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LoD considerations when an analyte is a tested with a matrix type that differs from the sample matrix

Not really sure how to phrase this more precisely, as it's a complex question that entails a complex answer. I presume that the main potential for statistical bias in diagnostic LoD comes from the physiochemical property differences between the two matrices.

I'd like to verify that and see what - if anything - is an important consideration in such circumstances; it's not always possible/feasible to obtain the exact matrix used during clinical testing in an analytical study, so it's definitely worth covering this issue and the sources of bias in the LoD article either way.

I have no idea which parts of these sources cover it or to what extent, but it's unequivocally going to be mentioned in both of these reference manuals:

• CLSI EP12-A2 (User Protocol for Evaluation of Qualitative Test Performance)
• EP14-A2 Evaluation of Matrix Effects; Approved Guideline—Second Edition (2005)

Anyone happen to have access to these pdfs? Seppi333 (Insert 2¢) 10:37, 22 October 2022 (UTC)

@Seppi333: I've not been here all that long -- but long enough to fondly remember your great work on psychoactive substance articles, addiction-related articles, et al. You were a regular at WT:MED when I started coming around. You're around less now, and your expertise is sorely missed. I appreciate your interests are now elsewhere. The purpose of this page is to discuss improvements to Wikipedia's coverage of medical topics. This post and your last one are outside that purpose. I wish you all the best in your business ventures, but please seek advice, discussion, and resources for them elsewhere. If you're ever interested in working on the encyclopedia again, I for one would be glad to see you back. All the best, Ajpolino (talk) 00:37, 23 October 2022 (UTC)

Thanks for the kind words. I ended up just paying for an organizational license for my company and downloading like 20 of those manuals because the standards documentation they've published on test method validation is FDA-approved regulatory-grade consensus standards ("The U.S. Food and Drug Administration (FDA) has evaluated and recognized this approved-level consensus standard for use in satisfying a regulatory requirement."). I.e., if you do/follow what they say (correctly, anyway), the FDA will ok what you do. They also publish standards used as training/certification materials by various medical licensing/accreditation bodies. I do intend to add the answer I find to the LOD article once I've read through the above 2 reference manuals within the next few days.

I know it might not sound like what I was asking had to do with medicine, but for context, a partner at our prospective lead VC firm asked me if we could potentially do limit of detection testing with animal blood (e.g., pigs, which have similar blood viscosity to humans) instead of human blood. You might be wondering, 'why bother?' And, in general, I'd completely agree that it's a bit asinine to consider that. In our case, it's cuz we're going to be simultaneously testing over 3000 analytes on a single test panel. Ignoring viruses that are DNA or RNA viruses, there's 1 DNA analyte for every pathogen, 1 RNA analyte for every pathogen, and a variable number of common/unique AMR genotype markers per pathogen, and a total of over 1400 distinct pathogenic species. When you consider sterile blood samples cost upwards of $100/tube and the need for multiple replicates for each LOD test, 3000 analytes might very well require a multi-million dollar study just to compute our panel's limits of detection. lol

The analogous question to this in an in vivo pharmacology experiment is to consider the measurement considerations that come into play when you change the environment of an animal study. The analogously ambiguous answer is that it depends on the thing being measured and the manner/extent in which a change in environment affects that measurement. In any event, happy to share CLSI documentation in the event anyone finds themselves writing about medical lab topics. Seppi333 (Insert 2¢) 04:08, 23 October 2022 (UTC)

"LoD" appears to mean Detection limit, which Roy Bateman was working on last month. Seppi, if you're working on this significantly at work, it might shade into a COI for you to update that article, but if you find anything interesting that's missing, you could let us know. WhatamIdoing (talk) 20:32, 23 October 2022 (UTC)

Right now, my involvement in standards development is nonexistent; I'm merely learning about and/or using ones that are relevant to me (i.e., my same relationship with various drug articles). If/when I become involved in that process for any particular standard (perhaps later this decade), I'll indicate my COI on my userpage as usual. I may very well return to sporadically editing WP articles on medical lab topics over the next year since the primary reason I write Wikipedia articles is to learn about a topic while creating a reference page for relocating sources/information that I've read more easily.

Not sure I even need to say this, but since I am the foremost expert on my own company and I know Wikipedia is an utterly useless marketing tool for advertising/promotion, I wouldn't write about my COIs (e.g., my business) in the article space even if self-promotion on WP were strongly encouraged rather than a blockable offense. It's just not what motivates me to write article content. Seppi333 (Insert 2¢) 23:20, 23 October 2022 (UTC)

Hello Both - it seemed to me that some of the issues previously raised had been addressed. My interest in LOD, LOQ, etc. is mainly focused on pesticide residue issues: where I have seen "LoD" used for Limit of Detection and ~ Determination. Personally, I try not to get too excited about acronyms, provided they are defined and used consistently within an article - but that's just my opinion. Brgds. Roy Bateman (talk) 11:50, 24 October 2022 (UTC)

Seppi, it sounds like your editing motivation matches that of the reference librarians in #1lib1ref. The concept is less a brilliantly written individual article and more a place for collective note-taking, because if one person brought a question to the library reference desk, someone else will inevitably have the same question another time. WhatamIdoing (talk) 16:53, 24 October 2022 (UTC)

So... I had a chance to go through a portion of the 41-manual/document bundle I bought over the last few days. The correct standards manual was actually EP35Ed1E - Assessment of Equivalence or Suitabilit…Laboratory Measurement Procedures, 1st Edition. and the high-level summary of important considerations pertaining to the use of a surrogate matrix vs the sample matrix in a measurement procedure (e.g., an IVD test panel) is covered in a single page. The relevant evaluation procedure that spans 3 different flowcharts (fig. 1 - similarity evaluation; fig 2 - similar matrix type validation procedure; fig 3 - dissimilar matrix type suitability evaluation) and most of that 80-page manual explains how to assess the similarity and equivalence/suitability of two matrices for a particular purpose with a measurement procedure (e.g., in our case, it's for establishing clinically equivalent performance of human and non-human animal species blood for determining and reporting the detection limit of analytes on an IVD test panel with either sample matrix).

I imagine it would probably be best if I simply summarized their 1-page high-level summary of the factors that affect the evaluation of two sample matrices under a level 2 subsection on this topic in matrix (chemical analysis). I could write my own high-level summary of the manual's entire evaluation process in an encyclopedic (vs the manual's WP:NOTHOWTO) manner, although that would considerably lengthen the section and article as a whole. Any thoughts? Seppi333 (Insert 2¢) 04:10, 27 October 2022 (UTC)

Draft:Vaccinated versus Unvaccinated Studies

A contributor already blocked from the Vaccine hesitancy article for edit-warring, and a complete inability to understand Wikipedia polices (notably WP:MEDRS but probably all of them), has just started this misguided draft. Since I have run out of patience, and am liable to resort to profanities if I have to engage with them further, could I ask if there is maybe someone here willing to try to knock some sense into User:High5sw before they waste any more of their own time and everyone else's? AndyTheGrump (talk) 22:45, 27 October 2022 (UTC)

Surely the (lone) cited paper is not the Neil Z. Miller profiled in The Encyclopedia of American Loons blog? The one who "had the honor of interviewing several extraterrestrials" according to forbetterscience.com/2021/11/22/elseviers-pandemic-profiteering/ ? WhatamIdoing (talk) 01:49, 28 October 2022 (UTC)

Input requested regarding merger of medical law into health law

I have created a proposal that medical law be merged into health law. Since the article topic falls within the subject matter area of WPMED I invite anyone interested to contribute to the discussion. InsaneHacker (💬) 20:14, 21 October 2022 (UTC)

merger closed--Ozzie10aaaa (talk) 16:53, 29 October 2022 (UTC)

Intravenous Alendronic acid

Please could someone suitably experienced take a look at Talk:Alendronic acid#Oral vs intravenous? Andy Mabbett (Pigsonthewing); Talk to Andy; Andy's edits 16:42, 29 October 2022 (UTC)

Commented. Thanks @Andy for bringing this up. Dr. Vogel (talk) 12:01, 30 October 2022 (UTC)

Aplasia cutis congenita

No first name for "Frieden" on first line of entry. WHICH Frieden? Who is he/she??? 75.110.177.12 (talk) 05:40, 30 October 2022 (UTC)

please be Wikipedia:Be bold on articles you believe may need some adjustments--Ozzie10aaaa (talk) 12:03, 30 October 2022 (UTC)

The original paper was PMID 3514708 and the author's name was Ilona J. Frieden. WhatamIdoing (talk) 18:22, 30 October 2022 (UTC)

Maribavir

Maribavir

Could someone take a look at Maribavir. I removed two spurious headings but my edit was reverted with the explanation that they are standard headings. If so, then maybe move the info re FDA approval into the same section as the CHMP decision. Thanks 76.14.122.5 (talk) 00:57, 31 October 2022 (UTC)

Well, those are common section headings, but I can see why it feels odd. The ==History== section has some of the ===Legal status=== information. WhatamIdoing (talk) 05:52, 31 October 2022 (UTC)

Alcohol abuse RFC at MEDMOS

Wikipedia talk:Manual of Style/Medicine-related articles#RFC on changing MEDLANG was duly advertised for 30 days, but it did not prove to be a popular discussion. If anyone feels like adding their views now, please do. WhatamIdoing (talk) 06:07, 31 October 2022 (UTC)

CZ Biohub Organization Draft

Hello! I'm here on behalf of Chan Zuckerberg Biohub, a nonprofit that partners with universities to advance medical science research. You can read my full COI disclosure on my user page.

I've been searching for a helpful independent editor to review an Organization section I composed for the Biohub page. It combines parts of the page's existing History section with information about the Biohub's structure, how it operates, and the types of research projects it pursues. That request is available for review here and if you would like to review the full text of the Organization draft, which I uploaded to my user page, you can do so using this link. Would anyone at this WikiProject be interested in reviewing my request and/or draft? Any help or feedback would be deeply appreciated. Thanks! Patricia at GMMB (talk) 18:24, 28 September 2022 (UTC)

thank you for posting--Ozzie10aaaa (talk) 12:07, 18 October 2022 (UTC)

Hello, User:Ozzie10aaaa! Would you be interested in reviewing this edit request? I'll link to it here. As you can see, I've tagged a few editors, but haven't yet gotten anyone to approve the section draft, or give me feedback on how I might be able to improve it. Given your status as an editor on this WikiProject, I thought I would ask. Thanks! Patricia at GMMB (talk) 22:13, 31 October 2022 (UTC)

What counts as relevant for addiction epidemiology?

Hello, I am working on the Addiction page, and I have a question about substance use as an indicator of addiction I'd appreciate WikiProject Medicine's opinion on. Talk:Addiction#Epidemiology: Addiction Prevalence vs Usage Prevalence I've started a discussion here on the talk page already. Thanks, Tunnardc (talk) 19:10, 1 November 2022 (UTC)

commented--Ozzie10aaaa (talk) 12:24, 5 November 2022 (UTC)

Microbiome in Guillain-Barré

Anyone fancy weighing in on a discussion I have been having on Talk:Guillain–Barré_syndrome#25Th-17 and bifidobacterium? JFW | T@lk 13:05, 2 November 2022 (UTC)

thank you for posting--Ozzie10aaaa (talk) 12:28, 5 November 2022 (UTC)

Vaseline

Hi - could a subject-matter expert take a quick look at Vaseline#Health? Someone just added some 'it's safe to use' content, based on a source that doesn't look very MEDRS-compliant to me; but on the other hand, the preceding paragraph, which takes an 'it's not safe to use' angle, is also based on a source that I don't think would meet MEDRS. Should the entire section be removed, or does anyone have any better sources to hand covering the safety of MOAHs? Girth Summit _(blether) 13:21, 4 November 2022 (UTC)

I consider Consumer Reports to be VERY MEDRS. It is a very respected source. Jaredroach (talk) 15:30, 4 November 2022 (UTC)

Thanks for the enquiry @Girth Summit: and hope all else good with you.. much appreciated. Looks complex and need some investigating. I actually have a special interest in applying grease to skin and its effects so will get back soon. Whispyhistory (talk) 16:39, 4 November 2022 (UTC)

Thanks Whispyhistory - I appreciate you taking a look. I see that Shibbolethink has also made some edits, thanks for that too. Jaredroach, sorry if I'm being stupid here, but... are you joking? Girth Summit _(blether) 16:45, 4 November 2022 (UTC)

No. Consumer Reports is non profit. It is reviewed more carefully than any peer reviewed PubMed journal. It is largely funded by donations, similarly to Wikipedia. Jaredroach (talk) 18:08, 4 November 2022 (UTC)

Wikipedia is not a MEDRS. We require higher quality sourcing for medical issues on purpose, specifically peer-reviewed expert written secondary review articles in topic-relevant journals. And systematic reviews or meta-analyses if possible. And REALLY the gold standard is policy statements by government or health agencies or professional organizations. see WP:MEDASSESS. — Shibbolethink ^{(♔ ♕)} 18:23, 4 November 2022 (UTC)

OK - sorry, I thought you might have been joking, but you're serious. Like Shibbolethink says, it's not a suitable source. Being a non-profit does not automatically make a source reliable; WP:MEDRS sets out the expectations for sources used to support assertions about biomedical information, and Consumer Reports doesn't meet that standard.

