Talk:Alternative medicine/Archive 27

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The lede's definition is UNDUE, cf. Harrison's

I'm not surprised that the lede defines CAM in terms of evidence, but there's an UNDUE problem with that. Harrison's Principles of Internal Medicine ("most recognized book in all of medicine") defines it differently, and specifically takes issue with the evidence-based definition. Quote:

The phrase complementary and alternative medicine is used to describe a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine. Most of these practices are used together with conventional therapies and therefore have been called complementary to distinguish them from alternative practices, those used as a substitute for standard care. ... Until a decade ago or so, “complementary and alternative medicine” could be defined as practices that are neither taught in medical schools nor reimbursed, but this definition is no longer workable, since medical students increasingly seek and receive some instruction about complementary health practices, and some practices are reimbursed by third-party payers. Another definition, practices that lack an evidence base, is also not useful, since there is a growing body of research on some of these modalities, and some aspects of standard care do not have a strong evidence base. (chapter 14-E, Harrisons', 19th edition 2015, from PDF)

Harrison's weighs at least as strongly as the two sources currently cited in the first sentence. Suggest rewording in WP's voice to encompass both definitions; in the body we can mention Harrisons' criticism of other definitions (and just use a footnote in the lede for that). Sound reasonable? --Middle 8 (t • c | privacy • COI) 19:06, 10 May 2015 (UTC)

P.S. Also potentially useful, on demarcation: By its nature, the demarcation between mainstream medicine and complementary health practices is porous, varying from culture to culture and over time. Traditional Chinese medicine and the Indian practice of Ayurvedic medicine were once the dominant health teachings in those cultures. Certain health practices that arose as challenges to the mainstream have been integrated gradually into conventional care. Examples include the teachings of Fernand Lamaze that led to the widespread use of relaxation techniques during childbirth, the promotion of lactation counseling by the La Leche League, and the teaching of Cicely Saunders and Elizabeth Kübler-Ross that established the hospice movement. (chapter 14-E, Harrisons', 19th edition 2015, from PDF) --Middle 8 (t • c | privacy • COI) 19:06, 10 May 2015 (UTC)

I suggest you start by reading the many pages of archive material that discuss this question. :-) That said, perhaps Harrison's would be a good source to reference for expanding sentence 2 or other parts of the paragraph. Sunrise (talk) 19:23, 10 May 2015 (UTC)

Please specify what exactly in the present version of the lead is at variance with the Harrison text quoted. The first paragraph is indisputable: the practices here and in sources called 'alternative medicine', do not profess to be founded on evidence gathered using the scientific method. The sources support the statement that CAM is used in a belief, not proven by using scientific methods, that it "complements" the treatment. But the article is always open to updating with later sources. Qexigator (talk) 19:43, 10 May 2015 (UTC)

@ Sunrise, I'm sure the wording has been discussed ad nauseam, but Harrison's isn't showing up in the archives at all. And it's a stronger MEDRS than the other two (NSF and Angell, which are still good ones), so....

@ Qexigator -- lede: Alternative medicine is any practice that is put forward as having the healing effects of medicine, but is not founded on evidence gathered using the scientific method vs. Harrison's Another definition, practices that lack an evidence base, is also not useful... et passim. It shouldn't be a surprise, there have always been multiple definitions of CAM.

There are not multiple definitions of CAM. "Lacking an evidence base" is a very different definition from "lacking a scientific evidence base". Harrison simply states that the former is not a good definition, since some alt med has some evidence, so does not lack an evidence base. If the evidence for that particular alt med increases to scientific standards, then the alt med becomes science-based med. FloraWilde (talk) 05:09, 17 May 2015 (UTC)

I don't see how we keep Harrison's out of the first sentence: we need to say, in WP's voice, that CAM is (a - what NSF and Angell say) or (b - what Harrison's says). Anything less is insufficient weight to Harrison's. --Middle 8 (t • c | privacy • COI) 20:10, 10 May 2015 (UTC)

Please note that the article's first sentence is indisputably correct, and not rebutted by the quote from Harrison: AM practices do not profess to be founded on evidence gathered using the scientific method. Qexigator (talk) 20:20, 10 May 2015 (UTC)

I'm not arguing about the sentence's correctness about AM and the evidence base, I am saying that it has become insufficient as a standalone definition of CAM given the sources we now have. --Middle 8 (t • c | privacy • COI) 20:38, 10 May 2015 (UTC)

OK, first sentence stands. So what is in error in the description of CAM as alternative medicine used together with conventional medical treatment in a belief, not proven by using scientific methods, that it "complements" the treatment? If that needs expansion with reference to Harrison or others, the place for that would be the section "Definitions and terminology", which states: 'These descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and CAM introductory courses or modules can be offered as part of standard undergraduate medical training; alternative medicine is taught in more than 50 per cent of US medical schools and increasingly US health insurers are willing to provide reimbursement for CAM therapies. In 1999, 7.7% of US hospitals reported using some form of CAM therapy; this proportion had risen to 37.7% by 2008.' Qexigator (talk) 21:06, 10 May 2015 (UTC)

@ Qexigator - How would one surmise from my comments that I'm agreeing first sentence should stand? More below to Sunrise. --Middle 8 (t • c | privacy • COI) 05:37, 12 May 2015 (UTC)

Some curious turns of phrase are being used here, perhaps because Harrison's is demonstrably wrong? Why would we say "not proven by using scientific methods"? No hypothesis in natural sciences is ever proven by using scientific methods, only tested. Worse, "Standard care", "Mainstream" and "Conventional" are not synonyms for "Evidence based". Each has a distinct meaning. We muddle them only at peril of error. LeadSongDog come howl! 22:25, 12 May 2015 (UTC)

LeadSongDog is correct as to the meaning of "proven". LeadSongDog is especially correct in warning Wikipedians not to create a language muddle by using expressions that may have synonyms in some contexts, but are not synonyms outside those context, i.e., are not synonyms.

In the context of a science-based medical publication, the expression "proven" may be used as a synonym for "established using the scientific method" or "tested and got a p-value of .05 or less" (e.g., when a doctor loosely says "this medicine has been proven to be effective"). But in a more general context (like in a logic class, philosophy of science class, or in our encyclopedia) the expressions are not synonymous. I suggested different language, "established", in the proposal at the bottom of this section.
LeadSongDog is correct that "mainstream medicine", "standard treatment", "conventional medicine", etc., are not synonymous with "EBM". The expressions may be intended to be synonymous in the context of a science-based medical journal (or science-based medical text like Harrison, which is based on publications in science-based medical journals). But without that context, the expressions are not synonymous. Using such language creates a muddle from nothing. Some of our lead sources explicitly discuss this language-muddle creation being intentional by some alt med promoters, e.g., the Journal of the Association of American Medical Colleges' "Alternative medicine and common errors of reasoning", and the New York Academy of Sciences' "Antiscience Trends in the Rise of the 'Alternative Medicine' Movement". These and other sources we use explicitly discuss how these ambiguities in language are manipulated by alt med promoters to create language muddles from nothing. For example, they discuss how the use of the word "alternative" was chosen to create the false appearance of being an effective alternative because of an ambiguity in the word "alternative", and "complementary" being used to create the false appearance that it actually complements and improves on what is established using science. NSF is unassailable as being as high ranking a MEDRS can get, and its overtly stated NSF definition is consistent with all our sources (including Harrison). We should not deliberately muddle things by taking expressions like "mainstream" that appear in a context (like where it appears in Harrison, in the context of being in a science-based text), and putting them into our lead without that context. FloraWilde (talk) 15:28, 14 May 2015 (UTC)

Yes, I agree that much of the lead is poorly written, that being a good example. I think it's difficult to come up with good incremental improvements from the current state. I think you may be confusing Harrison's with something else though (it's not being used to support "not proven by using scientific methods," which is already in the article). Sunrise (talk) 02:56, 13 May 2015 (UTC)

I would just add that there were (and are) good sources for both definitions already, so the existence of another good source is unsurprising. I would also disagree that Harrison is a stronger MEDRS than NSF and NEJM, which we can discuss if it becomes necessary. Sunrise (talk) 21:19, 10 May 2015 (UTC)

@Sunrise - Hmmm. Dunno, Angell's an editorial (a good one, and it's about demarcation, but still, editorials are not generally real high up the list), and NSF isn't about demarcation. And both are old. Harrison's is, well, Harrison's, and has the added benefit of considering demarcation from a current perspective.

What I don't get is this: if that there are multiple, more-or-less equally-well-weighed definitions around, then why do we open with just one of them? If we're NPOV surely we should open with "CAM is {Definition A}, or {Definition B} etc." Seems like we're getting out in front of the debate with the present text. I may make a bold edit later to show to a broader audience what I'm getting at. --Middle 8 (t • c | privacy • COI) 05:37, 12 May 2015 (UTC)

One normally suffices for the top/lead, as here, and the rest in the main body of the article. Qexigator (talk) 05:52, 12 May 2015 (UTC)

No, that violates WP:WEIGHT, we shouldn't favor one when sources (a) diverge and (b) are comparably good. --Middle 8 (t • c | privacy • COI) 18:05, 13 May 2015 (UTC)

One covering the thing defined, not a multiple of variants, though competing nuances etc. can be discussed in further detail where they belong in the main body. Qexigator (talk) 18:14, 13 May 2015 (UTC)

The lede should summarize the body and the definitions aren't so close to each other as to justify glossing (and in the case of the EBM definition is specifically disputed by one good source). And the one from the weightiest source should be primary, and that would be IOM -- which has the benefit of fuzziness/broadness which takes in all of them. --Middle 8 (t • c | privacy • COI) 18:52, 13 May 2015 (UTC)

Like I said, I'm happy to discuss MEDRS weighting if it becomes necessary. But the article only cites representative sources, so any discussion would need to consider the rest - thus my request that you go through the previous discussions, mainly over 2012-2013. IIRC at one point there were 14 sources supporting the current lead sentence, before it was reduced to something reasonable. (I'd also add that Harrison's definition is unusual in specifying historic origins outside mainstream medicine; the other sources that use the "outside mainstream medicine" description use their present status instead, sometimes also specifying present status within a particular geographical area, so any evaluation of weight would need to consider that difference as well.)

I've never seen an article use "X or Y" before, and I think it violates WP:LEADSENTENCE, specifically "If [the] subject is definable, then the first sentence should give a concise definition." That also presumes similar weighting (which I didn't say, as you suggest I did), although that is probably true. By the time the issue was resolved I was exhausted enough, and sufficiently aware of the weighting of both definitions, that I no longer really cared which definition went first. At this point, absent significant reason to change, I would much prefer to keep the stable version without the edit wars - and hopefully the dozen or more editors whose input has been considered would agree. Sunrise (talk) 20:14, 12 May 2015 (UTC)

I do not see how the Harrison quote can be taken as a basis for revising the present version of the lead. It does not clarify the description of AM or CAM we now have there. Qexigator (talk) 22:06, 12 May 2015 (UTC)

@Sunrise -- Re a construction like "CAM is {A} or {B}" in the first sentence, I'm not sure, but we could also split it into 1. CAM is {A}. 2. Alternatively, it's {B} or {C} etc. The point being to have it right up there instead of buried in the body. And to have the definition from the weightiest first, which is now IOM [1] (see below). Weighting of sources is presently relevant, and good luck arguing Harrisons weighs less than Angell & NSF if that's what you're hinting. :-) Anyway IOM's a good bit weightier still. --Middle 8 (t • c | privacy • COI) 18:05, 13 May 2015 (UTC)

Is there a link so we can see the context of the selected quotes from Harrison?

Qexigator is correct that the Harrison quotes above (which are cited without their context), cannot be taken as a basis for significantly revising the existing lead. They do not clarify the description of AM or CAM we now already have. The Harrison quote is about CAM, not a definition of it. Harrison criticizes definitions of CAM that we do not use in our lead, so the criticism is not relevant. The Harrison quotes are not inconsistent with the existing lead or existing sources, so we do not need to rate NSF against Harrison as the "better" MEDRS.

The Harrison quote, "The phrase complementary and alternative medicine is used to describe a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine.", is not a definition. It is a declarative sentence about CAM. It is like the sentence "The phrase CAM is used to describe a group of practices that are now practiced in shops in some strip malls", which is also a true declarative sentence about CAM, but it is not a definition of CAM.
Re - "The phrase complementary and alternative medicine is used to describe a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine. Most of these practices are used together with conventional therapies and therefore have been called complementary to distinguish them from alternative practices, those used as a substitute for standard care". This part of Harrison is entirely consistent with the existing lead.
Re - "Until a decade ago or so, 'complementary and alternative medicine' could be defined as practices that are neither taught in medical schools nor reimbursed, but this definition is no longer workable, since medical students increasingly seek and receive some instruction about complementary health practices, and some practices are reimbursed by third-party payers." This is a criticism of a definition we do not use in our lead, so is irrelevant to any change in the lead first sentence. Harrison is saying CAM is now taught, when it used not to be, and that insurance companies are now paying for it. CAM is taught so that doctors can address questions patients might have, but not as something that should be practiced. What is taught is that CAM does not meet scientific standards for ethical medical practice. Teaching CAM does not mean that it is taught to be practiced, just that it is taught. It is reasonable to teach med students why the evidence for it (if any) does not rise to scientific standards. That insurance companies may pay for cheaper, but inneffective CAM "treatment, speaks to the ethics of the insurance company, and is not relevant to our lead.

The possible relevance of this part of the Harrison quote is to two of our lead's sentences.

The lead first paragraph third sentence says, "The treatments are those that are not part of the conventional, science-based healthcare system.". This is ambiguous in that med students may be taught them, but this does not mean that it is taught to be practiced. It is taught not to be practiced, since it is does not meet scientific evidence standards.

Removing the word "conventional" would make this sentence consistent with the existing cited sources, and with the Harrison quote. So I propose changing the first paragraph third sentence to, "The treatments are those that are not part of the ~~conventional,~~ science-based healthcare system", and leave the existing sources.

The lead third paragraph first sentence is, "Alternative medical diagnoses and treatments are usually not included in the degree courses of medical schools, or used in conventional medicine, where treatments are based on what is proven using the scientific method."

Adding the word "science-based", and removing the word "conventional" in the third paragraph first sentence would make it consistent with the cited sources and with Harrison. In response to LeadSongDog's comment on the word "proven", changing it to "established" would be more clear. So I propose changing the third paragraph first sentence to be - "Alternative medical diagnoses and treatments are not included as science-based treatments that are taught in medical schools, and are not used in medical practice where treatments are based on what is ~~proven~~ 'established" using the scientific method."

Re - "Another definition, practices that lack an evidence base, is also not useful, since there is a growing body of research on some of these modalities, and some aspects of standard care do not have a strong evidence base." Harrison criticizes this definition as not being useful, but since it is not the definition used in the lead, this criticism is irrelevant to our article. Our defining lead first sentence says "not founded on evidence gathered using the scientific method". That is very different from "lack any evidence base". Having an "evidence base", no matter how weak or scant, is very different from having a scientific evidence base, by which it becomes an accepted treatment in science-based medicine. There may be some evidence for some CAM treatments, so there is an evidence base for that treatment, and there may be a growing body of research that may some day add evidence for that treatment until it is established using the scientific method, whence it gets published in a scientific or medical journal and stops being CAM. If it ever reaches that point, it stops being called CAM and becomes science-based medicine. But before a scant or weak evidence base reaches that point, it is still CAM, and is not accepted practice in science-based medicine. So our lead, as it exists, is not inconsistent with this part of the quote from Harrison.
Re - "Another definition, practices that lack an evidence base, is also not useful, since... some aspects of standard care do not have a strong evidence base." This is an accurate criticism of medicine as taught practiced. This is an inconsistency in all definitions of "alternative medicine" and "medicine" in all our sources. The logical conclusion to be drawn is that some things doctors put forth as science-based, should be reclassified as alternative medicine. But it is WP:OR for us to do so without sources. And the quoted part of Harrison does not indicate that a significant portion of what it calls "standard" practice fails to meet scientific standards, so it is UNDUE for us to include this in the lead. I would not object to pointing out this inconsistency in the article body, but others might object since it is a WP:OR logical inference.
Re - "By its nature, the demarcation between mainstream medicine and complementary health practices is porous, varying from culture to culture and over time. Traditional Chinese medicine and the Indian practice of Ayurvedic medicine were once the dominant health teachings in those cultures. Certain health practices that arose as challenges to the mainstream have been integrated gradually into conventional care. Examples include the teachings of Fernand Lamaze that led to the widespread use of relaxation techniques during childbirth, the promotion of lactation counseling by the La Leche League, and the teaching of Cicely Saunders and Elizabeth Kübler-Ross that established the hospice movement."

This goes to LeadSongDog's comment on getting into a muddle by using ambiguous terms such as "mainstream", "conventional", "standard", etc., in defining alternative medicine. Since our lead, especially with the above minor proposed changes, principally uses the consistent NSF defining idea as claims to heal that are not based on using the scientific method, we don't need to worry. The demarcation between science-based medicine and alt med is not porous. So the Harrison quote critiques a definition of alt med that is not the main thing used in our lead, and so is irrelevant to our lead. Even if our demarcation was "porous", i.e., having small holes through which things pass, or "gray areas", WP:UNDUE does not let us put these small holes in the lead.

Middle_8 is correct that Harrison is as good a MEDRS as our other sources. And Sunrise is correct that the existing sources already in the lead such as NSF are almost unassailably good as MEDRS. But we need not be concerned, since Harrison is not inconsistent with the existing top-notch MEDRS sources in the existing lead, such as NSF. (The authors and editors of Harrison are likely in, or associated with, NSF and the other MEDRS sources already in the lead.)

In conclusion, the quoted passages of Harrison do not justify any major revision in the article. Making the small proposed changes will make the existing lead more consistent with Harrison. FloraWilde (talk) 03:43, 13 May 2015 (UTC)

Agree that conclusion, including proposed small changes. Qexigator (talk) 06:29, 13 May 2015 (UTC)

@FloraWilde -- No link AFAIK, and I'm sure others will verify this independently, but I've omitted no context; I'm just quoting from the intro of the chapter on CAM in the 2015 electronic (PDF) edition (it's not in the written edition apparently). Or email me...might have some ideas...

Three basic disagreements come immediately to mind: First, "a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine" (Harrison's) is indeed a definition, simply a broad one. There's nothing in the nature of a definition that excludes locus of origin as a criterion for demarcation (and I don't believe Harrison's is the first to use such a definition, or something close to it). Second, [practices] not founded on evidence gathered using the scientific method (lede) are tautologically the same as practices that lack an evidence base (Harrison's), EBM being itself based on the sci method (hence its acceptance in the sci community). Which means that Harrison's is very much criticizing the primary definition the article uses now, creating the UNDUE problem. Third, um, demarcation between science-based medicine and alt med is porous if a good source says so (or at least we weight dissenting views, not omit one). It's not the same as a source making a basic factual error -- with respect, you are mistaken on that (cf. WP:WEIGHT and WP:NOTTRUTH), and again a noticeboard will clarify that if needed. --Middle 8 (t • c | privacy • COI) 18:05, 13 May 2015 (UTC)

OK, another general comment re sources: I'm very surprised that the Institute of Medicine IOM is absent (in the lede), and that one's certainly unsurpassed, and probably unequalled by most if not all sources here: it's one of the most prestigious bodies of its kind on the planet. It consider demarcation in some detail and concludes: [2] This discussion of definitions shows that no clear and consistent definition of CAM exists, nor is there a recognized taxonomy to organize the field, although the one proposed by NCCAM is commonly used. Given the committee’s charge and focus, for the purposes of this report, the committee has chosen to use as its working definition of CAM a modification of the definition proposed by the Panel on Definition and Description at a 1995 NIH research methodology conference (Defining and describing complementary and alternative medicine, 1997). This modified definition states that:

Complementary and alternative medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed.

Obviously IOM is both different from, and weightier than, Angell and NSF (the latter, again, not being about demarcation and only tangentially about CAM, and NSF itself consisting of scientists appointed by politicians rather than scientists). Given IOM, it's just not defensible to leave the opener as it is, and I'm guessing noticeboard or RfC if we can't agree. Weight of sources is as fundamental an issue as it gets, and the article is currently favoring one definition and two sources for no good reason (other than local consensus, which is flawed). regards --Middle 8 (t • c | privacy • COI) 18:05, 13 May 2015 (UTC) revised, minor clarification 04:17, 17 May 2015 (UTC)

The IOM definition is not different from NSF and NEJM. In the current historical period, in our society and culture, the science-based health system is the dominant health system. So IOM says alt med is theories and beliefs perceived by their users as associated with positive health outcomes that are other than those based on science. So IOM is no different in what it says than NSF and NEJM (and the other academic sources cited). There is likely a large overlap and close links between members of IOM, NSF, and NEJM. FloraWilde (talk) 05:00, 17 May 2015 (UTC)

Another possibility could be based on the WHO definition, which rather neatly avoids national biases:

The terms complimentary medicine and alternative medicine are used interchangably with traditional medicine in some countries. They refer to a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system.
— WHO, MDS-3: Managing Access to Medicines and Health Technologies (2012) Policy and legal framework Ch 5: Traditional and complimentary medicine (in Box 5.1)

Of course, in any country where traditional medicine dominates, this would locally define EBM as alternative, which might be rather problematic for WP. LeadSongDog come howl! 19:58, 13 May 2015 (UTC)

LeadSongDog correctly states that misinterpreting the ambiguous word "dominant" in the WHO definition, creates the "problematic" (absurd) inference that "in any country where traditional medicine dominates, this would locally define EBM as alternative, which might be rather problematic for WP." When the ambiguous word "dominant" is correctly interpreted, it is not inconsistent with our lead (or with NSF, NEJM, or our other sources.)

