Talk:Alternative medicine

QuackWatch and NPOV

Noting revision 10:30, 14 September 2012 (TimidGuy), and in view of discussion connected with the recent decision to merge Whole medical systems, it can be said that mention of QuackWatch (here and elsewhere) may be useful for NPOV. Given that the everyday terms "regular / conventional / mainstream" can be used for a more or less restricted range of medical practice, the name "QuackWatch" points both ways. It alerts those who look further than the more restricted range that the opinions, claims or information which it publicises may lack NPOV, while at the same time it is likely to give comfort to those who favour the use of those terms for a narrower range. Qexigator (talk) 11:24, 14 September 2012 (UTC) (typo correction Qexigator (talk) 07:00, 18 September 2012 (UTC))

--Also noting: 1_ Well-designed studies have shown that most "alternative" methods are used in addition to—rather than instead of—standard methods.;[1] and 2_Quackwatch received a 2003 award as a useful source for online consumer information (article on Stephen Barrett). There is an everyday use of the word "sceptic" and most people probably learn to practice mild scepticism in respect of such matters from any source, including sources using the word as a distinguishing badge or title of their own. --Qexigator (talk) 23:15, 14 September 2012 (UTC)

--For further information: The National Council Against Health Fraud - Scientific Review of Alternative Medicine - Wallace Sampson - Paul Kurtz - Consumer advocacy groups - Committee for Skeptical Inquiry - Council for Secular Humanism. --Qexigator (talk) 00:37, 26 November 2012 (UTC)

...and "propaganda"

"Quackwatch" is cited at the end of the lead, mentioned twice in the body of the article, under "Scientists" and "Criticism", and listed in External links under "Criticism" which also links to the article Quackwatch. That article shows that "Quackwatch" is steeped in its founder's POV. The section for "Site content" links to over 30 articles in a list of products, services, and theories that "Quackwatch" considers questionable, dubious, and/or dangerous, It is a longish article with a short section for "Criticism". On the use of "Quackwatch" as a source Talk:Quackwatch and its links to -- RS/N: Usage of Quackwatch as RS in medical quackery and -- RS/N: How can Quackwatch be considered a "reliable source"? show to a non-partisan that some editors may have been inclined to a Quackwatch's campaigning style and POV. But none of that suffices to support the unexplained use of "propaganda" and "fraud" in the lead of "Alternative medicine" (stemming from the unexplained IP revision of 22:54, 4 November 2012). --Qexigator (talk) 15:14, 23 December 2012 (UTC)

In the past, at least one of the editors with the largest number of edits to this article has been accused of having close links to Quackwatch. Personally though, I've all but given up on this page for the time being as there's almost zero chance of it ever becoming a decent well-written article any time soon. And I'm not merely talking about its content either; in the encyclopedic sense, the article is appallingly badly written. Quite how or why we expect anybody to waste time trying to make any sense of it is, quite frankly, beyond me. Vitaminman (talk) 15:45, 23 December 2012 (UTC)

Undergoing improvement with restucturing now in progress.[2] --Qexigator (talk) 22:21, 9 January 2013 (UTC)

Ex hypothesi

This article has 326 watchers.[[3]] Thoughtful editors wishing to see the article improved (ex hypothesi all editors excepting vandalists) are invited to consider recent edits and comments, say from the merger in September to date. A major flaw has been the insertion in the lead of "propaganda" and "fraud" (stemming from an IP revision of 22:54, 4 November 2012),[[4]], which are not so found in the body of the article. Nor has a suitable source been properly identified. It is a major flaw because its retention there (irrespective of any source or other citation) vitiates any other attempt to improve the article. Qexigator (talk) 11:34, 30 November 2012 (UTC)

...and irrespective of Rational skepticism, Naturalism (philosophy) or any other philosophical, academic, scientific or medical orientation or personal conviction or belief[[5]], or commitment, or point of view, or "original research". --Qexigator (talk) 14:25, 30 November 2012 (UTC)

I agree. This article, or rather its lead, lost its way about two months ago. Some ten different notes on Alternative Medicine's unscientific character, lack of evidence, quackery status etc. when one or two, taken from the article proper, would have been quite enough, and made a stronger (encyclopedic) case... Hallodria (talk) 00:02, 1 December 2012 (UTC)

I don't know what the article was like two months ago or two years ago but I'd imagine it goes through regular polemical edit wars to establish either that 'alternative medicine' is not medicine or that it provides access to nature's secrets leading towards that distinctly modern desideratum of maximised "health". Whatever. In my opinion, in its current version it does a terrifically poor job of elucidating its subject. I would like to propose something of a compromise in terms of the current lead. Firstly, I think it would be beneficial if the lead, insofar as it's possible, just summarised the body of the article and was restrained in the use of citations. To achieve that those statements about the absent scientific validity and potentially fraudulent nature of alternative medicine where they are not already should be incorporated into the body of the text. For the lead, while not an ideal solution, I'd also propose that the most problematic sentence ("Alternative medicine is based on tradition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, or fraud") should be divided up in the following way: "Alternative medicine is based on tradition, belief in supernatural energies, pseudoscience or errors in reasoning. It can also be based on propaganda and outright fraud." I hope that such a formulation while reflecting the sources and recognising that real and conscious fraud, often of very vulnerable people, certainly exists in this domain it at least allows for the possibility that this is not universal (fanaticism, for instance, is certainly a more plausible explanation for some practitioners and adherents). FiachraByrne (talk) 02:49, 14 December 2012 (UTC)

I also think that there's a problem in defining alternative medicine predominantly through mainstream medical & scientific sources although I'd happily concede that the article would be much less satisfactory if it largely represented the self-definition of the proponents of these various and varied non-conventional medical fields. I'd also like to make a distinction between using medico-scientific literature to assess the efficacy of treatments offered by alternative medical practitioners or the scientific validity of their medical systems – which is an essential feature of this article in my opinion – and defining, outside of these dimensions, alternative medicine(s). Thus the first definition of alternative, which is from a reliable source according to Wikipedia's criteria, states that: "Alternative medicine is any practice that is put forward as having the healing effects of medicine, but is not based on evidence gathered with the scientific method." This, in my opinion, is a polemical definition which doesn't serve to elucidate its subject and is rather ludicrous in privileging a certain concept of medicine specific to certain cultural and social developments largely initiated in the western world. If adopted one could, in fact, exclude most of the western medical tradition until the late nineteenth-century. Also, in those rare instances where a facet of alternative medicine was proven scientifically valid (a rare event, I know, but I guess something like acupuncture for certain forms of pain relief) it would cease to be alternative and become mainstream. However, this would entirely decontextualise the origination, context and understanding of a practice such as acupuncture whose presence in the west is the product of four centuries or so centuries of cross-cultural medical exchange. In my opinion, aside from specific entities that are the product of the amalgamation of alternative and conventional medicine (e.g. complementary, complementary and alternative, and integrative medicine) or in the evaluation of truth claims amenable to medico-scientific evaluation, definitions of alternative medicine from the perspective of mainstream medical or scientific sources should be so designated as to indicate that these are specific perspectives (e.g. mainstream medical and scientific sources regard the broad mass of alternative therapies as without any validity whatsoever). FiachraByrne (talk) 02:49, 14 December 2012 (UTC)

FiachraByrne, for the most part, I agree with your reasonable assessment of the article. I support your specific proposal to change the sentence "Alternative medicine is based on tradition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, or fraud" to "Alternative medicine is based on tradition, belief in supernatural energies, pseudoscience or errors in reasoning. It can also be based on propaganda and outright fraud." As you said, it is still not ideal, but it is better than the current mess and is reasonable enough that it will hopefully not initiate any controversy. Would you object to the suggestion that your proposal could use the same type of language for the first and second sentence? IE: "Alternative medicine ['may be' or 'can be'] based on tradition, belief in supernatural energies, pseudoscience or errors in reasoning. It can also be based on propaganda and outright fraud."