I must say a huge thanks to everyone who has already worked on the article - it's looking in much better shape now. Cheers Girth Summit _(blether) 19:15, 4 November 2022 (UTC)

If that were true (which it is not), then 99% of our sources would not meet the standard . I am guessing you have not read a lot of Consumer Reports. No one thing makes a source MEDRS or not. One has to consider the totality of facts in deciding MEDRS. Jaredroach (talk) 20:49, 4 November 2022 (UTC)

@Jaredroach I would WP:DROPTHESTICK on this one. Just a friendly word of warning as you are really off-base here. @Girth Summit never said one thing makes a source MEDRS or not. Consumer Reports doesn't meet the standard because its articles do not go through a formal peer-review process, it's not edited by an academic review panel of topic experts, and it's not recognized as a scholarly journal. It's a great source, but not for health topics. — Shibbolethink ^{(♔ ♕)} 20:52, 4 November 2022 (UTC)

I think you'll find it's more complicated than that.

For one thing, MEDRS does not require a formal peer-review process. MEDRS does not require editing by an academic review panel (and Consumer Reports does have topic experts). MEDRS does not require scholarly journals. (If this actually surprises anyone here, then I suggest that you read MEDRS's ===Books=== section.)

I think anyone familiar with them would agree that Consumer Reports is better than a typical newspaper article. But to compare it to a research journal is really comparing apples and oranges. Consumer Reports doesn't do medical research. They sometimes summarize medical research that other people have done. It would be more apt to compare them to a carefully fact-checked book than to a research journal. WhatamIdoing (talk) 20:57, 4 November 2022 (UTC)

I think we're agreeing while en face disagreeing. I already said above that lots of specific things can be MEDRS which don't have those things. But Consumer Reports is also not those (e.g. not a policy statement by a governmental or health body). Typical non-professional non-monograph non-review books are also sub-par for MEDRS. WP:MEDBOOK. In this particular situation, in Vaseline, Consumer Reports would be a primary source and therefore heavily heavily disfavored for MEDRS, although I suppose not specifically forbidden. WP:MEDANIMAL. But in this use case, and in general, it is not a MEDRS. There would maybe be exceptions where it could be used, if an article is authored by a recognized expert saying uncontroversial factual information, for instance. But in general its use should be discouraged as it fails some of the things we hope to have in MEDRS. e.g. WP:MEDREV and WP:MEDSCI. — Shibbolethink ^{(♔ ♕)} 21:03, 4 November 2022 (UTC)

There are a couple of references that might meet your bar. UpToDate, Cochrane Reviews, and NEJM come to mind. References about equal in reliability to Consumer Reports are JAMA and Lancet. References less reliable include Science and the majority of journals indexed in PubMed. Consumer Reports has a rigorous editorial process, using professional authors and editors. Most journals (including mine) rely on unpaid reviewers and editors. As a result, the quality of papers is hit and miss. Review articles can often have more erroneous or misleading information than primary articles. This arises because they have so much more diverse facts than a primary article. Specialist reviewers are unlikely to have expertise to fact check everything in a Review, and since they are not paid, may skim over parts for which they lack expertise. So Wikipedia is wise to have its MEDRS policy. I remain convinced you are not familiar with Consumer Reports, based on the characterizations you make above. Jaredroach (talk) 00:50, 5 November 2022 (UTC)

Actually UpToDate is specifically discouraged in WP:MEDRS due to a lack of version archiving, permalinking difficulties, and unclear peer review policies. Not sure what you mean when you say NEJM. If you mean reviews published in NEJM, these would be overall higher quality than CR due to peer review and expert academic editors.

Overall it seems you may disagree with specific points of Wikipedia policy. If so, then the place to raise those disagreements is over at WT:MEDRS or, for concerns with relying on peer review, probably WP:RS, since that’s a pretty universal policy on Wikipedia.

As an aside, I share your concerns with peer review of unpaid invited and requested editors. But the point is that this is better than the alternative. The perfect is the enemy of the good. Do wikipedias policies sometimes make things difficult? Yes. But they are usually created over years of refinement across many different edge cases and problem issues. They are usually, as a result, better than most alternatives. — Shibbolethink ^{(♔ ♕)} 01:44, 5 November 2022 (UTC)

The sentences in question you referred to are: "Medical information resources such as WebMD and eMedicine are usually acceptable sources for uncontroversial information; however, as much as possible Wikipedia articles should cite the more established literature directly. UpToDate is less preferred as it is not possible to reference specific versions of their articles, archives do not exist, and it can be difficult to access." First, 'Less preferred' is hardly 'discouraged'. 'Less preferred' indeed means 'not perfect' but nevertheless pretty good - and as you say, the perfect is enemy of the good. Second, Consumer Reports is much better than WebMD. I am sure if I searched hard I could find some things on MEDRS I would change if I were king. But MEDRS is a really good consensus document. It encourages common sense. Jaredroach (talk) 14:05, 5 November 2022 (UTC)

This entire conversation has been about what is and is not "preferred." At this point we are arguing about the number of angels on the head of a pin. It's already established that CR can, under very specific circumstances, qualify as a MEDRS, but it is certainly not automatically one and it is not, in general, one. It's a case-by-case situation, as with most venues for expert non-peer-reviewed writing, such as The Conversation. I don't think we're really disagreeing at this point, it feels as lot more like arguing for the sake of arguing, so I'm gonna go ahead and do other more productive things. Have a great day. — Shibbolethink ^{(♔ ♕)} 14:12, 5 November 2022 (UTC)

I tentatively suggest starting by scrapping the whole section, and then starting over if you want to.

The claims of health risk are based on a lab study by Stiftung Warentest, which is the German equivalent of Consumer Reports. (They even have the same primary funding mechanism: magazine subscriptions.) The results were published in their magazine. But it's not necessarily about the Vaseline brand; it's about w:de:Vaseline, which Germans use for petroleum jelly the same way that Americans use "Kleenex" when we mean Facial tissue. The lab tests seem to have come to the entirely expected conclusion that the products that contain more mineral oil contain more of mineral oil's constituents. It doesn't differentiate between external use and internal use (e.g., stuffing it up your nose, which risks Lipid pneumonia) or determine whether any of these constituents are absorbed. It's just a chemical assay.

I think it would make more sense to start over with stronger sources, and to put whatever information you find in Petroleum jelly instead of in this article. WhatamIdoing (talk) 17:17, 4 November 2022 (UTC)

Yes, like I would agree that Stiftung Warentest is fundamentally not a MEDRS. But it is true that there are overall concerns about Vaseline and MOAH, we would just need to find better sources on it. Like it's a thing that was really concerning in the early 2000s and 2010s, and subsequent investigations showed there probably wasn't much to worry about if you aren't straight up eating it every day. What that one physician said to consumer reports is accurate, that dermal use probably has negligible absorption, like most lipid-based excipients (or whatever you would call barrier creams with no active ingredient...). But we would want a MEDRS to say as much.

You're right that it's all petroleum jellies and not just Vaseline, definitely agree there. Maybe we could have a section over at Petroleum jelly that is really well-sourced, and then just transclude or abbreviate it at Vaseline. — Shibbolethink ^{(♔ ♕)} 17:43, 4 November 2022 (UTC)

Or maybe not, for the same reason that we have Car#Environmental effects but we don't have a matching section at Ford F-150. Articles about brands should really stick to information that is specific to the brand. WhatamIdoing (talk) 20:58, 4 November 2022 (UTC)

I think the more apt comparison would be to Facial tissue#History and Kleenex#History. The latter heavily references the former and vice versa. Vaseline is commonly recognized to be a genericized name for petroleum jelly. Ford F-150 is a popular truck, but it isn't a genericized name for pickup truck, at least not in the parts of the US I've lived... — Shibbolethink ^{(♔ ♕)} 21:12, 4 November 2022 (UTC)

Charley horse

Skeletal muscle

Is there a better name for our article on muscle cramps in the leg, than Charley horse? I'd never heard the term until today. I believe it to be an Americanism, not in common use elsewhere. Andy Mabbett (Pigsonthewing); Talk to Andy; Andy's edits 12:16, 2 November 2022 (UTC)

[1] there doesn't seem to be an alternate way of 'saying it' at least not in Pubmed...--Ozzie10aaaa (talk) 12:27, 2 November 2022 (UTC)

Andy Mabbett, what are you used to calling this? Cramp? WhatamIdoing (talk) 15:45, 2 November 2022 (UTC)

The aticle reads to me like a subset of cramp. Maybe "leg cramp". Andy Mabbett (Pigsonthewing); Talk to Andy; Andy's edits 15:22, 4 November 2022 (UTC)

'Charley horse' is an informal name for 'cramp'. Charley horse should redirect to Cramp and the articles should be merged. @Ozzie: I found several articles in PubMed that mention "Charley horse" as a synonym for cramp, particularly "lower leg cramp". Jaredroach (talk) 19:34, 3 November 2022 (UTC)

Here's a definition from Collins dictionary: [2]. It mentions arm and leg. D6194c-1cc (talk) 20:45, 3 November 2022 (UTC)

Such a merger seems sensible to me, but then we'd need to find a better target for Dead leg to redirect to. Andy Mabbett (Pigsonthewing); Talk to Andy; Andy's edits 15:27, 4 November 2022 (UTC)

Agree with merge proposal; I've put up the templates on the article; let's continue on the target talk page: Talk:Cramp#Merge proposal. Klbrain (talk) 08:32, 6 November 2022 (UTC)

Healing of periapical lesions

Hello friends! I present you with another orphaned oddity. It's such a weird title/scope. Should this be retitled? Rescoped? Merged somewhere? ♠PMC♠ (talk) 05:54, 7 November 2022 (UTC)

I agree it looks a bit odd.

Title and scope:

• The first question on my mind before I opened it was, "which of the many structures in the body called "apex" does this refer to?".
• So something in the title that points to the context in which "apical" should be interpreted.
• So something "endodontal" in the tile or "(endodontology)" at the end.

As regards the orphanhood:

• all those articles mentioned above could link to it
• we could make a template for the category Category:Pathology of the maxilla and mandible to interlink this article to the other ones in that category.

Just some ideas. Hope it helps. Dr. Vogel (talk) 08:30, 8 November 2022 (UTC)

My primary concern here is scope/encyclopedic-ness, with de-orphaning a lesser issue. To me the title healing of periapical lesions sounds inappropriate for a Wikipedia article and reads more like the title of an instructional article. Your comment on the title/scope seems to illuminate further issues more given that even someone with medical knowledge can't clearly determine what it's talking about from looking at the title.

We could move it directly to periapical lesion to resolve the title issue, but to me the content reads more instructional than encyclopedic, so that wouldn't solve the overall problem. Personally my inclination would be to merge it, but as we don't have periapical lesion as an existing article, I don't know what the parent topic would be. ♠PMC♠ (talk) 01:53, 9 November 2022 (UTC)

WP:SUMMARY form from a new section on Physiology of wound healing, or similar, on Periodontal disease should work. Klbrain (talk) 10:39, 9 November 2022 (UTC)

I like Klbrain's idea.

I don't see any how-to contents. WhatamIdoing (talk) 16:50, 9 November 2022 (UTC)

I agree too, good idea. Dr. Vogel (talk) 01:20, 11 November 2022 (UTC)

Merge biliary pruritus into cholestatic pruritus

Good evening Team,

I'm not really sure why we have separate articles about biliary pruritus and cholestatic pruritus. I am very tempted to merge biliary into cholestatic. The latter is a more commonly-used term, and it's also much more speficic and more about the actual cause of the presentation. And actually, given that the biliary one is just one sentence, I'm very tempted to just redirect it to its yes-developed twin, which also holds the most commonly-used term (at least in the UK).

If you have any objections please say :)

If no objections, I'll just leave it here for a few days and then do it. Dr. Vogel (talk) 00:07, 8 November 2022 (UTC)

Support; a bold merge seems fine to me as a synonym (or duplication). It has one reference, so will boost the referenc on the target by 50% (cough); hence a merge is preferred to a redirect. Klbrain (talk) 10:33, 9 November 2022 (UTC)

agree as well--Ozzie10aaaa (talk) 02:34, 10 November 2022 (UTC)

 Done Thanks for your input guys. I've also made a couple of improvements to pruritus. Dr. Vogel (talk) 01:20, 11 November 2022 (UTC)

I'm curious about this change to Itch:

| causes = Various skin disorders, environmental factors, allergy, skin infections, reduced excretion behaviour other medical conditions

| causes = certain infections, allergies and blood derangements

I assume that the old "environmental factors" was meant to include things like mosquito bites and dry skin during the winter. Those don't seem to represented in the new list. WhatamIdoing (talk) 16:48, 11 November 2022 (UTC)

Oh dear, I messed that one up, I'm sorry. I was really eager to edit that sentence because of the broken English. Dr. Vogel (talk) 22:25, 11 November 2022 (UTC)

Electronic cigarette and nicotine addiction

electronic cigarette (edit | visual edit | history) · Article talk (edit | history) · Watch

See this talk page section

An editor at this page (joined by a brand new SPA) is attempting to remove the text "nicotine is highly addictive" based on research reports from Public Health England [3] and the National Academies [4] which say, in effect "more research is needed to understand if the delivery system affects how addictive a nicotine product is". These sources also say that it could be more addictive based on the added flavorings and delivery mechanisms, or less addictive if limited in delivery and without other tobacco ingredients etc. These same sources say that trading smoking for e-cigarette use is preferable given the much lower health risks of e-cigarettes. Which is pretty undisputed at this point, but does not mean that it helps them quit vaping as well, so much as trading one for the other: [5] [6] [7]

And then we have reports, clinical practice guidelines, and systematic reviews from the NIH/Surgeon General/CDC/American Academy of Pediatrics/Cochrane/US PSTF/American Thoracic Society which say that nicotine in e-cigs is still highly addictive. And we have systematic reviews from other very trustworthy publications which say that it may not actually help people quit smoking (let alone quit nicotine), if done outside of a medical therapeutic relationship or otherwise supervised "quit" program: [8] [9] [10]

Can we get some assistance from some other editors with expertise in this area? Thanks — Shibbolethink ^{(♔ ♕)} 22:39, 11 November 2022 (UTC)

Post-Finasteride sydrome

Dutasteride

• Dutasteride (edit | visual edit | history) · Article talk (edit | history) · Watch
• Finasteride (edit | visual edit | history) · Article talk (edit | history) · Watch

Recent activity at these articles, which concerns me in light of the historic controvery and COI edits for these topics, and the significant shift in POV the new edits make. More eyes would be helpful. Bon courage (talk) 20:07, 11 November 2022 (UTC)

Yeah, that is definitely not a decided or settled controversy by any means. Those edits are POV pushing from one side of the debate with weak sourcing that does not overturn the strongest of our sources. — Shibbolethink ^{(♔ ♕)} 20:12, 11 November 2022 (UTC)

What a series of blind rage edits. Nothing but reverts - and each with a comment that reveals complete absence of knowledge on the matter.

