Talk:Acupuncture

This article is inappropriately negative. It's meant to be about Acupuncture, not 'Acupuncture Skepticism'

Acupuncture is a long-established form of treatment, coming from a pre-scientific background. The fact of this background does not in way, prove it is not effective or does not work -- that is a logical fallacy.

It is inappropriate for this page, intended to be about Acupuncture, to be hijacked to convey a clear skeptical POV. This page should be removed from the purview of the 'Skepticism Project'. They can write a counter-page if they want.

Acupuncture has been of significant scientific interest, for a long time. With many studies ongoing. It is unlikely it would be of such interest, in finding the means, if there were no effect.

Many current studies, appear to find it useful for Cardiology, Anasthesia as well as Musculo-Skeletal and other conditions.

Here are just a very few studies:

• [1]
• [2]
• [3]
• [4]
• [5]

There are dozens or hundreds more, searching PubMed alone. (Published under auspices of the US Government NIH).

I also challenge the objectivity & neutrality of skeptics -- very few surgical procedures have been validated by double-blind trials, and 'medical error' is a leading cause of death in industrialized countries.

• 195,000 deaths from errors in hospitals, per year in US: http://www.medicalnewstoday.com/articles/11856.php

http://www.chron.com/disp/story.mpl/deadbymistake/6555095.html

• up to 780,000 deaths from wider medical errors, per year in US:

http://www.ourcivilisation.com/medicine/usamed/deaths.htm

• [Iatrogenesis] [6]
• $19.5 billion cost per year, from medical errors in US

http://www.soa.org/news-and-publications/newsroom/press-releases/2010-08-09-med-errors.aspx

Where are the skeptics defacing pages, on surgery & Western medicine? I'm a supporter myself, but this a clear embedded bias which the skeptics seem too irrational & uninformed to acknowledge. — Preceding unsigned comment added by Twhitmore.nz (talk • contribs) 01:40, 26 February 2011 (UTC)

I call upon the editor to remove this page from the purview of the skeptic's group & edit the page, so it provides a genuine neutral view of Acupuncture rather than this negatively biased POV.

Thankyou.

Twhitmore.nz (talk) 00:49, 25 February 2011 (UTC)

I agree that this is an article written from a skeptical viewpoint. The 'criticism' should be placed in a subsection. The bulk of the article should just inform about acupuncture and its principles and practice in a more neutral way. It is hard to know where to begin to put this right (I have very little experiecne of editing Wikipedia. — Preceding unsigned comment added by Aaprescott (talk • contribs) 10:22, 11 March 2011 (UTC)

Twhitmore.nz and Aaprescott, If you think that you have evidence to counter any of the "POV" claims in this article, or evidence to show that medical procedures or pharmaceutical treatments are dangerous or ineffective then please add them to WP in order to redress the "imbalance". If there are "dozens or hundreds" of studies showing that acupuncture works, please add them. Myself and the other editors can then assess the quality of these studies. Otherwise, stop whinging. WP is not a "conspiracy" of "skeptics". This page has not been "hijacked". You are free to add any information you want at any time, since WP is an open-access encyclopedia. But be warned that it is one in which claims (especially those pertaining to health and medicine) require evidence - if this presents an insurmountable problem for the alternative "therapies" that you believe "work" then tough luck. You'll have to post unsupported claims on your own websites. Famousdog (talk) 15:24, 11 March 2011 (UTC)

The above response is itself problematic. Characterising the criticims as 'whinging', and such like comments, amounts to making this personal. You have missunderstood the nature of the criticism and shown yourself to have a particular viewpoint. I added my comments to the previous one, and do not necessarily agree with all of them e.g. I make no claim of organized conspiracy.

Neutrality would explain the theory of Chinese medicine and include an evidence based medicine criticism. Not make such criticism the prevailing tone of the article. Andy — Preceding unsigned comment added by Aaprescott (talk • contribs) 10:54, 14 March 2011 (UTC)

Please see WP:MEDRS, we require recent secondary sources. Particularly since the development of adequate shams in the form of nonpenetrating needles (around 2002) the evidence base for acupuncture has eroded. Also, what on earth does the number of surgical procedures have to do with acupuncture? Even if surgical procedures aren't justified by an adequate evidence base (which is more of a CAM talking point than a real concern) how does that magically make acupuncture more effective? Does the Toyota acceleration problem make the Yugo a better car? No it does not.

Evidence based medicine doesn't support TCM, and it barely supports the idea that poking people with needles can help with pain and nausea (which is the only part of acupuncture that's really got an evidence base). Neutrality means "within the expert opinion", not "extremely positive". WLU (t) (c) Wikipedia's rules:^simple/_complex 21:37, 14 March 2011 (UTC)

17th March 2011 I tried to make some fairly small changes that would make this article more neutral. But I did not remove any of the critical perspective. I was originally a psychiatric nurse and so I recognize the orthodox perspective is important. I also made some changes to incorect information. I am a practitioner of 30 years experience and the introductory section contains factual inacuracies. The description of the cause of disease is incorect it is desecribing mechanims (systems) not causes per se. The idea that their are 12 channels because of the twelve rivers of China could have been true at one time, I don't think that even that is certain, but is probably a redundant idea except as an historical note - presumably this is here simply to ridicule. My edits have all beeen removed. I recognize that there may be some technical deficiencies in my contribution especially in terms of sources, but undoing all of them seems to confirm a strong bias. There is clearly an attempt to maintain an 'evidence based medicine' perspective front and center, and this contravenes the Wikipedia policy of absolute neutrality. I attempted to report this non neutrality to wikipedia, but I could not find an easy way to do this. There seems to be no other mechanism than a war of editing! This is going to make me more cautious in my reading of Wikipedia articles in future. It seems that right would probably not prevail as caring form my patients probably does not allow me the time to devote to such a concerted effort. Andy Prescott B.Ac. (UK), Dipl.Ac. (NCCAOM) L.Ac. (NC) — Preceding unsigned comment added by Aaprescott (talk • contribs) 13:41, 17 March 2011 (UTC)

Andy, I looked at your changes and you do not provide sources for your changes. For example, your changes to the lead don't seem to be supported by the source as it currently stands (the acupuncturetoday.com article). For example, your comments about causes being "a lifestyle that is not in accord with the Dao" are not supported by the current source, so you would need to add a new one to support this view. Your edits that TCM has "three classifications of causes" are similarly not supported by a citation. Your comments on metaphysics, empricism and syncreticism seem to reflect your own opinion, which counts as inappropriate synthesis or original research. You are not being unfairly treated here. I would be expected to provide similar citations for my own edits, as would anybody. And if we're fishing for credibility by posting our credentials, then you can call me Dr. Famousdog BSc(Hons) PhD. Famousdog (talk) 12:27, 18 March 2011 (UTC)

Yep, we need sources. Since I'm just an editor, I'm just going to put my usual signature. Note that it has links to the full and abbreviated lists of policies and guidelines, feel free to check out both since they determine page content. For instance, per WP:RS we are supposed to use the best and most reliable sources available. I see the insistence on using peer-reviewed material from medicine, history and related fields as an effort to maintain a "high quality" page; it's certainly worth noting that actual evidence doesn't support the use of acupuncture for anything but pain and nausea. I don't know why we'd prefer the opinions of practitioners over opinions published in peer-reviewed journals where methodological rigor has been applied to the investigation. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:10, 18 March 2011 (UTC) Again, I'm just an editor

