Talk:Acupuncture

Petition regarding this page

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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change.org/p/jimmy-wales-clean-up-the-wikipedia-acupuncture-page-to-reflect-medical-and-scientific-consensus (site in spam blacklist) - I haven't gone through their claims in detail, but editors experienced on this page may wish to go through and see if they've put forward anything that would be useful - David Gerard (talk) 23:46, 29 December 2016 (UTC)

Thanks but change.org has been considered in the past with an epic response—Wikipedia:Lunatic charlatans. Johnuniq (talk) 00:26, 30 December 2016 (UTC)

What does Jimmy Wales have to do with this? Sure he managed to settle the debate with an excellent response last time through, but do they not understand that he doesn't dictate what this (or any) page says? A few of the sources they list are interesting, such as the AHRQ's [1], which is excellent. On the other hand they're vastly overstating its conclusions, and the report does not "recommend" acupuncture at all. (In fact as a HTA-report it isn't supposed to give recommendations.) The NICE report (available at [2], their link doesn't work) states that acupuncture may be considered when other treatment is unsuitable or does not work, but that isn't very different from what our article already states. Many of the reports they list are either old and outdated or otherwise inadequate as per WP:MEDRS and WP:DUE. If they try to pressure us in any way I think it should be made known that this action will not result in change — and they are welcome to discuss the page here in civil debate weighing sources against one another. However, creating silly petitions will not sway us. Especially so when their rub seems to be with the labeling if acupuncture as pseudoscience, which is fully backed by the sources included in the article. There's also a precedent set in a 2009 ArbCom case. I will further dive into the sources once I have more time, but for now I suggest we ignore this and combat any of the vandalism it may promote. Carl Fredrik 💌 📧 01:10, 30 December 2016 (UTC)

Carl, interesting point about their medical guidelines. Specifically, which ones are inadequate WP:MEDRS? Which ones have been superseded (which is how a guideline becomes outdated)? And which of the guidelines provided are considered adequate WP:MEDRS?

"The NICE report (available at [3], their link doesn't work) states that acupuncture may be considered when other treatment is unsuitable or does not work, but that isn't very different from what our article already states." For tension-type headaches, acupuncture is recommended as a first-line treatment for prophylaxis (it's actually the only treatment recommended for prophylaxis) (https://www.nice.org.uk/guidance/cg150/chapter/Recommendations).

"they are welcome to discuss the page here in civil debate weighing sources against one another." Looking at the petition, I think their point specifically was that those who have tried doing that were quickly banned. What you call 'civil debate' has been labelled by others here as 'challenging consensus' and resulted in immediate ban. Looking through the dialogue on this page, I'd be very interested to understand the distinction. Banning too quickly means that commenters are left with no choice but to try to influence through means outside of Wikipedia, which isn't ideal.86.153.15.89 (talk) 09:24, 31 December 2016 (UTC)

There has been no such thing as "banning too quickly". Only those who continually show an unwillingness to consider evidence, incapacity to accept consensus and who have acted rashly and disruptively have been banned. The fact is that this is more or less ideal — seeing as trying to exert external pressure will not and can not succeed. Guy's reply below is excellent, but I felt I could not let this slip.Carl Fredrik 💌 📧 12:09, 31 December 2016 (UTC)

"Consider" is not the same as recommend. Nothing in that NICE document is in any way inconsistent with the current article. Note also that it's approaching 5 years old; here's what happened when NICE reviewed the similar guidance for low back pain: [4]. Medical science is getting better at blowing away the dust. Nonsensical therapies, with homeopathy being top of the list, are the inevitable casualties. Guy (Help!) 10:34, 31 December 2016 (UTC)

"Consider a course of acupuncture" is the recommendation for TTH prophylaxis just like "Consider aspirin" is the recommendation for acute headache. None of the recommendations begin with the word "recommend." If you're not sure how medical guidelines work, feel free to ask rather than misinterpret them. It isn't relevant if a clinical guideline is 5 years old as long as it's current, particularly as the evidence has become stronger in the interim.

As an aside, which medical guidelines recommend homeopathy? I wasn't aware of any but it's interesting if you're saying that there are and that now support is being removed.31.51.233.8 (talk) 10:18, 2 January 2017 (UTC)

First, "consider" is not the same as saying it works; second, the guidance on back pain was recently revised and acupuncture removed, so the age of this guidance is relevant. It's likely the next review cycle will see this downgraded still further. Neither of these things goes tot he core of the problem, though, which is that acupuncture is based on refuted doctrines, and supported by poor quality evidence, largely beset with obvious bias and conflicts of interest, and even then shows only tiny effect sizes in a few arbitrary conditions with no indication why these would be physiologically different from the many for which it is shown not to work. The trajectory of evidence is pretty clear. Scientists have become better at removing bias, and the more bias is removed, the more likely a trial is to show no effect. This is entirely consistent with the absence of evidence for any of the core doctrines of acupuncture. Guy (Help!) 10:30, 2 January 2017 (UTC)

""consider" is not the same as saying it works" - Sure, what it means is that NICE performed an exhaustive evidence review and has come to a consensus to recommend acupuncture based on the strength of the evidence and compared to other available treatments. This is evidence that conventional medical organisations disagree that it is pseudoscience, as they don't recommend pseudoscience. Medical guidelines are considered by Wikipedia to be high quality MEDRS for a reason, regardless of whether or not their conclusions happen to coincide with your beliefs. Unfortunately, future evidence reviews that have not yet happened that you guess will have conclusions that are magically identical to your particular beliefs are not MEDRS. Current published reviews are, whether or not you personally agree with their conclusions.167.98.3.58 (talk) 09:05, 3 January 2017 (UTC)

NICE accepts current practice with a pretty low bar. If acupuncture were a new treatment it would geta full review; existing treatments also periodically get a full review, and that is what happened with back pain. Guess what? Acupuncture was removed.

We have at present three conditions for which acupuncture is stated to have net positive evidence. Given the number for which evidence is net negative, and given the absence of any credible difference between the many conditions where it's net negative and the few where it's net positive, and given the refuted nature of its fundamental premise, and givent he documented difficulty of rmeoving bias in trials and the equally well documented fact that bias is the strongest predictor of a positive outcome, and given the small effect sizes of most trials, the most parsimonious explanation is that the net positives are false positives, consistent with P=0.05. That's the actuality of it. Guy (Help!) 09:23, 3 January 2017 (UTC)

"NICE accepts current practice with a pretty low bar. If acupuncture were a new treatment it would geta full review" - well now I'm really confused. Acupuncture was a "new" traetment to the NHS when the migraine and TTH review was created.

