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:::::7 out of 9 shoddy studies with poor methodologies. Would you accept a chemotherapy treatment, blood thinner or antibiotic with a similar evidence base? I wouldn't. Multiple reverts from multiple editors suggest nor would others. [[User:WLU|WLU]] <small>[[User talk:WLU|(t)]] [[Special:Contributions/WLU|(c)]] Wikipedia's rules:</small>[[WP:SIMPLE|<sup><span style='color:#FFA500'>simple</span></sup>]]/[[WP:POL|<sub><span style='color:#008080'>complex</span></sub>]] 16:40, 1 February 2012 (UTC) |
:::::7 out of 9 shoddy studies with poor methodologies. Would you accept a chemotherapy treatment, blood thinner or antibiotic with a similar evidence base? I wouldn't. Multiple reverts from multiple editors suggest nor would others. [[User:WLU|WLU]] <small>[[User talk:WLU|(t)]] [[Special:Contributions/WLU|(c)]] Wikipedia's rules:</small>[[WP:SIMPLE|<sup><span style='color:#FFA500'>simple</span></sup>]]/[[WP:POL|<sub><span style='color:#008080'>complex</span></sub>]] 16:40, 1 February 2012 (UTC) |
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Poor comparisons- acupuncture does not carry nearly the same risk, nor does it claim the same effects. But that's irrelevant to the question of whether or not we can include carefully qualified statements about research from primary sources in a field of research that is not well-covered. To give an accurate picture of the current scientific understanding of acupuncture, I think we should include primary sources as long as proper context is given. To only include the conclusion of the only systematic review of the very few studies of this kind gives the illusion of certainty of lack of "existence" due to the lack of context.[[User:Herbxue|Herbxue]] ([[User talk:Herbxue|talk]]) 16:20, 2 February 2012 (UTC) |
Poor comparisons- acupuncture does not carry nearly the same risk, nor does it claim the same effects. But that's irrelevant to the question of whether or not we can include carefully qualified statements about research from primary sources in a field of research that is not well-covered. To give an accurate picture of the current scientific understanding of acupuncture, I think we should include primary sources as long as proper context is given. To only include the conclusion of the only systematic review of the very few studies of this kind gives the illusion of certainty of lack of "existence" due to the lack of context.[[User:Herbxue|Herbxue]] ([[User talk:Herbxue|talk]]) 16:20, 2 February 2012 (UTC) |
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:The Ahn et al (2008) review INCLUDES the Lee et al (2003) paper among its references. You know what that means? It means that they've already looked at it - and lots of other papers - and conclude: "The studies were '''generally poor in quality''' and '''limited by small sample size''' and '''multiple confounders.''' Based on this review, the evidence '''does not conclusively support''' the claim that acupuncture points or meridians are electrically distinguishable." If you include the Lee et al paper, then you should include ALL the primary sources from Ahn et al, and then what's the point of qualified researchers doing reviews AT ALL? Unfortunately, Ahn et al have thrown a spanner in the works by saying that "the preliminary findings are suggestive". Acupuncture adherents will of course jump on this as "evidence" that there's something in it. But Ahn et al don't say '''of what''' the preliminary findings are "suggestive." We cannot, and should not, interpret what Ahn et al may have meant by that statement. It could have meant that they thought the preliminary findings are suggestive of bullsh*t. We don't know. Debate over. Go home. [[User:Famousdog|Famousdog]] ([[User talk:Famousdog|talk]]) 16:49, 2 February 2012 (UTC) |
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== Source == |
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Origin
which part of the following text suggest/explains that "Acupuncture's origins in China are uncertain"? Shang Dynasty (1600–1100 BCE) is a dynasty in China. "Acupuncture's origins in China are uncertain" is ambiguous.