The WHO "definition", containing the ambiguous word "dominant", was discussed several times in the archives. The discussions repeatedly resulted in the current consensus lead. I add to those discussions that the WHO statement that "complementary medicine" and "alternative medicine" is synonymous with "traditional medicine" in some (unspecified) countries, is false in countries in which English language is the principal language. Wikipedia is an English language encyclopedia. So we cannot define "alt med" as "traditional medicine". We can make a declarative sentence that alt med includes traditional medicine, which we do with the cited MEDRS sources.
When correctly interpreted, the WHO word "dominant" is consistent with our lead (and with NSF, NEJM, and all our other sources). But like the words "mainstream", "standard", and "conventional", "dominant" is ambiguous and can be misinterpreted when taken out of context, so as to create the absurdity that "EBM is alt med", as LeadSongDog states.

- If "dominant" (or "mainstream", "standard", or "conventional") is interpreted to mean "most practiced", then in some countries where traditional medicine is more widely practiced than EBM or science-based medicine (e.g. some countries in Africa, and possibly still in China), EBM would be "alternative medicine". But "EBM is alt med" is false. So this interpretation of "dominant" as used by WHO, is not correct.

- If the WHO use of "dominant" is interpreted in its context to mean "science-based", as the dominant worldwide highest standard of medical decision making, then the WHO definition does not lead to absurdity, and is consistent with our lead (and with NSF, NEJM, and all of our many other sources used in our article). For the WHO, science-based medical treatments are "dominant" in this sense, since they are what is recommended by WHO. Our lead (and the NSF and other sources) is consistent with the correct interpretation of the WHO definition.

- There is no reason for us to modify our lead by introducing ambiguous words that might be misinterpreted, such as "dominant" (or "conventional" or "mainstream"), which only creates a language muddle and the absurdity LeadSongDog points out. NSF, the New England Journal of Medicine, and other sources used in our article, know what they are doing. If some MEDRS such as NSF or NEJM use unambiguous words in their definitions, and other MEDRS sources like Harrison and WHO use ambiguous words like "standard" or "dominant", which can be interpreted to be consistent with the unabigous MEDRS sources, then we should use the wording in the unambiguous MEDRS sources. WHO and Harrison, when their ambiguous words are correctly interpreted, are consistent with our lead and NSF and the NEJM (and all our other MEDRS sources in the rest of the lead). "Conventional", "mainstream", "standard", and "dominant" may be roughly synonymous with EBM in the context of a science-based medical text (like Harrison), but they are not synonymous without that context. Putting ambiguous words into our lead without that context only creates a language muddle in the lead. The lead is currently not muddled, and we should not put in ambiguous words to create a muddle where it does not exist. WHO and Harrison are consistent with our lead and with NSF, NEJM, and all our other good sources used in the lead, but they contain ambiguous words. There is no reason to modify our lead by introducing ambiguous words, when we have a lead with unambiguous words and unassailably MEDRS sources such as NSF, NEJM, and the many other MEDRS sources in the lead.FloraWilde (talk) 15:28, 14 May 2015 (UTC)

<od>In the quantity of text above, the small changes proposed by FloraWilde (03:43 13 May) may be lost to sight. As I understand it, one is to remove the word "conventional" in the sentence at the end of he first paragraph, thus:

The treatments are those that are not part of the ~~conventional,~~ science-based healthcare system.

The other is to change the third paragraph first sentence from "Alternative medical diagnoses and treatments are usually not included in the degree courses of medical schools, or used in conventional medicine, where treatments are based on what is proven using the scientific method." to read:

"Alternative medical diagnoses and treatments are not included as science-based treatments that are taught in medical schools, and are not used in medical practice where treatments are based on what is established using the scientific method."

Qexigator (talk) 20:48, 13 May 2015 (UTC)

I made the minor changes Qexigator just summed up per WP:Silence. FloraWilde (talk) 12:09, 14 May 2015 (UTC)

@ FloraWilde "There is no reason for us to modify our lead by introducing ambiguous words ...." Sure there is: MEDRS do it, specifically strong MEDRS that we aren't weighting enough, if at all. Some things are ambiguous/fuzzy/nuanced, and when sources say so, we do too (one way or another). Nothing in NPOV/VER makes an exception just because a source recognizes ambiguity. For example, WP:WEASEL refers to editorial language that is vague or misleading about a source, not to a source itself making an ambiguous statement.

The problem with making minor changes here is that the weight of sources demands substantially more. Harrison's specifically refutes Angell and NSF, and IOM is barely mentioned, when it ~~and probably the WHO~~ should be at the very top, weight-wise. --Middle 8 (t • c | privacy • COI) 19:20, 16 May 2015 (UTC) strike 05:30, 17 May 2015 (UTC)

Harrison does not "refute" NEJM and NSF, unless you misinterpret "mainstream" in "have historic origins outside mainstream medicine", in which case you get the absurdities correctly noted above by LeadSongDog. The context of Harrison is that it is a science-based medicine text, based on published studies (many likely funded by NSF), which only get published if they pass scientific muster. There is no author or editor of Harrison that is not also closely linked to NSF and NEJM. Harrison's wording, "historic origins outside mainstream medicine", in the context of Harrison being a science-based medical text, means founded in non-science, which is exactly what NSF and NEJM say. FloraWilde (talk) 01:18, 17 May 2015 (UTC)

Hi FloraWilde, (1) please see here (scroll to "Three basic disagreements...") re Harrison specifically refuting (or disputing) the EBM definition used in the lede's first sentence. Where specifically is my reasoning wrong? (2) No absurdities necessarily arise; LeadSongDog's objection to the word "proven" is imo beside the point, and does not indicate that Harrison's is "demonstrably wrong". (Besides, the WHO source is caveated; IOM is the 800 pound gorilla.) Anyway, (1) and (2), among other issues, will probably need to be resolved via a broader consensus.

I agree that the multiple definitions and their sources are related in various ways -- per RS (e.g. Harrison's, IOM) -- they are distinct enough for each to have particular advantages and disadvantages. Our task is to summarize and weight these issues as they are discussed by RS, not to synthesize them.

And again, while Harrison's and Angell and NSF and perhaps others are very strong, IOM (p. 19 et. passim) is pretty much unequalled as a source here; see here (scroll to very end). Which means it should be the main one we use, right? --Middle 8 (t • c | privacy • COI) 05:28, 17 May 2015 (UTC) add comment re deprecating WHO 05:33, 17 May 2015 (UTC)

@Middle8 - (1a) Re your question - "Where specifically is my reasoning wrong?" - Your quoted portion of Harrision says, ""Health care systems, practices, and products that have historic origins outside mainstream medicine"". This is in the context of being a medical text based on methods published in science-based medical journals. So "mainstream medicine" means "science-based medicine" in the context of the rest of Harrison. In its own context of being a science-based medical text, Harrison says the equivalent of "alt med is Health care systems, practices, and products that have historic origins outside science-based-medicine", which is our definition, and that of NSF, NEJM, and all our other MEDRS sources. (1b) Another error in your reasoning is that you confuse "evidence" with "scientific evidence". "Lacking an evidence base" is very different from "lacking a scientific evidence base". Harrison said "Practices that lack an evidence base is also not useful". Harrison did not say "Practices that lack a scientific evidence base is also not useful". Your confusion may arise from the expression "evidence based medicine", which is a self-description by the science based medicine community, which is used by that community to be equivalent to "science-based-medicine". You are taking the word "evidence" from that expression out of context, to misinterpret it to mean "any evidence", when it means "scientific evidence" as used by the scientific medicine community. (2) LeadSongDog made two points, one about the word "proven", as loosely used in the medical community, and the other about the absurdity that arises from using ambiguous words out of context. The absurdity arises from misinterpreting "dominant", "standard", "conventional", "mainstream", etc., as meaning "most prevalent in number" (as in some African countries). This incorrect interpretation leads to "science based medicine is alt med" in countries where alt med is more prevalent. This is false and absurd. In the context of usage of such terms by Harrison, WHO, IOM, etc, the correct interpretation is that they mean these expressions to be equivalent to "science-based". Outside that context, the expressions are not synonymous. But in the context of IOM, Harrison, and WHO being advocates of science-based medicine, they mean the same as what NSF and NEJM say more clearly, in that the NSF and NEJM definitions do not require providing the context. There is substantial overlap in the participants of NSF, NEJM, IOM, WHO, and Harrison, and the same people do not have inconsistent definitions when they go from one body to the other. The definitions of these agencies, which share participants, are not inconsistent unless those agencies using ambiguous expressions have the expressions misinterpreted by removing the context. Our lead, NSF, and NEJM, are entirely consistent with Harrison, WHO, and IOM, when the ambiguous expressions used by the latter agencies are correctly interpreted with the context in which they appear, i.e., agencies and texts advocating for the use of the scientific method in recommending treatments. FloraWilde (talk) 13:14, 17 May 2015 (UTC)

Of course "evidence" used in a sci context means "scientific evidence". That should go without saying, and we should read all our sources in that light, and my comments presume it. And of course there is overlap among the various definitions; the way I'd put it (not necessarily as article wording) is that "alternative medicine" is generally taken to mean "medicine (or quasi-medicine) outside of mainstream medicine". But there are still differences, e.g. criteria for demarcation. We know this because some of the sources, like Harrison's and IOM, outright say some of the definitions differ from one another, and that they have various pluses and minuses. For example, Harrison's criterion for demarcation is locus of origin, and they contrast that with demarcating according to evidence base (which is how Angell and NSF demarcate). Some mainstream meds are wanting for evidence, some alt-meds have some; that is exactly what Harrison's says, and we cannot and should not hand-wave it away.

Couple more comments: (A) If any of the definitions really do imply that mainstream medicine is, or historically has been, something other than modern science-based medicine, then we report that too: it's not an "absurdity", it's just a source saying something different than what FloraWilde (or Middle 8 or anyone else) of Wikipedia thinks ought to be the case. (B) It makes no difference that the various bodies and commentators may receive grant money from some of the same places, because that is hardly something sufficient to show scientific agreement... I mean come on! On the contrary, scientists are supposed to evaluate stuff on the merits, not who is paying them. (C) IOM remains the weightiest source by a comfortable margin, and (cf. my comment in section below) we should write the definitions sections accordingly and then work on the lede. They agree, btw, that CAM should be held to the same evidentiary standards as mainstream medicine. But they don't use evidence base as the criterion for demarcation. Happy editing. --Middle 8 (t • c | privacy • COI) Minor copy-edit for clarity 17:42, 24 May 2015 (UTC)

I do not support removing anything already in the lead, but the following two sentences could be added, with citations to all of the sources mentioned in this section, at the same time - NSF, NEJM, Harrison, WHO, and IOM. The following could be added to the end of the first paragraph - "The diverse types of alternative medicine share that their practices do not have historic origins in the scientific methods that are dominant in standard, conventional, mainstream medicine (medical science.". The following could be added to the end of the second paragraph (which defines terms and expressions that are commonly used in discussions of alt med) - "When contrasted with alternative medicine, medicine (medical science), which is generally based on scientific evidence, may be referred to as "science-based medicine", "evidence based medicine", "standard medical practice", "conventional medicine", "mainstream medicine", "allopathic medicine", or even medicine based on the dominant dogmatic orthodoxy (i.e., science, in developed countries in the 21st century)." These two sentences are consistent with all of the various sources mentioned in this section - NSF, NEJM, Harrison, WHO, and IOM. So all five sources could be refs or each of these two sentences at the same time. Given the above editor comments, we may even get unanimous consensus for making these additions. FloraWilde (talk) 20:02, 18 May 2015 (UTC)

Sorry I won't be able to join that. Per just above (see my comment beginning "Of course "evidence" used..."), the various definitions we have certainly overlap but do not coincide to such a degree that the present wording does justice to them. IOM most especially, being the strongest source we have for demarcation. --Middle 8 (t • c | privacy • COI) 08:03, 24 May 2015 (UTC)

@Middle8 - What is one example of an alternative medicine practice that has historic origins in the scientific method? The IOM committee report says that the definition of alt med as being treatments that are untested or unscientific is not airtight (porous), because "many conventional treatments have not been supported by rigorous testing", whereby the "boundaries" between what is put forward as being medical science, and alt med, are "not always sharp or fixed". The IOM committee report cites as an example of a fuzzy boundary being that one study of meta-studies (where 160 meta-studies, which were not randomly selected from the hundreds of thousands of treatments in medical science, and was therefore itself unscientific), a significant percent of the treatments in those 160 treatments did not pass scientific muster. Harrison refers to this problem as a "porous" boundary. This "fuzzy boundary" problem could be brought against any lead first sentence definition of any Wikipedia article, and is dealt with by the WP:UNDUE policy of not mentioning it in the lead. Furthermore, nothing in any of this argues that there is not a sharp boundary between science based medicine and alt med. FloraWilde (talk) 15:12, 24 May 2015 (UTC)

Hi FloraWilde -- In a nutshell: Demarcation is a judgement call that is up to our sources, not up to us.

I don't see any source that mentions "historic origins in the scientific method" as a criterion, so I don't see the relevance of your question. Harrison's says "historic origins outside mainstream medicine" and gives examples of [c]ertain health practices that arose as challenges to the mainstream [and have] been integrated gradually into conventional care.
Re your objections to Harrison's and IOM, please have good look at WP:NOTTRUTH (which elaborates on NPOV, VER and OR): "Editors may not add their own views to articles simply because they believe them to be correct, and may not remove sources' views from articles simply because they disagree with them." That applies to much of what you've said.
Your last assertion that all our sources agree with the lede's sharp boundary is directly contradicted by the IOM (boundaries "not always sharp or fixed") and Harrison's ("porous"). Your arguments seem to be all over the place: One moment you're criticizing Harrison's and IOM for not agreeing with Angell/NSF/lede-opener and for leading to absurdities; the next, you're asserting they all actually agree with one another. That's not helpful.

Please, respect the fact that our sources indeed differ amongst themselves and that we need to depict them accordingly. Happy editing, Middle 8 (t • c | privacy • COI) 18:44, 24 May 2015 (UTC)

I'd tend to agree with Middle 8. When I wrote the terms and definitions section, most of which still exists down to the Marcia Angell quote (I think most of the quotes following this should be removed by the way; I doubt Minchin in particular should be included), it was pretty clear from most authoritative sources that there was no stable definition of 'alternative' medicine and this is clearly so because it is a relational category the context of which can change significantly according to time and place. Most definitions either posit a demarcation based upon some intrinsic quality of a given medical theory and practice (scientific basis or lack thereof) or one based upon social distance. Neither are really satisfactory for reasons well-rehearsed in the above exchange. It's not appropriate for inclusion in this article, but I've written another section on the definition in the historical article on alternative medicine which approaches this point from a different angle. Rewriting the lede is a bastard, of course, and alteration is likely to invite all sorts of trouble, but, if the lede, in providing a definition of the topic, is supposed to be summarising the existing terms and definitions section of this article, it does a pretty poor job. Good luck in any case. FiachraByrne (talk) 02:01, 28 May 2015 (UTC)

@FiachreByrne - If alternative medicine "is a relational category the context of which can change significantly according to time and place", then there should be at least one time or place change where the expression "alternative medicine" no longer referred to a "practice that is put forward as having the healing effects of medicine, but is not founded on evidence gathered using the scientific method". What is such an example? FloraWilde (talk) 04:43, 28 May 2015 (UTC)

For alternative medicine to exist you have to an established medical orthodoxy. Generally that requires state regulation of the medical marketplace, the licensing of practitioners, and so on. In Europe that process begins in the late eighteenth century. Despite increases in medical knowledge, most conventional medical treatments at that time and well into the nineteenth-century were not particularly effective and, from the perspective of the present-day, lacked a scientific basis. Therefore, to adopt that definition as you outline above - the so-called normative definition - would be to define as alternative a large proportion of nineteenth century conventional/orthodox medical practice. Notwithstanding that, the distinction between the scientific basis of modern biomedicine versus alternative medicine becomes more salient from the latter part of the nineteenth century and down to the present day. This in itself can have interesting effects such as in the attempt to establish the scientific validity of folk or traditional Chinese medicine in different national contexts and often tied up in questions of nationalism and national identity, etc. Mostly, of course, this entails the appropriation of scientific rhetoric for the purposes of establishing legitimacy. FiachraByrne (talk) 21:11, 28 May 2015 (UTC)

@User:FiachraByrne

For alternative medicine to exist you have to have science, not a "medical orthodoxy". TCM would still be alternative medicine, even if the Chinese Communist Party were to declare it to be the "medical orthodoxy".
It is not true that for alternative medicine to exist, this in any way "requires state regulation of the medical marketplace, the licensing of practitioners, and so on". If the government of Syria ceased to exist, giving antibiotics for a bacterial infection would be medicine, and sticking needles into a body at acupuncture points, or into a voodoo doll, to cure the bacterial infection, would be alternative medicine.
Re - "Mostly, of course, this entails the appropriation of scientific rhetoric for the purposes of establishing legitimacy." (i.e., pseudoscience) The "mostly" in your sentence is exactly why the lead works as it is, under WP:UNDUE. Any Wikipedia user who reads the lead would go away with a pretty clear idea of what alternative medicine is. That's a good thing. Esoteric problems with definitions belong in a subsection of the definitions section, in the article body not the lead, by WP:MOS. FloraWilde (talk) 23:44, 28 May 2015 (UTC)

Well, all I'll say is that your criterion above is largely contradicted by the broad mass of authoritative sources from the history of medicine. To employ it would be to exclude, for example, antiphlogistic therapies from the history of medicine. Scientific validity and therapeutic effectiveness are important to the historical establishment of 'biomedicine' as the medical mainstream (simply put), not least in establishing its public legitimacy, but there are other social, legal, economic and cultural factors that are also important. Equally, terms such 'alternative', 'heterodox', or 'irregular' make little sense unless there is a mainstream orthodoxy to which they refer. For the same reason, in highly pluralistic medical marketplaces, the employment of concepts such as 'alternative medicine' makes little sense. FiachraByrne (talk) 10:06, 29 May 2015 (UTC)

If "the broad mass of authoritative sources from the history of medicine" say that TCM is not "alternative medicine" should it become more widely practiced than science based medicine, or that acupuncture to heal a bacterial infection in a country without any regulations of medical treatments is not "alternative medicine", or that science based medicine is "alternative medicine" if a government declares and enforces a different dominant medical othodoxy, then sources in the history of medicine must be using the expression "alternative medicine" in a different and technical way, than the expression is used in the medical community and general society. Your statement that "in highly pluralistic medical marketplaces, the employment of concepts such as 'alternative medicine' makes little sense shows that you have an extreme WP:fringe position. If the number of botanicas, chiropractors, acupuncturists, energy healers, faith healings, and homeopathy sales in the US were to equal or exceed science based medicine treatments in the US, making what you refer to as a "pluralistic" medical marketplace, the expression "alternative medicine" would still makes plenty of sense to US MDs. Your position that the expression "alternative medicine" only makes sense relative to prevalence of use is very a fringe view, and violates WP:NPOV "Indicate the relative prominence of opposing views." (I have no idea what you logic is in your citation of an 1854 article extolling the virtues of bloodletting (antiphlogistic therapies), is not part of the history of medicine, because the expression "alternative medicine" only arose in the 1970's as a catch-all category generally collecting treatments not arising from science.) FloraWilde (talk) 11:46, 29 May 2015 (UTC)

The broad mass of authoritative sources from the history of medicine do not engage in contrafactual history. However, they also don't treat scientific medicine as an ahistorical phenomenon. One can't have an alternative without an established mainstream and there are necessary conditions for the establishment of a mainstream. If in one country concepts and practices considered alternative were in fact mainstream it wouldn't make much sense to refer to them as alternative in that national context. This statement makes no claim to the medical efficacy or scientific validity of any medical practice.

Growing popular acceptance and usage of what are termed alternative medical practices, which is a cyclical phenomenon, could be taken as indicative of a diminution of the authority of mainstream biomedicine. That's probably true to some degree at least when seen from the perspective of biomedicine's highpoint of prestige during the mid-20th century, but most studies seem to indicate that medical consumers in the present-day quite happily shop from the biomedical and alt medical shelves as the occasion suits them; there's also clear differentiation in usage according to the medical (e.g. chronic vs non-chronic) or other conditions for which consumers seek treatment. One could also point to the way that some alt therapies, rebranded as complementary, have been incorporated into standard medical practices (although hardly given priority of esteem). There are other factors determining the boundary - porous or not - between the orthodox and heterodox relating to prestige, access to resources, institutional basis, state and regulatory support, perceived efficacy, scientific legitimacy etc.