I agree, I came here to read about the mechanics, and with the opening statements such as, "Traditional acupuncture was developed prior to the understanding of human anatomy and cell theory upon which modern biology is based", "there is no anatomical or scientific evidence for the existence of qi or meridians; concepts central to acupuncture theory", "The evidence for acupuncture's effectiveness for anything but the relief of some types of pain and nausea has not been established", "Evidence for the treatment of other conditions is equivocal", "a 2011 review of review articles concluded except for neck pain acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including death"-- I didn't even feel the desire to continue reading. As for WLU, "opinions of practitioners over opinions published in peer-reviewed journals"-- Because peer-reviewed journals, unless it's a journal dedicated to acupuncture is just that-- an appeal to authority regardless of the authority's experience in the field. I don't go to a zoology journal to read about nutrition or neurology-- even though all are biological sciences. Each discipline specializes in different fields under the same biology umbrella, and this applies to medicine as well. I went to Britannica instead; the article there is much more objective and descriptive. I recommend it to other researchers until this article is a. cleaned up, and b. treated as description, not prescription. TheObserverEffect (talk) 20:09, 13 April 2011 (UTC)

Please see WP:NPOV. A neutral article doesn't mean we write an article that just talks about a fringe idea and not give it the balance of what it really is. There is NO scientific evidence that supports the efficacy of acupuncture beyond a placebo, and even then the evidence is mitigated by the lack of sham controls. Moreover, given that there is no efficacy, the fact that there is a safety issue makes it worse. You risk your health to get no benefit. Sounds perfectly neutral. OrangeMarlin ^{Talk• Contributions} 20:17, 13 April 2011 (UTC)

Actually, that's not at all what NPOV means. we should strive to give a proper and neutral description of the topic without allowing editors to make 'factual' judgements about it one way or another. I haven't read this article yet, but I'll do that as I get a chance and see if any revisions are required to better the topic. --Ludwigs2 22:31, 13 April 2011 (UTC)

Yes of course Ludwigs. Yours is the ONLY interpretation that matters. And of course, your revisions to this article is the ONLY one that is the truth.OrangeMarlin ^{Talk• Contributions} 00:18, 14 April 2011 (UTC)

OM - lol - going straight to the insults without any preliminaries? whatever happened to foreplay?

I think we can all safely ignore that last foray into argument-by-sarcasm. Do you have anything that's more relevant to the topic, or would you like to talk about me some more? --Ludwigs2 02:19, 14 April 2011 (UTC)

NPOV

This article is not neutral and is factually inacurate. As a begininer to Wikipedia I am very frustrated by the unrelenting resistance to change that I am encountering. This in itself I believe is contrary to Wikipedia policy that is supposed to be cooperative. People should be helping to make the article neutral, and accurate, and helping resolsve any technical inadequacies in my entries, not just hitting 'undo'. Whether intended or not this just conveys the impression that some editors are determined that no one will change thei 'point of view' of these entries.

The introduction is not a neutral statment. It is critical from an 'Evidence Based Medicine' point of view.

The statement about 'TCM' is inacurate. Japanese, Korean practitioners woudl not identify themselves as practicing TCM, 38% of British practitioners do not practice TCM their approach having more Japanese origins. (I can quote a source for that). TCM is identified with modern Chinese practice. On the TCM page it also fails to make this clear, and in fact treats Classical Chinese Medicine and TCM as synonymous - which is also inacurate.

The statement about what produces disease is inacurate it compares 'mechanisms' of Chinese medicine with 'causes' in Western medicine. Turn this round and I would say that Western medicine beleives that illness is 'produced by disturbances of lymph cells, and circulatory systems, and Chinese medicine beleives that disease has physical causes in climatic exposure, parasites, emotional disturbance.'

The statement that the meridians are based upon the 12 rivers of China comes from a quote in the Ling Shu - it does not prove this. Simply that the Chinese at one time made an anaology. Given that there were originally only 11 meridians this anaology may have come later. In the Ling Shu it is simply a mmnemonic device. And most practitoners would have never heard of this. If the Chinese had found through experience that there were 14 channels they would have changed it. The only purpose of this information in context seems to be to portray acupuncture in the worst possible light.

I notice the TCM page is under a dispute resolution process. If I knew how to initiate this I would do. Isn't there anyone else out there who knows how to do this? 66.57.104.142 (talk) 11:48, 18 March 2011 (UTC)

I refer you to this thread and my responses. If you think there is a problem with the article stop huffing-and-puffing and do something. Just remember that you will be expected to provide reliable sources for statements that you make. Famousdog (talk) 12:33, 18 March 2011 (UTC)

The only interesting thing in that post was the allusion to an actual source, please provide the source that many practitioners do not adhere to the meridian/qi theory (I'm assuming what the "TCM" bit is referring to) so we can integrate it into the page. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:04, 18 March 2011 (UTC)

Hear, hear. This quote from the page is hilarious:

A prominent example of this difference appears in an article appearing in the Journal of Chinese Medicine, which describes the cause of bleeding from the mouth and nose as "Liver fire rushes upwards and scorches the Lung, injuring the blood vessels and giving rise to reckless pouring of blood from the mouth and nose."[68] Science based medicine would look for some other cause, for example, a tuberculosis bacterial infection, and not consider other causes.

Wtf does that last line have to do with acupuncture?! ArlenCuss (talk) 11:31, 9 April 2011 (UTC)

I'm sorry, but how can "Evidenced-based medicine" or evidenced-based anything be a bias? Someone is either biased or is basing their conclusion on evidence. It certainly would be POV to treat approaches to health based on superstition or tradition as equal in validity to approaches based on analysis of data, as the former is a demonstrably inferior way of understanding the universe. —Preceding unsigned comment added by 158.143.133.63 (talk) 12:27, 12 April 2011 (UTC)

new meta-meta analysis

• On-line
• Editorial
• Sciencebasedmedicine post

I'd like to take the time to integrate this, but I may not. Obviously anyone who wishes is free to do so, here they are! WLU (t) (c) Wikipedia's rules:^simple/_complex 12:27, 29 March 2011 (UTC)

I've got full text (and the Pain commentaty) on my desktop if anyone wants it. --Anthonyhcole (talk) 16:40, 29 March 2011 (UTC)

Also another one from 2010 which I'm not sure if it's included or not: [7]. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:08, 29 March 2011 (UTC)

Added the new Ernst review and editorial (and made some bold changes). Not sure whether its worth adding the other post. Famousdog (talk) 08:39, 30 March 2011 (UTC)

frequency of deaths & other adverse events?

I put a {{clarify}} tag on a statement in the lead[8]. (Please leave the tag until discussion has run its course, per WP:TAGGING.) The abstract for this paper says "Ninety-five cases of severe adverse effects including 5 fatalities were included", but it doesn't mention the frequency. Needless to say, a raw number of outcomes doesn't mean very much without knowing their frequently. Does the full text address this? (The abstract doesn't, and the full text requires a subscription.)