I also agree with your assessment of the first definition provided in the lead. I had previously made a proposal to (in my opinion) help improve the article [6], but this did not gain any traction with other editors. The discussion continued at my talk page [7] with another editor, but again, my idea did not seem to gain traction, despite what I thought were arguments well-supported by policy and sources. Do you have any thoughts on the discussion regarding this proposal? Puhlaa (talk) 03:53, 14 December 2012 (UTC)

I think the phrase, "Alternative medicine is often based on ...", would be more likely to gain consensus. That list of the constituent features of "alternative medicine" is hardly exhaustive in any case. FiachraByrne (talk) 05:05, 14 December 2012 (UTC)

For the initial definition of alternative medicine I would favour the definition drawn from Roberta Bivins (Alternative Medicine? p. 171) that I have used elsewhere: "The term alternative medicine refers to systems of medical thought and practice which function as alternatives to or subsist outside of conventional, mainstream medicine." I would think you would have to address the complexity of its relation to contemporary biomedicine (subordinate integration, co-option, marketplace competitor, rejection, "counter-hegemonic", etc) and I also think you'd have to address questions of its scientific validity prominently in the lead. FiachraByrne (talk) 05:05, 14 December 2012 (UTC)

Wikipedia is not a dictionary etc and this is not really the kind of definition I would favour but I think the OED does a better job than this article currently in defining alternative medicine as: "medical practice encompassing various techniques regarded as unorthodox or scientifically untested by practitioners of conventional Western medicine". This is elaborated as follows: "Such techniques are of varying age, provenance, and demonstrable efficacy, and include acupuncture, chiropractic, herbalism, homeopathy, hypnotherapy, osteopathy, and reflexology (some of which have been accepted by conventional medicine)." A draft definition of complementary medicine from the OED reads: "Designating or pertaining to medicine seen by its practitioners as complementary to traditional or orthodox medicine but not based on modern scientific knowledge and not recognized by the majority of medical practitioners." It's against one of my proposals but those definitions would tend to foreground its distance from accepted and acceptable scientific norms but they at least have the virtue of attributing that perspective (i.e. not so much that it lacks scientific validity but that that is its defining feature) to mainstream medical practitioners. FiachraByrne (talk) 05:20, 14 December 2012 (UTC)

FiachraByrne, I agree that the correct adverb of frequency in the controversial sentence you proposed to change should be 'often' or 'usually'.

The definition you quote from Roberta Bivins is very similar in theme to the definitions used by the WHO[8], NCCAM[9], IOM[10], etc. That is, they all define CAM in contrast to 'conventional' or 'dominant' or 'mainstream' therapies. Definitions with similar theme have been described as commonly used and inclusive by secondary sources [11][12]. This is the essence of my previous proposal (at least that is what I thought I was saying). I would fully support text similar to that which you quoted from Roberta Bivins for the Beginning of the lead.

There are countless works that do a better job than this article, in my opinion the article is a mess. However, as you can see in many of the threads above, there are experienced editors who suggest that the current article is good. I (usually) try to tread carefully, but I am happy to contribute towards improvements to the article if you are planning to work on it.Puhlaa (talk) 06:36, 14 December 2012 (UTC)

FiachraByrne: 1_ OED, agreed this is useable, whether or not with other sources. 2_"in the evaluation of truth ...mainstream medical and scientific sources regard the broad mass of alternative therapies as without any validity...". Agreed. 3_The vitiating mischief in the lead is that in such a context as this it is a conceptual error to state that something which is not in itself propaganda or fraud is based on propaganda or fraud. Propaganda (which may also be but is not always used in connection with fraud) is a species of activity (akin to "marketing") used for promoting something (such as a religious or political doctrine or creed): what is the practice of "alternative medicine" said to be promoting in any way which distinguishes it from the way in which the practice of mainstream medicine is promoting itself? Fraud is using something which in itself is honestly based in a dishonest way: any medical or pharmaceutical practice can be used fraudulently, whether so called mainstream or alternative... "real and conscious fraud, often of very vulnerable people, certainly exists" in connection with mainstrem practice and sales of products: is that to be inserted in articles about medicine and medical practice? Or about any other academic or professionally practiced acivity-- law, accountancy, research....? Nor is fanaticism a stranger to proponents of mainstream, science based or other. Qexigator (talk) 09:40, 14 December 2012 (UTC)

Should psychitry article have Alternative medicine category? Is DSM MEDRS?

Discover Magazine just named this story as "Top 100 Science Stories of 2012" - The "Bible of Psychiatry" Faces Damning Criticism—From the Inside From that story -

"...the most recent attack comes from within the DSM-5’s ranks. Roel Verheul and John Livesley, a psychologist and psychiatrist who were members of the DSM-5 work group for for personality disorders, found that the group ignored their warnings about its methods and recommendations. In protest, they resigned, explaining why in an email to Psychology Today. Their disapproval stems from two primary problems with the proposed classification system: its confusing complexity, and its refusal to incorporate scientific evidence.

That is the very definition of pseudoscience in out article on the topic. Here is a quote from the DSM docs who resigned -

The proposal displays a truly stunning disregard for evidence. Important aspects of the proposal lack any reasonable evidential support of reliability and validity. For example, there is little evidence to justify which disorders to retain and which to eliminate. Even more concerning is the fact that a major component of proposal is inconsistent with extensive evidence…This creates the untenable situation of the Work Group advancing a taxonomic model that it has acknowledged in a published article to be inconsistent with the evidence."

Discussion of whether to add an Alternative medicine category to the psychiatry article is here[13].

Discussion on Is DSM MEDRS is here[14].

Possible Tendentious editing?

I recently made a series of edits to the Alt Med article (on Dec 9th), 5 were minor copy-edits and reference improvements, 2 removed sources that IMO seemed to fail WP:V and WP:UNDUE. Park seems to have decided that none of these are improvements.

1. The first edit [15] fixed some references in the lead. The full citation was in the lead and in the body; I shortened the citation in the lead to be only the ‘ref name’.
2. The second & third edit [16] moved text that discussed the characterization by individual scientists from the ‘Institutions’ section to the ‘Scientists' section.
3. The fourth edit [17] removed the low-quality CMAJ source from the lead.
4. The fifth edit [18] reordered the paragraph under ‘Institutions’ so that the institutions who describe CAM with common themes were grouped together.
5. The sixth edit [19] removed a UK dept of health source, which could not be verified.
6. The seventh edit [20] moved a high-quality secondary source from the middle of nowhere in the body to the section in the body that describes NCCAM’s definition of CAM (under 'self caracterization'). This is an appropriate location for the source because the source discusses the common usage of the NCCAM definition; it did not have any context in it’s previous location.

• The removal of 2 sources (edits 4 & 6) were challenged by Dominus Vobisdu; his/her edit summary said “removal of reliable sources”, but he/she blanket reverted all seven of my edits [21]. I restored the copy-edits and reference fixes that were removed as part of Dominus’ blanket revert [22], but, consistent with collaborative editing, I also restored [23] the 2 sources that were still under discussion.
• Park then decided to again revert [24] all of the minor copy-edits and reference fixes that I made.
• I explained why Park was incorrect to revert the changes and why they were improvements at the talk page [25] to try and resolve the issue. I then reverted Parks removal of the minor copy edits.
• Park then proceeded to accuse me of edit warring [26] and bad faith editing [27], but failed to explain why the minor copy edits (#1,2,3,5 & 6 discussed already) were improper according to any policies.
• Regardless of my attempts at the talk page, Park has again reverted the minor improvements I made to the article [28].
• Park’s actions are an example of Tendentious editing, something that he is already known for [29]. I don’t want to have to move this to ANI, so I hope for some resolution here at the talk page. Are any reasonable editors watching? Puhlaa (talk) 18:53, 10 December 2012 (UTC)

--In my view Puhlaa's points are well made, and the improvement of the article is not being progressed by reverts such as those mentioned above. Please also see proposal in section below. Qexigator (talk) 19:11, 10 December 2012 (UTC)

You reverted edits by others three times.