Now personally, I have been involved in NICE guideline development. However, according to your profile it says that you're Dell employee. Do you have any medical, research, or guideline development background? I just ask because you say a lot things about how NICE guidelines are developed but none of them seem to be true, at least according to my experience or that of my colleagues. For example, when talk about NICE accepting 'current practice with a pretty low bar', what would be an example of the differences in methods and criteria for literature review, evidence syntheses and strength of evidence to support a recommendation? Can you provide a specific example of the point you're making or any evidence to support it? I've simply never come across what you're claiming. It sounds an awful lot like you're making things up to support your opinion about acupuncture.167.98.3.58 (talk) 15:14, 3 January 2017 (UTC)

Wikipedia being what it is, we allow anyone to contribute, within limits. You might believe that NICE applies exactly the same standards to existing treatments as it does to new ones or withdrawal of recommendations. That's not what I have concluded from reading the literature. Of course I could be wrong. I'm not an expert, and expertise is not recognised on Wikipedia. What is unquestionably true is that the evidence shows no reason to believe qi exists; no evidence for the existence of meridians; no consistency about acupoints between traditions; no mechanism for evidence-based correction of error; it makes no difference where you stick the needles, or even whether you insert them at all; most conditions show net negative evidence; effect size is always small; and the chances of a positive result are mainly down to the scope for bias to creep in. Guy (Help!) 16:09, 3 January 2017 (UTC)

Detailed response
The following discussion has been closed. Please do not modify it.
By "The Acupuncture Now Foundation", whose views are obviously entirely neutral. There is a rather obvious reference to lobbying of this group by LesVegas and/or Ellaqumentary. All the points in that petition are, I think, already covered in the article and have been discussed here at length before. The acupuncture page on Wikipedia, in a flagrant violation of Wikipedia's Neutral Point of View Policy, currently states that "acupuncture is pseudoscience." Wiki's Neutral Point of View policy says, in a nutshell: "Articles must not take sides, but should explain the sides, fairly and without editorial bias. This applies to both what you say and how you say it." This is begging the question. If we were applying this label without the benefit of reliable independent sources then it would be a valid point, but the statement is well sourced. My personal view is that acupuncture is a quasi-religious belief system, and that study of acupuncture is largely pseudoscientific, but the sources are less nuanced. Pseudoscience, according to Wikipedia, is determined by medical and scientific consensus. No, it's defined by people who specialise in the demarcation issue. Science usually ignores pseudoscience altogether, and medicine ignores it other than in the specific field of quackademic medicine, aka integrative medicine, otherwise known as SCAM. Throughout the years, volunteer editors have clearly demonstrated that considerable swathes of the mainstream medical and scientific community firmly support the use of acupuncture - position statements, medical consensus guidelines, Cochrane Reviews, and reviews of acupuncture's biological mechanism research clearly demonstrate that the statement 'acupuncture is pseudoscience' is controversial at best, which means that this categorisation of acupuncture violates Wikipedia's neutral point of view policy. Editors who attempt to update the article in line with high-quality medical references are consistently banned from editing. This is an attempt to legislate inclusion of specific sources they like. Cochrane reviews have been discussed. They should be viewed in the light of the work of Ioannidis, and also the fact that several (e.g. [5]) have been withdrawn after comments. The result of any review is highly sensitive to inclusion criteria. It could be argued that all studies from certain countries (notably China) should be excluded: a review found not one single published paper from China that found the intervention under test to be ineffective, and all Chinese studies of acupuncture are positive. Great care is necessary in reviewing sources for inclusion. Medical consensus guidelines that recommend acupuncture include: [snip] These are irrelevant. All (most especially the WHO) are the result of True Believers advocating within the bodies concerned, and medicine is not science. These are all highly respected, mainstream medical institutions and they all recommend acupuncture in their consensus statements based on unbiased evidence reviews. Your logical fallacy is: Appeal to authority. Yet, the administrators of the page essential practice denialism and have consistently stated that merely providing evidence that acupuncture has this support is grounds for being banned, for example: "if you continue to claim that acupuncture has mainstream scientific validation, you have no future as an (sic) Wikipedia editor." That was a statement by Tgeorgescu ([6]) who is not an admin. I clarified here: [7]. Acupuncture does not have mainstream scientific validation. If it did, this argument would not be happening. There is no such thing as qi, no such things as meridians, no evidence that acupoints are significant (and they differ between traditions). There is no convincing evidence that it matters where you put the needles, or even whether you insert them. That's not our problem to fix. In order to maintain the position that the statement 'acupuncture is pseudoscience' is not controversial, even though it clearly is, the administrators who are controlling the acupuncture page are censoring this vast and growing body of evidence that presents a very different reality. They frequently make factually incorrect, unreferenced statements while ignoring and deleting high-quality peer-reviewed systematic reviews that contradict their opinion. It's controversial to say acupuncture is pseudoscience (see above) but it's not our controversy so we can't fix it. In 2014, you said: "Wikipedia's policies around this kind of thing are exactly spot-on and correct. If you can get your work published in respectable scientific journals - that is to say, if you can produce evidence through replicable scientific experiments, then Wikipedia will cover it appropriately." It is this evidence, from Cochrane, Harvard, the Journal Neuroscience, Plos and many others, that is being systematically censored by Wikipedia's administrators. Wikipedia is not remotely covering acupuncture appropriately, by your or any reasonable definition. Your logical fallacy is: cherry picking. Not one of those studies refutes the null hypothesis. This is the core point they don't seem to understand. Clinical evidence is by nature probabilistic, and P=0.05 means one in twenty positive results will be false even if all bias is eliminated. There is a great deal of discussion in the literature of just how difficult it is to remove bias in studies of acupuncture, specifically. There is a core difference between medical trials and science. Science tests: is this hypothesis true? Medicine tests: does it look like this treatment works? It is perfectly possible for an entirely bogus treatment to look as if it works. Treatments are withdrawn all the time because it's found they don't. Knee washouts, for example. Very little real science is done on acupuncture - virtually none in fact. The reason it's often described as pseudoscience is that most studies start by stating the validity of acupuncture as an assumption, usually by reference to a fallacy (appeal to tradition or popularity). We fully recognise that there are those who believe acupuncture to be pseudoscience - these are typically members of vocal pseudoskeptical organisations, such as Guerilla Spepticism on Wikipedia (most of the editors and admins of the acupuncture Wikipedia article are members of such organisations) and a number of highly vocal Skeptical individuals. However, these groups constitute one opinion and do not reflect the overall medical consensus. Their opinion papers and websites constitute much weaker evidence than peer-reviewed evidence syntheses and institutional medical guidelines. Feel free to cite the basic science that shows that qi exists, meridians are a thing, and whihc has led to a convergence on a single set of acupoints in all traditions. In fact I think that last would be pretty persuasive. If every acupuncture group int he world, from every country, collectively reviewed a set of tests and changed their charts, discarding the ancient sacred texts sin favour of new empirical evidence, I think that would probably kill the pseudoscience claim right there. Those Wikipedia editors who point out the copious high-quality medically reliable sources that contradict the biased tone of the article are bullied and banned from editing, in a clear act of censorship and abuse of administrative powers. Last week alone, two editors were banned from editing the acupuncture article without having violated a single Wikipedia policy. Both editors had merely pointed out the violation of Wikipedia's neutral point of view policy, with the support of high-quality, peer-reviewed medical references published in mainstream publications. This state of affairs is completely unacceptable and puts the public at risk by denying access to a balanced and accurate perspective on evidence-based health care options. In the United States, the number one cause of accidental death (more than car accidents) is overdose from prescribed opioids for pain - the Wikipedia article misinforms patients, doctors and healthcare policy makers about an effective and safe treatment option for pain, unnecessarily increasing the risk to the public. They were topic banned for refusing to accept consensus. Both were given WP:ROPE, one of them for many months. There is no risk to the public by failing to promote acupuncture. Even its best friends would have to admit, if they were honest, that it's of little benefit. Again, if we were able to see large effect sizes and objective, rather than subjective endpoints, this argument would not even be happening. Wikipedia, which is a highly accessed source of medical information by medical professionals and patients alike, has a responsibility to ensure that articles accurately reflect the balance of information available and the appropriate participation of the editorial community through enforcing its guidelines. In the case of the acupuncture article, this process has clearly broken down. Valid, appropriate, evidence-based and referenced perspectives are being systematically silenced so that administrators can present their narrow opinions as scientific consensus. No, it's working as designed. Wikipedia habitually shows the door to people who won't take "no" for an answer, especially if the question has already been asked dozens of times and they have no other area of interest. We get bored easily these days. Wikipedia: for the sake of accuracy, scientific integrity, and public health, please clean up the administration of the acupuncture article to be in line with your editorial and administrative policies so that the article can reflect best-evidence, not individual bias, and allow editors to remove acupuncture from the Pseudoscience category. Your logical fallacy is: begging the question. So, the substantive request comes down to the oft-repeated and frequently discussed question: should this be in Category:Pseudoscience. My view is that it should not, but that we should mention that study of acupuncture is dominated by pseudoscience. I would put it in Category:Pseudomedicine instead. But that's just my personal view, which, unlike the trypanophiles, I do not misperceive as objective fact. Guy (Help!) 01:09, 30 December 2016 (UTC)