We should cite sources that mention the frequency -- ses this, and also an earlier Ernst paper that said: "According to accepted criteria, none (0/10,000 to 1.2/10,000) of these events was serious"[9][10]). We should also cite sources comparing acupuncture with other therapies, such as this one, and NIH: "One of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions."[11]) There is also a multiply-sourced statement in the lead that we can tie into: "There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles." Middle 8 (talk) 07:29, 30 April 2011 (UTC)

It appears you are conflating two authors named Ernst. Gernot and Edzard are very likely different people. The G. Ernst et al paper is of no use to us, it is a primary study, and a feeble one at that: a questionaire survey of a small group of practitioners in one country. The E. Ernst et al paper is somewhat better, but still based on a subset of practitioners in one country, all of whom were MDs or Chartered Physiotherapists in addition to their accupuncture training. This group would be expected to have a safer practice than another group trained solely in a traditional form of accupuncture. LeadSongDog come howl! 16:11, 30 April 2011 (UTC)

@LeadSongDog: I noticed two different Ernst's, but didn't conflate them. Please re-read: that first quote I cited was correctly attributed to E. Ernst. I understand the problems you point out with the papers I cited, but it's even worse not to give the sample size at all. Did Ernst et al. (2011) provide it in the full article, or even give an estimate? As I mentioned, it's not in the abstract. It would be great if someone with access could post the relevant parts of the article so we have some context. --Middle 8 (talk) 00:39, 1 May 2011 (UTC)

Note that this review, which also lacks a sample size, found 202 adverse events in 35 years. Ernst et al. (2011) found 95 events in 10 years. While inclusion criteria for the two papers differed, the numbers aren't that far apart. But without sample sizes, those numbers don't mean much. --Middle 8 (talk) 00:39, 1 May 2011 (UTC)

Still, "95 cases of severe adverse effects" is a meaningless number without reference to the sample group used. It's also likely to be insignificant - I mean, aspirin has a chronic overdose mortality rate of 25%, which had to rack up a lot of people before warning labels were required on bottles, but our article doesn't see fit to dwell on that fact. --Ludwigs2 17:17, 30 April 2011 (UTC)

Strawman. False dichotomy. OrangeMarlin ^{Talk• Contributions} 18:02, 30 April 2011 (UTC)

Why would you say that? --Ludwigs2 18:04, 30 April 2011 (UTC)

It's all there. I try not to be as verbose as others around here.OrangeMarlin ^{Talk• Contributions} 00:53, 1 May 2011 (UTC)

(undent)@Ludwigs2: you hit the nail on the head when you said: "Still, "95 cases of severe adverse effects" is a meaningless number without reference to the sample group used. It's also likely to be insignificant..." See this for comparison of total deaths annually. --Middle 8 (talk) 00:39, 1 May 2011 (UTC)

Logical fallacy. False dichotomy once again. OrangeMarlin ^{Talk• Contributions} 00:52, 1 May 2011 (UTC)

@ Middle 8: wow, I would have guess a few hundred deaths a year from NSAIDs, not 7,600. that's somewhat disturbing.

@ OrangeMarlin: repeating the same point without explaining it does not help in understanding it. what makes you think this is a false dichotomy or strawman argument? You surely cannot be objecting to the request for a baseline figure (which is essential to any statistical statement...) --Ludwigs2 00:56, 1 May 2011 (UTC)

nonsensical discussion archived. problem referred to wikiquette at Wikipedia:Wikiquette_alerts#Orangemarlin_at_acupuncture
The following discussion has been closed. Please do not modify it.
WP:TLDR.OrangeMarlin Talk• Contributions 01:01, 1 May 2011 (UTC) WP:RFC/U? --Middle 8 (talk) 01:42, 1 May 2011 (UTC) Wow, so because you push a set of POV edits, your choice is to proceed with a drama inducing useless activity instead of actually editing? You amuse me Middle. OrangeMarlin Talk• Contributions 02:10, 1 May 2011 (UTC) I'm sorry, did you just suggest that my two sentence (45 word) comment was too long for you to read comfortably? --Ludwigs2 01:05, 1 May 2011 (UTC) See WP:NPA. Any further personal attacks and I'll request, what is it? Block #15, most of which are for continued personal attacks? OrangeMarlin Talk• Contributions 02:08, 1 May 2011 (UTC) Methinks the fish is baiting. Why? Because he cannot form any cogent argument here.68.122.51.169 (talk) 03:40, 1 May 2011 (UTC)

Concur that a count (95) without a sample size is meaningless. Gerardw (talk) 13:42, 1 May 2011 (UTC)

Nausea and tagging

I just tried to update a Cochrane reference for nausea; as anyone can tell from reading the 2008 Cochrane review, the conclusions have change from 2004 and are unambiguous: "P6 acupoint stimulation prevented PONV. There was no reliable evidence for differences in risks of postoperative nausea or vomiting after P6 acupoint stimulation compared to antiemetic drugs." (PONV = post-operative nause and vomiting.) My edit removed the 2004 Cochrane review and put in the new one, with a summary reflecting its contents. For some reason, User:OrangeMarlin removed the edit, saying it was "horribly POV". It's not POV to reflect the literature. I wonder if the editor even read the source? Looks like a case of reverting based on what the editor thinks should be true rather than what the source says; we've seen this before.

Note - the same editor twice violated WP:TAGGING by removing a {{clarify}} tag,[12][13] and after I twice reverted, posted on my talk page falsely claiming I was at 3RR -- which his reversions were likely meant to provoke, in a clear case of baiting.[14] This sort of editing, combined with the plainly unproductive use of the talk page above, is disruptive and harassing. I wasn't born yesterday, and I know why it's being done: to make the editing environment so hostile for editors with whom OrangeMarlin disagrees that they'll grow discouraged and leave. I've seen it before from this editor and others, and I no longer AGF about it. OM, your recent string of edits is indefensible. Knock it off or you'll likely find yourself sanctioned for this ridiculously noncollegial behavior. --Middle 8 (talk) 01:34, 1 May 2011 (UTC)

Well, it's best not to talk about editors on the article talk page. If there's an administrator present who can comment on the issue that would be best, otherwise we should just leave this be until/unless we decide to pursue something administrative elsewhere. In the meantime, let me review the last round of article revisions. --Ludwigs2 02:00, 1 May 2011 (UTC)

He'll likely delete it from his talk page. --Middle 8 (talk) 06:22, 1 May 2011 (UTC)

WP:TLDR. Article fixed <--Appropriate amount of verbiage required to respond to such comments. OrangeMarlin ^{Talk• Contributions} 02:06, 1 May 2011 (UTC)

@OrangeMarlin: That's not even close to an adequate discussion, especially for an edit summary that said "Reverting highly POV edits per talk page discussion". That ES is highly misleading; you haven't engaged discussion at all. And you're removing a more recent (2008) Cochrane review in favor of one from 2004; that is flagrantly against MEDRS. My summary, which you reverted, said:

A 2008 Cochrane review found that acupuncture treats post-operative nausea and vomiting as well as anti-emetic drugs, with minimal side effects. It was found to be equally effective in adults and children. Publication bias was found to be minimal in studies analyzed in this review. [15]

The review itself said (omitting statistics):

"There was no clear difference in the effectiveness of P6 acupoint stimulation for adults and children; or for invasive and noninvasive acupoint stimulation. There was no evidence of difference between P6 acupoint stimulation and antiemetic drugs in the risk of nausea, vomiting, or the need for rescue antiemetics. The side effects associated with P6 acupoint stimulation were minor. There was no evidence of publication bias from contour-enhanced funnel plots. Authors' conclusions: P6 acupoint stimulation prevented PONV. There was no reliable evidence for differences in risks of postoperative nausea or vomiting after P6 acupoint stimulation compared to antiemetic drugs."