The first edit [30] is restored. ParkSehJik (talk) 22:01, 10 December 2012 (UTC)

Your assertion that the Canadian Medical Association Journal is not a reliable source, and your removal of it as a supplementary source, was already overruled above. ParkSehJik (talk) 22:13, 10 December 2012 (UTC)

Park, please provide the diffs for my 3x edit warring reverts? Your diffs on my talk page incorrectly attribute my original copy-edits as a revert? Those were the original changes? Also, the second revert you diffed on my talk page it is not tendentious editing on my part because while I restored the non-controversial copy-edits that were reverted by Dominus [31] I still ensured that I did not restore the edits that were under discussion at the talk page [32]. Your accusations on my talk page suggest that you still don't understand what constitutes edit-warring. If it is me who is incorrect, I hope that someone will correct me. Moreover, In my view your actions are still unacceptable, you have only reintroduced 1 of my many discussed copy-edits! You have not provided any policy based reasons for your moving of high-quality sources and text in the body of the article back to locations where they lack context (reverting edit #2, #3, #5 & #7). You have also not addressed your improper accusations of bad faith and POV editing, as I discussed above. You are making it very difficult to improve the article. Puhlaa (talk) 22:15, 10 December 2012 (UTC)

An issue is discussed, then when you do not like the outcome, you and two or three other editors keep trying to put it back in by starting new talk page sections. For example, you keep trying to use an article on assessing "prevalence of use" in pediatrics questionaires, as a sort of meta-meta-prevalence of use to use language to create ambiguitiy where there is no ambiguity.[33] This was already discussed above, but you keep moving it up. Prevalence of use is not, and never will be, a criteria of truth or efficacy, yet it is all over the poorly written article body, as if it had anything to do with the topic beyond its citation being a marketing device, so it is WP:UNDUE. Adding vagueness to the defintion to obscure the fundamental nonscience or worse basis of alt med, repeatedly citing sources on "prevalence of use", to the point of citing "prevalence of prevalence of" in "questionaires", does not add information on the topic to the Wikipedia user, nor does it give a scientific basis to anything; it is confusing to the reader; and it is highly WP:UNDUE. ParkSehJik (talk) 01:13, 11 December 2012 (UTC)

You are not listening Park, another example of tendentious editing! I did not add any text or surces, I MOVED the source from PLoS One that discussed the NCCAM definition from an illogical location in the body to a logical location, next to the discussion of NCCAM (edit #7). Everything else you are saying is meaningless here; the issue is that you reverted multiple copy-edits without even assessing what they were. I have spelled them out for you above (edits #1-7) and you still are not getting it.Puhlaa (talk) 01:28, 11 December 2012 (UTC)

And you deleted a source previously discussed. ParkSehJik (talk) 03:10, 11 December 2012 (UTC)

Park, this source is currently under discussion above and is not the issue here in this thread, changing the subject suggests that you know that you are wrong. I restored the source under discussion, as I prefer to edit collaboratively. Can you please provide the link to a previous discussion of the CMAJ source and it's appropriateness for the lead? I do not remember ever specifically discussing this source in the past. Also, feel free to join the discussion above, where we are currently discussing this source and if it is appropriate for the lead. As far as this thread goes, please address wh the minor copy-edits you keep reverting are not improvements to the article? Puhlaa (talk) 03:47, 11 December 2012 (UTC)

Terms section

The sentence "The term 'alternative medicine' is generally used to describe practices used independently or in place of conventional medicine" is not sourced, and the best sources cited above in the lede state that "The term 'alternative medicine' is generally used to describe practices that are not based on science." "Conventional medicine" is a made up term used only by alt med practitioners, yet redirects to medicine, as if "unconventional evidence based medicine", such as newly introduced, but proven, techniques, or socially inacceptable medicine, such as proven to be effective abortion pills, are somehow therefore "alternative medicine". This needs to be fixed. ParkSehJik (talk) 23:56, 10 December 2012 (UTC)

Done. It was easy to find sources as this is a commonly used definition of alternative medicine. I added a few high-quality sources to support the relevant text and removed the 'citation needed' tag.Puhlaa (talk) 05:25, 11 December 2012 (UTC)

Terminology

I reorganized the terminology section with boldface on the terms of art, for ease of reading. I also added PLAIN ENGLISH, for the technical terms, using the plain english in the stable linked articles as the source of the plain English. These changes should not be controversial, since I kept the content and sources intact.

Proposed additions - "Whole medical systems" - "spiritual wholeness" - Gypsy Spirit made an edit regarding a specific alt med school in Florida with its website as the source, which was correctly deleted by Scray as violating RS. The webisite has language taht is characteristic of the use of the expression "spiritual wholeness". The website says - "knowledge and tools for personal healing at all five levels of consciousness/existence", and "It’s time we recognize that we are more than a clump of interacting chemicals but a spiritual being". I would propose that if it can be properly sourced, similar language might be added to the "terminology" section, following the sentence - "One refers to a spiritual belief, that “spiritual wholeness” is the root of physiological and physical well-being.[28] Ayurveda, Chinese medicine, Homeopathy and Naturopathy are cited as examples." This added language would be informative and helpful to users from all POVs. Does anyone have a suggestion for RS for similar helpful language? ParkSehJik (talk) 17:42, 11 December 2012 (UTC)

"Integrative Medicine" - Some university medical schools now have departments making claims such as that science can be "integrated" with traditional practices, using examples such as that some herbal "remedies", while not based on use of the scientific method, may have survived as traditional practices because of their efficacy, while others did not because of their lacking it, a kind of natural selection process for efficacy. They further argue that these herbal remedies might therefore be better targets for testing than randomly selecting herbs. In case efficacy is proven, they become medicines of evidence based medicine, otherwise they are discarded. If anyone has sources for this point, and sources that establish its WEIGHT, a proposed edit can be made from the sources. ParkSehJik (talk) 17:58, 11 December 2012 (UTC)

Alternative medical systems - I support this recent edit by FiachraByrne adding -"Alternative medical systems can only exist when there is a identifiable, regularized and authoritative medical orthodoxy, such as arose in the west during the nineteenth-century, to which they can function as an alternative." ParkSehJik (talk) 20:08, 11 December 2012 (UTC)

The Terminology section[[34]] as now looks to me as making some further progress for improving the structure and readability of the article, subject to others' comments on adequacy of sources, about which no comment is being made by...Qexigator (talk) 20:41, 11 December 2012 (UTC)

--Would the inclusion of a definition of medicine as meaning based on evidence based science now be suited to the article, or does the first sentence of the lead suffice? Qexigator (talk) 22:47, 11 December 2012 (UTC)

Under that definition you'd exclude much of the history of medicine. For it to stick, in my opinion, you'd have to state that it's a (probably idealised) definition of contemporary, conventional biomedical science.FiachraByrne (talk) 00:51, 14 December 2012 (UTC)

--Given FiachraByrne's point, would it be acceptable to put in such a definition? Qexigator (talk) 01:02, 14 December 2012 (UTC)

Definition

I know definitions have been argued to death but I think the current first sentence is NOT consistent with WHO / Cochrane / NCCAMS either as a theoretical or operational definition.

The definition that these bodies use is "Not part of conventional medicine". None of them go on to define 'conventional medicine' as using the 'scientific method' in this context. To do so (im my view) creates a logical fallacy.

In effect we are saying "altenative medicine is the opposite to conventional medicine, doctors use the scientific method, therefore alternative medicine is the opposite of the scientific method". The is wrong for the same reason as saying "sally is a girl, girls are short, therefore sally is short."

The scientific method is an important aspect of medicine but is a small part of what makes a good doctor/nurse. It is subject to abuse [35] and occasionally subject to ridicule [36]

By starting off this way we immediately create a battle line between "nerds and hippies" which makes it hard to edit the rest of this article collaboratively, the article turns in to a polemic and the reader suffers.Aspheric (talk) 22:30, 2 January 2013 (UTC)

Re - "The is wrong for the same reason as saying 'sally is a girl, girls are short, therefore sally is short.'". "If Sally is a girl, and girls are short, then sally is short" is a valid inference, not an invalid inference. If it is based on science, it is medicine, not alternative medicine. If it claims to heal but is not based on science, it is alternative medicine. No definitions are inconsistent. The three called "more broadly", i.e., those referring to what is "not as practiced", are the same as the definitions in the other ten sources, since what is practiced is the stuff based on science. Those definitions are just a little less complete in that they require an extra step of looking up what is practiced, which is that which is based on science. There is no inconsistency in the sources or in the definitions in the article. 64.134.228.53 (talk) 22:45, 2 January 2013 (UTC)

But what if Sally is a tall girl ? I think the omission of the term 'scientific' by WHO / NIH, etc... is deliberate and the article suffers when we try to create a false dichotomy. A scientific approach is important but even within mainstream medicine people argue whether 'conventional medicine' is really an art or a science [37]. Only a minority of therapies are based on Randomised control trials, the widespread use 'off label' medicines and the absence of studies where the answer is obvious [38] are 2 examples of where the scientific approach breaks down Aspheric (talk) 23:03, 2 January 2013 (UTC)

