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Currently there is confusion around if references are needed in the lead or not. My position is that we should have references in the lead and this is for a couple of reasons:

1. Our readers expect them. I used to not add refs to the lead and people would come along and add "citation needed". Used to get into small edit wars to remove them. A huge drain on time.
2. Am working to improve and translate the leads of key medical articles into as many other languages as possible. So far have 51 articles ready Wikipedia:WikiProject_Medicine/Translation_task_force/RTT(Simplified)L. Other languages of course need references to. Thus everyone referencing the lead helps support this effort.

Will add something along this line to our MOS unless people oppose. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:46, 4 September 2014 (UTC)

• I completely agree that referencing the lead of medical articles is important. Ideally, the lead of Wikipedia health articles will be a well referenced plain language overview of the topic that can be re-used separately for a brief standalone article for either translation or as simple introduction to a topic. Sydney Poore/FloNight♥♥♥♥ 13:49, 4 September 2014 (UTC)
• Support It seems like a good idea but this is a change at odds with many years of precedent as presented at Wikipedia:Manual_of_Style/Lead_section#Citations. I would like to see a lot of support from health editors before this is put into MEDMOS. This might also be a good time to confirm WikiProject Medicine's stance on the necessity of citations. In much of Wikipedia, citations are optional. In medicine it is my understanding that information is deleted without discussion when it is not backed with citations. Perhaps the broader idea here is that all health content on Wikipedia must be followed with citations after every sentence, with the complementary idea that it is desirable for as many statements on Wikipedia as possible to be backed with citations. Blue Rasberry (talk) 13:59, 4 September 2014 (UTC)

The style I use if a ref supports an entire paragraph is have the ref at the end and hidden refs after each sentence. It makes it a lot easier to figure stuff out if text is rearranged or someone adds a citation needed tag Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:47, 4 September 2014 (UTC)

Bluerasberry You are saying that most of WP violates WP:VERIFY? That is terrible! Jytdog (talk) 13:18, 13 December 2014 (UTC)

Jytdog WP:VERIFY says that content must be "verifiable", meaning that someone could add citations to the content. There is not a general rule that says content must have citations after it. I would like to press for a general rule to say that all content must be followed by a citation, and trend toward changing WP:VERIFY to say that content must be "verified with citations" and not just "verifiable". In medicine, people have almost always required citations. For other areas, perhaps 20% of content is kept without citations. Blue Rasberry (talk) 19:59, 31 December 2014 (UTC)

The proposal above is not so much at odds with Wikipedia:Manual of Style/Lead section#Citations; that guideline is clear that it's a good idea to add citations to the lead for controversial or otherwise likely to be contested matters. Well, medical text (not all of it, but a lot of it) is likely to be contested. I prefer citations in the lead for any Wikipedia article, since so many Wikipedia editors (even experienced Wikipedia editors) don't consider that what is in the lead might be cited lower in the article. It's the same type of thing that leads to WP:Citation overkill; for example, a Wikipedia editor not considering that an entire paragraph is likely sourced to the one reference at the end of the paragraph (it's often the case that the editor simply was too lazy to read the source).

Blue Rasberry has started a discussion on this matter at Wikipedia talk:Manual of Style/Lead section. Flyer22 (talk) 16:22, 4 September 2014 (UTC)

• Support. I tried to do this on the dextroamphetamine page, but they were removed by User:Seppi333, and then he told me that in order to make them in line with other amfetamine-related articles I had to place the references in some footnotes, which takes up some unnecessary time, especially seeing how I was only going to place just one pertinent reference for each point, hence there'd be no issue of clutter (If you would like to see this discussion see here). Brenton (contribs · email · talk · uploads) 17:25, 4 September 2014 (UTC)
• support any claim made about health is highly likely to be contentious and since there is a high likelihood of people assuming that "Its in Wiki, it must be true" we should be extra cautious about putting people's health in jeopardy. -- TRPoD aka The Red Pen of Doom 21:56, 6 September 2014 (UTC)
• Oppose. The general WP manual of style is stringent enough by saying refs can be added for controversial claims. I do not agree with above commenters that most health claims are controversial, only a small minority are and they are the exception rather than the rule. Furthermore I fully support the translation project, but I don't think that is reason enough to change guidelines for article content on this Wikipedia. --WS (talk) 22:07, 6 September 2014 (UTC)
• Support. Will save my sanity at subsequent FA noms. Seppi333 (Insert 2¢ | Maintained) 22:34, 6 September 2014 (UTC)
• Support. I agree with the statement above that readers expect references in the lead. I think the absence of references in the lead can cause a lot of confusion for readers since some of them may not be willing to scroll lower and see that the content in the lead is just the brief summary and that the references come later. I don't see any particular harm in having the references in the lead and again in the body of the article. Is it a bit redundant? Yeah, but as an encyclopedia it is always best to remember that these articles are meant to be read and it's important to appreciate the readers' perspective. Even if this is at odds with years of precedent from Wikipedia guidelines, I think this can be a positive change. TylerDurden8823 (talk) 23:01, 6 September 2014 (UTC)
• Oppose. Wow, this thread sure shows a lot of confusions piled on top of confusions.

  WP:Verifiability policy trumps WP:Manual of Style and other guidelines; any facts added to a WP article's lead have to have citations somewhere in the article. If the facts are not in the main body of the article and cited there, then they have to be cited in the lead. That also means rewriting is in order, because something in the lead should also be mentioned in the main body of the article, as the lead is just a summary.

  WikiProject Medicine does not maintain its own manual of style, but a Wikipedia Manual of Style sub-page, and it is subordinate to the main one and to the general rules in the not-field-specific sub-pages like MOS:LEAD; it is not "our [i.e. this wikiproject's] MOS" in distinction to WP's MOS. This is a matter of policy, at WP:LOCALCONSENSUS. If some participants in WP:MED want to do something notably divergent from the mainstream MOS, they should seek consensus outside their topical camp, to change the broader guidelines (either to apply more generally what these wikiproject participants want to do specifically, because it's a better approach, or to account for what these wikiproject participants want to do as an explicit topical exception to general practice, and why). Note WP:ADVOCACY, WP:SOAPBOX and WP:FACTION and the failure of WP:Esperanza; no wikiproject is an entity unto itself, a club, an organization, in a position to engage in collective wikipolitical activism positions; there is no "WikiProject Medicine's stance on" anything, except on the off-chance that something actually gains unanimous wikiproject participant support, and even then that's simply what some editors with a similar interest agree on, and does not represent any kind of supervote on Wikipedia.

  The notion that facts in medical article leads are unusually likely to be challenged is false; rather, facts in leads that are not sourced in the main body are likely to be challenged, regardless of topic, and facts anywhere within medical articles are more likely to be challenged than facts in more trivial topics like fiction fandom. That it's happened more than average with regard to medical articles' leads is side-effect of this wikiproject's habit of translating the leads (only) of foreign-language Wikipedias' medical articles to create stubs here, and has nothing to do with the general reliability of medical info on WP or its likelihood of being challenged, vs. political, botanical, or other information people care about the accuracy of. Putting citations where they belong has nothing imaginable to do with "putting people's health in jeopardy" (see hyperbole and argument to emotion).

  Further, this idea would be a massive change to Wikipedia policy, site-wide, and is not a decision some wikiproject can make in a vacuum: "the lead ... will be a well referenced plain language [sic] overview of the topic that can be re-used separately for a brief standalone article for either translation or as simple introduction to a topic." That is absolutely not what lead sections are or intended to be. This wikiproject's habit of creating en.wikipedia stubs by perhaps uncritically translating just the lead of articles at other-language Wikipedias is something that needs to be questioned, not something we need to intentionally encourage more of.

  Another example of nonsense is "In much of Wikipedia, citations are optional." That's not true at all. But neither is the opposite claim, "information is deleted without discussion when it is not backed with citations"; that's generally untrue except in cases where there's good reason, e.g. because it seems to violate WP:Biographies of living people policy, seems to be fringe theory or pseudoscience, or is patently POV-pushing. (What usually happens is questionable material gets challenged with ((citation needed)).) When something actually factual is deleted, restore it with a citation. If it was already cited elsewhere in the article, reinstate it without a new citation and note that it's already cited. If someone still deletes it, seek WP:Dispute resolution, as the other editor is the one in error. If they want to insist on a citation at that spot, even in the lead, you can go ahead and put one there to mollify them, but no one has the magical right to re-re-re-remove information from the article simply because it's not cited the exact way they want it to be cited. It's usually not worth arguing with these people, and the redundant citation in the lead will eventually be removed by someone else as redundant.

  Re: WP:Citation overkill (an essay) and this wikiprojects' penchant for engaging in it, and the suggestion to cite after every sentence: There is no WP rule that citations should be used after every sentence. Universally, they should be used after every fact or string of facts that come from a single source. There's no problem adding more citations to the same source (unless it rises to the level of citation overkill), if several discrete but contiguous sentences came from the same source, especially if they're discrete enough that someone might insert other material between them. But some sentences require multiple internal citations when facts in them come from separate sources. I.e., there is no relationship of any kind between "a sentence has ended" and "facts need citations".

  PS: Some of the concerns here are invalid, and are coming from some kind of "this is WikiProject Health" position, where the purpose of our articles on medical topics is imagined to be providing health advice. But this is forbidden by the WP:What Wikipedia is not policy (and could raise legal issues in many jurisdictions, too).  — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼  23:27, 6 September 2014 (UTC)

• 2¢: I'm just going to point out that this proposal is not actually at odds with the MOS (specifically, MOS:LEADCITE). That policy section doesn't indicate a particular way to deal with citations in the lead. The case-by-case basis clause ("The necessity for citations in a lead should be determined on a case-by-case basis by editorial consensus" - note that this language does not mean an article-by-article basis) isn't at odds with this proposal since, in this context, all WP:MED-tagged articles are the current "case" under consideration. Seppi333 (Insert 2¢ | Maintained) 23:50, 6 September 2014 (UTC)

Indeed, there is much wrong with SMcCandlish's initial post in this section. On a side note: SMcCandlish told WP:Manual of Style editors that they perhaps need to keep an eye on MOS:MED, as if MOS:MED can't offer advice on formatting medical articles and generally follow that advice. Flyer22 (talk) 23:56, 6 September 2014 (UTC)

And specifically regarding "information is deleted without discussion when it is not backed with citations," that is often true. Happens all the time on Wikipedia, even in common sense matters, as many experienced Wikipedians know. In other words, it's not always a "violate[s] WP:Biographies of living people policy, seems to be fringe theory or pseudoscience, or is patently POV-pushing" matter that causes the deletion. The WP:Verifiability talk page has had recent discussions about that type of thing. Many Wikipedia editors don't know of or rather ignore the WP:Preserve policy. Flyer22 (talk) 00:09, 7 September 2014 (UTC)

• Oppose All articles should follow the general English Wikipedia guidelines. If the lead section is properly constructed and summarizes the rest of the article, then it doesn't need any citations. Of course, while an article is being built up, the "lead section" may contain new information, and citations are needed. But in a properly constructed article, there should be no new information in the lead and hence no need for citations. Wikipedia is not an academic journal. Peter coxhead (talk) 07:59, 7 September 2014 (UTC)
• Infoboxes first The lead, by its nature, is a general summary in ordinary text. As it is summarising the body of the article, there ought to be some sort of cross-reference between the lead and the body to make sure it all hangs together. Appropriate structures for doing this seem to be lacking. In the meantime, please consider infoboxes, such as the one for dextroamphetamine, which is the example given above. Infoboxes are intended to contain discrete, hard facts, rather than general statements and so would be a better place to start requiring detailed citations of these hard facts. In the case of dextroamphetamine, you currently have to go quite a long way down the infobox before you find any citations. But note that some content there may be implicitly citing a reference. For example, we are told that the IUPAC name is "(2S)-1-phenylpropan-2-amine". Is this implicitly citing IUPAC as an authority or do they just provide general rules rather than definitive names for every compound? I look around and find the NCBI page. This seems to be a good reference and agrees about the IUPAC name. But I notice that the 2D and 3D representations of the structure seem to be different. This seems quite a big deal. Perhaps the infobox templates should have their parameters in pairs - one parameter for the fact and one for the the supporting citation. If there's no citation then the fact is not displayed. With a tight, formal structure like that, we might get somewhere. Andrew (talk) 08:08, 7 September 2014 (UTC)

It's not just medicine-related articles where sourcing in infoboxes is an issue. Editors seem to believe, wrongly, that briefly presented information in an infobox doesn't need sourcing, whereas it is subject to the same considerations as any other part of the article. It certainly helps if infoboxes have explicit parameters for references (e.g. taxoboxes for organisms have |synonyms= and |synonyms_ref=). Peter coxhead (talk) 08:26, 7 September 2014 (UTC)

• Oppose a special guideline per SMcCandlish. Note that I am only opposing the proposal that there be a different standard for medical articles, not an increase of citations in the lead either by changing the main guideline or in the course of your editing per WP:IAR if nothing else. There is just too much bureaucracy already without having it where the first paragraph is or isn't referenced inline based on what the topic of the article is. Wnt (talk) 09:38, 7 September 2014 (UTC)

User:Wnt as you will noteDoc James (talk · contribs · email) (if I write on your page reply on mine) 00:45, 17 September 2014 (UTC)

• Support The opposition is severely miss-guided to what issue this tackles. Most cases are trivial to correct, and there is no reason to go through "dispute resolution" for any of them. The case is rather one of work-load. By having such a policy we make the job of policing articles much much simpler. -- CFCF 🍌 (email) 11:48, 7 September 2014 (UTC)

  Nay, I think that when we define what a "lede paragraph" is, we're creating an expectation in the reader. Maybe the reader should be expected to trust that the lede is a general summary of the article and not expect to see claims verified there. Maybe that doesn't work well so we should verify claims there. But either way, the reader is going to have to develop a mental image that "this is how a Wikipedia article works". If we have different standards on it for different types of content, then there will be less clarity as to whether a lede of any given article is questionable or not. Wnt (talk) 12:48, 7 September 2014 (UTC)

  This isn't a reader focused change, and anything summarized in the lede must still be present in the full article–this is not changed. The only difference is us actually giving the citation used for statements in the lede. Having this type of policy simplifies the writing of good ledes and allows for more time spent working on improving content, and less on discussing why poor edits are removed. -- CFCF 🍌 (email) 14:14, 7 September 2014 (UTC)

  Well, the OP said "our readers expect them" - and it may be true. Bear in mind that I don't think that we can even accurately categorize articles as medical vs. non-medical, because I think there is a smooth continuum between these, and even an arbitrary distinction would rely on a very specific philosophy of what is medical on which people will disagree. Wnt (talk) 15:25, 7 September 2014 (UTC)