Now please explain why my summary of the 2008 review is "highly POV", and why the 2004 review is a better MEDRS than the 2008 review. --Middle 8 (talk) 06:22, 1 May 2011 (UTC)

Regarding the tag on Ernst (2011): per WP:TAGGING and general consensus, it should not be removed until there is agreement on the talk page. Restoring. In this edit, the tag was removed and the wording changed. The wording that was removed was relevant and I disagree with its removal, another good reason to keep the tag. I'm surprised that the authors said that the adverse effects were statistically significant, since they're anecdotal. What was the confidence interval and the sample size? --Middle 8 (talk) 09:14, 1 May 2011 (UTC)

More to the point, 'significant' has a particular meaning in statistics: i.e. that an observed effect is likely not due to random chance. However, this edit does not say what the observed effect in question is, nor what it's being compared to, and so 'significance' is totally meaningless. that needs to be clarified or removed. --Ludwigs2 18:01, 1 May 2011 (UTC)

It looks like there were more disputed changes than just the nausea one, there were also changes to the lede etc. Can we see a clear set of proposed changes here please Ludwigs2 --Snowded ^TALK 18:19, 1 May 2011 (UTC)

Not to be highly critical, but I've been around this block before with Ludwigs. He believes others have to explain why they revert him, not that he needs to explain why he made the changes in the first place. And the changes are highly POV, making it appear that Acupuncture actually has some usefulness, which, based on tons of reliable sources, it certainly does not. Moreover, several of the edits give undue weight to fringe ideas.OrangeMarlin ^{Talk• Contributions} 18:28, 1 May 2011 (UTC)

Cochrane (2008) says acu works for nausea[16]; Cochrane isn't fringe; therefore the idea that acu works for certain things isn't fringe. I summarized Cochrane (2008) and put it in the article, replacing the older Cochrane review on nausea. There was no good reason to revert that. What Orangemarlin seems to be doing is reverting anything that suggests acu has efficacy beyond placebo, no matter how well-sourced that is. Obviously, that's unacceptable. Do any editors have an objection to my restoring the edit, per the 1st paragraph in this section? --Middle 8 (talk) 20:52, 1 May 2011 (UTC)

go ahead, it seems reasonable. --Ludwigs2 21:37, 1 May 2011 (UTC)

The link in your edit doesn't work for me. ("Sorry an error has occurred") Maybe try PubMed? (Also, review is misspelled in the last sentence, and I am not sure if changing the sentence makes sense or if it's a case of hyperprecision. And it removes footnote pmid15266478, which is reused elsewhere, but citationbot will take care of that.) As the article has been protected, you will have to do it by edit request anyway. Hans Adler 04:38, 2 May 2011 (UTC)

(undent)OK, here's a link that should work: [17] And I agree, let's just focus on updating the review and not worry about the rest of the edit for now. At any rate, I'll probably have to repost this in a condensed form below, which is ok. --Middle 8 (talk) 01:45, 3 May 2011 (UTC)

page progress and page troubles

@ Snowded (and anyone else who pops in here). I'm open to reasoned discussion about the ongoing changes to the article, but we have had none of that to date - just pithy obstructionism from a single editor. I'd ask you not to revert a reasonable amount of good work simply because one editor has been doggedly obstructing things. If you don't like the changes that have been made, please discuss them here. Do not become part of the problem by engaging in large-scale reverts without considering the issues properly. --Ludwigs2 18:15, 1 May 2011 (UTC)

Lay out the issues so other editors can look at them. For the moment I've put the article back to where it was before this dispute broke out - WP:BRD and all that. As far as I can see you are as much a part of the problem as other editors. --Snowded ^TALK 18:16, 1 May 2011 (UTC)

Snowded, READ THE TALK PAGE. these issues have been laid out as we've gone along, and been regularly reverted by one editor who does nothing except declaim 'POV edit!' You are currently supporting someone who has been tendentiously edit warring against page development. is that what you mean to be doing? --Ludwigs2 18:21, 1 May 2011 (UTC)

P.s. If you're really going to insist that I spell out all the rationales for changes again, I'll do that: but but I want your word first that if I do so you will behave reasonably and cease edit warring. --Ludwigs2 18:23, 1 May 2011 (UTC)

Wow, you really enjoy personal attacks on everyone. For someone with 14 blocks to their name, is this a wise course of action? I'm just trying to give you some helpful advice. And yes, your edits were POV. It's upon you to explain your edits to a stable version of an article, not for me to explain why every one of your edits were unacceptable and violations of POV. Again, I'm here to give advice to an editor who is subject to a variety of Pseudoscience article sanctions. OrangeMarlin ^{Talk• Contributions} 18:25, 1 May 2011 (UTC)

(ec) Its far from clear to be honest. I went through the discussion above and some of it relates to the actual edits. Rather than commenting on other editors maybe you would put the same effort into summarising the main changes you want so they can be treated one by one. I also suggest you stop shouting and failing to WP:AGF. I've restored a position per WP:BRD if you think that is edit warring or unreasonable behaviour fine --Snowded ^TALK 18:27, 1 May 2011 (UTC)

I don't understand what you're asking for that isn't already there. for instance:

• my edits of yesterday were clearly marked as clean up and rewrite for clarity [18]. mostly they were just rewording for style; some of it was removal of odd ramblings. why didn't you open a discussion and ask about it? I would certainly have been open to that discussion, but since I have no idea what you think is wrong with the edits in particular, how can I justify them?
• you reverted a clarity tag that middle 8 put on - why is that?

it's easy to revert Snow, but it's really hard to figure out what's bothering you about the edits if you won't explain yourself. So, explain what you think is wrong with the edits, in enough detail so that we can discuss it - how long do you need to make a reasonable explanation? --Ludwigs2 18:40, 1 May 2011 (UTC)

FYI my id here is snowded. Its very easy to edit war, I reverted to a stable position with the suggestion that you (or some other) involved editor summarises the desired changes. Simple really, if you are not happy with that I will look at it again later, but for the moment I have flights to catch --Snowded ^TALK 18:44, 1 May 2011 (UTC)

Ludwigs, once again, it is your responsibility to defend your edits on a fringe article. You haven't. You cannot take your path of editing and think you can "get away with it." You could go the teapot around the moon article, write that it's there, and ask everyone else who tries to revert "well, provide a reliable source that it isn't there." OrangeMarlin ^{Talk• Contributions} 18:47, 1 May 2011 (UTC)

OK, well will you summarise the issues with the changes (which I see have been put back) then maybe we can make progress. --Snowded ^TALK 18:51, 1 May 2011 (UTC)

I'm seeing less than ideal behavior from both OM and L2. L2, edits like this [[19]] are simply petty. OM, your snarky WP:TLDR, and references to L2's number of blocks don't contribute to the discussion; if the number of blocks is relevant, what are to make of your 4? (By the way, [zero] here. Don't that make me better or more virtuous than both of you???)Gerardw (talk) 18:56, 1 May 2011 (UTC)

