Wikipedia talk:Identifying reliable sources (medicine)
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![]() | Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Identifying reliable sources (medicine).
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![]() | To discuss reliability of specific sources, please go to Wikipedia:Reliable sources/Noticeboard or to the talk pages of WikiProject Medicine or WikiProject Pharmacology. |
These are some Frequently Asked Questions about Wikipedia's guidelines on sourcing for medical content, manual of style for medicine-related articles, and how the guidelines and policies apply to biomedical content.
Primary sources aren't completely banned, but they should only be used in rare situations. An individual primary source may be flawed, such as being a clinical trial that uses too few volunteers. There have been cases where primary sources have been outright fraudulent. Furthermore, a single primary source may produce a different result to what multiple other primary sources suggest, even if it is a high-quality clinical trial. Secondary sources serve two purposes: they combine the results of all relevant primary sources and they filter out primary sources that are unreliable. Secondary sources are not infallible, but they have less room for error than a primary source. This follows a principle that guides the whole of Wikipedia. If a company announces a notable new product, Wikipedia would not cite a press release on the company's website (a primary source) but instead would cite a newspaper article that covers it (a secondary source). The difference with medical information is that the popular press are not suitable sources. Whenever possible, you should cite a secondary source such as:
Primary sources might be useful in these common situations:
The popular press includes many media outlets which are acceptable sources for factual information about current events, sometimes with significant caveats. It also includes media outlets which are discouraged in all cases because the quality of their journalism is inadequate. However, even high-quality media outlets have disadvantages in the context of medicine. Firstly, news articles on medicine will frequently be reporting a new medical primary source, such as the results of a new study. This means that they are effectively acting as a primary source, which as explained above makes those articles generally unsuitable for medical information. These articles also tend to omit important information about the study. If a medical primary source is to be cited at all, the academic paper should be cited directly. Secondly, media coverage of medical topics is often sensationalist. They tend to favor new, dramatic or interesting stories over predictable ones, even though studies that reflect the current scientific consensus tend to be predictable results. They tend to overemphasize the certainty of any result, such as reporting a study result as a conclusive "discovery" before it has been peer-reviewed or tested by other scientists. They may also exaggerate its significance; for instance, presenting a new and experimental treatment as "the cure" for a disease or an every-day substance as "the cause" of a disease. The sensationalism affects both which stories they choose to cover and the content of their coverage. High-quality media outlets can be good sources of non-medical information in an article about a medical topic. Another acceptable use is using a popular press article to give a plain English summary of an academic paper (use the
When fringe claims have been widely reported in the press, have a large popular following, and/or have a long history, it may be appropriate to describe them in terms of that reporting, popularity, or history. However, weight should be determined by MEDRS-compliant sources, and the context (or lack thereof) should not make implications about medical statements that are not supported by such sources. Guidance on the additional considerations relevant to fringe subjects can be found at WP:FRINGE, as well as at other places such as WP:WEIGHT and WP:EXCEPTIONAL. In the case of alternative medicine, medical statements are often derived from an underlying belief system, which will include many propositions that are not subject to MEDRS. These propositions are subject to the usual sourcing requirements and the usual requirements for determining fringe status. There are three possible situations:
In the first case, we cannot say that it does not work, but we can say that there is no evidence to determine whether it works. After multiple, high-quality independent studies have been published, the understanding may transition from "no evidence" to "some evidence" of either an effect or no effect. You should follow the lead of review articles and other secondary sources for determining when this threshold has been crossed. Reports may conflict with each other. For example, a clinical trial may produce no evidence of an effect, but the treatment's manufacturer might produce testimonials claiming a positive effect. You should follow the lead of review articles and other secondary sources for determining how to balance these claims. In other words, is it necessary to say in the article's text the source which supports a medical statement (with attribution)? Or can it simply be stated as an unchallenged fact, with the source only mentioned in the citation (without attribution)? A statement without attribution will come across as being a stronger claim than one with attribution. A result or statement from a reliable secondary source should be included without attribution if it is not disputed by any other recent secondary sources. You should do a search to check that the secondary source you are citing is the most up-to-date assessment of the topic. If there have been two recent secondary sources that contradict each other, then you should attribute the disputed findings. On the other hand, if the findings of one or more recent secondary sources are disputed by one or more secondary sources from many years ago, but not by any recent ones, the recent findings can be stated without attribution. You should also take into account the relative weight secondary sources have. For example, Cochrane Collaboration reviews provide stronger evidence than a regular secondary source. When you are discussing the history of how knowledge on a medical topic has developed and changed, you should state findings from secondary sources with attribution, even if they are now undisputed. In the rare cases where primary sources can be used, they should be attributed.