Acupuncture's origins in China are uncertain. One explanation is that some soldiers wounded in battle by arrows were believed to have been cured of chronic afflictions that were otherwise untreated,[37] and there are variations on this idea.[38] Sharpened stones known as Bian shi have been found in China, suggesting the practice may date to the Neolithic[39] or possibly even earlier in the Stone Age.[40] Hieroglyphs and pictographs have been found dating from the Shang Dynasty (1600–1100 BCE) which suggest that acupuncture was practiced along with moxibustion. — Preceding unsigned comment added by 69.159.47.75 (talk) 17:31, 14 January 2012 (UTC)
Lede: Existence of TCM concepts
In my understanding, this article is about the cultural phenomenon of acupuncture. Apart from informing the reader about A: "what this phenomenon actually is", a thorough encyclopedic article naturally should also inform about B: "what are the pros and cons about it?". But if we rush to B before properly laying down A, we get what we have here with the bracketed sentence in the lede: it sounds awkward and overzealous. Therefore, I recommend to delete it. The lede puts too much weight on the pros and cons of acupuncture already (but that's a problem we save up for later). --Mallexikon (talk) 04:44, 18 November 2011 (UTC)
- No, the page is about acupuncture, period. Though a definition is important, so is the research. Also note that the sentence is now different, not bracketed and juxtaposed with the statement that many practitioners don't practice according to TCM. To have one page on "cultural phenomenon" and another on research, particularly when the research doesn't really support acupuncture, is to engage in content forking and that is not appropriate. Though the historical basis of acupuncture is important, the modern research is lively and ongoing, an increasingly large body of knowledge that is a hugely important part of acupuncture's use in modern society. The research can not be shunted or diverted to a separate page or ghettoized into a single "criticisms" section. Giving readers the impression that acupuncture is an old and sophisticated system without acknowledging that the system has failed to be validated by empirical testing is not appropriate. WLU (t) (c) Wikipedia's rules:simple/complex 11:25, 18 November 2011 (UTC)
- WLU your absolutism is discouraging improvement of the article. Please seek consensus rather than playing the role of a judge. Mallexicon is making some important points and we should discuss them further.Herbxue (talk) 19:10, 18 November 2011 (UTC)
- The overwhelming, site-wide consensus is that WLU is correct. This consensus is laid out in guidelines such as WP:DUE, WP:FRINGE, and WP:CFORK. Local consensus cannot override that. WLU is working collaboratively and civilly within our existing content policies, and accusing him of combatively stunting the article is uncalled for. If you have a problem with another editor, please see WP:DR. — Jess· Δ♥ 19:28, 18 November 2011 (UTC)
- I'm not really buying into that "trust me, we know better, you have to do it this way" story. Consensus on this article's content needs to be hashed out here. WLU is not the arbiter of consensus, even though he is a really competent and collaborative editor. Even the best editors have been know to occasionally wikilawyer to advance a POV, no?
- I do not see anyone trying to remove all criticism of acupuncture, and although I recommend a separate article on the contentious and messy topic of acupuncture research, I have never recommended removing all scientific research from this article completely. Please stop implying that that is what is being suggested. Still, the very fact that the issue of weight balance between description and criticism keeps coming up is a clear sign that consensus has NOT been reached.Herbxue (talk) 23:13, 18 November 2011 (UTC)
- Obviously, the content of this article needs to be discussed on this page. I don't think anyone suggested otherwise. However, we absolutely cannot, even with local consensus to do so, violate a policy like WP:CFORK by separating the scientific view of acupuncture from the "cultural view", nor can we violate policies like WP:FRINGE and WP:DUE by pushing the criticisms out of the lead, and de-emphasizing their significance. Accusing WLU of being disruptive for pointing this out is unhelpful, and creating a "pro-acupuncture vs anti-acupuncture" mentality. You're welcome to see WP:DR if you have problems with that - an RfC could be helpful for instance - but a couple of editors here can't just decide to IAR away WP:NPOV. — Jess· Δ♥ 01:38, 19 November 2011 (UTC)
- Guys, please, come out of the trenches. My apologies if I didn't sound clear about this. I have not been suggesting to split this article when I talked about A and B. Of course and obviously the question (and research) about efficacy has to be a very important part of the acupuncture article. My concern right now is merely about the lede and the awkward impression it gives when it has to mention that "scientific research has failed to validate the existence of any of the TCM concepts" already in the very third sentence. Could me maybe at least move that sentence to the second half of the lede, where efficacy/criticism is discussed? --Mallexikon (talk) 06:31, 19 November 2011 (UTC)
- Please note that I consistently cite policies, guidelines and sources to substantiate my points. Please do the same to substantiate yours. Claiming my suggestions and edits don't "improve the article" is invalid given my consistent integration of new sources and information in line with the P&G. I may not move it towards the version preferred by editors who believe acupuncture is a valuable and effective medical intervention, but your issue is with the sources, not with me.
- The fact that the weight balance between description and criticism keeps growing is due to the fact that I keep discovering more and more criticism the more I dig. This suggests that "criticisms" (which is really scientific testing which fails to validate TCM concepts) are a large and vivid part of the research on acupuncture. The failure of science to validate TCM concepts should appear juxtaposed with the first discussion of those very concepts, and IMO should appear quite early. I believe this is a fairly routine editing decision and the only purpose to moving it to a later part of the lead would be to reduce criticisms of acupuncture - a violation of neutrality. WLU (t) (c) Wikipedia's rules:simple/complex 12:58, 19 November 2011 (UTC)
- Guys, please, come out of the trenches. My apologies if I didn't sound clear about this. I have not been suggesting to split this article when I talked about A and B. Of course and obviously the question (and research) about efficacy has to be a very important part of the acupuncture article. My concern right now is merely about the lede and the awkward impression it gives when it has to mention that "scientific research has failed to validate the existence of any of the TCM concepts" already in the very third sentence. Could me maybe at least move that sentence to the second half of the lede, where efficacy/criticism is discussed? --Mallexikon (talk) 06:31, 19 November 2011 (UTC)
Ok, I apologize for the attack on WLU, which I mistakenly thought was pretty mild. I have no time to learn how to paste fancy policy links in my posts, but I've read them, including fork, and I think they all basically back up common sense. For the last time - I never ever said take out all the criticism from the main article. In fact, I want the research given even more space in a separate article. Its not a violation of fork guidelines if the subject is large and complex enough to warrant a spin-off article - and acupuncture research is certainly a large enough issue. Skeptics like to think that the doubts and uncertainty in the literature can be summed up in a neat little box - that acupuncture is just placebo - but the reality is more complex. I think that complexity deserves to be represented properly.