There is no controversy on the existence of adverse sexual effects. There is only a controversy on the persistence of the effects after discontinuation of medication (post-Finasteride sydrome).

They way in which valid sources are reverted that are fully compatible with WP:MEDRS is breathtaking. Please help. --Saidmann (talk) 22:16, 11 November 2022 (UTC)

What "valid source" did you have in mind? Bon courage (talk) 12:14, 12 November 2022 (UTC)

All sources that you (and your follower) reverted were reviews in PubMed-listed journals. Thus they were valid sources according to WP:MEDRS. Further, none of these sources was in disagreement with any other sources on this subject matter - neither concerning other sources in the article, nor concerning other sources anywhere in the academically published literature. --Saidmann (talk) 12:25, 12 November 2022 (UTC)

Don't think so. Which source(s) did you think was usable? I think your edits had quite an effect on the POV of the article. Bon courage (talk) 12:31, 12 November 2022 (UTC)

Sorry, your thoughts are utterly in error. They give the impression that you have not looked into any of the sources that you reverted. --Saidmann (talk) 12:45, 12 November 2022 (UTC)

Incorrect. Anyway, since you seem unwilling to engage substantially with my questions I suggest we are done here & the consensus can stand. Bon courage (talk) 12:50, 12 November 2022 (UTC)

Your questions had been answered by the way I used the sources. You reverted all of them by no-content-statements, like "weakly sourced". This is a problem of yours, not of mine. --Saidmann (talk) 13:23, 12 November 2022 (UTC)

A journal being in Pubmed does not make it a MEDRS source. An article being a review does not make it a MEDRS source. And please refrain from using words like "follower" to denigrate the opinions of other editors, thanks. This verbiage perpetuates a WP:BATTLEGROUND "us" vs "them" mentality. — Shibbolethink ^{(♔ ♕)} 14:52, 12 November 2022 (UTC)

Here's my analysis of two of the journals recently added:

• PMID 30651009 is a review in The Aging Male, a mid-tier journal, indexed not only in MEDLINE but also in the more restrictive/prestigious Index Medicus.[11]
• PMID 32435662 is a review in Neurobiology of Stress, a newer top-quartile journal that isn't indexed in MEDLINE.[12]

These are probably both acceptable journals.

The bigger question is not whether we can source claim X or claim Y, but what most researchers in most places think. For this, it might be better to step beyond journal articles to position statements that can be attributed to specific organizations ("The World Health Organization says...") and to medical school textbooks. WhatamIdoing (talk) 18:25, 12 November 2022 (UTC)

• please (both) try to come to an agreement (also this conversation should be had on the article talk page), thank you--Ozzie10aaaa (talk) 13:46, 12 November 2022 (UTC)
• It seems like some of these disputes rest on whether or not the article should be updated to reflect most current findings. The answer, as with all of these medical issues, is to ask: what do our best available MEDRS sources say? In the case of Dutasteride and PMDD, they actually say it's worth studying, but preliminary, so that is what we should report. I Think we still need to ask that question appropriately for the post-Finasteride syndrome questions leveled above, as per WhatamIdoing, the best way to do that is with textbooks and position statements. Not with single studies or narrative reviews if at all possible. In most cases, I think these things actually do need a rewrite, but they should not be rewritten from a POV as described above. — Shibbolethink ^{(♔ ♕)} 18:39, 12 November 2022 (UTC)

  Okay I've updated the dutasteride article with stuff from the 2021 American Urological Association clinical guidelines and other well-regarded position statements and systematic reviews from reputable journals re: PFS and prostate cancer risk. I think we should probably update the finasteride article to match since most of this content is the same for the two drugs. Anybody able to help out on that? thanks. — Shibbolethink ^{(♔ ♕)} 20:26, 12 November 2022 (UTC)

RfC: Proposal – moving Breast binding to "Chest binding"

A proposal has been made to have Breast binding renamed "Chest binding". You are invited to participate in this discussion @ Talk:Breast binding#Requested move 2 November 2022. Pyxis Solitary (yak). L not Q. 14:02, 13 November 2022 (UTC)

thank you for post--Ozzie10aaaa (talk) 22:17, 15 November 2022 (UTC)

RFD

Please see Wikipedia:Redirects for discussion/Log/2022 November 15#Wikipedia:CANCER, which proposes that this redirect be pointed at Wikipedia:WikiProject Medicine/Hematology-oncology task force. WhatamIdoing (talk) 21:17, 15 November 2022 (UTC)

• give opinion(gave mine)--Ozzie10aaaa (talk) 17:51, 16 November 2022 (UTC)

Assigning importance

I found that major adverse cardiovascular events page has no talk page, so I assigned it to Wikiproject Medicine. How can I make decision for this page's importance at Wikiproject Medicine? --LR0725 (talk) 08:01, 18 November 2022 (UTC)

[13]--Ozzie10aaaa (talk) 13:05, 18 November 2022 (UTC)

CABG

Hey all, I have been told that the article I have been preparing for GA that (CABG) has a I think from a surgical / medical perspective" [14]. I am not sure if there are other RS on the subject that are dealing with the subject from a non-medical perspective. Can you please help me or guide me on how to improve the article? Thanks! Cinadon36 11:51, 18 November 2022 (UTC)

I'm not sure that's a request for a non-medical perspective. It sounds a bit more to me like a request for information about medically sound prevention and alternatives to the surgery, as well as information on recovery after the surgery. WhatamIdoing (talk) 15:31, 18 November 2022 (UTC)

FAR for Lung cancer

User:Buidhe has nominated Lung cancer for a featured article review here. Please join the discussion on whether this article meets the featured article criteria. Articles are typically reviewed for two weeks. If substantial concerns are not addressed during the review period, the article will be moved to the Featured Article Removal Candidates list for a further period, where editors may declare "Keep" or "Delist" in regards to the article's featured status. The instructions for the review process are here. MediaWiki message delivery (talk) 06:20, 19 November 2022 (UTC)

Traditional chinese medicine education assignment

I just partially removed a post in Cinnamomum cassia for not being MEDRS. This appears to be part of a Wiki Education assignment on traditional chinese medicine. It would be a good idea if you guys kept an eye on what they are doing, it's almost bound to be problematic. SpinningSpark 16:20, 18 November 2022 (UTC)

Here's the text you removed:

While Westerners use it as a spice and for its strong aromatic properties, Eastern medicine uses it as a drug and it is listed in the Pharmacopoeia of the People's Republic of China (CH.P).

There are two statements here:

• People from one culture choose to eat it because it tastes good (e.g., in Cinnamon rolls), and people from a different culture choose to eat it when they aren't feeling well (apparently under the same circumstances that people from that first culture eat chicken soup).
• Whether something is included in a particular list.

Neither of these two claims are, strictly speaking, Wikipedia:Biomedical information. It does not say (e.g.,) that it has any biological effect. WhatamIdoing (talk) 21:26, 18 November 2022 (UTC)

• The claim that it is listed in Chinese Pharmacopia isn't medical information? In any case, that is not stated in the source, nor is the claim that their is a difference in Eastern and Western usage. The first part about spice use is already stated in the article. SpinningSpark 23:43, 18 November 2022 (UTC)

  Chinese Pharmacopoeia is a list maintained by a government. Putting a name on a list, or taking it off a list, has no biological effect whatsoever. WhatamIdoing (talk) 00:07, 19 November 2022 (UTC)

The claim that any kind of "medicine" uses it as a "drug" is a medical claim. If someone put "in Western medicine chicken soup is used as a drug" that should also be deleted. Crossroads ^-talk- 00:07, 19 November 2022 (UTC)

Not really. The fact that someone classifies a given substance as a drug has no biological effect or medical implications, and it is therefore not biomedical information. It needs a reliable source, but it doesn't need MEDRS' ideal type of source. It should be sourced, but it's sufficient to cite the pharmacopoeia itself. In case it's not clear, when you cite a pharmacopoeia to verify the claim that something is listed in it, you're using the pharmacopoeia as a primary source for describing its own contents, which means it's not MEDRS' ideal type of source. But that's okay, because this just needs a regular reliable source) WhatamIdoing (talk) 00:17, 19 November 2022 (UTC)

A little background for folks less familiar with this: A pharmacopoeia is primarily concerned with consumer rights, rather than medical utility. They list what ought to be present (is ±10% the listed amount okay, or should it be ±1%?), how to store it, what to put on the label, and how to chemically determine that the right stuff is there.

For example, the USP–NF has an entry for plain old white sugar, which says things like "Packaging and storage: Preserve in well-closed containers." The chemical tests says things like "A 2.0-g portion shows no more chloride than corresponds to 0.10 mL of 0.020 N hydrochloric acid (0.0035%)" and "Place 50 mL of the clear liquid in a 250-mL beaker, add 50 mL of alkaline cupric tartrate TS, cover the beaker with a watch glass, and heat the mixture at such a rate that it comes to a boil in approximately 4 minutes, and boil for 2 minutes, accurately timed."

I've never seen anything about how/why the substance is used; they are unconcerned with what happens to the substance after it leaves the pharmacy.

Pharmacopoeias all over the world contain entries for things like a mixture of low-sodium salt, baking soda, and sugar, which sounds like the starting point for Honeycomb toffee instead of a drug. They have entries for food additives, and for "chemicals" that we normally think of as being food (e.g., table salt, alcohol, ginger, hot peppers, lemon oil, and honey are all in the US version). The fact that these entries exist doesn't mean that these entries are "drugs" in the sense that MEDRS cares about. We shouldn't jump from "X is used as a drug" or "X is listed in a pharmacopoeia" to "any mention of reality must meet MEDRS' ideal or be omitted". WhatamIdoing (talk) 02:02, 19 November 2022 (UTC)

Even if you're right that this claim does not need MEDRS (and ok, I concede this project is better placed to judge that) I was still right to challenge it. And I still think that it would be a good idea for this wikiproject to keep an eye on what this education course is doing. Getting you to take a look at them was the main purpose of me posting here. SpinningSpark 07:56, 19 November 2022 (UTC)

I agree: it needs a source – just a plain-old-reliable source, not a MEDRS-ideal source, but definitely at least one source. WhatamIdoing (talk) 21:33, 19 November 2022 (UTC)

Love is the drug I'm thinking of // Oh-oh, can't you see? // Love is the drug for me. -- Colin°^Talk 09:47, 19 November 2022 (UTC)

Otoscope

Hey there!

I saw this article, Otoscope, and i noticed that there is a a section of the article dedicated to Use in Media, including uses in media without any valid citations. I checked the MOS for Medical related articles, and I didn't see anything relating to this section of the article listed in it. I was wondering if this was okay to remove, as it doesn't really make any sense why a medical tool used in standard checkups needs a Use in Media part in the article.