Small nit: "Clinical evidence is by nature probabilistic, and P=0.05 means one in twenty positive results will be false even if all bias is eliminated." This is wrong. P=0.05 means one in twenty results will be positive even if all bias is eliminated - if there is only random chance at work. If there is only random chance at work, all positive results will be false, not just one in twenty. The proportion of false positives among the positives is not constant, but it can be computed using the Bayes formula. This misunderstanding is very common, and it is probably one of the causes of belief in things like acupuncture: "we have that many positive results, and only 5% of them are false positives, so there is an effect". --Hob Gadling (talk) 10:42, 2 January 2017 (UTC)

You're right, of course. I meant that one in twenty could still be false, but your vwersion is better and clearer. Guy (Help!) 13:10, 2 January 2017 (UTC)

no new sources brought to actually support changing the article; WP:NOTFORUM
The following discussion has been closed. Please do not modify it.
I understand that this petition has little likelihood to result in change, however the often repeated claim that labeling acupuncture as pseudoscience is "well sourced" is a bit of a stretch - one is an anonymous editorial that flippantly throws out the term and doesn't even make a clear argument for its use (Nature), and the others are personal opinion blogs. There are far more studies and reviews that show the value of acupuncture in pain relief than there are showing that pseudoscience is an appropriate descriptor. My only point here is that just because you or I have a source to support a statement does not mean it is appropriate to make that statement in wikipedia's voice.Herbxue (talk) 17:52, 30 December 2016 (UTC) This cited source: Baran GR, Kiana MF, Samuel SP (2014). Chapter 2: Science, Pseudoscience, and Not Science: How Do They Differ?. Springer. pp. 19–57. doi:10.1007/978-1-4614-8541-4_2. ISBN 978-1-4614-8540-7. various pseudosciences maintain their popularity in our society: acupuncture, astrology, homeopathy, etc. {{cite book}}: |work= ignored (help) seems to be neither a flippant editorial nor a blog, so your comment appears to misrepresent things. It is well sourced (and not contradicted in RS) - Wikipedia can't help it if acupuncturists don't like reality. Alexbrn (talk) 17:58, 30 December 2016 (UTC) A brief (dare I say flippant) statement by engineers in a book about the role of technology in healthcare. Maybe. Better source than the previous ones, but still not one that involves a thoughtful exploration of what acupuncture is. This would be like a business textbook quipping about the pharmaceutical industry and using it to support a statement like "drug companies prioritize profit over safety". I think it is cherry picking, or flippant use of a statement in a work that does not really concern itself with the nature of acupuncture practice or underlying assumptions. Herbxue (talk) 20:08, 30 December 2016 (UTC) That is just one of many. There is an excellent book by Caleb W. Lack PhD and Jacques Rousseau out this year called: Critical Thinking, Science, and Pseudoscience: Why We Can't Trust Our Brains. Unfortunately I don't have access to it right now, but it makes very clear the lack of scientific underpinning in acupuncture. We could pile on sources, the only issue here is WP:OVERCITE. Why we only have two sources is because there are really no sources refuting the statement, and there's no need for more than two strong sources. Carl Fredrik 💌 📧 20:24, 30 December 2016 (UTC) I disagree, I think you should pile on if you have something more substantive than the passing remarks you describe as strong sources, especially considering this comes up for debate quite often (I have brought it up myself in the past, but did not have anything to do with it being brought up this time). Herbxue (talk) 20:37, 30 December 2016 (UTC) It doesn't need great discussion because it's an obvious commonplace that this stuff is pseudoscientic: it isn't debated seriously. Acupuncturists getting upset about reality does not count as "debate" - we follow the sources. Alexbrn (talk) 20:40, 30 December 2016 (UTC) We are discussing the use of a pejorative label, not a matter of fact. You don't see much debate in general about what is and isn't pseudoscience anywhere other than wikipedia, so I don't think "obvious commonplace" describes this situation at all outside of the bubble of wikipedia. Its just that you want to call something a mean name, adding nothing of substance to the readers understanding other than that the editors have made a value judgement and backed it up by citing other writers that loosely used a pejorative label in passing. Herbxue (talk) 22:27, 30 December 2016 (UTC) You could put the references inside a note if you want to add more and not have it look cluttered. Sizeofint (talk) 02:12, 31 December 2016 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

He-said-she-said

Herbxue, one of our more assiduous trypanophile editors, is keen to include the following:

Andrew Vickers, lead author of the original 2012 paper and chair of the Acupuncture Trialists' Collaboration, rejects that analysis, stating that the differences between acupuncture and sham acupuncture are statistically significant.ref name=Vickers2013/>

I think it should be excluded as WP:UNDUE - Vickers published a pro-acupuncture review which was criticised, and this is his response saying the tiny effect sizes are statistically significant but failing entirely to address the actual point made, which was that they are clinically irrelevant. It's a non-sequitur and special pleading from someone committed to promoting acupuncture. Guy (Help!) 22:47, 3 January 2017 (UTC)

I looked at Vicker's review, and I'm rather shocked by the disconnect between the results and the conclusion. The results were that acupuncture is no different from sham treatment, no matter how you vary the acupuncture, (except that "moar needles = moar results!" which can't possibly have anything to do with the placebo effect...) So yeah, UNDUE by a long bit. Sorry about forgetting my <sarcasm></sarcasm> tags in that last sentence. I figured you guys can puzzle out where they belong. MjolnirPants Tell me all about it. 14:22, 4 January 2017 (UTC)

"(except that "moar needles = moar results!" which can't possibly have anything to do with the placebo effect...)" - Using more needles in both groups increases the placebo effect in both groups. A relationship of effect size to number of needs used is evidence of a dose-response effect. 85.255.235.151 (talk) 12:37, 10 January 2017 (UTC)

NICE

NICE is being held out as an arbiter of truth based on the current guidelines for migraine etc. which say to "consider" acupuncture. I think it's worth looking at what NICE said about acupuncture and back pain at the time this guidance was written:

Your doctor should offer you a choice of one of the following treatment options:

• An exercise class that is appropriate for your particular needs.
• A course of manual therapy, which will include manipulation of the spine.
• A course of acupuncture.

Your doctor may offer you another of these options if the chosen treatment doesn't result in much improvement in your back pain.

Fast forward to March 2016:

The draft guideline recommends exercise, in all its forms (for example, stretching, strengthening, aerobic or yoga), as the first step in managing low back pain.

Massage and manipulation by a therapist should only be used alongside exercise because there is not enough evidence to show they are of benefit when used alone.

The draft guideline also recommends encouraging people to continue with normal activities as far as possible.

The draft guideline no longer recommends acupuncture for treating low back pain because evidence shows it is not better than sham treatment. Paracetamol on its own is no longer the first option for managing low back pain. Instead, the draft guideline recommends that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin should be tried first. Weak opioids, such as codeine, are now only recommended for acute back pain when NSAIDs haven’t worked or aren’t suitable.

That's science for you. The evidence develops to better exclude bias and confounding, and if it turns out a treatment doesn't work after all, well, so be it. Has this stopped acupuncturists and chiropractors form continuing to offer treatment for low back pain? Of course not. It's always legitimate to ask: what evidence will cause you to change your mind? In the case of acupuncturists, I honestly believe there is no evidence that will cause them to question their fundamental assumptions. It is resistant to refutation, for the same reason as homeopathy and any other religious dogma.