Also, I support what Mallexikon is suggesting above. I understand what WLU is saying about NPOV, but disagree that every single sentence needs an awkward tit-for-tat negation.Herbxue (talk) 21:38, 19 November 2011 (UTC)
- Having two articles on the topic is not a violation of WP:CFORK, but having one for criticism and another devoid of criticism is. Your proposal (however you decide to phrase it), fits into that problem area: one for science and another for "culture"; one history and another "modern practice"; one "practice" and another "pros and cons". These proposals all aim to discuss the claims of acupuncture in one place, and push the scientific criticism to another separate area. As WLU has pointed out, the scientific criticism of acupuncture is a rich part of this topic, and it deserves necessary weight alongside acupuncture's claims per WP:DUE. We could have two articles, but we'd need scientific reception of the topic in both. — Jess· Δ♥ 22:05, 19 November 2011 (UTC)
- Herbxue, I didn't read your post as an attack (or if it was one, I've seen far, far worse so no worries). Thanks for the apology, it wasn't necessary but I appreciate it anyway. I realize this is frustrating but the reason I keep pointing to policies, guidelines and sources is because they are what wikipedia is based on and without them we are anarchopedia (there's a reason they've only got 200 articles and we've got several million). If anyone can show that my actions are inappropriate per the policies and guidelines, or that I've mis-interpreted a source, I will do my best to correct it. But please realize my standard is always those three things.
- As far as spin-off articles, the main page is a roll-up of daughter articles the way the lead is a roll-up of the body of an article. The significant points in parent articles are elaborated on in daughter articles, or the complexities of daughter articles are summarized (per WP:SS) in parent articles. It's not simply a matter of content forks and ghettoizing criticisms, it's also the fact that the articles themselves should show relationships in terms of what they cover. If a point is controversial in a daughter article, the parent article gives a brief overview of the controversy.
- Mallexikon, why is the presentation of the lack of scientific validation of TCM "awkward"? Is it because of the wording? Because structurally, in my mind it makes a lot of sense to put the two together. Otherwise the reader will work through a paragraph of text, get the impression that acupuncture has some sort of theoretical basis, only to have to read in another paragraph that none of the theory can be substantiated. Most controversial or discredited topics note quite early that the topic is controversial or discredited. Written from a solely TCM-practitioner perspective the page may give too much credit to the scientific skepticism, but read from a scientific skepticism perspective it spends far too much time on prescientific magical concepts that there is no real reason to expect any sense from (much like the humoural theories of the Ancient Greeks, or the magical medicine of the Egyptians). WLU (t) (c) Wikipedia's rules:simple/complex 01:50, 20 November 2011 (UTC)
- While it would not be right to pretend that many of TCM's theories, like "Qi" or "Essence" are unique, physically identifiable entities, I would recommend broadening your understanding of the phenomena they are an attempt to describe. For example, you might say that there is no such thing as "Yin" or "Yang", but these are relative concepts that describe things as they relate to other things. Qi is not as clean an example, but still to say that "Qi" does not exist because it is not a unique thing (like atoms) or energy (like heat) kinda misses the point of why people continue to consider it a useful concept. To the acupuncturist, heat is one manifestation of qi, nerve propagation is another; lack of of gastric secretion is a deficiency of qi in the digestive system, and so on. Its not a thing but a description of many phenomena. The reader would not have a chance to start to understand this thought process if every single term is immediately treated from a reductionist viewpoint. That viewpoint needs to be included, but describe the thing it refutes first.Herbxue (talk) 03:03, 20 November 2011 (UTC)
- The thing is, I can't just read up on something and write it up. I would need to cite sources. If someone says that qi is not meant to represent an actual entity, then we need that person saying it in a source, and we need to cite that source. If you have these sources, I strongly urge you to integrate them! I have read comments like yours before, but I don't remember where, and I'm really not that interested in finding them again or reading an entire book on the subject. I have zero objections to this information being in the article (including the lead) but I have to insist it is attached to a source or I will remove it per WP:PROVEIT. I've said this before Herbxue, neither you, nor I, can use our own opinion as a source - we need a book, journal article, web page from a reliable publisher, etc. In order to integrate this information, someone needs to look on google books, google scholar, or just plain google. I would also suggest revisiting WP:RS for a common understanding of what "reliable" means. If you don't feel like integrating it, provide me with the publication and page number and I'd be happy to do it.
