
- The topic (as the article was before it was gutted) was something like "List of things that people often diagnose themselves with without medical evidence" That doesn't mean that the disease doesn't exist, that means it's a target for people looking for something to blame any symptoms on (small intestinal bacterial overgrowth), or superstitions they want to avoid developing symptoms of (fan death). Obviously, that's not a proper title, but that's essentially the topic of the article. Also, if Empty nose syndrome wasn't part of the original list, it should be. Perhaps List of diagnoses lacking medical consensus could work. Or List of commonly self-diagnosed conditions. Natureium (talk) 16:05, 5 July 2018 (UTC)
- The list (as was) was not "List of things that people often diagnose themselves with without medical evidence". At least, many of the things on the list were very obscure with only tiny numbers ever claiming to have them (e.g. Morgellons, Reward Deficiency Syndrome, fan death). But it's useful to hear how you saw the list.
- If you want "List of things that people often diagnose themselves with without medical evidence", then I think you want functional disorders. That article needs work, but that's where much of the real medical research has been, around understanding those sorts of conditions. We have a real scientific term and MEDRS-worthy research on the topic.
- List of commonly self-diagnosed conditions doesn't work. It would have to include cold, flu, sprain, migraine etc.!
- List of diagnoses lacking medical consensus, it seems to me, includes two different categories: diagnoses where there is medical consensus that they don't exist (Morgellons, vertebral subluxation) and diagnoses where there is no medical consensus either way (chronic fatigue syndrome, empty nose syndrome, Gulf War syndrome). I don't think it's useful to combine those in the same list. The former is easy to describe (and are covered at List of topics characterized as pseudoscience#Health_and_medicine); the latter are harder to handle -- how much consensus is enough or not enough? Is 23 standard metric units of consensus enough? Bondegezou (talk) 16:40, 5 July 2018 (UTC)
- The topic (as the article was before it was gutted) was something like "List of things that people often diagnose themselves with without medical evidence" That doesn't mean that the disease doesn't exist, that means it's a target for people looking for something to blame any symptoms on (small intestinal bacterial overgrowth), or superstitions they want to avoid developing symptoms of (fan death). Obviously, that's not a proper title, but that's essentially the topic of the article. Also, if Empty nose syndrome wasn't part of the original list, it should be. Perhaps List of diagnoses lacking medical consensus could work. Or List of commonly self-diagnosed conditions. Natureium (talk) 16:05, 5 July 2018 (UTC)
Babies and bathwater
editWhy was electromagnetic hypersensitivity removed? It is the canonical non-existent disease. Guy (Help!) 22:05, 4 July 2018 (UTC)
- It was duplicated in List_of_topics_characterized_as_pseudoscience#Health_and_medicine. T0mpr1c3 (talk) 00:07, 5 July 2018 (UTC)
You cannot just gut this article without coordinating with people. It survived an AfD and now you are changing it into an article that it was not. These deletions should be undone. Information can be present in more than one article. Natureium (talk) 16:08, 5 July 2018 (UTC)
- There was nothing there to gut, really. A hodgepodge of poorly referenced links whose subject matter was covered better elsewhere. I'm happy to populate the page once there is some consensus around what the content is supposed to be. T0mpr1c3 (talk) 18:01, 5 July 2018 (UTC)
Changes 4 July 2018
edit- In the absence of a clear consensus, I have tried to make a useful distinction between contested diagnoses and pseudoscience by removing the overlap to List_of_topics_characterized_as_pseudoscience#Health_and_medicine. If you think there is a better way to do this, please have at it. T0mpr1c3 (talk) 00:37, 5 July 2018 (UTC)
- In addition to including these items on List_of_topics_characterized_as_pseudoscience#Health_and_medicine, where necessary I have tagged them as Category:Pseudoscience and Category::Alternative diagnoses, and included them on Wikipedia:WikiProject_Skepticism/List#Health_and_healing.