• It depends on exactly what you add. I don't mind having citations in the lead, especially for well-developed articles that are being translated. However, I don't want to see people saying that they're "required by MEDMOS". For the specific case of articles for translation, it might be better to recommend this on the advice to translators page, on how to prepare a page for translation. WhatamIdoing (talk) 16:41, 7 September 2014 (UTC)
• Support In order for our health articles to be useful for reuse, they need to have a plain language comprehensive summary that is supported by references. We know that Wikipedia English article leads are regularly being reused for translation. We know that the lead of our articles are being reused by other organizations to explain health concepts in plain language. And we know that Wikipedia medical articles are regularly read by people with pretty different potential levels of comprehension of the topic. We need to keep this in mind and structure the articles so that we are useful for these different audiences. For example, we know that medical students and clinicians use Wikipedia articles and benefit from a greater level of detail than the average reader. So, it is appropriate for the body of the article to cover the topic with more complex language and concepts. But the general reader should not have to read to the bottom of the article and try to comprehend the more complex vocabulary and concepts in order to find the references. So there are valid reasons to add references to the lead of articles and mentioning this in the manual of style will help everyone understand why it is needed. Sydney Poore/FloNight♥♥♥♥ 20:52, 7 September 2014 (UTC)

Very well put, agree completely. -- CFCF 🍌 (email) 05:54, 8 September 2014 (UTC)

Wikipedia is not a medical encyclopedia. Articles on all sorts of topics are used by all sorts of readers. There's no reason to treat medical articles differently in this respect, even supposing a clear-cut separation were possible. Peter coxhead (talk) 21:42, 8 September 2014 (UTC)

Thanks for sharing your thinking. Actually there are loads of good reasons for treating medical articles differently. :-) And many regular editors to Wikipedia health articles are up to the challenge of creating high quality content that is CC BY-SA licensed and can be read by a broad range of readers on Wikipedia English, or reused off Wikipedia English. I hope you will reconsider your objection because I think that it is short sighted to have a one size fit all approach for all types of articles when there a sensible reasons to use different approaches. Sydney Poore/FloNight♥♥♥♥ 23:03, 8 September 2014 (UTC)

Many WikiProjects could claim that there are "loads of good reasons" for treating their articles differently (and indeed some of them have done so). I always distrust 'slippery slope' arguments, so an exception could be made for medical articles without necessarily setting a precedent, but the reasons would have to be more convincing to those outside the project than I've seen so far. Also, a discussion here cannot over-ride the existing MOS; if the project wants to change the MOS there needs to be a discussion there. Peter coxhead (talk) 13:06, 9 September 2014 (UTC)

• Support References in the lede are a convenience to our readers who may not go on to examine the rest of the article. For a FA quality article you could be sure that the lede content is expanded in the body. But most articles are not at the standard, so to remove doubt there should be references up front. Referencing should apply to important facts,not just controversial statements. Verifiability trumps style, so that is why we need references. Graeme Bartlett (talk) 22:11, 8 September 2014 (UTC)
• Support Especially per the last two (FloNight and Graeme Bartlett. Wiki CRUK John (talk) 09:39, 9 September 2014 (UTC)
• Oppose The lead is a summary of an encyclopedic article. Refs in the lead are therefore redundant, except under certain circumstances. See Manual of Style for those. Medical articles are largely based on current science, and should therefore not be any more controversial than any other "type" of article also based on current knowledge. There is nothing special about medical articles here. GenQuest ^{"Talk to Me"} 17:29, 10 September 2014 (UTC)

Your response shows a striking lack of understanding of the subject matter. Medicine is highly controversial, and there are constantly those who push new unproved treatments onto Wikipedia. Medical articles are uniquely controversial and any statement at all is open to controversy, and it would be fully legitimate to accept references in the lede of medical articles purely on that basis. (Without needing to change the main MOS). -- CFCF 🍌 (email) 06:55, 11 September 2014 (UTC)

There is nothing uniquely controversial about medical articles. POV-pushers abound in articles about history, religion and politics, to name but three. Peter coxhead (talk) 10:52, 11 September 2014 (UTC)

It is not the likelihood of controversy but the potential risks of incorrect information that is special about medical articles. Armenia–Azerbaijan relations is highly controversial but mistakes or bias in the English Wikipedia article are unlikely to kill anyone. That's not so with Alternative cancer treatments. Wiki CRUK John (talk) 11:34, 11 September 2014 (UTC)

Your response shows a striking lack of understanding of Wikipedia. It is NOT, and does not purport to be, anywhere near a primary reference work, especially in the field of medicine. If non-sourced info is added to the article or the lede, it should be removed. The structure of the WMoS is what governs that. Medical articles may be near and dear to you, but they carry the same weight as any other article in this little encyclopedia. Besides, if someone is using Wikipedia as their main source of medical knowledge, they have other issues in their life, lack of common sense being the most prominent diagnosis. GenQuest ^{"Talk to Me"} 15:19, 11 September 2014 (UTC)

GenQuest, I'm pretty familiar with WP:CITELEAD. It says (direct quotation), "The presence of citations in the introduction is neither required in every article nor prohibited in any article." I'm not sure how people get from what CITELEAD says to claiming that citations in the lead are redundant and shouldn't be used except for specific, explicitly authorized exceptions. WhatamIdoing (talk) 15:39, 11 September 2014 (UTC)

• Support We want to make our articles more easily verifiable by our readers. I agree that this is especially key as people life may be in the balance. BLPs receive `special` acknowledgement. But precedent is not an issue. This is an issue of common sense. The proposal is not a requirement for refs in the lead just an explicit allowance of references in the lead. They are already allowed implicitly. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:01, 11 September 2014 (UTC)
  • What special allowance is being proposed? I see "My position is that we should have references in the lead and this is for a couple of reasons..." That looks like a soft requirement (Should rather than shall). What is the actual proposal.? Protonk (talk) 19:56, 11 September 2014 (UTC)
    • ”Ａｄｄｉｎg references to the lead is reasonable but not required as long as the text in question is supported in the body of the article"Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:19, 12 September 2014 (UTC)
      • Seems fine to me. I can support that. Protonk (talk) 11:53, 12 September 2014 (UTC)
      • As I understand it, direct quotations must be sourced at every instance, including the lead. In practice, contentious negative matter (especially if not widely known) about living people is also commonly "required" to be cited in the lead. It might be preferable to write only, "Adding references to the lead is reasonable but not normally required". WhatamIdoing (talk) 00:50, 26 October 2014 (UTC)
• Oppose. All facts in the introduction should be in the main body of the article . Introductions are easier to write without in-line references. Snowman (talk) 18:19, 9 October 2014 (UTC)
• In my mind, WP:LEADCITE is clear, and we don't need to do anything on this page that may put us at odds with that more general page. In application, LEADCITE means we often add citations in the lead (for quotations, hard data that may need verification, anything surprising or controversial), but we aren't obligated to cite summarizing info. SandyGeorgia (Talk) 15:46, 4 December 2014 (UTC)
  • The "problem" being addressed here is that, although LEADCITE is clear to you and me, some editors apparently believe that LEADCITE says "editors must omit citations from the lead". WhatamIdoing (talk) 09:19, 5 December 2014 (UTC)
• Oppose. Lede is only a summary of what is below. It should never be independently referenced as this would go against what WP:lede is meant to be. Thus, no new information in lede, only what is in the body. If I come across an info in the lede that is not mentioned in the body, I kick it down. kashmiri ^TALK 11:45, 13 December 2014 (UTC)

Yes the ideal is to have all content in the lead also in the body. This proposal does not change that. Doc James (talk · contribs · email) 04:13, 17 December 2014 (UTC)

• Oppose - per WP:LEAD, lead is only a summary of the body and only controversial statements need to be cited there. When I look over articles and find a citation on a non-controversial statement in the lead, this is actually a useful sign that someone added content only to the lead (don't have statistics, but it is a good tip in my experience), which is something that needs fixing. wrt to the spirit of the proposal, that people's life may be in the balance... we are WP:NOTMANUAL and see the disclaimer. We do need to take our responsibility to provide accurate health information seriously but redundant obligatory citing in the lead is just more work, and has no point. Jytdog (talk) 13:37, 13 December 2014 (UTC)

Sure and the solution is to often add it to the body of the article. Doc James (talk · contribs · email) 04:12, 17 December 2014 (UTC)

• Support having one or a few key references in the lead for the reasons mentioned above. Having references doesn't decrease the stand-alone-ability of a lead, nor its translatability to other articles. BakerStMD T|C 17:18, 14 January 2015 (UTC)

I have doubts about out to phrase this, but I think an optional "classification", "variation" or "types" section should be added to the list of recommended sections for treatments, procedures, and tests when multiple unrelated therapies exist which from the consumer perspective give the same benefit.

Consider a class of drugs grouped by function, like anticoagulants. This is a grouping by effect, but not by the entries in the MEDMOS outline. The anticoagulant warfarin has all kinds of side effects, but some weird exotic anticoagulants are completely different in what they are and how they function so their Contraindications, Adverse effects, overdose, interactions, mechanism, physical properties, pharmacokinetics descriptions could be completely different. In other cases, some or all of these might apply to treatments which have radical differences but somehow achieve the same effect in the same way.

Leaving drugs aside, I was looking at strength training and thinking about how to talk generally about the topic when there are so many different variations of this practice as a rehabilitation treatment.

I think that adding a "Types of treatment" heading immediately below the uses section would address the problem in these cases. With that section in place, the reader can get an introduction to the idea that multiple treatments exist. This could also apply to "surgeries and procedures" and "medical tests". Some time ago I tested a "classification" section on c-section because there are actually several variations on the procedure which all deliver a baby but in very different ways. With medical tests, I again think many readers are more interested in the end result than in technical information about the ways that the tests work, so being able to note that variations in the tool exists would be a worthwhile addition to the MEDMOS. Blue Rasberry (talk) 17:53, 14 November 2014 (UTC)

• Support. Makes a lot of sense for things like Stent and Vascular closure device. BakerStMD T|C 17:22, 14 January 2015 (UTC)

As you will see, except for the notable case of medical specialties articles and articles about diseases that are historical-only, WP:MEDMOS recommends we put history toward the end of the article. I recently had a section on vitamin D history moved from middle to end of article so it would conform to the nazified straight-jacketted unified military order type structuring of all biomedical articles on Wikipedia. My response was this:

I can live with the history going farther down, though I'm not sure I like it for a vitamin. Vitamins were discovered, like atoms or electrons or chemical elements. The physics and chem articles treat their subjects with more attention to history of discovery. The further you get into the life sciences, the less attention history gets. I came up from chemistry as an undergrad, and noticed that by the time we got to medicine, there's was very little history left (and what their was, was wrong-- I can remember being told that Semmelweiss got push-back because he wanted doctors to use soap and water). In medical school, they tell you this lack is because they have no room in the curriculum for the history of medicine. That's a lie. The truth is they don't care, and would put it at the end even if there was room. As here. But quite often I think it helps understanding to put an abbreviated history up front (with a detailed one later), so the thing you're discussing doesn't just appear to come out of no where. BTW in pharmacology they also are not as likely to slight history. For example, Goodman and Gilman in The Pharmacological Basis of Therapeutics (now in 12th ed.) start out discussion of every drug with its history, and it doesn't seem to hurt. So what's the problem?

I know, you're going to tell me to take it to TALK:MEDMOS. Okay, I will. SBHarris 02:38, 11 December 2014 (UTC)

We put the more clinical information first and the more history stuff latter generally. This is the ordering for thousands of articles.

Some argue to have epidemiology put first with some good reason aswell. Changing it around is a massive effort. I think consistency is generally a good thing. Doc James (talk · contribs · email) 03:05, 11 December 2014 (UTC)

I don't care if it's a massive effort. If the readers are better served, we could make that massive effort. After all, it'd be no more massive than the one you've undertaken to make things match the MEDMOS for several years.

I have trouble thinking of Vitamin D as a "drug". Humans make it naturally. It probably ought to be structured more like Hemoglobin (which puts "Research history" first). WhatamIdoing (talk) 04:01, 11 December 2014 (UTC)

I think you're saying we already did the work, and changing it would take a lot more work. Are you satisfied with that argument? Maybe you shouldn't have done the work in the the first place. Or maybe you should have had some discussion before doing that much work.

In Wikiproject elements we decided that an imposed template that is the same for every chemical element would not be a good thing, because chemical elements are different, and the various sections for each one are bloated or sparse or even missing with regard to the others. It doesn't make SENSE to do them all the same way. Nor really does it make sense for medical topics.

If you look at medical topics reviewed in journals (for example the reviews of diseases that NEJM does periodically) you will not see that they are NOT all done the same way. Why should they be? If you look at medical texts, you find that most do not have histories, but those that DO, invariably have it up front as chapter 1. I am looking at Sabiston's massive Textbook of Surgery, for example. And in books where history exists as bits in the text, in various chapters, it's invariably up front in the chapter. For example, in Goodhart and Shils Modern Nutrition in Health and Disease, a standard text, many chapters have no history. But the ones that do (vitamin chapters, etc) the vitamin history always begins the chapter. Never is history, if it exists, stuck toward the end.

So I challenge you to find me some examples of it done otherwise from your own bookshelf or the secondary review literature. So far as I can see, nobody in the medical review literature does it the WP way, except Wikipedia. That's kind of outrageous. It may not violate the letter of NPOV to cover information differently and with a different emphasis than the literature you (are supposed to) summarize, but it certainly violates the spirit of NPOV. SBHarris 04:06, 11 December 2014 (UTC)

I was following the MEDMOS at the time. But yes what I am saying is you need a good reason to change it and I am not seeing one.

Many sites have a ordering and naming of sections including nlm [1] and emedicine that they consistently apply across topics. Doc James (talk · contribs · email) 04:27, 11 December 2014 (UTC)

talking about history, I just went strolling through the achives.

• In Archive 1 (and my goodness SandyGeorgia has been here a long time!) is this Wikipedia_talk:Manual_of_Style/Medicine-related_articles/Archive_1#Top_level_headings from 2007. History first.
• As far as I can tell it history was moved out of the top in this dif in March 2011. Conversation at Talk was in Project Pharmacology here. Not intensely debated or disputed. Til now. Jytdog (talk) 06:51, 11 December 2014 (UTC)

• I have some sympathy with this view, but would say: firstly, our history sections are typically rather short and poor in medical articles, where they exist, so often deserve to be left at the end, and secondly, in most areas of WP it is the other way round, and the usual convention is to put history first after the lead, which imposes its own tyranny, and is often inappropriate, partly because they are often so long. Surgery is another area where moving history up might often be appropriate, to after a descriptive section. Wiki CRUK John (talk) 09:45, 11 December 2014 (UTC)

I worked on the original section headings/orderings of MEDMOS. There never was a "best order" or "best set of headings". Let's be quite clear: MEDMOS has never defined the order or sections in medical articles nor even which sections a medical article should/must contain. The most it has ever done is "encouraged" and "suggested", with the focus on new articles or complete rewrites. And it has always made it clear that simply changing the order/name of sections to meet the guideline is disruptive and unwelcome. Despite this, Doc James has been on a one-man mission to mandate section ordering "per MEDMOS". I'm not at all surprised that your attempt to introduce a logical order to the sections got reverted by him.