Best, Zekerocks11 (talk) 18:05, 19 November 2022 (UTC)

Not really a medical issue. See Wikipedia:"In popular culture" content. Only an essay, but in accord with accepted best practice: "In popular culture" sections should contain verifiable information with sources that establish its significance to the article's subject. Exhaustive, indiscriminate lists are discouraged, as are passing references to the article subject.. See also this RfC [15]. Delete the lot as unsourced trivia. AndyTheGrump (talk) 18:54, 19 November 2022 (UTC)

Alright, thank you. I brought it to attention here as it was a medical based article and thought it was the best place to bring it to attention. If there is a better place, just let me know. Best, Zekerocks11 (talk) 18:58, 19 November 2022 (UTC)

I'm not sure there is really a 'best place' for discussing this sort of thing. A common problem on all sorts of articles. If I see a bad case, I generally just delete it with an appropriate edit summary, and then watchlist the page. It's rare for anyone to actually contest removal, but if they do, you can point them at the essay and RfC above, along with MOS:POPCULT. AndyTheGrump (talk) 19:10, 19 November 2022 (UTC)

Alrighty. I'm new to this kind of thing and it seemed out of place to me so that's why I asked. I'll take note of that. Thanks mate! Zekerocks11 (talk) 19:15, 19 November 2022 (UTC)

Also, @Zekerocks11, thank you for trying to improve these articles. If you can find a decent source for some, then adding that information is super helpful. If you can't find a source, or if it just doesn't seem like an important connection (e.g., a movie that shows one in the background for two seconds), it might have to be removed, and that's okay, too. WhatamIdoing (talk) 21:42, 19 November 2022 (UTC)

Understood, thanks Zekerocks11 (talk) 21:44, 19 November 2022 (UTC)

Move discussion

Any input would be appreciated at: Talk:Sex reassignment surgery#Requested move 23 November 2022. WanderingWanda🐮👑 (talk) 08:02, 23 November 2022 (UTC)

commented--Ozzie10aaaa (talk) 13:47, 24 November 2022 (UTC)

Patient blood management: need to remove puffery

I think (?) that the actual medical claims down the article are reasonably sourced. However, it also contains a lot of non-medical, puffery material (e.g. "patient blood management is a patient-centric approach" looks good on a marketing brochure, but it has zero actual meaning in an encyclopedia article). I have cut the worst from the lead, but much remains. At that point I am afraid to cut actually useful content with the puff - if anyone wants to give it a go... Tigraan^{Click here for my talk page ("private" contact)} 10:26, 22 November 2022 (UTC)

thanks for post--Ozzie10aaaa (talk) 14:18, 27 November 2022 (UTC)

Gradient of infection

Do we have an article on the concept that some (infectious) diseases are worse than others? This book calls it a biological gradient or gradient of infection. It would be nice to be able to link to something about disease severity in Endemic (epidemiology). WhatamIdoing (talk) 06:23, 30 November 2022 (UTC)

Pandemic's over?

Discussion could probably use medical editor input at

• Talk:COVID-19 pandemic#Extended-confirmed-protected edit request on 17 November 2022

About whether Wikipedia needs to move on from the "stubborn" WHO and stop saying that there is still a pandemic.

Relatedly,

• Endemic phase of COVID-19 (edit | visual edit | history) · Article talk (edit | history) · Watch

has been nominated[16] for GA. I am concerned this is in large part an assemblage of what various politicians have said at various times about COVID being endemic in their countries, with little explanation of what that means and/or how accurate it is. Bon courage (talk) 07:20, 24 November 2022 (UTC)

thank you for posting here...yes the COVID-19 pandemic article has not been easy --Ozzie10aaaa (talk) 14:06, 24 November 2022 (UTC)

Given that Ghebreyesus of the WHO said that "the end is in sight", I don't understand why any editor would seek to waste time getting it declared over by Wikipedia (as if that means much anyway) when it might actually be over in the not too distant future and then we would just change it without any controversy. Crossroads ^-talk- 21:29, 24 November 2022 (UTC)

I don't think there is any standard by which the pandemic could be deemed to have concluded globally. BD2412 T 22:03, 24 November 2022 (UTC)

Lots of the endemicity content is actually emergent across many months and last year. I recently added a section on Lebanon from a source published in February. Malaysia transitioned toward endemicity in October 2021. The endemic article was spun off Living with COVID which was then integrated boldly back into the endemic article. While endemicity is a bit constraining it serves as the assemblage of endemicity/living with covid/new normal etc in aggregate. There's plenty of substance and nuance here and in the interest of building an encyclopedia it is beneficial to readers to include this material in the project, since sources observe it. We defer to sources and we use due weight accordingly. This is a subject that hasn't been well-represented on wiki and I am happy to have contributed significantly to the project by expanding it. As I said on the COVID pandemic talk page, the lead currently does not mention this material, which is not compliant with MOS. SmolBrane (talk) 04:14, 25 November 2022 (UTC)

The transition to endemicity is an ongoing process at varying phases all around the world, so I don't see how that article could be stable anytime soon. Maybe in the future when the WHO has declared it no longer pandemic, and COVID policies have been stable for a while, it could be nominated if it meets the criteria, but right now I would suggest withdrawing the nomination and refocusing on documenting how things are right now, rather than jumping the gun and trying to edit based on ideas about how close or not full endemicity is. Crossroads ^-talk- 05:14, 25 November 2022 (UTC)

Instability in the WP:GACR refers specifically to edit wars and content disputes, and the article isn't changing day to day. "Good faith improvements" and "potential instability in the future" are not grounds for failure either, according to the criteria. Editing on this article has been pretty straightforward and reasonably infrequent actually, not much different from the COVID-19 pandemic article which was also recently reviewed.

I'm also really interested in the general quality of the article currently; it doesn't need to pass if it isn't ready. There are six criteria for good article status and I'd love to hear feedback on the other five areas regardless. This is the first article I've created and I learned lots from the review of the COVID pandemic article. Based on criteria at WP:GVF I think the endemic article is certainly within the reach of being "decent". More editor participation on the article is desired--as per WP:GAN "anyone may nominate an article" and "nominators should respond positively to constructive criticism and work with the reviewer to improve the article" which is precisely my intent here. In my pursuit of collaboration and consensus-building the nomination will not be withdrawn. SmolBrane (talk) 18:16, 25 November 2022 (UTC)

The article has a systemic POV problem. What is the purpose of relaying that Jair Bolsonaro said Brazil was entering an endemic stage in March 2022? He said a lot of stupid things. What actually is Brazil's status? There seemed to be a wave following Bolsonaro's pronouncements. We're in danger of Making Wikipedia an uncritical relay of politicians' anti-scientific talking points.[17] Bon courage (talk) 18:37, 25 November 2022 (UTC)

Not sure if that source is due; they cite their own podcast--you could add it to the article, I suppose, but you know sources well and you haven't for some reason. Not a lot of substance in that article. Anyway, we defer to RSes of course--kindly aim your concerns of rigor at them. If 'endemic' is being misused by politicians it needs to be established by secondary sources. Some of these statements are coming from experts--the Lebanese commentary I mentioned earlier comes from Abdul Rahman Bizri, a specialist of Infectious Diseases and Clinical Microbiology. Unless you have a suggested edit I see nothing actionable in your comment here. SmolBrane (talk) 02:23, 26 November 2022 (UTC)

@SmolBrane, I skimmed over the article. I had a lot of paragraphs that said "On this exact date, someone said something". What I was hoping to find was something more like this:

"This country had lockdowns and other significant restrictions from March 2020 to July 2021, but then changed the policy in August 2021 to _______, and further loosened restrictions a year later, to the point that COVID-related restrictions are nearly the same as how they approach seasonal influenza. The two main differences are that healthcare workers and some others who experience any COVID-related symptoms must test negative before returning to work (which they don't have to do for flu) and that it's no longer unusual for people to wear masks indoors, which was nearly unheard of in this country before the pandemic started", maybe followed by a description of how the situation is going (e.g., case load).

I was really hoping for a general, non-politician-focused summary of the overall situation. WhatamIdoing (talk) 03:23, 26 November 2022 (UTC)

Most of my additions to this article were intended to be concise; you can probably find more context in the sources and expand the content if you find them DUE. Let's be clear that these are qualified individuals discussing endemicity, not simply some people saying some things. We don't have sources casting doubt on these individuals despite the fact that they are often politicians(often heads of states, in fact).

It's also possible that the sources simply don't offer what you are 'hoping for'; it is of course our job to follow the sources. It is not our job to try to project what endemicity might look like on the behalf of our sources. We have to assume that endemicity is endemicity; to do otherwise is WP:OR(analysis or synthesis of published material that serves to reach or imply a conclusion not stated by the sources). SmolBrane (talk) 05:37, 26 November 2022 (UTC)

To take the example above, Bolsonaro is not qualified[18] for anything in the realm of science (or reality probably). Politicians say things for political reasons and that might include giving their country "good news" about the end of the pandemic, no matter whether it's true or not. Bon courage (talk) 09:25, 26 November 2022 (UTC)

Of course Bolsonaro is not a qualified scientific expert. But he's a highly qualified person when you understand the statement less as a statement of scientific fact, and more as a statement of government policy. The wording of that sentence strikes me as quite carefully written: "the country is looking to downgrade COVID-19 to the status of an endemic." The linked source says "countries have expressed their desire to start treating COVID-19 as an endemic disease like the seasonal flu". This is a statement about future government policy plans. Science does not "have a desire to start treating COVID-19 as", well, anything. WhatamIdoing (talk) 20:33, 26 November 2022 (UTC)

This article should reflect scientific knowledge, the only form of reliable knowledge. Hence articles not linking to WHO, Nejm, lancet etc, I simply dont click. Arguments based on media ...well are aimply not valid. Cinadon36 07:59, 26 November 2022 (UTC)

• Note Talk:Endemic phase of COVID-19/GA1 has ended as a quickfail, with similar concerns being raised to here. Bon courage (talk) 09:34, 26 November 2022 (UTC)

  There's more to this subject than science. Science doesn't determine whether we should do something or what we should call it. Science can tell you that requiring hospital staff to test for COVID frequently will reduce in-hospital transmission of COVID and staffing levels. Science can even, eventually, if the right data is collected, tell you whether the variable and lower staffing levels will kill more patients than COVID, and what the effect would be if the same was applied to influenza. But science can't tell you whether a given society should value reduced transmission in a hospital more than it values reliable staffing levels in a hospital, and it can't tell people how they should feel and how they should respond when their needs are being de-prioritized in favor of someone else's needs. This article needs some science, but it also needs some non-science. Don't be fooled by the slogan that non-science is nonsense. Human values are not nonsense. WhatamIdoing (talk) 20:28, 26 November 2022 (UTC)

  I'm with you on this, and this fits nicely with another social media phenomenon that we'll need to watch out for lest it bleed into Wikipedia, which is implicitly using "science" to mean simply "suppressing transmission", and valuing that above all else. Science can tell you how to suppress transmission, but it cannot tell you how much to value normalcy, unhindered socialization, and so forth. It's pretty obvious that most societies at this point (except maybe the Chinese Communist Party) value things other than maximal transmission suppression.

  Mainstream scientists understand this, which is why reputable groups and public health agencies throughout the world have been updating recommendations and regulations to not simply be focused on case numbers and to account for the fact we have vaccines and so forth. We have to watch out for undue weight for the fringes on either side, both the "we should have done nothing" camp and the "restrictions for as long as the virus exists" camp. Crossroads ^-talk- 22:44, 26 November 2022 (UTC)

  @WhatamIdoing: Indeed, an interesting (lay source) article in The Atlantic[19] discusses how the term is contested in politics (and even among scientists) and how even some people think because it begins "end..." it means the "end of COVID". I'd prefer to see an article where pronouncements by various people are contextualized by a discussion of what endemicity is, rather than have an assumption it means something like "we're free!" and then listing people who've used the term. Bon courage (talk) 09:33, 27 November 2022 (UTC)

  @WhatamIdoing sorry for the delayed reply. I am well aware that there is much in love outside science, ie our choices, what to do etc. But when it comes to epistemology, that is understanding reality or the nature of reality, nothing beats science. So, if there is a flying object orbiting around earth, if there is a disease spreading around, if there is climate change, all these issues are within Science domain. Wikipedia should reflect how Science perceive reality, not to dictate our actions (suggest what we should be doing). Cinadon36 07:27, 28 November 2022 (UTC)

Arbitrary break

Not sure what the goal with the sentiments here are. We have DUE material sourced to secondary sources. I feel like editors(including myself) are at an impasse, and I feel like I've made myself clear. There is a lack of suggestions here for editing. Perhaps a wider RfC or nomination for deletion should be attempted. Wider community input can resolve this issue one way or another and develop a precedent so we can stop talking past each other. Regards, SmolBrane (talk) 21:47, 26 November 2022 (UTC)

I'm not sure if this is stated anywhere in guidelines, but IMO some articles just cannot be made GA at this time due to their controversial nature. If it was years from now, the pandemic having been officially declared over years ago, all Covid policies basically matching those of seasonal flu pre-Covid, and those haven't changed in years, then the topic will be much easier to edit. I look forward to that day, but we're just not there yet. In the meantime, a lot of good work can still be done. In fact, there's a number of articles and sections, like here, that document things like the imposition of restrictions in excruciating detail and that speak as if they are still in place, and like everyone is behaving like they did in 2020, which is not true. The end of these things and the ever-gradual return to normalcy need to be documented too. Crossroads ^-talk- 22:25, 26 November 2022 (UTC)

I'm not too concerned about the cursory rejection of GA status, it was mostly a nomination in the pursuit of improving the article in a nuanced way. I'm not sure if I got what I wanted there, but there is work to be done and I have limited time for wiki anyway. Getting any feedback in an active way is appreciated. Changes in COVID related interventions at the public health level need to be documented and I have been working in the relatively explicit area of endemicity for this reason. Many articles are not well updated and I am also trying to help POV to some degree by staying focused here.

More generally I am fascinated with how wiki deals with divergence in professional statements and what appear to be emergent POV forks and the related challenges. Not to mention the challenges of politicians making MEDRS-type statements. We outsource our rigor to RSes, and we cannot presume that non MEDRS RSes are misusing terms without sources suggesting as such. What concerns me is the sentiments in this section that seem to suggest that the secondary sources are not saying what they should. Endemicity is a big statement, and it needs accurate representation on the project. I will continue working in this area, and it will be telling to see how long the MOS:LEAD noncompliance(my opinion) remains on the COVID-19 pandemic article. Let me be clear that I am not trying to canvas on that matter, simply observing the issue as I currently see it. SmolBrane (talk) 02:12, 27 November 2022 (UTC)

I won't even go look at the lead, to avoid being tempted to "fix" it, especially since I wouldn't be fixing it properly.