- Also, just because there are those that use qi as a metaphor for actual metabolic processes doesn't mean we get to claim effectiveness; saying a deficiency of qi in the stomach is an analogy for low gastric secretions doesn't obviate the need to say testing has not supported acupuncture's ability to increase gastric secretions. WLU (t) (c) Wikipedia's rules:simple/complex 15:15, 20 November 2011 (UTC)
- I think Herbxue has a very good point, there, and just out of goodwill, you could take a look at our section dealing with qi, where it says: "...qi is something that is defined by five cardinal functions..." (it's sourced). Then again, WLU has a very good point here, too. If we want to state the point that most of these TCM entities like yin, yang, qi, the zang organs etc. are abstract entities only defined by their postulated functions, we need sources to verify that. So should I maybe transfer this:
from the TCM article? --Mallexikon (talk) 03:09, 21 November 2011 (UTC)"TCM's view of the human body is only marginally concerned with anatomical structures, but focuses primarily on the body's functions[40][41]... These functions are aggregated and then associated with a primary functional entity - for instance, nourishment of the tissues and maintenance of their moisture are seen as connected functions, and the entity postulated to be responsible for these functions is xuě (blood)[42] - but this is mainly a matter of stipulation, not anatomical insight.[43]"
- I'm willing to accept Herbxue's point, provided there are sources. My objections are continually based on the lack of adequate sourcing, not an abstract opposition to TCM (wikipedia is about verifiability, not truth). If there are sources, I want to be sure they are reliable, and I want them to be summarized accurately - that's as far as my concerns go.
- Are we still talking about the lead? I don't think we should get into a lot of detail in the lead, I think the current version adequately summarizes the broad-strokes TCM concepts and the lack of scientific justification. If more detail is required in the body, I'm OK with that. WLU (t) (c) Wikipedia's rules:simple/complex 16:42, 21 November 2011 (UTC)
- That's all fine but my concern right now is with the lead. This sentence: "Scientific research has failed to validate the existence of any of the TCM concepts" has multiple issues which I hope we don't have to discuss here. Can we get a quick solution by consenting to changing it to "scientific research has failed to find physical equivalents for qi, meridians, and acupuncture points"? --Mallexikon (talk) 04:31, 22 November 2011 (UTC)
- There has been no modern verification of any aspect of the concepts as far as I know. "Physical equivalents" implies that there are non-physical equivalents that justify TCM concepts. As far as I know there are none. I understand that people want to believe the Chinese discovered, despite lacking empirical testing, dissection, microscopes and chemistry, some sort of modern understanding of the body - but the evidence just isn't there. They invented an oriental version of Greek humourism that, like most pre-modern societies, is mystical rather than rational. Qi bears no resemblance to any actual modern understanding of anything I've seen - acupuncture at best reduces pain and nausea, though possibly only through placebo. It doesn't have any effect on disease that I'm aware of, only to symptoms highly amenable to placebo. Are there any "non-physical" equivalents that I've not seen yet? WLU (t) (c) Wikipedia's rules:simple/complex 11:23, 22 November 2011 (UTC)
- That's all fine but my concern right now is with the lead. This sentence: "Scientific research has failed to validate the existence of any of the TCM concepts" has multiple issues which I hope we don't have to discuss here. Can we get a quick solution by consenting to changing it to "scientific research has failed to find physical equivalents for qi, meridians, and acupuncture points"? --Mallexikon (talk) 04:31, 22 November 2011 (UTC)
- I think Herbxue has a very good point, there, and just out of goodwill, you could take a look at our section dealing with qi, where it says: "...qi is something that is defined by five cardinal functions..." (it's sourced). Then again, WLU has a very good point here, too. If we want to state the point that most of these TCM entities like yin, yang, qi, the zang organs etc. are abstract entities only defined by their postulated functions, we need sources to verify that. So should I maybe transfer this:
- While it would not be right to pretend that many of TCM's theories, like "Qi" or "Essence" are unique, physically identifiable entities, I would recommend broadening your understanding of the phenomena they are an attempt to describe. For example, you might say that there is no such thing as "Yin" or "Yang", but these are relative concepts that describe things as they relate to other things. Qi is not as clean an example, but still to say that "Qi" does not exist because it is not a unique thing (like atoms) or energy (like heat) kinda misses the point of why people continue to consider it a useful concept. To the acupuncturist, heat is one manifestation of qi, nerve propagation is another; lack of of gastric secretion is a deficiency of qi in the digestive system, and so on. Its not a thing but a description of many phenomena. The reader would not have a chance to start to understand this thought process if every single term is immediately treated from a reductionist viewpoint. That viewpoint needs to be included, but describe the thing it refutes first.Herbxue (talk) 03:03, 20 November 2011 (UTC)
One problem is the lumping of all TCM concepts together, and claiming that lack of science on one part = no evidence for any part. For example, a red sore throat would be labeled a "heat pattern" in TCM and treated with "cold herbs", in modern medicine it may be labeled and infection or inflammation and treated with antibiotics or NSAIDs. Both work very well. Some have tried to argue that "heat" = "inflammation" or "infection" but it is not really true and probably not even helpful. But many of the "cold" herbs also happen to have antibiotic or anti-inflammatory actions. So, is the TCM concept validated by the science? Or do you conclude that the "mystical" idea of treating hot with cold was a lucky guess? I know you hate to hear this, but the fact that TCM speaks a different language and is based on different assumptions poses a real problem for us and requires that we not make overly simplistic statements based solely on the modern medical model.Herbxue (talk) 21:19, 22 November 2011 (UTC)
- What evidence is there for any concepts? Again, none of this debate really matters in the absence of sources. What specific sources support specific TCM concepts? What sources support "cold herbs" having antibiotic or anti-inflammatory properties? What sources support a "heat pattern" being inflammation (aside from the trivial observation that inflamed areas are warm)? Without sources, these abstract discussions are pretty pointless. If a reliable source echoes your assertion, for me the only real question becomes how to summarize it.