If Sally is a tall girl, then it's not true that "girls are short." You are talking about the difference between a sound and a valid argument. Nobody cares what the WHO, NIH, etcetera says AT ALL. They are ultimately political, not scientific. What matters is what reliable sources can verify. Greg Bard (talk) 00:03, 3 January 2013 (UTC)

Yep, I think it's an invalid argument, i.e. the inference that conventional medicine is 'scientific' and alternative medicine is 'not scientific' is a gross oversimplification. Do the definitions from WHO/NIH/Cochrane not qualify as reliable sources (it's a genuine question - I don't know what the rules are for heirachy's of evidence are on wikipedia)? reliable sources describes "a position statements from nationally or internationally reputable expert bodies" as ideal medical source Aspheric (talk) 00:13, 3 January 2013 (UTC)

NIH, WHO, NCCAM, IOM, etc. are very reliable sources according to WP:RS. The current article defines CAM as those therapies not based on evidence. This definition is flawed because it does not account for the fact that:

1. “certain CAM interventions do have evidence, and the entire industry should not be tarred with the same brush” as was pointed out in an article in the Australian Medical Journal [39]
2. Some CAM have Cochrane reviews that say they are effective: "The results from all eligible Cochrane reviews of CAM therapies were assigned to one of the following categories.....The largest number of treatments described in the reviews were classified as insufficient evidence of an effect (n = 82; 56.6 percent), followed by positive effect (n = 36; 24.8 percent) and possibly positive effect (n = 18; 12.4 percent)" [40].
3. Some CAM are accepted as effective treatments in the medical literature "Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option."’’ [41]

Moreover, if CAM are those therapies supposedly defined as being "not based on evidence", then mainstream medicine must be defined as those therapies based on evidence? How do we account for the fact that "only retrospective or anecdotal evidence (level 3 evidence) was available to support 55% of the identified decision/interventions" in hematology-oncology [42].

There is a good reason why well-recognized international medical bodies like WHO, Cochrane collaboration, NIH and IOM define CAM very differently from the definition emphasized in our current lead...the definition in our current lead is flawed.Puhlaa (talk) 01:36, 3 January 2013 (UTC)

Many thanks but what is the answer to my question i.e. - "what is the heirachy of sourcing and how do we sort the wheat from the chaff ?" It's not difficult to find journal articles that describe alternative medicine as mumbo jumbo, nor is it difficult to find high quality journal articles that decry all doctors/scientists as fraudsters[43] and characterise the widespread use of alternative medicine a "biting criticism of conventional medicine"[44].

As Nigel Molesworth would say[45], this all makes for a terrific bun fight but doesn't help little Jonny who needs to write an essay on alternative medicine and finds the normally useful wikipedia either one sided or composed of tit for tat arguments. In academia, senior editors and peer reviewers filter out the extreme views and maintain balance. What is the equivalent here ?Aspheric (talk) 02:20, 3 January 2013 (UTC)

• My apologies for not answering your specific question Aspheric! In medical category articles like this one, to determine the sources that are reliable, and the relative ranking of those sources that are considered reliable, we use policies like WP:MEDRS. To decide what gets the most weight in the article, and what does not get any weight, we usually use policies like WP:UNDUE, which is a part of the greater policy WP:NPOV. Give those a read (if you haven't already) and let me (or another editor) know if you have any questions.Puhlaa (talk) 02:43, 3 January 2013 (UTC)

In reply to Aspheric: as you said, the definition has been argued to death. The previous (very long) discussion discussed the same issues, and closed with WP:CONSENSUS for the current version. You can find it at Talk:Alternative_medicine/Archive_21, the first ~2/3 of the page (unfortunately, you'll have to check the timestamps as the discussion is unfortunately not in strict chronological order; you'll probably need to cross-reference with the page history as well to determine what versions are being discussed). There is some further background near the bottom of Archive 20. Arc de Ciel (talk) 10:11, 3 January 2013 (UTC)

There is most definitely not consensus for the current version! This discussion [46], this discussion [47], this discussion [48] and now this current discussion are all initiated by, and commented in, by various editors that feel that the current lead is problematic. Some of the major concerns are described in this[49] post by an objective editor. Some of the other major concerns have been 1) the article describes CAM as fraud, but then says NIH has a CAM branch, suggesting NIH may be involved with fraud; 2) the article primarily defines CAM with a flawed definition (as detailed above) used by a minority of sources; 3) The lead gives low-quality sources like the news brief in CMAJ that was written by a freelance-writer [50]more weight than high-quality sources like WHO, IOM, NIH, BMJ. 4) The least weight in the lead is given to a definition that is described as "commonly used" and "inclusive" in reliable sources.Puhlaa (talk) 16:53, 3 January 2013 (UTC)

Wow, I'd only looked at this page. Talk about 'tip of the iceberg'. So much effort for 4 paragraphs and it still has problems ! I'm unlikely to be able to sort out issues that have vexed better minds than mine but perhaps I can summarise some of the more obvious problems with the lead and suggest a possible way forward:

• 1. Science vs Non-science. None of major bodeis or major journals (WHO/NIH/Cochrane/BMJ/NEJM) defines alternative medicine as "not scientific" but instead of using one of these references, the central reference of the lead is based on the pseudoscience section of a non medical primary source. This seems inconsistent with editing guidence and sets up an antagonist relationship between editors.
• 2. The lead is a good description of the critiscm section but not of the article proper.
• 3. There does not appear to be a heirachy of evidence. Because this is such a broad and controversial topic, it's not difficult to find a pubmed paper to say whatever you like. In the absence of the equivalent of an "editor in chief" we need some way of ranking / weighting the different references. The lead is top heavy with critical articles, the logical next step would be to challenge or contextulise each assertion. This will lead to "Hippies are naive soap dodgers[51] but on the other hand lab geeks are lying hypocrites[52]. This would improve balance but would disserve the reader.

Solution ? I would suggest going back to an older version of the lead, remove comparisons to 'conventional medicine', bringing the 'critiscm section' up the article so it's the first section after terminology and beefing up 'criticsm' with the refs that are currently in the leadAspheric (talk) 19:09, 4 January 2013 (UTC)

Why are some editors trying to obscure the unscientific nature of alt med to Wikipedia users?

Medicine as "conventionally" practiced is based on science. Alternative medicine is a claim to heal that is not. All reliable sources cited agree to these two facts. Not all sources overtly state both of these facts, but that is no reason to constantly deliberately try to introduce ambiguities to our definition to confuse the reader. There is nothing else going on here. There is no supernatural healing powers implied to possibly exist, or in any way believed in, by WHO, Cochrane, NIH, or BJM.

It is preposterous to claim that BJM, Cochrane, and NIH, are at odds with NSF, New York Academy of Sciences, Academic Medicine, etc., over the existence or not of supernatural energies, such as chiropractic energy fields of vital forces, flowing supernatural qi energy, or demonic spirits infecting a patient. This ambiguous appearance of difference is entirely created by a small number of Wikipedia editors trying to created ambiguities where none previously existed.

Introducing ambiguous words, such as “conventional”, without providing context that “conventional” means based on science, only disserves the reader. "Unconventional medicine", without context, is ambiguous in that it could either mean evidence based medicine that is rarely practiced, such as due to inaccessablity because of political constraints (e.g., abortion pills), high cost, being very new, or being effective but surpassed by more modern treatments. Or it could mean claims to heal that are not based in science. So there is an ambiguity created here that is not in the specific sources cited.

In the context provided by the sources, it is clear that they mean by using "unconventional", "that which is not as practiced because it is not based on science". They do not mean something based on science but rare.

The current Wikipedia article ambiguously transfers the word "conventional", without the implied context of the sources, thereby creating an ambiguity to the Wikipedia user. This must be fixed.