I would love to see (the sources existing so we could re-write the article to use) a regional or category-based approach. From what I hear, the public health positions of most low-income countries were tuned towards endemic status a long time ago. This isn't a case of "this one country"; it's a case of "the entire Africa continent, with one or two exceptions". Similarly, while it's easy enough to say "France did this" or "Germany said that", the EU countries did most things in concert, so the case is really "Europe, with one or two exceptions". WhatamIdoing (talk) 00:40, 28 November 2022 (UTC)

I had looked for commentary in Africa and elsewhere a few weeks ago but didn't find anything. What you hear may very well be the case but I haven't seen a source on it.

Ozzie10aaaa had made an image for the endemic phase section on the COVID-19 pandemic article but it only featured Mexico as an example. If it is straightforward to generate a similar image that demonstrates COVID status by region it would be helpful and productive. SmolBrane (talk) 04:17, 28 November 2022 (UTC)

The Atlantic article mentioned by Bon Courage (above) [20] summarizes the situation regarding the definition of 'endemic' exceptionally well. Any editor thinking of modifying a relevant article may wish to consider it a "must read". Jaredroach (talk) 17:45, 27 November 2022 (UTC)

I did read it and it does make some good points regarding us not really knowing yet what endemicity will be like, though I would be a bit cautious of treating one pop-media article as too much of an authority. The media isn't always good at getting a representative sample of experts, and even the best written article can become out of date as the situation evolves and as endemicity gets closer and possibly clearer in nature. The article notes some researchers who don't even agree that the flu is endemic, but of course the flu isn't pandemic either.

Since it isn't endemic yet we can't say for certain what it would look like, but when we do get there we should rely on sources describing that time, and even thereafter be ready to keep updating because things will still probably be normalizing after it's officially declared for some time. And right now describing some jurisdictions and health authorities who have moved towards endemicity, directly relevant sources are important for that as well. Crossroads ^-talk- 02:26, 28 November 2022 (UTC)

I agree with the critical component of what you said about the Atlantic article here--I mean, it's literally titled "Endemicity is meaningless". Still not sure what the reticence is towards endemicity, the recent Finland addition comes from virologist Mika Salminen, the director of the Finnish Institute for Health and Welfare--he has twelve thousand citations on google scholar... SmolBrane (talk) 03:35, 28 November 2022 (UTC)

I don't think anyone is challenging that Finland addition, nor should they. That doesn't mean it's truly endemic worldwide yet, but it is a noteworthy development. The situation is always changing and has been ever since the pandemic began, and so it's always taken a balance about being careful not to make excessive assumptions about the future while also not being stuck in the past, leading to good-faith disagreement. With time more sources and developments appear and it becomes clearer to all eventually. Crossroads ^-talk- 04:19, 28 November 2022 (UTC)

A "world view" from Nature earlier this year:

• Katzourakis A (January 2022). "COVID-19: endemic doesn't mean harmless". Nature (World view). 601 (7894): 485. doi:10.1038/d41586-022-00155-x. PMID 35075305.

again noting the disconnect between political and epidemiological uses of the term "endemic". Bon courage (talk) 04:25, 28 November 2022 (UTC)

"World view" isn't a peer-reviewed research article, and is more about presenting the views of a particular scientist as far as I can tell. While it's correct that endemic does not in itself mean "do nothing", at the same time that article seems to take a stance of 'we should still fight transmission intensively with restrictions etc.' This should not be given undue weight; judging by how things have been going since then, it seems that most public health agencies are relaxing restrictions on personal behavior even while they do other things like focus on vaccination, etc.

Central to the issue, of course, is that knowing what endemicity will look like isn't even possible now, let alone in January 2022 when the Omicron variant was causing massive waves in cases and hospitalizations all around the world. We still don't know what endemic levels of disease from Covid-19 would even look like, so nobody can possibly know what society's response will or should be.

Also, "politics" cannot be entirely disentangled from this subject; as WhatamIdoing said earlier, "Science doesn't determine whether we should do something or what we should call it....But science can't tell you whether a given society should value reduced transmission in a hospital more than it values reliable staffing levels in a hospital, and it can't tell people how they should feel and how they should respond when their needs are being de-prioritized in favor of someone else's needs. This article needs some science, but it also needs some non-science. Don't be fooled by the slogan that non-science is nonsense. Human values are not nonsense." What endemicity will look like and what material on it should be included is not simply a matter for epidemiologists. Crossroads ^-talk- 06:30, 28 November 2022 (UTC)

I don't think there can be a "peer-reviewed research article" of definitions, and it would just be the authors' views also. Unlikely to be a secondary MEDRS source on it. What endemicity is, is entirely science. How policymakers choose to react to it (or misrepresent it) is maybe important non-science. So long as these aren't blurred that's fine. Bon courage (talk) 06:38, 28 November 2022 (UTC)

Anyway, maybe you could stop edit warring [21] to delete the comments of the head of the World Health Organization, the literal authority over what is or is not a pandemic? Pointing to WP:SYNC is a disingenuous justification since it was you who removed it from the other article just moments before. And when Ghebreyesus speaks about the "end of the pandemic", what is he talking about if not endemicity? Crossroads ^-talk- 06:43, 28 November 2022 (UTC)

This is an example of the problem. Taking sources that don't mention endemic covid and blurring them into service. WP:NOR is a core policy. Bon courage (talk) 06:46, 28 November 2022 (UTC)

WP:NOR: Rewriting source material in your own words while retaining the substance is not considered original research. Does anyone seriously believe that Ghebreyesus could possibly mean anything other than endemicity? Excluding relevant material about 'after the pandemic' or the like on the grounds that it doesn't use the magic word even though it is clearly the same topic is itself a huge problem. Crossroads ^-talk- 06:49, 28 November 2022 (UTC)

"Does anyone seriously believe that Ghebreyesus could possibly mean anything other than endemicity" ← yes; interpreting what "he means" is OR. This is one of the central points here. Editors trying to coerce everything to do with "good news" into meaning "endemic" is not what our good sources are doing (or in this case any source). Why should Wikipedia be doing something so odd? Bon courage (talk) 06:55, 28 November 2022 (UTC)

Looking forward to hearing from others on this, but anyway here's a source [22] explaining the incredibly obvious. Crossroads ^-talk- 06:58, 28 November 2022 (UTC)

prevention.com!?!? Looks like some kind of spam site, advertising "detox" on its front page. I suggest not clicking the link unless your antimalware software is in shape. (Rum to be citing this while being snffy about Nature above.) Bon courage (talk) 06:59, 28 November 2022 (UTC)

I don't know what you're talking about, the site is cited in other Wikipedia articles and is probably equivalent in reliability to CNN, and contains material from interviewing WHO epidemiologist Dr. Kerkhove. Looks fine to me. It's unnecessary anyway because excluding Ghebreyesus talking about the end of the pandemic because he didn't use the exact word "endemic" smacks of WP:WIKILAWYERING anyway. Maybe the article should be retitled "Post-pandemic COVID-19" if that's how people are going to be. Crossroads ^-talk- 07:06, 28 November 2022 (UTC)

"How to detox your home" looks fine to you? Might be okay for lifestyle stuff but not serious medical content. I think your final suggestion actually hits the nail on the head. The article isn't really about endemic COVID, it's about the COVID-19 pandemic aftermath. Even for the most major endemic diseases (Malaria) we don't have such articles: no Endemic malaria, no Endemic HIV/AIDS. But we do have Epidemiology of HIV/AIDS. Why don't we have Epidemiology of COVID-19? Bon courage (talk) 07:15, 28 November 2022 (UTC)

Prevention (magazine) is a pop health magazine. I would not recommend that magazine to anyone for any purpose, but the fact that they are aimed at a lay audience does not prove that they are wrong about every single thing they write. On wiki, I'd suggest double-checking anything they say against other sources (or your own prior knowledge, if you happen to be highly familiar with the specific subject area).

@Bon courage, your line about '"peer-reviewed research article" of definitions' above is one of the reasons that I started Wikipedia:Biomedical information. There's no such thing as a systematic review on whether we should call that bone the femur or the patella, or whether this definition or that definition is the appropriate one. Systematic reviews and meta-analyses are good for statistical questions, such as whether a drug prevents a death. They are frequently inappropriate sources for, well, pretty much everything else. Literature reviews, practice guidelines, and position statements are good for the current state of mainstream thinking. Graduate-level textbooks are the MEDRS ideal for definitions and other human-decided facts. In this case, we should be looking to textbooks for standard definitions, and to non-systematic secondary sources for the application of the standard concepts to COVID, until the textbooks start incorporating that content directly. And, as always, the goal is to accurately represent mainstream expert views in the article's text, not to have a single cited source score perfectly on some checklist for ideal sources. If you have to use a couple of second-best sources to get the content right (where "right" means "matching the most common views in the wide range of reputable sources"), then please remember that a second-best source isn't a bad source. (Please don't use sources that are actually bad.)

In terms of steps forward:

Expanding the ==Background== section to explain what endemic means, in the general scientific sense, would probably help. The article in The Atlantic or similarly reputable sources would be good for adding, at the end of that explanation, that politicians/non-scientists do not always use the word correctly. It probably also needs some List of common misconceptions-type content (e.g., people say they want endemicity, but they probably don't want holo-hyperendemicity).

Should we resurrect the List of endemic diseases, or add a column in that table to mark endemic/etc. status? Can we add more (sourced) links to Holoendemic and Hyperendemic? Turn Mesoendemic and Hypoendemic into articles (or at least get these words and their definitions added to Endemic (epidemiology))? WhatamIdoing (talk) 17:15, 28 November 2022 (UTC)

Exactly. As I put I don't think there can be a "peer-reviewed research article" of definitions. I did however find a review article about COVID-19 endemicity! (now added to the article). Bon courage (talk) 17:30, 28 November 2022 (UTC)

• "I would not recommend that magazine to anyone for any purpose" ← note however that now that Crossroads and SmolBrane are edit warring to get this back into the article. I agree this is a bad source, and especially so for a serious topic like COVID-19.

Bon courage (talk) 09:28, 2 December 2022 (UTC)

Then remove the source if that is the issue. You are the one edit warring to purge the head of WHO's viewpoint entirely. Crossroads ^-talk- 09:31, 2 December 2022 (UTC)

I think you were the one with edit-warring in your mind with your snarky "mind the 3RR" edit summary, while not acknowledging your WP:ONUS and the disagreement on this matter here and elsewhere. This reflects poorly on you. The WHO guy was not talking about endemicity and even the comments he did make had to be walked back later, so no - what you're doing looks like edit-warring in service of a OR and a certain POV. Bon courage (talk) 09:35, 2 December 2022 (UTC)

I don't know what "walked back later" is referring to. Regarding ONUS, we did have a consensus because you were at the time the only one saying that the head of WHO should not be included, but the material was pre-existing and had support from 2 editors. I don't know what POV I supposedly am pushing, and I could just as easily make similar vague complaints. I would have preferred hashing it out on the talk page first and maybe figuring out a compromise or something rather than just taking a hatchet to it. Oh well. Hope future interactions can be less fraught. Crossroads ^-talk- 09:47, 2 December 2022 (UTC)

The whole point at issue in these extensive discussions is that "end of the pandemic" should not be smudged by editors into "endemic", so thinking there was a consensus to do so and edit warring over it was poor. As to "walking back", per PMID:36220172 the issue is that a clarification was issued over these apparently incautious WHO comments. Bon courage (talk) 09:55, 2 December 2022 (UTC)

Holy heck, a lot has happened while I was sleeping. I'll try to catch up but it might take me a while! SmolBrane (talk) 15:54, 28 November 2022 (UTC)

(regarding WHO 'end in sight')During the GA review of the COVID-19 pandemic article, Reviewer Tom_LT wrote under Focus that "In February 2022, the Icelandic Ministry of Health lifted all restrictions and adopted a herd immunity approach" (the article later says the disease is endemic in many countries, I'm not sure how this is in fact any difference). This never produced an edit but it does lend credence to what Crossroads is saying here--if herd immunity in Iceland is functionally the same as endemicity, then why would "[The world has] never been in a better position to end the pandemic" be functionally different? I have to assume Tom is a robust commentor here. I haven't yet decided to revert Bon courage's alleged edit warring but I will try to review the situation and the new source when I can. SmolBrane (talk) 17:06, 28 November 2022 (UTC)

Here's my puzzle. We have good sources, WP:MEDRS sources even, specifically on COVID-19 endemicity. Surely the job is to relay the knowledge found in them? Instead editors are picking sources not on COVID-19 endemicity, deciding for themselves that must be relevant, and using those. So far as I can see the WHO is very careful about discussing endemicity, yet editors are deciding "oh, this is what they must mean". The WHO have talked about the end of the pandemic, but this is a different thing. It's as if we had an article on The Empire Strikes Back and editors want to fill it with descriptions of what happened at the end of Star Wars. Bon courage (talk) 17:13, 28 November 2022 (UTC)

Not a good interpretation here--we have a long list of secondary sources observing endemicity or the transition towards in various countries in the world. We cannot assume they are faulty in their words simply because they are not MEDRS. I am surprised that I have to keep saying this. SmolBrane (talk) 17:34, 28 November 2022 (UTC)

Sources are very clear that the end of the pandemic, and entering the endemic phase, are exactly the same thing and same topic. Incidentially, our The Empire Strikes Back article does mention what happened in the original Star Wars, for obvious reasons. Crossroads ^-talk- 19:11, 28 November 2022 (UTC)

(Further) the same can be said of Biden's statement, which also doesn't explicitly refer to endemicity but 'pandemic is over' is pretty darn DUE and has lasted on the article. SmolBrane (talk) 17:11, 28 November 2022 (UTC)

The fact that political declarations that the "pandemic is over" feel DUE suggests that Wikipedia editors are just as shaky on the concept of what endemicity means as the politicians. Malaria and tuberculosis are endemic, and they were among the top infectious disease priorities before COVID crowded everything else out of our minds. Those two represent about a quarter Billion-with-the-big-B people getting sick every year and a couple million dying. People who read Endemic COVID-19 should not leave the article thinking that the endemic phase looks almost the same as the pre-pandemic phase, despite the empty promises of politicians. They should be thinking that endemic COVID is uncertain and changeable: It could be as severe as malaria, as deadly as tuberculosis, as mild as the common cold, as universal as chickenpox, or as rare as rabies. Above all, they should know that endemicity isn't guaranteed at all, and it definitely isn't guaranteed forever. It could be as variable as influenza. WhatamIdoing (talk) 17:35, 28 November 2022 (UTC)

Let me suggest a different way to understand this.