Hence the issues seen on this talk page. Science says one thing, belief says another. Wikipedia goes with the science. Sorry, guys. Guy (Help!) 11:01, 4 January 2017 (UTC)

Change.org again

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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The Change.org petition lists the many problems with this article. I come here and see you editors locking discussion about it. Now NICE is being accused of being problematic. NICE is made of scientists who the NHS takes recommendations from. If you editors want to be on the opposite side of scientific officials, and pretend to have a scientifically backed article, shame on you. — Preceding unsigned comment added by Playalake (talk • contribs) 15:00, 4 January 2017 (UTC)

Did you bother to read the section above this? Saying that "NICE is being accused of being problematic" here is straight up bullshit: editors have had it explained to them that NICE is not the end-all on medical matters, that NICE isn't anywhere near as supportive of acupuncture as pro-acupuncture editors are claiming, and that recommendations for practical medicine (i.e. making people feel better) don't distinguish between treatments that only work through the placebo effect and treatments that are only as effective as the placebo effect. That is nothing like anyone accusing NICE of being "problematic". Furthermore, the article is well-sourced. Try checking out some of the sources used in it to figure out why the article says the things it says, instead of coming here with your preconceived notions about truth and trying to impose them upon the facts. MjolnirPants Tell me all about it. 15:27, 4 January 2017 (UTC)

OK I see that they have updates now, but still are waiting to issue their final statement. But before their update, I'm curious about something. How did Wikipedia cover NICE? Can someone tell me this? And NICE isn't the only thing that updates. So do Cochrane Reviews and they have since moved toward more positive statememts than your encyclopedia covers. Why does Wikipedia update NICE findings but not Cochrane findings? — Preceding unsigned comment added by Playalake (talk • contribs) 16:50, 4 January 2017 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Unanswuestions

You editors prefer to censor questions than answer them. I won't bring up other websites, but my questions remain unanswered. How did Wikipedia cover NICE before they updated? And why is everyone here quick to update based on NICE, but not care to update many Cochrane Reviews? — Preceding unsigned comment added by Playalake (talk • contribs) 19:31, 4 January 2017 (UTC)

Reverting editors: this doesn't look like trolling or off-topic discussion to me. It shouldn't be removed out of hand.

Playalake: the article as it stands summarizes scientific consensus with due mention of fringe theories. If you have specific complaints, please point out the section(s) you are referring to. AlexEng^(TALK) 22:22, 4 January 2017 (UTC)

Actually, if you read the article, there are citations to Cochrane reviews and other meta-analysis all over the place. I don't understand the basis for the question? Roxy the dog. bark 22:57, 4 January 2017 (UTC)

I was talking about updates. Cochrane updates. You Wikipedia editors are so quick to dismiss NICE because they updated, but everyone else in science does as well. The article says, "An overview of Cochrane reviews found that acupuncture is not effective for a wide range of conditions, and it suggests acupuncture may be effective only for chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache.[13] " This is old. There are at least a dozen new conditions they recommend acupuncture for based on the research. Playalake (talk) 23:03, 4 January 2017 (UTC)

Results saying "may be effective" are a dime a dozen. That wording suggests that it is an uncorroborated statistically significant study. 5% of all studies will yield statistically significant results if there is no effect - for that reason such results are neither exciting enough to quote nor an indication that there is something to it. There will always be some "may be effective" wordings, but the conditions acupuncture "may be effective" for change every few years when the old findings are disconfirmed and new random hits are made. That is the typical situation for all inefficient but well-researched medical stuff. --Hob Gadling (talk) 23:17, 4 January 2017 (UTC)

And 100% of studies designed to yield positive results will yield positive results. This is what happens in China - it's an extended exercise in taking credit for the placebo effect. Even the most glowing reviews of acupuncture for any condition have to lean on objectively terrible studies to reach a positive conclusion, but they usually admit that and are equivocal as a result. Someguy1221 (talk) 00:23, 5 January 2017 (UTC)

Trying to refute the claims of acupuncture (see here and here, and again here, for example) is like playing whack-a-mole. Proponents claim it cures dozens (or hundreds) of different conditions, and each time a claim falls flat, they simply make up a new one. Acupuncture also carries small but real risks to patients, who can suffer infections and sometimes much worse, such as punctured lungs.

— Steven Salzberg, Fake Medical Journals Are Spreading, And They Are Filled With Bad Science

Quoted by Tgeorgescu (talk) 04:07, 5 January 2017 (UTC)

Not only is there always a new condition, there is also always a new form of acupuncture. Someguy1221 (talk) 04:10, 5 January 2017 (UTC)

Also, Playalake, if you want your questions answered, you should be more truthful when you pose them: "NICE is being accused of being problematic" was, as was pointed out above, bullshit. You should at least acknowledge that. And when you write "still are waiting to issue their final statement" that is still bullshit. Unless acupuncture will some day turn out to actually work (which is pretty unlikely), there will never be a "final statement" since the status of the evidence will forever remain "no evidence for an effect was found" and there will always be people who demand "more research" until the research shows what they want it to show.

"But before their update, I'm curious about something. How did Wikipedia cover NICE?" Does that matter? Not if you are trying to improve the article, which is the goal of this page. --Hob Gadling (talk) 23:17, 4 January 2017 (UTC)

I think that as Wikipedians we're reasonably clear on the difference between clinical practice and scientific evidence, and the reason the two are often out of step (especially with pseudomedicine). I'm not sure the same can be said of the trypanophiles. Guy (Help!) 00:07, 5 January 2017 (UTC)

No! You Wikipedians are wrong. How did Wikipedia cover NICE before they updated themselves on acupuncture? Nobody answers me! Yes it matters. It shows you always have a bias! And you were the one who brought up the context for NICE being the arbiter of truth, you brought up the change.org petition so it's only fair for me to address. The petition says NICE still lists acupuncture for tension headaches and migraines, yet you Wikipedians hate this idea. Wikipedia is so keen to update NICE on back pain but not Cochrane updates! There are many many Cochrane updates yet Wikipedia lists only the old conditions! Fraud! Playalake (talk) 20:36, 5 January 2017 (UTC)

Except it's simply not true: the article is crammed full of recent Cochrane reviews. Alexbrn (talk) 20:47, 5 January 2017 (UTC)

ec NICE. You are welcome. Roxy the dog. bark 20:49, 5 January 2017 (UTC)

• How is any of this about improving the article? MjolnirPants Tell me all about it. 21:18, 5 January 2017 (UTC)

Lies! The article does not have new Cochrane updates! How about somebody reconcile a Cochrane update that says "From the available evidence, acupuncture may have beneficial effects on improving dependency, global neurological deficiency, and some specific neurological impairments for people with stroke in the convalescent stage, with no obvious serious adverse events." with says, "An overview of Cochrane reviews found that acupuncture is not effective for a wide range of conditions, and it suggests acupuncture may be effective only for chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache.[13] " sentence from the opening paragraph. Delete this sentence or turn on my edit button so I can do it myself! Cochrane changes, but Wikipedia does not! Playalake (talk) 21:40, 5 January 2017 (UTC)

You mean this Cochrane review? The one that looked at 31 randomized controlled trials on acupuncture for stroke, all of which were deemed by the authors to be heavily biased, and the best studies they could locate were unblinded. Seriously. Someguy1221 (talk) 22:51, 5 January 2017 (UTC)

Right, so this review concluded acupuncture "may have" beneficial effects (i.e. just a possibility, no good evidence) and so "There is, therefore, inadequate evidence to draw any conclusions about its routine use". Alexbrn (talk) 10:14, 6 January 2017 (UTC)

Playa you can edit articles - add or edit paraphrases from recent cochrane reviews. You may get reverted but at least we can discuss the merits of the source. Don't call people liars, focus on the content you think they are ignoring and why its relevant. You will get banned quickly which would not help to make this article less ridiculously negative. I got banned for calling a dude "Betty" and swearing a bunch. Not worth it, if you really want to help focus on the actual sources (systematic reviews).Herbxue (talk) 23:09, 5 January 2017 (UTC)

Terrible advice, given that this has already been discussed here multiple times. Much better advice is to propose an edit, and wait until it has achieved consensus before making it. Guy (Help!) 23:14, 5 January 2017 (UTC)

For the record, I think there would be some merit in including the high level summary of this review, namely:

We found some evidence that acupuncture improved activities of daily living and a number of aspects of neurological function. However, these conclusions were based on studies with low quality evidence.