- The assertion that TCM is speaking a different language rather than simply "right by accident" is also an assertion that requires a source. All prescientific medicine usually manages to be correct about certain herbs, be they emetics, analgesics, laxatives or soporifics, but that doesn't validate the medical system. And if we're debating the modern medical model, when modern medicine was introduced to China I believe that, like all nations, they experienced a considerable boom in longevity, a drop in infectious diseases and a much higher rate of survival out of childhood. Mao brought back TCM for political reasons, not because it was as effective as vaccinations, surgery and drugs.
- But again - to be integrated into the page, sources are required. WLU (t) (c) Wikipedia's rules:simple/complex 22:48, 22 November 2011 (UTC)
- But now we're discussing efficacy again, which is a totally different topic. The sentence as it stands is semantically wrong as it states that the TCM concepts are not existing. But of course they are existing (we are dealing with them/discussing them right now) - a concept is something abstract after all. The question is whether these concept have an equivalent in the real/physical world. But instead of discussing philosophy here we should take a look at whether this semantically wrong sentence is really supported by its sources - and when I checked the sources that are accessible online, I couldn't find that they do. Could you point out the supporting quotes to me, please? --Mallexikon (talk) 03:21, 23 November 2011 (UTC)
“ | Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial. Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and other related theories, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture. | ” |
“ | Of course, the existence of qi has never been demonstrated in any sort of scientifically acceptable manner and perhaps never will. Without being able to scientifically validate the existence of qi, the traditional rational for acupuncture and Chinese medicine will never receive modern science’s seal of approval no matter how many clinical trails show effectiveness in treating disease. The combination of mounting evidence of acupuncture’s clinical effectiveness together with an inability to scientifically validate its traditional rational has lead to a new and rapidly growing class of acupuncture supporter; those who acknowledge acupuncture’s clinical value while disavowing its traditional rational. This new breed of supporter is beginning to do more to undermine long-held notions about Chinese medicine than all the sceptics who doubted its effectiveness combined! | ” |
“ | Based on this review, the evidence does not conclusively support the claim that acupuncture points or meridians are electrically distinguishable | ” |
- Mann also makes somewhat similar points, but obviously more complicated to summarize. Trick or Treatment does make this point I believe, but google books doesn't have a preview anymore. I'll request it from the library. Matuk wasn't a good choice as a reference, I've removed it. I've adjusted the wording to refer to a lack of link between any TCM concept and any biological structure or function. If anyone is going to claim that there is such a link or that TCM is a valid framework for diagnosis or treatment, I'd really, really like to see the source this is based on before discussing further. WLU (t) (c) Wikipedia's rules:simple/complex 17:29, 23 November 2011 (UTC)
- Fair. Regarding your wording, I think it's very good. I'll just change "TCM concepts" to "the concepts of qi, meridians, and acupuncture points" because that's what is supported by the sources, and it also goes smoother with the preceding text. The problem with "TCM concepts" as a whole is that this includes things like yin/yang and the Five Phases - to write that science couldn't come up with an anatomical/biological/functional equivalent to these philosophical/abstract concepts is probably true, but IMO smells of tautology. Altogether, I'd still have preferred to position the criticism a few lines further down, but that's a mere matter of style; and as it is now, it feels smooth. Cheers, --Mallexikon (talk) 10:14, 24 November 2011 (UTC)
- @Famousdog: yes, that's even better wording. Thanks, --Mallexikon (talk) 02:57, 25 November 2011 (UTC)
- I got Trick or Treatment out from the library and it does indeed verify this point. WLU (t) (c) Wikipedia's rules:simple/complex 18:37, 3 January 2012 (UTC)
- To claim that "Scientific research has not found any physical or biological correlate of qi, meridians and acupuncture points" is wrong. Am J Chin Med. 2005;33(5):723-8. finds 'Differences in electrical conduction properties between meridians and non-meridians.'