In reference to the Lancet article cited above, your contention that antiphlogistic therapies are 'not part of the history of medicine' is not supported by the sources. It's a practice which receives extensive treatment in the history of medicine and is, actually, kind of important in nineteenth century disputes between orthodox and heterodox medical practitioners. The point of its inclusion is that your definition of medicine as solely limited to practices that have proven scientific validity, which is necessarily an idealisation of contemporary medical practices in any case, necessarily excludes many practices that were once part of mainstream, orthodox medicine.

The term 'alternative medicine' was indeed coined in the 1970s. Standard histories, however, trace the history of alternative medicine back to Europe in the late 18th century (coincident with the rise of a mainstream, medical orthodoxy there).

If you think I'm promoting a fringe position I'd encourage you to take it to the fringe theories noticeboard: WP:FTN

FiachraByrne (talk) 13:19, 29 May 2015 (UTC)

@User:FiachraByrne. After (superficially) reviewing sources you cite in both this and the history article, I no longer think you are promoting a "fringe" position, but instead it appears you are using the expression "alternative medicine" in a technical or esoteric meaning as used by some pre-science medical historians, in comparing different pre-scientific medical practices, one dominant, the other not (both of which may be totally ineffective as medical science), where the word "alternative" by itself has the meaning "other than", whereas in the medical community, the expression "alternative medicine" cannot and should not be broken into parts, because use of the expression by (at least some) modern practitioners was deliberately chosen to imply there is an alternative to scientific testing. This use (abuse) of wording is repeatedly discussed in many sources in this article. I would support adding this other, technical-pre-science-historian use, to the terminology section I suggested restoring in the definition discussion below. When you say "one can't have an alternative without an established mainstream", you are using the word alternative in a way different than the way the medical community uses the expression - As our many medical sources say, "alternative medicine" is not an "alternative" to anything, but an abuse of words in an expression.

I tried to review the article history and talk page archives, and it is clear that you did not delete the WLU version terminology section and replace it with your own. It appears to have eroded away in a diffuse manner, without much talk page discussion.

It is not contrafactual that in the 1950's and 1960's (and maybe still today), more Chinese used TCM than science based medicine, but TCM was still alternative medicine (as the expression is used by the medical community), and science based medicine was not. If a not-implausible contrafactual condition makes a history source imply an absurdity from its use of terminology, e.g. what LeadSongDog pointed out where the conclusion would be "evidence based medicine is alternative medicine", then either that is not a good source, or the source is using words in a way that is different than what is used in other contexts. For example, Nazi medicine is pseudoscience and therefore alternative medicine, and if the Nazis came to power again in Germany, it would still be pseudoscience and alternative medicine. Denmark licensing chiropractic, or having a political body declare that it is not alternative medicine, does not stop it from being alternative medicine. But licencing it and declaring it not to be alternative medicine certainly causes confusion, by introducing a different meaning" for "alternative medicine" than what is meant as used by the medical science community. This should be pointed out in a subsection on problems with definitions, or a subsection on "other meanings of alternative medicine". The esoteric use by pre-science medical historians should not be in a subsection on problems, but should not be in the lead, because of its esoteric/technical use (per MOS).

"A diminution of the authority of mainstream biomedicine" would be nice, especially if the diminution also occurs among the biomedical community themselves, and they start looking more carefully at relict practices that never had any scientific basis in the first place, and more carefully at industry hype for profit, e.g., by the pharmaceutical industry, or over-promotion of minimally effective surgeries. But that is editorializing and we are getting far from the subject of this talk page, which is the quotes in Harrison and in the report to the IOM (I made a subsection on discussing the latter).

(Where did I ever contend "that antiphlogistic therapies are 'not part of the history of medicine'"? If they are still practiced, they are clearly a kind of "alternative medicine" as the expression is used by the science based medical community. I assume your point is that for historians of pre-science medicine, who may be using the expression "alternative medicine" in a different way than what is meant by the modern medical science community, an 1864 science-based treatment opposed to that therapy might be called "alternative" in a history article about 1864 medicine. If that is your point, then the historian is using the expression "alternative medicine" with a different meaning than the modern science based medicine usage. If so, then this difference in meaning in medical science usage, historical usage, and maybe even usage by political declaration by a government such as in Denmark, should be clarified in a terminology section or possible subsections of it.) FloraWilde (talk) 17:50, 29 May 2015 (UTC)

What was 'alternatve medicine' before 'alternative medicine' so called from the later 20c., and what is it today? At one time, the Royal College of Physicians in England, and similar elsewhere, would determine the norm, others would be alternative. Hahnemann's homeopthy enters the stage and is seen by some to be based on a credible theory, particularly in comparison with resort to 'quackery' such as leeching. Then comes the stage for what came to be seen as medical practice based on medical research in the manner of modern scientific practice, originating in Europe and imported to USA, as the article describes, and which is the rationale for the encapsulation in the opening paragraph. Meantime, tropical medicine develops. and the newly developed 'science based' medicine is exported to India and China, while Chinese and Indian medical treatments find ways into America and Europe, and then become 'alternative' alongside western 'alternative' treatments, such as chiropractic and naturopathy, founded outside the developing 'scientific medicine'. The article is attempting to let this be described in a way which is npov acceptable, but also includes much in the way of cautionary criticism. Qexigator (talk) 22:06, 28 May 2015 (UTC)

"Alternative medicine" is a concept that did not exist before the 1970's. There were practices that claimed to heal, which were not based on any scientific basis for the claims, which are now called alternative medicine. FloraWilde (talk) 23:44, 28 May 2015 (UTC)

That comment is both right and wrong. Given that the words 'alternative' and 'medicine' have been part of the language for many years (centuries?), and that they may have been used together in the past whether we know it or not, and could be used retrospectively today in some context to refer to what was at some time an alternative to the then norm, they would not have been used in the past or retrospectively today to name the same entity (however exact or vague that may be) as the words/concept have come to denote from the late 20c. That is consistent with the article and, as I understand it, with FiachraByrne's contributions. Is there any disagreement to discuss? Qexigator (talk) 00:10, 29 May 2015 (UTC)

The inconsistency pointed out by what Middle8 quoted in the IOM and Harrison quotes, should be somewhere in our article. Harrison says, "historic origins outside mainstream medicine", with mainstream medicine, in the context of this purportedly science based medical text, meaning science based medicine. But IOM says "no clear and consistent definition of CAM exists", because some purported medical "science" in fact has no scientific foundation (like all of alt med). This IOM committee is factually incorrect. if the unscientific relicts in what purports to be medical science, are reclassified as alt med (as humoral theory), then there is a consistent definition, that of NSF. This IOM committee is logically incorrect, unless there is some context we are not being given.

IOM says, "Given the committee’s charge and focus, for the purposes of this report, the committee has chosen to use as its working definition..." Saying there is no consistent definition, then using a definition (which has just been admitted to being self-inconsistent), appears to be an absurdity, unless there is some context we are not discussing. What is this "charge, focus, and purpose" of this particular committee of IOM? Is it the same as the charge, focus, and purpose of Wikipedia? FloraWilde (talk) 02:01, 29 May 2015 (UTC)

But, or also, one major problem is the use of an acronym 'CAM', which too often may portend a latent ambiguity, veiling the actuality, may be in the way mentioned above. The full expression 'Complementary Alternative Medicine' is in contrast to the use of AM alone and not as 'Complementray'. But, given that AM is a label for a range of theories and practises which have pratically nothing else in common but the fact that they profess to have a basis which pre-dates modern 'scientific' medicine, or which was founded with the intent to be outside 'scientific medicine', that remains the case whether or not any particular 'alternative medicine' is being used alongside or to 'complement' a treatment which is not classed as 'alternative'. Thus, the meanings of these terms is best explained by historic-descriptive narrative, not merely by comparing contemporary 'definitions' which have been adopted to define a particular survey or study in bona fide research, or for the purposes of promotion or polemic. Qexigator (talk) 06:37, 29 May 2015 (UTC)

User:Qexigator is correct that "The full expression 'Complementary Alternative Medicine' is in contrast to the use of AM alone and not as 'Complementray'", and is correct that "a range of theories and practises which have pratically nothing else in common but the fact that they profess to have a basis which pre-dates modern 'scientific' medicine, or which was founded with the intent to be outside 'scientific medicine', that remains the case whether or not any particular 'alternative medicine' is being used...", and in the conclusion earlier in this section that these quotes cannot be used as a "basis for revising the present version of the lead. It does not clarify the description of AM or CAM we now have there." FloraWilde (talk) 17:00, 29 May 2015 (UTC)

As a matter of interest, FloraWilde is there an authoritative mainstream source that classifies 'humoral theory' in a historical context as a form of alternative medicine? I think you're espousing a position of how you'd like things to be rather than a source-based argument. FiachraByrne (talk) 13:39, 29 May 2015 (UTC)

Humoral theory is part of the foundation of naturopathy, as stated in its Bible, Textbook of Natural Medicine, Fourth Edition, 2013, Ch. 49, pp. 419-437. For more, read Naturopathy Embraces the Four Humors. All mainstream sources classify naturopathy and its underlying theory as alt med, e.g., in the NCCAM classification. FloraWilde (talk) 04:16, 10 June 2015 (UTC)

The cited committee report to the IOM is not MEDRS for a definition of alt med

User:Qexigator is entirely correct that the Harrison quote above cannot "be taken as a basis for revising the present version of the lead. It does not clarify the description of AM or CAM we now have there." Quexigator's comment also applied to the IOM definition, which fails MEDRS and fails NPOV.

A majority of the committee that produced this report are being paid to be promoters and practitioners of homeopathy, reiki, acupuncture, etc. Only 7 out of 17 members of the committee were from the IOM science based medicine community. A report by homeopaths, reiki practicioners, and acupuncturists, is not MEDRS.

The stated “purpose” of the definition and of the report includes “the goal should be… promotes choices in care that can include CAM therapies”. That clearly fails NPOV.

The majority of committee members who produced the report and definition were specifically chosen to represent alternative medicine "interest groups".

“Committee membership was chosen to represent the most salient perspectives (of alt med practictioners)… there was no possibility that all or even most of the interest groups could be represented. Members included providers of CAM (9 of 17) and conventional health care (7 of 17) as well as analysts, observers, and managers of CAM and conventional health care systems… To ensure effective input from CAM providers, the committee established a working liaison group composed of 35 leaders… The committee deliberated at length concerning whether and how to define CAM most usefully for the purpose of this report… the goal should be… promotes choices in care that can include CAM therapies”. A definition chosen to promote health care choices that includes CAM fails both WP:NPOV and WP:MEDRS.

The committee members with a majority being alt med promoeters and practitioners are in no way are characteristic of the membership of IOM, so are not the “800 pound gorilla in the room” that Middle8 claims outweighs NSF and NEJM, even if the committee definition were not overtly POV. Here is the background of the majority of the committee members, from their own online words -

Joyce K. Anastasi operates a private acupuncture practice and received her degree in Oriental Medicine and Acupuncture from the New York College of Wholistic Health.
Michele Chang is the massage therapist who worked for Senator Tom Harkin, who pushed through legislation for $2.5 Billion of federal medical research funds to study alternative medicine, because he insisted that alternative medicine healed his friend. None of the $2.5 Billion in alternative medicine trials produced positive results.
Brian Berman was trained in acupuncture, received a NIH grant for the study of complementary medicine (principal investigator of the NIH specialized center grant for the study of complementary medicine), is director of the Center for Integrative Medicine at the University of Maryland, and founded the first program for complementary medicine in a mainstream US medical school, and is
Florence Comite founded Destinations Health, which provides (at a cost of $2,600 to $2,850 for a four-day stay), homeopathy, reiki, acupuncture to “balance the flow of energy within your body's natural meridians”, aromatherapy to “blend essences of aromatic plants and flowers that have particular healing effects for your… hormonal condition", Traditional Chinese medicine providing “healing herbs that… [treat]] your illness… through investigation into where imbalances are interrupting your physical… health", etc.
Jeanne Drisko is a board member of ACAM, which promotes chelation therapy for cardiovascular disease. Chelation therapy has been condemned as fraud by the American Heart Association, the American Medical Association, and the American College of Physicians. She is a paid professor of Complementary and Alternative Therapies.

Susan Folkman is a non-MD Director of the Osher Center for Integrative Medicine. The center offers courses on homeopathy, acupuncture, ayurvedic medicine, etc. It states that it “embraces the best of… alternative medicine… as important… to healing as… understand(ing) the molecular basis for cancer or which drug to prescribe." It’s staff includes two practitioners of reiki. It sent faculty members for training in an "intensive two-year course in five-element acupuncture". Its lecture series includes "Energy Healing: Meridians, Shiatsu, and Reiki", "Acupuncture: For More than Pain," etc.
Alfred P. Fishman is the is principal investigator in a grant to "develop and implement an integrative program in complementary and alternative medicine at an academic medical center". He is a paid as a representative to the Consortium of Academic Health Centers for Integrative Medicine, and paid as chair of the Steering Committee on Complementary and Alternative Medicine at U Pen.
David M. Eisenberg was advisor to the television series, "Healing and the Mind" and is paid as the Director of Division for Research in Complementary and Integrative Medical Therapies.
Stuart Bondurant, the committee chair, was awarded a five-year, $1.7 million grant to “develop and implement a… program that incorporates complementary and alternative medicine into the School of Medicine curriculum."

A report to IOM by a group of homeopaths, reiki practitioners, acupuncturists, and people getting grants to study these alt meds, fails WP:MEDRS. It certainly does not come close to outweighing NSF and NEJM as MEDRS, as Middle8 claimed. The stated goal of the committee definition is to come up with one so that consumers add CAM to their treatments, which fails NPOV. FloraWilde (talk) 16:21, 29 May 2015 (UTC)

Reply by Middle 8

No, the report is not POV, and is indeed a top-flight MEDRS, as we'd expect from the Institute of Medicine (IOM).

Authorship and content:

We can dig further, but it appears that yes, the full weight of the IOM is behind this report.

"Responsibility for the final content of this report rests entirely with the authoring committee and the institution."^(p.R16).

update -- even more sure it reflects the IOM's conclusions: It's a "consensus report",^([3]) described here. Compare to "workshop summaries" which do not reflect the IOM's conclusions, e.g. the box at the top of this page. I totally get the FloraWilde is, like the rest of us, trying to get this right and applaud their enthusiasm, but they're mistaken about this. It really is an 800-lb.-gorilla source.(/update, 05:05, 4 June 2015 (UTC))

Goals of report:

The report has multiple goals ^(pp.R8-R10). FloraWilde's excerpt, which is about one of those goals, unfortunately omits a key piece of context which shows that the committee in fact holds CAM to the full standards evidence-based medicine (emphasis mine):

"The committee concluded that the goal should be the provision of comprehensive medical care that is based on the best scientific evidence available regarding benefits and harm, that encourages patients to share in decision making about therapeutic options, and that promotes choices in care that can include CAM therapies, when appropriate. Our challenge was to eliminate parochial bias and to apply the best-available means of assessment of safety and effectiveness adapted to particular clinical circumstances of both CAM and conventional medicine. In this way we will be able to ensure that we are making informed, reasoned, and knowledge-based decisions about the safety, effectiveness, and use of CAM in health care."^(p.R10)

When is use of CAM "appropriate"? When there is sufficient evidence:

"...the committee adopted proven and conventional standards of scientific evidence as the basis for judgments of the safety and effectiveness of both CAM and conventional medicine."^(p.R10)

This is not fringe or POV; this is the mainstream sci view.

Committee membership:

It's 17 people -- all but one MD's and/or PhD's -- 9 of whom FloraWilde objected to because they are CAM-affiliated to varying degrees. But all of them (except the massage therapist/legislative aide) are also just as much part of the sci/med community as anyone else.^(p.R5-R6)

Mainstream affiliations of IOM committee members that FloraWilde neglected to mention

Text in green is what FloraWilde didn't say (other emphasis mine):

Joyce K. Anastasi operates a private acupuncture practice and received her degree in Oriental Medicine and Acupuncture from the New York College of Wholistic Health. Helen F. Pettit Endowed Chair, Professor of Clinical Nursing, Columbia University School of Nursing
Michele Chang is the massage therapist who worked for Senator Tom Harkin, who pushed through legislation for $2.5 Billion of federal medical research funds to study alternative medicine, because he insisted that alternative medicine healed his friend. None of the $2.5 Billion in alternative medicine trials produced positive results. Aside, FWIW: the situation with NCCIH (NCCAM) isn't that simple
Brian Berman was trained in acupuncture, received a NIH grant for the study of complementary medicine (principal investigator of the NIH specialized center grant for the study of complementary medicine), is director of the Center for Integrative Medicine at the University of Maryland, and founded the first program for complementary medicine in a mainstream US medical school... Professor of Family Medicine at University of Maryland
Florence Comite founded Destinations Health, which provides (at a cost of $2,600 to $2,850 for a four-day stay), homeopathy, reiki, acupuncture to “balance the flow of energy within your body's natural meridians”, aromatherapy to “blend essences of aromatic plants and flowers that have particular healing effects for your… hormonal condition", Traditional Chinese medicine providing “healing herbs that… [treat]] your illness… through investigation into where imbalances are interrupting your physical… health", etc. Associate Clinical Professor, Yale University School of Medicine
Jeanne Drisko is a board member of ACAM, which promotes chelation therapy for cardiovascular disease. Chelation therapy has been condemned as fraud by the American Heart Association, the American Medical Association, and the American College of Physicians. She is a paid professor of Complementary and Alternative Therapies. Associate Professor, Program in Integrative Medicine: Functional Medicine and Complementary and Alternative Therapies, University of Kansas Medical Center
Susan Folkman is a non-MD Director of the Osher Center for Integrative Medicine. The center offers courses on homeopathy, acupuncture, ayurvedic medicine, etc. It states that it “embraces the best of… alternative medicine… as important… to healing as… understand(ing) the molecular basis for cancer or which drug to prescribe." It’s staff includes two practitioners of reiki. It sent faculty members for training in an "intensive two-year course in five-element acupuncture". Its lecture series includes "Energy Healing: Meridians, Shiatsu, and Reiki", "Acupuncture: For More than Pain," etc. PhD ["non-MD degree"? come on! --Middle 8], Director, Osher Center for Integrative Medicine, and Osher Foundation Distinguished Professor of Integrative Medicine, Professor of Medicine, University of California, San Francisco
Alfred P. Fishman is the is principal investigator in a grant to "develop and implement an integrative program in complementary and alternative medicine at an academic medical center". He is a paid as a representative to the Consortium of Academic Health Centers for Integrative Medicine, and paid as chair of the Steering Committee on Complementary and Alternative Medicine at U Pen. William Maul Measey Professor Emeritus of Medicine, and Senior Associate Dean for Program Development, University of Pennsylvania Health System
David M. Eisenberg was advisor to the television series, "Healing and the Mind" and is paid as the Director of Division for Research in Complementary and Integrative Medical Therapies. Director, Osher Institute; Director, Division for Research and Education in Complementary and Integrative Medical Therapies; and The Bernard Osher Associate Professor of Medicine, Harvard Medical School
Stuart Bondurant, the committee chair, was awarded a five-year, $1.7 million grant to “develop and implement a… program that incorporates complementary and alternative medicine into the School of Medicine curriculum." Interim Executive Vice President and Executive Dean, Georgetown University Medical Center

Some of these people are heavy hitters! Ditto many of the other members, below:

Margaret Buhrmaster, Director, Office of Regulatory Reform, New York State Department of Health
Gerard N. Burrow, MD, David Paige Smith Professor Emeritus of Medicine, Dean Emeritus, Yale University School of Medicine
Larry R. Churchill, PhD, Anne Geddes Stahlman Professor of Medical Ethics, Vanderbilt University
Albert Mulley, MD, Associate Professor of Medicine, Associate Professor of Health Policy, Harvard Medical School; Chief, General Medicine Division; and Director, Medical Practices Evaluation Center, Massachusetts General Hospital
David Nerenz, PhD, Senior Staff Investigator, Center for Health Services Research, Henry Ford Health System
Mark Nichter, PhD, MPH, Professor of Anthropology, Professor of Family and Community Medicine, Professor of Public Health, University of Arizona
Bernard Rosof, MD, FACP, Senior Vice President for Corporate Relations and Health Affairs, North Shore Long Island Jewish Health System
Harold Sox, MD, FACP, Editor, Annals of Internal Medicine

Bottom line: This is a well-rounded and distinguished board, the consensus of which is to be respected. (Duh -- it's the IOM)

Thing is, some segments of the mainstream are into in CAM and use it, hence the epithet "quackademic medicine" from those who object. It's called "multiple significant views" within the mainstream, all of which we cover, per NPOV. (See also No True Scotsman fallacy; interest in CAM ≠ mainstreamness, necessarily.)

