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Is the guideline for leads in medicine-related articles in this version of the Medicine-related articles Manual of Style in agreement with Wikipedia:Manual of Style/Lead section? Should WP:MEDLEAD be in sync with WP:LEAD?

Please avoid threaded responses in the "Survey" section, and start a new sub-section in the "Discussion" section for threaded commentary. 22:10, 22 December 2019 (UTC)

• No, not in sync, but should be. Remove all content from the section, WP:MEDMOS#Lead: there is nothing unique about leads in medicine-related articles, this is a fork of a standard guideline, and there is little in this section that is in agreement with Wikipedia's broader guideline, WP:LEAD. Some of the forked guideline text directly contradicts Wikipedia's broader guidelines, and application of these recommendations has resulted in choppy prose, a loss of clarity, and over-cited leads.

  See the discussion at the talk page of Featured article Schizophrenia for a sample of problems resulting from application of this guideline. The specific issues in this text—that has been disputed for many years—are:

1. Language can often be simplified by using shorter sentences, having one idea per sentence, and using common rather than technical terms. No such restriction on sentence length is in LEAD. Guidelines on making technical articles accessible are already available (MOS:JARGON and WP:TECHNICAL), and they do not include restrictions on sentence length. The advice about using common rather than technical terms is contained in the general sections of MEDMOS, and is not unique to the lead. Application of this sentence length restriction and oversimplified language has led to a loss of clarity and the precision required in medicine (see Talk:Schizophrenia example cited above).
2. It is also reasonable to have the lead introduce content in the same order as the body of the text. This is not true for every topic, and forcing the lead to a specific flow causes prose deterioration in articles (particularly Featured articles with carefully written leads) where the flow of information may need to be presented differently than the set structure that has been imposed. There is no such requirement at LEAD, and forcing a set structure can actually cause the lead to be less understandable to a broad audience.
3. Avoid cluttering the very beginning of the article with pronunciations or unusual alternative names. This is distinctly at odds with the wider guideline, MOS:LEADALT.
4. Medical statements are much more likely than the average statement to be challenged, thus making citation mandatory. This text is at odds with LEAD (see example at Talk:Schizophrenia). Text that must be cited is clearly discussed in broader guidelines: no evidence that medical content is any different has been presented. That overcited leads aid the reader has been rejected by the broader community, and medicine is not an exception.
5. The final sentence at WP:MEDLEAD indicates why these deviations from WP:LEAD have been introduced: To facilitate broad coverage of our medical content in other languages, the translation task force often translates only the lead, which then requires citations. Translation to other languages may be a laudable goal, but to facilitate a non-English-Wikipedia project, restrictions in medical articles that go beyond WP:V and LEAD are being added to MEDMOS, resulting in deterioration of leads on en.wikipedia. The chart does not contain information unique to medical content.

Medicine project guidelines must remain consistent with Wikipedia's broader guidelines. If the Wikipedia community wants to force citations and short sentences in a set order into leads for purposes of translation to other languages, that should be accomplished at WP:LEAD, not within the guidelines of one Wikiproject. SandyGeorgia (Talk) 22:10, 22 December 2019 (UTC)[reply]