The section headings and the ordering of sections/article-text is a matter for editors of the article and should be decided by consensus on the article talk page, as with any other content issue. As noted above, and in MEDMOS itself, there is huge variation among articles that fall under our umbrella. MEDMOS does not and never has require an order or set of sections, and if someone changed it to do that I'd be among the first to ask for its official-guidance status to be revoked. The edit summary "Not should be towards the top per WP:MEDMOS" is absolutely 100% bullshit. -- Colin°^Talk 10:09, 11 December 2014 (UTC)

some strong emotion here! What MEDMOS says now is "Changing an established article simply to fit these guidelines might not be welcomed by other editors. The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition." That is indeed very guideline-y (as in, not policy) language, so cannot be cited as an Authority. Seems like something to be discussed on Talk indeed. It also seems very hard to resolve on any kind of objective basis. Which is all the more reason for everybody to do their best to remain calm and do their best to convince each other, which yelling and name-calling (the Reductio ad Hitlerum in opening post is unfortunate) rarely does. Opening this discussion was a very good thing, though.

All that said, I think the current order in MEDMOS does give people want they want upfront for health-related content, which is better, practically. (personally, I like history sections for drugs and often flesh them out, as i am interested in the process and business of how drugs get discovered and brought to market. I don't mind that history is at the end in drug articles and I think it would be strange if it were put upfront.)

With respect to the vitamin D article.. three is a LOT going on there. Physiological roles, supplementation, history of science. That's a lot. And MEDMOS wasn't built to deal with articles like this, where a natural substance is also manufactured and used in a health context (same thing for, say IL-2) Very debatable what to have go first. I believe history was last for a long time, and Sbharris would have to get consensus to change the order. A better edit note in the revert would have been "please get consensus on Talk for this", but the reversion itself was correct, I think, under just plain BRD. Jytdog (talk) 14:27, 11 December 2014 (UTC)

The reversion itself was incorrect. Not only did it misquote our guideline into claiming some authority/mandate it doesn't have, but no, BRD does not entitled editors to revert at will, and is an essay for dealing with controversial edits on controversial subjects. Actual policy at Wikipedia:Editing policy is routinely ignored by, cough, a certain editor, who thinks that anyone doing something he doesn't like needs to gain his prior approval. Sbharris's change was a good-faith edit designed to make a logical order to that article (I make no judgement on whether it did improve, because that's not what is important here). Therefore, per editing policy, it is actually up to James to either improve it further or to explain on the article talk page why the article is better as it was before, with argument specific to the text in that article. I've already seen one expert chased away from Wikipedia because of this ownership-of-all-medical articles behaviour, and blind insistence no imposing MEDMOS sections. Jytdog, we don't need consensus to make edits. Let me repeat this. We don't need consensus to make edits. If you hang around James then you might get that impression, but please folks, go actually read our policy. Which part of " Improve pages wherever you can, and do not worry about leaving them imperfect. Preserve the value that others add, even if they "did it wrong" (try to fix it rather than delete it)." and "Be bold in updating articles, especially for minor changes and fixing problems. Previous authors do not need to be consulted before making changes. Nobody owns articles. If you see a problem that you can fix, do so." is so hard to understand? -- Colin°^Talk 13:16, 12 December 2014 (UTC)

Hi Colin, thanks for your remarks. I don't see things quite the same way. I think if other editors disagree with a change I make, they can revert it, and it is up to me to go to Talk and get consensus for the change I want. Of course we want people to be bold - nothing would happen without that. But consensus is the foundation of this whole place, and in my view every version of an article exists, based on the current consensus of the editors working on that page. Other people may disagree with my edit on grounds of policy or guideline, or on the basis of their own preference is no policy or guideline provides some community-wide consensus upon which to judge whether edits are OK or not. Looking at the page history, Sbharris boldly did a major reorganization of the page (good on him!) (without prior discussion, which was probably unwise); Doc James reverted him on the basis of MEDMOS (which is a guideline, but the reversion could just as well have been "major organization and I don't agree; let's discuss). I just checked the Talk page and it looks like rather than opening a discussion there and making arguments for his preferred version per BRD, Sbharris came here with a bit of a rant. Which is not great behavior. This seems like a pretty normal content dispute. Resolving it will come down to consensus of the editors working there, once a discussion actually gets opened. That's how I see it. Jytdog (talk) 13:45, 12 December 2014 (UTC)

What you call "not great behavior" is pretty inevitable. The most efficient way to deal with a reversion which is ostensibly on the basis of some policy or guideline or guidance or habit or controlling favorite opinion essay, when you disagree, is to go to the TALK page for the guideline and find out just what consensus for it exists. As here, where we found out that the thing was put in 3 years ago without discussion, and the same people who did that, have been beavering away for years getting it their way, and now are arguing it's too much work to undo!

The proximate problem with doing things the way you suggest, is that can't ever pin down down somebody who thinks they have "imaginary consensus" on their side. On the article TALK page, they just point to the guideline. On the the guideline TALK page, then other people get all annoyed and want you to go back to the article TALK. If you are lucky you can get what we got here, which is to find out that this is a submarine guideline being applied innappropriately, since it was never discussed properly by the community, and doesn't even meet consensus as a guideline. That's what we wanted to know. And here you are, upset that I finally forced a discussion where the facts and history came out. Shame on me.

But now I would like to insert some language in MEDMOS to remind people that article heading substructure is not set in stone, and is not worth changing solely to conform or "harmonize" (to use the hated E.U. term) with examples on MEDMOS. We gaven't been over this nearly as thoughtfully as some of the stuff in MEDRS, and I think it's "not great behavior" to pretend that we have! SBHarris 18:34, 12 December 2014 (UTC)

but Sbharris, the language is already in the guideline. If folks are not remembering and using that, that is on them, not the guideline. :) So its there. No need for drama nor Godwin. fwiw, please look down the road. If you want to start the process of trying to change the order in MEDMOS now, you could of course do that. And let's say you succeed after a big long RfC (which is probably what it will take). That version will also contain the same disclaimer about not forcing changes to section-order through, based on MEDMOS. And you will still have to go back to the Vitamin D Talk page and make your arguments there, to gain consensus of the folks who care about that article, for the order you want. And then follow the normal DR processes for content, if consensus doesn't come easy. The order of the Vitamin D article is ultimately just a content dispute (especially since MEDMOS gives latitude) and no drama board will give you the time of day, until you have used the article Talk page. Good luck! Jytdog (talk) 19:08, 12 December 2014 (UTC)

The present guidelines are inadequate. The suggested place for the history section varies with the type of article, but no reason is given in any case as to why these suggestions are being made. Who decided? Why? We just have these fiat templates. The section does indeed say that none of this is set in stone and can vary with the article, but it also says: The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition. For me, that means the article should begin at the beginning, and with the etymology and history of the disease or whatever. How are you going to "progressively develop concepts" if you're hit with the latest knowledge immediately? That's the function of the lede/lead. After that, the MEDMOS cautions: "Do not discourage potential readers by placing a highly technical section near the start of your article." ;'p) Well, if your first section is the history, you can pretty well guarantee THAT won't happen, can't you?

Look, most of WP is constructed with etymology and history first. If you look at the most popular article on en.wiki, The United States of America, that's how it's constructed. The same with most other countries. States in the union sometimes have history first and sometimes geography, but history is always at least second. Technology? If you look up airplane, automobile, computer, you get etymology and history first. Nobody complains that they just want to know how the dang machine works, and don't have time even to scroll over the history that they're not interested in. Skipping over history doesn't take very long, after all.

I didn't go through the topic range of the entire Wikipeda, but biography is chronological is most cases. Articles on animals start with origin and evolution. Topics in chemistry and physics are mixed, but start with discovery history more often than not. Astronomical objects generally start with characteristics, and history is way down at the end (Like medicine)-- unless the history is interesting like Halley's Comet. For the entire Universe, however, the two "histories" (history of the Universe and history of its observation) come first.

Again, Wikipedia is not a Washington Manual for medical interns, or a PDR, or WebMD, a how-to or advice book. This is emphasized over and over, and so why do we have this (implied) time constraint that we have to get to the meat of (say) choking without a digression on Henry Heimlich (whose role come way later). But that's not how Wikipedia is meant to be used and this faux-urgency which saves us from scrolling over history, should have no place in our construction of WP medical articles. There is no hurry for the reader, that we need to be thinking about, in the backs of our heads, as we write. It's an encyclopedia, not a help-me book. If we don't skip history to get the nitty-gritty for the United states and airplanes and the Universe itself, we surely have no good reason to do it for vitamin D. You know? SBHarris 23:12, 12 December 2014 (UTC)

i've said all i have to say. good luck! Jytdog (talk) 23:28, 12 December 2014 (UTC)

Jytdog, you say "Doc James reverted him on the basis of MEDMOS". He didn't. I thought I was quite clear. I thought the guideline was quite clear. The guideline gives no basis for the revert. There is no community consensus for setting section headings in stone. Sbharris should, feel free to have and to order sections how best for each individual article. It is quite understandable that when people get stupid things forced on them that they rant and complain. I wish WP:MED would wake up and realise is has a long-term editor-behaviour problem here rather than reach for the auto-defence button whenever "on our ours" gets attacked. I personally would like to see a topic ban on Doc James arranging/reverting article sections. One only has to look at the contribs to see such actions are not done on the basis of deep thought and considered work on an article, but randomly like guerrilla warfare and it seeds editor discontent. But I have better things to do with my life that battle against a project which chases experts away [2][3] and has completely forgotten our Wikipedia:Editing policy in favour of fighting good-faith editors. -- Colin°^Talk 08:24, 15 December 2014 (UTC)

HI Colin thanks for the ping. I wasn't defending Doc James at all. When I wrote "on the basis of" I just meant "that's the reason he gave." I actually supported what you said - that selection and order of sections in a given article depends on consensus of the editors working on that article. Because sectioning depends on consensus, making a big change from the standing version also requires consensus. consensus! MEDMOS provides some foundation for a discussion (it is a guideline) to reach consensus but is especially not normative for sectioning, due to the explicit disclaimer in that part of MEDMOS. Did you not find all that in what I wrote? I am sorry if you didn't - that was my intention. Jytdog (talk) 14:13, 15 December 2014 (UTC)

Jytdog, thanks for the clarification but you are supporting what James did -- that SBHarris was wrong to change the order without gaining article consensus first, and hence James right to revert (even if the edit summary is wrong). I'll tell you why this is wrong: it isn't how James is allowed to edit. Every time this happens, I see WP:MED members rise to the defense of WP:OWNership with an "ends justifies the means" or "some collateral damage expected" or even with utterly non-policy justifications like "consensus before edit". On the 12th October 2013, James reordered the sections "per MEDMOS" without any article talk page discussion at all. I've seen this OWNership before and it drove off an expert. Everyone else is "required" to gain consensus for making changes except the one editor with all WP:MED articles in his watchlist.

Today, Jimbo wrote: "I don't think it's possible to recruit experts without warmness and welcome mats. If we want good contributors, we need make sure that when they are newbies they are supported and made to feel welcome. The myth of "good contributors are naturally cantankerous" is just false and it's a shame that some in the community think that it's worthwhile putting up with nasty people if they make good contributions - what they miss is how many good contributors we lose when the culture is not healthy, especially for newbies." Now I wouldn't use the word "nasty" in this situation, but plenty other adjectives are suitable. The "does a lot of good work" editor-defense is busted. Consensus is not another way to spell "agree with me". I appreciate that many WPMED members feel they are in a battle but you are attacking good faith editors, established and newbie, by hitting the revert button whenever the last edit in an article in your watchlist doesn't have your name on it. MEDMOS does not exist to piss people off who might otherwise make a contribution to article content. Seriously, "gain consensus before editing" is not policy. Do you really think WP was founded on this principle? Do you really think you will attract editors if the first thing they have to do is explain to a group of people, none whom are remotely expert in your subject, why your edit is an improvement and get the majority to agree? Has an article ever been written by endless RfC? Or when editing an article on a vital body chemical, one first has to explain why this is not the same as a pharmaceutical drug in order for the MEDMOS police not to revert your edits? Do these things make this a welcome place? Are these edits warming or chilling? Is "rv per MEDMOS" a sign of a healthy culture or an dysfunctional insular one? -- Colin°^Talk 14:49, 15 December 2014 (UTC)

Hi Colin, I am very interested to hear your thoughts on the fundamentals of editing in WP. (I mean that, and I will start a thead on your Talk page to continue). As far as I can see this page is for talking about MEDMOS and to the extent this thread is OK (the vitriol and personal attacks are really not OK) it is about a) changing the order of sections in MEDMOS and b) the "authority" of sections described in MEDMOS. I've said all I have to say on that, and I don't see how this thread can progress much further. Action items are proposing a change to the order of sections (really a matter for another thread) and strengthening the disclaimer language (also a matter for another thread), in my view. To the extent you are concerned about Doc James editing style that would be a matter for RfU or RfA.... but I really am interested in what you say about the basics of collaboration here. I'm not sure I agree but want to hear more. Thanks. Jytdog (talk) 14:55, 15 December 2014 (UTC)

I agree this page is for talking about MEDMOS, which includes how MEDMOS should be used. The thing I'm most concerned about is that this is the umpteenth time I've seen editors get upset with "per MEDMOS" reverts/changes. And yet when it is raised, and "no, MEDMOS doesn't say that" is clarified for the umpteenth time, nothing happens to the editor abusing MEDMOS. Instead, we see the poor good faith editor gets attacked for being upset and is told fairy stories about the made-up fictitious policy called "gain consensus before you dare edit". But for umpteenth time, it is trivial to discover that the editor who claims this fictitious policy (which you repeat) doesn't actually believe it applies to himself: he edits without prior consensus. And if you look further back, you see History was put up the top of Vitamin D many years ago in some edits that rearranged sections for "better article flow", also undiscussed. That's what happens in a wiki. This wikiproject is complicit it letting editors be ill treated and rallies round to protect its own when attacked for it. I see above a mild rebuke by WhatamIdoing but nobody else daring to say "wrong about MEMDOS", "wrong about prior consensus required", "wrong to revert", "wrong to believe inter-article consistency is more important than in-article flow". If I saw those kind of comments I might be encouraged about the future of medical articles on WP. This isn't just a "Topic ban James from "per MEDMOS" edits" RfU issue. It's a WP:MED needs to sort itself out and be warm and welcoming issue. And until WP:MED fixes itself then there's no point in an RfU. -- Colin°^Talk 16:07, 15 December 2014 (UTC)

I am interested in what you are saying about the culture you see as having grown up inside ProjectMed - I very much appreciate these kinds of critiques, as each of us is trapped in his or her own head, and groups do fall into bubbles or groupthink, and it is healthy to try to get out of our heads and to try to see the bubble and adjust, if things have gone astray. I have been doing some of that with regard to consensus v evidence, as you probably recall from the discussions at WT:MEDRS. I think the conversation you are trying to have here, would be more productive at WT:ProjectMed. and fwiw, the less flame-y, the less personalized, and the more clearly you identify the core issues, the more likely it will be that lots of folks will engage in a thoughtful and productive discussion... but I am sure you know that. And I am sure you know that changing culture is not something that happens overnight. (there are those who work to make change in slow and steady ways, and those who protest/riot to shake things up... it takes all kinds. I don't know which kind you are) It will be particularly interesting to me, to see how the endless war between quack-fighters and alt-med pushers fits into and affects the discussion. I would be very open to participating in that discussion there, if you want to start it. Jytdog (talk) 16:37, 15 December 2014 (UTC)

and again, I encourage Sbharris to work calmly and use WP's great WP:DR processes to try to win consensus for his vision of the Vitamin D article. that article also has some long running wars, and people with strong POVs (about what the appropriate RDA is, whether supplementation is good for anything, etc). A long and considered discussion to reach consensus on article structure would probably be a welcome change from all that. Jytdog (talk) 16:41, 15 December 2014 (UTC)

Oh may the Lord protect us from "long and considered discussions" on talk pages. Lead us not down the path of WP:DR to make good faith improvements. Save us from those who demand "consensus" is a precondition to editing.