Gerard - I archived that because it was off-topic and specifically intended to be personal rather than content-related. I'd appreciate it if you'd restore the archive, because it adds nothing to the discussion, and leaving it out there will simply encourage more comments along the same line. If you like, I can do more focused redaction of off-topic personal material, but I do believe it should be obscured. --Ludwigs2 19:01, 1 May 2011 (UTC)

What possible reason would I have for restoring it? I think it's inappropriate. Gerardw (talk) 19:04, 1 May 2011 (UTC)

ok, I'll do it myself. If you continue to think it's inappropriate, please bring it up somewhere (not here) where we can discuss the matter with the community and reach a decision on the usefulness of it. Just let me know where. --Ludwigs2 19:17, 1 May 2011 (UTC)

Ok, well, as I said, they were mainly clarity changes. let's start going through it line by line and try to figure out what to do about each. sorry about shortening your username, by the way; didn't realize that was an issue. --Ludwigs2 18:57, 1 May 2011 (UTC)

first line

old version	my change
Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body.	Acupuncture is an alternative medicine in which thin needles are inserted into a the skin and manipulated in various ways, ostensibly to influence the patient's qi for therapeutic benefit.

what do you object to in this revision? the latter is a clearer description of what acupuncture attempts to do, I think. --Ludwigs2 18:57, 1 May 2011 (UTC)

Can we have all the suggested changes? That is just a small part of the changes in the first couple of sentences of the lede. --Snowded ^TALK 19:31, 1 May 2011 (UTC)

Snowded - it's three paragraphs of copy-editing revisions, involving material that was added, reworded, moved to different places, or removed. If you want to deal with the whole thing at once you can look at the diff and tell me what specifically you found distasteful in it. If it helps any, I had three main goals:

• to clarify specific details (e.g. needles are inserted into the skin, they are not stuck into the body like daggers).
• to organize the paragraphs: first paragraph as overview of topic, second paragraph dealing with medical issues and efficacy.
• to remove redundancies and pithinesses (e.g. removing link to 'evidence-based medicine', which is a POV neologism for western scientific medicine, or combining the three or four separate references to efficacy issues into a single line for easier reading)

Otherwise I don't understand what you mean by 'all the suggested changes' - we look at it as a block or we look at it in pieces; there doesn't seem to be a middle ground. --Ludwigs2 19:44, 1 May 2011 (UTC)

2 hours, no response from Snowded or Orangemarlin. I'll check back in a bit. --Ludwigs2 21:39, 1 May 2011 (UTC)

What are you talking about. no one here is full time and I am grabbing spots between hotels and airports over the whole of this evening so don't expect any detailed work in a two hour window - please. Otherwise I don't think its all or nothing. When I looked at it some of the editors improved things, others attempted to reduce any medical criticism. Its going to take a bit of work given this and the article is thanlfully frozen for a few days anyway. --Snowded ^TALK 23:57, 1 May 2011 (UTC)

Just marking time, more with respect to Orangemarlin than you. Eventually, the fact that OM does not use the talk page to discuss revisions is going to become significant, and it's worth highlighting it as we go along. For instance, this thread has now been hanging here for 7.5 hours without anyone trying to discuss the reasons for reverting the material. You're busy, valid excuse; Orangemarlin has been working on different pages on project. the longer this thread goes without anyone explaining the reasons for reverting, the more effectively I can assert that we have the established the groundwork for a new consensus. --Ludwigs2 04:12, 2 May 2011 (UTC)

Nonsense. See wp:NODEADLINE. Certainly nobody seriously believes we operate on a timescale of hours. Give it a few days.LeadSongDog come howl! 06:15, 2 May 2011 (UTC)

Agreed, its going to be necessary to go through the changes which have been restored by Adler/Ludwig2. The one listed above is fairly inconsequential, other changes appear to attempt to reduce scientific criticism. Making such major changes without consensus was bound to be provocative. --Snowded ^TALK 06:20, 2 May 2011 (UTC)

If either of you has concerns with the changes you will have to say what they are. See the 4RR report currently open at WP:EW/N or the discussion on my talk page for some background. OM is a serial abuser of the BRD principle. For him it quite obviously means "bold, revert, leave the regular editors of the article puzzled about what he might be objecting to and why". It's just a technique for producing maximal chaos at an article with minimal effort.

NODEADLINE refers to imperfections in article space. It doesn't say that you can hold up editors who are doing content work on an article by putting unreasonably long intervals between the BR and the D of BRD. And the point of Ludwigs2's comment was probably not that it's taking too long but that there is a reasonable expectation that OM is not going to get to the D step at all. Which is why it was perfectly proper to revert him. Hans Adler 06:33, 2 May 2011 (UTC)

You can't use one persons bad behaviour to justify the fact that there was little attempt to argue the changes here on the talk page. As it is its going to be a good hours work to go through the changes and comment. The example given above is cherry picking the least controversial change. Given that its unreasonable to start demanding responses within two hours --Snowded ^TALK 06:42, 2 May 2011 (UTC)

This section is about L2's attempt to draw OM into discussion. It's not cherry picked, it's the $%^ first sentence of the lead.

It's predictable that OM won't bite because it's (almost?) unprecedented that OM engages in discussion at one of his revert-only articles. But I don't see why we need this meta-discussion here in the meantime. For all I know your own content concerns may well be valid. Find out what they are, express them, and start a fresh section.

This all started with disruptive behaviour by OM (5 unexplained reverts in 24 hours, not acceptable by any standard, with not remotely comparable behaviour on the other side), and you jumping in essentially just supporting OM uncritically. Now it's your turn to stop supporting OM's pure stone walling and take this into a constructive direction. Hans Adler 06:56, 2 May 2011 (UTC)

The first line is minor, the substantive changes were elsewhere so it is cherry picking. The ne content has all being placed there by Ludwig and one other (and now reverted by you) rather than leaving the previous stable version in place while a discussion takes place. Rather than edit warring after the reversal the case should have been made on the talk page. If after a few days no one objected then the case would have been stronger. However we have a edit war flurry over a day so neither side really comes out well here. Now we have forum shopping on top. I am now going to bed, and I have a very long couple of days on my feet with flights and late night arrivals. I will go through this as a content issue if another editor does not do it first however, but it may take a few days. --Snowded ^TALK 07:04, 2 May 2011 (UTC)

Maybe you will understand things better tomorrow. A 3RR report for 5 reverts in 24 hours, with no content discussion and no history of constructive work on the article, cannot possibly be forum shopping unless an admin is already dealing with the problem.