• Someone should go through the article body and either remove "conventional" and "unconventional", or add, wherever they occur, information to remove the ambiguity. If the ambiguous words must be in the article, there must be clarification that that medicine conventionally practied means that which is based on science, and does not mean something based on science that is rare. Otherwise the user may walk away from reading the ambiguity with the misunderstanding that the simple distinction between medicine and alternative medicine is something other than being based in science or not. — Preceding unsigned comment added by 64.134.228.53 (talk) 16:11, 3 January 2013 (UTC)

You're absolutely right. In an ideal world we'd discuss proven and unproven treatments and some have suggested this [53] but it's never that simple. There are lots of alternative remedies with good science and lots of conventional treatments that are snake oil. A further complication is that most therapies regardless of classification are not proven. This is for a variety of reasons; a strong theoretical mechanism, practicality or common sense. If we take a strict scientific approach we have to conclude that we should not recommend the use of parachutes when jumping out of a plane [54]. Manuka honey and maggots are common sights on vascular surgery wards - Are these conventional or alternative therapies ? Someone holding a bell and mumbling is unlikely to do you much good but a herbalist might since many medicines were orginally herbs and the the word drug is derived from 'dried herb'. How do you distinguish ? How do you prove the benefit of holding someones hand and listening ? Is a naive doctor who inadvertantly prescribes a placebo more or less ethical and/or effective than a knowledgeable cynic who sends you away ?

The one thing i'm sure of is that if we start debating what is medicine, what is science, what is conventional, what is alternative we will add another couple of archives but get nowhere on the article.Aspheric (talk) 19:31, 4 January 2013 (UTC)

What does the comment by Aspheric have to do with the proposal in this section? — Preceding unsigned comment added by 64.134.224.230 (talk) 01:55, 5 January 2013 (UTC)

I believe he's trying to point out that the most common use of "conventional" means just that: whatever is commonly done by convention. Since medicine is an applied science like auto mechanics, it's partly science, partly guess, and partly art and fashion. It's hard to tell sometimes what is what. If we didn't have a word for the whole gemish we'd have to invent one. Fortunately, we do, so we don't. SBHarris 07:24, 5 January 2013 (UTC)

SBHarris is correct and describes my point more elegantly and succinctly than I did. Fortunately the solution is simple. Lets take another look at the sources in the lead, examine the exact wording they use and rank them as per [WP:RS]. Regarding the point below, I don't think it would be feasible, helpful or appropriate to go through each instance of the term 'conventional' and ascribe an arbitary meaning to itAspheric (talk) 13:37, 5 January 2013 (UTC)

It might be helpful to make a 2x2 "medicine" box with one axis "conventional" yes/no and the other "proven" yes/no. Conventional medicine has large unproven areas that change all the time, like common outpatient regimens of amoxicillin for simple otitis media, most of which are placebo. And given for 7 to 10 days not because of science but due to a number in genesis plus your total total finger count. Conventional proven is the science core. Unconventional proven is the old or odd stuff like fecal flora transplant for severe C. difficille infection. It works but have you ever seen it done? Unconventional unproven is "alternative". This can further be subdivided to unproven and unprovable (faith-based techniques), unproven but perhaps provable (energy healing and chi'i flow), and provable in theory but not yet proven like many vitamin and herb claims. Alternative medicine is a gemish also. The only thing that ties it all together is that it claims to be medicine but isn't accepted (is unconventional) and is unproven (including disproved stuff like Laetrile). As for the odd things that are conventional and seem resistant to being disproven even when tested , some of these are not medicine, so they aren't alternative medicine. Example here is intercessory prayer. People are going to conventionally do this no matter how many science tests, since it's not science, but religion. Note that it's very hard to define religion, too. SBHarris 19:11, 5 January 2013 (UTC)

Shame about the no 'OR' policy since it would be a fun paper to write. You'd bill it as "convential vs alternative medicine" but in fact you'd be comparing the proportions of conventional treatments for which an RCT would be pointless/unethical/impractical with the proportion odd stuff that works. I bet it would get in to the Christmas issue of the BMJ (when they include all the silly stuff).Aspheric (talk) 21:27, 5 January 2013 (UTC)

Massive undue, and introduced ambiguity - "conventional" occurs 200 times in this article, without the context provided in the cited sources

The word "conventional" is used about 200 times in this article, without the context provided in the sources. This is massively undue weight. If the word must be massively repeated for some purpose, it will be replaced with the context provided in the sources, - "convetional" to "conventional, science based" - so the reader is not misled by an ambiguity in "conventional", when there is no ambiguity in the sources; in the cited sources, "conventional medicine" is to "science based medicine". There is no reason to create an ambiguity where none exists.

Constant misleading ambiguities violate WP:MOS - "conventional", "mainstream"

The article body constantly switches back and forth among various ambiguous uses of "conventional" and "mainstream", creating a misperception that alternative medicine is something other than heling claims that are not based on science. The words are often in the sources cited, but the sources cited provide context to disambiguate, and the context is not transferreed to the article body. Instead, the article body seems to be constructed to ustilize the ambiguities to create an impression that Cochrane, NIH, BJM, etc., are promoting the possibility that there is a supernatural energy, such as that proclaimed in chiropractic or acupuncture, beyond what is detectable by mere science. This is not the case. This needs to be fixed. Editors should be wary of edits constntly adding ambiguous words out of context, and padding the article body with uses of the words far beyond what their weight would justify. — Preceding unsigned comment added by 64.134.225.194 (talk) 15:52, 6 January 2013 (UTC)

Be careful there 64--who knows when we will look back on our present knowledge and say that we still had so much to learn? Think back to the time that childbed fever killed so many women and yet the medical profession refused to consider the possibility that little unseen "animals" were the culprits (doctors were gentlemen and it went without saying that there was no need to wash their hands, which were clean just due to the fact that they were gentlemen). Back then the idea that little unseen animals were running around would have been seen as a "supernatural" possibility. Gandydancer (talk) 16:23, 6 January 2013 (UTC)

("64" is Starbucks' central IP addy in Austin TX.) Gandy, such religious musings belong on a blog, not a WP talk page, and are unresponsive to this talkpage section topic. — Preceding unsigned comment added by 64.134.225.194 (talk) 16:28, 6 January 2013 (UTC)

I'm grateful for everyone's edits, including yours '64'. I'm too green to pontificate but i've already seen the benefits of a mix of editors contributing. My edits to [Cataract] were good science but unreadable till Gandydancer corrected and improved them and i've found that my ideas are more accepted now I've started 'logging in' instead of using an IP. I came to Alt med after seeing some dodgy 'scientific' eye drops on the cataract page (a good example of scientific but unproven and unconventional treatment) and it seemed obvious that creating 'factions' had stagnated the progress of this article. The first step to correct this should be to remove divisions where none naturally exist. To recap, you suggest that sources use the word 'conventional' interchangeably with 'scientific'. This is not the case and is a poor reflection on the authors of those papers. Many articles include a detailed discussion of successes, failures and challenges in applying a scientific approach in CAM. I'd recommend looking at the BMJ article, I thinks it's very readable and is a good overview of the issues involved. We can do a lot worse than using it as our central reference to start the article.Aspheric (talk) 17:46, 6 January 2013 (UTC)

Usage

Re this sentence - "According to Andrew T. Weil M.D., a leading proponent of integrative medicine, the principles of integrative medicine include: appropriate use of conventional and CAM methods; patient participation; promotion of health as well as treatment of disease; and a preference for natural, minimally-invasive methods."

This has nothing to do with usage, and was removed. Including it elsewhere is undue weight to this individuals views, which are inconsistent with the sources cited in the above terminology section. (Also, a person cannot self proclaim themselves to be "leading", and use their self declaration as a source supoorting the declaration in WP.)

The section contains stats from very outdated sources, such as a 15 year old 1997 study on usage. It will be removed as outdated and therefore having very undue weight.

Special article from a very prestigious core medical journal. An odd choice to removeAspheric (talk) 17:43, 6 January 2013 (UTC)

This has nothing to do with usage. You restored materiral irrelevant to the section on usage - [55]. Please undo this improper restoration. You restored a sentence removed for lack of any source - [56] - You cannot do that - Please see WP:V. You restored original research, "therefore", which is not in the sources, please see WP:OR. The individual, Weil, is already promoted three times in the article, using his own self-promotion as a source - That is not allowed - Please read both WP:RS and WP:Undue. Please undo your edit violating these policies, then read the policies. Thank you.

Examples and images

Acupuncture is a Traditional Chinese Medicine, where it is believed that a supernatural energy called qi flows through the body, helping propel the blood, and that insertion of needles in the body can have an effect on that energy flow and thus on health and disease.

Ayurvedic medicine is a traditional medicine of India, and includes a belief that use of traditional herbs and having the spiritual balance of the religions of Hinduism and Buddhism, including by suppressing natural urges of food intake, sleep, and sexual intercourse, can be used to heal.

A Botanica of traditional Hispanic medicines may look like a pharmacy of science based medicines. The difference is not in their appearance, but in the basis for belief that the medicines have a healing effect.