Vitamin D:

• sections ordered without prior consensus "to improve flow"
• sections ordered without prior consensus "per MEDMOS"
• sections ordered without prior consensus "to give a logical order .. (+ other reasons given)"
• sections ordered without prior consensus "Not should be towards the top per WP:MEDMOS"

Twice this article (at least) has been rearranged when editors read the material and felt it would be better ordered differently. Twice this article has been rearranged by an editor misinterpreting MEDMOS on multiple levels. None of these times has the editor discussed their change prior to making it. Which is absolutely per policy. Jytdog, it's personalised because it is one editor repeatedly abusing this guideline. Yet rather than appreciate the problem here, you rebuke Sbharris and claim he needs to jump though the hoops of DR and lengthy talk page discussions before he can improve the article. The core issues are an imagined MEDMOS that never existed, James, and protectionism at WP:MED. I've raised this before at WP:MED and was made to feel as welcome as Richard Dawkins at a prayer meeting. I'm raising it on this page, because it is this page where the problem has most recently occurred and made worse by this project. The response to Sbharris's original posting should have been (a) MEDMOS says nothing about vitamins and (b) MEDMOS merely suggests, not requires. Followed by a rebuke of James for yet again pissing people off over this nonsense. I await hell freezing over... -- Colin°^Talk 18:36, 15 December 2014 (UTC)

ok, good luck. if you are trying to get me interested in the problem, o persuade me to help in some way, you are doing the exact opposite. I am done here, and unwatching. Jytdog (talk) 19:32, 15 December 2014 (UTC)

Jytdog, you are part of the problem, so I don't expect you to welcome what I'm saying. On 11th December, James added a Society and Culture section to Vitamin D. It contains sub-headings on dietary reference intake (a health/nutrition guideline), dietary sources, and industrial usage. I await reports of recreational vitamin D usage or references in popular music. The edit summary did not say how this improved the article. The talk page did not seek consensus among editors for this change. This is (currently) the only vitamin article with such a section. Why would anyone add such a ridiculous section with such inappropriate content to this article? Because MEDMOS has such a section for Drugs. Why did this edit not elicit a WTF reaction from WP:MED members? You guys all know this has been going on for years. It is loosing you editors. Do something about it. -- Colin°^Talk 20:15, 15 December 2014 (UTC)

saw your ping. Sorry you think i am part of the problem. You appear to me, to very angry and disappointed and bitter and helpless-feeling about where things stand - I am ignorant of the history of how we got where we are, and it is clear you lived through it. i really am sorry. But you seem so angry that I don't know how to talk productively with you, and I am uninterested in being a surface for you to grind your anger on. I think things could be improved too. If you want to actually talk, I would be very interested in that. For now, I really don't see a way forward in this particular conversation. Jytdog (talk) 20:28, 15 December 2014 (UTC)

I'm not really sure how you psychoanalysing this is relevant. Do you have a different reason for why James can reorder the sections at will without being told to seek consensus beforehand, but those who disagree with him must? Is that just something I am imagining or making up? Do you have another explanation or support for the "Society and Culture" section addition to vitamin D? Perhaps I missed the "long and considered discussion" before making such a radical and unique change to a vitamin article. I guess vitamin D has cultural aspects I was hitherto unaware of. Are you aware that WPMED lost a newbie neurologist who was treated like a vandal, had "per MEDMOS" forced upon him, and was required to follow pre-consensus WP:DR steps before making any edits to an article that isn't even controversial. We're making the same mistakes. -- Colin°^Talk 20:59, 15 December 2014 (UTC)

I wasn't aware of the Talk:Epilepsy debacle until today, and it was certainly rather depressing to read. But there were a number of editors in those discussions, and it is not unreasonable to say that a consensus of sorts prevailed, though a narrow one. Nobody could accuse James of lacking boldness in his editing, but he is extremely active and productive all over the subject area, and naturally has a lot of respect from other editors. If he sees a consensus against him in a discussion he will respect that in my experience. But yes, he often won't initiate the discussion; you have to do that. The lobby for a consistent set of section headings is strong, certainly for diseases/conditions. Wiki CRUK John (talk) 22:26, 15 December 2014 (UTC)

John, this project could do with reassessing it's automatic "is extremely active and productive" defense and really examine the edits and behaviour. Other projects have their own highly productive but ultimately wikipedia-destructive editors. If you followed Jimbo's speech at Wikimania you will be aware of his call for us to stop supporting this so blindly. There is absolutely no reason why Epilepsy should have been become the kind of article where dispute resolution and seek-consensus-before-any-edit measures were enforced and there is one editor to fault for that. No reason at all why educated gentlemen could not have cooperated on that article. I see the same thing happening at Vitamin D. We now have the (shamefully short) paragraph on dietary sources of vitamin D placed inside the ridiculous "Society and culture" section. The actual article is largely unreadable with highly technical sections at the beginning. Does anyone here not boggle at that? Why should any editor here be forced (as above) to do battle with such misguided and unthinking behaviour? There is zero, absolutely zero, consistency among vitamin articles and zero absolutely zero reason to treat a vitamin like a pharmaceutical drug (no more than sugar or fat). And even if we were dealing with a drug, there is zero support in MEDMOS for demanding inter-article consistency in the face of reasonable article-flow rationale. Such consistency is a very low-down-the-priority-list "nice to have". I once also blew the trumpet for James and defended his over-enthusiasms, but when I actually found myself on the other side of the dogmatic editing style, complete ownership of articles, and actually examined the edits... I was sorely disappointed. The text, such as any makes much sense, really does not match the sources, and the real experts are chased away by our very own Randy in Boise MD. The MEDMOS that I helped create is being used to wreck vitamin D and when someone comes here to complain they are chased away and told they should learn to edit-by-consensus always. -- Colin°^Talk 08:40, 16 December 2014 (UTC)

• Disagree. As mentioned above, history sections are often a mess, particularly in lower-importance articles that aren't monitored closely. People are forever adding "So-and-so did the first left heart cath" to history sections and if I'm not particularly interested in that, I'd rather not edit it. BakerStMD T|C 17:25, 14 January 2015 (UTC)

I would like to propose "Biology" as a section heading for disease articles, in place of "Mechanism".

While I fully support the communication/accessibility aims of adopting "Mechanism" as a heading instead of "Pathophysiology", I do have serious misgivings about the appropriateness of the term. As I mentioned at the meeting before Wikimania at CRUK, I've spent years trying to help writers deploy the term appropriately , reserving it for (postulated) biological mechanisms of disease, rather than pathophysiological considerations in general. I think our current "Mechanism" sections tend to concern the biology of the disease in question, rather than the actual biological mechanisms. (For instance, a reported association between a given disease and a particular gene mutation is not in itself a mechanism; researchers look for mechanism/s to explain the association.)

In the discussion here regarding the change, Blue Rasberry raised a somewhat related concern. I suppose I should really apologise for not coming up with this alternative proposal at the time.

Wouldn't "Biology" be just as simple as a heading... And rather more correct? 109.158.8.201 (talk) 12:03, 27 December 2014 (UTC)

I have never seen the term used like this. Do we have refs that use it this way? Doc James (talk · contribs · email) 12:57, 27 December 2014 (UTC)

Well, "biology of disease" is used quite commonly (eg [4], [5], etc). I agree that "Biology" [of disease] is not a straight synonym for "Pathophysiology" (which regards the study of disturbances in organic function [6]), but imo the two concepts are closely enough related (per [7]) for our purposes. In practice, I think "Biology" [of a disease] is a suitably broad term to cover the kind of content that normally goes into these sections, including genetics, molecular biology, pathophysiology, biomechanics, etc, etc. 109.158.8.201 (talk) 13:55, 27 December 2014 (UTC)

I think we first need to get our definitions straight. The MOS currently reads:

• Mechanism: For information about pathophysiology

Shouldn't the link be changed from pathophysiology (functional changes associated with or resulting from disease or injury) to pathogenesis (source or cause of an illness or abnormal condition)? Boghog (talk) 13:33, 27 December 2014 (UTC)

The difference between "pathophysiology" and "pathogenesis" is analogous to "mode of action" (cellular) and "mechanism of action" (molecular). So on second thought, perhaps the scope of this section should include both. Hence "biology" (including molecular biology) for a section heading may not be such a bad idea. Boghog (talk) 14:03, 27 December 2014 (UTC)

(edit conflict) Agreed... My impression is that what actually tends to go into these sections is often (though certainly not always) basically information about the "biology" of the disease, which often gets relatively little coverage elsewhere in the article. Obviously, I think there should be nothing here to prevent (sub-)sections on the "Mechanism/s" [of the disease] / Pathogenesis. 109.158.8.201 (talk) 14:12, 27 December 2014 (UTC)

A revised definition would then read:

• Biology: For information about pathogenesis and pathophysiology. Boghog (talk) 14:10, 27 December 2014 (UTC)

Yup, that'd be good, imo. 109.158.8.201 (talk) 14:14, 27 December 2014 (UTC)

Mechanisms of drugs are often as much about chemistry as biology. Most of the antihyperphosphatemia drugs act by mechanisms in which anything that could reasonably be called "biology" is peripheral. Ditto for bile acid sequesterants. Nucleosides have been around for 60 years, but sofosbuvir is the antiviral of the decade because of better chemistry - its a prodrug that overcomes barriers to oral bioavailability and drug entry into cells. Cancer drugs alkylate DNA and penicillin alkylates PBPs. Forgive me if I'm sounding partisan here, but as someone who spent 20 years in drug discovery as a medicinal chemist, I see calling mechanism "biology" akin to calling Europe "Germany". Formerly 98 (talk) 14:24, 27 December 2014 (UTC)

Please keep in mind that there are two sections in the MOS, one covering diseases and a second, drugs. I completely agree with you on the later (I have also spent 20+ years in drug discovery as a medicinal chemist), but the current discussion is about the former. Boghog (talk) 14:35, 27 December 2014 (UTC)

Per Boghog's comment (edit conflict), please note that my proposal only regards articles on diseases etc. (Also, as regards biochemical considerations in disease articles: in the biomedical context at least, "biochemistry" is generally commonly considered to be a branch of the "biological sciences" [8].) 109.158.8.201 (talk) 14:46, 27 December 2014 (UTC)

Or maybe the reverse?. ;-) Boghog (talk) 15:23, 27 December 2014 (UTC)

Well, yes... and certainly in the context of Life, the Universe and Everything ;-) (though I think it should be ok within this particular editorial context). 109.158.8.201 (talk) 15:47, 27 December 2014 (UTC)

While meant to be humorous, the cartoon does accurately reflect an underlying reality. Biochemistry is the chemistry of life and the ultimate molecular explanations of disease are fundamentally chemical in nature. Boghog (talk) 13:40, 28 December 2014 (UTC)

...and fwiw, my allusion to the book was meant to be a humorous take on that ultimate mechanistic point. 109.158.8.201 (talk) 15:44, 28 December 2014 (UTC)

On a serious note, I don't see anything about the definition of biochemistry as "the study of the composition, chemical structures, and chemical reactions of living things" that defines it as a part of biology. I interpret that definition as saying exactly the opposite. The words "biology" and "biological" don't even appear in the definition. "Composition", "Chemical structure", and "chemical reactions" are all clearly refering to chemistry. I'd also note that the most widely cited biochemistry journal is published by the American Chemical Society.Formerly 98 (talk) 15:44, 27 December 2014 (UTC)

Seriously, I think the position on the MeSH tree of "Biochemistry" beneath "Biological Science Disciplines" highlights the editorial sense, at least from a broadly biomedical perspective. 109.158.8.201 (talk) 16:15, 27 December 2014 (UTC)

Not to quibble, but MeSH also lists biochemistry as a subdiscipline of chemistry. Formerly 98 (talk) 22:43, 27 December 2014 (UTC)

Fwiw, my point was that it can be seen as a branch of the biological sciences (not that it must be seen in that way). 109.158.8.201 (talk) 00:45, 28 December 2014 (UTC)

...or to put it another way: Is the broad term "Biology" (as used in "biology of disease", tumor biology, etc, etc) editorially pertinent here? Imo, yes. And I'm suggesting that this term doesn't suffer from the semantic restrictions and associated editorial inconsistencies to which the current advice to use "Mechanisms" (as in "pathogenesis") as a heading is almost inevitably prone. 109.158.8.201 (talk) 16:45, 27 December 2014 (UTC)

• I request clarification of the proposal. Which section are we considering, and what is the proposed change? Are we talking only about Wikipedia:Manual_of_Style/Medicine-related_articles#Diseases_or_disorders_or_syndromes, and proposing to replace "biology" as the default term over "mechanism"? Or is biology just proposed to be one of the acceptable terms? Blue Rasberry (talk) 15:51, 27 December 2014 (UTC)

Yup, the proposal only regards articles on "Diseases, or disorders or syndromes". I think "Biology" could be a reasonable default term, per Boghog's wording above (fwiw, personally I'm not a fan of editorial straightjackets, but I realize other editors' mileage on editorial flexibility varies). 109.158.8.201 (talk) 16:03, 27 December 2014 (UTC)

I oppose the use of "Biology" as the preferred heading, because it is actually too narrow and ultimately not descriptive. I find "mechanism" more useful because it describes how a particular condition arises and leads to symptoms. When I hear "biology" I think of diseases caused by other organisms, but it wouldn't be the term of choice in conditions that relate to physical phenomena (e.g. trauma or poisoning). I think I am with Formerly 98 here. JFW | T@lk 22:26, 27 December 2014 (UTC)

Well, that's certainly a fair enough view, and I agree we shouldn't be forcing square pegs into round holes – a possible concern imo with having a single default heading. In that case, should we expect "Mechanism" sections to focus specifically on "how a particular condition arises and leads to symptoms"? Frankly, that's not what I'm always seeing at the moment. And I'm not at all sure it would be desirable to restrict ourselves in that way... 109.158.8.201 (talk) 00:43, 28 December 2014 (UTC)

I also oppose for similar reasons. "Mechanism" is a more useful and appropriate title. --Tom (LT) (talk) 23:04, 27 December 2014 (UTC)

The OP has identified a specific problem with many of our articles: people are putting stuff under ==Mechanism== (or similar headings) that does not belong there. Perhaps one small practical improvement we make could be this: we could all try to keep an eye on those sections, and move information about ==Causes== and ==Epidemiology== to their correct places whenever we see it. WhatamIdoing (talk) 06:06, 3 January 2015 (UTC)

An alternative is to just add a more specific heading name as necessary. E.g., to make it completely clear that I wasn't talking about some vague psychological process in mechanism sections that cover the neuronal signal transduction which gives rise to addiction, I used "Biomolecular mechanisms" in place of "Pathophysiology" or just "Mechanisms" in most addiction articles that I've edited (e.g., amphetamine#Biomolecular mechanisms, addiction#Biomolecular mechanisms, sex addiction#Biomolecular mechanisms, drug addiction#Biomolecular mechanisms, behavioral addiction#Biomolecular mechanisms, etc). Using this approach to title the section or, if other content is included, the relevant subsection, seems (to me) to circumvent the need to rename the section heading. Our MOS doesn't indicate/dictate the titles of subheadings to the indicated sections anyway. Seppi333 (Insert 2¢ | Maintained) 06:26, 3 January 2015 (UTC)

Arbitrary break - 2c

• Following the opposition expressed above I'll withdraw this specific proposal. At the same time, I'd like to reiterate that I think the editorial issue it was trying to address is genuine. For instance, in a cancer article we really shouldn't need to be providing highly relevant content (which doesn't seem to fit in elsewhere under MEDMOS) about the clinical significance of precancerous lesions in a section (titled "Mechanism") regarding tumor biology. But that's how it seems to turn out at the moment...