The first sentence of an article is the most important. This is the one position that most edit wars are about, and there was a substantial change there. If OM is fine with that change, nothing objectively prevents him from saying so. Even saying it in a nasty way would have advanced the discussion. But he has just run away. Hans Adler 07:13, 2 May 2011 (UTC)

@ Snowded: as far as I'm concerned what I did was inconsequential copyediting. You throw around words like 'controversial changes' and 'attempts to reduce scientific criticism' but I have no idea what you are referring to and you're not explaining it. I told you above precisely what I was trying to do (see the three bullet points above). So note well: You have a problem with this edit; I don't. You need to express what your problem is - in words - so that we can address it properly. If you cannot express what your problem is in words, then how can we possibly credit your problem as being valid? wp:IDONTLIKEIT is not a valid argument.

and 'cherry-picking' refers to quoting sources, not discussing content. If you're not averse to this particular change, just say so and we'll move on to the next. easy as sinning, if not as much fun. --Ludwigs2 07:36, 2 May 2011 (UTC)

@ LeadSongDog: the fact that there's no deadline doesn't mean that we can't assert a new consensus has been formed. we have the opportunity to discuss any objections now, which is great if that's what you want to do. If you choose not to raise or discuss objections at this point, then you can certainly raise them at some later point (because there's NODEADLINE), but in the meantime we will take this new revision as the new consensus. As far as I can see it was a reasonable edit that I am more than willing to discuss and explain; you need to tell me what you see wrong with it.

I understand the 'temporizing' tactic - block changes to the article, toss out a few vague policy worries in talk, refuse to explain much of anything all the while accusing everyone else of haste and impropriety, and then sit on your heels and temporize in the hopes the issue will melt away without further ado. It's a common enough tactic on wikipedia, and not necessarily an unreasonable approach in many cases, though it is a bit on the passive-agressive side (particularly when used against reasonable editors). Just be aware that this is not the first time that I've had to address this particular tactic on project - not by far - and it certainly won't be the last. If this is the approach to be used here, then I will take it as an opportunity for practice and experimentation; it's good to have the chance to discover more reasonable, civil, and effective approaches to dealing with it. --Ludwigs2 07:36, 2 May 2011 (UTC)

For all this talk of how OM is dodging discussion, has anyone actually tried contacting him to let him know there's a discussion taking place? Apparently not, so I have. I get that editing can get tense around here sometimes, but all this talking about a specific editor on an article talk page when he's not even involved in the discussion is a little out of line. Watchlists get clogged up sometimes, and I very often find myself reverting changes with which I disagree and not seeing the subsequent discussion until a bit later. If there are specific complains with a specific editor, they should be taken to their talk page, not here. As for the article changes, I'll lodge my disagreement with the provided diff as well. The previous version properly contextualized Acupuncture as variously claiming efficacy in a broad range of areas, for which there isn't currently scientific support. The new proposal reduces that weight substantially, further adding undue weight to the concept that Acupuncture is effective for some treatments. This doesn't properly reflect the article, or the weight of the sources. The previous version needs work, but this largely isn't a step in the right direction.   — Jess· Δ♥ 15:58, 3 May 2011 (UTC)

Mann_jess: OM made five (5) reverts in one day, and has seen fit to make multiple comments here on my putative POV, logical fallacies, personal character, and etc. It's safe to assume that he's following the conversation and choosing not to participate for unknown reasons. I applaud your adherence to AGF, but will suggest kindly that the principle should generally not be extended to the point where one has to ignore a whole range of behavior in order to make it make sense.

With respect to your substantive comments... This is an article about acupuncture, not an article about the scientific criticism of acupuncture. while I agree that the scientific criticism needs to be there, we do not need to pack the lead with multiple separate claims about the same weakness; one line is sufficient for framing, and we can draw out the specifics in the body more extensively as appropriate. Please remember that it is not the purpose of wikipedia to make an argument that acupuncture is flawed. We simply describe acupuncture, including its flaws and critiques, in a way that makes the subject clear to readers. Filling out the lead with excessive critiques is an effort to make an argument; balance is needed. right? --Ludwigs2 17:56, 3 May 2011 (UTC)

Criticisms of an editor should still be kept on the editor's talk page (or a noticeboard). Having a whole section practically devoted to that editor, particularly when he isn't even participating, isn't what article talk pages are intended for. Regarding content: I agree fully that the article shouldn't focus on criticism, and I'm not claiming anything of the sort. I'm simply objecting on the grounds that the new revision doesn't properly convey the scientific standing of acupuncture on the claims being made. The last version did that, so while it may have had problems, this revision is still not forward progress.   — Jess· Δ♥ 18:37, 3 May 2011 (UTC)

I think it's generally accepted that normally a lead should have no more than 3 paragraphs. (Ludwigs2 reduced the number of paragraphs from 4 to 3.) How many of these 3 paragraphs need to say that acupuncture doesn't work all that well? This is a serious question, and I expect a number as an answer. Hans Adler 19:09, 3 May 2011 (UTC)

Jess, cool, I'm actually glad to hear you say that abut "Criticisms of an editor should still be kept on the editor's talk page (or a noticeboard)". could you please take a look at these diffs - [20], [21], [22], [23], [24] - and remind Orangemarlin of this principle? That's just the ones from the last few days, excluding the edit summaries on his article page reversions; I can find more, if you like. And yes, I do actually expect to see you remind him, otherwise your comments to us here lose whatever moral authority they might have. --Ludwigs2 20:13, 3 May 2011 (UTC)

@Ludwigs, the argument "he did it first" isn't a good one. I'm in no way lodging support for OM's editing. I'm simply saying that, as you and Hans are experienced editors, you should adhere to policy regarding article talk pages, namely by keeping discussion of other editors on their talk page or a noticeboard. Your irritation at OM in this thread appeared to be that he wasn't participating, so reminding him to stay on topic in a conversation he's not a part of seems a little silly. That said, consider this a reminder for him too, since it equally applies to everyone.

@Hans There's no one number which answers that question absent discussion of actual content (and along side a decent proposal). Again, I've made it clear that 1) I don't think the article should be driven by criticism, and 2) the previous version needs work. The answer to your question is "however many is necessary to describe the criticism well". I imagine that would probably be one or less, but it needs to be done well, and the current proposal doesn't. I'm objecting on those grounds. Weight was removed from criticism and added to efficacy for nausea. That doesn't reflect the article or the sources properly.   — Jess· Δ♥ 20:37, 3 May 2011 (UTC)

Jess, I wasn't using a he did it first argument - I was suggesting that you be equal and fair in your condemnation of he practice. But let me point out that you and I talking about each other isn't productive either, so let's drop this.

With respect to your disagreement. I actually welcome disagreement and discussion. I don't welcome a "let's go back to square one" approach. Overall the writing in my version is an improvement. if you think I've gone too far in organizing the material, then you're welcome to suggest new adjustments, but neither you nor anyone else has given a pressing rationale for blanket reversion. what criticism do you want to add to the criticism that's already in the article that you think is important? --Ludwigs2 21:50, 3 May 2011 (UTC)

Jess, it's very difficult to edit here with Ludwigs' constant personal attacks. It makes for a very troubling and hostile editing environment. I'm assuming that Ludwigs will get his 15th block sooner or later, which will make this area much more civil and prone to agreement. I thought Ludwigs was on a fringe article restriction? If not, I'd rather work on articles with a more collegial environment. I'm not sure why he hasn't been blocked for all of his hounding of me and of his constant personal attacks. OrangeMarlin ^{Talk• Contributions} 22:50, 3 May 2011 (UTC)

@ Jess: so much for idealism... --Ludwigs2 23:04, 3 May 2011 (UTC)

I can't take these personal attacks from Ludwigs. It's clear he hasn't learned anything from his prior 14 blocks. OrangeMarlin ^{Talk• Contributions} 23:21, 3 May 2011 (UTC)