• Reject RfC wording as a leading question where there is only one right answer. However, this is not the website to argue that the rules must be followed without exception. Is there any actual problem apart from pointless arguments about whether complex jargon (because it's an encyclopedia) is preferable to comprehensible wording, or whether the rule about no-citations-in-lead is mandatory? Are Pokemon articles really the same as medical articles? Johnuniq (talk) 22:40, 22 December 2019 (UTC)[reply]
• Reject RfC Adding a second even more leading question doesn't make the first question less leading. Also "agreement" or "sync" are not the important question but whether something is permitted in which case consensus would prevail. AlmostFrancis (talk) 00:00, 23 December 2019 (UTC)[reply]
• Yes in sync however we are here to write an encyclopedia We have a guideline that says "The content in articles in Wikipedia should be written as far as possible for the widest possible general audience." which is similar to saying "The lead of an article, if not the entire article, should be written as simply as possible without introducing errors or ambiguity." This was discussed in 2015 when this text was added.[1] Wikipedia has received a lot of criticism, both in the academic[2][3] and lay press, for being overly complicated. We are not talking about writing the entire article to a grade 6 or 8 reading level (or any of the article for that matter). What we are discussing is trying to approach a grade 12 reading level for the leads which we have made progress on over the last 5 years in the area of medicine.[4] Translation is tremendously important. Our mission is to provide "every single person on the planet... free access to the sum of all human knowledge". This helps achieve that. The medical translation effort has resulted in more than 6 million words of text being translated. User:Subas Chandra Rout has translated more than 1,000 of these leads into Odia, a language spoken by about 40 million people, in which machine translate does not exist, and in which basically no medical content previously existed online. Efforts to try to isolate English Wikipedia from collaborating with other language versions is disappointing. Doc James (talk · contribs · email) 01:41, 23 December 2019 (UTC)[reply]
• I don't see that WP:MEDLEAD contradicts the general principles of MOS:LEAD. It seems to me that MEDLEAD builds upon MOSLEAD in the same sort of way that MEDRS builds upon WP:RS, and does so because we have specific needs within our topic area. We know that our medical articles have impact well beyond the English-speaking world, and that they are accessed by many readers whose first language is not English, as well as being frequently translated into many other languages. We understand the importance of getting clear and simple medical information to readers in countries when disease outbreaks occur: Wikipedia is acknowledged as one of the foremost sources of that information. If you summarise the advice in MEDLEAD as "keep the language simple and cite the content", it doesn't seem to me to contradict the spirit of any of the guidance in MOSLEAD concerning the text of the lead, in particular "The lead should stand on its own as a concise overview of the article's topic." and "The lead must conform to verifiability ... there is not ... an exception to citation requirements specific to leads." I remain convinced that the advice given in MEDLEAD is good advice, and has a good purpose behind it. I don't believe that removing the advice or attempting to make it say only what is in MOSLEAD is beneficial to medical articles or to their readers. --RexxS (talk) 03:03, 23 December 2019 (UTC)[reply]
• I worked with others many years ago to polish MEDMOS and helped push it to guideline status. We examined featured content at the time, and got input from expert writers. Guidelines should reflect best practice as performed by multiple editors in consensus, and must never be amended in order to support an idiosyncratic approach. There's a clear COI and this is a guideline-fork being used to support non-consensual editing at odds with wider Community guideline and practice. That shouldn't be how Wikipedia works. Why does MEDMOS have a chart of native languages? The tail-wagging-the-dog argument wrt translation is yet another example of where off-wiki projects lead to a sub-optimal kludge that makes Wikipedia worse. Our leads should be a joy to read, not choppy fragmented sequences of incoherent factoids littered with unnecessary citation noise. I don't accept the argument at all that this makes translation harder, but fundamentally, that isn't Wikipedia's primary concern, which is to our readers. There is no good justification for any of the content in WP:MEDLEAD. -- Colin°^Talk 10:11, 23 December 2019 (UTC)[reply]
• yes in sync per Doc James rationale, which seems logical IMO--Ozzie10aaaa (talk) 12:44, 23 December 2019 (UTC)[reply]
• Yes in sync to the first question of the RfC; which means the second question does not apply imo. We have good data that people access medical articles for medical advice (rather than general knowledge) and that many only read the intro. I think the MEDLEAD is a natural extensive of the LEAD guideline and the advice is solid given the use case. Ian Furst (talk) 14:54, 23 December 2019 (UTC)[reply]

Discussion of JohnUniq's comment

I added a second question to hopefully make the choice less binary.[5] Pokemon articles are quite different from medical articles; clarity in medical topics is undoubtedly more important than in Pokemon, and community-wide guidelines have been vetted to enhance clarity and accessibility. SandyGeorgia (Talk) 23:04, 22 December 2019 (UTC)[reply]

More discussion

SandyGeorgia, it appears that WP:TECHNICAL says to "Use short sentences when possible. Comprehension decreases dramatically when sentence length exceeds 12 words. However, using too many short sentences in a row becomes monotonous; vary sentence length to maintain reader interest." This direction to use short sentences feels more restrictive than merely observing that "Language can often be simplified by using shorter sentences". WhatamIdoing (talk) 05:14, 23 December 2019 (UTC)[reply]

Precisely. And the drive to make them ever shorter, and ever simpler, than Wikipedia-wide guidelines suggest, leads to a loss of clarity and specificity (so essential to making medical content digestible, accessible and relevant). Adding to that the drive to put a citation in the lead on each text fragment means that sometimes the clearest and most accessible wording can't be used, because it can't be cited to (or at least, hasn't been in examples I've seen) the simple sources (not necessarily the highest quality sources) used. I'll continue in RexxS's section below. SandyGeorgia (Talk) 15:43, 23 December 2019 (UTC)[reply]

Content fork?