Full, searchable list of all tutorials - training materials in HTML, PDF and Video formats YouTube channel for the National Library of Medicine: Tutorial videos from the National Center for Biotechnology Information (NCBI), part of the U.S. National Library of Medicine. Includes presentations and tutorials about NCBI biomolecular and biomedical literature databases and tools. NLM Catalog Help - This book contains information on the NLM Catalog, a database which provides access to NLM bibliographic data for journals, books, audiovisuals, computer software, electronic resources, and other materials via the National Center for Biotechnology Information (NCBI) Entrez retrieval system. The NLM Catalog includes links to full text materials and the library's holdings in LocatorPlus, NLM's online public access catalog. NLM Catalog (rev. December 19, 2019). For full comprehensive instructions, go to: Searching for Journals in NLM Catalog If you know the full or abbreviated name for a journal, and you want to see if it is indexed in MEDLINE, see the instructions at searching by journal title, which I will also reproduce here:
Via a search of the NLM Catalog: List of Abridged Index Medicus journals, also known as "Core clinical journals". Stand alone list: List of current Abridged Index Medicus (AIM) journals (118 journals as of 5 May 2020) Search the NLM Catalog using ====Create a list of all journals indexed in MEDLINE}}
Search the NLM Catalog using MEDLINE, PubMed, and PMC (PubMed Central): How are they different? Most scholarly journals are behind paywalls. Some options to access these articles include visiting a local university library, visiting The Wikipedia Library, and WikiProject Resource Requests. Note that paywalled articles are frequently pirated and made available on the open web. When linking to a journal article, care must be taken not to link to such a pirate copy, as such a link would be a copyright violating link in contravention of Wikipedia's policy. In general if you find such a copy and it is not accompanied by text explicitly stating that it is made available with the permission of the copyright holder, assume that it is potentially infringing, and do not link to it. This holds for all edits in Wikipedia, not just in article space. Search for the title of the article on Google Scholar. On the results page, click on "All n versions" (where n = the number of available versions of that article) at the bottom of a listing. The resulting page might contain PDF or HTML versions of the article. Consult Unpaywall.org for journal articles available without a subscription. Install the UnPaywall extension for Chrome or Firefox to immediately identify articles with a free version. After you install the extension, look to the right side of the page (when you are on the website for an article) for either a grey locked symbol (no free version) or a green unlocked symbol (click on that symbol to access the full text version of the article). An article by librarian John Mark Ockerbloom, titled, "Why Pay for What’s Free? Finding Open Access and Public Domain Articles" offers helpful suggestions.[9] Almost all medical articles are indexed by the PubMed search engine and have a Digital object identifier (DOI) assigned to them. All articles included in PubMed are assigned an eight-digit PubMed identifier (PMID). These identifiers can be used to refer to articles, which is preferred to URLs as it makes a reliable link which is resilient to changes beyond our control – i.e. the publisher being acquired by another publisher and it's "normal" web URLs changing as a consequence. Once you have the PMID, there are a number of tools such as this one which you can use to generate a full citation automatically. In article references, the "doi" and "pmid" parameters are preferred to the "url" parameter for such reasons. On Talk pages, when referring to journal articles, is it good practice to make any link using these types of identifier also:
References
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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)
- @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)
- Best would be to use the correct pyramid in MEDASSESS. sbelknap (talk) 17:09, 22 February 2023 (UTC)
- 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)
- Best would be to use the correct pyramid in MEDASSESS. sbelknap (talk) 17:09, 22 February 2023 (UTC)
- 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).
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)
References
- ^ 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.
- ^ "Evidence-Based Decision Making: Introduction and Formulating Good Clinical Questions | Continuing Education Course | dentalcare.com Course Pages | DentalCare.com". www.dentalcare.com. Retrieved 2015-09-03.
- ^ "The Journey of Research - Levels of Evidence | CAPhO". www.capho.org. 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)
- 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)
- Wikipedia essays about reliable sources
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