And of course any report will include subject-area specialists:

The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.^(p.R2)

and

"Members included providers of CAM and conventional health care as well as analysts, observers, and managers of CAM and conventional health care systems."^(p.R9)

Again, not POV. The IOM (800 lb. gorilla that they are) can put whomever it wants to on their committee. And it's a consensus report,^([4]) so all members weighed in. And again, responsibility for content lies also with IOM itself.^(p.R16)

The objections above reflect misreadings (sometimes pretty serious ones) of the source and/or of WP's PAG, and in some cases are simply aspersion. It's a top-tier source, and it's not even speaking to whether any given CAM is effective: it's more than fine for defining CAM.

Obviously this issue (and much else) is destined for a noticeboard and perhaps RfC/A etc. .... --Middle 8 (t • c | privacy • COI) 07:16, 2 June 2015 (UTC) minor copyedit 10:23, 2 June 2015 (UTC); added update re source in fact reflecting IOM's conclusions 05:05, 4 June 2015 (UTC)

Could this be walking backwards into an epistemological inquiry below the surface or above the ceiling of everyday medical practice, schooling, etc., and beyond this topic's scope. Is a 'medical' or 'scientific' community (of indefinite location or affiliation, but apparently USA centric) more united than those who practice 'alternative medicine' or 'CAM' or some particular segment of them? What is the basis for the present article? To a reader it may seem that its underlying theme is hostile (rightly or wrongly) to what is scorned by 'the scientific community' (per top, para. 3) and its 'Miracle Cure' image and caption, or could that be the Quackwatch community? If so, how much quibbling about definitions is likely to improve the article? But I remain of the opinion that at least the opening sentence is indisputable: Alternative medicine is any practice that is put forward as having the healing effects of medicine, but is not founded on evidence gathered using the scientific method. Qexigator (talk) 08:05, 2 June 2015 (UTC)

Harrison's specifically discards that definition: "Another definition, practices that lack an evidence base, is also not useful.." Which doesn't mean it's "wrong" (cf. NOTTRUTH), but does mean that we can no longer assert it in WP's voice. But I think BullRangifer is probably right that we can come up with some first-sentence wording that adequately captures various sources' common ground (e.g. "outside mainstream medicine") without getting too far into SYN. And then go on to mention, in next few sentences, some of the better-weighted definitions. --Middle 8 (t • c | privacy • COI) 10:20, 2 June 2015 (UTC)

I do not see anything in Harrison or anywhere else that contradicts that opening sentence, whether or not it is "useful" in the Harrison context or other contexts, and it is, in my view, entirely in accord with BullRangifer's approach to top writing. The simple statement is elaborated, expanded, discussed etc a little in the top, but mostly in the body of the article. That is the way it should be. This is not intended to be a comprehensive dictionary for advanced medical students, but for informing any reasonably intelligent layman, who certainly will not be helped with a plethora of disputable assertions claiming to be the only, or one of the only, statements acceptable to the predominant opinion in medical schools or hospitals or private clinics or research establishments, even those situated in USA. Some of that vast field may usefully be abstracted to explain something of the outline and principles operating there at the present time, to help the layman and perhaps first year student, have an entry into the subject. Some of the current discussion on this page is helpful in that respect. Qexigator (talk) 11:58, 2 June 2015 (UTC)

"Practices that lack an evidence base" = "practices not founded on evidence gathered using the scientific method." --Middle 8 (t • c | privacy • COI) 21:50, 2 June 2015 (UTC)

No, not equivalent. The practices being described under the name alternative medicine in the article were founded before the emergence of the scientific method as we now have it, or were intentionally founded on some other basis. See the first discussion on this page: The article has been edited so as to present the information in a way that would make clear, and, it is hoped (from the encyclopedically neutral point of view) unarguable, that the distinguishing feature between "mainstream" and other/"alternative" is precisely that mainstream is (per history section) based on (evidence gathered) using the scientific method pioneered in USA by Welch (after visiting Europe) and promoted by Flexner and now dominant in medical schools in USA and elsewhere. Other practices "put forward as having the healing effects of medicine" are based on a variety of other theories, teachings or traditions, whether or not any evidence of efficacy can be produced using what are currently recognised as "the scientific method". Qexigator (talk) 22:27, 2 June 2015 (UTC)

Evidence gathered using the sci method is precisely what makes an evidence base. That's the nub. I don't see how the other stuff you mention is relevant at all here, sorry. Anyway, the all-encompassing thread below looks pretty good... --Middle 8 (t • c | privacy • COI) 22:58, 2 June 2015 (UTC)

@Qexigator -- oh, OK, I see what you mean about "founded" -- you're reading it as referring to the origins, or founding, of types of CAM's (e.g. homeopathy being founded by Hahnemann). In this context I believe "founded upon" meant "based upon", or "that depend on", but I could be wrong. Seems like it's moot now since that sentence is no longer in the article, but anyway, I do see what you were saying. Regards --Middle 8 (t • c | privacy • COI) 06:20, 4 June 2015 (UTC)

What is the earliest grouping under one category, "alternative medicine" ?

About the 1970's, a group of practices not previously associated were collected and promoted as "alternative medicine". Irregular western practices were grouped with traditional practices not only practiced in the west, together with anything unproven or untested that is practiced but not biomedicine, all in a collection called "alternative medicine". E.g., Other healers, other cures: A guide to alternative medicine[5], 1974, Helen Kruger . Does anyone have sources on earlier occurrences of the expression "alt med"? FloraWilde (talk) 05:01, 10 June 2015 (UTC)

Email Stephen Barrett (User:Sbinfo). He might know the history of this subject. -- BullRangifer (talk) 02:59, 9 June 2015 (UTC)

NBC News source

The lead says "...almost none have shown any effectiveness greater than that of false treatments..." I am concerned that this statement needs to be sourced to a source that meets MEDRS. The popular media, e.g. NBC News does not meet MEDRS. Everymorning talk 13:43, 12 June 2015 (UTC)

There are other sources in the article body. Also in 2009, Senator Harkin (who bankrolled the spending) summed up the results of his targeted spending, “One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. It think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving.”. He started off in 1992 by complaining about scientific methodology by complaining about the "unbendable rules of randomized clinical trials" and, citing his use of bee pollen to treat his allergies, stated: "It is not necessary for the scientific community to understand the process before the American public can benefit from these therapies. FloraWilde (talk) 14:22, 12 June 2015 (UTC)

As I recall, that NBC report (and many others at the time) was based on evaluations of the accumulated negative results of years of failed research at NCCAM. The body of our article goes into more detail, and the NBC article sums it up quite nicely and accurately, and is also quite suitable for the quotes from critics. -- BullRangifer (talk) 14:34, 12 June 2015 (UTC)

Herbal remedies and other substances used, phytology

There was an extensive discussion at Wikiproject Plants about herbal remedies.[6] Notice if the discussion was made at this talk page.[7] I made corresponding changes in the section on "Herbal remedies and other substances used".[8] FloraWilde (talk) 12:07, 16 June 2015 (UTC)

Defining secondary terms used in literature about alt med, "quackademic medicine", "postmodernism", "natural", "organic", ...

Terms commonly used in literature discussing CAM and integrative medicine (CAI), e.g., when viewed as a social phenomenon, should be defined. I suggest an "other terms and definitions" subsection. There are many terms that refer to alt med, but that have different meanings and are intended to point to different aspects of alt med. When I read some of the literature, there are common terms that are not defined that the authors seem to presume the reader already knows the meaning of. For example "quackademic medicine" means CAI, but focuses on absurd "research" to make something that is already disproven by other established science look like it may work. E.g., research testing efficacy of homeopathic remedies, where all false positives get published in an alt med journal, or like publishing research on "possible" mechanisms for homeopathy by publishing nonsense papers on homeopathy, chaos theory, and quantum physics "models" in an alt med journal. "Tooth fairy science" roughly means doing research that presumes a non-existing entity (e.g., whose existence contradicts basic science, like on "external qi energy" or on the tooth fairy), does "research" to measure its effects, then publishes random false positives, then practices treating illness by treating (e.g. the external "energy"). Definitions of "tooth fairy science" that came after the initial example, improve on that initial def and example. "Cultural relativism" (in the context of discussing alt med) roughly means that using statistics and scientific methodologies to establish efficacy is not objectively better than using self-defined or perceived efficacy, and is only viewed as better because of a cultural bias of the "western" scientific community. "Postmodernism" (in the context of alt med) goes further and deconstructs everything, so that there is really no such thing as science or biomed. Etc. These are esoteric terms and expressions, so their defs should not be in the basic terms and defs section, but rather should be in a subsection. "Natural", "organic", "new age", "spirituality", "holistic", etc. are similarly often used, but not defined in our article, and appear in common usage all over. For example, "natural medicine" is an expression that appears in plant field guides with pretty pictures, but the author does not define it, and it is not in our article for a person using that field guide to quickly use Wiki to figure out what it refers to. "Organic" does not mean that it contains hydrocarbons, but constantly appears in alt med discussions as a necessary part of a "healthy" diet. FloraWilde (talk) 10:55, 6 June 2015 (UTC)

No to defining quackacademic certainly. 21 mentions in Google Scholar. None in Scopus. None in Web of Knowledge. I think we're generally getting into undue territory here. FiachraByrne (talk) 14:34, 6 June 2015 (UTC)

A limited Google search shows over 6,000 websites use the expression "quackademic medicine". The first result is the Science-Based Medicine website, which itself has over 100 articles that use the expression. I did not check how many of the 6,000 websites have multiple articles like this. Our article cites links for the verification of content, some of which link to articles using the expression "quackademic medicine". A casual user would read this expression as being synonomous with alt med (I did at first), when it in fact has a specialized use. As far as I can tell, quackademic medicine refers to the research on biologically implausible nonsense that is being funded at previously scientific institutions, like major university medical departments, and their new integrative medicine departments. It does not refer to testing biologically plausible alt med treatments. The expression does not refer to the practice of alt med at your local strip mall acupuncturist. Putting a paragraph or subsection of these definitions in the criticism section would improve Wikipeida by helping users who check sources supporting what is in the criticism section. (Offtopic - The criticism section artificially divides into US and UK, as if there are different kinds of criticism in each. Why?) FloraWilde (talk) 17:55, 6 June 2015 (UTC)

Quackademic medicine is a well known topic of discussion among the reality-based community. It is not a scientific or technical term - quackery also rarely gets called out as such in the literature. I think pseudo medicine is a more technically correct term for fake therapies such as homeopathy and the magical thinking in TCM (rhino horn for impotence, for example). Guy (Help!) 12:40, 18 June 2015 (UTC)

This might be a good place to mention that I think the statement "not included as science-based treatments that are taught in medical schools" (lead paragraph 3, sentence 1) should really be adjusted, for this reason. It could be true if emphasizing the term "science-based," but then it becomes largely tautological (non-science-based treatments are not science-based). For example, some readers might think it means that if they find a treatment being taught in a medical school course, then it isn't alternative.

Does that make sense? Last time I said something on the acupuncture page, I don't think my comment was very coherent. I'm not sure how that happened, and I'm having a similar feeling here. Sunrise (talk) 08:59, 19 June 2015 (UTC)

It may seem tautological to some, but to readers more or less fresh to the topic or not otherwise well-informed, it is helpful to cover the various factual situations: What MDs are taught as science-based treatments (they are also taught other things, about clinical practice, patient care and nursing); and What is generally used in regular MD practice. Qexigator (talk) 09:54, 19 June 2015 (UTC)

That's a fair distinction, but in that case I think it largely presents the same information as something like "medical school courses do not present alternative medicine as science-based" which is much a more straightforward way to write it. The thing is, I'm not sure that's always true - I think there would be much less criticism of the med schools on this subject if it were. I think acknowledging the existence of exceptions would fix that (e.g. a word like "typically" or "usually," potentially with additional description of the associated criticism). That said, it's not an issue I plan to pursue beyond raising it. :-) Sunrise (talk) 04:43, 20 June 2015 (UTC)

I may be wrong, Sunrise, but I seem to remember that in some earlier versions, that was attempted, and we know how difficult it has been to say in a few concise words something about this topic which is npov, and true to the history, which is in continuing development. For some editors, the history may seem to begin within a short lifetime of 40-50 years, and to be mainly or exclusively concerned with a period when there was major lobbying in the US Congress for funds in recent years. The present version is obviously oriented that way, as the images show. The obviousness counters the undeclared pov, and is therefore not wholly unacceptable. It may even be the only practicable way to present the information encyclopedically here. The website is hosted in USA and this article is probably visited mostly by US citizens or residents, whether under the influence of, or opposed to, Quackwatch. ("Alternative medicine has been viewed 97728 times in the last 90 days."[9]) It treats of CAM/AM as a late 20c. phenomenon arising in the USA, as the presumptive world leader in medical science and healthcare systems, as well as in other fields of science, marketing and the arts of peace and war, and while debate may be fiercely contested there it has overspilling influence in other English speaking countries, like toothpaste marketing and human dental care.[10], [11] Cheers! Qexigator (talk) 11:02, 20 June 2015 (UTC)

Acupuncture lead and summary in this article

The acupuncture article first paragraph violates WP:LEAD, WP:NPOV, WP:UNDUE, and uses WP:Weasel words to violate WP:MEDRS, as follows. I am discussing at this talk page, to hopefully reach a more broad range of editors on alt med topics. WP:LEAD says, “The first paragraph should define the topic with a neutral point of view, but without being overly specific.” WP:NPOV says, “…undue weight mean(s)… that articles should not give minority… aspects as much of or as detailed a description as more wide… aspects…” The existing first paragraph does not define the topic. It is overly specific in that it gives undue weight to the specific condition of pain, with almost no weight at all to all other disease conditions acupuncture is believed to treat. (Pain is also a specific condition that is very problematic in objectively measuring, and is problematic in double-blinding for sham treatment to compare to placebo effect). I am proposing the following as the lead first paragraph in that it defines the topic, is NPOV without being overly specific with undue weight to treatment of any one condition (e.g., pain, or anything else acupuncture claims to treat). It meets MEDRS in that it defines in terms of “belief”, which avoids the existing WP:Weasel wording which is ambiguous as to actual efficacy.

Acupuncture is an alternative medicine component of traditional Chinese medicine in which needles are inserted into the body in the belief that this helps treat disease. The treatment is based on the belief that disease is caused by incorrect flow of blood and a supernatural energy (qi), resulting in change in regions of the tongue that are believed to be connected to major organ systems of the body. It is believed that by examining the appearance of regions of the tongue, specific points in the body can be located, into which insertion of needles will rebalance the flow of blood and or the supernatural energy, and thereby help treat the illness. Acupuncture is usually given in conjunction with other modalities of traditional Chinese medicine, such as traditional Chinese herbal medicine. The traditional Chinese theory of blood flow and supernatural energy flow, that regions of the tongue are connected to major organ systems, and that acupuncture points correspond to real anatomical locations, is inconsistent with the sciences of physics, anatomy, and physiology, whereby acupuncture has been criticized as being a pseudoscience by members of the scientific and biomedicine communities.

This satisfies WP:LEAD in that the first paragraph would define the topic with a neutral point of view, without being overly specific, and satisfies WP:NPOV in that it does not give undue weight to any minority aspect of what acupuncture claims to treat. It satisfies WP: MEDRS in that it states these as beliefs, and avoids speculations based on meta-analyses using admittedly flawed (non-double blinded) studies. FloraWilde (talk) 18:11, 16 June 2015 (UTC)

The problem is that your lead gives no weight to the sources that treat acupuncture as a potentially valid medical treatment based on such things as purinergic signalling. It seems unlikely to me that that perspective will hold up in the long term, but that's not the way that weight in a lead (or an article) is determined. Acupuncture sits on a weird boundary in the real world: founded on obvious nonsense, but just enough studies show just enough evidence of there being some effectiveness that the scientific community hasn't completely dismissed it.—Kww(talk) 17:46, 16 June 2015 (UTC)

The lead first paragraph is supposed to be a stand-alone abstract on the broadly defined subject. Specifics like "purinergic signaling" are exactly the kind of specifics WP:LEAD says should not be in the lead first paragraph. Speculations about "potentially valid medical treatment" specifics are also not to be in the first paragraph, and is what WP:MEDRS says to avoid. Acupuncture does not "sits on a weird boundary in the real world". There is no published study comparing acupuncture to a double blinded sham treatment and every (purported) meta-analysis uses qualifying wording that it did not include any study with a true double blind (the standard of science), in which a licensed acupuncturist was somehow blinded as to whether or not they were really sticking needles into acupuncture points. FloraWilde (talk) 18:05, 16 June 2015 (UTC)

Those aren't really speculations. So long as Cochrane Reviews of legitimate studies exist that show positive results of acupuncture, we aren't going to have an article that portrays acupuncture as purely magical thinking, despite your personal opinion of the quality of the studies involved. There's a dispute over that, and a far more widespread and entrenched dispute than there is over homeopathy, reiki, and similar nonsense. Will it settle in time to recognising that all of those effects are actually false positives from poorly-designed studies? I think so, but we aren't there yet. I spend a lot of time trying to keep acupuncture proponents from taking over the article (as does another admin, JzG), but we just haven't got the sourcing to take it as far the other direction as you want it to go.—Kww(talk) 18:12, 16 June 2015 (UTC)

Every study in Cochrane used in any meta-analysis, was specific that the acupuncturist was not blinded as to whether or not they were truly sticking needles in the body or not, but that even though they looked at no double blind study, they went ahead and did a meta-analysis anyway. Discussing specific areas of treatment such as treating bacterial infections, pain, or blood cancer, violates WP:LEAD as to being in the first paragraph. FloraWilde (talk) 18:19, 16 June 2015 (UTC)

In terms of your opinion of the studies, you are preaching to the choir. I do, however, think that you won't be able to form a consensus around your proposed lead.—Kww(talk) 18:59, 16 June 2015 (UTC)

We got consensus for the alt me lead, so don't be too quick to be pessimistic about consensus for the acupuncture lead. What acupuncture is, is not really controversial. What is controversial is the value laden pejorative language, or weasel-wording, common in both anti- and pro- blogs. (Our opinions about the studies should not be in the lead first paragraph, which should be a short, very broad, summary of the subject, with at most brief mention of criticism.) FloraWilde (talk) 20:19, 16 June 2015 (UTC)

I appreciate the encyclopedic tone and emphasis on description for the lede. A couple technical issues:

1. Tongue and pulse diagnosis are common assessment techniques, but neither take precedence over inquiry or other assessments. If we mention these techniques at all in the lede, it should be something more general like "assessment techniques include inspection of the tongue, palpation of the pulse,…" or we could mention the four basic categories of assessment techniques - "inquiry, inspection, palpation, and auscultation/olfaction".

2. The text does not accurately portray the thought process used in assessing and determining points to needle (for example, a tongue presentation does not directly lead to point selection or location, it is used as one of many bits of information to form a "pattern" or TCM diagnosis, which then leads to a "treatment principle", which then has treatments associated with it.

3. "Energy" is not an acceptable translation of Qi, and "supernatural energy" is definitely not appropriate. Qi is typically not translated, because the term is used very differently depending on context. In some cases energy may be part of the connotation ("deficiency of Qi" as a pattern associated with fatigue), but in other cases it may simply mean gas or flatulence ("Qi stagnation" as a pattern associated with borborygmus or abdominal discomfort). It is more of a descriptor for various phenomena, rather than seen as a distinct form of energy or matter.

Finally, there is still the question of whether this article is specifically about "TCM style" acupuncture, or about the modality itself, which is used with a variety of theories/rationale by practitioners both here and in the East. This article has historically been a hybrid in that sense, which is appropriate considering we have a separate article on TCM.Herbxue (talk) 19:06, 16 June 2015 (UTC)

Measuring pulse should be added, and modification that this is not the only diagnostic tool. That qi should be translated as "energy", and that the energy is supernatural (i.e., not part of natural science) is well established in all major sources - subtleties about translation into English is for sections in the article body per WP:MOS, and not for the lead first paragraph. That there is acupuncture in other cultures should be added. Here is a proposed revision incorporating Herbxue's comments.

Acupuncture is an alternative medicine component of traditional Chinese medicine in which needles are inserted into the body in the belief that this helps treat disease. The treatment is based on the belief that disease is caused by incorrect flow of blood and a supernatural energy (qi), resulting in change in pulse rate and regions of the tongue that are believed to be connected to major organ systems of the body. It is believed that examining the pulse and appearance of regions of the tongue can help determine location of specific points in the body into which insertion of needles will rebalance the flow of blood and or the supernatural energy, and thereby help treat the illness. Acupuncture is usually given in conjunction with other modalities of traditional Chinese medicine, such as traditional Chinese herbal medicine. Other pre-scientific Asian traditional medical practices also use insertion of needles in the belief that this influences disease, by altering supernatural energy flow, but with different theories. Some practitioners of acupuncture believe that insertion of needles produces psychological effects based on actual physiological processes that are not yet well understood. The traditional Chinese theory of blood flow, that regions of the tongue are connected to major organ systems, that acupuncture points correspond to real anatomical locations, and all theories of supernatural energy flow, are inconsistent with the sciences of physics, anatomy, and physiology, whereby acupuncture has been criticized as being a pseudoscience by members of the scientific and biomedicine communities.