Endemicity means (only) that there is a stable rate of infection.

For easy math, let's assume that stable rate for our hypothetical disease, Scaryitis, is 100% annual infection, evenly spaced through the year with no long-term immunity conferred, and 50% mortality per infection. There are 8 billion humans this year. There are 8 billion infections this year. There are 4 billion deaths this year. There are 4 billion humans left next year. There are 4 billion more infections. There are 2 billion deaths next year. In year 3, there are 2 billion humans, 2 billion infections, and 1 billion deaths. In year 4, there are 1 billion humans, 1 billion infections, and half a billion deaths.

This is "endemic". The rate of infection is stable. And not only would there be severe social disruption, but modern civilization would basically be destroyed in the space of a few years. "Endemic" doesn't mean "good". Endemic means "predictable" – including predictably bad. WhatamIdoing (talk) 17:43, 28 November 2022 (UTC)

I wouldn't consider it the least bit plausible that a disease killing half of humanity every year would be classified as anything other than pandemic. Endemic doesn't mean "nobody needs to think about it", true, but it also doesn't mean just "infection rates are stable". The first source I cite below describes it as a kind of détente, and the last as not causing significant disruption in our daily lives. This wouldn't apply to a virus killing half the world every year.

People who read Endemic COVID-19 should not leave the article thinking that the endemic phase looks almost the same as the pre-pandemic phase, despite the empty promises of politicians. Disagree, because it very well might. In much or most of the world it already does, and it isn't even truly and fully endemic yet. Never mind politicians - public health agencies, who count as the most prominent experts for the purposes of weight, in country after country have shifted many or most policies to lift restrictions on personal behavior, and this is a process that is still ongoing. I would be very leery of giving undue weight to the minority of people who essentially solemnly intone that 'just because it's endemic doesn't mean you can ever go back to living like you did in 2019 even when not sick'.

It's pretty easy to find sources taking a different tone. This August 2022 UMass source interviewing a virologist, for example, draws a comparison with the four existing common cold coronaviruses, states there are plenty of virology experts who are entertaining this as a possible end game, and I think it’s likely that we will go back toward a situation like what we had pre-pandemic. This Council on Foreign Relations November 2022 source notes that "endemic" can still involve a policy response as we do with flu, however, the responses are typically not as intense as those during a pandemic, when surging infections prompt the type of tight restrictions seen throughout the COVID-19 crisis. Another noteworthy quote is that Some countries are already treating COVID-19 as an endemic disease, while others, namely China, are keeping rigid pandemic measures in place. These policies can depend on infection trends as well as on the social mood, says CFR’s Jennifer Nuzzo. “In terms of when a pandemic is over, it’s really a social term,” she says. “We don’t have an epidemiologic criteria for the end of a pandemic.” This American Medical Association source from April 2022 states, The U.S. has a chance to move COVID-19 from being a pandemic to an endemic, which “means that the disease is still around but that it's at a level that is not causing significant disruption in our daily lives,” said Dr. Parodi, an infectious diseases physician....“This shift to looking at it from a severity of disease standpoint is important,” Dr. Parodi said. “A measure of endemicity really is going to look at how many people are developing severe disease at a given time. If we're seeing increases in that, we've got to take action. If we're not, that's a different set of actions, and that's similar to what we do for influenza year over year.” Incidentally, these are all newer than the Atlantic piece. Crossroads ^-talk- 18:38, 28 November 2022 (UTC) expanded Crossroads ^-talk- 20:12, 28 November 2022 (UTC)

It very well might, and it very well might not. Part of it's going to depend on what you count. For example:

• I'm expecting annual booster shots for COVID. Is that "the same" or "different"?
• Laws in some countries have changed to strengthen, weaken, and/or clarify the authority of public health agencies. You won't see it in practice until another novel virus appears. Is that "the same" or "different"?
• People are voluntarily wearing face masks in public places. Is that "the same" or "different"?
• Many people are feeling more disconnected from society than before. Is that "the same" or "different"?
• More people are voluntarily using contactless payment systems, self-checkout, online shopping, and delivery services. This reduces weak ties in society for everyone, not just the people using these systems (because even if you do everything the same, you're less likely to see your neighbor at the grocery store). Is that "the same" or "different"?
• Some older people and people with riskier health conditions stopped working or had to retire earlier than they wanted to, because of the pandemic. They will have less money to live on for the rest of their lives. Is that "the same" or "different"?
• People are choosing more holiday trips that they can reach by automobile instead of mass transit (planes, trains, buses). Is that "the same" or "different"?
• Three times as many people in the US workforce now work remotely, compared to pre-pandemic levels. A quarter of the customers for downtown businesses that served office workers are no longer potential customers for those businesses. Is that "the same" or "different"?

Lifting the legal restrictions on personal behavior is not the same as returning to the pre-pandemic world. Government officials can promise an end to legal restrictions. They cannot give orphans their dead parents back, even though those children had living parents in the pre-pandemic world. They cannot even give children the education they lost due to school closures.

The doctor who said "the disease is still around but that it's at a level that is not causing significant disruption in our daily lives" is technically wrong. Endemicity means that the rate of infections is stable. Even stable levels can cause significant disruption, and at the hyperlocal/individual level, it almost always does. Nobody gets malaria – widely called endemic – and says "No big deal; that didn't cause any significant disruption in my daily life". More generally, finding sources who claim the likely outcome is the only possible outcome does not actually re-write the definition. WhatamIdoing (talk) 20:52, 28 November 2022 (UTC)

I don't have much to say right now and I've skimmed these comments. But human behavior does normalize. Maybe not to the same level as previous, but a pandemic ending and endemicity being declared seems to be cut from the same type of cloth. Living with COVID, new normal etc are all in the same basket imo. Doesn't make our job easy though. SmolBrane (talk) 05:09, 29 November 2022 (UTC)

a pandemic ending and endemicity being declared seems to be cut from the same type of cloth. Living with COVID, new normal etc are all in the same basket imo. No, they're not. Something becoming endemic is not the same as "living with COVID" or a "new normal". The current attempt at an Endemic COVID-19 article is a mess because people keep dumping unconnected journalistic coverage of various public health measures ending, which is not the same as moving to endemicity, a topic that comes under WP:MEDRS. (See discussion at Talk:Endemic_COVID-19#Fundamental_problem.) If editors want content about decisions to end public health measures or "living with COVID", that is already covered in COVID-19 pandemic and related articles for specific countries/regions, where it is placed in an appropriate context. Bondegezou (talk) 17:41, 30 November 2022 (UTC)

BTW, I've expanded Endemic (epidemiology) with a section on terminology. One thing that has been interesting to learn recently is the epidemiologists don't consider influenza to be endemic. We "live with the flu", but it's epidemic flu (with occasional bursts into pandemic flu), not endemic flu.

Also, anyone who is interested in malaria should look into this, because some of the finer points of the definitions seem to have been developed primarily with malaria in mind, and it's interesting. WhatamIdoing (talk) 21:01, 30 November 2022 (UTC)

See also Talk:Endemic (epidemiology)#What people say is not biomedical information. I do not think we should push the idea that COVID-19 will become either mild or (technically) endemic. WhatamIdoing (talk) 07:36, 1 December 2022 (UTC)

We should not push the idea that it definitely will, true, but it should be mentioned, as neither should we push the idea that it will not be mild. Some in the media like to write articles and thinkpieces debunking people's hope for normalcy or whatever - negativity gets more views and always has - but we should not think that MEDRS mostly think this is the most likely possibility. e.g. [23] Crossroads ^-talk- 19:55, 1 December 2022 (UTC)

Yes, that one source, which was first published when the delta variant was dominant, says that iff COVID-19 becomes endemic it "could be" mild. That's one source, it's out of date, and it's not making strong claims. It's talking about multiple possibilities, only one of which you mentioned in the article about endemicity as a concept – where, IMO, I don't think that the predicted disease severity for one disease that may or may not ever become endemic, is actually a relevant point. It's possibly relevant to say that COVID could become endemic; it is not IMO relevant to say that COVID could become endemic plus that if that happens, it "could be mild". WhatamIdoing (talk) 20:53, 1 December 2022 (UTC)

I don't know of any reliable medical source suggesting any end for the COVID pandemic except that it will become endemic. There's nothing "out of date" about that source at all; nothing it says about coronaviruses, immunity, or epidemiology has been contradicted or disproven by Omicron or anything else. It's odd to see you disparage a model MEDRS review article, while a thinkpiece in The Atlantic is cited instead. Again, it's undue weight to only emphasize a version of endemicity in which it is severe, like we're the media or our mission is to debunk misconceptions or the public's hopes and wishes. We are supposed to relay the views of experts in general with due weight and in a neutral tone. Crossroads ^-talk- 00:28, 2 December 2022 (UTC)

Here's Christopher J. L. Murray discussing the end of the pandemic: PMID:35065006. He does not talk about "endemic" disease but reckons "COVID-19 will become another recurrent disease that health systems and societies will have to manage". Bon courage (talk) 08:05, 2 December 2022 (UTC)

The review article doesn't support the sentence that I wrote. The sentence I wrote says, in polite terms, that politicians don't understand science, which should surprise approximately none of the regulars on this page. The Atlantic article supports this content, and is a reliable source for this content.

The review article says that when the pandemic ends, COVID could become epidemic or endemic (but almost certainly won't be eradicated), and that in addition to being either constant (like the common cold) or variable (like the flu), the disease could be mild or not.

"I'm a scientist and I say that whenever the pandemic technically ends, it might become endemic, and it might become a milder disease" is not a relevant source for a sentence that says "Hopes for COVID-19 to become endemic make a similar mistake; generally, the speaker expresses a wish that COVID-19 will become relatively harmless." WhatamIdoing (talk) 21:27, 2 December 2022 (UTC)

It's worth noting, though, that regarding things like rates of feelings of disconnection, voluntary mask wearing, remote work, etc., these sorts of things are still very much in flux, and we're not even in the endemic stage yet. Even once we are, those things will take even more time to reach whatever steady-state they will. So who knows how that will all end up. Crossroads ^-talk- 01:41, 1 December 2022 (UTC)

I think the point is it might never be judged endemic, but sporadically epidemic. We will have to wait for the epidemiologists. Bon courage (talk) 04:10, 1 December 2022 (UTC)

Proposed merge

Okay, from all the above I think these issues could be dealt with by merging. So, see:

• Talk:Endemic COVID-19#Proposed merge

Thoughts welcome. Bon courage (talk) 08:47, 2 December 2022 (UTC)

Fields Condition

A mention of this, as reportedly the rarest rare disease, was added unsourced to Rare disease which is on my watchlist, and I reverted it. But I see it is also mentioned in Ribose-5-phosphate isomerase deficiency, though only sourced to a news item about the patients' family's living arrangements, which doesn't name the condition. I've found another news item which mentions "Fields condition". Can any find a WP:MEDRS for this disease? Is it recognised, either by this name or by some other name? I'm not an expert medical editor, just a rare disease patient with an interest in my own and related ailments. PamD 23:33, 1 December 2022 (UTC)

I've also found a 2005 BBC news item which names the condition. PamD 23:40, 1 December 2022 (UTC)

rather difficult, only found this "Medical Definition of Fields' disease Doctor Written". MedicineNet. Retrieved 2 December 2022. which isn't MEDRS,--Ozzie10aaaa (talk) 00:54, 2 December 2022 (UTC)

Not in OMIM or PubMed or Google Scholar. But, if you do a web search for the names of the twins (with last name 'Fields') mentioned in the news article that you link, you find a number of webpages, such as this one [24]. Jaredroach (talk) 20:33, 4 December 2022 (UTC)

Apo (drink)

This isn't formally listed under this wikiproject, but is making quite a lot of strong claims about this beer's medicinal properties. The article doesn't inspire confidence but I don't have the time or knowledge to untangle fact from pseudoscience, so dropping it here in case anyone wants to take a look. Rusalkii (talk) 01:17, 5 December 2022 (UTC)

I had a look at the cited references (and a couple of the references they cite); they aren't looking at trials of efficacy, but rather surveys of local practice. I've hence refined some of the text in the context of local tribes believe .... — Preceding unsigned comment added by Klbrain (talk • contribs)

Nurse-Family Partnership

Hi, I would like to suggest some knowledgeable editors to look at the WP page(s) relating to NFP. As you may know, this is a program of intervention originating from the US but widely rolled out in the UK (and possibly elsewhere, I'm not sure) see 1. I'm not in a position to sensibly suggest edits, but there have recently been large trials of the scheme see 2 and I wonder if this should be reflected in the page or pages. Thanks. JMWt (talk) 07:16, 4 December 2022 (UTC)

@FloNight, @Sectionworker, have either of you heard about this? WhatamIdoing (talk) 17:12, 4 December 2022 (UTC)

02:03, 5 December 2022 (UTC)

I had never heard of them except for a mention in information of them in research I was doing, which I ignored because I had no idea what they were talking about and it was just mentioned along with doula, etc., and I just thought something in the UK since I know they do more home work with women than we do here in the US where we use fewer midwives. Anyway, I am very enthusiastic about this form of assistance as I have long been concerned about these forgotten girls and young women who are still in need of mothering themselves when they are forced into the role of motherhood. And now the added burden of making it next to impossible to obtain badly needed abortions... I could go on and on about this... Anyway I have added it to the new pregnancy split article on birthing plans and classes. I'm also going to add it to the teenage girl section of the pregnancy article. Thanks to JMWt and Waid for passing this information along. Sectionworker (talk) 03:39, 6 December 2022 (UTC)

Geir Bjørklund

Hello all, I am a little bit concerned about Geir Bjørklund. I have shortend again a lot of irrelevant information, whitewashing and advertisement.