Non-celiac gluten sensitivity
editI'm chopping this from the list. Leonard et al. (2017) in JAMA doi:10.1001/jama.2017.9730 satisfies WP:MEDRS way better than the current citation given and concludes it exists. Plenty of similar references too. Lots of people stop eating gluten for faddy reasons, but that does not make NCGS a "questionable disease". Bondegezou (talk) 09:52, 5 July 2018 (UTC)
- The main issue seems to be the amount of self-diagnosed people who believe to suffer from it. It is also difficult to confirm that gluten is the actual cause. —PaleoNeonate – 12:50, 5 July 2018 (UTC)
- I agree with the removal. WP:MEDRS show NCGS is considered a genuine medical diagnosis. I'm not sure if there is complete consensus in the medical community as yet. There are charlatans selling fad diet products, for sure, but the diagnosis itself is not in the realm of alternative medicine. Multiple chemical sensitivity is closer to a borderline case. T0mpr1c3 (talk) 19:04, 5 July 2018 (UTC)
Survey
editWhat did you think this article covered (before recent edits)? Please indicate below which of these is closest to your understanding of what this article should be about (+ any notes about whether you think such a definition is practical or what to call it). Indicate more than one category if appropriate. I have based this categories on a rough thematic analysis of comments to date, but I'm sure you'll tell me if I've got this wrong. Bondegezou (talk) 17:15, 5 July 2018 (UTC)
1. A list of pseudoscientific diagnoses: i.e. fake diseases/discredited diseases/"wingnuttery"/quackery/diagnoses related to List of topics characterized as pseudoscience#Health_and_medicine. Stuff that's definitely nonsense. Examples would include Reward Deficiency Syndrome, vertebral subluxation, Morgellons, Autistic enterocolitis, Electromagnetic hypersensitivity, Adrenal fatigue etc. (One could subdivide this further.)
2. A list of "contested" diagnoses/diseases: i.e. where there is a lack of medical consensus whether this is real or not. Examples might include restless leg syndrome, empty nose syndrome, Gulf War syndrome.
3. A list of real diseases associated with some dubiousness, a faddish over-diagnosis or something. Examples include non-celiac gluten sensitivity, PANDAS, chronic fatigue syndrome (or should that be in the previous category)... maybe restless leg syndrome should go here.
4. Edison came up with, "diseases which are popular but which may lack a scientific basis". Natureium above said, ""List of things that people often diagnose themselves with without medical evidence". The article text talks of conditions where, "Most purported symptoms are vague, generic, nonspecific, and generally categorised as "symptoms of life"." So something around things that are (a) popular, (b) contested and (c) often self-diagnosed.
5. Other
Responses:
- 1 Most of the old list came under this category. I think that's closest to what it has been (although T0mpr1c3's edits removed all these). I think it's also the easiest to define. And I also think that List of topics characterized as pseudoscience#Health_and_medicine covers much the same ground and does it better. I think 2 is very difficult to define and we shouldn't try to, least not in such a simplistic way as a unitary list. I think 3 is also very difficult to define and the individual articles do a better job of handling the disputes and discussions. A lot of people see something around 4. Something around 4 is recognised and described in the scientific medical literature as functional disorders. Again, I think tieing in with and/or improving that article would be a better approach. Bondegezou (talk) 17:15, 5 July 2018 (UTC)
- 4 I though it was (4), but to me, that encompasses 1, 2, and 3. My idea of what this article is would be unverified medical diagnoses. Maybe the article should encompass 1, 2, and 3, but trying to split them up into categories that way would probably involve OR. Diseases not medically recognized or not verified could include all of these though. Natureium (talk) 18:06, 5 July 2018 (UTC)
- I think maybe over-self-diagnosis is getting a little out in the weeds. If I've convinced myself that I'm soooo OCD because I've cleaned my house particularly well, that's not a problem with the disease, that's a problem with my medical expertise. GMGtalk 18:14, 5 July 2018 (UTC)
- 2 Number two is the list that I prefer, because it is not covered elsewhere. I think of it as a sort of drill-down from the topic of evidence-based medicine. I admit that it is rather a specific subset of what was here before. I think that is actually a good thing, because the list was a ragbag assortment.
- Number one is covered well by existing content. You could take a subset of List of topics characterized as pseudoscience and put it here. I would be absolutely fine with that, provided that someone first wipes the slate clean by removing the list 2/list 3 diseases. The problem with the list as it was previously is that controversial aspects of medical practice had got jumbled up with the lint-collection that is new-age pseudomedicine.
- Number three covers areas that fall under fad diets and disease mongering. I think you could justify a list like that, but the only item that springs to mind is nonceliac gluten sensitivity. So that would basically involve creating a new list from whole cloth. Restless legs syndrome belongs here IMO. One might also include over-prescription of things like ADHD meds, Valproate for "childhood bipolar disorder", and so on, even Halitosis. That would appear to be a whole new direction.