After several decades and, at a conservative estimate, thousands of trials of acupuncture, the fact that this is the best they can find is pretty damning. Guy (Help!) 23:20, 5 January 2017 (UTC)

Whoah. I'm late to this party, but I have to say I agree with most of the advice and responses given to Playalake so far. Calm down and focus on the facts of acupunture - not peripheral issues such as whether NICE is 100% trustworthy or not - or you will get banned fairly quickly (that's not a threat, it's just based on experience). Famous_dog (c) 12:21, 6 January 2017 (UTC)

"it suggests acupuncture may be effective" You know what "may" means, right? You can always replace it by "may or may not" without changing the meaning. Then you see that this is not information, just noise. --Hob Gadling (talk)

How did Wikipedia cover NICE before they updated themselves on acupuncture? You can check yourself in the edit history if you're so inclined. All revisions are preserved. Sizeofint (talk) 08:17, 11 January 2017 (UTC)

In fact, acupuncture is very safe medical therapy. Clean Needle Technique is a professional stand established by several national committees more than 30 years ago in the USA. It is required by all licensed acupuncturists in their training and practice. Neither WHO nor OSHA requires acupuncturists to wear gloves in routine practice. (see position letter from CCAOM) There is no evidence or any report that needling by a dark skin acupuncturist process any risk of “non-asepsis”. Adding "Note bare hands and long sleeves" is pointless. Of course, needle should be inserted into to a bare hand and I do not see anything wrong or good with the sleeve. In fact, we do not even know if he is a licensed acupuncturist. Because of the history of this photo: a link between dark skinned acupuncturist hand to "Note lack of gloves" with Wikipedia page on "asepsis". I recommend to delete this photo and description. — Preceding unsigned comment added by Tcmaa2004 (talk • contribs) 16:45, 15 January 2017 (UTC)

There is precious little evidence that it is a medical therapy at all. Guy (Help!) 16:49, 15 January 2017 (UTC)

Acupuncture is ancient and current medical therapy for everyone, but its efficacy beyond placebo is challenged by RCTs for sure. However, RCT methodology was really developed for drugs and its direct application in a technical-device-based procedure is still very controversial. For example, many dental therapies are not RCT tested and no one call them pseudoscience. Dr Vickers report on acupuncture for pain from MSKCC is a major resource and evidence, and there are many more. — Preceding unsigned comment added by Tcmaa2004 (talk • contribs) 04:52, 16 January 2017 (UTC)

Semi-protected edit request on 12 January 2017

Please remove the words "and acupuncture is a pseudoscience" because it's a subjective judgement. Rcsoul (talk) 01:43, 12 January 2017 (UTC)

No, it is content that has been discussed extensively here on the Talk page over the years, and is well-sourced and compliant with Wikipedia's policies and guidelines. Jytdog (talk) 01:47, 12 January 2017 (UTC)

@Jytdog: So you mean those who oppose to that biased statement have to find evidence to proof that acupuncture is NOT "a pseudoscience" right? Got it. There has been much misunderatanding since the Great Firewall not only harms the freedom of us Chinese's to access foreign sites but also contributes to some bigots' comprehension to(or any suitable conjunctions) Chinese traditional and classical wisdom. Thanks to that goddamned wall!!Super Wang 11:43, 12 January 2017 (UTC)

No to oppose the statement you need to find a good source that says it is not pseudoscience. Wikipedia is built on sources, not the argumentation of editors. Alexbrn (talk) 12:03, 12 January 2017 (UTC)

And of course even then the statement would not be deleted, because there are good sources for it. If you find equally good sources, it would be qualified: Pseudoscience experts A, B, and C say it is, but pseudoscience expert D says it isn't.

But a better resolution of your problem (with slightly higher chance of success) would be to inform yourself about the properties of pseudosciences. Then you would be able to confirm for yourself that acupuncture is indeed one. --Hob Gadling (talk) 12:31, 12 January 2017 (UTC)

I'm not trying to define what a pseudoscience is, never. What I care and am concerned most is that that so-called objective and just definition hurt people. Did you mean that there must be MORE reliable sources to proove that TCM is not pseudoscience? So what does "science" mean then? Super Wang 12:24, 14 January 2017 (UTC)

Unless there's some new source on the table focusing on acupuncture and pseudoscience this thread is pointless and I suggest it be closed. Alexbrn (talk) 12:26, 14 January 2017 (UTC)

Acupuncture is not a typical subject of Sciences, but it is NOT pseudoscience. It contains a lot of scientific components with medical values, some have been approved others are being testing. Any ancient medical therapy may carry some unscientific contents but, it is not right to simply classify them as pseudoscience. The opinion of reference books cited under "acupuncture is pseudoscience" is not very popular among medical and scientific communities at least in the USA. — Preceding unsigned comment added by Tcmaa2004 (talk • contribs) 05:11, 15 January 2017 (UTC)

Wikipedia is built on sources, not the assertions of its editors. If you have no source, we're done. Alexbrn (talk) 05:20, 15 January 2017 (UTC)

Sources should be selected without bias, and more real experts should be invited to join the discussion. It's not done yet. — Preceding unsigned comment added by Tcmaa2004 (talk • contribs) 17:01, 15 January 2017 (UTC)

So, which source are you suggesting then, Tcmaa? TylerDurden8823 (talk) 23:47, 15 January 2017 (UTC)

https://health.spectator.co.uk/fakery-massive-scale-means-just-cant-trust-studies-china/ Tgeorgescu (talk) 23:55, 15 January 2017 (UTC)

Acupuncture is not science. It is a quasi-religious set of practices, so I personally don't think it's pseudoscience either (though the study of it very often is). It is definitely pseudomedicine. The thing is, though, that what we think doesn't matter a hill of beans, it's what the reliable sources say, and no reliable source on the subject of the demarcation issue between science and pseudoscience, has come down in favour of acupuncture being science.