Impo you can delete this article, it is just constructed to promote Bjørklund - the lack in secondary sources acc. to WP:MEDRS shows that clearly. Best, --Julius Senegal (talk) 20:18, 1 December 2022 (UTC)

SPA?--Ozzie10aaaa (talk) 01:08, 2 December 2022 (UTC)

Definitely.

Interestingly, the Norwegian wikipage (as well those of other languages) are still short, so Ruth_Dahle seems not be Bjørklund himself (he is Norway, so should have interest to improve his page). Still, the issue remains. --Julius Senegal (talk) 18:49, 2 December 2022 (UTC)

Is this person actually notable? I'm a bit worried about the concerns User:Tournesol expressed here when this article was simultaneously created on en.wiki and on several other language wikipedias. How does one go about getting an article deleted in all the wikis? Dr. Vogel (talk) 03:17, 3 December 2022 (UTC)

That requires individual nominations at each wiki. WhatamIdoing (talk) 20:19, 3 December 2022 (UTC)

Thanks for clarifying that @WhatamIdoing. That's what I feared. I'm not saying this is spam, and I don't know if this person is notable or not. But if you were going to spam Wikipedia... a good trick would then be to write up an article, Google-translate it into other 6 or 7 languages, and create it in all those wikis, making it look like an important subject that's covered in several languages. Sorry for going so off-topic.. I'd just never thought about this before. And this may or may not be what happened here. Dr. Vogel (talk) 21:21, 3 December 2022 (UTC)

I've seen it happen at least once before. (You wouldn't necessarily need to use machine translation. Plenty of educated people in the world can write several languages fluently.) WhatamIdoing (talk) 21:35, 3 December 2022 (UTC)

The SPA has removed now much content, still did not improve anything the article is lacking.

I have started AfD. --Julius Senegal (talk) 15:39, 6 December 2022 (UTC)

Generalized hypoxia: all but one sentence fragment cited to the US Department of Transportation

Iatroapathetic topics part III! I recently linked to Generalized hypoxia (on account of this[25]), and it's a bit scant. It cites two souces, "A Quick Look at Reflexes", from the Health Encyclopedia of the University of Rochester Medical Center, and the non-inline cite to the "Pilot's Handbook of Aeronautical Knowledge: FAA Manual H-8083-25", by the Flight Standards Service of the US Federal Aviation Administration.

I would appreciate any improvements to the article, especially if it starts getting more pageviews from COVID-19 sufferers. Alternately, is there a useful merge or alternate target? Suggestions welcome. HLHJ (talk) 04:57, 26 November 2022 (UTC)

If Pbsouthwood is around, he knows a lot about what oxygen (and its absence) does to the body. Generalized hypoxia seems to mostly be about circumstances (like high-altitude settings) than about a disease. Tissue hypoxia, which appears to be the localized version (e.g., in case of infarction or stroke), redirects to Hypoxia (medical). WhatamIdoing (talk) 21:28, 26 November 2022 (UTC)

Thank you, WAID. I've used anemia as a target for now as it's more comprehensive and seems to apply regardless of the precise mechanism by which one's blood is pooched. The article seems to have once been titled "Hypoxic hypoxia" (which it defined as "insufficient oxygen available to the lungs", a somewhat different scope). I'm not up to judging if a merge is a good idea; I'd be glad if Pbsouthwood has a view. HLHJ (talk) 00:34, 27 November 2022 (UTC)

My knowledge of oxygen metabolism is largely related to the effects of variation in partial pressure in the breathing gas on underwater divers, who are usually in fairly good general health, and by extension, to effects due to hyperbaric and hypobaric exposures on reasonably healthy subjects. Not sure if this is likely to be of any use. Cheers, · · · Peter Southwood ^(talk): 06:28, 27 November 2022 (UTC)

Turns out it is good enough to fix most of the problems. · · · Peter Southwood ^(talk): 13:19, 27 November 2022 (UTC)

The FAA source appears to be [26] and probably to be more precise [27], which talks about various types of hypoxia i.e. Hypoxic Hypoxia, Hypemic Hypoxia, Stagnant Hypoxia and Histotoxic Hypoxia (obviously from an avaition point of view). Does this actually support the article?Nigel Ish (talk) 10:22, 27 November 2022 (UTC)

A bit, but not much, but I have found and added more relevant sources, expanded a bit, and cleaned out a lot of tangential, unsourced, dubious, and out of scope content. What remains is mostly good. · · · Peter Southwood ^(talk): 12:45, 27 November 2022 (UTC)

Anemia is still probably a better link for the original purpose. · · · Peter Southwood ^(talk): 12:47, 27 November 2022 (UTC)

I'll keep using anemia . Thank you very much, the article is much better. I'm still very confused by the ontology. Hypoxia (medical) says that hypoxia is generalized when it affects all tissues, and localized when it doesn't. That makes sense. But then altitude sickness, carbon-monoxide poisoning, anemia and circulatory hypoxia would be forms of general hypoxia, though presumably some tissues would be worse-affected. But the Hypoxia (medical) article lists low hemoglobin as a cause in its section on local hypoxia. And the Generalized hypoxia article seems to contradict the Hypoxia (medical) article on scope. A hierarchical list of forms of hypoxia, in order of the progression of oxygen into the body, like the one in Generalized hypoxia#Other types of medical hypoxia and Generalized hypoxia#Causes but more comprehensive, would be useful.

An article on COVID-19 and hypoxia would also be very useful, as it's now a notable, complex topic of high public interest (and there's some confusing pop science content out there). We have silent hypoxia, which is clearly related but different as you can get silent hypoxia (defining it broadly as hypoxia without distress) very fast by breathing helium (or any gas containing neither oxygen nor CO2, a fact the article does not note). HLHJ (talk) 18:20, 27 November 2022 (UTC)

The helium containers available to the general public have ~20% oxygen these days, for safety reasons. WhatamIdoing (talk) 02:33, 28 November 2022 (UTC)

The precise meaning and scope of generalised hypoxia also bothers me. It is claimed to be synonymous with hypoxic hypoxia by the sources I used, but I agree that other sources appear to use it differently, and that the use in Cavezzi et al appears to be using it as a distinction between affecting all tissues and having localised effects. I would explain that in the article, but cannot find a suitable source. I will leave a comment on the talk page, maybe someone who is an actual expert will know where to look.

Balloon helium contains oxygen, technical helium (five nines - 99.999% He) does not. Both are available from industrial gas suppliers. Pure nitrogen is probably the cheapest and most easily available asphyxiant which you would not notice and would probably not be identifiable by standard pathology tests. Nitrogen has a large range of industrial uses, from fizzing beer to inflating tyres. Cheers, · · · Peter Southwood ^(talk): 04:53, 28 November 2022 (UTC)

It may be that there isn't a single clear meaning agreed upon by the medical community, in which case I guess we should have descriptive title for the meanings and make the disputed term a disambig. I think it was unfair to call this topic iatroapathetic, it may just be a muddled term people avoid.

Pure argon also has a variety of uses. These gasses are often delivered in huge pressurized carboys, as tall as a person and sometimes made of glass, which are often refrigerated until delivery, at which point they are wheeled into a small windowless basement room and hooked up. I'm told that if you breathe a pure inert gas, you may feel slightly lightheaded or dizzy just before you actually lose consciousness. So the safety proceedure for major leaks, or feeling a bit off, or seeing someone apparently slumped unconscious, is to exit yelling and evacuate the building, sending someone else in a SCBA back to retrieve any bodies. RS sources for this could probably be found. I can't help liking the safety precaution often taken on boats, where dangerous gasses are placed so that if they leak, they will drain (or vent, if they are lighter than air) outside the boat. There may be some naval sources on that, regulations perhaps. Argon is heavier than air, helium lighter, and nitrogen, of course, only very slightly heavier... it would be safer to have a storage room with separate ventilation, as in a medical isolation room, and a sensor that could be read before opening the door. Someday there'll be a major accident and they'll do that. HLHJ (talk) 15:52, 28 November 2022 (UTC)

Bulk industrial and medical gases are usually stored and transported in high pressure cylinders or in large amounts as liquefied gas at cryogenic temperatures in very well insulated containers. Storage is usually in very well ventilated areas, sometimes outside or just under a roof to protect fron the worst of the weather. I am not familiar with the OSH requirements for most countries, but fairly sure they exist. I would not consider this a medical aspect, more occupational safety.· · · Peter Southwood ^(talk): 09:59, 9 December 2022 (UTC)

Comment invited at Talk:Hypoxia (medical)#What next?

I have done a bit of work on the article, ungraded it to B-class, and would appreciate constructive comments on what is still needed to get it to GA some time. It is a level 4 vital article and rated high importance by this project, so worth a look by those who can spare the time, particularly if you have specialist knowledge of the topic. Cheers, · · · Peter Southwood ^(talk): 10:09, 9 December 2022 (UTC)

Comment invited at Talk:Generalized hypoxia#Hypoxic hypoxia

The article has an odd history, and it is not clear what the scope is intended to be as the current title is ambiguous. As I see it, the name change should be reverted, or the article may be redundant. Expert opinion requested. · · · Peter Southwood ^(talk): 11:23, 9 December 2022 (UTC)

Systematic reviews

"Systematic reviews and meta-analyses are good for statistical questions, such as whether a drug prevents a death. They are frequently inappropriate sources for, well, pretty much everything else. Literature reviews, practice guidelines, and position statements are good for the current state of mainstream thinking. Graduate-level textbooks are the MEDRS ideal for definitions and other human-decided facts." by WhatamIdoing (talk) 17:15, 28 November 2022 (UTC)

Compare the nutshell of WP:MEDRS

"Ideal sources for biomedical material include literature reviews or systematic reviews in reliable, third-party, published secondary sources (such as reputable medical journals), recognised standard textbooks by experts in a field, or medical guidelines and position statements from national or international expert bodies.

The lead says

"Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals...."

So WhatamIdoing's comment is clearly heretical. I'm joking. And actually, I'd go further and wonder if we can "rely" on them to be "good", in practice, for statistical questions. Is it just me or does it seem like just about anyone can write a "systematic review and meta-analysis" these days. There seem to be more of them than there are actual studies. There are even systematic reviews that include other systematic reviews. Perhaps Covid lockdown is to blame, when everyone was stuck at home with just the internet and no patients to study. I wonder if some of them, in trying to answer a difficult question with a high bar and rigid algorithm, end up concluding we are more ignorant than is actually the case. Or that when the studies prove to not be suitable for meta-analysis, that the authors then cherry pick whatever conclusions they want from their carefully and systematically collected set. Is there some useful way we can classify systematic reviews that identify their value? For example, is there a difference whether the review successfully performed a meta-analysis that gave a result (adding to knowledge) or whether the review fails and merely describes our lack of knowledge.

But aside from whether they have problems, they are only really seeking to answer one specific question, and as such, I think we are elevating them way way too high at MEDRS in recommending editors consider them "ideal sources". The vast majority of a systematic review is spent documenting their system, describing the studies, producing tables of figures and then a short conclusion. For us, trying to write an article, it is thin stuff. I suggest we re-order the sequence of ideal sources and drop one. I'd place medical guidelines and consensus statements first. They both document something much closer to actual reality than some academic exercise that began and ended at someone's computer desk. Often, they describe the quality of evidence and get to the point quickly. Both represent a consensus (at least, on what should be happening, and what we agree we know), which is very much what Wikipedia should be prioritising. International statements can also represent a consensus of global opinion rather than just documenting what "our" hospital does or thinks is best. I'd keep the professional textbooks next (most likely to be comprehensive, though harder to get hold of), with literature reviews following. And then systematic reviews should be eliminated from both nutshell and lead, and dealt with in the section on assessing evidence quality.

