Dr Reeves

Welcome to Wikipedia from the Wikiproject Medicine!

Welcome to Wikipedia and Wikiproject Medicine

Welcome to Wikipedia from Wikiproject Medicine (also known as WPMED).

We're a group of editors who strive to improve the quality of content about health here on Wikipedia, pursuing the mission of Wikipedia to provide the public with articles that present accepted knowledge, created and maintained by a community of editors.

One of our members has noticed that you are interested in editing medical articles; it's great to have a new interested editor on board!

First, some basics about editing Wikipedia, which is a strange place behind the scenes; you may find some of the ways we operate to be surprising. Please take your time and understand how this place works. Here are some useful links, which have information to help editors get the most out of Wikipedia:

• Everything starts with the mission - the mission of Wikipedia is to provide the public with articles that summarize accepted knowledge, working in a community of editors. (see WP:NOT)
• We find "accepted knowledge" for biomedical information in sources defined by WP:MEDRS -- we generally use literature reviews published in good journals or statements by major medical or scientific bodies and we generally avoid using research papers, editorials, and popular media as sources for such content. We read MEDRS sources and summarize them, giving the most space and emphasis (what we call WP:WEIGHT) to the most prevalent views found in MEDRS sources.
• Please see WPMED's "how to" guide for editing content about health
• More generally please see The five pillars of Wikipedia and please be aware of the "policies and guidelines" that govern what we do here; these have been generated by the community itself over the last fifteen years, and you will need to learn them (which is not too hard, it just takes some time). Documents about Wikipedia - the "back office" - reside in "Wikipedia space" where document titles are preceded by "Wikipedia:" (often abbreviated "WP:"). WP space is separate from "article space" (also called "mainspace") - the document at WP:CONSENSUS is different from, and serves as a different purpose than, the document at Consensus.

Every article and page in Wikipedia has an associated talk page, and these pages are essential because we editors use them to collaborate and work out disagreements. (This is your Talk page, associated with your user page.) When you use a Talk page, you should sign your name by typing four tildes (~~~~) at the end of your comment; the Wikipedia software will automatically convert that into links to your Userpage and this page and will add a datestamp. This is how we know who said what. We also "thread" comments in a way that you will learn with time. Please see the Talk Page Guidelines to learn how to use talk pages.

• Thanks for coming aboard! We always appreciate a new editor. Feel free to leave us a message at any time on our talk page. If you are interested in joining the project yourself, there is a participant list where you can sign up. You can also just add our talk page to your watchlist and join in discussions that interest you. Please leave a message on the WPMED talk page if you have any problems, suggestions, would like review of an article, need suggestions for articles to edit, or would like some collaboration when editing!
• The Wikipedia community includes a wide variety of editors with different interests, skills, and knowledge. We all manage to get along through a lot of discussion that happens under the scenes and through the bold, edit, discuss editing cycle. If you encounter any problems, you can discuss it on an article's talk page or post a message on the WPMED talk page.

Feel free to drop a note below if you have any questions or problems. I wish you all the best here in Wikipedia! Jytdog (talk) 23:58, 14 July 2017 (UTC)

We can chat here

For sources, we tend to stick with journals that are pubmed indexed and have an impact factor. Thus trimmed one of the refs. Doc James (talk · contribs · email) 21:21, 13 July 2017 (UTC)

If you are using references that you have written you need to disclose that fact on your user page. Also with such a COI present probably not the best idea to remove high quality sources by others. Doc James (talk · contribs · email) 21:24, 13 July 2017 (UTC)

Just place the disclosure here. Best Doc James (talk · contribs · email) 21:46, 13 July 2017 (UTC)

Dr Reeves, you are invited to the Teahouse!

Hi Dr Reeves! Thanks for contributing to Wikipedia. Be our guest at the Teahouse! The Teahouse is a friendly space where new editors can ask questions about contributing to Wikipedia and get help from experienced editors like Cullen328 (talk). Visit the Teahouse We hope to see you there! Delivered by HostBot on behalf of the Teahouse hosts 20:04, 14 July 2017 (UTC)

Quick note

Hi Dr Reeves. You are off to a pretty good start by using reviews instead of primary sources, per WP:MEDRS. The only thing I ask you is to be please be mindful of the various "rules" and norms discussed in the Welcome message I just placed at the top of this page.

And with regard to prolotherapy and its ...alternative-ness, please do be mindful of Wikipedia:Conflicts of interest (medicine), which includes things that are not part of usual COI considerations in medical publishing. One thing discussed in that guidance document, is the use of Wikipedia to advocate for medical theories in which editors are personally invested. This often arises in light of Wikipedia's neutral point of view policy, which obligates editors to give the most "weight" (space and importance) to mainstream views. This can be difficult to achieve for editors when they believe strongly in a given notion, that others may not share. I hope that makes sense.