- " The current conduction and potential profiles were compared after switching the current direction in the Hegu (LI-4) and Quchi (LI- 11) meridians and over a non-acupuncture point 1 cm from Quchi (LI-11) in 20 healthy subjects. Both meridians demonstrated significantly higher conductivity between Hegu (LI-4) and Quchi (LI-11) than between Hegu (LI-4) and the non-acupuncture point. The direction of current, peak frequency and absolute potential values in the direction Hegu (LI-4) to Quchi (LI-11) differed significantly from those in the direction Quchi (LI-11) to Hegu (LI-4). These results suggest that the conducting pathways are stronger in the meridians than in the non-meridians and that preferential conduction directions exist between two acupuncture points. These results are consistent with the theories of Qi-circulation and traditional Chinese medicine."Dickmojo (talk) 14:09, 30 January 2012 (UTC)
- Indeed the source 5 listed to back this in the text after this quote itself says in relation to the electro-conductivity of meridians that "the findings are suggestive". Surely for balance this view ought to be alluded to.Dickmojo (talk) 00:03, 31 January 2012 (UTC)
- Ok, so I just amended the text to include this part of source 5. Now to pre-empt any knee-jerk reaction by sceptics to automatically revert it out of hand, let me say that we are not here to *debunk* acupuncture. Well I mean, you guys are, but that is contrary to the spirit of WP. What we should actually be here to do is give a balanced and rounded summary of the various viewpoints out there, and it is a mainstream view amongst many acupuncturists that acupoints and meridians do have electro-conductivity properties. This is not a fringe view, and there is acceptable secondary evidence which is suggestive of such, so I don't think it should be reverted without due discussion.Dickmojo (talk) 13:27, 31 January 2012 (UTC)
- I got Trick or Treatment out from the library and it does indeed verify this point. WLU (t) (c) Wikipedia's rules:simple/complex 18:37, 3 January 2012 (UTC)
- @Famousdog: yes, that's even better wording. Thanks, --Mallexikon (talk) 02:57, 25 November 2011 (UTC)
- Fair. Regarding your wording, I think it's very good. I'll just change "TCM concepts" to "the concepts of qi, meridians, and acupuncture points" because that's what is supported by the sources, and it also goes smoother with the preceding text. The problem with "TCM concepts" as a whole is that this includes things like yin/yang and the Five Phases - to write that science couldn't come up with an anatomical/biological/functional equivalent to these philosophical/abstract concepts is probably true, but IMO smells of tautology. Altogether, I'd still have preferred to position the criticism a few lines further down, but that's a mere matter of style; and as it is now, it feels smooth. Cheers, --Mallexikon (talk) 10:14, 24 November 2011 (UTC)
- Mann also makes somewhat similar points, but obviously more complicated to summarize. Trick or Treatment does make this point I believe, but google books doesn't have a preview anymore. I'll request it from the library. Matuk wasn't a good choice as a reference, I've removed it. I've adjusted the wording to refer to a lack of link between any TCM concept and any biological structure or function. If anyone is going to claim that there is such a link or that TCM is a valid framework for diagnosis or treatment, I'd really, really like to see the source this is based on before discussing further. WLU (t) (c) Wikipedia's rules:simple/complex 17:29, 23 November 2011 (UTC)
I agree, and although there are questions about the research on conductivity, we should present sources that both confirm and fail to confirm any difference in conductivity on channels in order to present the current state of the research accurately.
One big difference for me, however, is that I think this issue is better discussed under the "Possible Mechanisms" section. I think the idea of debating the "existence" of TCM concepts is unfruitful. To argue whether Qi is a distinct force or material really misses the point of why it continues to be a useful concept.Herbxue (talk) 19:15, 31 January 2012 (UTC)
- Wrong. See WP:MEDRS. PMID 16265984 is a primary source that should not be used on the page, particularly when a secondary source (PMID 18240287) that was published three years later concludes there is no good quality evidence to support the existence of meridians. WLU (t) (c) Wikipedia's rules:simple/complex 20:58, 31 January 2012 (UTC)
- Primary sources are not to be used to make medical claims (efficacy claims). This is not an efficacy claim. Thats why I think it should be discussed under possible mechanisms.
- If the preponderance of evidence fails to show any anatomical, electrical, or other distinctiveness of meridians vs. non-meridians then the article should certainly say that, but that is not equivalent to saying they do not "exist" because they exist as a concept that is taught, studied, and tested on for entry to the profession, and as a tool used in practice.Herbxue (talk) 22:02, 31 January 2012 (UTC)
- See WP:PSTS. Doesn't matter if it's a medical claim or not, the secondary source takes precedence in terms of age, reliability and policy. MEDRS is explicit about it, but the same statement applies - review articles take precedence over low-n studies and the latter can not be used to contradict the statements made in the former. Positive claims must rest on positive evidence, it's sufficient to note that traditionally acupuncture's mechanism is points, meridians and chi and that no good evidence has been found for any. We can note that people believe they exist, but must also mention that there's no actual evidence for it. In fact, per WP:STRUCTURE the current section discussing the lack of support for points, chi and meridians should be moved to the same section discussing their traditional alleged mechanism. WLU (t) (c) Wikipedia's rules:simple/complex 22:43, 31 January 2012 (UTC)