- Number four, syndromes that are collections of nonspecific symptoms, is as you say basically the definition of functional disorders. There is overlap with 1 (Candida hypersensitivity,Hypoadrenia), 2 (Multiple chemical sensitivity, Gulf war syndrome), and 3 (Non-celiac gluten sensitivity). T0mpr1c3 (talk) 18:55, 5 July 2018 (UTC)
- The question isn't what do you prefer, it's what the list was before it was gutted without consensus. Natureium (talk) 21:44, 5 July 2018 (UTC)
- What it was was "other" - a pig's ear. T0mpr1c3 (talk) 21:48, 5 July 2018 (UTC)
- I've never heard that saying before, but I'll assume it's not a good thing. Natureium (talk) 21:53, 5 July 2018 (UTC)
- I like bits of pig, but only after the guts have been taken out. T0mpr1c3 (talk) 22:01, 5 July 2018 (UTC)
- I've never heard that saying before, but I'll assume it's not a good thing. Natureium (talk) 21:53, 5 July 2018 (UTC)
- What it was was "other" - a pig's ear. T0mpr1c3 (talk) 21:48, 5 July 2018 (UTC)
- The question isn't what do you prefer, it's what the list was before it was gutted without consensus. Natureium (talk) 21:44, 5 July 2018 (UTC)
- 5 A mishmash of things that are described sympathetically more often in the popular press than in the conventional medical literature. WhatamIdoing (talk) 21:32, 5 July 2018 (UTC)
- Also, I want to say thanks to Bondegezou for asking this question, because we can't figure out the title until we know what the subject is supposed to be. WhatamIdoing (talk) 22:44, 5 July 2018 (UTC)
- I don't like list articles much and am sorry to see so much effort being put into this one. I have two suggestions:
- Just redirect to List of topics characterized as pseudoscience#Health_and_medicine and forget about the rest
- Leave the title as it is, but define "questionable" as "not listed in ICD" which is a very concrete definition. (btw, misophonia and Trypophobia and the rest of the ^&%$ fun-with-greek phobias should be listed too. :) ) Jytdog (talk) 07:03, 6 July 2018 (UTC)
- So, unrecognized disorders, perhaps? I think this is an excellent suggestion. T0mpr1c3 (talk) 10:42, 6 July 2018 (UTC)
- As of ICD-11, "not listed in ICD" means that Traditional Chinese Medicine diagnoses (e.g., "stagnant qi") are off this list, but all newly discovered viral illnesses belong on it. "Unrecognized" isn't a bad approach, but it does beg the question of who gets to do the recognizing. WhatamIdoing (talk) 21:29, 8 July 2018 (UTC)
- That is a good point, thanks. Jytdog (talk) 22:54, 8 July 2018 (UTC)
- I don't see any TCM stuff here, which is the US adaptation of ICD-10. That page is linked from here which is turn linked from the section on 2019 release of ICD-10-CM here. Jytdog (talk) 23:00, 8 July 2018 (UTC)
- We could specify ICD-10, I suppose, except that isn't sustainable and has difficulties such as making several thousand rare diseases appear on this list. We could also specify ICD-11 with the caveat that it must be a code that's acceptable on a death certificate (the TCM chapter won't be). I'm not sure what we'd do with historical conditions (e.g., real diseases, accepted at the time, but since re-classified into multiple unrelated conditions) under a rule like that. Presumably all of the proposed diseases and newly discovered pathogens would appear here, which isn't ideal. WhatamIdoing (talk) 07:56, 9 July 2018 (UTC)
- Yes, what WhatamIdoing said. We could have List of conditions not in ICD-10, but that won't be sustainable once ICD-11 is finalised. We'd have to move to List of conditions not in ICD-10. It would be a rather different list to what this article has been in the past. Things are not in ICD for a variety of different reasons. I don't quite understand the bit about what will be acceptable on a death certificate. Many diseases are real, but would be unlikely to ever be on a death certificate. "Sexual dysfunction associated with pelvic organ prolapse" is in ICD, but is never going to be on a death certificate. Bondegezou (talk) 10:14, 9 July 2018 (UTC)
- ICD-11 itself seems to be creating a "second-class citizen" with the TCM stuff. They'll get numbers, but they can't even theoretically be used to report a cause of death. By contrast, "Sexual dysfunction associated with pelvic organ prolapse" is at least theoretically acceptable on death certificate (e.g., if you die during a related surgery?). We could specify "accepted by conventional medicine" as an exclusion, and treat the appearance of a condition in any version of ICD means that it doesn't belong in this list. WhatamIdoing (talk) 21:47, 9 July 2018 (UTC)
- I think that's more workable: if it's in ICD-11, then it's not in the list, but if it's not in ICD-11, then we can look at other factors. Do we also go with List of diseases not accepted by conventional medicine as a new name?Bondegezou (talk) 22:30, 9 July 2018 (UTC)