Colin suggests that MEDLEAD is a content fork, which of course is a guideline about articles, and not project space. The relevant advice for guidelines is actually neither policy nor guidance and is at WP:GUIDELINEFORK, which recommends not to create a page "that conflicts with or contradicts an existing one". I maintain that MEDLEAD neither conflicts with or contradicts MOSLEAD, but supplements it for medical-related articles. It is common practice on Wikipedia for sub-topics to receive different, sometimes inconsistent guidance, and an obvious example is how WP:NPROF and WP:NSPORT differ from WP:GNG and from each other – the criteria in NPROF replace those in GNG; while those in NSPORT supplement GNG.

We are not a bureaucracy, with hide-bound rules, and the guidance given should reflect best practice, and if necessary, we have an RfC to determine what that is.

Turning to specifics: why shouldn't MEDLEAD have a chart of native languages? It helps editors understand the issues faced in making our content available to its readers. Our vision is "a world in which every single human being can freely share in the sum of all knowledge" and that means we should be doing whatever we can to increase the availability of our content to every single human being, which includes improving its readability and accessibility, as well as making it easier to translate. This not "tail-wagging-dog"; it is a fundamental principle of writing Wikipedia – what Jimbo called "the nearest thing we have to a prime directive".

There is nothing sub-optimal about making the reading level of our leads (medical or otherwise) low enough to be accessible to the broadest possible audience. That means writing shorter, more direct and less complex sentences to aid comprehension. It means using the simplest phrase available, while still preserving meaning. Wikipedia is not the place for editors to show off their vast vocabulary by using "oral" instead of "by mouth" or "renal" instead of "kidney". I'll gladly sacrifice some of the joy of reading a lead of Shakespearean quality for having one that a 15-year old kid in sub-Saharan Africa can grasp immediately. That's the justification for what's in MEDLEAD, which makes it clear that our editors are pragmatists, not elitists, and write content for the whole world, not just the privileged few. --RexxS (talk) 14:39, 23 December 2019 (UTC)[reply]

RexxS, once again, yes, once again, you haven't read carefully what I wrote and spent the first part "correcting" something I didn't write. I wrote "guideline fork" both in the text above and the edit summary. I should also point out that we do have actual content forks for translation: Wikipedia:WikiProject Medicine/Translation task force/RTT(Simplified)L lists lots. So the argument that our leads, read by millions of en.wp readers and thousands of times every day by poor Alexa, needs to be corrupted in order to help translation is, well rubbish. We end up with articles saying weird stuff like Hydromorphone: "It may be used by mouth". Indeed at Haloperidol the infobox has "by mouth, IM, IV, depot (as decanoate ester)" as though anyone familiar with the other jargon and abbreviations would stumble over "oral". The irony is:

• "By mouth" -> oral (Spanish), par la bouche (French), mit dem mund (German), pela boca (Portuguese), per via orale (Italian)
• "oral" => oral (Spanish), oral (French), oral (German), oral (Portuguese), orale (Italian)

So we've substituted a word "oral" that has a direct equivalent in every major European language, for a word "mouth" that is exclusive to English. We've also failed to help learners see the word "oral" used in a common context, the most important way that we learn and establish words. By going out of our way to avoid "taken orally" we fail to educate our readers with examples of common English they might hope to pick up when reading an encyclopaedia. But hey, apparently the sentence "Neuroleptic malignant syndrome and QT interval prolongation may occur.", is just fine -- a pair of incoherent factoids with no meaning. And "Haloperidol may result in a movement disorder known as tardive dyskinesia which may be permanent" is just grammatical garbage. Haloperidol is a noun can can't "result in" anything, even if "result in" was ever good English. There is more to writing accessible English than inserting baby words here and there and Wikipedia does have role in helping readers see words in context rather than hiding them away. Some basic competence with gramma,r and stepping back to see if what has been written is a coherent paragraph that makes any sense. Once again, WP:MED is focusing on the wrong thing, and forgetting the basics. -- Colin°^Talk 16:26, 23 December 2019 (UTC)[reply]