Wikipedia talk:Identifying reliable sources (medicine)

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Deprecated hierarchy of evidence[edit]

The inline text acknowledges that the figure on the left at WP:MEDASSESS in this article has been deprecated and that the source now presents a pyramid that differs in important ways from the one in the figure. Would it be possible for somebody to clean this up? (Deleting the left figure would be the simplest fix.) sbelknap (talk) 13:05, 28 December 2022 (UTC)Reply[reply]

@Sbelknap, I have been wondering whether the whole "hierarchy of evidence" explanation in MEDASSESS could be (mostly) replaced with a link to a relevant Wikipedia articles. I'd be happy to see both pyramids removed. WhatamIdoing (talk) 03:32, 22 February 2023 (UTC)Reply[reply]
Best would be to use the correct pyramid in MEDASSESS. sbelknap (talk) 17:09, 22 February 2023 (UTC)Reply[reply]
I thought that the point that was being made is that there isn't just one correct way to evaluate evidence. It would be strange to say that there are different ways to rank levels of evidence in medicine, but they have some similarities, and then provide a picture of the One True™ Way to Rank Evidence. WhatamIdoing (talk) 06:35, 23 February 2023 (UTC)Reply[reply]
This is a valid point. Using more than one pyramid to reflect the various ones in use seems OK to me. The text needs changes then to make this point more clearly. sbelknap (talk) 03:35, 1 March 2023 (UTC)Reply[reply]
Well, maybe this would work better?

Assess evidence quality

When editors are writing about treatment efficacy, epidemiology, survival rates, and similar subjects, evidence quality helps editors distinguish between minor and major views, determine due weight, and identify accepted information. Even within the same journal, different types of papers should not be given equal weight. Research studies can be categorized into different levels of evidence.[1] There are multiple accepted models for ranking evidence levels, but they all rank sources that combine the results of multiple research studies higher than other types of sources.

Wikipedia editors should rely on sources that offer higher levels of evidence, such as systematic reviews, meta-analyses of randomized controlled trials, narrative reviews, medical guidelines, and position statements by internationally or nationally recognized expert bodies (see WP:MEDORG).

Canadian Association of Pharmacy in Oncology[3]
There are several ways to rank levels of evidence in medicine, but they all put review articles and practice guidelines at the top.

Sources that present lower levels of evidence or non-evidence should be avoided. Lower levels of evidence in medical research come from primary sources (see WP:MEDDEF). Roughly in descending order, these include: individual randomized controlled trials; quasi-experimental studies; prospective observational (non-experimental) studies, such as prospective cohort studies (one type of longitudinal study); case control studies; cross-sectional studies (surveys), and other correlation studies such as ecological studies; case reports, other retrospective analyses (including retrospective cohort studies); and non-evidence-based expert opinion, clinical experience, or conventional wisdom.

Speculative proposals and early-stage research should not be cited to imply wide acceptance. For example, results of an early-stage clinical trial would not be appropriate in the 'Treatment' section of a typical disease article, because possible future treatments have little bearing on current practice. The results might, in some cases, be appropriate for inclusion in an article specifically dedicated to an experimental drug or procedure in question, or to the researchers or businesses involved in it. Such information, particularly if analyzed by secondary sources, may be appropriate in research sections of disease articles. To prevent misunderstanding, the text should clearly identify the level of research cited (e.g., "first-in-human safety testing").

Note: Editors should not perform detailed academic peer review. "Assess evidence quality" means that Wikipedia editors should identify and use the appropriate type of source and quality of publication for the subject at hand. Do not reject a higher-level source (e.g., a meta-analysis) in favor of a lower one (e.g., any primary source) because of personal objections to the inclusion criteria, references, funding sources, or conclusions in the higher-level source.

I'm not sure that the paragraph about speculative proposals is strictly necessary.
I wonder if it needs a statement that the goal is to use the best evidence that exists (assuming evidence is a relevant quality; it's irrelevant for things like "What's this body part called?"), and if there aren't any review articles about some super-rare disease, then it's okay to use the best that you've got. WhatamIdoing (talk) 00:13, 23 March 2023 (UTC)Reply[reply]


  1. ^ Wright JG (May 2007). "A practical guide to assigning levels of evidence". The Journal of Bone and Joint Surgery. American Volume. 89 (5): 1128–30. doi:10.2106/JBJS.F.01380. PMID 17473152.
  2. ^ "Evidence-Based Decision Making: Introduction and Formulating Good Clinical Questions | Continuing Education Course | Course Pages |". Retrieved 2015-09-03.
  3. ^ "The Journey of Research - Levels of Evidence | CAPhO". Archived from the original on 21 February 2016. Retrieved 2015-09-03.

The Lancet[edit]

This is about [1]. It might sound funny, but The Lancet has less draconian editorial standards than Wikipedia. E.g. WP:PRIMARY medical studies are allowed to make medical claims. tgeorgescu (talk) 03:33, 23 April 2023 (UTC)Reply[reply]

I don't think that's quite true. The Lancet has different standards, but not necessarily lower ones. WhatamIdoing (talk) 23:31, 23 April 2023 (UTC)Reply[reply]