- What do we do about the fact that e.g. Multiple Chemical Sensitivity is coded as "Somatoform disorder, unspecified" in ICD-10? Clearly that is valid diagnostic code, but effectively the WHO is saying that the causes of the symptoms do not involve chemical sensitivity at all. (Only in Germany and Austria do medical authorities recognize MCS to be an actual cause of disease.) One answer to this is that the important point is that a diagnosis is given (diagnosis as decision to treat, or diagnosis as billing code for insurance companies). A different answer is that formally a diagnosis is an attempt to specify the cause of disease: therefore somatic symptom disorders, which are presumed to have psychological causes, are not the same as chemical sensitivities, which are presumably have immunological or toxicological causes. T0mpr1c3 (talk) 04:50, 10 July 2018 (UTC)
- I understand that neither Germany nor Austria accept it either. The basis for that years-old blogosphere claim appears to be a letter from the Austrian health ministry that said they code everything the same way that the Germans do, which is a far cry from "we agree that your symptoms are caused by 'chemicals'". Which leads us to another question: Do we mean "we question whether people with MCS are sick at all" (=they're all malingering, or they shouldn't be so upset about all this nausea and stuff, because that's just "symptoms of life") or "people with MCS are sick, but we question whether the problem is caused by the specific mechanism that they claim is the accurate cause"? WhatamIdoing (talk) 17:35, 10 July 2018 (UTC)
- There are a lot of issues here, none of which are addressed by this article in its current form. First, what is a disease, and what is a diagnosis? It can just be a label for a group of people. If one is studying, say, Gulf War syndrome, then you talk about Gulf War syndrome, because you have to talk about it to study it. So it has some existence as a diagnosis whether or not you think it's "real". It's a useful label for a group of patients, which is all any diagnosis is really. Second, what do we mean by real? "Real" can mean is it a distinct thing. That is, can you characterise a group of patients with a particular shared set of symptoms, who are distinct from other groups of patients with other diagnoses. But "real" can also mean do you accept the aetiological mechanism implied by its name. Few people believe ME (i.e. myalgic encephalomyelitis) is real, because there is little evidence for any encephalomyelitis, but chronic fatigue syndrome is more widely accepted. Medicine is also pragmatic, so if lots of people insist that CFS is a thing, then it is a thing. Most of the Controversies related to chronic fatigue syndrome aren't so much whether it's "real", but about what it is: is it psychogenic or is it 'physical'? Is it treated better by CBT or by something else? To a health researcher like me, both of those are "real", so I don't see that as a "real"/"not real" debate. However, for many patients and lay people, stuff that's 'in your head' isn't "real" whereas calling it chronic fatigue immune dysfunction syndrome makes it 'physical' and "real". This is stuff better covered at functional disorders perhaps.
- Another example... let's go back to Morgellons as my favourite. Morgellons is "real" in the sense that it is a specific phenomenon that warrants having a Wikipedia article about it: ergo, it's real. People diagnosed with Morgellons, or people self-diagnosing with Morgellons, are a distinct group of people who one may wish to treat in particular ways distinct from other groups. But what Morgellons really is is a mass delusional parasitosis. Ergo, it's not "real". So, if pushed, I would say it is a real diagnosis (i.e., it's not from List of fictional diseases), but a fake disease. Bondegezou (talk) 18:01, 10 July 2018 (UTC)
- I understand that neither Germany nor Austria accept it either. The basis for that years-old blogosphere claim appears to be a letter from the Austrian health ministry that said they code everything the same way that the Germans do, which is a far cry from "we agree that your symptoms are caused by 'chemicals'". Which leads us to another question: Do we mean "we question whether people with MCS are sick at all" (=they're all malingering, or they shouldn't be so upset about all this nausea and stuff, because that's just "symptoms of life") or "people with MCS are sick, but we question whether the problem is caused by the specific mechanism that they claim is the accurate cause"? WhatamIdoing (talk) 17:35, 10 July 2018 (UTC)
- What do we do about the fact that e.g. Multiple Chemical Sensitivity is coded as "Somatoform disorder, unspecified" in ICD-10? Clearly that is valid diagnostic code, but effectively the WHO is saying that the causes of the symptoms do not involve chemical sensitivity at all. (Only in Germany and Austria do medical authorities recognize MCS to be an actual cause of disease.) One answer to this is that the important point is that a diagnosis is given (diagnosis as decision to treat, or diagnosis as billing code for insurance companies). A different answer is that formally a diagnosis is an attempt to specify the cause of disease: therefore somatic symptom disorders, which are presumed to have psychological causes, are not the same as chemical sensitivities, which are presumably have immunological or toxicological causes. T0mpr1c3 (talk) 04:50, 10 July 2018 (UTC)
- I think that's more workable: if it's in ICD-11, then it's not in the list, but if it's not in ICD-11, then we can look at other factors. Do we also go with List of diseases not accepted by conventional medicine as a new name?Bondegezou (talk) 22:30, 9 July 2018 (UTC)