This proposal incorporates Herbxue's suggestions, leaves technical issues for the article body, and unlike the current lead, is consistent with all of WP:MOS, WP:LEAD, WP:NPOV, WP:UNDUE, WP:WEASEL, and WP:MEDRS standards. FloraWilde (talk) 20:25, 16 June 2015 (UTC)

Except that it completely ignores the large group of practitioners that claim they are practicing a form of medicine that doesn't rely on blood or qi flow, but instead are stimulating endorphin release and purginetic signalling. I fully agree that those terms don't belong in the lead (certainly not in the first paragraph), but you can't ignore the existence of the group that claims there is a scientific basis for acupuncture. Are they wrong? Almost certainly, but they do exist and they do get written up in scientific journals.

By the way, please stop distorting the discussion flow by the inappropriate use of {{od}}. I've had to remove it twice now. Herbxue is not replying to your comment at 20:19, 16 June 2015 (UTC), he's commenting on the main topic. As such, his comment never should have been indented with respect to mine, and the {{od}} is not only unnecessary, it's wrong.—Kww(talk) 20:54, 16 June 2015 (UTC)

Here is a revision of the proposal trying to incorporate the comment by Kww, but without getting into specificity.

Acupuncture is an alternative medicine component of traditional Chinese medicine in which needles are inserted into the body in the belief that this helps treat disease. The treatment is based on the belief that disease is caused by incorrect flow of blood and a supernatural energy (qi), resulting in change in pulse rate and regions of the tongue that are believed to be connected to major organ systems of the body. It is believed that examining the pulse and appearance of regions of the tongue can help determine location of specific points in the body into which insertion of needles will rebalance the flow of blood and or the supernatural energy, and thereby help treat the illness. Acupuncture is usually given in conjunction with other modalities of traditional Chinese medicine, such as traditional Chinese herbal medicine. Other pre-scientific Asian traditional medical practices also use insertion of needles in the belief that this influences disease, by altering supernatural energy flow, but with different theories. Still others believe that insertion of needles produces psychological effects based on physiological processes that are only recently being studied, not because of effects of the flow of any supernatural energies. The traditional Chinese theory of blood flow, that regions of the tongue are connected to major organ systems, that acupuncture points correspond to real anatomical locations, and all theories of supernatural energy flow, are inconsistent with the sciences of physics, anatomy, and physiology, whereby acupuncture has been criticized as being a pseudoscience by members of the scientific and biomedicine communities.

Kww might be able to suggest better rewording of his/her own comment, but still keeping away from esoteric specifics. FloraWilde (talk) 21:10, 16 June 2015 (UTC)

You're getting closer to something that people might find palatable. I wouldn't explicitly refer to them as "psychological" effects, because that appears to take the "100% placebo" stance. They're just "effects".—Kww(talk) 21:56, 16 June 2015 (UTC)

I think the technically correct term is nonspecific effects. Guy (Help!) 22:00, 16 June 2015 (UTC)

Revised removing "psychological" (some dictionaries define specific effects as "outcomes other than predicted or caused by the treatment being employed", which may be accurate, but is too technical for the lead first par).

Acupuncture is an alternative medicine component of traditional Chinese medicine in which needles are inserted into the body in the belief that this helps treat disease. The treatment is based on the belief that disease is caused by incorrect flow of blood and a supernatural energy (qi), resulting in change in pulse rate and regions of the tongue that are believed to be connected to major organ systems of the body. It is believed that examining the pulse and appearance of regions of the tongue can help determine location of specific points in the body into which insertion of needles will rebalance the flow of blood and or the supernatural energy, and thereby help treat the illness. Acupuncture is usually given in conjunction with other modalities of traditional Chinese medicine, such as traditional Chinese herbal medicine. Other pre-scientific Asian traditional medical practices also use insertion of needles in the belief that this influences disease, by altering supernatural energy flow, but with different theories. Still others believe that insertion of needles may produce physiological effects based on processes that are only recently being studied, not because of effects of the flow of any supernatural energies. The traditional Chinese theory of blood flow, that regions of the tongue are connected to major organ systems, that acupuncture points correspond to real anatomical locations, and all theories of supernatural energy flow, are inconsistent with the sciences of physics, anatomy, and physiology, whereby acupuncture has been criticized as being a pseudoscience by members of the scientific and biomedicine communities.

FloraWilde (talk) 23:54, 16 June 2015 (UTC)

There are still technical inaccuracies here. Please read the body of the acupuncture article regarding causes of disease and the role of tongue and pulse. The way it is presented here places too much emphasis on 2 types of patterns (stagnation of Qi and blood) and is inaccurate regarding the linking of assessment findings to treatment choices (see my post on link from assessment-pattern-tx principle-tx above). Qi and blood stagnation are not "causes" of disease, they are manifestations of disease. Also, I have to insist that "supernatural energy" is not an adequate translation of Qi, nor is "energy". In most published works on Chinese medicine, philosophy, cosmology, or various traditional arts, the term is not translated. Perhaps the lede of this article is not the place to try to describe TCM theory, but just say "acupuncture is most commonly practiced according to TCM theory" and link to the TCM page or lower in the article text? Herbxue (talk) 15:41, 17 June 2015 (UTC)

Here is a modified proposal based on Herbxue's comments. Wikipedia is an English language encyclopedia, and the lead first paragraph should be in plain English that anyone can understand. The lead summarizes what is in the article body. The article body says, "the general theory of acupuncture is based on the premise that bodily functions are regulated by an energy called qi (氣) that flows through the body; disruptions of this flow are believed to be responsible for disease". It is also standard in English language sources (e.g., NCCAM - "Qi, a vital energy that flows through the body") that qi is translated, into English, as "vital energy". Despite the article body saying that the flow causes disease, here is a proposal that uses the word "manifestation" per Herbxue's comment.

Acupuncture is an alternative medicine component of traditional Chinese medicine in which needles are inserted into the body in the belief that this helps treat disease. The traditional belief is that disease manifests itself by altering flows of blood and of a vital energy (called qi), and by changes in pulse rate. Regions of the tongue are believed to be connected to major organ systems of the body. The belief is that examining the pulse and the tongue can help identify specific points in the body where insertion of needles would help rebalance those flows, and thereby help treat the illness. Acupuncture is usually given in conjunction with other modalities of traditional Chinese medicine, such as traditional Chinese herbal medicine. Other pre-scientific Asian traditional medical practices also use insertion of needles in the belief that this influences disease, by altering supernatural energy flow, but with different theories. Still others believe that insertion of needles may produce physiological effects based on processes that are only recently being studied, not because of effects of the flow of any supernatural energies. The traditional Chinese theory of blood flow, that regions of the tongue are connected to major organ systems, that acupuncture points correspond to real anatomical locations, and all theories of supernatural energy flow, are inconsistent with the sciences of physics, anatomy, and physiology, whereby acupuncture has been criticized as being a pseudoscience by members of the scientific and biomedicine communities.

Remember, a casual reader should be able to read just the lead first paragraph and go away with a general understanding of the article subject, without going into esoteric specifics or subtleties. FloraWilde (talk) 16:23, 17 June 2015 (UTC)

I think you're making progress here, but it could be more succinct. Rather than

The treatment is based on the belief that part of the way disease manifests itself is by altering the flow of blood and of a vital energy (qi), and in change in pulse rate and regions of the tongue that are believed to be connected to major organ systems of the body. It is believed that examining the pulse and appearance of regions of the tongue can help determine location of specific points in the body into which insertion of needles will help rebalance the flow of blood and/or the supernatural energy, and thereby help treat the illness.

it might be better as

The traditional belief is that disease manifests itself by altering flows of blood and of a vital energy (called qi), and by changes in pulse rate. Regions of the tongue are believed to be connected to major organ systems of the body. The belief is that examining the pulse and the tongue can help identify specific points in the body where insertion of needles would help rebalance those flows, and thereby help treat the illness.

LeadSongDog come howl! 18:41, 17 June 2015 (UTC)

Succinct is good. Here is the complete revision -

Acupuncture is an alternative medicine component of traditional Chinese medicine in which needles are inserted into the body in the belief that this helps treat disease. The traditional belief is that disease manifests itself by altering flows of blood and of a vital energy (called qi), and by changes in pulse rate. Regions of the tongue are believed to be connected to major organ systems of the body. The belief is that examining the pulse and the tongue can help identify specific points in the body where insertion of needles would help rebalance those flows, and thereby help treat the illness. Acupuncture is usually given in conjunction with other modalities of traditional Chinese medicine, such as traditional Chinese herbal medicine. Other pre-scientific Asian traditional medical practices also use insertion of needles in the belief that this influences disease, by altering supernatural energy flow, but with different theories. Still others believe that insertion of needles may produce physiological effects based on processes that are only recently being studied, not because of effects of the flow of any supernatural energies. The traditional Chinese theory of blood flow, that regions of the tongue are connected to major organ systems, that acupuncture points correspond to real anatomical locations, and all theories of supernatural energy flow, are inconsistent with the sciences of physics, anatomy, and physiology, whereby acupuncture has been criticized as being a pseudoscience by members of the scientific and biomedicine communities.

FloraWilde (talk) 18:52, 17 June 2015 (UTC)

I'd also abbreviate the repeated instances (after the first) to TCM and scrub some other repetition.LeadSongDog come howl! 19:43, 17 June 2015 (UTC)

Proposed revision for lead first par, based on comments above -

Acupuncture is an alternative medicine treatment in which needles are inserted into the body in the belief that this helps treat disease. It is a component of traditional Chinese medicine (TCM) and other pre-scientific Asian belief systems. The TCM belief is that disease manifests itself by altering flows of blood and of a vital energy (called qi), and by changes in pulse rate. Regions of the tongue are believed to be connected to major organ systems of the body. The belief is that examining the pulse and the tongue can help identify specific points in the body where insertion of needles would help rebalance those flows, and thereby help treat the illness. Acupuncture is usually given in conjunction with other modalities of traditional Chinese medicine, such as traditional Chinese herbal medicine. Other traditional Asian practices share the belief that insertion of needles influences supernatural energy flow associated with disease, but with different theories. Some nontraditional practitioners believe that insertion of needles produces physiological effects based on processes that are not yet understood by science. The TCM theory of blood flow, of how regions of the tongue are connected to major organ systems, that acupuncture points correspond to real anatomical locations, and all theories of supernatural energy flow, are inconsistent with physics, anatomy, physiology, and other basic sciences, whereby acupuncture has been criticized as being a pseudoscience by members of the scientific and biomedicine communities.

Please comment. FloraWilde (talk) 17:57, 22 June 2015 (UTC)

"Acupuncture is an alternative medicine treatment in which needles are inserted into the body in the belief that this helps treat disease." According to which source it treats disease? "It is a component of traditional Chinese medicine (TCM) and other pre-scientific Asian belief systems." According to which source it is a component of other pre-scientific Asian belief systems? I'm afraid without sources I can't help. It would be easier if you summarized the acupuncture page using sources from that page. QuackGuru (talk) 22:45, 22 June 2015 (UTC)

Actually, QG, the lead isn't supposed to have citations: acupuncture only has them because of the long conflict there. The article certainly supports that acupuncturists believe they are treating disease, and that it is also a component of Japanese and Korean medical systems. Is there actually a statement here that you don't feel is supported by the body of the article?—Kww(talk) 23:03, 22 June 2015 (UTC)

I can't improve or review the wording without citations. QuackGuru (talk) 17:48, 23 June 2015 (UTC)

Trouble archiving links on the article

Hello. I am finding myself repeatedly archiving links on this page. This usually happens when the archive doesn't recognize the archive to be good.

This could be because the link is either a redirect, or I am unknowingly archiving a dead link. Please check the following links to see if it's redirecting, or in anyway bad, and fix them, if possible.

http://books.google.com/books?id=EnEFAAAAQAAJ&pg=PR3

In any event this will be the only notification in regards to these links, and I will discontinue my attempts to archive these pages.

Cheers.—^{cyberbot II}_{Talk to my owner:Online} 19:31, 13 July 2015 (UTC)

Marketing using "non-scientific explanations": definition and section

The content in Medical Hypotheses mentioned above reminds med of a needed addition to the definition. An older version contained an important fact which is now missing. It concerns how alt med is marketed ("put forward"). This is nearly always done using "non-scientific explanations" of many kinds. Some are clothed in pseudoscientific language, and others are outright deceptive fabrications made from whole cloth:

Older version: Alternative medicine is any practice that is put forward as having the healing effects of medicine,..." (my bolding)

Newer version: Alternative medicine is any practice that is perceived by its users to have the healing effects of medicine,..."

I suggest we add this content so it looks something like this:

Alternative medicine is any practice that is marketed as having, or perceived by its users to have, the healing effects of medicine,..."

I place it first because marketers are the driving impetus which keeps alt med alive at all. Without them, scientific enlightenment would have more success and quackery would die out to a great degree. The average person uses alt med because worthless products and services are being marketed as if they are of equal or "safer" value than mainstream medicine. This is the quackery aspect which accompanies nearly all alt med. We should not ignore this in the definition.

Since content in the lead must be based on existing content in the body, a separate section dealing exclusively with marketing, using typical examples of egregious advertising and claims (usually using "non-scientific explanations"), should be created. We make very small mention of marketing a few places in the article (search the page for "promo" and "market"). Such a section would have great informational value. The articles on quackery and pseudoscience might have some usable content and sources. -- BullRangifer (talk) 17:32, 6 June 2015 (UTC)

I added much re "marketing" from good early sources to the history section.[12]. The 1983 quotes from BJM are particularly on point about marketing - "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen". I did not delete any content, but the previously existing history section was mostly about the histories of biomedicine and "irregular practices", with very little on the history of "alternative medicine" as a collectively marketed group. FloraWilde (talk) 18:51, 28 June 2015 (UTC)

Please be careful. The claim that "marketers are the driving impetus which keeps alt med alive at all" is certainly dubious. While I have no "reliable source" with actual statistics, my personal experience is that I know a great number of people (myself being one) that have ailments that mainstream medicine is unable to correctly diagnose (based on the fact that multiple mutually exclusive diagnoses have occurred and the persistence of the ailments in spite of mainstream medicine's best efforts). Until mainstream medicine explains every chemical and biological process that goes on in the human body, I believe there will always be a market for alternative medicine. I am not saying that marketing isn't an important driver, just that I think it should be pointed out that the market exists for a reason besides just "marketing".192.249.47.204 (talk) 19:17, 18 September 2015 (UTC)

Need help to fix a ref error

This message appears in the refs in big red letters:

Cite error: Invalid <ref> tag; name "FOOTNOTEIOM_Report200519" defined multiple times with different content (see the help page).

It's a ref format I don't understand, so would someone else please take a look and fix it? Thanks. -- BullRangifer (talk) 03:10, 21 December 2015 (UTC)

Too many images?

As one goes down through the article, there is suddenly a clutter of many images. We really need to pare down on them. It makes for a messy article. Some of them are really good, so instead of just deleting them, why don't we create a gallery? While galleries are discouraged, they are not forbidden. We should also make many of them smaller and shorten the text.

Below are the images we are using: -- BullRangifer (talk) 21:40, 20 December 2015 (UTC)

Yes, a gallery would be a good way to avoid the clutter: perhaps some visible, the rest drop down? But some could go, such as Sen. Harkin, Prince Charles and Edzard Ernst. Qexigator (talk) 00:22, 21 December 2015 (UTC), 00:30, 21 December 2015 (UTC)

+ I have gone ahead and removed those three person pics. Qexigator (talk) 09:39, 21 December 2015 (UTC)

+Maybe we could put in the gallery the images for the various AMs, but retain in the text the two FDA cautionary notices. Qexigator (talk) 10:04, 21 December 2015 (UTC)

+Then, maybe the proposed gallery would belong to the main section 'Types of alternative medicine', and could be placed at the end of that section, or at the end of the article, with a jump link at the top of the section. There are eight subsections, but, given that the various types shown in the images may belong to more than one classification, this is another good reason for putting them together in a single gallery. Qexigator (talk) 10:30, 21 December 2015 (UTC)

I am going ahead with adding the proposed gallery of the images, except the three persons and the two FDA cautions mentioned above. If acceptable, the repeat images alongside the text could be removed. Qexigator (talk) 13:54, 21 December 2015 (UTC)

+ In "Types of alternative medicine" we now have four visible images: two products to be taken by mouth, of which one is western (homeopathy) and the other traditional Chinese; and two "energy" therapies, originating in the east and now practised in the west. That is a reasonable sampling of the 16 included in the gallery, while the gallery supports the lead sentence: AM "consists of a wide range of health care practices, products and therapies". Qexigator (talk) 11:15, 23 December 2015 (UTC)

I don't think we'll find a prevalence of MEDRS support sufficient for describing this as "health care" or "therapy". More likely "interventions" or "treatments", which have no implication regarding efficacy. LeadSongDog come howl! 14:57, 23 December 2015 (UTC)

Images

The following discussion has been closed. Please do not modify it.

Acupuncture involves insertion of needles in the body.

Christian laying on of hands, prayer intervention, and faith healing

A Botánica of traditional Hispanic medicines may look like a pharmacy of science based medicines. The difference is not in their appearance, but in the basis for belief that the medicines have a healing effect.

A homeopathic remedy is unlikely to contain one molecule of the original herb or mineral

Traditional N'anga medical doctor in Zimbabwe

Indian Ayurvedic medicine includes a belief that the spiritual balance of mind influences disease.

In Japanese Reiki, some other traditional medical systems, and some New Age practices, it is believed that supernatural energies flow from the palms of the healer into the patient near Chakras, influencing disease.

Images in gallery format

A Chiropractor manipulating the spine.
Acupuncture involves insertion of needles in the body.
Christian laying on of hands, prayer intervention, and faith healing
The science community is critical of alternative medicine for making unproven claims.
A Botánica of traditional Hispanic medicines may look like a pharmacy of science based medicines. The difference is not in their appearance, but in the basis for belief that the medicines have a healing effect.
A homeopathic remedy is unlikely to contain one molecule of the original herb or mineral
Traditional N'anga medical doctor in Zimbabwe
Ready to drink traditional Chinese medicine mixture
Indian Ayurvedic medicine includes a belief that the spiritual balance of mind influences disease.
In Japanese Reiki, some other traditional medical systems, and some New Age practices, it is believed that supernatural energies flow from the palms of the healer into the patient near Chakras, influencing disease.
Tai chi
Yoga class
Qigong practitioners in Manhattan
Medicinal herbs in a traditional Spanish market
Traditional medicines in Madagascar
Assorted dried plant and animal parts used in traditional Chinese medicine
Shaman healer in Sonora, Mexico.
Sen. Tom Harkin at a press conference.
Prince Charles in 2012.
Edzard Ernst in 2012
Health campaign flyers, as in this example from the Food and Drug Administration, warn the public about unsafe products.

I've cleaned up a bit, but want to remind the editors here that while galleries are totally acceptable, hidden galleries are not. Check out WP:MOS & WP:MOSIMAGE. CFCF 💌 📧 12:08, 23 December 2015 (UTC)

Well, BullRangifer, back to clutter, per User:CFCF [13] If the gallery must be made visible, like it or not, perhaps it could be thinned out. Proposed deletes: Botánica, looks like any shop anywhere, A homeopathic remedy, looks like any small container, like a fuse in an electric plug, Tai chi, Yoga class, Qigong look like any sort of physical exercise regime. I am going ahead to remove them, and we can see what it looks like. Qexigator (talk) 14:35, 23 December 2015 (UTC)

I think you've all done a great job and it looks much better. I removed one image from the gallery that seemed out of place for this article. That also makes the gallery only one line (at least on my screen). I notice that further down there are no images, so it needs something so it's not just a wall of text. I'm going to restore the three notable persons who were previously there and we can see how that looks. -- BullRangifer (talk) 06:00, 24 December 2015 (UTC)

BullRangifer: Agreed, may be good to break up walls of text, but pics of persons in "History" (Sen.Haskin) and "Criticism" (Pr. Charles) look to me more like space-filling, in default if something more relevant. But if persons are acceptable, how about Marcia Angell. Another image could be Peking Union Medical College [14]. I have added these, but would propose removing said Senator and Prince. Qexigator (talk) 09:44, 24 December 2015 (UTC)

References

Generally speaking, should not the references follow MEDRS?

Barbara (WVS) (talk) 12:04, 28 December 2015 (UTC)

WP:MEDRS is the requirement for sources that are used to support medical claims. To support non-medical claims, such as discussion about definitions, the standard for sources is WP:RS.2001:56A:75B7:9B00:F5AF:BFB8:4B3C:B02A (talk) 16:24, 28 December 2015 (UTC)

Barbara, why have you removed a reliable source twice from the article when it is relevant to the respective topic of 'definitions of CAM' and also complies with WP:RS?75.152.109.249 (talk) 23:32, 28 December 2015 (UTC)

$$$ Reward levels for editing the science out of alt med articles? Need for sources on alt med marketing schemes.