In the Western version of Japanese Reiki, the palms are placed on the patient near Chakras, centers of supernatural energies, in a belief that the supernatural energies can transfered from the palms of the practitioner, to heal the patient.

Chiropractic was developed in Canada and the United States in the belief that manipulation of the alignment of the spine affects a supernatural vital energy in the body that is part of the cause of health or diseases.

Alternative medicine contains a diverse range or practices and bases. Examples should be given to better inform the user. Images are always helpful to the user, and should indicate the range by including examples from the various regions of the world.

There is an alt med list article, but examples would be helpful here too, as per MOS avoid overlinking when unnecessary.

The current article body is highly uninformative as to the diversity and nature of alt med practices, appearing to be mostly repititions of the words "conventional" and "mainstream" ad nauseum, and about success of the relatively recent massive promotion of alt med, and measurement of the success by "increasing usage".

This leaves the encyclodia user with an impression that there is some vast unconventional and nonmainstream set of practices being used more and more around the world, but wondering what these practices are or may look like.

Please discuss examples and images to include. — Preceding unsigned comment added by 64.134.225.194 (talk) 17:21, 6 January 2013 (UTC)

Good suggestion, pictures of herbs are included at the top and others would be easy to source. The Nature Immunology article has some other graphics that help the reader understand the concepts involvedAspheric (talk) 17:39, 6 January 2013 (UTC)

--64/Starbucks: Editors before you who are looking for improvement of the article may agree with much you are proposing, but if you are now joining in, what about signing in the 4 tilde way anyhow, or using your login, in the conventional/ mainstream/ normal/ usual fashion? Qexigator (talk) 17:46, 6 January 2013 (UTC)

The images at right are more informative, as to what alternative medicine is, than the entire rest of the overbloated article body, which reads more like a "get on the unconventional bandwagon" promotion, than an article about alternative medicine. It would make a nice addition to the end of the lead if it could be arranged horizontally, not vertically, especially if the purpose is to inform the user. Does anyone know how to arrange them horizontally, not vertically? 64.134.225.194 (talk) 18:57, 6 January 2013 (UTC)

Not that informative as images, whoever put them here. For the ordinary reader all but one of them could be illustrating mainstream medical practice (Medicine), and in some traditions the chakra image could be regarded as mainstream. Qexigator (talk) 18:48, 6 January 2013 (UTC)

More full captions were added after Qexigator's correct comment. Image with very minimal captions might not be that informative.

Qexigator's usage of one interpretation of the ambiguoous word, "mainstream", is correct that his usage. But Reiki chakras as a basis for a claim to heal is always alternative medicine. This argues for removal of the word "mainstream" from the article, because of the ambiguity introduced. — Preceding unsigned comment added by 64.134.225.194 (talk) 19:02, 6 January 2013 (UTC)

Proposal - replace "conventional medicine" and "mainstream medicine"

"Conventional medicine" and "mainstream medicine" could refer to "conventional science based medicine" and "mainstream science based medicine", as contrasted with "unconventional science based medicine", or "nonmainstream science based medcine".

None of this has anything at all to do with alternative medicine. But that is not what this article says.

The context of NIH is that what they call "conventional" medicine refers to that which is based on science. They even outline proposed categories of other bases of belief, e.g., energy, tradition, etc. This article picks up the word, "conventional", and leaves behind the context, "science based". This introduces an ambiguity that is not in the source.

It is very confusing, and for no apparent reason at all.

"Conventional" and "mainstream" will be replaced with "science based", without the introduction of the ambiguous words, whenever that the implied context of the sources, so the article has consistency in use of words, required by MOS.

Then the article will be drastically pared down, so as not to be a giant promotion of the words "conventional" and "mainstream", promoted to create the false impression that this is the distinction between medicine and alternative medicine, obscuring the true distinction, which boils down to "there is knowledge of health and disease that does not come from science" claim. Alt med users should have no problem with this, since "there is knowledge of health and disease that does not come from science" is what they believe. Only those (hopefuly in the estreme minority of editors) who want to market or mislead, should have a problem with this. Their objections to this will flush them out.

Then examples and images of actual alterntive medicine practices will be added, so the article body wieight goes back to informing the user about alternative medicine, rather than an endless and uninformative promotion of a "conventional v unvonventional" distinction, and "get on the unconventional bandwagon" promotion. This is an encyclopedia, not an advertisement campaign. — Preceding unsigned comment added by 64.134.225.194 (talk) 18:55, 6 January 2013 (UTC)

I'm sorry but if the NIH is using "conventional" as a straight synonym for "science based" they are flat wrong, or else have a very loose definition of science based. For me, a science based treatment is not simply one proven to fix physiological test numbers but actually proven to fix patients. Confusion between these has led to much conventional treatment that caused much expense and many complications, but did no good for the sick patient. I've used the ESCAPE trial [57] test of PACs for CHF (very conventional for a generation) as an example but there are many more. The issue of the NEJM Dec 27 is looking at a very similar problem with ICP monitoring in severe head trauma. It's conventional but what about the science? Is it at the number level or the better outcome level? Questions now abound. SBHarris 01:47, 7 January 2013 (UTC)

I'm very confused. Are you suggesting creating an article entitled 'science based medicine' or have I got the wrong end of the stick ? I have no objection to inserting images to help illustrate modalities involved but I would try to encompass the breadth of the subject. The Nature immunology article is a good place for inspirationAspheric (talk) 19:11, 6 January 2013 (UTC)

The proposal is to remove the ambiguity. The entire context of the NIH website is clearl that "mainstream" or "conventional" medicine refers to what is licensed because of its scientifically proven efficacy. This article takes the two words and leaves the context behind, creating a situation as above, where Qexigator argues that palm healing with Reki Chakras is not alternative medicine where it is mainstream, and that an outdated evidence based pharmaceutical medicine, replaced by a newer and more effective pharmaceutical medicine, becomes alternative medicine just by no longer being conventionally used by the mainstream. NIH is clear that the distinction is in the basis for belief, not in how common the practice is among MDs.

Well then if by "conventional" NIH means something OTHER than the common practice among physicians (what state medical boards call "usual standard of care") then NIH is attempting to change the English language all by its little lonesome self. Good luck to it, but I'm having none of it. SBHarris 03:24, 7 January 2013 (UTC)

Can this (habitually unsigned) proposal be seriously intended with its assumptions around the notion that the true distinction boils down to a "science does not know it all" claim. Practising scientists do not claim to know it all (Outline of science), whether in the field of medicine or physics, and it is false to assume that practictioners of the various "alternatives" deny the validity of the proven results of scientific research and practice. Qexigator (talk) 20:23, 6 January 2013 (UTC) --Noted that the unsigned proposal has been altered to read boils down to "there is knowledge of health and disease that does not come from science" claim. Qexigator (talk) 20:40, 6 January 2013 (UTC)

Loose talk (from a coffee house in Texas?): Look again-- I have not argued, claimed or asserted that "palm healing with Reki Chakras is not alternative medicine where it is mainstream, and that an outdated evidence based pharmaceutical medicine, replaced by a newer and more effective pharmaceutical medicine, becomes alternative medicine just by no longer being conventionally used by the mainstream". My comment was on a misplaced claim for the efficacy of the images for the purpose of communicating the topic of this article. Qexigator (talk) 21:47, 6 January 2013 (UTC)

Name an alternative medicine that was based on the scientific method, and not on something else?