Doc James or I would be happy to discuss more if you have any questions. But again, welcome! Jytdog (talk) 00:03, 15 July 2017 (UTC) __________________ Let me know where best to reply. Is this ok?

I am grateful for your feedback, Jytdog. (And Doc James of course.) This update will be more impactful and useful if balanced and I appreciate the importance of giving the most "weight" (space and importance) to mainstream views. Unfortunately, I have been disappointed for quite a number of years now by a lack of evidence basis of the "mainstream view". To be sure, the literature on prolo is thin, as all studies are self-funded and performed with the volunterism of the primary investigators with no proprietary support for dextrose, but the quality of the RCTs is high per Cochrane risk of bias. This quality is reinforced by selection of three of the RCTs for review on POEMS by Essential Evidence Plus with identical bias ratings to recent prolotherapy review articles. In addition there are now 37 residency or fellowship programs in neuomusculoskeletal medicine that require training in prolotherapy and active residency training in prolotherapy is underway in PM&R training programs at Walter Reed and in the Harvard and University of Wisconsin systems.

This evening, I am working on arguably the toughest section now (low back/sacroiliac pain), and I will including the Cochrane reviews mentioned in the original comments, and placing them in the perspective of more recent studies in hopes of balance. This section is the hardest for me, so I am eager to hear perspective about how I am perceived as meeting the NPOV policy.

Kind regards Dr Reeves (talk) 03:25, 15 July 2017 (UTC)

July 15 I just uploaded the low back/SI pain comments. Prior reviews comments were essentially untouched, but clarified/ updated, and the conclusions were not really any different or reaching. Hope I am on the right track here. Dr Reeves (talk) 15:52, 15 July 2017 (UTC)

I see that changes have been made already in some of the sections. (IE: Knee OA) How do you have time to do this? Thank you. I will see if I can tweak a little but again this gives me an idea of the nudging that you are doing with changes, which I will keep in mind. Dr Reeves (talk) 16:12, 15 July 2017 (UTC)

The knee OA was further modified. Just added one review article. What struck me was a P.I. orthopedic surgeon who seriously proposed to disqualify all injection studies for systematic review if they have less than 50 PARTICIPANTS PER ARM and misused the Cochrane bias tool to downgrade every study to low grade automatically on that basis. I mentioned in the summary because it does taint the review rather dramatically, but if I have gone overboard, set me straight there. Dr Reeves (talk) 20:14, 15 July 2017 (UTC)

I reviewed editing changes by colleagues. Thank you. I can see how better balance has been obtained with the changes and I was unnecessarily overeditorializing. Dr Reeves (talk) 11:45, 16 July 2017 (UTC)

It is generally understood and corroborated by recent review articles that the mechanisms of prolotherapy is multifactorial. Some of the references listed can be deleted but I did not do so and defer to other editors about deleting the multiple references listed. Instead, I added two sentences for update and listed the most updated review indicating a multifactorial reference and a recent review that summarized basic science findings in multiple RCTs. In this case there were 3 consecutive RCTs performed by the Orthopedic Research Lab at Mayo Clinic done in development of their animal model of carpal tunnel syndrome in which they used non inflammatory dextrose (10%), proved that no white cells were found and demonstrated doubling of the transverse carpal ligament thickness and a stronger ligament with normal histology. 1. Oh S, Ettema AM, Zhao C, et al. Dextrose-induced subsynovial connective tissue fibrosis in the rabbit carpal tunnel: A potential model to study carpal tunnel syndrome? Hand. 2008;3(1):34-40. 2. Yoshii Y, Zhao C, Schmelzer JD, Low PA, An KN, Amadio PC. The effects of hypertonic dextrose injection on connective tissue and nerve conduction through the rabbit carpal tunnel. Arch Phys Med Rehabil. 2009;90(2):333-339. 3. Yoshii Y, Zhao C, Schmelzer JD, Low PA, An KN, Amadio PC. Effects of hypertonic dextrose injections in the rabbit carpal tunnel. J Orthop Res. 2011;29(7):1022-1027. 4. Yoshii Y, Zhao C, Schmelzer JD, Low PA, An KN, Amadio PC. Effects of multiple injections of hypertonic dextrose in the rabbit carpal tunnel: a potential model of carpal tunnel syndrome development. Hand (N Y). 2014;9(1):52-57.