This edit says, "Classifying Alternative Medicine as pseudoscience... Wikipedia is on a misinformation campaign against alternative health and the healing arts... Natural health deserves fair representation.... We’re going to set the record straight. We need your help and invite you to get involved in the process. Please check the various reward levels to discover how to participate."

An editor on this talk page suggested more is needed on these kind of marketing schemes by alt med promoters, to create the illusion of scientific justification, biological plausibility, or that there may be energies undiscovered by physics that alt med studies can reveal by "systematic reviews" that admit to using imperfect studies, yet get published as showing efficacy anyway. Does anyone have RS sources for these marketing strategies? FloraWilde (talk) 15:27, 26 June 2015 (UTC)

Hi Flora, this looks worrisome. Could you please cross-post this to WT:MED and WP:FT/N? Alexbrn (talk) 15:29, 26 June 2015 (UTC)

When I posted notice of discussions on more than one talk page, User:‎AndyTheGrump asked me to "please stop forum shopping". FloraWilde (talk) 16:31, 26 June 2015 (UTC)

Yes - at Talk:Reason. Acupuncture has nothing whatsoever to do with the topic of that article. AndyTheGrump (talk) 16:34, 26 June 2015 (UTC)

I made an error, and failed to provide links and full explanation of my talk page posts. I am collapsing this as offtopic to this talk page section. FloraWilde (talk) 17:21, 26 June 2015 (UTC)

@ ALexbrn, I posted at the suggested talk pages. FloraWilde (talk) 17:21, 26 June 2015 (UTC)

Uncollapsed for transparency at a glance. 121.211.33.244 (talk) 17:59, 15 February 2016 (UTC)

Split

Comeplementary Medicine and Alternative Medicin are quite different topices. I ask to split the article in two.

Rationale: Complementary is often part of normal healthcare and mainstream practices (compare e.g. doi: 10.1055/s-0033-1364013 Complementary and alternative medicine in the German outpatient setting: extent, structure and reasons for provision), alternative is much less in use. Quote "Es ist davon auszugehen, dass CAM hauptsächlich als Ergänzung (komplementäre Anwendung) und nicht als echte Alternative zur Schulmedizin Verwendung finden und von einem Groß- teil der Bevölkerung in Europa, Nordamerika und anderen industrialisierten Regionen in Anspruch genommen werden", English summary: A large amount of people in Europe, North america and other industrialized countries use CAM, as part of a complementary offer of mainstream medicine, not as an true alternative.

Thats said, the article title currently is an example of Wikipedia:Coatrack - it critisises an nonexisting alternative use and ignores the wolrd wide (compare the WHO and WTO traditional medicine strategy) actually practice, which is about complementary. Polentarion Talk 14:44, 20 December 2015 (UTC)

We have had this discussion many times, with several RfCs, and the decision to merge the articles (Alternative medicine, Complementary medicine, and Integrative medicine) was not made lightly. (Traditional medicine is a separate topic.) A condition for the merge was that each be mentioned and defined here, and they are. The archives contain many discussions about this and how the clear consensus was reached. Some fringe proponents will never be happy with that decision, but so be it.
One of the major reasons is that the techniques and methods are all the same, and they are covered here. It is only the setting that changes, and that is described in this article. The evidence base is also the same, even though proponents of Complementary medicine claim otherwise. Their claims are mere marketing.
For some reason, Integrative medicine was resurrected and further developed, which of course provided a much better venue for the multiple criticisms against it. The same would happen if Complementary medicine was reestablished. Not only would the criticisms of the main uses of Alternative medicine be relevant there, the criticisms directed at the deceptive nature and claims made to justify quackademic medicine (complementary medicine) would get a better venue there than here.
BTW, "alternative" is indeed the dominant way such methods are used in a totally unregulated market controlled by quacks. The fact that a few quacks exist in academia and mainstream hospital centers pushing for acceptance of quackery, and marketing it as "complementary" and "integrative", does not make such non-EBM methods anymore effective or proven. It's just the setting which has changed. After all these years, NCCAM has still failed to find evidence of effectiveness.
This would always be the mother article, with summary style mention of each of those topics. Right now, instead of having separate sections for each one (only justifiable if there are separate sub-articles), we discuss them at Alternative medicine#Definitions and terminology. They should each be bolded there. I'll do that right now.
So, in summary, we have previously had separate articles, and they were merged here. Unless you can provide a new argument for splitting, there is no reason to rehash this again. If you want to go to the bother and push for this, you've got a lot of homework to do in the archives. You'll need to study the previous arguments which have been rejected, and come up with new ones. If you choose to do that, I suspect we won't see you back here for a couple months, some time in the new year. Until then, let's leave off the tag and wait for a new section then. -- BullRangifer (talk) 21:06, 20 December 2015 (UTC)

Point is, I dont need to check WP, I check real life studies. I am not much interested in dealing with WP internal conflicts, I am just aware of quality health studies which make a strong and reasonable difference between complementary and alternative. Complementary medicine works, alternative medicine works not. As said, what you seem to call "quackademic medicine" is currently in world wide use, based e.g. on the WHO and WTO Traditional medicine strategy and quite reasonable (evidence based) practices. The tendency to repeat "sceptical" polemics against a lot of quite different established medical and healthcare practices is a) not very in line with actual sourcing and b) tries to ignore the well established reasons and practical explanation for the world wide success of complementary medicine. As said, complementary works, alternative does not. WP should allow to show the difference. I would write a draft if needed. Polentarion Talk 02:19, 21 December 2015 (UTC)

Wikipedia is based on RS from the real world. Anything else is original research. Go ahead and provide some properly sourced content to show us here. Then maybe we will be able to understand your point. If you succeed, you'll have success and we'll help you. -- BullRangifer (talk) 03:14, 21 December 2015 (UTC)

Polentarion, I agree with BullRangifer's comments above, but you may like to have a look at the articles listed at Book:Alternative medicine. Qexigator (talk) 16:56, 21 December 2015 (UTC)

Sigh. I started with a RS, but I was told a lot about WP internals, and sceptical ideology. As said, doi: 10.1055/s-0033-1364013 clearly shows that complementary offers are part of mainstream medicine and why. The Bejing declaration, the WHO, WIPO, WTO Trilateral Cooperation on Public Health and the WHO traditional medicine strategy, which involves, among other complementary health practices are similar "complementary" approaches. They are not using "alternative medicin". That said, I asked to split the article here since this article covers two different topics. WP:I-don't like it doesnt help. Polentarion Talk 17:06, 21 December 2015 (UTC)

Polentarion, in my point 2 above, I stated: "the techniques and methods are all the same,... It is only the setting that changes,... The evidence base is also the same, even though proponents of Complementary medicine claim otherwise. Their claims are mere marketing."

So you are right that they "are not using "alternative medicin" (in the sense that they are not using it "instead" of real medicine), but they are still using the same methods, techniques, products, etc., and the (lack of) evidence base is the same. There is no evidence that use of AM in conjunction with mainstream medicine improves prognoses. For cancer it worsens the prognosis.

For better or worse, the methods are termed "alternative medicine", so they are discussed here. This is the mother/main article for all other articles which describe use of these methods. For "complementary" and "integrative", the main difference is the setting in which "alternative medicine"/quackery methods are combined with real medicine, and that can be done in a few sentences. Integrative medicine has an article where the comments in RS about the unique settings are made, but since this involves deceptive marketing attempts to blend ineffective quackery with evidence based medicine, the criticisms are also part of the article. Keep in mind that this is not about traditional medicine. -- BullRangifer (talk) 07:51, 23 December 2015 (UTC)

The artcile should treat "alternative" in a short section and focus on "complementary". The real world does as well. I am sorry that I started to use a foreign language source here, but its about the worldwide situation and b) confirmed by the WHO. Its an established fact that a wide range of health practioners do not have any problem with the combination, and according the WHO, they should not have a problem. Reasons being described in the study. E.g. if a mainstream medic uses Acupuncture or homeopathy now and then, it improves the interaction between doctor and patient, enhances Compliance (medicine) and of cause it increases the range of possible treatments. Its obvious that a multitude of physical therapy, exercice, dieting, massage and relaxation techniques can be derived from CAM likewise, same as Jane Fonda (and her looks) was much more important for exercice than "science" or any study. Polentarion Talk 13:11, 23 December 2015 (UTC)

Polentarion: If you can compose a paragraph about that, with sources, let us look at it here to see where it could go in the article. Qexigator (talk) 14:10, 23 December 2015 (UTC)

That's a good suggestion, because these vague claims need to be backed up by sources. -- BullRangifer (talk) 06:10, 24 December 2015 (UTC)

I know this has died and I hate to rekindle it, but I just have to point out - Polentarion - a lot of people thought witches stole penises in Africa. That doesn't make it work. A lot of people do and believe and practice a lot of stupid things thinking that it works. That doesn't make it work. So a lot of people humoring and tolerating quackery purely because the fact of the matter is that the average believer in such nonsense finds the (rightful) academic shunning of said quackery as 'proof' of some grandiose conspiracy to keep the quacks suppressed and silenced so bigpharma(tm) can make lots of money so the fastest way to dispel these claims and the absolute deluge of abuse and psychotic nonsense it attracts is to just humor the quackery and let the imbeciles 'try both at the same time' - that does ... can you guess what I'm about to say? Not. Make. It. Work. If you don't have evidence of efficacy of these methods working on their own, or efficacy that these methods combined with other treatments surpass the treatment on it's own then you are arguing from popularity and not from facts. Science doesn't care if you believe in it or not, it doesn't care if you know why it works or not, science works. 121.211.33.244 (talk) 18:07, 15 February 2016 (UTC)

Drive-by tagging

This diff added a tag today which is frankly not needed. I will remove it within 24 hours, unless a policy based reason for adding the tag is given. -Roxy the dog™ woof 15:03, 31 May 2016 (UTC)

Per Template:Too_few_opinions/doc#Purpose, the tagger should have promptly provided a reason. Being bold.LeadSongDog come howl! 15:16, 31 May 2016 (UTC)

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Sourcechecked —jmcgnh^{(talk) (contribs)} 18:38, 26 July 2016 (UTC)

Hatnote referring to CAM

I deleted this hatnote, since it does not match the page title and the only current redirect to this page is the full name "Complementary and Alternative Medicine" – that redirect is listed on Cam (disambiguation) but I don't think it merits a hatnote here. User:CFCF [reverted] this, along with a another edit that we may need to discuss separately.

I believe the hatnote should go, but I seek consensus here before removing it again. —jmcgnh^{(talk) (contribs)} 18:21, 26 July 2016 (UTC)

Complementary medicine redirects here as well, but I don't think that affects the argument. —jmcgnh^{(talk) (contribs)} 18:30, 26 July 2016 (UTC)

I agree with no hatnote. I don't see how there's a risk of people ending up at this article that were looking for a different use of CAM. —PermStrump(talk) 20:43, 26 July 2016 (UTC)

Ethics and controversial sentence about marketing being taught in schools of chiropractic

The following sentence was has been in the article since at least 2014, but was put into the Ethics section of the article in a reorg in June 2015:

According to two writers, Wallace Sampson and K. Butler, marketing is part of the medical training required in chiropractic education, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels in their promotion of pseudoscience in medicine.^Refs

User:Roxy the dog removed it for being Godwinesque, while I removed it for being misplaced. User:CFCF reverted [15] both removals.

Now Carl Fredrik has been around a lot longer than I have, but I don't quite understand his edit summaries. I'm bringing this matter here for further discussion.

If you look at the statement, it has two parts. The first

marketing is part of the medical training required in chiropractic education

describes a situation I believe is true and not blameworthy. Many doctors have lamented how unprepared they were, when they got out of medical school, for the business aspects of starting and running a medical practice. That chiropractic education includes instruction in this area is not an ethical issue.
The second part is a non sequitur

propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels

alleging a similarity between propaganda methods in alternative medicine and propaganda methods used by Nazis. I can believe this is true, since advertising and propaganda use rhetoric and methods of persuasion that have been practiced for thousands of years. I've not mentioned the

their promotion of pseudoscience in medicine

part, since the antecedent of their could be considered ambiguous and part of the artful construction of a polemical argument.

So what is the overall meaning of this sentence in this Wikipedia article? One reading might be

alt med practitioners learn marketing

→ marketing is like propaganda

→ Nazis used propaganda

→ therefore: bad ethics

That's not worthy of being in Wikipedia. —jmcgnh^{(talk) (contribs)} 20:44, 26 July 2016 (UTC)

@Jmcgnh: It does seem a bit screwball to compare chiropractic practice to Nazism. @CFCF:, thoughts? Blue Rasberry (talk) 20:52, 26 July 2016 (UTC)

The direct quote from this source is:

It may seem forced to identify propaganda, developed to its highest form by Hitler and Goebbels, with cultural relativism, which eliminates prejudice from the study of foreign cultures. But they are both responsible for much current medical mischief, from quackery and Laetrile to the creation of an Office of Alternative Medicine in the National Institutes of Health. Postmodernism, a more abstract and esoteric phenomenon, takes cultural relativism one step further into a disorienting world with no standards of accuracy or ethics...

It goes on about it as that is the topic of the entire essay. I don't have access to the full text of the other sources, but it has a reputable publisher and authors who are an experts on the topic. I think the material belongs on WP as it is covered in multiple reliable sources and I see how it fits in the ethics section, though I'm open to other locations. —PermStrump(talk) 21:06, 26 July 2016 (UTC)

@Permstrump: That article looks like a culture-war screed/editorial more than an objective source. The entire issue of the journal is devoted to the "The Flight from Science and Reason". It's clearly a controversial issue and our job on WP is to avoid polemics from either extreme.

[Should the system message be trimmed from that URL?] —jmcgnh^{(talk) (contribs)} 21:35, 26 July 2016 (UTC)

our job on WP is to avoid polemics from either extreme. Is it? This material obviously shouldn't be in WP's voice, but it was appropriately attributed. —PermStrump(talk) 21:52, 26 July 2016 (UTC)

Note that I said "extreme", not just "side". In the sense that a polemic is a one-sided argument, I think we ought to avoid that. In the sense that it's a bad argument, we definitely ought to avoid it. Even if this sentence appeared in an otherwise reliable source, it's not a good argument or even a sensible statement. —jmcgnh^{(talk) (contribs)} 23:15, 26 July 2016 (UTC)

As I see it — applying Godwin's law is not an argument. If a legitimate comparison has been made — that it compares to Hitler or Goebles does not disqualify it. There is no "reverse Godwin" on Wikipedia — requiring us to omit all comparisons to a certain cult — that is not neurtal. If the criticism is notable it doesn't matter what it compares it to.
What I object to is that this article covers marketing of alternative medicine far too lightly, and that attempts to remove this piece of information were made without discussion.
If we're going to remove it we're going to need to make sure:

We have something to replace it with — so that the article retains balance.
It really isn't notable enough on its own to be WP:DUE.

Carl Fredrik 💌 📧 13:58, 27 July 2016 (UTC)

I think that over-the top rhetorics is not needed. If person A says person B "has an ugly moustache, like Hitler", the last two words are unnecessary steamroller tactics that add nothing to the substance of the statement. There are so many propagandists in the world one could compare one specific propagandist to, that picking Hitler and Goebbels for that purpose is arbitrarily malicious. If Sampson and Butler want to do that, that is their decision. But it is our decision to include the comparison or not in the article. Several people said above it is bad writing style, and I agree. --Hob Gadling (talk) 15:16, 27 July 2016 (UTC)

So far I haven't commented on whether I actually think it belongs or not, just that it can't be removed without properly replacing it with better information about marketing in altmed/chiropractic. And this comparison was directed at the psuedoscientific underpinnings of the propaganda, and that we chose to infer that anything related to Hitler/Goebles must be pure evil or "over the top rhetoric" is not related. The fact is that they supported psuedoscience, and that isn't something we can back away from, however much we invoke Godwin's law. Carl Fredrik 💌 📧 15:43, 27 July 2016 (UTC)

For me this isn't about whether it belongs or not, but whether saying that it is "Godwinesque" is an argument at all — and that we need to have something on marketing as an important tenet of alternative medicine. I defer judgement to other editors whether you chose to keep it or not, just base the removal on real arguments. Carl Fredrik 💌 📧 15:45, 27 July 2016 (UTC)

Discuss : "... propaganda methods in the Brexit campaign have been traced back to those used by Hitler and Goebels." or "Marketing methods in Donald Trump's campaign have been traced back to those used by Hitler and Goebels." -Roxy the dog™ woof 16:07, 27 July 2016 (UTC)

Unrelated, those statements have no sources, and if they did they wouldn't be considered reliable. That is a strawman argument. Carl Fredrik 💌 📧 16:15, 27 July 2016 (UTC)

I was just wondering what people might think if those sentences appeared in the related articles. Would NPOV editors object? Those of us who inhabit the dark corners of the internet, where the quacks and lunatic charlatans roam almost unrestricted, deride the use of the Godwin; "You scientists are just like Hitler." I find it just as unpleasant used in the other direction, and still support its removal. I also see no need to replace it with anything. -Roxy the dog™ woof 16:31, 27 July 2016 (UTC)

It doesn't matter — the question is if including it is is due. If Obama or Corbyn goes out and says these things — of course they are notable and should belong in those articles — with attribution. So asking whether NPOV editors (whatever that is) would object is still a strawman argument!
The question here is whether this statement is WP:DUE, and whether we aren't missing a big part of what is important on this article by not covering marketing.
Do not conflate WP:NPOV with the idea that we can't include non-neutral statements. In this case I frankly do not care whether this statement stays or goes — but it shouldn't go just because it invokes Godwin's law and that people don't like it! Carl Fredrik 💌 📧 16:50, 27 July 2016 (UTC)

I think CFCF has made a sound assessment of my position. Note that I didn't comment at all when my initial bold edit was reversed. -Roxy the dog™ woof 17:04, 27 July 2016 (UTC)

"Marketing" is mentioned in 6 other places, appropriately as I see it, in the article. In the U.S., the FTC has sporadically taken action against individual alt med or fringe providers, but supplements, chiropractic, and prayer have all received safe-harbor legal protections in some jurisdictions. Allegations of fraud, rather than just "aggressive" marketing would need careful treatment here in the absence of regulatory sanctions or legal verdicts.

The sentence under discussion does not add to the article and I would not hesitate to remove it if it were inserted at this location today (in fact, I misunderstood it to be a recent addition when I reverted CFCF's reversion of Roxy the dog's removal.

It seems it is just the sentence's tenure that means we are doubting whether to remove it. If it were being proposed as an addition, would we look at it differently? The sloppy attempt at guilt by association without actually saying anything concrete is just incoherent if you examine it. —jmcgnh^{(talk) (contribs)} 20:23, 27 July 2016 (UTC)

Convenience break

I think paraphrasing these guys is definitely DUE. They're all experts in their field (two physicians and a nutritionist) and some of the best known consumer advocates in health and medicine. What about this compromise:

Current: According to two writers, Wallace Sampson and K. Butler, marketing is part of the medical training required in chiropractic education, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels in their promotion of pseudoscience in medicine.^Refs
Compromise: According to consumer advocates Wallace Sampson, Kurt Butler, and Stephen Barrett, marketing is part of the training required in chiropractic education, and the methods used by the alternative medicine industry to promote pseudoscience are dangerous, unethical and fraudulent propaganda.^Refs

There's a decent sized preview of Butler and Barrett source on Amazon FYI. Thoughts? —PermStrump(talk) 10:02, 28 July 2016 (UTC)

Your text is an improvement, but still too sweeping of a generalization. It presumes that there is such thing as a homogenous alternative medicine industry. You could perhaps say "dietary supplement industry" and actually describe a group that operates with similar intentions and under similar rules, but alt med is a blanket term for very different practices and products. Many licensed alt healthcare providers and dietary supplement companies do not engage in dangerous, unethical and fraudulent propaganda.Herbxue (talk) 19:09, 28 July 2016 (UTC)

Your proposed text is an improvement, since it removes the sloppy guilt-by-association component. I still don't find it acceptable, since it continues to imply that marketing classes in chiropractic education are somehow nefarious without evidence. The transition to the second part remains a non sequitur.

Given that this section is titled Ethics, there should be a more specific allegation that applies to the general category of practitioners - in general - and not just to some subset of bad actors.

Please don't misunderstand me; I'm not an advocate for alt med. But the arguments against it need to be properly based and not engage in exaggerated rhetoric that, in the end, fail to accurately reflect the facts or be persuasive. —jmcgnh^{(talk) (contribs)} 03:47, 29 July 2016 (UTC)

I had thought of some other wordings first that ended up having little to do with the thing I was attempting to improve, so I kind of scaled back to keep it close to the original, so I will try again. :) If I were writing it from scratch, I wouldn't have combined the two sources like that anyway, because it's really limiting what I can say without synthesis, so I'll probably break them apart. —PermStrump(talk) 04:08, 29 July 2016 (UTC)

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Mistaken vandalism on page

Hi,

The recent edits I have made in good-faith to the definition of alternative medicine have been repeatedly rejected by editors on the grounds of vandalism. I kindly request that these editors review their decisions to revert these changes. Please contact me with questions regarding my edits. I would like to resolve this issue peacefully and in a timely manner. Thank you.