What science tells us about acupuncture is that it doesn't matter where you pit the needles or whether you even insert them, so acupoints are fictional, the claimed "meridians" have no associated anatomy and have never been shown to exist, and a large part of acupuncture's popularity in the West stems from a propaganda stunt by Mao in the 1970s. We know it does not work for most things, we know that the effect size in all studies is small, we know that the more scope there is for bias, the greater the chance of a positive outcome from a trial, we know that no study from China has ever found a negative result, and we know that the evidence trend is firmly against it. Guy (Help!) 00:03, 16 January 2017 (UTC)

Acupuncture is ancient and current medical therapy for everyone, but its efficacy beyond placebo is challenged by RCTs for sure in the last 15 years. However, RCT methodology was really developed for drugs and its direct application in a technical-device-based procedure is still very controversial. For example, many dental therapies are not RCT tested and no one call them pseudoscience. Dr Vickers report on acupuncture for pain from MSKCC is a major resource and evidence, and there are many more. What you said about acupuncture reports from China and Mao's acupuncture are INCORRECT. If you could not read Chinese or never studied Chinese medicine and Chinese history, please declare that FIRST before you make such an absolute judgement. — Preceding unsigned comment added by Tcmaa2004 (talk • contribs) 05:05, 16 January 2017 (UTC)

It's not medical therapy, it's a quasi-religious set of practices that have been shown not to work for most situations and where the evidence of efficacy is restricted, weak and contradictory. The popularity of acupuncture in the West can be directly traced to the propaganda demonstration involving Reston during Nixon's visit in 1971. And as with most SCAM practices, acupuncture is immune to self-correction (and thus scientific validity) because it employs inoculating tactics to avoid facing incontrovertible evidence of error. Guy (Help!) 10:16, 16 January 2017 (UTC)

In can be proven with inductive reasoning that Acupuncture is not "pseudo science". "Pseudo science" is something which is pretending to be science, sort of synthetic science. Acupuncture however does not pretend to be science, rather it is pre-scientific. A subset of Traditional Chinese Medicine, which itself is subset of an ancient Taoist philosophy. I think its clear there is no consensus here that acupuncture can really be classified as "pseudo science". In fact, stating so is highly contentious, and therefore shouldn't be included in the lede of this article. In fact this entire article has no NPOV at all, which can be proven by comparing and contrasting to this article: https://en.wikipedia.org/wiki/Humorism . To say "we are not going to stop calling it a pseudo-science unless someone comes up with 20 different sources saying its not" is a ridiculous position, because thinking acupuncture is only a pseudo science and not else really is a very narrow and un-holistic viewpoint, which is frankly absurd, so not that many authorities would ever even have the notion cross into their minds, apart from the very small but vocal community of fanatical sceptics which exists mainly on the internet. This article reads like it was entirely written by single-minded sceptic fanatics and not by, you know, actual acupuncture scholars and experts. The problem as I see it is this article reads so NPOV because of the xenophobia and racism of some editors who are too small minded to see that acupuncture is a cultural and philosophical subject moreso than a medical subject. Even if we wish to treat acupuncture as a science, which it doesn't claim to be, then because of the experiential nature of the practice, it should use Husserl's paradigm of phenomenology https://en.wikipedia.org/wiki/Phenomenology_(philosophy) . Once you do that, any notion of "placebo" becomes laughable, because you're exposing your idiocy by missing the whole point. Sure, devote maybe 10% of the article to how you sceptic fanatics think that acupuncture is no better than "placebo", (but also include the evidence showing acupuncture meridians to be planes in the connective tissue of lower electrical impedence), however the bulk of the article, and especially the lede, should be devoted to the writings of actual acupuncture experts about acupuncture.Arthur Long (talk) 05:35, 20 January 2017 (UTC) EDIT: source for one medical authority stating acupuncture is not pseudo science http://blogs.bmj.com/aim/2016/12/30/is-acupuncture-pseudoscience/

Don't be silly. He's an acupuncturist. In a blog. He would say that, wouldn't he. This was explained this year, on this page I believe.Roxy the dog. bark 05:53, 20 January 2017 (UTC)

"rather it is pre-scientific" You are claiming that it will be science one day. But encyclopedias do not describe what will happen in the future, because sources from the future are hard to come by. If you want the description of acupuncture as a pseudoscience changed, you need to change acupuncture into something else.

There are lots of pretend scientific publications that claim to have found evidence. Just have a look at this page.

BTW, one hallmark of pseudosciences is that their proponents, when they recognize they have no evidence, claim that the evidence is just around the corner and that what they are defending is protoscience. I suggest we just wait until acupuncture has become a science, then describe it as one. --Hob Gadling (talk) 09:33, 22 January 2017 (UTC)

"Lack of gloves"

The "lack of gloves" description of the lead image which Guy recently re-added has been discussed before. I don't see a consensus for this description, which is basically a POV comment used to push Guy's personal opinion on the (lack of) prevalence of aseptic technique in acupuncture. For comparison, among various pages such as intramuscular injection, immunization, vaccination and so on I found a single image of use of a needle accompanied by use of gloves - and zero comments about the "lack of gloves" (with a nice easter egg link to sterile technique) in the descriptions of all the other images. If there are reliable sources that say the lack of use of gloves is a significant problem in architecture, I'd like to see them; then we could discuss - and possibly illustrate - that issue in the article's section on "adverse effects" (which currently does not mention gloves at all). Using an image caption for WP:OR commentary is not appropriate. I will thus (again) remove that part of the image caption. Huon (talk) 02:46, 15 January 2017 (UTC)

The more serious problem of this black skin hand acupuncturist needling a white hand with a description of "lack of gloves" and link to asepsis is that it make people think a dark or dirty hand transmits pathogens. The fact is with or without gloves, dark or light skin, does not matter. So, just delete the description is too late and the photo should be deleted or replaced. — Preceding unsigned comment added by Tcmaa2004 (talk • contribs) 04:50, 15 January 2017 (UTC)

I think that is taking it to far. Carl Fredrik 💌 📧 10:15, 15 January 2017 (UTC)

— While there has been criticism of acupuncture for lack of antiseptic technique, mentioning the lack of gloves does seem to be unnecessary and is unlikely to be the major point of criticism in this realm. It is correct to say that using gloves is part of suggested antiseptic technique — however in practice they are often omitted upon taking blood samples or even drawing arterial blood — simply because they decrease the accuracy of the wearer. Acupuncture has many issues, I think this is one of the lesser ones, and doesn't require mentioning. The argument could be made that since acupuncture is entirely unnecessary (unlike a properly indicated arterial blood-test) that it is more of an issue since choosing to forgo gloves doesn't take into account an analysis of risks vs. benefits. However that sets an odd precedent and likely borders on WP:OR. Carl Fredrik 💌 📧 10:15, 15 January 2017 (UTC)

What concerns me more is that the practitioner is wearing a suit with long arms — making it very difficult to properly clean and sterilize his hands. Carl Fredrik 💌 📧 10:17, 15 January 2017 (UTC)

Lack of sterile technique is a common criticism of acupuncture (e.g. in isbn:1938463633, by an infectious disease specialist). Acupuncturists don't seem to believe in it, and write their own rules, much as they invent their own anatomy. Some acupuncturists don't get the germ theory in the first place, of course. The picture is a perfect illustration of what not do do when penetrating the skin with a needle. The constant efforts of trypanophiles to normalise the problems with acupuncture are a bit of a problem. Guy (Help!) 10:33, 15 January 2017 (UTC)

Yes, absolutely. But we're not even mentioning gloves in the body of the text. Unless we're able to prove that this is a major criticism, and actually state this in the article I think it is undue to caption the image like that. I'm not saying it's incorrect, but if we only have it in the image caption (and unreferenced to boot) it seems undue. I'd be more supportive to of a caption in style of "needles inserted into a human arm without proper sterile technique". That seems less OR and also covers the inadequacy of wearing long-sleeves. Carl Fredrik 💌 📧 11:26, 15 January 2017 (UTC)

I'm happy to discuss how we cover it, but ultimately the most striking thing about that photograph is that it will make anybody with any awareness of infection control cringe - and that is representative of most photographs of acupuncturists at work. Guy (Help!) 12:04, 15 January 2017 (UTC)

How about the following:

This image displays inadequate use of sterile technique, something acupuncture has seen significant criticism for.[ref 1938463633]</ref>

That doesn't reek of OR in my eyes, at least not as much. Feel free to add it if you want, otherwise I will do so shortly. Carl Fredrik 💌 📧 12:14, 15 January 2017 (UTC)