- ICD-11 itself seems to be creating a "second-class citizen" with the TCM stuff. They'll get numbers, but they can't even theoretically be used to report a cause of death. By contrast, "Sexual dysfunction associated with pelvic organ prolapse" is at least theoretically acceptable on death certificate (e.g., if you die during a related surgery?). We could specify "accepted by conventional medicine" as an exclusion, and treat the appearance of a condition in any version of ICD means that it doesn't belong in this list. WhatamIdoing (talk) 21:47, 9 July 2018 (UTC)
- Yes, what WhatamIdoing said. We could have List of conditions not in ICD-10, but that won't be sustainable once ICD-11 is finalised. We'd have to move to List of conditions not in ICD-10. It would be a rather different list to what this article has been in the past. Things are not in ICD for a variety of different reasons. I don't quite understand the bit about what will be acceptable on a death certificate. Many diseases are real, but would be unlikely to ever be on a death certificate. "Sexual dysfunction associated with pelvic organ prolapse" is in ICD, but is never going to be on a death certificate. Bondegezou (talk) 10:14, 9 July 2018 (UTC)
- We could specify ICD-10, I suppose, except that isn't sustainable and has difficulties such as making several thousand rare diseases appear on this list. We could also specify ICD-11 with the caveat that it must be a code that's acceptable on a death certificate (the TCM chapter won't be). I'm not sure what we'd do with historical conditions (e.g., real diseases, accepted at the time, but since re-classified into multiple unrelated conditions) under a rule like that. Presumably all of the proposed diseases and newly discovered pathogens would appear here, which isn't ideal. WhatamIdoing (talk) 07:56, 9 July 2018 (UTC)
Arbitrary break
editLet's keep the survey responses coming and thanks to those who have inputted so far. So far, not much consensus has emerged as to what this list was ever about, but let's review when more people have inputted. Several people describe a mishmash. So, in the mean time, I have boldly re-written the text of the article (I've left the actual list unchanged in this edit) to try and reflect that, along the lines suggested by Little pob during the AfD. It's just a suggestion: revert if I'm going in the wrong direction, or edit further to make it better. I remain concerned too about WP:MEDRS, but it will be easier to tackle sourcing when we know what we're trying to source! We also still need to settle on a new name. Bondegezou (talk) 09:53, 6 July 2018 (UTC)
- Does MEDRS apply when the information is about things that are specifically not medical? Natureium (talk) 15:31, 6 July 2018 (UTC)
- They are medical because they relate to someone's health. WP:MEDRS begins, "Wikipedia's articles are not medical advice, but are widely used as a source for health information." If someone thinks they have vertebral subluxation, or whatever, they are using Wikipedia for health information. We have a responsibility to get such information right and we shouldn't be afraid to not say something if we can't source it properly. Bondegezou (talk) 15:44, 6 July 2018 (UTC)
- Well WP:PARITY definitely applies, as Guy noted above. So MEDRS if such refs exist, but because by definition of the topic they may not, then PARITY is fine. Jytdog (talk) 15:48, 6 July 2018 (UTC)
- If we want this article to focus on 1 (above), on the pseudoscience, I am perfectly happy with the sort of sourcing used for Wikipedia's excellent coverage of many pseudoscience topics. Indeed, I'm all for this article focusing on that category. But as we get into the other categories above, I don't see that the argument that "by definition of the topic" sources "may not" exist holds. There is plenty of more MEDRS-compliant sourcing that does exist for the functional disorders etc. Anything that's contested (rather than where there's a consensus that it's nonsense) in the medical literature by definition has sources in the medical literature. Bondegezou (talk) 16:37, 6 July 2018 (UTC)
- Well WP:PARITY definitely applies, as Guy noted above. So MEDRS if such refs exist, but because by definition of the topic they may not, then PARITY is fine. Jytdog (talk) 15:48, 6 July 2018 (UTC)
- They are medical because they relate to someone's health. WP:MEDRS begins, "Wikipedia's articles are not medical advice, but are widely used as a source for health information." If someone thinks they have vertebral subluxation, or whatever, they are using Wikipedia for health information. We have a responsibility to get such information right and we shouldn't be afraid to not say something if we can't source it properly. Bondegezou (talk) 15:44, 6 July 2018 (UTC)
Proposal: List of diseases rejected by conventional medicine
editWe've had a lot of useful and friendly discussion above. Nonetheless, it doesn't particularly feel like we're moving towards much of a consensus on a new name or inclusion criteria. I've asked some open-ended questions above. Maybe it is time for a closed choice. Can editors say whether they support or oppose this proposal?