P.S. As I have not yet created an account, I do not have a user name. Please just refer to me as Josh for the time being. 98.115.14.11 (talk) 17:31, 24 September 2016 (UTC) (Josh)

Josh, you are choosing to edit in a minefield which is not a good place for a new editor to start. If you look at the top of the talk page you will see a list of many archives of this talk page. In those archives are many, often bitter, disputes about what should and what should not be in this article. Wikipedia relies on quality references for all contentious issues in articles, and in this article that is particularly rigorously enforced. I would suggest staying well away from this article until you have a great deal of experience on Wikipedia; reading as many of the talk page archives as you can bear and practising providing good quality referenced text on other, less contentious articles. I have been around here for 11 years yet I only dare put a toe to add new content on very rare occasions! Velella ^{Velella Talk} 17:59, 24 September 2016 (UTC)

To expand a bit on Velella's comments above: The Wikipedia has a number of policies relevant to this article and others like it that you may want to read. The first one I would recommend is Scientific Consensus, which states that where scientific consensus has coalesced around a particular set of views, those views should be the ones presented, and that if minority views are included, the article must make clear that they ARE minority views and explain clearly why they are minority views. This is looked at from a different perspective in the policy regarding Fringe Theories, which states that minority positions should not be made to appear more notable or more widely accepted than they really are. More generally, I encourage new editors to review the policy about Reliable Sources. Because otherwise reliable sources cannot be considered reliable with regards to science, I would also recommend the specific Reliable Sources (Medicine) policy. TechBear | Talk | Contributions 18:49, 24 September 2016 (UTC)

And, "Josh", if you are not aware of it, let me add to the sagacious advice above, that a reader may infer that the history and present content of the article, and its sources, suggest that on the whole it has been constructed to address a readership concerned with the situation, arising in and after the 1970s, in the USA, for reasons that may be apparent from certain portions in the current version, such as "Irregular practitioners". Given that Wikipedia is hosted in USA, and articles such as this are likely to have a more numerous readership there than elsewhere, it seems reasonably acceptable that it be so. In the past, anonymous IPs (who could be skirting a sockpuppet ban) have caused a certain amount of difficulty in respect of contentious issues. Qexigator (talk) 22:36, 24 September 2016 (UTC)

New review

^[1]

^ Wardle, Jon; Frawley, Jane; Steel, Amie; Sullivan, Elizabeth (2016). "Complementary medicine and childhood immunisation: A critical review". Vaccine. 34 (38): 4484–4500. doi:10.1016/j.vaccine.2016.07.026. ISSN 0264-410X. PMID 27475472.

Might be useful. QuackGuru (talk) 19:47, 25 September 2016 (UTC)

Written almost entirely by SCAM proponents, who have a vested interest in downplaying the torrent of criticism of anti-vax activism among SCAM practitioners. Nasty. Guy (Help!) 22:42, 14 October 2016 (UTC)

I know I said...

Hey, I really don't want to dive too deeply into contention, but refs 10 and 11 do not contain the words: "quackery", "fraudulent", or "unethical". I did find the word "nonsense" used in the 2009 NBC article. Best Regards,

Barbara (WVS) (talk) 21:56, 11 October 2016 (UTC)

Hmmm, it seems that those refs went astray during revisions somewhere back in 2013-2015. Dawkins2003a seems to have covered it.LeadSongDog come howl! 18:39, 12 October 2016 (UTC)

Proof

The article clearly says that alternative medicine has been proven not to work.. This is a very blanket statement as there are so many different types .. Most of the very few tests that have been done have been done very badly without actually following the systems practiced.. It could be said that some alternative medicines have not been proven to work but this is not the same as saying they have been proven not to work.. The tests used in the drug industry are hugely expensive and used to indicate drug effectiveness.. They do not spend the money on the alternative medicines.. — Preceding unsigned comment added by Yousofa (talk • contribs) 11:37, 15 October 2016 (UTC)

Read the rest of the sentence, the part after the comma. Carl Fredrik 💌 📧 12:48, 15 October 2016 (UTC)

You mean semicolon? 212.200.65.123 (talk) 22:23, 22 October 2016 (UTC)

It was a comma when I wrote that, but yes, the semicolon. Carl Fredrik 💌 📧 22:47, 22 October 2016 (UTC)

I think another lawsuit is coming up soon because of all this aggressive attack on alternative medicine. 212.200.65.123 (talk) 22:26, 22 October 2016 (UTC)

More and more Wikipedia looks like CNN outlet than encyclopedia. Bias, selective information, disinformation. This article reeks from it. I used to fight for balance for a long time, but this project just strayed away so much from its initial vision. :( 212.200.65.123 (talk) 22:29, 22 October 2016 (UTC)

I find it very damaging, and personally offensive and aggressive that editors here claim alternative medicine does not work, including chiropractics, when I personally had chronic back pain for a decade and classic medical doctors couldn't find the cause of it, and one chiropractor helped me out. I would personally punch anyone advising me against chiropractors and telling me I should only go 'mainstream' route. This whole article is a piece of crap. 212.200.65.123 (talk) 22:34, 22 October 2016 (UTC)

You are free to do whatever you want, that doesn't mean it's scientific. That you take offence is frankly irrelevant. May we never meet, I don't think I've ever been punched before and I'd rather avoid it... Carl Fredrik 💌 📧 22:45, 22 October 2016 (UTC)

It is not scientific if I get better after chiro treatment, but it is scientific when you tell me it doesn't work. One evidence is enough to disprove scientific theory. So if your theory tells me chiro does not work, and I have one evidence it does, your theory is wrong! There are doctors who are bad, there are chiropractors who are bad. but in every profession there are also those that know what they are doing. Your method to disaprove alternative medicine is to find cases where it didn't work. My method is to find cases where it did work. Your arrogant attitude that only acceptable knowledge is what YOUR method validates, and all other human knowledge is 'anecdote' is frankly irrelevant for the pain in my back. Unfortunately, your kind is pushing such myopic view onto others. You are inept to help people in many cases, and are feeling threatened that people go for alternative treatments and finding people who know how to help. You should be ashamed. May we never meet indeed. 212.200.65.123 (talk) 22:58, 22 October 2016 (UTC)

Correct. See post hoc fallacy, placebo effect, and numerous other relevant articles. Glad we've cleared that up for you. Guy (Help!) 23:05, 22 October 2016 (UTC)

I thought medical science was full of statistics, meta-studies, and correlations! 212.200.65.123 (talk) 23:26, 22 October 2016 (UTC)

It's also based on physics, chemistry, biology and causality. Carl Fredrik 💌 📧 23:39, 22 October 2016 (UTC)

And evidence and observation. 212.200.65.123 (talk) 23:44, 22 October 2016 (UTC)

Yupp, of which anecdotal evidence is the weakest. Carl Fredrik 💌 📧 23:47, 22 October 2016 (UTC)

some physicians believed chiropractic to be effective and that chiropractors were better trained to deal with muscular-skeletal problems than medical physicians, {http://www.nytimes.com/1987/08/29/us/us-judge-finds-medical-group-conspired-against-chiropractors.html so try to hide the evidence when there is some]. 212.200.65.123 (talk) 23:50, 22 October 2016 (UTC)

Beliefs ≠ evidence. Carl Fredrik 💌 📧 23:52, 22 October 2016 (UTC)

And you think those physicians who were students of science based their beliefs not on evidence? 212.200.65.123 (talk) 23:54, 22 October 2016 (UTC)

Yupp, which is the reason why we need evidence based medicine. Carl Fredrik 💌 📧 23:55, 22 October 2016 (UTC)

So tell me, how did 'ancient' people, before 'scientific method' was defined and formalized, chose which herbs will be used for different medical issues? Did they not observe? Did they not use some logic, cause-effect evidence? What did they do before 19th century? Were they all so irrational? Were not principles of logic invented more than 2,000 years ago? Please enlighten me about this. 212.200.65.123 (talk) 00:10, 23 October 2016 (UTC)

Now we're back to heuristics. That something is unscientific doesn't necessarily mean it is wrong, however ancient people were also wrong about a hell of a lot of things. Carl Fredrik 💌 📧 00:26, 23 October 2016 (UTC)

Unlike modern. My heuristics tells me to avoid doctors like yourself! 212.200.65.123 (talk) 00:36, 23 October 2016 (UTC)

To make the problem easier to understand, think of them instead as "former medical students". Some former medical students believed chiropractic to be effective and that chiropractors were better trained to deal with muscular-skeletal problems than medical physicians,but we now have a solid body o evidence showing it to be no more effective than reality-based manual therapy for low back pain, and of no value at all for any other condition. Oh, and chiros kill people every now and then, but are in total denial about it. Plus some of them treat babies, which is utterly immoral. Guy (Help!) 10:18, 23 October 2016 (UTC)

Finding cases where it does work is not scientific, for it to be scientific it has to withstand efforts to disprove it. See scientific method and the criticism directed towards Tom Harkin. I can also add that I've done no personal research into alt-med, but I adhere to science and evidence when I write on Wikipedia. We're also pretty clear that alt-med can be summed up to be a belief in magic and supernatural forces. You're free to believe in such things, that you are offended when that is pointed out is your problem. Also by your logic medical practitioners should love smoking, (hint, we don't). Carl Fredrik 💌 📧 23:07, 22 October 2016 (UTC)

You claim I believe in magic and supernatural forces, and that I should perceive disappearance of long lasted back pain as placebo! I would be crazy to believe in your 'theory' and not in my personal experience. A real scientist would ask me 'who was your chiropractor that helped you?' but you being pseudo-scientist assume that evidence contrary to your 'scientific' theory is magical and supernatural. That speaks of your own beliefs and problems.

Also, your comment about "we don't" tells me you are psychic when you know what other people love. Unlike you I cannot read other people's minds and am not yet psychic, and can only speak for myself. I do know medical practitioners who do smoke. In fact, many of them. Maybe they don't love it though. 212.200.65.123 (talk) 23:24, 22 October 2016 (UTC)

Good thing it worked for you, but it doesn't matter one iota to science or evidence to hear you say that on a discussion page on the internet (for a brief and simplified overview see Levels of evidence). Concerning my interpretation of what other medical practitioners think about smoking, its documented fact that they in general dislike it because it causes death and suffering. For what you claim is mind-reading see theory of mind, it works and is generally found in children above the age of 3 (see Sally-Ann test). The same applies to placebo, it really does work, that doesn't mean the sugar pills actually do anything to your body even if your belief that they do does (kinda awkward phrasing, sorry). Carl Fredrik 💌 📧 23:32, 22 October 2016 (UTC)

Depends on the country, so I guess you failed to recognize that others can have beliefs about the world that are diverging. 212.200.65.123 (talk) 23:41, 22 October 2016 (UTC)

See generalization. Carl Fredrik 💌 📧 23:43, 22 October 2016 (UTC)

Exactly my point. Your generalizations lead to errors in judgment. 212.200.65.123 (talk) 23:46, 22 October 2016 (UTC)

Without generalizations we fail to function as human beings, see heuristics. Carl Fredrik 💌 📧 23:48, 22 October 2016 (UTC)

I know you are just human. See Rationalization_(psychology). 212.200.65.123 (talk) 23:52, 22 October 2016 (UTC)

I've never claimed to be anything else... Carl Fredrik 💌 📧 23:56, 22 October 2016 (UTC)

Sir,you seem to be increasingly getting stuck in a heated exchange with other editors!I would like to advice that-you are perfectly authorized to embrace chiropractics as a popular mainstream scientific cure, supported by the many scientific jargons and incidents you have used previously to your cause. But a WIKIPEDIA article do not reflect one's POV irrespective of their locus standi on any issue as is evidenced by WP:POV and WP:NOR. You have fought hard for the supposed changing/deletion of a/a set of particular line(s) on the basis of a single scientifically-controversial report and your own experience in the regard.It may be helpful if you could add some striking notable evidence(rigorous scientific journals, Cochrane reviews etc.) to back up your claims since they seem to oppose the scientific consensus in general and as you may know-"Extraordinary claim requires extraordinary proof!" rather than continuing this tirade.And we will be more than happy enough to add the info the article. Hope this finds you in good spirits. Cheers! Aru@baska^{❯❯❯ Vanguard} 12:21, 23 October 2016 (UTC)

But this wikipedia article does reflect point of view of one profession against another profession, as is illustrated by lawsuit link provided above. There is a conflict of interest involved in this article being edited mainly by medical practitioners. Shouldn't you guys stick stick to "medical" articles and leave this "pseudo" stuff to pseudo guys? What is your interest in shaping this article according to your views? If alternative medicine is not real medicine, it does not fall under WP:MEDRS sourcing. Although I see altmed phrase pushed in the guideline lead, I guess to expand 'authority' of biased medical editors into non-medical fields. Get my sarcasm? 89.216.16.52 (talk) 13:56, 23 October 2016 (UTC)

You seem hell-bent on the idea that the entire aim of the bio-medical community is to go after the practitioners of alternative medicine.I believe I am damn no body to withstand your thought-process and beliefs, but that your bringing a lawsuit to your support paints a humorous picture of a conspiracy!(Am I in it??).Aru@baska^{❯❯❯ Vanguard} 15:43, 23 October 2016 (UTC)

For your kind information,your claim- this article being edited mainly by medical practitioners is wholly unfounded and features a selective bias towards a community of editors and your statement--"Shouldn't you guys stick stick to "medical" articles and leave this "pseudo" stuff to pseudo guys?" seems to be a strict violation of the WP:OWNERSHIP policy! Aru@baska^{❯❯❯ Vanguard} 15:43, 23 October 2016 (UTC)

Further, (to quote you), you replied-"What is your interest in shaping this article according to your views?" I have a simple answer.I have no motive other than contributing to this sea of knowledge from the drop of mine.Also it is not my view but the view which is prevalent as broader consensus in the community. Aru@baska^{❯❯❯ Vanguard} 15:43, 23 October 2016 (UTC)

As a side-note,I may commit mistakes and get rebuked but at least always respect the WP:PERSONAL policy.(Hope you get the sarcasm!).And no body is authoritative over anyone except where need may mask our willpower!Aru@baska^{❯❯❯ Vanguard} 15:43, 23 October 2016 (UTC)

You are choosing to edit in a minefield which is not a good/wholesome place for a new editor to start. If you look at the top of the talk page you will see a list of many archives of this talk page. In those archives are many, often bitter, disputes about what should and what should not be in this article. Wikipedia relies on quality references for all contentious issues in articles, and in this article there is aneccesity that the guideline is particularly rigorously enforced. I would suggest staying well away from this article until you have a great deal of experience on Wikipedia; of providing good quality referenced text on other, less contentious articles.(Close paraphrasing of an earlier comment in the talk page by Velella issued to an IP address on 24 September 2016 (UTC).)Aru@baska^{❯❯❯ Vanguard} 16:22, 23 October 2016 (UTC)

You are just proving my point. See past disputes (a.k.a. no consensus) ... stay stay away from this article (a.k.a. leave it for us to edit and form our own consensus). btw, your first edit is from 2013.. i've been around for more than a decade.. sarcasm is not WP:PERSONAL, it was used by other editors here, so just returning favor. 89.216.16.52 (talk) 16:33, 23 October 2016 (UTC)

This article reflects the view of the published science. If the opinion of the medical profession aligns with this, and against unscientific claims, that is incidental - albeit not especially surprising given that medicine at least tries to be evidence based. Guy (Help!) 23:31, 23 October 2016 (UTC)

Really? How about this evidence? Will you put that into the article? 79.101.133.211 (talk) 08:57, 24 October 2016 (UTC)

First of all , absolute support to the last comment by Guy!But this is getting ridiculous.Despite of you being here for 10 years or so(your contribution list proves otherwise but you may have some other registered account/IP address/a clean start etc.), you seem blissfully ignorant about the WP:OWNERSHIP policy! as evidenced by-(to quote you)-(a.k.a. leave it for us to edit and form our own consensus).Finally,I did not take your sarcasm to be a personal attack but yours asking me about my intentions of editing is not good either!Cheers!Aru@baska^{❯❯❯ Vanguard} 09:12, 24 October 2016 (UTC)

please read the guideline you cite before you cite it.. 79.101.133.211 (talk) 09:20, 24 October 2016 (UTC)

I am perfectly aware of the policy.It states--"All Wikipedia content − articles, categories, templates, and other types of pages − is edited collaboratively. No one, no matter how skilled, or how high standing in the community, has the right to act as though they are the owner of a particular page. Also, a person or an organization that is the subject of an article does not own the article, and has no right to dictate what the article may say.Some contributors feel possessive about material they have contributed to Wikipedia. A few editors will even defend such material against others. It is quite reasonable to take an interest in an article on a topic you care about − perhaps you are an expert, or perhaps it is just your hobby; however, if this watchfulness starts to become possessiveness, then you are overdoing it. Believing that an article has an owner of this sort is a common mistake people make on Wikipedia."Aru@baska^{❯❯❯ Vanguard} 09:41, 24 October 2016 (UTC)

And I strongly believe this serves as an appropriate reminder to your possesive behaviour!Aru@baska^{❯❯❯ Vanguard} 09:41, 24 October 2016 (UTC)

Regarding your source you are ~~all right.It is good and notable.~~But the ~~lone~~ blemish is that the acknowledgement section states-"This study was partially funded by The European Chiropractors' Union (grant number A.03-1) and by the Foundation for Chiropractic Education and Research (Fellowship number 06-03-04).This may point to an inherent bias in the study!But I don't think that weak argument excludes it from not being used and you are free to edit the article and incorporate the info in a few words in the proper section, giving due consideration to the WP:WEIGHT policy.(It's a single report against a thousand others that proves otherwise!)It prob. violates WP:MEDBIAS.It's category according to WP:MEDASSESS is Cohort study which fails in comparison with the several prominent sources mentioned in the article.Further please take a look at WP:MEDPRI which clearly states-"Primary sources should not be cited with intent of "debunking", contradicting, or countering any conclusions made by secondary sources. ". Cheers! And a big thanks to CFCF (talk · contribs)!Aru@baska^{❯❯❯ Vanguard} 09:41, 24 October 2016 (UTC)

Wonder who is funding most of medical research? Drug research? Who is paying their salaries. No more comment. 178.223.26.53 (talk) 09:10, 25 October 2016 (UTC)

Actually, no — that is a cohort study and is not accepted per WP:MEDRS. Cohort studies are quite low quality when assessing treatment efficacy. Carl Fredrik 💌 📧 13:28, 24 October 2016 (UTC)

Our anonymous friend cites a paper in the Journal of Manipulative and Physiological Therapeutics as if it somehow balances out the robust science in the article. Guess what? This low impact (1.67) publication is a house journal for chiropractors. So no we will not be putting it into the article, but thank yo for an excellent example of the reasons WP:MEDRS is written as it is. Guy (Help!) 22:45, 24 October 2016 (UTC)

Precisely on spot. Medical profession being in war against chiropractic profession. In chiropractic journals you can find evidence, in medical journals this seems to be way harder.. Chiropractors taking away patients and money from physicians, no wonder doctors are mad and biased. Another meta analysis. WP:MEDRS was written to push bias of mainstream western medicine onto every article in Wikipedia having anything to do with medicine, western or not. It has condescending attitude towards anything non-western as inferior. Some western source are much more balanced and objective: Alternative health approaches are a set of practices based on a philosophy different from Western biomedicine. Most of these systems have evolved apart from and earlier than the conventional medical system used in the United States.. or further: There is research to show that some CAM techniques can help with problems like pain and nausea. But other alternative therapies don't have enough medical evidence to determine if they are effective. IT is further symptomatic that WebMD is accepted in general by WP:MEDRS, yet not when it comes to 'controversial'.. a.k.a. mainstream medical against other opinion. So it is good, peer-revied, reputable resource, yet not when it comes to alt med. So much about your objectivity, and the agenda behind MEDRS. 178.223.26.53 (talk) 08:42, 25 October 2016 (UTC)

Thank you, that you finally understood our agenda, our objectivity, our mainstream bias, the condescending attitude of our policies and what not!Cheers!Aru@baska^{❯❯❯ Vanguard} 15:34, 25 October 2016 (UTC)

Citation code errors

There are numerous errors at the end of the reference section that need to be addressed. Search "Cite error." I made an attempt to correct this issue but have had no luck and just gave up without savingany of my attempts. Whatever is wrong has something to do with grouping references - and I am unfamiliar with this practice so fixing the problem seems to be beyond my current editing capabilities. Hopefully someone who understands what was being attempted here can easily fix it! RobP (talk) 13:10, 5 November 2016 (UTC)