I'd say adding that commentary to the lead image is at the very least undue weight, particularly since we don't use it to illustrate the relevant parts of the article and since a single book hardly qualifies as "has seen significant criticism for". I expect all the people who cringe at this image equally cringe at File:Typhoid inoculation2.jpg? Long sleeves, no gloves? Should I add such notes to instances of that image, too? I'm aware this is a pointy argument and do not propose doing that, but I'd like to hear from all those who are concerned about the image in this article whether they're equally concerned about the other - and if not, why not. Huon (talk) 13:07, 15 January 2017 (UTC)

Well the typhoid photo was taken in 1943... Adrian J. Hunter^{(talk•contribs)} 13:23, 15 January 2017 (UTC)

Yup. Since then reality-based medicine has learned to do things much better. Acupuncture lags behind best practice by the odd millennium or two. Guy (Help!) 13:52, 15 January 2017 (UTC)

That is fine by me. The claim of "undue weight" can be viewed as special pleading in context I think. Guy (Help!) 13:50, 15 January 2017 (UTC)

The comment in the lede presently mentions "clean needle technique and single-use needles." That seems appropriate and it's properly referenced. In the context of the picture being compatible with clean needle technique, and also with ordinary practice in office medicine, we'd need a specific reference to suggest that there's a problem with the practice depicted. Richard Keatinge (talk) 14:41, 15 January 2017 (UTC)

Like the book I cited, by infectious disease specialist Mark Crislip. Guy (Help!) 16:47, 15 January 2017 (UTC)

Could you give the title or the isbn-13? Carl Fredrik 💌 📧 16:56, 15 January 2017 (UTC)

It's Puswhisperer: A Year in the Life of an Infectious Disease Doctor, published by Bitingduck Press - I haven't found the specific entry, but I'm pretty sure it's a collection of blog posts from here. The author's sources for his conclusions: A Google Image search plus some isolated cases. Somehow I doubt that book is WP:MEDRS compliant for such a general conclusion. As an aside, if you want newer cringe-worthy images where you can include warnings about the lack of sterile technique, try File:Bracing for a short, sharp jab.jpg - that's 2011, long sleeves, no gloves. Found in intramuscular injection. Or File:Intramuscular Injection.JPG from the same article, 2010, no gloves (no way to judge sleeve length), fingers very close to the point of injection. What I call special pleading is to argue for the addition of such personal commentary in this article but not in others. Huon (talk) 22:47, 15 January 2017 (UTC)

The issue is, though, that those images are not representative of current practice, whereas the acupuncture image, by its position at the head of the article, is implicitly exactly that. And actually the evidence shows that this is correct, that aseptic technique is not commonly followed by acupuncturists, and indeed there's credible evidence that a sizeable proportion of the acupuncture community don't even understand the issue. Guy (Help!) 23:01, 15 January 2017 (UTC)

Depending on the indication, some IM-injections do not include a recommendation of being performed under sterile conditions. For example adrenaline IM is rarely if ever given under sterile conditions, and autoinjectors are made to be used in non-sterile conditions. Carl Fredrik 💌 📧 23:14, 15 January 2017 (UTC)

Well, the trypanophiles seem to want to have it both ways: they are somehow exempt because they have "special" rules, and yet there is no need because it's inherently safe. In fact, as with most things related to acupuncture, it's a mess, because the agenda is driven by belief, not fact. Guy (Help!) 23:23, 15 January 2017 (UTC)

You're welcome to bring reliable sources that make those points. Are you seriously arguing that that collection of blog posts which says a Google Image search shows few acupuncturists use gloves is compliant with WP:MEDRS? Or is this just your personal opinion? And yes, the acupuncture image, because someone put it at the head of the article, indeed will be taken as representative of current practice. That, however, is not some inherent property of acupuncture but an editorial decision on Wikipedia. If this aspect of acupuncture is the one that needs to be emphasized in the lead image, I'd like to see much better references declaring that it is indeed the main aspect. Huon (talk) 07:35, 16 January 2017 (UTC)

That is an assessment of the endless debates on this page, not a content suggestion. The endless special pleading by trypanophiles is self-evident form the archives. Guy (Help!) 10:11, 16 January 2017 (UTC)

The inconsistent use of sterile technique by acupuncturists is a frequent topic of discussion by skeptical sources. I'm actually surprised it is only mentioned in the caption to that photo. Someguy1221 (talk) 10:19, 16 January 2017 (UTC)

Indeed. However, there is a difference between full sterile technique using gloves, drapes, wipes etcetera - which is not used for most skin puncture procedures by acupuncturists, nor by conventional doctors - and clean needle technique, which is routine for even the most minor procedure. And the picture seems entirely compatible with clean needle technique and therefore with accepted good practice. The comment does need to go, sorry. Richard Keatinge (talk) 10:27, 16 January 2017 (UTC)

Several guidelines state that clean needle technique is not enough. Carl Fredrik 💌 📧 10:49, 16 January 2017 (UTC)

Maybe I need to change my own practice for taking blood etc. If you have authoritative guidelines, well-founded on good evidence, I might do so. Let's have them. Richard Keatinge (talk) 11:04, 16 January 2017 (UTC)

Dunno, our local practice nurses use a minimum of gloves and alcohol wipes for all injections and blood draws, and of course bare below the elbows. Guy (Help!) 11:24, 16 January 2017 (UTC)

Richard Keatinge – [8]/[9]

Aseptic technique is one out of 5 points involved in preventing infections. Carl Fredrik 💌 📧 11:59, 16 January 2017 (UTC)

Thanks for those references. They are guidelines written for and presumably by acupuncturists and they don't seem to quote any evidence. Now, neither I nor any of the primary health care professionals whose practice I'm familiar with use anything more than clean needle technique for blood sampling. Many years ago I recall some evidence - I can't be any more specific - that so long as the skin is socially clean, nothing more is required. And, in thirty-five years of practice, I've never seen or heard of an infection that could plausibly have been caused by my venous sampling technique or anyone else's. (It's different with longer-term IV lines.) The lack of infections I did have occasion to check with a room full of perhaps thirty colleagues in primary care. I'd require direct evidence to change my practice or that of my nurses, and I don't see it. I have no interest in doing acupuncture or having it done, but I'd have thought that clean needle technique would be perfectly acceptable so long as you're not sticking the needles in too far. Over-cautious guidance from socially-aspiring acupuncturists are not, to put it politely, evidence. Richard Keatinge (talk) 13:45, 16 January 2017 (UTC)

Well, Richard, you know I hold your opinion in high regard, so what do you think we should say? There is a decent amount of commentary on poor infection control, we know that humoural belief systems encompass germ theory denialism, and there is no doubt that the picture exhibits poor practice which is not at all unrepresentative. I'm pretty sure we both remember Cameron being booted from a ward because he had long sleeves on. I'd be happy to replace the image with one showing best practice. Guy (Help!) 20:53, 16 January 2017 (UTC)

Note to onlookers: Richard and a couple of friends taught me skepticism even before I knew it was a thing: respect for evidence above all else. Guy (Help!) 20:56, 16 January 2017 (UTC)

Thank you for your kind remarks. Poor practice for hospitals maybe, where there are nastier germs around and sicker patients with much larger holes being made in them, but I still come back to the point that actually, the practice shown is not unusual nor necessarily poor. I would think the best solution would be a picture that shows the full sterile precautions recommended by the WHO acupuncture guidelines, with no comment. I don't have such a picture but maybe another editor can produce one? Richard Keatinge (talk) 15:55, 19 January 2017 (UTC)