- If we are to mention in the lede that there is no scientific evidence for the existence of qi, acupuncture points and meridians, then we must ALSO mention that there is research which is suggestive of the electro-conductivity properties of acupuncture points and meridians, or else we are concealing parts of the broader picture and are in violation of NPOV. Either delete that sentence entirely or restore my qualifier. C'mon now! There's a link to the source, let people read it and make up their own minds! Don't try to hide parts of the body of knowledge that you personally find unpalatable WLU! Dickmojo (talk) 04:23, 1 February 2012 (UTC)
- Pursuant to my point, the wording of that sentence ("there is no evidence blah blah blah") implies that research has been conducted and that the results of this research conclusively found that there was no evidence at all. Well, this is patently false, because the source itself says that 7 out of 9 studies reviewed found positive evidence to support the theory of enhanced electro-conductivity of meridians. Now it is a gross violation of NPOV to seek to cover that fact up, WLU, so I have restored it in the lede. If you want to delete it, then delete the whole sentence, and move it to the mechanism section.Dickmojo (talk) 06:37, 1 February 2012 (UTC)
- 7 out of 9 shoddy studies with poor methodologies. Would you accept a chemotherapy treatment, blood thinner or antibiotic with a similar evidence base? I wouldn't. Multiple reverts from multiple editors suggest nor would others. WLU (t) (c) Wikipedia's rules:simple/complex 16:40, 1 February 2012 (UTC)
- See WP:PSTS. Doesn't matter if it's a medical claim or not, the secondary source takes precedence in terms of age, reliability and policy. MEDRS is explicit about it, but the same statement applies - review articles take precedence over low-n studies and the latter can not be used to contradict the statements made in the former. Positive claims must rest on positive evidence, it's sufficient to note that traditionally acupuncture's mechanism is points, meridians and chi and that no good evidence has been found for any. We can note that people believe they exist, but must also mention that there's no actual evidence for it. In fact, per WP:STRUCTURE the current section discussing the lack of support for points, chi and meridians should be moved to the same section discussing their traditional alleged mechanism. WLU (t) (c) Wikipedia's rules:simple/complex 22:43, 31 January 2012 (UTC)
- If the preponderance of evidence fails to show any anatomical, electrical, or other distinctiveness of meridians vs. non-meridians then the article should certainly say that, but that is not equivalent to saying they do not "exist" because they exist as a concept that is taught, studied, and tested on for entry to the profession, and as a tool used in practice.Herbxue (talk) 22:02, 31 January 2012 (UTC)
Poor comparisons- acupuncture does not carry nearly the same risk, nor does it claim the same effects. But that's irrelevant to the question of whether or not we can include carefully qualified statements about research from primary sources in a field of research that is not well-covered. To give an accurate picture of the current scientific understanding of acupuncture, I think we should include primary sources as long as proper context is given. To only include the conclusion of the only systematic review of the very few studies of this kind gives the illusion of certainty of lack of "existence" due to the lack of context.Herbxue (talk) 16:20, 2 February 2012 (UTC)
- The Ahn et al (2008) review INCLUDES the Lee et al (2003) paper among its references. You know what that means? It means that they've already looked at it - and lots of other papers - and conclude: "The studies were generally poor in quality and limited by small sample size and multiple confounders. Based on this review, the evidence does not conclusively support the claim that acupuncture points or meridians are electrically distinguishable." If you include the Lee et al paper, then you should include ALL the primary sources from Ahn et al, and then what's the point of qualified researchers doing reviews AT ALL? Unfortunately, Ahn et al have thrown a spanner in the works by saying that "the preliminary findings are suggestive". Acupuncture adherents will of course jump on this as "evidence" that there's something in it. But Ahn et al don't say of what the preliminary findings are "suggestive." We cannot, and should not, interpret what Ahn et al may have meant by that statement. It could have meant that they thought the preliminary findings are suggestive of bullsh*t. We don't know. Debate over. Go home. Famousdog (talk) 16:49, 2 February 2012 (UTC)
Source
Main use of acupuncture in China
Ok, our text says: "... in China its main uses are Bell's palsy and cerebrovascular events like strokes and heart attacks." Citation is Ernst's article. Ernst's article says: "By contrast, the two most important indications for acupuncture in China are Bell’s palsy and cerebrovascular accidents." - how did heart attack sneak in there (which is not a cerebrovascular accident)? Anyway, Ernst's citation for this statement is an article by Napadow and Kaptchuk [2]. Napadow/Kaptchuk say: "The second most common condition was cerebrovascular accident (CVA) rehabilitation." Emphasize: rehabilitation. Let me explain the difference: if a patient has a stroke (=cerebrovasc. accident) he needs acute care (usually, a CT and heparin). Rehabilitation, of the other hand, means that the patient has remaining neurological deficits (like paralysis or speech problems) after a stroke - requiring physiotherapy etc. Ernst obviously did a very sloppy job here, which we actually made worse by us inserting the heart attack. But what angers me the most is that Ernst refers to "China" as if his source did a China-wide study. In fact, his source only talks about the experience of two guys "at two prominent outpatient acupuncture clinics in Beijing, China (n = 563, n = 233)." I recommend to delete this sentence in our article altogether. Comments? --Mallexikon (talk) 06:54, 19 November 2011 (UTC)