Can anyone name an alternative medicine that was based on the scientific method, and not on something else? Can anyone name an evidenced based medicine that is considered "alternative medicine"? If so, the reliable source and content from it should be used to modify the article. If not, then the incessant time spent arguing about trying to introduce the ambiguities in "conventional" and "mainstream", and most of the rest of the things on this talk page, should finally end. — Preceding unsigned comment added by 64.134.225.194 (talk) 20:43, 6 January 2013 (UTC)

Collapse comment admitted not to be an example

Here's one [58]. Somehow I don't think it'll end the discussion.Aspheric (talk) 21:10, 6 January 2013 (UTC) That is not an example of anything being based on science. It is a test of a substance for effect on killing a bacterium. That has nothing to do with the traditional basis of belief, nor does it even say it was ever believed to work on what it was tested for. 24.130.156.204 (talk) 22:29, 6 January 2013 (UTC) Didn't think it would help. Next step is that I provide a source to say it is a 'traditional remedy' and then that source is questioned, dismissed as a 'one off' or ignored. Also, is there any rule about editing other peoples comments ? I understand that you were trying to add context to the list of references but things could get very confusing if we all start 'editing' other peoples views. Especially with all the IP addresses here!Aspheric (talk) 23:01, 6 January 2013 (UTC) If you knew no source was provided that it was a "traditional remedy for killing Pseudomonas aeruginosa", and that it is a single study result and therefore primary, then why did you waste our time providig just a link, knowing it was no good, and why are you pretending elsewhere to be a new editor? What are some example of your previous edits? 24.130.156.204 (talk) 23:43, 6 January 2013 (UTC) I agree, we are getting distracted. The article has lots of problems, the lead is the main one, the issue is quality of sources. Lets stay focused. If there are no other comments on the sources in the lead, then I'll assume we are good to change the first sentence and I'll start moving the other sources in to their respective sectionsAspheric (talk) 21:02, 6 January 2013 (UTC)

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Voodoo Science is a reliable source

"... a bewildering array of untested and unregulated treatments, all labeled alternative by their proponents. Alternative seems to define a culture rather than a field of medicine—a culture that is not scientifically demanding. It is a culture in which ancient traditions are given more weight than biological science, and anecdotes are preferred over clinical trials. Alternative therapies steadfastly resist change, often for centuries or even millennia, unaffected by scientific advances in the understanding of physiology or disease. Incredible explanations invoking modern physics are sometimes offered for how alternative therapies might work" - Robert L. Park, Voodoo Science

Park is a reliable source. NSF cites him as one of their sources. 24.130.156.204 (talk) 01:11, 7 January 2013 (UTC)

Which sources should and shouldn't be in the lead

I've listed the current sources in the lead and tried to distinguish which ones should and shouldn't be there. As I understand, the lead is simply a description of the article so ideally it shouldn't have any references but since it does and since it's a sticking point, lets take another look at them. Refs 8 and 17 are really at the bottom of the first category and at the top of the second.Aspheric (talk) 20:09, 5 January 2013 (UTC)

lengthy list of Aspheric collapsed for readability

Good quality sources suitable to define the lead 2. NCCAMS - good quality position statement from authoritative medical body 8. Nature Review Immunology. Review. (good quality secondary source) 10. BMJ, core medical journal, high quality secondary source. "Complementary medicine refers to a group of therapeutic and diagnostic disciplines that exist largely outside the institutions where conventional health care is taught and provided" 11. IOM - position statement/lay guide, secondary source 12. WHO (high quality position statement - extracted from the General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine)- The terms "complementary medicine" or "alternative medicine" are used inter-changeably with traditional medicine in some countries. They refer to a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system. 15. Lancet core medical journal high quality source (old paper, not accessed) 17. The oncologist (good quality secondary source) OK Sources, these probably shouldn't be in the lead but will have a place within one of the other sections 4. Op-ed/ narrative review, non-medical journal, primary source 5. Review, core journal, primary source "CAM remains “alternative” because its practitioners depend on subjective testimonials rather than randomized clinical trials (RCTs) for support, and because most of their hypothesized mechanisms are at variance with those accepted by basic science." 6c. Op-ed/ narrative review, primary source 6d. Review, secondary source 14. Op-ed/ narrative review, secondary source, supports a link between CAM and Science 18. Letter in core journal Sources that probably don't meet MEDRS criteria, although they may still have a limited place within the article 1. primary source, non-medical - "As used here, alternative medicine refers to all treatments that have not been proven effective using scientific methods" 13. White House Commision - non-medical review secondary source 6e. News article in core journal - weak secondary source 6a. Book review pop science text 6b. Book review pop science text 16. Web-interview 19. Web dictionary 20. Web blog 21. Web blog 22. Herbal medicine text book - non-academic publisher 24. Non pubmed indexed journal 25. BBC News Report 26. Web blog Duplicates 3. see 1 6f. see 6a. 7. see 6e 9. see 2 23. see 11.Aspheric (talk) 20:09, 5 January 2013 (UTC)

I am, for the most part, in agreement with your analysis of the sources from the lead below Aspheric. One thing that I would watch-out for, if your goal is to avoid controversy, is many editors here do not agree that NCCAM is an authoritative medical source. Although it is a branch of NIH and is mandated to producing and assess the evidence surrounding CAMs, it has been criticized here by some editors as being too 'CAM-friendly'. Puhlaa (talk) 22:23, 5 January 2013 (UTC)

Thanks very much Puhlaa, I was relying on the NIH tag but am not really fussed about using NCCAM or not. I haven't including Cochrane (or NEJM), although I think they use the same definition. Ideally the article would open with Cochrane/WHO and maybe have just one other reference in the lead. Looking back at previous edits I'm not convinced the article is "better" than the version on 29th Oct. Back then, the lead was poorly sourced but did a good job of introducing the topic. The referencing is now better (though still poor) but the lead doesn't explain the topic very well at all.Aspheric (talk) 22:46, 5 January 2013 (UTC)

The list above is so ambigous as to be unintelligable. Alterations to the article should not be made based on it. If there is a specific source that is claimed not to be reliable, then state what sentence it supports and why it is not reliable. Otherwise, such sweeping comments as below are unintelligable. The BJM, etc., sources, when cited, should always include the context in which "conventional" is used - "unconventional" refers to things not based on science, and does not refer to things that are based on science, but are uncoventional because they are outdated or too new or expensive to be common. Otherwise, a user of this article might walk away thinking that BJM, NIH, Cochrane, etc., are promoting the possibility of etiological supernatural energies existing, as claimed in Reiki, Chiropractic, Voodoo, Acupuncture, Homeopathy, etc., which is not true. — Preceding unsigned comment added by 64.134.225.194 (talk) 16:13, 6 January 2013 (UTC)

I think you've misunderstood the headings. The list is based on article strength as per [WP:MEDRS] only not on my opinion of the sources or my interpretation of their contents Aspheric (talk) 17:56, 6 January 2013 (UTC)

It looks like you are proposing massive edits without specificity. MEDRS speaks for itself, and there is no reason to restate it all on this talk page. — Preceding unsigned comment added by 64.134.225.194 (talk) 18:54, 6 January 2013 (UTC)

And without sensitivity either (geddit?). The lead is a mess, it's unrealistic to 'redefine' conventional, this is the best way forward. Let's get started ! Aspheric (talk) 19:40, 6 January 2013 (UTC)

It looks like you want to remove all sources that say alternative medicine is based on traditional use, belief in supernatural entergies, etc., instead of being based on proven medicine. Why would you want a reader to think that alternative medicine is based on things proven with scientific method, when it is not? 24.130.156.204 (talk) 02:36, 7 January 2013 (UTC)

Are NSF, NYAS, and other first ten sources in lead too low quality to be in lead?

The article has lots of problems, the lead is the main one, the issue is quality of sources. Lets stay focused. If there are no other comments on the sources in the lead, then I'll assume we are good to change the first sentence and I'll start moving the other sources in to their respective sections.Aspheric (talk) 21:02, 6 January 2013 (UTC)

The first sentence should not be changed becuase Aspheric finds that its source, the National Science Foundation, is not a "quality source". NSF is a quality source. 24.130.156.204 (talk) 22:44, 6 January 2013 (UTC)

In the right context it could be a very good source but in the way it's used it's a non-medical primary sourceAspheric (talk) 22:54, 6 January 2013 (UTC)

The second sentence is based on the following sources -

• National Science Foundation is a quality reliable source.
• National Institute of Health is a quality reliable source.
• New York Academy of Sciences is a quality reliable source.
• Nature Medicine is a quality reliable source.
• Journal of the Association of Medical Colleges is a quiality reliable source.
• American Psychological Association is a quality reliable source.
• Medical Journal of Australia is a quality source Aspheric is incorrect.
• Canadian Medical Association Journal is a quality reliable source.
• Carl Sagan on use of the scientific method is a reliable source.