This article should focus on diagnoses that are rejected by conventional medicine/science, with a name something like "List of diseases rejected by conventional medicine". We retain some of the current text pointing people to other sorts of contested cases, e.g. functional disorders, but the list of conditions is defined as those where there is a consensus that they do not exist in their claimed form. This article would complement List of topics characterized as pseudoscience#Health_and_medicine but be focused on diagnoses. Examples would include Reward Deficiency Syndrome, vertebral subluxation, Morgellons, Autistic enterocolitis, Electromagnetic hypersensitivity, Adrenal fatigue etc. Bondegezou (talk) 09:05, 10 July 2018 (UTC)
- sorry about this; accident. Jytdog (talk) 15:21, 10 July 2018 (UTC)
- Support T0mpr1c3 (talk) 16:51, 12 July 2018 (UTC)
Name
editWell, that's two of us in favour and no-one's actually said they don't like it, so... we go with this? What should the name be? I offer: List of diagnoses characterized as pseudoscience; or List of diseases rejected by conventional medicine. Please pick which you want, or make another suggestion. Bondegezou (talk) 18:51, 17 July 2018 (UTC)
- Let's go with the first. We have had a hard time settling on anything else. Doctors can't agree what a disease is anyway T0mpr1c3 (talk) 21:49, 17 July 2018 (UTC)
- I also think List of diagnoses characterized as pseudoscience is fine. —PaleoNeonate – 22:01, 17 July 2018 (UTC)
Name changed
editIn the absence of any objection (albeit without much explicit support either), I have changed the name of the article, restored much of the content that was removed but several editors wanted back, and re-ordered and re-jigged the material to fit the new name, as per prior discussion. I think the article still needs work, but thought I would pause there. Bondegezou (talk) 18:15, 19 July 2018 (UTC)
- Your effort has been awesome. Thanks. T0mpr1c3 (talk) 21:08, 19 July 2018 (UTC)
- I've tightened up the blurb a bit. I'm still not sure where MCS belongs, but let's leave it where it is for now. T0mpr1c3 (talk) 21:40, 19 July 2018 (UTC)
- Thanks, T0mpr1c3 for your follow-up edits. I think the article is way better now. Bondegezou (talk) 12:48, 20 July 2018 (UTC)
List vs Examples
editI renamed the section titled "Examples" to "The List". The article is titled "List of...". This section simply is that list, it is not examples of the list. There may be a better title than "The List" but "Examples" is nonsensical.
If the article were instead titled "Diagnoses characterized as pseudoscience" or such, then "Examples" would make sense, and the way this article is written, that might well be a better change. --Ericjs (talk) 23:14, 8 March 2019 (UTC)
Disease mongering vs completely pseudoscientific
editThere is a Wikipedia entry for disease mongering ("a pejorative term for the practice of widening the diagnostic boundaries of illnesses and aggressively promoting their public awareness in order to expand the markets for treatment."). Good examples would be the promotion of problems related to MTHFR, gluten, and toxins. Alt med practitioners frequently falsely diagnose these conditions, though a small portion of the population does have problems with MTHFR, gluten, and toxins. This is different from something like Morgellons, which was completely made up. Quackwatch similarly distinguishes between "Not Scientifically Defined or Recognized" and "Scientifically Recognized But Inappropriately Diagnosed." So it might be a good idea to distinguish between these types of pseudoscientific diagnoses. ScienceFlyer (talk) 05:31, 17 November 2022 (UTC)