  Fwiw, my own 2 cents would be that MEDMOS is trying to do too much, in that it's seen simultaneously as a Help guide for newbies and a style manual for everyone, as well as a sort of checklist for GA/FA, etc. And so it ends up being inappropriately rigid, and (arguably) editorially stifling. But that's a separate issue really... 109.158.8.201 (talk) 12:22, 28 December 2014 (UTC)

Mechanisms I think is sufficient Doc James (talk · contribs · email) 13:18, 30 December 2014 (UTC)

• Support changing "Mechanism" to Biology. I'm trying to imagine what a non-scientific, non-medical person who happened across an article like Atherosclerosis or Peripheral artery disease would want the section in question to be called, and I think the answer is "Biology" rather than "Mechanism". BakerStMD T|C 17:32, 14 January 2015 (UTC)

@user:Flyer22, If you are talking about the discipline, it is surgery. If you are talking about an operating room in the UK, it is called a surgery, so multiple operating rooms might be surgeries. But the procedure is an operation. Multiple surgical procedures are called operations, not 'surgeries'. BakerStMD T|C 15:56, 14 January 2015 (UTC)

I'll admit that colloquially, people use the singular "surgery" synonymously with "operation". But the plural should not be done. As far as clarity, I think "Operations" is just as clear as "Surgeries" in context. We might instead get around this issue by titling the section in question "Procedures and Surgery". Hows that for compromise? BakerStMD T|C 16:09, 14 January 2015 (UTC)

Bakerstmd, regarding this edit you made, which I reverted, I thought you were making that edit because the word surgery gave you unpleasant mental images; after all, you used the word cringe in your edit summary. But I see that you mention the topic of surgery on your page. Given that, and what you stated above, it seems that I was wrong about why you added "operations" in place of "surgeries." As for my preference, "surgeries" is clearer to me than "operations" because of how broad the term operation is. We have a Surgery article, not an Operation article (though, yes, the Surgery article mentions the interchangeability of the two terms). Flyer22 (talk) 16:18, 14 January 2015 (UTC)

Yes I was reacting to the misuse of the term, not the idea of surgery, with which I am quite comfortable. Am I off base here? Is anyone else bothered by this bastardization of the english on our guidelines for style? BakerStMD T|C 16:50, 14 January 2015 (UTC)

Afaik "an operating room in the UK" is a theatre (note correct spelling); it always is on tv anyway. GPs (family doctors) and vets have consulting rooms called surgeries; medical consultants and members of Parliament hold surgeries, sessions when people come for appointments. Actually I think everyone has surgeries except surgeons, but maybe a UK medic can confirm. Can't we use "Surgical procedures"? Is that murdering anyone or anything? Wiki CRUK John (talk) 01:46, 15 January 2015 (UTC)

I just changed the title of a section to read "Drugs, treatments, and devices" when previously it said ""Drugs, medications, and devices". I did this because I think this section should be applied to treatments, including perhaps exercise, lifestyle changes which have been researched as medical interventions, alternative therapies which are not drugs and not devices, and anything else that is a treatment but not a drug or device. Thoughts? Blue Rasberry (talk) 15:17, 20 February 2015 (UTC)

In general this is an improvement - the section should include mainstream behavioral recommendations along with drugs and devices used in mainstream medicine. This section should not include "alternative treatments" if that means things like dietary supplements or other quackery. I can't think of anything outside of drugs, devices, and behavioral recommendations backed by treatment guidelines that should go here, and we should name those three in guideline.... Jytdog (talk) 15:23, 20 February 2015 (UTC)

Not entirely sure that's an improvement for a section intended for pharmacological interventions, as indicated by the ((main)). If non-drug treatments go into this section then that main link has to change too. LeadSongDog come howl! 02:16, 21 February 2015 (UTC)

I'm not wild about it. I don't share the worry about dietary supplements: if they do anything, then they should be treated (sort of) like drugs.

My worry is more like this: The most effective treatment for cancer (taken as a whole) is surgical excision. There's a separate section on writing articles about surgical procedures. But this seems to say that you should use the 'drug' pattern for "anything that is a treatment but not a drug or device", which would include all surgical procedures. Something like "Drugs, devices, and similar treatments" might be okay. (I'm not sure that manufactured devices should be treated like chemicals, either.)

Also, I think it would be a serious mistake to re-write an article like Physical exercise as a medical article. The subject is much broader.

However, there are types of articles that we don't have a pattern for. So here are a few examples, and you tell me what you think would be good for them: Radiation therapy, Talk therapy, Hyperbaric oxygen therapy, Speech therapy, and Joint mobilization therapy. WhatamIdoing (talk) 00:28, 27 February 2015 (UTC)

I had a go at creating a new section in Wikipedia:Gender-neutral language#Precision and clarity. Since nobody's commented there, and since I used some healthcare-related examples, I thought I'd ask some of you all to take a look. Comments should go on the talk page over there, I think. WhatamIdoing (talk) 18:33, 4 March 2015 (UTC)

Thanks WhatamIdoing. I agree what you've written about "male" and "female" and think what you've written is very sensible and also clearly written. I'd also add that in some instances (such as when talking about Sexual determination) I think it's necessary to talk about "biologically female" and "biologically male" to remove ambiguation, as in sexual development it's a bit confusing to explain that the initial biological sex might not reflect the person's sexual characteristics, let alone the gender a person assigns themselves when fully developed. That said I don't think there's a need to include this thought in your addition :). I wonder how languages other than English deal with this issue? --Tom (LT) (talk) 09:35, 9 April 2015 (UTC)

I don't know. I have heard some speculation that gendered languages (like Spanish or French) mightn't produce the same level of concern about language. The idea is that if everything is masculine or feminine, and with a defined default for what to do with the mixed-group setting, then it feels less "wrong" because you're used to the language not matching you. Everyone puts on their feminine socks and their masculine shoes, and the fact that the words for your clothes don't match your own gender is just no big deal. WhatamIdoing (talk) 22:12, 9 April 2015 (UTC)

See new section added to bottom of Pain management; I don't think MEDMOS (section suggestions) addresses this ... should it? SandyGeorgia (Talk) 21:55, 8 April 2015 (UTC)

Not too sure but would definitely like to see "In children" replace "In paediatric populations" --Tom (LT) (talk) 09:38, 9 April 2015 (UTC)

WP:MEDMOS#Drugs, treatments, and devices doesn't include a special populations section. Perhaps it should. In the meantime, I think that this is a good solution. BTW, "In children" seems to have changed to the more difficult word "Pediatrics" a while ago (in the "Diseases" list). Perhaps it should be changed back. WhatamIdoing (talk) 22:25, 9 April 2015 (UTC)

Ah, now I see it ... down there in Special populations! SandyGeorgia (Talk) 22:49, 9 April 2015 (UTC)

Have added "The leads of articles, if not the entire article, should be written as simple as possible without introducing errors." to the top of the section on writing style. Peoples thoughts? Doc James (talk · contribs · email) 21:20, 4 June 2015 (UTC)

I think that's a good addition to the guidelines. It's easy for medical articles to unintentionally turn into unreadable jargon. Kaldari (talk) 05:23, 10 June 2015 (UTC)

I think this is an unnecessary addition. The section that you've linked is to 'Make technical articles understandable' which is very different to making them as simple as possible. It's already made clear that plain English be used instead of jargon.To then add that the lead should be written as simply as possible just distracts from the non-technical non-jargon approach to stretch to the oversimplification of ordinary language. --Iztwoz (talk) 06:19, 10 June 2015 (UTC)

Support the change. This is one of the things you need to keep banging on about in the hope people will eventually take notice. Johnbod (talk) 12:33, 10 June 2015 (UTC)

I support this change as a very necessary improvement. --Anthonyhcole (talk · contribs · email) 12:50, 10 June 2015 (UTC)

The chart at right shows the effect of renaming the article Candidal vulvovaginitis to Vaginal yeast infection. This rename was against the guidelines given in WP:MEDMOS, but clearly had a positive effect on people being able to find the article. Even though "Vaginal yeast infection" previously redirected to "Candidal vulvovaginitis", traffic to the article was virtually nil before the rename, despite the fact that this is a very common medical condition. This dramatic increase is likely due to traffic from 3rd party search engines, since "vaginal yeast infection" is a much more common search term. In light of this, I was wondering if we should revisit the wording of the MEDMOS guidelines concerning article titles. I know that using exact terminology is important for medical professionals, but I think it's important for us to keep in mind the general public as a consumer of medical information. If people can't find our articles, they aren't serving much purpose. Perhaps the wording in the guidelines could be softened to allow more exceptions. Thoughts? Kaldari (talk) 06:04, 10 June 2015 (UTC)

An excellent illustration of an effect I think many of us have long been aware of. Frankly though, in some cases one wonders if pushing our article to the the top of google searches is helping the public - it all depends what else is on the top half of the first page. We also lose out on traffic because usually the most common medical search terms (professionals will tell you) include condition + "symptoms" - so most big sites have special symptoms pages. Johnbod (talk) 13:34, 10 June 2015 (UTC)

I fail to recognize a problem with WP:MEDMOS or how the move was in opposition to WP:MEDMOS. At the move discussion the opposition was due to lack of case made that the new name was commonly used. I agree with the opposition in that discussion that supporting evidence of a term's popularity on Google is not the same as verifying that the same concept is being discussed in a Wikipedia article of a similar name. You proposed a name change and it passed quickly in an efficient process. What change to MEDMOS could generate any better outcome? Why bypass this review process? Blue Rasberry (talk) 13:49, 10 June 2015 (UTC)

One of the two oppose votes specifically cited MEDMOS as their reason for opposing and one of the support votes stated that the article should be an exception to MEDMOS. Personally, I would like to see WP:MEDMOS be more in line with WP:COMMONNAME, especially for common medical conditions. For articles like headache (aka cephalalgia), heart attack (aka myocardial infarction), etc. the results can be dramatically different if you look at all reliable sources vs. only medical sources. That's just my personal opinion though, and I'm interested in hearing other editors' opinions. Kaldari (talk) 17:47, 10 June 2015 (UTC)

Where there is an exact equivalence between the common term & the medical one, I agree. The problem very often is that the common term actually covers a number of different medical conditions, which have their own articles. As Heart attack (disambiguation) says, "Heart attack may refer to: .... (#2) An inaccurate reference to cardiac arrest or sudden cardiac death" - and to a linguist these meanings are so common they cannot be called "inaccurate". Johnbod (talk) 17:53, 10 June 2015 (UTC)

Actually, your graph is not accurate in representing actual article traffic - just visits to the page titled "Vaginal yeast infection." The graph you displayed is how many people go to Vaginal yeast infection, and does not at all represent how many people go to Candidal vulvovaginitis. If look at this new graph, it is how many people go to Candidal vulvovaginitis. By looking at the first graph, basically no one used the redirect from "Vaginal yeast infection" to "Candidal vulvovaginitis" before the move on 25 May 2015. Afterwards, as the article was located at that title, the traffic to that title obviously went up and ranges roughly 80-200. By looking at the second graph, before the move, traffic was roughly 150-250. After the move, traffic to "Candidal vulvovaginitis" dropped to 50-100. So in summary, your point about the article being found more easily clearly is false. If anything, changing the title may have caused a drop in pageviews. --Scott Alter (talk) 06:07, 12 June 2015 (UTC)

I do not see a drop in page views. Simply adding the page views for Candidal vulvovaginitis + Vaginal yeast infection in the 7-day period June 3-9 and comparing that to the pre-change scenario Candidal vulvovaginitis from May 19-25 indicates an improvement: average 235 views versus 193 views. Page traffic from same source as above. --Lucas559 (talk) 19:37, 15 June 2015 (UTC)

To get an accurate count, you should NOT add the two together. Just look at each individual graph before and after the move. Before 25 May 2015, look at Candidal vulvovaginitis for the actual article's views. After 25 May 2015, look at Vaginal yeast infection for the actual article's views. If you add them together, you are double counting readers that went to one name, and then were redirected to the other. This report only tells you how many page views there were for each title. So if today, you click on Candidal vulvovaginitis, it would add a page view for both Candidal vulvovaginitis and Vaginal yeast infection (the page you are redirected to - so it double counts). I didn't do the math, but by looking at the graphs, there doesn't appear to be any significant difference after the move. --Scott Alter (talk) 19:14, 16 June 2015 (UTC)

All of the Neuroanatomy stub templates I've seen are at the very bottom of pages, where they're very unlikely to be seen. Other non anatomy articles I've read have their stub templates front and center at the top of the page, which I think increases visibility and awareness. If the goal is to get contributors to help out where they can, wouldn't it make more logical sense to place the "This article is a stub" at the very top of pages, so more people see it, rather than basically hiding it in the "fine print" that nobody pays attention to at the bottom??? Bush6984 (talk) 16:53, 30 June 2015 (UTC)

Hi Bush6984,

Stub templates are placed last per WP:ORDER, no matter what the subject is. If you've seen pages that do not follow the standard order, then I would be happy to see a few examples. WhatamIdoing (talk) 02:32, 20 July 2015 (UTC)

When considering the content of an article about a medical condition the prognosis (outlook, outcomes, result – whatever you want to call it) is hugely important to readers, and it's often ignored by editors. We usually write about causes, symptoms, diagnoses, and and treatments. This is probably a consequence of our demographics (healthcare professionals make diagnoses and prescribe treatments, but they don't have to live with the results) and our sourcing guidelines (there are no Cochrane reviews about whether you're going to live or die if you've got Scarynameitis), but we need to do something about our blind spot. Is there some way we could flag this as being important in MEDMOS? Perhaps ==Prognosis== could get an encouraging note saying that it "should always be included unless no reliable source addresses it"? WhatamIdoing (talk) 02:46, 20 July 2015 (UTC)

• Further input here please Talk:Haemophilia#Simplier

IMO the pronunciations should be moved to the infoboxes as I have done here

And the etymology should occur near the end of the lead and end of the body of the article.