Apparently you haven't learned anything from your prior 6 blocks, either. Hans Adler 23:36, 3 May 2011 (UTC)

He has a few problems with basic math, as well - only about half of those items are block entries, the rest are unblock entries. I've wracked up a number of 20 minute deals, where someone makes a hasty block and it gets quickly overturned. but it's no never mind. stuff like this is so obvious it's actually kind of funny. --Ludwigs2 00:31, 4 May 2011 (UTC)

Guys, take this to talk. If anyone has an issue with another editor's behavior, it should be handled on a noticeboard. We now have multiple sections devoted to attacking others. That's not ok. No response to this is needed... just concentrate on article improvement from here on out, please. Thanks.   — Jess· Δ♥ 00:48, 4 May 2011 (UTC)

Comment from a non-editor Although I do not edit articles of this kind, I requested that the article be fully protected for a short period while the disputed changes to the lede were discussed. The whole form of the lede was changed in a single edit, described as a "copy-edit". Given that, discussing such major changes sentence by sentence does not seem to be a helpful way to move forward. My suggestion is that the previous lede be restored and that arguments for the proposed new lede should be presented and discussed here (per WP:BRD). Thanks, Mathsci (talk) 08:16, 4 May 2011 (UTC)

Now that we have entered actual discussions about the content (for the record: OrangeMarlin has so far not been involved in this at all), I support this proposal undere the optimistic assumption that there will be an actual constructive discussion rather than all the sceptics running away because it's been reverted back to a version in which a third of the lead is made up by the following and blocking any improvements ensures that it stays that way:

Template:Blockquotetop Acupuncture being effective beyond the placebo effect has never been proven, except some pain relieving applications, though the latter results are somewhat inconsistent as well.

[...] and there is no anatomical or scientific evidence for the existence of qi or meridians; concepts central to acupuncture theory.

The evidence for acupuncture's effectiveness for anything but the relief of some types of pain and nausea has not been established. Systematic reviews have concluded that acupuncture is no more effective than nonpenetrating stimulation of one point to reduce some types of nausea. Evidence for the treatment of other conditions is equivocal. Although evidence exists for a very small and short-lived effect on some types of pain, several review articles discussing the effectiveness of acupuncture have concluded it is possible to explain this as a placebo effect.

A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including 38 cases of infection, 42 cases of trauma and 5 cases of death. The authors considered the adverse events to be statistically significant. Publication bias is a significant concern when evaluating the literature. Template:Blockquotebottom

In case someone still doesn't see the problem, while every single sentence is probably correct, a large part of this is not the kind of high-level summarising that we normally expect in a lead. There is some obvious redundancy, such as the first and third sentence saying almost exactly the same thing. I am not seeing this phenomenon for the first time; it appears to be caused by a perceived necessity that every single lead paragraph debunks the subject of the article to some extent, and that at least one paragraph is fully devoted to debunking the subject. Of course this technique of hitting the reader with 16 ton weight right at the start ensures that (1) they stop reading, and (2) if for whatever reason they do continue reading, they take everything negative said in the article about acupuncture with a pound of salt. Unless they are already subscribed to the Skeptical Inquirer and are used to this amateur debunking style.

As a very minor observation, the previous version of the lead had "that treats patients by insertion and manipulation of needles" in the first sentence. At homeopathy there was once extreme opposition against using "treat" in this non-technical sense. Having seen Middle8 use the word in its technical sense of treating effectively, I am now more inclined to believe that this is a legitimate point. Ludwigs2's edit solved this problem. Hans Adler 08:47, 4 May 2011 (UTC)

It might be a good idea to start a new section, putting the two ledes side by side (in a template as above) and then making comments on their various merits and demerits. Mathsci (talk) 08:54, 4 May 2011 (UTC)

Mathsci:

1. Can you document where you made this request? it's not at the edit-warring thread I opened.
2. It was a copy edit and rewrite for clarification (as I explicitly said), and no one has pointed out anything actually problematic with the revision (it's all vague, unsubstantiated worries about POVitude).
3. Given what's happened at the page in the last few days, I suggest that any attempt to undo the revision again without thorough talk page discussion can be viewed as an effort to resume edit warring on the page, and I will treat it as such. It's not going to harm anything for the version of the page you dislike to remain in place for a few days while you explain (clearly and succinctly) why you dislike it.

That being said, I will set up the side-by-side comparison you asked for below, in a separate section. --Ludwigs2 17:24, 4 May 2011 (UTC)

The request was here.[25] It resulted in the article page being fully protected. Template:Nono Mathsci (talk) 21:28, 4 May 2011 (UTC)

I second MathSci's proposal. This is in accord with WP:BRD, and is how this dispute should be handled. The appropriate route is not to "keep the new proposal until there's consensus to revert it", it's to revert the proposal and discuss the reason to add it. Once again, if there are issues with an individual editor being disruptive, that's no reason to treat all objections from other editors as disruptive as well. I raised valid concerns above regarding weight which must be addressed. Regarding Hans' comment, I agree that we should avoid using "treat" in the previous first sentence, and as such, I'm in agreement with the first sentence change. That said, the entire "copy edit" change should be undone, with individual changes applied which are either non-contentious or with consensus support. Policy is BRD, not "BDR".   — Jess· Δ♥ 17:41, 4 May 2011 (UTC)

Jess, nothing needs to be or should be undone until the issue is discussed. --Ludwigs2 23:30, 4 May 2011 (UTC)

I disagree, and per the support here and in the variety of editors initially reverting, I think it's reasonable to adhere to the BRD cycle. I've reverted to the stable version on those grounds. We can discuss individual changes here, and incorporate those as consensus allows. Thanks.   — Jess· Δ♥ 23:49, 4 May 2011 (UTC)

and I'm reverting back, because no valid reason has yet been given in talk for reverting the material. --Ludwigs2 00:59, 5 May 2011 (UTC)

Ludwigs, you've been reverted by myself, Orangemarlin and Snowded, and restoration of the previous version has been supported on this talk page by myself, MathSci, Hans Adler, and LSD (below). I see no one besides yourself supporting your proposal stay while the issue is discussed. Furthermore, guideline dictates that the proposal be reverted followed by discussion, not the other way around. Per policy, and consensus support, I'm going to revert to the stable version again. This is the last time I'll do this. Considering your 9 blocks (5 for edit warring), I'd highly suggest working collaboratively rather than combatively on this issue, and avoid edit warring until consensus for the inclusion of your proposal is reached. If you continue to institute your version against consensus, I will take the issue to AN3. Furthermore, your assertion that "no valid reason has been given" is incorrect, as multiple editors have lodged objections, myself included. I'd very much appreciate if you worked with other editors, rather than against them, on this issue. All the best,   — Jess· Δ♥ 01:38, 5 May 2011 (UTC)