A bot will come and fix it. Carl Fredrik 💌 📧 13:40, 5 November 2016 (UTC)

$2.5 billion spent .... testing alternative medicine

please include a citation for a reference for the following statement. "Contrary to popular belief, significant expense is paid in testing alternative medicine, including over $2.5 billion spent by the United States government," ≈≈≈≈ — Preceding unsigned comment added by Sdtk (talk • contribs) 23:44, 13 November 2016 (UTC)

It's already referenced further down the page, references numbered 135 and 136. PepperBeast (talk) 00:26, 14 November 2016 (UTC)

Invalid an non WP:MEDRS citation

Citation 269 [16] talks about An anecdotal example, and as far as we know, anecdotal evidence is no evidence in medical articles? Please remove it. 93.87.226.245 (talk) 09:52, 23 November 2016 (UTC)

I think you may be confusing anecdata (inadmissible as a source of medical claims) with critical commentary based on real-world examples. Guy (Help!) 10:49, 23 November 2016 (UTC)

Critical commentary based on anecdote. Guess positive comment based on anecdote would be inadmissible in this article... 212.200.65.127 (talk) 17:10, 23 November 2016 (UTC)

Well yes, it would, obviously. -Roxy the dog. bark 17:23, 23 November 2016 (UTC)

obviously unbiased objective article writing. 212.200.65.127 (talk) 18:30, 23 November 2016 (UTC)

Thank you, though I had little to do with it. -Roxy the dog. bark 18:39, 23 November 2016 (UTC)

I see this (Page not found) citation [17] is still in the article.. 212.200.65.112 (talk) 15:42, 24 November 2016 (UTC)

Extension of personal experience

it appears personal experience of reality interferec a lot with objective assesement of things. for example, meditation is listed here as example of pseudoscience, and a simple search on the topic gives lazar lab as result, a Harvard lab publishing tons of research on the topic. what kind of myopic mind could still believe it is pseudoscience. i guess a mind that is order of magnitude more brilliant than a mind of Harvard researcher. show us your research then, PLEASE! i guess if i am colorblind, colors cannot exist. if i dont know how to meditate, meditation cannot exist. this article is full of crap and needs complete revamp of the tone and attitude. 80.233.239.118 (talk) 14:45, 16 December 2016 (UTC)

Meditation is not de facto pseudoscientific, but its practice most assuredly can be and often is presented in a pseudoscientific light. Saying that something is full of crap will only get you ignored, come with suggestions for improvement or go away. Carl Fredrik 💌 📧 14:58, 16 December 2016 (UTC)

remove protection of the article and you will see improvement. it would be very nice if you started ignoring these pages for a while and its editors.. but think you are unable to do that. as for practice.. some doctors (mal)practice but we don't label the whole thing as such. 80.233.239.118 (talk) 15:05, 16 December 2016 (UTC)

Concrete content suggestions, this is not the place to discuss policy. Carl Fredrik 💌 📧 17:27, 16 December 2016 (UTC)

Probably not. Protection is there precisely because most of the anonymous edits were not actually improvements. Guy (Help!) 01:31, 25 December 2016 (UTC)

Response to above: I am not sure exactly the debate in this thread, but I wanted to mention two things. First I will respond to this "thread": There are a lot of scientific journal articles and studies on meditation; there might not be as much as there could or should be, however there is already documentation out there. Studies show meditation changes the neurons in the brain for the better and such.

Also, the second thing is, I am thinking it would be nice to have a separate classification for things that are unproven instead of just lumping it in with disproven things etc. even something that is disproven might have been a bad experiment so maybe there is a range of how proven or disproven something is, though just because it isnt proven yet doesnt make it grouped with false. all the great science we have now was once unproven until it was proven. I think lumping it with disproven things will slow down scientific progress possibly, and wikipedia is about giving knowledge not blocking knowledge. — Preceding unsigned comment added by Wikipediaisgreat (talk • contribs) 23:32, 23 December 2016 (UTC)

Even if we agree that the term alternative medicine is bad we can't change it — we merely report what the reliable sources say. Carl Fredrik 💌 📧 23:54, 23 December 2016 (UTC)

Conflict of interest section

re [18]: WP:SOME is an amusing objection given that the paragraph just above opens with the exact same "some" language; the only honest position is to either moot the objection or delete both paragraphs. This is about striking the right balance between NPOV and any VER/OR problems that may arise from noting the absence of material in a given source. I see no other reasonable way to balance that first paragraph, especially given the difference in weight between the opinions of Ernst/Gorski/Hall and the policies of Cochrane/Nature/NEJM. Bigger entities can't be expected to address every concern raised by smaller ones, and it's plainly UNDUE to cover only the latter.

Am pretty sure that this argument would be uncontroversial if the views were switched 'round the other way, such that some respected scientist-bloggers took a less CAM-critical view while some of the best journals took a more CAM-critical view. Nu? ಠ_ಠ --Middle 8 (t • c | privacy • COI) 23:53, 7 February 2017 (UTC) || (revised 02:40, 8 February 2017 (UTC))

Quoting any of those institutions opinion on "conflict of interest" as it pertains to alternative medicine would likely be useful for this page. However, this is not in anyway what you did. Instead you did your own research and decided that these institutions by not mentioning alternative medicine at all were subliminally trying to comment on alternative medicine. If only there was a prohibition against doing your own research.2601:645:C201:5D0:7526:B28B:A5FD:67BE (talk) 03:58, 8 February 2017 (UTC)

It's not the only time an article has noted, for the sake of NPOV, that a given source is silent on a particular topic. Yes, doing so is an OR compromise. But I could be wrong about the degree of NPOV violation going on, which would reduce the justification for such a compromise. --Middle 8 (t • c | privacy • COI) 09:40, 8 February 2017 (UTC) || typo fix 21:18, 8 February 2017 (UTC)

You would need reliable independent sources that identify this as relevant. 100% of your edit was a novel synthesis from primary sources. Guy (Help!) 09:48, 8 February 2017 (UTC)

Original research is original research. That is what this is. Arguing to restore it is not helpful. Middle 8, you have refused to provide verification or are unable to. Each individual source must explicitly make the claim. The word "some" is often misused. Please remove any unsupported weasel word on this page or any page. QuackGuru (talk) 21:25, 8 February 2017 (UTC)

In this case it is WP:SYN, but your fundamental problem is that you use WP:OR the way that Donald Trump uses "FAKE NEWS" - it just means you don't like it. Guy (Help!) 11:39, 9 February 2017 (UTC)

None of the sources verify any such claim. Not every editor follows WP:OR. QuackGuru (talk) 22:51, 9 February 2017 (UTC)

You missed the point. As usual. Guy (Help!) 17:08, 12 February 2017 (UTC)

As far as I can see the issue is that Middle8 performed his own original research. What two ideas do you think he synthesized. Or is this just you lashing out to score ponts?2601:645:C201:5D0:EC00:5A4D:9083:30FA (talk) 03:40, 13 February 2017 (UTC)

A novel synthesis form primary sources does not require combination of ideas. But again: you miss the point. You use WP:OR like DOnald Trump uses "FAKE NEWS" - generally, in multiple venues, not specifically or only here. Guy (Help!) 07:46, 13 February 2017 (UTC)

There is no synthesis or combining any sources to come to a conclusion. It was all original research because no source make any claim whatsoever. QuackGuru (talk) 20:08, 13 February 2017 (UTC)

As always, I find your lack of any talent for self-criticism disturbing. Guy (Help!) 00:22, 14 February 2017 (UTC)

It is not about talent or no talent. It is about following the sources. Following the rules can be difficult. QuackGuru (talk) 01:21, 14 February 2017 (UTC)

So can understanding which rule is being broken, so of course it's much simpler just to call everything you don't like "original research" and leave it at that. Guy (Help!) 10:54, 14 February 2017 (UTC)

Science-based = disproven, unproven, impossible to prove, or only harmful?!

@JzG:, Phytotherapy is included as alternative medicine. Phytotherepy="science-based medical practice". So, how exactly can we have:

Pytotherapy is part of Alternative medicine
"Science-based medical practice" is part of "disproven, unproven, impossible to prove, or only harmful"
"Science-based medical practice" is part of "not part of medicine or science-based healthcare systems"

Am I the only one that see the obvious logical contradictions?Sthubbar (talk) 01:21, 5 January 2017 (UTC)

So, it would seem either phytotherapy should be removed from consideration as alternative medicine or the intro paragraph needs to be loosened up to indicate that some alternative medicine is science-based. Right?Sthubbar (talk) 01:30, 5 January 2017 (UTC)

There are strongly opinionated editors who feel anything outside the realm of allopathic medicine is by definition alternative and non-science-based. It is difficult to convince these editors otherwise; good luck. Clean Copy^talk 03:58, 5 January 2017 (UTC)

As in many disputes about whether a thing is science or pseudoscience, we encounter the Demarcation problem. The boundary is not sharp and expert sources may be applying differing criteria to make their classification. Accepting that this variance may lead to logical conundrums, such as X being a member of class Y according to some, while a member of class Z according to others, while nearly everyone agrees that we would like to see Y and Z as disjoint. Phytotherapy is somewhere on the spectrum closer to standard medicine than, say, reiki. Since there are respectable sources calling phytotherapy science-based and others classifying it as "alternative", we're stuck with a certain discomfort and have to rely on consensus mechanisms. —jmcgnh^{(talk) (contribs)} 04:58, 5 January 2017 (UTC)

Though do we, really, have high-quality WP:FRINDependent sources calling phytotherapy science-based? I just checkout out our phytotherapy article and we said this, but it was sourced to a tertiary source (Britannica) - and specifically, an entry written by a phytotherapist. I have fixed this. We should be using independent secondary sources for this ... what do they say? Alexbrn (talk) 08:11, 5 January 2017 (UTC)

I've tried to address the phytotherapy article before, thanks for taking a look again Alexbrn. Carl Fredrik 💌 📧 09:20, 5 January 2017 (UTC)

Exactly what Alex says. I reverted personal opinion stated as fact. Want to change the article? Bring better sources. And make sure you don't fall into the trap of most activists on Wikipedia: assuming that any challenge means that other editors are shills for Big Something. Remember, phytotherapy is also a commercial practice. Guy (Help!) 10:02, 5 January 2017 (UTC)

NPOV

The present lead is extremely one-sided. It should be rewritten to reflect the varied opinion of alternative medicine in the medical world today. Clean Copy^talk 21:42, 30 December 2016 (UTC)

Refer to specifics. Carl Fredrik 💌 📧 21:48, 30 December 2016 (UTC)

The wholly critical and pejorative tone and content is completely out of line with objective sources such as WebMD and Mayo Clinic and The Gale Encyclopedia of Medicine, which "features specific Alternative Medicine sections for diseases and conditions that may be helped by complementary therapies e (p. vii). See also The Complete Encyclopedia of Medicine & Health (Johannes Schade, ed.); Companion Encyclopedia of Medicine in the Twentieth Century edited by Roger Cooter, John Pickstone (pp. 119ff), etc. Clean Copy^talk 23:40, 30 December 2016 (UTC)

See also: The American Medical Association Encyclopedia of Medicine (ed. Clayman), The Gale Encyclopedia of Alternative Medicine, and this interesting table of efficacy for alternative therapies collated by an evident skeptic Clean Copy^talk 23:43, 30 December 2016 (UTC)

Do you have any specific suggestions? Others may not read the sources or make any edits based on the sources you found. You may have to make the edit or edits yourself.

For over ten years this page has been under dispute. A tag to remind editors of this will not change anything. You can edit to improve the article. Good luck. QuackGuru (talk) 23:48, 30 December 2016 (UTC)

A consensus on the talk page would be valuable first. The tendency of certain editors has been simply to revert changes, even when grounded in solid sources such as the above. Clean Copy^talk 23:51, 30 December 2016 (UTC)

A RfC can help. If you start a RfC it may be mentioned at the fringe noticeboard. QuackGuru (talk) 23:53, 30 December 2016 (UTC)

Your logical fallacy is: begging the question. You judge the sources you propose as solid, but that is prejudging a consensus you have failed to test. Oh, and FYI, anyone concluding that homeopathy results are positive, is not a skeptic. I am completely familiar with the basis of that specific claim, and it depends on very obvious statistical sleight of hand, combining several negative studies and conjuring out of them a positive result which is at odds with all of physics, chemistry, biochemistry and physiology, and also the primary studies on which it is based. Guy (Help!) 23:59, 30 December 2016 (UTC)

I refer the hon. gentleman to Minchin's Law. Alternative medicine, by definition, either hasn't been proven to work, or has been proven not to work. The name for alternative medicine that has been proven to work is: medicine. Guy (Help!) 23:52, 30 December 2016 (UTC)

@JzG:, if this is true, then how can we include phytotherapy as alternative medicine, because by definition phytotherapy is science-based medicine?Sthubbar (talk) 03:10, 5 January 2017 (UTC)

Obviously alternative means alternative to allopathic medicine; it is not by definition quackery, for example accupuncture is not allopathic and nutrition is not much addressed by allopathy, but both have been proven effective; you can wiki-lawyer all you want, but keeping this article as obvious anti-CAM propaganda discredits wikipedia and could lead to illness and death, like any other widely consumed inaccurate information on medicine.JustinReilly (talk) 12:48, 25 February 2017 (UTC)

Allopathy is a word the charlatan Samuel Hahnemann invented for methods and ideas (such as bloodletting and humorism) that are today be categorized as dangerous quackery. Today, his disciples use it for modern medicine, which shows its meaning is just "something homeopaths don't so". So, your rant doesn't make any sense. --Hob Gadling (talk) 19:44, 25 February 2017 (UTC)

Mumbo jumbo as a synonym

Can anyone give a coherent argument that mumbo jumbo is a synonym for alternative medicine? We all know that alternative medicine has been called mumbo jumbo, but that is not the same thing as it being a synonym.

I refer, of course, to this edit which has been reverted twice by Roxy the dog. The first edit summary says "You should read the title of the book", which doesn't really work as an argument, since the book is about mumbo jumbo as a whole, and not just alternative medicine. If anything, the book is a good argument that mumbo jumbo is not synonymous with alternative medicine.

Yaris678 (talk) 16:32, 22 March 2017 (UTC)

It is not a synonym, since Mumbo jumbo (phrase) also includes non-medical bullshit. I actually read the Wheen book quoted here, and it talks about all sorts of stuff, including alt-med, but also including Reaganomics. Does not belong here. Nice book though. --Hob Gadling (talk) 16:41, 22 March 2017 (UTC)

Synonyms are not necessarily exactly the same. They carry different nuances and differences in when/where they are employed. The usage of mumbo jumbo is sufficiently apt to be included here, and there are in fact many many more sources which entirely equate altmed with mumbo-jumbo. That mumbo-jumbo is sometimes used to denote other nonsense does not disqualify it from being a synonym. Carl Fredrik^talk 16:54, 22 March 2017 (UTC)

For a derogatory quasi-synonym, "snake oil" is more specific to alternative medicine than "mumbo jumbo."David notMD (talk) 22:45, 22 March 2017 (UTC)

There is no reliable source that connects the term mumbo-jumbo with alternative medicine. The title of a book on a wide variety of themes is not a sufficient connection. Clean Copy^talk 02:43, 23 March 2017 (UTC)

Agree with Hob Gadling and others opposing, because a category is not a synonym. If "mumbo-jumbo" were a synonym for alt-med, it would by the same token be a synonym for a number of beliefs and practices that have flourished since The Enlightenment: the "millenialism" of the Iranian Revolution, the zeitgeist under which Margaret Thatcher came to power (from the Prologue, "Two Messiahs"); Ronald Reagan's "voodoo economics", mystical movements including Rosicrucianism and New Age spirituality, the self-help schemes of authors such as Tony Robbins and Steven Covey (Chapter One); and of course stuff like astrology -- need I go on? Wheen categorizes these things as nonsense; he does not suggest that the book's title is a synonym for all the stuff he writes about, for crying out loud! Now, if there are other RS for the term as a synonym, as Carl suggests, let's see them, but I think it's unlikely; just do a search for {{ mumbo-jumbo definition }}: you'll get hits like "language or ritual causing or intended to cause confusion or bewilderment". Again, no matter how much some of us hate alt-med, not every pejorative edit is a good one! --Middle 8 (t • c | privacy • COI) 09:53, 24 March 2017 (UTC)

Rough Draft for "Integrative Medicine"

Hello Everyone:

I do believe that Alternative Medicine and Quackery are important articles to be included in Wikipedia. However, I would like to update everyone on the use of the term "Integrative Medicine" as used by the National Institute of Health (NIH), the US National Library of Medicine (via the Medline database), the Agency for Healthcare Research, and the Institute of Medicine (IOM). Also please note that, as of 2013, "Integrative Medicine" is now a medical specialty offered by the American Board of Physician Specialties.

Would you mind reviewing my (extremely rough!) skeleton of an article on "Integrative Medicine", and giving me your feedback?

Here is the link: https://en.wikipedia.org/wiki/Draft:Integrative_Medicine

Thank you, All! :-)

Lbertucci (talk) 07:04, 16 March 2017 (UTC)

Yeah, that's not very helpful. Anyone can write some things off the top of their head, you need sources. Also there is no consensus to split the articles. Carl Fredrik 💌 📧 11:01, 16 March 2017 (UTC)

More sources are needed, but I count five in the current draft [19]. Lbertucci's point about official recognition of IM is well-taken and the article should reflect this; these bodies generally weigh more than do individual critics of IM, and obviously should be included here under § Integrative Medicine whether or not there's eventually a spin-off. --Middle 8 (t • c | privacy • COI) 15:34, 16 March 2017 (UTC)

IM stands for internal medicine — which is recognized. And 5 crappy sources from promoters of quackery gets you nowhere (not saying these specific ones are), and this article has hundreds of sources, so you'd be less than 1/20th of the way to creating a proper split. Also, really? Criticism weighs less than promotion? Go away and read WP:COMPETENCE. Carl Fredrik 💌 📧 11:02, 17 March 2017 (UTC)

@ Carl: If MEDRS don't follow Minchin's definition (and most don't), that doesn't mean they're promotional; believing that they must be is illogical and reflective of editorial tigers. Definitions are opinions, and for opinions, group-authored MEDRS generally weigh more than individually-authored ones -- even if some of us disagree with them. (P.S., I doubt anyone's confused by the use of "IM" in this context; it's used both in this article and at e.g. Medline Plus.[20]) --Middle 8 (t • c | privacy • COI) 18:22, 18 March 2017 (UTC)

No, the issue is one of history and confusion (sometimes deliberate) between alt-med, SCAM and "integrative". As I have pointed out rather often now. Guy (Help!) 10:33, 24 March 2017 (UTC)

@ Guy -- "Confusion" relative to whose definition?

WebMD: Alternative medicine is a term that describes medical treatments that are used instead of traditional (mainstream) therapies. Some people also refer to it as “integrative,” or “complementary” medicine. ... then, listed among examples: Herbal Medicine: This alternative therapy uses parts of a plant ... to heal the body.[21] (emphasis mine)
Taber's Medical Dictionary: CAM: Any of the therapies designed and promoted to improve health and well-being that are usually considered to be outside the scope of Western, allopathic, medical practice. ...SYN: SEE: alternative medicine.[22]. Appendix mostly devoted to herbal remedies.[23]

There: MEDRS that are silent on efficacy; instead defining alt-med as non-mainstream; and specifically including herbs (a few of which, per good sources, work). This isn't the same as Minchin's "alt-med = unproven/disproven" def'n: though in practice there is tremendous overlap, it's obviously not 100%. The "not-mainstream" def'n, already covered in the body, needs to be restored to the lede.

Note: I haven't seen RS discussing a history of confusion and misrepresentation when it comes to definitions. But today, good MEDRS, as we've seen, use varying ones and/or treat the terms "alt-med, comp-med, CAM, and integrative-med" as fuzzy and interchangeable. [24] Doesn't that moot the issue? They may be "wrong" in your opinion, but so what, if they're good MEDRS? Again, this is WP 101 stuff.

(And no, I'm not trying to promote CAM as being effective and awesome. Most of it doesn't work and sucks. But our article sucks too when its lede ignores a common definition, evidently the most common one -- something that readers who have done a web search will pick up on.) --Middle 8 (t • c | privacy • COI) 11:51, 26 March 2017 (UTC); added link for WebMD 20:37, 30 March 2017 (UTC)

Well. Considering WP:SILENCE, I'm inclined to put the "not-mainstream" definition back in the lede, where it belongs. --Middle 8 (t • c | privacy • COI) 21:02, 30 April 2017 (UTC)

Editors made so many posts on this talk page. I think editors gave up. QuackGuru (talk) 01:00, 1 May 2017 (UTC)

[WardleFrawley2016-1] Wardle, Jon; Frawley, Jane; Steel, Amie; Sullivan, Elizabeth (2016). "Complementary medicine and childhood immunisation: A critical review". Vaccine. 34 (38): 4484–4500. doi:10.1016/j.vaccine.2016.07.026. ISSN 0264-410X. PMID 27475472.

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