Neither one of these should be in the first sentence as WP:NOT a dictionary. Others thoughts on this case and thoughts on the issue in general? Doc James (talk · contribs · email) 01:36, 2 September 2015 (UTC)

Instead of dealing with the one article, I think that we should have a discussion at WT:MEDMOS on the general question of whether pronunciation and etymology should normally be in the lead at all. WhatamIdoing (talk) 07:05, 2 September 2015 (UTC)

That is why I started this discussion here. We can move it to talk WT:MEDMOS though. Doc James (talk · contribs · email) 07:40, 2 September 2015 (UTC)

agree..Wikipedia not a dictionary, should have better use for first sentence--Ozzie10aaaa (talk) 12:55, 2 September 2015 (UTC)

Should probably be put in a "History" or similar section. The article should focus on the subject, not the word. Sizeofint (talk) 18:20, 2 September 2015 (UTC)

If memory serves, the usual views run something like this:

• Pronunciation needs to be early in the article, because it helps people actually read the article.
• Everyone wants an audio link to pronunciation (so that you can find out how to pronounce it even if you can't read IPA or other pronunciation symbols), but nobody makes them.
• I don't believe that a proposal to relegate either etymology or pronunciation to the infobox has ever been considered before.
• Etymology is considered important for anatomy articles, but less important for other stuff.
• Etymology is usually stuffed into ==Society and culture== and occasionally into ==History== (if it's an eponym).
• Nobody has ever been really satisfied with any of the locations for etymology. ==Etymology== doesn't seem like a good section on its own, and it doesn't really fit into any of the other stuff.

Does that seem about right? WhatamIdoing (talk) 02:44, 3 September 2015 (UTC)

The element folks have been putting pronunciation in the infobox for a long time per Iron etc. So not my idea. But I am following their lead. Doc James (talk · contribs · email) 03:12, 4 September 2015 (UTC)

Just to say that fully agree with location of infobox for pronunciation. A separate section at the end of an article for etymology is almost the norm in anatomy articles which seems to suit there - save for saying that some of these are excessively lengthy. I think often a straightforward origin is helpful in the lead - not in the first sentence which I agree needs to be kept simple as for example in Streptococcus and Dysphagia. Such a short reference then needs no etymology section.--Iztwoz (talk) 12:43, 4 September 2015 (UTC)

I agree. It's difficult to read a long introductory sentence and I am not familiar with IPA so that's just symbols. Then some editors want to include national variants and it just makes the lead a mess and difficult to understand. As Iztwoz says, if it is useful to the reader then we should keep a short summary in the lead, but certainly not in the lead sentence. --Tom (LT) (talk) 00:42, 5 September 2015 (UTC)

User:Quercus solaris has been adding a link right after the name to one section of the article.[9] I strongly disagree with this. Imagine if right after the name we provided a list of all sections in the article? This is what the TOC is for and should not be duplicated in the first sentence. Doc James (talk · contribs · email) 22:14, 4 September 2015 (UTC)

Hi all. The bold that follows is not shouting, it is just for emphasis for those who might skim fast (TL;DR). The model I'm following right now has been moving etymology and pronunciation info out of the lede and into a later section, to make the lede cleaner. I do leave a jump link behind. I think people would not object to this link if it was shorter, as in tiny—like one symbol instead of 2 words. But this model replaces an earlier tendency throughout Wikipedia (not just in medical articles) of having that info not only in the lede but also clogging up the opening sentence. So what I'm doing is an improvement on that aspect, but I think the move to one symbol for the jump link is the next step. This has been broached before at Help talk:IPA for English but the brainstorming did not proceed to action points yet. Another option is a footnote, it still accomplishes the same point of jumping to a lower spot on the page. One more thought. Why does anyone care about etymology and pronunciation? Answer: for some learners, it helps them to absorb and recall. It is a learning aid. When all words are just long gobbledegook of unknown sound, a student is less likely to remember what they all mean later. The jump link is meant to lower the barrier on that. It moves students past rote memorization into spontaneous recall of what things are. Quercus solaris (talk) 23:15, 4 September 2015 (UTC)

I see that Wikipedia:Manual_of_Style/Pronunciation#Placement exists. This will be relevant to the solution. Quercus solaris (talk) 23:41, 4 September 2015 (UTC)

Here is one example of a new, tiny jump style:

Cytokinesis^{[word help]} is the process during cell division in which the cytoplasm of a single eukaryotic cell is divided to form two daughter cells. It usually initiates during

Quercus solaris (talk) 23:33, 4 September 2015 (UTC)

Not a fan of this approach as we are not a dictionary, readers can access the table of contents and select sections on their own, and links such as this encourage editors to do the same with other topics in the lead, eg:--Tom (LT) (talk) 00:42, 5 September 2015 (UTC)

Cytokinesis^{[word help]} is the process ^[mechanism]during cell division in which the cytoplasm of a single eukaryotic cell is divided to form two daughter cells. It usually initiates ^{[develompent]}during

OK, that makes sense. A footnote, as Wikipedia:Manual_of_Style/Pronunciation#Placement does it, would eliminate that possibility. Quercus solaris (talk) 02:40, 5 September 2015 (UTC)

I think this content should go in the infobox and that is sufficient. We should not be putting this info in the first sentence or adding notes their. It is undue weight IMO. Doc James (talk · contribs · email) 03:58, 5 September 2015 (UTC)

Have proposed changeing Wikipedia_talk:Manual_of_Style/Pronunciation#With_respect_to_placement here [10] to reflect the practice at the elements project

I find those tags make our content harder to read. We need to make it easier to read. Doc James (talk · contribs · email) 04:01, 5 September 2015 (UTC)

Brought it up here [11] Doc James (talk · contribs · email) 07:21, 5 September 2015 (UTC)

Update after some days of open comment opportunity. I am going to implement Doc James's preference in my editing, to the extent of infobox existence. Regarding a note link in the first sentence as described at Wikipedia:Manual_of_Style/Pronunciation#Placement: its abolishment is unlikely to become a Wikipedia-wide standard, because almost no Wikipedians have ever objected to it. However, as pointed out by Doc James, there has been movement away from it in certain categories of articles when the infobox offers a pronunciation parameter. Examples are chemical element articles (Infobox element) and disease entity articles (Infobox medical condition). Here's my plan: If I am adding or fixing pron or etym info, then as follows: (1) If I edit an article that has Infobox medical condition, then I'll remove any pron and etym info from the lede and make sure that pron is in the infobox and that etym is in an etym section near bottom. And if the word uses combining forms (eg, cyto- + kinesis or hyper- + kerato- + -osis), they will fall in parens after the infobox pron and be linked to the etym section for explanation. This is a pedagogical service to people learning vocabulary, such as A&P 101 students and, frankly, many humans who are trying to parse big words rather than treat them as unanalyzed black boxes, and thus having a hope of internalizing them (versus rote memorization). (2) Else if I edit an article that has no such infobox (for example, an A&P topic that is not a disease entity), I will use the note link in the first sentence as described at Wikipedia:Manual_of_Style/Pronunciation#Placement, which successfully gets pron and etym out of the lede (serving goal of simple and clear lede) but leaves a tiny breadcrumb behind so that people who want it can instantly find it. Another way to summarize the above is that I'll be following the best option of the WP general standard for placement of pron and etym info except in any articles, such as element or disease articles, where the infobox approach is available instead. Quercus solaris (talk) 22:51, 8 September 2015 (UTC)

Thanks Doc James (talk · contribs · email) 07:15, 9 September 2015 (UTC)

Person-first language has been criticized by some Autistic, Deaf, ADHD, Dys*ic, Bipolar, etc. people as, they believe, their condition is an inseparable part of who they are and of their identity. They argue you can't separate a person from their Autism, Deafness, ADHD, Dys*ia, Bipolarity because if you did, "they" would not be them anymore. Some people have complained they can't use identity-first language with cerebral palsy easily for the same reason.

The MOS knows this and says some people dislike person-first language. However, when should we use what language. When it comes BLPs it is easy, whatever they prefer. However, what about articles about general subjects? "People with lupus are more likely to give birth to autistic children" or "give birth to children with autism?"

Sorry if I make no sense. Should we just let it be or should we have guidelines for what language to use and when? Andrea Carter (at your service | my good deeds) 15:42, 20 September 2015 (UTC)

Hi all, just wanted to share a discussion started by The Wikipedia Library at the Wikiproject Medicine talk page about a pilot exposing the WP:Research help page more in medical article reference sections. Please share feedback/thoughts. Thanks, Astinson (WMF) (talk) 17:02, 3 November 2015 (UTC)

I've proposed a change to the wording on citations in the lead at Wikipedia_talk:WikiProject_Medicine/Archive_77#.22Adding_sources_to_the_lead_is_a_reasonable_practice_but_not_required_as_long_as_the_text_in_question_is_supported_in_the_body_of_the_article.22. That page gets higher visibility than here I think. Please comment there; we can copy the discussion over here after it closes. Johnbod (talk) 15:10, 23 February 2016 (UTC)

 Done by Boghog

Not infrequently, INN (generic drug names) are wrongly being treated as proper names and being capitalized. This is even occurring when the INN is listed with a brand name, such as Levothyroxine (Synthroid). (A contrived example.) I can't find a direct policy guiding editors, but one should exist. (If it does, it should be more apparent, included here and WP:PHARMMOS.) This current practice may also create confusion between INN and brand names in our audience. — Box73 (talk) 17:37, 27 February 2016 (UTC)

I gather this has been discussed in Archive 8:

https://en.wikipedia.org/wiki/Wikipedia_talk:Manual_of_Style/Medicine-related_articles/Archive_8#Section_ordering_for_addictive_drugs

The Amphetamine article under the title "4 Overdose", discusses addiction and tries to imply that any recreational use is an overdose. In the article Drug Overdose itself, the correct definition is used and explained. For example, it is recreational use of an illicit drug to take cocaine, and not an overdose of cocaine. However, injecting cocaine can easily lead to overdose.

It is in an attempt to convey "The stimulants are not addictive in the doses used to treat ADHD" that the world is being turned upside down with semantics.

I think there needs to be consensus across all the psychoactive drugs.

Overdose is not a title for addiction, and dependence & withdrawal. These terms all have independant and separate meanings. Logically, if the statement "The stimulants are not addictive in the doses used to treat ADHD" is true, the mechanism for becoming addicted is still not "overdose", by definition. Over-use and misuse come to mind.

Overdose is not a side effect. It could go under adverse effects, or a new title such as 'safety profile of psychoactive pharmaceuticals.' Eloerc (talk) 23:56, 20 March 2016 (UTC)

This is also discussed at Wikipedia talk:WikiProject Pharmacology/Style guide/Archive 1#When is an overdose not an overdose?. Essentially this is an issue of differing (but equally valid as I understand) definitions of "overdose". Sizeofint (talk) 00:12, 21 March 2016 (UTC)

I've removed this:

Entries in the list must normally be notable (a straightforward test of which is the presence, or realistic hope, of a Wikipedia article). Non-notable relatives of notable people should not be included. Questions may be directed to the noticeboard for biographies.

It was based on the (mistaken) belief that WP:LISTPEOPLE requires that any person (living or dead) in a list be notable (=qualify for a separate article). This isn't an accurate representation of that guideline. In practice, there are several exceptions that might be relevant, e.g., being the first person formally diagnosed or being involved in a high-profile incident.

I don't think this was helping us much anyway (no matter what this page says, inexperienced people add their friends and neighbors, and experienced editors quietly remove them), so I've just removed it. WhatamIdoing (talk) 07:58, 25 July 2016 (UTC)

Is someone "diagnosed with autism" or "diagnosed as autistic"?[12] The New York Times article cited, says "...received a diagnosis of autism..." and it seems one would be diagnosed with a condition ("autism", a noun) rather than being diagnosed as a person who has a condition ("autistic", as a person with autism) or diagnosed as being described a certain way ("autistic" as an adjective). People are diagnosed "with cancer", not "as cancerous" or "as a person with cancer". Thoughts? - SummerPhD^v2.0 20:50, 24 July 2016 (UTC)

With a lot of mental disorders and disabilities, it's generally preferred to use person-first language, as in "a person with autism" as opposed to "an autistic person", but there's a movement within the autism community that prefers "an autistic person" as a way of reappropriating the term and asserting that it's not a negative thing (like cancer, for example). So as far as NPOV/tone, I think debatable and I recently decided that in general, I'd stop changing it from however it was written when I got there (whereas I'd previously been changing it to person-first language whenever I came across it). In the example you gave though, stylistically, I think "diagnosed with autism" sounds better than "diagnosed as autistic", which sounds kind of awkward IMO. —PermStrump(talk) 00:00, 25 July 2016 (UTC)

Yes would typically do "diagnosed with X" but autism is a borderline case as some view it differently. Doc James (talk · contribs · email) 04:04, 25 July 2016 (UTC)

Well you can't be diagnosed as cancerous, unless you're chock-full of radiation and poisoning everyone around you — but for this specific case I would tend towards the active voice, rather than the passive. The literature is clear that people (not just those with low reading scores) find the active voice easier to understand. Regarding neutrality I don't see how that could be an issue. Carl Fredrik 💌 📧 07:47, 25 July 2016 (UTC)

Perhaps this construction is more common among psychiatric conditions (loosely defined). It's not unusual to say that someone has been "diagnosed as anxious" or "identified as depressed", etc. I don't think there's one perfect phrase that should be used exclusively. WhatamIdoing (talk) 08:04, 25 July 2016 (UTC)

should be with autism...IMO--Ozzie10aaaa (talk) 09:44, 25 July 2016 (UTC)

Agree that person-first language is preferred; specifically, using the -ic suffix as a noun is seen as labeling and objectifying people who have conditions. Schizophrenic is the prototype example, though those with diabetes are less concerned about being referred to as diabetics. In conditions where stigma lives, avoid noun-ifying the condition. ... "Diagnosed with autism" could also be "diagnosed as having autism." Drdaviss (talk) 13:33, 25 July 2016 (UTC)