- Oops, that's probably my bad summary. Cerebrovascular accident actually redirects to stroke. I would prefer to retain the information. I've adjusted to use Napadow/Kaputchuk and tighten the wording a bit. Ernst's point still stands in my opinion, and is butressed by the for Dummies book. WLU (t) (c) Wikipedia's rules:simple/complex 13:11, 19 November 2011 (UTC)
- As you wish. In that case, however, we have to add more material to complete the picture. The problem with the Napadow/Kaptchuk study is that they didn't group the diagnoses they found - as in compiling ellbow pain, back pain, neck pain etc. into "pain conditions". I added the study of someone who took the effort for them. I also added another study very similar to Napadow/Kaptchuk's which grouped right away. Cheers, --Mallexikon (talk) 02:46, 21 November 2011 (UTC)
- The problem is, Ernst's is the only secondary source we've got in there - Napadow and Kaptchuk is primary and Guimaraes is a letter to the editor. It forces awkward compromises and dubious original research. This is the reason we try for review articles, they do the summarizing for us. This is an area we have to be careful with and where we need a review article making an international comparison. WLU (t) (c) Wikipedia's rules:simple/complex 15:59, 21 November 2011 (UTC)
- True. As for the current version, I think you did a very good job working with what we have (even though I'd still recommend deletion). --Mallexikon (talk) 04:46, 22 November 2011 (UTC)
- The problem is, Ernst's is the only secondary source we've got in there - Napadow and Kaptchuk is primary and Guimaraes is a letter to the editor. It forces awkward compromises and dubious original research. This is the reason we try for review articles, they do the summarizing for us. This is an area we have to be careful with and where we need a review article making an international comparison. WLU (t) (c) Wikipedia's rules:simple/complex 15:59, 21 November 2011 (UTC)
- As you wish. In that case, however, we have to add more material to complete the picture. The problem with the Napadow/Kaptchuk study is that they didn't group the diagnoses they found - as in compiling ellbow pain, back pain, neck pain etc. into "pain conditions". I added the study of someone who took the effort for them. I also added another study very similar to Napadow/Kaptchuk's which grouped right away. Cheers, --Mallexikon (talk) 02:46, 21 November 2011 (UTC)
Lede: what acupuncture proponents believe
This sentence here: "Proponents of acupuncture believe that it promotes general health, relieves pain, treats infertility, treats and prevents disease", suffers from clumsy phrasing and semantic blur (is preventing disease not the same as promoting general health?). On top of that, I don't agree with the wording of "proponents of acupuncture believe..." (All proponents? Some? Plus, we don't know what people believe. We can only know what they say.) Is this sentence really supported by its source? I tried to access it online but to no avail. Does anybody know what it says? --Mallexikon (talk) 03:32, 26 November 2011 (UTC)
- You could probably ask someone at WT:MED. This should be low-hanging fruit, it should be relatively easy to find a breakdown of what proponents think it can be used for since it's not about what it's been demonstrated effective for. A good phrasing to aim for might be more related to "Historically acupuncture was used to treat..." I looked in Needham & Lu but the search inside is limited and I don't know what terms to use and I've returned my copy to the library. I believe they said it was used for acute Anyone with access to the "pro" documents I would think might have an easier time. The WHO DOC unfortunately just says "wide range of disease and conditions". WLU (t) (c) Wikipedia's rules:simple/complex 13:05, 26 November 2011 (UTC)
Review article?
This was recently used as a source to support a direct quote from the article. I'm wondering if this counts as a MEDRS compliant article, however, as it simply reads like a summary of primary studies and doesn't seem to draw any conclusions regarding either acupuncture, nor does it contain analysis of the study. Thoughts? Noformation Talk 06:39, 16 January 2012 (UTC)
- It is certainly not a systematic review, but rather a convenient collection of individual studies. Depends on what it is being used to support - most likely it is better to reference the individual study mentioned in the article. Nonetheless I would say the article is a reliable source, just can't be used to establish general efficacy claims.Herbxue (talk) 17:32, 16 January 2012 (UTC)
- I wouldn't include it - seven articles, all published in China, unreplicated, using vague secondary measures of "improved immune function" is a rather meaningless addition. WLU (t) (c) Wikipedia's rules:simple/complex 18:45, 16 January 2012 (UTC)
- I didn't think so. It was being directly quoted in this edit. Summarizing a list of primary sources seems equivalent to simply using primary sources as claims of efficacy. Noformation Talk 20:19, 16 January 2012 (UTC)
- "Vague secondary measure"?? leukocyte phagocytosis, interleukin-2 (IL-2) and natural killer (NK) cell activity, CD3+ and CD4+ T-lymphocyte subsets, white blood cell count etc are "vague"? "Secondary"? I'm afraid not WLU. And I'm sorry, but its racist to imply criticism of a study on the sole grounds that it originates from a certain country. I think this evidence ought to be included, its the latest research and readers have a right to know about it. NPOV would be seriously impaired if we omitted all mention of this evidence.Dickmojo (talk) 13:54, 1 February 2012 (UTC)
- I wouldn't include it - seven articles, all published in China, unreplicated, using vague secondary measures of "improved immune function" is a rather meaningless addition. WLU (t) (c) Wikipedia's rules:simple/complex 18:45, 16 January 2012 (UTC)