Semi-protected edit request on 16 January 2017

close non-productive

TCM theory and practice are belongs to ancient science although not based upon modern scientific knowledge,[1] and acupuncture is not fully understood yet by the modern science therefor some people think it is a pseudoscienceATCMA (talk) 02:50, 16 January 2017 (UTC) ATCMA (talk) 02:50, 16 January 2017 (UTC) Please just add a proposal to modify the text in the article without using an edit request. Such requests are only for simple and non-controversial changes which could be performed by a robot if it could read the request. The text above includes "are belongs" which does not make sense. The rest of the text seems to be a suggestion that modern science should be disregarded. That is not going to happen at Wikipedia. How would you feel if you spent an hour reading an article here on a topic you were not familiar with, then later found that the article had ignored modern science and was in fact written by enthusiasts? Without reliable sourcing, such an article would merely be telling you what enthusiasts hope. Use Google to find websites to fill that need. Johnuniq (talk) 04:14, 16 January 2017 (UTC) off-topic: That actually sounds like "all your base are belong to us". --Artoria2e5 emits crap 01:15, 18 January 2017 (UTC) @Johnuniq: You mean Google is scientific?! With reliable sources?! Only on Google can we find appropiate sources?! LMAO. (off-topic) @Artoria2e5: Is laughing at others' poor English interestin g dude? Super Wang 09:24, 19 January 2017 (UTC) @Super Wang: While Google is nowhere near being a scientific source itself, its crawlers and search service yield a fair estimation of what's considered WP:DUE weight. If something is not found on Google, then it's usually either too new to be significant or too unpopular to be mentioned. off-topic: It's not, but most of your sources are belong to Google's index. --Artoria2e5 emits crap 15:52, 19 January 2017 (UTC) (off-topic) What a astonishing thought... What does "your sources" mean? By the way, I suppose and suggest you never learn Chinese. Now stop with that lingua praecellentia bulls**t. not off-topic-> I recall of the experience of appealing the meta to add Baidu as a transwiki. Though those meta fellows didn't promise, one must admit that they can get more reliable source in Chinese on Baidu -- of course, let go of the censorship. Super Wang 04:21, 20 January 2017 (UTC) Admittedly Baidu currently gives better results for simplified Chinese queries (Google has been better until recently). off-topic: This is getting insane. I admit my unfamiliarity with Baidu as I have always been avoiding it for searches since 2014 by using Bing China or Google instead, but what on earth does your comment on "Chinese" come from? I used to use Baidu Tieba, and I speak zh-CN natively. (My avoidance of Baidu has nothing to do with its infamous medical advertisement; it's instead based on usability with English and technical queries.) Regarding Chinese sources (which is what we are actually talking about), look around the rest of this talk page and section Publication bias for what usually happens to them in this article. Somebody set up them the bias; --Artoria2e5 contrib 05:21, 20 January 2017 (UTC) ... and Wikipedia's stance on acupuncture is not going to change as long as the medical society (I mean, WP:MEDRS) does not find these positive studies reliable. off-topic: For "someone", try the terrible "all the blame goes to the commies" (Chinese: 都是阿共仔搞的鬼) blame. It's not that unfair if you consider Acupuncture#Modern era. --Artoria2e5 contrib 05:39, 20 January 2017 (UTC) @Super Wang: Hmm. Johnuniq is not even suggesting that Google is scientific; he is just saying that you can find websites that match your taste with Google. Bad argument turn on. --Artoria2e5 contrib 09:11, 20 January 2017 (UTC) @Artoria2e5: Hm? I did NOT want a bad argument; maybe I misestimated your bilingualism. A'right, I have to express my apology. However, Google matches my taste? Don't mess that with me. I look forward to your explaination. About publication bias, not only PRC but also other countries emphasize on that. Once more, Communists have not ever dug your family's grave (I am responsible for whatever I comment), therefore you stop with "都是阿共仔搞的鬼". Besides, this is enwp. Super Wang 10:45, 20 January 2017 (UTC)

Just jumping in whenever the "Mao created TCM" myth pops up - he certainly was important for the establishment of the big 5 TCM Universities run by the government and supporting the business of Chinese herbs, but Chinese medicine based on Yin Yang and other traditional theories has been continuously practiced for over 2,000 years. The modern curriculum of study started taking shape decades before Mao and has been practiced in countries like Taiwan, Malaysia, Japan, Singapore without influence from the mainland Chinese government.Herbxue (talk) 16:55, 23 January 2017 (UTC)

Related discussion on zhwp VP

Chinese Wikipedia has seen a few posts around pseudoscience, acupuncture, and TCM in its Village Pump page for article discussions: acupuncture, Template:Alternative Medicine Systems, topics characterized as pseudoscience (inclusion of TCM). Some arguments for acupuncture's "disputed science" status on Wikipedia include:

• Scientific TCM theories, including "acupuncture science", are formally taught in universities in China and Taiwan. Related textbooks may safely count as WP:MEDRS if publication bias is not accounted for.
• Suggestions to use the phrase "borderline science", as given in Pigliucci, Massimo (2013). Philosophy of Pseudoscience: Reconsidering the Demarcation Problem. University of Chicago Press. p. 206..
• Disputes around the definition of pseudoscience. This is mainly uninteresting WP:original research, so I won't elaborate on this.

Unsurprisingly, there has been outcries against perceived unfairness/discrimination against Chinese publications in English Wikipedia and the removal (actually, renaming) of sections Scientific view on TCM theory and International reception (now Purported scientific basis and Adoption). Avoidance of publication bias in Chinese-language literature also lead to discussions around NPOV itself. --Artoria2e5 contrib 01:44, 20 January 2017 (UTC)

Edzard Ernst recently stated his belief in publication bias in Chinese medical literature, but a long time ago (I forget where, so I don't have a link) he had an alternate theory: design bias. That is, virtually all acupuncture studies conducted in China suffer from similar methodological flaws that guarantee a positive result: No control groups or the wrong controls, no blinding or improper blinding, small sample sizes or too many subgroups, and enough parallel measurements that something is bound to come out positive. And if all else fails, just torture the data and try every statistical test until you find something good to say about it. So basically you could potentially arrive at China's 99.7% positive-result rate with hardly any self-censorship. The trend I consistently see is that skeptics will call out the bad sources, explain in detail why they are pseudoscience, but the bad publications never stop coming. And then people come here, insisting that this new research rescues the subject by virtue of being more recent than the criticisms. "Those criticisms don't apply to this new source, because blah blah blah..." But a careful reading will show that all of these new sources suffer from the exact same problems skeptics have always been pointing out. So in summary, I would say that we call acupuncture a pseudscience because the best sources do, and the fact that acupuncturists won't stop arguing doesn't change anything. Someguy1221 (talk) 02:14, 20 January 2017 (UTC)

I think actually that there are multiple sources of bias.

First, studies are designed on the assumption that a theory is correct, when that assumption is at least questionable. This besets most SCAM research especially homeopathy and chiropractic .

Second, studies are designed to confirm the hypothesis rather than test it.

Third, negative studies are less likely to eb published (which also applies to reality-based medicine).

Fourth, there is a culture of not challenging respected authorities, which in most cases means not going against the status quo.

I am sure there are others too. Guy (Help!) 12:34, 20 January 2017 (UTC)

I am a Romanian. I know that it is an objective fact that scientific publications of Romanian scientists who live and teach in Romania have a low impact in world science. I am not offended by this fact, since it reflects the Romanian reality. Why Chinese people should be offended because Chinese scientists who live and teach in China produce low-quality scientific work? People should not be offended by objective facts. Tgeorgescu (talk) 23:10, 21 January 2017 (UTC)

JzG's first and second points say it well. Such ancient "scientific advances" as TCM & acupuncture (well, thank Mao for these two) are part of Chinese national pride, and you know your belief is in trouble when people say parts of your pride are wrong. --Artoria2e5 contrib 01:42, 22 January 2017 (UTC)