side-by-side comparison of ledes

old version

revised version

Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body. Its proponents variously claim that it relieves pain, treats infertility, treats disease, prevents disease, promotes general health, or can be used for therapeutic purposes. Acupuncture being effective beyond the placebo effect has never been proven, except some pain relieving applications, though the latter results are somewhat inconsistent as well. Acupuncture typically incorporates traditional Chinese medicine as an integral part of its practice and theory. However, many practitioners consider 'Traditional Chinese Medicine' (TCM) to narrowly refer to modern mainland Chinese practice. Acupuncture in Japan and Korea, and to a certain extent Taiwan, diverged from mainland China in theory and practice. In European countries such as the UK almost half the practitioners follow these non-TCM practices. The most notable difference is that these other approaches often are primarily acupuncture, and do not incorporate Chinese herbal medicine. The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in acupuncture points. Acupuncture dates back to prehistoric times, with written records from the second century BCE. Different variations of acupuncture are practiced and taught throughout the world. Ideas of what constitutes health and healing differ from concepts used in modern scientific, evidence based medicine. Traditional acupuncture was developed prior to the understanding of human anatomy and cell theory upon which modern biology is based, and there is no anatomical or scientific evidence for the existence of qi or meridians; concepts central to acupuncture theory. The evidence for acupuncture's effectiveness for anything but the relief of some types of pain and nausea has not been established. Systematic reviews have concluded that acupuncture is no more effective than nonpenetrating stimulation of one point to reduce some types of nausea. Evidence for the treatment of other conditions is equivocal. Although evidence exists for a very small and short-lived effect on some types of pain, several review articles discussing the effectiveness of acupuncture have concluded it is possible to explain this as a placebo effect. A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including death. Publication bias is a significant concern when evaluating the literature. Reports from the US National Center for Complementary and Alternative Medicine In America (NCCAM), the American Medical Association (AMA) and various US government reports have studied and commented on the efficacy of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles.

Acupuncture is an alternative medicine in which thin needles are inserted into the skin and manipulated in various ways, ostensibly to influence the patient's qi for therapeutic benefit. It is closely related to Traditional Chinese Medicine (TCM), sharing the same core philosophy and often being used in combination with TCM herbal preparations, but many acupuncturists construe TCM narrowly as the modern mainland Chinese practice and see acupuncture as a distinct concept, particularly in Korea, Japan, Taiwan, and prominent European practices derived from those, where acupuncture has diverged significantly from Chinese theory and practice. The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in acupuncture points. Acupuncture dates back to prehistoric times, with written records from the second century BCE. Different variations of acupuncture are practiced and taught throughout the world. Traditional acupuncture was developed prior to and independently of western advances in medicine and is based on a different conception of the human body. Many of its presuppositions - such as qi or meridians - have no identifiable correlates in western medicine, and even its conceptions of bodily organs is different, treating them as interrelated systems rather than discrete objects in the body. Acupuncture is a general system of medicine which claims to address a broad range of physical concerns. It may be used by practitioners as a tool to promote general health, for relief of symptoms, or for therapeutic purposes. Acupuncture's effectiveness for anything beyond the relief of some types of pain and nausea has not been established, and its effectiveness with pain is often cast as a placebo effect. A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including 38 cases of infection, 42 cases of trauma and 5 cases of death. The authors considered the adverse events to be statistically significant. Publication bias is a significant concern when evaluating the literature. Reports from the US National Center for Complementary and Alternative Medicine In America (NCCAM), the American Medical Association (AMA) and various US government reports have studied and commented on the efficacy of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles.

the revised version isn't missing anything significant, is better written and more focused, and more clearly describes both the practice and the critiques of acupuncture? Can anyone point to specific problems or general trends in it that are troubling?

Note further that I didn't actually get to the last paragraph (before the edit warring started, but it will have to be revised as well. The revision I intend to make there is this:

current version of last paragraph

intended revision

A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy and accompanied by serious risks and adverse effects, including 38 cases of infection, 42 cases of trauma and 5 cases of death. The authors considered the adverse events to be statistically significant. Publication bias is a significant concern when evaluating the literature. Reports from the US National Center for Complementary and Alternative Medicine In America (NCCAM), the American Medical Association (AMA) and various US government reports have studied and commented on the efficacy of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles.

A 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles.

This does the following:

• removes numerical referents that have no statistical baseline, as discussed above.
• removes a comment about 'statistical significance' which is statistically meaningless as written
• removes an off-topic statement about publication bias (probably true in general, but not specific enough to acupuncture to appear in the lead)
• removes a vague statement that various organizations have 'studied and commented on' acupuncture (the line adds nothing meaningful that I can see).

are any of these changes problematic? --Ludwigs2 17:43, 4 May 2011 (UTC)

Clearly the latter change, which whitewashes the discussion of the adverse effects, will not fly. The existence of those effects can easily be cited to high quality review sources, e.g. PMID 21440191. For editors who are interested, the historic inconsistency in reporting adverse events is discussed at PMID 20026952, though I don't suggest that discussion belongs in the lede. The point is that asserting the absence based on analysis of old data is not diligent. LeadSongDog come howl! 18:59, 4 May 2011 (UTC)

I'm sorry, I'm not sure what you're referring to by 'whitewashing'. I explained quite clearly why I removed the bits I did, and all the explanations had to do with sourcing and relevance issues. any of these points might be redeemable with better sourcing or clearer explanation, but as they stand they are senseless and irrelevant to the topic. Just to take the first point (which is what you linked to) - 95 cases of severe adverse effects out of what number examined? 95 cases out of 100 would be horrific; 95 cases out of 1000 would be bad; 95 cases out of a million would not be worth mentioning.

LSD, the problem you're having is that you're pointing to abstracts rather than articles. you need to go to the actual article to substantiate this claim, because the abstract does not present a clear picture of what the authors were doing. find a copy of the article that we can all see, so that we can examine the study properly, or face the fact that we need to limit how we reference this study in order not to misrepresent it. --Ludwigs2 20:52, 4 May 2011 (UTC)

I agree with LSD, and oppose the proposal to the last section. However, I do think the sentence quoting specific numbers can be omitted. Citing so much from this individual study in the lead doesn't properly summarize the weight of the study presented in the article, and Ludwigs is correct about the statistical significance, at least in part; Saying "the authors found it to be significant" is okay, per se, but unnecessary. I do think a list of adverse effects in the lead is warranted, but perhaps we could sum up those effects as a list with no numbers, instead combining all the reports from various studies we're already presenting within the article.   — Jess· Δ♥ 00:07, 5 May 2011 (UTC)

You agree with LSD on what? Neither of you has said anything meaningful enough to agree with.

Also, 'significance' has a particular meaning in statistics, and it should never, never be confused with the colloquial meaning of he word (it means 'likely not due to random chance', not 'meaningful and important'). we cannot simple state 'the authors claim it was significant' without clarifying which of those meanings is being used. --Ludwigs2 00:58, 5 May 2011 (UTC)

I've reread both LSD's and my response, and I'm having trouble understanding your confusion. Both seem to be fairly clear. Perhaps I can summarize them in a different way. LSD is saying that your proposal removes the list of adverse effects from the lead, which is unwarranted given that they can be cited to high quality sources. I agree that this is unjustified, given that the sources are present and that the information is being presented in the article, and is pertinent to be summarized within the lead. Furthermore, I provided an alternate suggestion, taking into account your concerns, suggesting that the numbers and statement of significance should be removed as they are unnecessary and provide undue weight to a single study. In other words, I object to the proposal on a high level, but I think the individual concerns might be addressed through alternate changes. All the best,   — Jess· Δ♥ 01:55, 5 May 2011 (UTC)