I have no problems with identity-first language being used to describe autistic individuals. In fact identity-first language is used throughout the Autism Speaks article. But the specific edit being questioned [13] is about the diagnosis, and the diagnosis is called "autism," not "as autistic." That's the term that the New York Times uses, and that's the term that's used by most medical sources to describe the diagnosis. I don't see "diagnosed with autism" as a problem, especially when the rest of the article uses identity-first language. CatPath (talk) 21:38, 25 July 2016 (UTC)

I guess I started the tangential conversation about person/identity first language. I wasn't sure if OP was talking about the words autism vs autistic in general or only in that specific context, so I was just covering all of the bases. I'm still not sure actually or if this discussion is about making an official guideline for how to word it. If that's the case, in the example OP gave, I do think "diagnosed with autism" is preferable, because, piggybacking on what CatPath said, the DSM and ICD talk about the diagnosis of autism, autism spectrum disorder, or ASD. —PermStrump(talk) 21:55, 25 July 2016 (UTC)

I have notified WP:WikiProject Autism of this discussion. I'm a bit concerned about the "selective" notification - excluding the most directly relevant WikiProject. Roger (Dodger67) (talk) 16:40, 26 July 2016 (UTC)

As oversight on my part. While I am aware of the "identity first" argument and the "person first" argument, I'm rather baffled by the application of either here. A diagnosis is a condition, not a person (however labeled). - SummerPhD^v2.0 03:11, 27 July 2016 (UTC)

SummerPhD, This should clear up the bafflement... See CatPath's comment above. The issue is the use of "autistic" versus "autism." The diagnosis uses the latter. Drdaviss (talk) 07:08, 27 July 2016 (UTC)

There's a proposal at WT:PHARM#Physical and chemical properties section name to change the "Physical and chemical properties" section header to "Chemistry" in MOS:MED#Drugs, treatments, and devices and MOS:PHARM. Seppi333 (Insert 2¢) 11:03, 21 August 2016 (UTC)

The current order seems illogical (eg. Prevention between Diagnosis and Management) and some editors try to enforce it despite the guidelines saying they may be varied. There has been support for changing the list of recommended sections and no opposition. Can we reorder the suggestions along the lines of Archive_6#Order_of_sections ? - Rod57 (talk) 16:20, 20 December 2015 (UTC)

Does anyone object to this proposal? I think it's a generally good idea. Also, perhaps we should highlight that note about varying the section order, to make it stand out. WhatamIdoing (talk) 08:07, 25 July 2016 (UTC)

We have thousands of articles organized by the current recommended layout. So not interested in seeing it changed. Doc James (talk · contribs · email) 19:11, 21 October 2016 (UTC)

We don't have to change the articles all at once. Just deprecate the old layout and use the new layout going forward. It is a fairly standard process when dealing with ...err... standards. We shouldn't let tradition hold us back if there is a better way. Sizeofint (talk) 20:18, 21 October 2016 (UTC)

CFCF removed the following in August, from the "Signs of writing or editing for (other) patients" section.

* You use a writing style appropriate for 12-year-olds, because the sixth grade reading level is recommended for patient information leaflets.

I restored it today, because we're not writing patient-information leaflets or for 12-year-olds. Doc James has removed it again. This has become an issue because even very common words are being challenged. SarahSV ^(talk) 21:12, 22 October 2016 (UTC)

We should be at least writing the lead of our article for a general audience. IMO "diaspora" is not a very common word. Wondering what other people's opinion is? I doubt a significant portion of grade 12 students would know it. Wikipedia should provide an introduction to most topics for those without a significant background already. Doc James (talk · contribs · email) 21:17, 22 October 2016 (UTC)

It appears that SlimVirgin is attempting to solve a content dispute at Female genital mutilation over this dif by Doc James by changing the guideline, which is not a good idea. Discussion is at Talk:Female_genital_mutilation#Diaspora. Jytdog (talk) 21:27, 22 October 2016 (UTC)

Always the bad faith, Jytdog.

Doc James, the sentence says that a sign of writing for the wrong audience is writing for 12-year-olds, not grade 12. Nowhere on Wikipedia does it say we should aim our writing at 12-year-olds or that medical articles should read like patient leaflefts, so it's worth pointing that out. I agree with you about removing jargon, but you're taking it too far. We need clarity, not simplicity that lacks clarity. SarahSV ^(talk) 21:32, 22 October 2016 (UTC)

you are the unconstructive "Dr No", SlimVirgin, except in cases like this where you are trying to "win" a content dispute. Then you will be constructive. And it is well established that we don't run and try to change a policy or guideline to solve a local dispute. Please solve this at the article. Jytdog (talk) 21:35, 22 October 2016 (UTC)

I have no idea what your first sentence means, except that (as usual) you're personalizing this, so please stop doing that.

This isn't about one article. It's happening in several articles. Poor prose and mistakes are being introduced under the guise of keeping things simple. We should aim for clear (not simplistic) communication, and that requires good writing. SarahSV ^(talk) 22:00, 22 October 2016 (UTC)

One can write using easier language without introducing mistakes. We should be working together towards this goal. Doc James (talk · contribs · email) 22:04, 22 October 2016 (UTC)

"Always the bad faith, Jytdog." is not personalizing? Again, we don't solve local content disputes by changing policies/guidelines. Jytdog (talk) 22:16, 22 October 2016 (UTC)

This article is an excellent example of the problem we face. Supposedly I have no idea after 11 years of post secondary education and a life time of reading what the term "diaspora" means and yet we are to use it in the lead of an article of great interest to many people who speaking English as a second language.

Our WP:FA process appear to seriously let down the audience we are supposedly writing for which is the generally public. We have a lot of FA that are way overly complicated. Doc James (talk · contribs · email) 22:23, 22 October 2016 (UTC)

Article leads should be understandable by the vast majority of readers (e.g., at a high school reading level). The article body should be understandable by the readership base for whom particular sections of text are intended; ideally article text should be accessible to everyone, but I really don't expect articles or particular article sections on specialist (sub)topics, like Fatou's lemma which is used in mathematical proofs involving Lebesgue integrals, to be accessible by the general public. In the case of medical articles, any article sections that cover a clinically relevant subtopic should be written in a manner that is accessible to as many people as possible. Ideally, that approach is what our MOS should advocate. Seppi333 (Insert 2¢) 23:35, 22 October 2016 (UTC)

Agree I have less concerns with the body of the text being more complicated. Doc James (talk · contribs · email) 23:41, 22 October 2016 (UTC)

In theory I agree the leads should be simple enough for the general public. I do cringe at some of the clunkiness that results from this though. Sizeofint (talk) 03:21, 23 October 2016 (UTC)

The issue with this line of the MOS is that it promotes the idea that if a text can be understood by a 12 year old it is poorly written. This strikes me as a problem because patient information guidelines are based on the average reading level of the population, and for our articles to be useful they need to be understood, especially the ledes. Carl Fredrik 💌 📧 00:08, 23 October 2016 (UTC)

I would like to propose adding to the list of suggested sections the option of "Case Studies and Experimental Treatments." Such a section may be especially appropriate in regard to diseases for which there are no widely accepted treatments, such as persistent vegetative state for which there is a body of peer reviewed literature documenting experimental treatments that have produced positive results. I believe this material would be of interest to general readers and to those starting the process of researching the topic (and discovering citations that may be pursued) for reasons related to school reports, professional research, or personal reasons (for example, a family member facing this condition).

While MEDMOS makes clear that other sections may be added, some editors hold the MEDMOS must be religiously adhered to and insist on deleting well documented experimental treatments, even when the fact that no treatment has been universally recognized is clearly stated. Adding to the list of section options a section title like "Case Studies and Experimental Treatments" would perhaps aid the development of many articles by providing a place to collect information that may be useful to readers while also doing so in a way that emphasizes that the information in that section does not reflect an evidence based general treatment recommendation.97.91.202.83 (talk) 16:01, 1 December 2016 (UTC)

There is already a "Research" section. How is this different? Sizeofint (talk) 18:52, 1 December 2016 (UTC)

Should still be supported by review articles even if it is research. Doc James (talk · contribs · email) 21:42, 1 December 2016 (UTC)

Yes. This would be likely, over time, to wreak havoc in cancer articles, & I must say I'm against it. Johnbod (talk) 15:47, 21 December 2016 (UTC)

Can we rule on whether or not we should include synonyms in section headings, and then update the MEDMOS?

For example, the "dyshidrosis" page only states it as "dyshidrosis." It doesn't open as "dyshydrosis (also known as acute vesiculobullous hand eczema,[1] dyshidrotic dermatitis,[2] cheiropompholyx, dyshidrotic eczema, pompholyx, podopompholyx[3])." And then it states them as synonyms in the infobox. What are your thoughts on this issue? IIIBALESIII 20:01, 1 April 2017 (UTC) — Preceding unsigned comment added by Iiibalesiii (talk • contribs)

Iiibalesiii — Could you please clarify what you mean. Are you referring to specific subsections, or as the first part of the lede? We've recently moved into including synonyms in the infoboxes instead of in the text. There is a decent writeup on this at Wikipedia's lead sentence problem, indicating a problem that we avoid by moving such information to the infobox. Carl Fredrik ^talk 10:34, 18 June 2017 (UTC)

Is there a preferred symbol convention for pressures, partial pressures etc for medical articles? • • • Peter (Southwood) ^(talk): 04:28, 18 June 2017 (UTC)

No aware of any no. If you would like to suggest one to include here: feel free to do so. Carl Fredrik ^talk 10:29, 18 June 2017 (UTC)

There is a discussion on this point at Wikipedia talk:Manual of Style#Query on symbols/abbreviations for pressure I know of one officially recognised format, and one that I know is commonly used in some fields, but I have no reliable source for it being a standard. There may be others I don't know about, and there are some formats which are occasionally used which appear to be wrong. I do not want to impose one system on the encyclopedia because I was ignorant of accepted options, or recommend options which then turn out to be deprecated. • • • Peter (Southwood) ^(talk): 11:43, 18 June 2017 (UTC)

I have no strong feelings either way. Why is standarization necessary? Carl Fredrik ^talk 13:10, 18 June 2017 (UTC)

Regarding:

"Avoid using the potentially ambiguous term doctor to refer specifically to physicians or surgeons. Avoid using doctor or physician in ways that incorrectly exclude other licensed healthcare professionals, such as nurses, physician assistants, and midwives."

When I refer to a person that offers medical treatment or advice, and is qualified to do so I call them a clinician. The ability to provide different types of medical treatment varies among countries and we can't assume that a physician in Cambodia can and will provide the same treatment in Great Britain. Conversely, another type of clinician in Haiti will provide medical care with little training including homeopathy.[don't consider that an endorsement]

Best Regards, Barbara (WVS) ✐ ✉ 17:12, 5 August 2017 (UTC)

I tend to use the term "health care provider". Must of what is done by physicians in the Western world is done by nurses of community health workers in other places. Doc James (talk · contribs · email) 23:23, 5 August 2017 (UTC)

You have just undone my edit, User:SMcCandlish, and I'd like to explain why I think my version was better than users. The section is about which standard headings to use for which type of article. So the Level 2 headings are about the different TYPES of articles, e.g. starting with articles about diseases. But then suddenly it continues with the so-called "appendices" (not a term that I found clear at all!). And it puts on the same level "See also" as "Diseases". That is not logical. In my opinion this needs to be put in a separate section. What was wrong with the way I had proposed it? If you want people to use this Manual of Style it needs to be clear. Currently it is not very clear. See how we have done it here for Manual of Style Sanitation - which I think is clearer: Wikipedia:Manual of Style (Sanitation)#Recommended section headings. EMsmile (talk) 22:58, 10 November 2017 (UTC)

I WP:BRDed it because it wasn't an improvement, doesn't have a consensus behind it, and the original version was long-stable without any issues. I did implement a minor clarification that would seem to address your issue (changing "Sections" to "Content sections", in distinction to the "Standard appendices" which technically are sections but are not really content in the sense we normally use that word here). There was no need to make these two section names long-winded, much less almost indistinguishable. And we actually use the phrase "standard appendices" pretty often, so it should stay. Not concerned with the heading level, myself, if you don't like the original.

"Manual of Style (Sanitation)" isn't actually part of MoS; it's a WP:PROJPAGE essay from WP:WikiProject Sanitation that's been misnamed; I've listed at WP:RM. There's been no WP:PROPOSAL to adopt as part of the MoS guidelines. It's not even correctly named as one. It would never happen, because it's too micro-topical, and most of it is WP:CREEP, just someone's personal preferences. We do not need thousands of MoS pages for every conceivable subject, only for those that involve an unusually high number of style problems/conflicts/questions/particularities, and about which there is broad site-wide consensus.
 — SMcCandlish ☏ ¢ >^ʌⱷ҅_ᴥⱷ^ʌ<  04:51, 11 November 2017 (UTC)

I'm curious, why does the Anatomy section recommend using 'Additional images' as the section heading for gallery sections? This is inconsistent with the rest of Wikipedia, where 'Gallery' predominates. Thanks, -- Black Falcon ^(talk) 16:54, 17 December 2017 (UTC)

@Black Falcon this title has been used in the majority of our articles for at least the last couple of years. The idea is to remind contributor and describe to readers that we include there "additional" images, ie. images that in some way add to the text. Otherwise the temptation for some contributors is to whack many images in the "gallery" because it is just that. And there have been some whoppers previously. I think we should continue to use "Additional images" if possible for the reason I have just stated. Otherwise we will get image creep again, and as we are WP:NOT a repository it is time consuming for someone to have to go trim it (not to mention it affects loading times). --Tom (LT) (talk) 23:05, 17 December 2017 (UTC)

I don't feel strongly about it either way. I prefer not to have additional images unless necessary or unless they are improvements, though. Flyer22 Reborn (talk) 23:42, 17 December 2017 (UTC)

IMO the galleries should be placed in the section of the article in which they fit best rather than in a separate section at the end. Doc James (talk · contribs · email) 02:04, 18 December 2017 (UTC)

I agree with that. There is no reason except ye olde habit to use "Gallery". Personally I tend not to use a header at all, as it is rarely needed in fact. Johnbod (talk) 05:24, 18 December 2017 (UTC)

Typically, I think a gallery section should be placed at the bottom. At the Blond article, galleries have become excessive and this was addressed on the article's talk page. Some images were subsequently removed, but there are still a lot of gallery images there at the moment. Flyer22 Reborn (talk) 18:44, 18 December 2017 (UTC)

Agree with the above - Iztwoz and I will often trim and integrate the galleries into the appropriate sections. As it is I'd estimate this is used in about one to two thousand articles or so in the anatomy space. It tends to be used when editors bulk upload images. One other factor to consider here is that a lot of articles that it is used on are stub or start class and so don't really have a section they can be placed in. --Tom (LT) (talk) 22:15, 18 December 2017 (UTC)

I've rewrote the "Trivia" section somewhat [16], since it seems for example "Research directions" works pretty well, without gathering too much miscellaneous entries, such as here. Mikael Häggström (talk) 12:45, 2 January 2018 (UTC)

Somewhere between these two diffs we lost two important points (especially given that this is MOSMED not MEDRS, but much of the new material is about sourcing): don't use the vague "Research", in particular, as the section header; and don't dwell on namedropping of researchers/teams and their affiliations.  — SMcCandlish ☏ ¢ >^ʌⱷ҅_ᴥⱷ^ʌ<  00:22, 3 January 2018 (UTC)

I've reinserted those pieces now. Mikael Häggström (talk) 11:42, 3 January 2018 (UTC)

Used as a subheading for drug articles. Following a discussion at a GA review. Why not "Creation"? I would say that is a simpler title much more likely to be understood by readers. We have made similar changes (eg pathogenesis -> mechanism) in medical articles for good reason - content needs to be able to be read or what's the point? --Tom (LT) (talk) 01:32, 19 December 2017 (UTC)

I can't think of "synthesis" without thinking of WP:Synthesis. Shows just how long I've been editing Wikipedia, LOL. I think any significantly experienced Wikipedia editor seeing the title of this section would first think you are talking about the policy (unless they solely work in an area that doesn't have to worry about that policy much, if at all, and they may therefore be unfamiliar with the policy).