In the "Biomedical journals" section, we note that the background section of a research paper isn't as good as a dedicated literature reivew (it may be incomplete and less reliable). Presumably the peer reviewers and editors are not nit-picking that section as much as the actual research itself. The same is sure true of a systematic review, with the added problem that the authors of the systematic review may not even be subject experts at all. Just academics of evidence-based medicine. I think we should include "systematic review" in that cautionary part of MEDRS about background sections.

In short, a systematic review is only useful for its conclusion, and even then, its conclusion may not often be worth wasting our readers time with (we know nothing). -- Colin°^Talk 19:28, 4 December 2022 (UTC)

Take a look a Cochrane's systematic reviews [28]. I think you will find them to be about as close to 'ideal' as any source, and that much in them besides the conclusion is useful, and they often reward the time spent reading them. Jaredroach (talk) 20:22, 4 December 2022 (UTC)

I've read several Cochrane reviews with great disappointment. I know they are respected and used as a source of information when creating clinical guidelines. I suspect the algorithmic nature of such reviews makes it attractive to folk with little clinical or research experience who want a paper published.

Could you list any Cochrane reviews that you've been able to use to write a serious portion of an article? Like one of those sources that end up with "a b c d e f g h i j k l m" in front of them in your references section?

An "ideal" source would be one that one could build a whole article from (should one wish). It would be comprehensive and up-to-date and neutrally represent the consensus of medical opinion while also encyclopaedically including social and cultural aspects. There is no one ideal source, but systematic reviews are for our purposes, closer to primary research papers, in that they mainly deal with one claim and produce what the authors hope are novel findings. Articles are more than one fact and healthcare is not an algorithm. -- Colin°^Talk 22:07, 4 December 2022 (UTC)

If one wants both 'comprehensive' and 'ideal' then perhaps one is looking for a textbook chapter or an encyclopedia article. Jaredroach (talk) 17:14, 5 December 2022 (UTC)

I agree. If you're trying to (re-)write an article, rather than just drop in a single fact, a textbook chapter can be an absolutely golden source. We were able to make real progress on Multiple chemical sensitivity#Diagnosis when we finally got a few pages from a regular medical textbook, instead of people bringing in this or that source with the "right" POV. WhatamIdoing (talk) 17:26, 6 December 2022 (UTC)

+1. Yes, I've long felt the WP:MEDRS advice on systematic reviews is out of touch with reality. A systematic review is a statistical exercise meant to eat clinical results, chew them up, and poop out quantified claims with associated confidence levels. Their utility when writing an encyclopedia is limited since giving an overall view of a topic (i.e. our mission) is not their goal. When trying to write an encyclopedia article I tend to find literature reviews and textbook chapters most helpful for giving me a sense of a topic. Medical guidelines and consensus statements are often essential for writing "Treatment" and "Diagnosis" sections, but sometimes are too narrow to be useful outside of that. Ajpolino (talk) 20:29, 4 December 2022 (UTC)

• I think systematic reviews are limited yes, but the questions they answer are often important ones that need coverage - which will necessary often be quite brief. One systematic (hah!) issue is perhaps that parts of MEDRS are seemingly written with a clinical-decision-making mindset, which is why evidence levels are emphasized so much there. Bon courage (talk) 17:21, 5 December 2022 (UTC)

  I think part of the problem with MEDRS's history is that there are two uses for it. The first is the advice to writers of medical articles where to find the best sources to help them in that task. The second is as a hammer to hit the heads of anyone pushing fringe or alternative medicine. Editors who enjoy(ed) doing the latter I suspect over emphasised systematic reviews, because they are excellent way of dismissing therapies (no evidence the therapy works) and research (it's always low quality). I do sometimes wonder if those same editors read the systematic reviews of the mainstream medicine they casually write about (if they do) which are often pretty low quality too. -- Colin°^Talk 12:16, 6 December 2022 (UTC)

  At the risk of distracting people from Bon courage's very interesting insight about the clinical-decision-making mindset, and the general notion of re-thinking how helpful this advice is for us in general, I wonder whether the most immediate problem with the nutshell could be solved with formatting. Compare:

  "Ideal sources for biomedical material include literature reviews or systematic reviews in reliable, third-party, published secondary sources (such as reputable medical journals), recognised standard textbooks by experts in a field, or medical guidelines and position statements from national or international expert bodies."

  vs

  "Ideal sources for biomedical material include:

  • literature reviews or systematic reviews in reliable, third-party, published secondary sources (such as reputable medical journals),
  • recognised standard textbooks by experts in a field, or
  • medical guidelines and position statements from national or international expert bodies."

We could probably also remove a few words (e.g., "reliable, third-party, published secondary sources (such as reputable medical journals)" → "reputable medical journals". And maybe list reviews last of the three, rather than first, if that would help people notice that more than one thing exists. WhatamIdoing (talk) 18:56, 5 December 2022 (UTC)

Getting back to the more interesting and complex question: I've been thinking for some time that we are over-emphasizing evidence levels. I've mostly felt this about the sections that attempt to educate editors about evidence issues. I think it might be better to link editors to the Wikipedia articles on those subjects, and then skip straight to the "advice" parts. WhatamIdoing (talk) 18:59, 5 December 2022 (UTC)

The formatting certainly helps, as the sentence is too long and there is a temptation to think "literature reviews or systematic reviews" are the nutshell, because we then explain where to find them (which I agree isn't necessary in the nutshell, and what is a third-party anyway?) I also agree with changing the order. Can I suggest sticking "professional or academic" in front of "textbooks" and dropping "recognised standard". The latter smells too much of medical students advising other medical students, and we aren't just dealing with undergraduate textbooks anyway. -- Colin°^Talk 12:03, 6 December 2022 (UTC)

Yeah, "standard" raises more questions than it answers. Though with my fringe antenna twitching I'm not sure about professional either. Is this a professional textbook for medical content? Bon courage (talk) 12:11, 6 December 2022 (UTC)

It may well be if one is writing about homeopathic medicine, but not if making claims about medicine that actually works. I'm thinking about books like Epilepsy: A Comprehensive Textbook (3 volumes) or Plotkin's Vaccines which aren't exactly an undergraduate-level (here's the heart and all the chambers) stuff. Colin°^Talk 12:21, 6 December 2022 (UTC)

Agreed, but I can foresee arguments that anything "professional" is "an ideal source" and WP:MEDRS for biomedical information. Hmmm. Can't think of the wording. It's somewhere in between established, reputable and mainstream. Bon courage (talk) 12:28, 6 December 2022 (UTC)

I think some of that is covered by our existing advice on WP:RS which state that the publisher of the work has an impact on reliability. The ones I linked were published by Lippincott Williams & Wilkins and Elsevier whereas yours was published by Full of Life Publishing. We also have the WP:MEDBOOK section to go into details. -- Colin°^Talk 13:23, 6 December 2022 (UTC)

I think even nominally reputable publishers these days have low standards. OUP gives us this which is something that has come up before. It's bursting with woo. Bon courage (talk) 13:59, 6 December 2022 (UTC)

Actually WP:SOURCE has a better list of things we think about for sources. Yes publisher is a vague term which can range from a particular newspaper or journal (The Guardian/Lancet published my article), to series of books, to imprints, to publishing house to a hierarchy of owning companies. They can all affect reliability. Here the OUP series was "Weil Integrative Medicine Library".

Anyway, the point of a nutshell is not to finesse the specifics of selecting the best such books. I think if we just say "textbooks" many people will just think of books you need for school, college or university, whereas we are really aiming for the kind of textbooks for undergraduate/graduate learning and for professional learning. Beyond that, is a matter for WP:MEDBOOK. -- Colin°^Talk 15:45, 6 December 2022 (UTC)

The problem with altmed textbooks is usually that the POV is undue for claims of efficacy, not that the source is unreliable for all fact-based statements. Homeopathy textbooks are reliable for statements like "Practitioners use arnica for bruises". WhatamIdoing (talk) 16:57, 6 December 2022 (UTC)

Right. But since we're talking about changing WP:MEDRS it's the biomedical content we're interested in. I think everybody in this thread has plenty of experience of how even slightly incautious wording in WP:MEDRS can open the door to a storm of wikilawyering. Bon courage (talk) 17:05, 6 December 2022 (UTC)

We attempted once to write a "MEDDUE" section in MEDRS, which would be the place to explain that "A hot toddy is a folk remedy for the common cold" is okay, but "A hot toddy cures the common cold" is not. WhatamIdoing (talk) 17:21, 6 December 2022 (UTC)

Generally, for books, we are hoping to find graduate-level textbooks (e.g., Harrison's Principles of Internal Medicine, which I wish were in Wikipedia:The Wikipedia Library, so pinging Samwalton9 (WMF) – also, anything from Doody's Core Titles, which is the modern version of the old Brandon–Hill list). We are also interested in professional reference works (e.g., medical dictionaries).

Perhaps "recognised standard textbooks by experts in a field" could be replaced by "graduate-level textbooks and professional reference works". WhatamIdoing (talk) 17:19, 6 December 2022 (UTC)

I think "professional or academic textbooks" is sufficient for a nutshell, whereas the above is twice as long and even more restrictive (not all professional books are for "reference" and I'm not sure we need to explicitly exclude undergraduate texts in a nutshell). -- Colin°^Talk 11:43, 7 December 2022 (UTC)

I'm not sure about that. Are there professional textbooks or non-academic textbooks? WhatamIdoing (talk) 20:31, 8 December 2022 (UTC)

Someone should do a systematic review;-P · · · Peter Southwood ^(talk): 11:39, 9 December 2022 (UTC)

Wikipedia:Reference_desk/Science#Demand_for_unvaccinated_blood?

Reference desk question, if you know anything. Gråbergs Gråa Sång (talk) 15:02, 2 December 2022 (UTC)

WAID answered--Ozzie10aaaa (talk) 13:33, 4 December 2022 (UTC)

Thanks! For the interested, Vaccine_hesitancy#Blood_transfusion. Gråbergs Gråa Sång (talk) 16:34, 9 December 2022 (UTC)

Gates MRI request

Hi editors, I'm Lee and I work for the Bill & Melinda Gates Medical Research Institute. I suggested some updates to the article that I think help it be more complete and read a bit better. Because of my conflict of interest, I won't make any edits myself. Would anyone here be willing to take a look? I'd really appreciate it! LBGatesMRI (talk) 16:13, 12 December 2022 (UTC)

Implemented, noting that there may be more similar edits to come if others are also interested in helpful. Klbrain (talk) 21:33, 12 December 2022 (UTC)

POV forking of "Longevity medicine"

I am bringing to your attention an article (Longevity medicine (aging)) that may need to be looked at by an expert; I described the issues on the article's talk page. The older article is redirected to from Longevity medicine, and is named Age management medicine. What I believe should happen is that the articles should be merged, but I am unable to determine if there is any content worth merging in the POV fork article. Thank you. tw^sabin 18:01, 7 December 2022 (UTC)

thanks for posting--Ozzie10aaaa (talk) 13:18, 13 December 2022 (UTC)

Ileo-anal pouch

Hi all, can we get some eyes on this article? We have a lightning-fast editor adding information in several revisions (of which I haven't gotten to the bottom of). Cheers. X750. Spin a yarn? _{Articles I've screwed over?} 00:57, 14 December 2022 (UTC)

It looks like there have been lots of edits over the last week or so by someone who apparently knows something about this subject and has been working on the article for months. It might be easier to let it rest for a bit, and then go through the article less with of the patroller's "what changed?" mindset, and more with "what do we need here?" The content before this editor arrived was undersourced and incomplete, so IMO preserving the old state should not be prioritized. WhatamIdoing (talk) 17:00, 14 December 2022 (UTC)

Yeah nah for sure, I just wanted a third opinion of sorts, I wasn't trying to insinuate that their contributions were bad per se, that would be bad faith on my part. Thanks WhatamIdoing. X750. Spin a yarn? _{Articles I've screwed over?} 18:54, 14 December 2022 (UTC)

Functional neurological disorder

Hi all, touching base after running into a medical article in a concerning state. I just removed a number of totally unsourced claims (including claim about recommended treatment) from the Functional neurological disorder page. I am not an expert on medical sourcing, by a long shot, and mainly know enough to know there are likely other issues? If someone more expert has the time and inclination to look it over, that would be wonderful. Thank you all for all you do; it’s incredibly valuable that WP has rigorous standards of evidence for medical articles. Innisfree987 (talk) 07:33, 10 December 2022 (UTC)

As an update: I reviewed MEDRS and MEDREF and made a pass removing the most obvious problems (as best I understand them), but there are still a number of sources I’m uncertain about, as well as places where it’s not immediately obvious whether a citation is meant to cover one sentence or a whole paragraph. Checking those of course is a heavier lift tho. Innisfree987 (talk) 00:32, 13 December 2022 (UTC)

@SandyGeorgia, is this related to the TikTok tics thing? WhatamIdoing (talk) 17:00, 14 December 2022 (UTC)

Yes. Anyone who wants to further improve this article might have a look at the sources at Tourette syndrome#Differential diagnosis. I looked over the article, and it's in bad, but not egregious, shape. I can't offer to work on it soon as I am doubly impaired; I sprained my wrist and my computer is getting a new hard drive. SandyGeorgia (Talk) 11:18, 15 December 2022 (UTC)

Thanks much @SandyGeorgia. I hope your wrist and your computer are both repaired without difficulty! Innisfree987 (talk) 07:42, 16 December 2022 (UTC)