Anyway, I'm not sure about making "creation" instead of "synthesis" standard for drug articles. Doc James probably has an opinion on it. He edits drug articles more than the two of us do. Flyer22 Reborn (talk) 15:04, 19 December 2017 (UTC)

Definitely something that should be asked at WP:Med before the matter is changed here at the guideline. Flyer22 Reborn (talk) 15:06, 19 December 2017 (UTC)

Perhaps that's because you aren't in the field of chemistry/drug development? "Synthesis" is the term that refers to the creation of drugs. As a scientist, "creation" makes me think of the position of anti-evolution. Natureium (talk) 15:37, 19 December 2017 (UTC)

Nope. Before Wikipedia, my first thought when seeing "synthesis" was chemistry matters. Like I noted, that is not the case anymore, especially when the term is being used on a Wikipedia talk page. I can't even think of the term original research in the same way I did before due to the WP:Original research policy. As for "anti-evolution," I think I got a slight biblical feel when seeing the "creation" suggestion. Either way, I'm not religious. I certainly don't prefer "creation" as the heading, but I am willing to wait and see what others state. I also clearly suggested that the matter be taken to WP:Med for discussion, or that we at least consult with that project and direct them here for discussion. Flyer22 Reborn (talk) 15:53, 19 December 2017 (UTC)

Is it about the chemistry or the production or both? · · · Peter (Southwood) ^(talk): 16:28, 19 December 2017 (UTC)

The subsection of the article under GA review is Beta-Hydroxy_beta-methylbutyric_acid#Synthesis. It does not make clear if it is bench or production. The subsection is appropriately titled - it is about how you make the stuff - chemical synthesis. I would expect content under a "creation" heading to be about drug discovery. Jytdog (talk) 17:52, 19 December 2017 (UTC)

The reason that this section was included under chemistry in our MOS is that the vast majority of drug articles are tagged with the WP:CHEMICALS banner (for obvious reason: drugs are chemicals) and MOS:CHEM+MOS:CHEM/Chemicals requires that preparation/synthesis be covered. Those MOS pages specify that this content be covered under a level 2 "Preparation" section; but, since articles on drugs follow the layout of MOS:MED+MOS:PHARM, we've incorporated discussion of content on that topic under a level 3 heading under "Chemistry". I think it'd be fine to re-title the level 3 "Synthesis" heading as "Preparation" for concordance with MOS:CHEM/Chemicals. "Creation" is too vague IMO. Seppi333 (Insert 2¢) 05:28, 20 December 2017 (UTC)

imo "Creation" is a 'loaded' term and best avoided.--Iztwoz (talk) 18:04, 19 January 2018 (UTC)

I would also like to add the following to the additional notes of WP:MEDMOS#Anatomy

• The term "nerve supply" is preferred to "innervation" because it is easier for lay readers to understand. (or something similar)

I propose this because:

• "Innervation" is a long, unfamiliar and daunting word to most readers
• "Nerve supply" is an equivalent term, used on most of our articles, that communicates the same meaning but uses two more familiar words to describe that is going on - ie what nerves (afferent or efferent) supply said structure
• Again, owing to work put in by myself and other editors, this reflects the state on the majority of our anatomical corpus

Thoughts? --Tom (LT) (talk) 23:33, 17 January 2018 (UTC)

Seems fine to me in general, although the vast majority of articles on brain structures that I've come across use a section titled "Inputs" and a corresponding "Outputs" section to specify the brain structures connected to it via incoming and outgoing neural projections, respectively. Seppi333 (Insert 2¢) 07:42, 18 January 2018 (UTC)

That's a good point - hopefully it's clear that this proposal is specifically for articles with the subsection title "Innervation" to become "Nerve supply" - rather than this more specific subset --Tom (LT) (talk) 08:45, 18 January 2018 (UTC)

We already use "Nerve supply" everywhere. Where is "Innervation" still being used on Wikipedia? Flyer22 Reborn (talk) 01:09, 19 January 2018 (UTC)

@Flyer22 Reborn - still used a fair bit on a lot of our garden variety articles (esp. muscles). --Tom (LT) (talk) 10:35, 20 January 2018 (UTC)

Not unreasonable. Doc James (talk · contribs · email) 02:53, 19 January 2018 (UTC)

have updated the MEDMOS. --Tom (LT) (talk) 04:39, 26 January 2018 (UTC)

• Support This is a difficult situation. "Nerve supply" is not standard but it seems to be a phrasing which has some use. "Innervation" is a technical term which is standard but which probably is not appropriate for typical Wikipedia readers who are the majority audience. In Wikidata innervates (P3190) and innervated by (P3189) are in use so that is supporting evidence that "innervation" is developing as standard language getting translated to all languages. I cannot guess at future trends in what language should be simplified and what propagates to wider usage for for now I agree that "nerve supply" seems simpler to understand. Blue Rasberry (talk) 14:46, 10 February 2018 (UTC)

I would like to propose a change in WP:MEDMOS#Anatomy from "Histology" to "Microanatomy". I propose this because:

• Microanatomy is much more likely to be understood by readers, who can piece together the two parts (micro + anatomy) to understand what it will be about
• It is less abtruse than histology (greek for "study of tissues") and doesn't require an understanding of what histology means or is
• This title also reflects the term used in most of our articles, due to work put in my me and other editors over the past 2-3 years

Thoughts? --Tom (LT) (talk) 23:30, 17 January 2018 (UTC)

Sounds fine to me. Seppi333 (Insert 2¢) 07:42, 18 January 2018 (UTC)

How often is this term used? I'm not saying it's not, but I don't think I've ever heard the word "microanatomy" before. Natureium (talk) 14:13, 19 January 2018 (UTC)

A google search will show plenty of entries. --Iztwoz (talk) 17:51, 19 January 2018 (UTC)

I think its a better name for reasons given.--Iztwoz (talk) 17:55, 19 January 2018 (UTC)

I disagree. Histology is still far more common of a term in this context. Natureium (talk) 14:41, 22 January 2018 (UTC)

• Support I did a Google search and found scientific articles across decades which use the term "microanatomy" to mean "histology". Both of these are difficult terms, but I agree that while "histology" is a term which any reader will have to learn as a new term, "microanatomy" is a term for which readers at least have some hope of guessing the meaning. Wikipedia's audience for health content is primarily layman consumers who are seeking information to inform health decisions for themselves and their loved ones. I advocate for simpler language use whenever possible and whenever we can retain most of the precision even by using simpler words which already have an established history of use. Blue Rasberry (talk) 14:50, 10 February 2018 (UTC)

I'm iffy on this since I think many people will have heard "histology" before "microanatomy." Even in middle and/or high school, I learned what "histology" meant. It was the term used in books. Flyer22 Reborn (talk) 20:03, 10 February 2018 (UTC)

I am not sure this is a good idea either. I agree with Flyer22, lay people are more likely to have heard the term histology. Histology is the far more widely used term and it is not even close:

• Microanatomy: about 358 000 results
• Histology: about 24 000 000 results

Boghog (talk) 20:49, 10 February 2018 (UTC)

I'm fine with either term, but I'd like to point out that "microanatomy" may be easier to figure out for the lay person: just micro + anatomy. To recognize "histology" you must have had a class referring to it. To be honest, my high school level biology classes never mentioned the term histology (they just said microbiology or cell structure), and I only learned about this terminology late in undergrad...

• Anatomy: about 91,700,000 results
• Micro: about 265,000,000 results

Myoglobin (talk) 21:42, 10 February 2018 (UTC)

We should simply mention in the guideline that using either is fine, just like we do for some other aspects. Flyer22 Reborn (talk) 17:10, 11 February 2018 (UTC)

Support this obvious solution, somewhat embarrassed I didn't think about it earlier. --Tom (LT) (talk) 09:50, 13 February 2018 (UTC)

 Done with no objections to this suggestion ("or microanatomy") I've made this change. --Tom (LT) (talk) 22:02, 24 February 2018 (UTC)

Jytdog just posted a note recommending citations in the leads of medical articles. I support this recommendation. I feel like this should be the policy everywhere, but in medicine there is more community support for this and a greater urgency because translation projects need the leads formatted in this way to carry the citations to other language Wikipedias.

The School of Nursing at LaGuardia Community College is presenting a Wikipedia translathon in April 2018. This is probably the most linguistically diverse school in the world. At the event the organizers will invite new user attendees to use the translation extension to translate the leads of Wikipedia articles. This sort of activity becomes much easier and much higher respectability when the translation includes carrying over citations; otherwise, all the academic sourcing never goes across languages.

I appreciate Jytdog's advocacy in this space both for the sake of English Wikipedia and the benefit of other language Wikipedias after translation. Blue Rasberry (talk) 18:11, 12 March 2018 (UTC)

Bluerasberry, as you know, we've discussed this before. I think the most recent discussion was the 2016 one that took place at WP:Med: Wikipedia talk:WikiProject Medicine/Archive 77#"Adding sources to the lead is a reasonable practice but not required as long as the text in question is supported in the body of the article". In that discussion, Jytdog opposed any language stating that it's necessary to have citations in the lead of medical articles. And his note shows he used cautious language; he didn't state that they are required. So I'm fine with his note. Flyer22 Reborn (talk) 22:02, 12 March 2018 (UTC)

I am ok with this recommendation as long as it is very clear that citations are not required in the lead. I can see how easily people are going to point to this to demand citations in the lead of all medical articles. Natureium (talk) 14:18, 13 March 2018 (UTC)

No, we need not include citations in lead, and forcing them (and 12-yo language) into leads for a different project (translation) not only results in less than optimal leads-- it also has resulted (as in the prostate suite of articles) in important parts of the bodies of articles being neglected. The lead is a summary of the whole article-- not a select set of facts that are for translating on a 12-yo level. And, the problem in the prostate articles is just that ... the leads do not summarize the articles, do not summarize the conditions, and reflect select cherry-picked facts for translation.

Further, with respect to MEDMOS and MEDRS, we had to jump through quite a few hoops back in the day to get those pages accepted as guidelines, and part of getting them accepted was making sure that they did not contradict project-wide guidelines, like LEAD and MOS. MEDMOS needs to stay in sync with the rest of the project, or we risk their acceptance as guidelines. This "local consensus at MEDMOS" is overridden by project-wide guideline. Please do not risk all of the work that went into getting these pages accepted as guideline by taking them out of sync with project-wide guidelines. If you want to force citations into the lead, the place to do that is WP:LEAD

This line of thinking has driven down the overall quality of medical articles, with attention focused on making them readable at a 12-yo level so they can be translated, and is perhaps is why the growth here has stalled. WP:MED has lost focus in the interest of making little devices that can be used for translated leads, while our articles rot. SandyGeorgia (Talk) 14:24, 16 March 2018 (UTC)

Excellent analysis SandyGeorgia: absolutely spot on that to gain a new consensus, the place to go is very much WP:LEAD, which also has the consequence of drawing a far greater number of eyes to an issue. —SerialNumber54129 ^{paranoia /cheap shit room} 09:59, 27 March 2018 (UTC)

• Just came across this, and I'm actually fine with the text that was removed. I'm hesitant about filling the lead with citations, but when particular studies are being mentioned in the lead, that's a good time to cite them. The added text seems to fit with that just fine and doesn't significantly deviate from what's over at WP:LEAD. I'm not seeing any issues that would warrant removal. Kingofaces43 (talk) 18:17, 16 March 2018 (UTC)

• We should absolutely recommend that citations be included for medical claims, if not all statements, in the lead of medical articles; however, as Natureium stated, if this recommendation is added to MOS:MED, it should be made very clear that lead citations are recommended but not required for medical articles. Otherwise, MOS:MED would be inconsistent with MOS:LEADCITE. In general, the use of lead citations should be based upon necessity (e.g., claims of uses/efficacy/pharmacodynamics/safety for drugs or signs+symptoms/pathophysiology/diagnosis/treatment/prognosis for medical conditions) and consensus among contributors to the article. Lacking a discussion with consensus, that decision should ultimately be up to the primary contributor(s) to an article. Seppi333 (Insert 2¢) 02:13, 28 March 2018 (UTC)

Per MEDMOS on Society and culture, we have (at least):

• Sociological and cultural aspects of autism
• Sociological and cultural aspects of Lewy body dementia Merged away. SandyGeorgia (Talk) 20:00, 23 April 2018 (UTC)
• Sociological and cultural aspects of Tay-Sachs disease
• Sociological and cultural aspects of Tourette syndrome

Per this discussion at Talk:Lewy body dementia, WhatamIdoing has suggested that we use the word societal rather than sociological.[17] Shall we move them all? SandyGeorgia (Talk) 17:48, 23 April 2018 (UTC)

I am in favor of this idea. SandyGeorgia (Talk) 17:56, 23 April 2018 (UTC)

It seems odd to use "sociological" and "cultural" together in a heading given the lack of adjectival agreement (NB: "culturological" is a word). I don't think it's a good idea to mandate the title format of subpages on those topics though. As for moving the pages: yes. Seppi333 (Insert 2¢) 21:59, 23 April 2018 (UTC)

IMO it should be changed because it's wrong. The notable-people articles (that's where this is mentioned as an example) aren't about sociology and culture (in which case, we might call them "sociological and anthropological"); they're about society and (pop) culture. The adjective form of society is societal. WhatamIdoing (talk) 15:27, 27 April 2018 (UTC)

Whereas nobody's objected, I've updated the guideline and boldly moved the TS page (so the new link would work). I'll leave the others to someone else. WhatamIdoing (talk) 03:29, 9 May 2018 (UTC)

I did the rest, SandyGeorgia (Talk) 17:28, 9 May 2018 (UTC)