Aspheric's proposal to remove these good reliable sources, as "poor quality", is not a good one. 24.130.156.204 (talk) 01:32, 7 January 2013 (UTC)

Says the guy who won't log in. In any case I completely agree; "this is a project to make the world a better place by giving away a free encyclopedia". The current article is not encyclopaedic by anyone's standards. I'm not brand new, I've been using wikipedia for a long time as a user, an ip and now an editor. WP:MEDRS was pretty much the first thing I read. Perhaps I should have stuck to the article I came here to edit, I probably wouldn't have started here if i'd known the trouble it would cause but I'm here now and want to contribute. I welcome other editors scrutanising my edits. That is the strength of this project, others looking over my contributions and improving them so that the whole becomes greater than the sum of its parts. Try assuming good faith, what's the worst that could happen ? Aspheric (talk) 23:31, 6 January 2013 (UTC)

Many thanks for looking at the list. Here is my view -

• National Science Foundation - primary source, non-medical
• National Institute of Health - authorative medical source but I don't think it's used to support the second sentence
• New York Academy of Sciences is a quality reliable source - op-ed/narrative review, non-medical
• Nature Medicine - book review
• Journal of the Association of Medical Colleges - core journal but low impact factor, op-ed/narrative review
• American Psychological Association - book review
• Medical Journal of Australia - good quality source, could be used as secondary source, currently primary source
• Canadian Medical Association Journal - news article
• Carl Sagan on use of the scientific method is a reliable source - popular science book

Aspheric (talk) 23:41, 6 January 2013 (UTC)

• NSF is not a primary source. In fact, it lists primary sources in its bibliography
• NIH is not a primary source.
• NYAS is not an "op- ed/narrative review"
• All of the sources, and many more, say the same thing, that what is licensed and practiced ("mainstream") is based on proven science, and alt med is that which is not.

I think we're making progress Aspheric (talk) 02:54, 7 January 2013 (UTC)

• NSF - Source states " As used here, alternative medicine refers to all treatments that have not been proven effective using scientific methods" I think this qualifies as a primary source
• NIH - I think it would be an excellent source to use. Are we referring to the NCCAM definition
• NYAS - it's certainly not a systematic review, it's non-medical and probably should carry the same weight as Ernst's review in JRCM
• None of the best quality sources oversimplify the issue to mainstream medicine is science, alternative medicine is not.

Aspheric, why would you spend so much time and effort to try to get a user to believe alt med is based on proven science, when it is not? 24.130.156.204 (talk) 02:28, 7 January 2013 (UTC)

I'm not. See belowAspheric (talk) 02:54, 7 January 2013 (UTC)

Bold new definition attempted. Old first para moved to criticism section

I attempted a bold new first paragraph but it quickly got reverted [59]. I'd be interested in what others think ?Aspheric (talk) 00:53, 7 January 2013 (UTC)

The "bold new edit" was to remove nine of the ten first sources from the lead, including National Science Foundation, New York Academy of Science, Nature Medicine, Journal of American Medical Sciences, Nature Medicine, Journal of Psychological Association, Medical Journal of Australia, Canadian Medical Association Journal, and Carl Sagan on scientific method. These are good reliable sources, inclusion of which was discussed fully, and put in with almost unanimous consensus, except for a small handful of editors. Why would you want a reader to think alternative medicine is based on proven scientific methods when it is not? 24.130.156.204 (talk) 01:32, 7 January 2013 (UTC)

Thanks for your comments, the long list categories sources in the lead in to high, good and low quality and primary / secondary. I've un-collapsed it as I think it's central to the discussion. The lead probably doesn't need 26 references particular when not all of them are the same quality. The problems with the 10 that you cite are listed above. If it's unanimous, it's not normally 'except' anything. You seem to know this site pretty well. Would it be worth logging in ? Aspheric (talk) 02:03, 7 January 2013 (UTC)

Aspheric, why would you want a reader to think alternative medicine is based on proven scientific methods when it is not? 24.130.156.204 (talk) 02:22, 7 January 2013 (UTC)

I don't want the reader to think anything. I want the article to reflect the best authorative references on the subject. I hope you do as well. None of the best sources create a division between science and anti-science. I don't know why this is an issue hereAspheric (talk) 02:33, 7 January 2013 (UTC)

Then either cite a source for an example of alternative medicine that is based on what is proven with the scientific method (based on, not based on somthing else, but tested and moved to the evidence based medicine category if proven, as might be expected of herbs in the same proportion as randomly tested ones), or cite an example of what is proven with the scietific methods that is alternative medicine, and not evidence based medicine, or stop trying to make an ambiguous and misleading distinction that is in conflict with NSF, NYAS, NIH, and all these premier cited sources. Instead of responding, you simply start a new section. The cited sources talk about doing this, including in NSF. 24.130.156.204 (talk) 02:47, 7 January 2013 (UTC)

That's not the issue here. The issue is proper use of the best authoritative material. I'm not interested in science/anti-science debate. I think we'd make progress if we examined each of the sources as per WP:MEDRS decided which were primary,secondary and tertiary sources and which were high,medium and low quality.Aspheric (talk) 02:58, 7 January 2013 (UTC)

conventional = state board "usual standard of care"?

In the midst of all the cross-talk above comes a proposal that the proper use of "conventional" (medicine) in this context is to signify the common practice among physicians (what state medical boards call "usual standard of care") per [[60]]. That sounds about right: any reasoned objections? Can we go on from there? Qexigator (talk) 10:05, 7 January 2013 (UTC)

Errrr, where are the reliable sources for this definition? --Enric Naval (talk) 14:02, 7 January 2013 (UTC)

Good point, EN: with the amount of editors' toing and froing about sources, there must be somewhere which covers this? If not, that itself raises questions. Meantime, the following (in what I take to be a "primary source") seems to cross boundaries for classifying types of medical practice: Now in its 35th year, the Foresight programme has not only helped couples have healthy babies, but has also succeeded in giving thousands of 'infertile' couples the chance to become parents naturally-- in many cases where conventional medicine has failed. This looks odd to me. There seems to be nothing in the programme which is not within what any licensed medical practitioner of 'conventional medicine' could propose to patients. It certainly could not be properly characterised as "voodoo". But the promoters of the programme themselves (Foresight Association For The Promotion Of Pre-Conceptual Care, UK Registered Charity) seem to set themselves apart from conventional medicine. That may be another reason for being wary about overuse of "conventional". I am concerned here only with clarity of communication, given the variety of current usages, and make no judgment about the medical merits of this programme or any other medical regimen. Qexigator (talk) 15:16, 7 January 2013 (UTC)

Yep, good point. If we define alternative as 'not conventional', then what is 'conventional' ? We could use the BMJ review (ref 10) that quotes the Cochrane definition: “Complementary and alternative medicine is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed.". My reading of this is that 'Conventional medicine can be defined as the "modalities, practices and accompanying theories and beliefs" intrinsic to the politically dominant health system.' . The sourcing is near perfect, it's an approachable article in a high impact, high quality, core medical journal, citing an authorative medical body's definition of the subject. The article dismisses a number of 'unhelpful' assumptions about CAM, including that it is 'natural, unscientific, irrational, unproved and harmless'. The section in question is even freely available without a subscription.

The NIH/NCCAM (ref 2) defines it as follows: " Conventional medicine (also called Western or allopathic medicine) is medicine as practiced by holders of M.D. (medical doctor) and D.O. (doctor of osteopathic medicine) degrees and by allied health professionals, such as physical therapists, psychologists, and registered nurses. The boundaries between CAM and conventional medicine are not absolute, and specific CAM practices may, over time, become widely accepted."

Does that help or hinder ?Aspheric (talk) 18:35, 7 January 2013 (UTC)

Will help, unless source naysayers object or if ...broad domain of healing resources... other than those intrinsic to the politically dominant health system of a particular society... is felt to be too truthfully and pragmatically descriptive, and scientifically and academically rational, for any intent on retaining the inappropriate use of "propaganda" and "fraud" in the opening paragraph. Qexigator (talk) 18:53, 7 January 2013 (UTC)

• The "politically dominant health system of this particular society" is a science base, not a supernatuural or a fraud base.

The "politically dominant health system of this particular society" is one based on science, not based on the supernatural or on fraud. Why deliberately mislead the encyclopedia reader by taking words out of context? Why try to make people think somthing false, that Cochrane, BJM, NIH, or WHO believe in the supernatural, when they do not? 71.202.76.76 (talk) 00:59, 9 January 2013 (UTC)

Please explain what you denote by this particular society. Qexigator (talk) 01:19, 9 January 2013 (UTC)

This particlular society is the world in the 20th and 21st century. Believe it or not, science is still dominant politically, despite the marketing onslaught of chiropractors and the such. 71.202.76.76 (talk) 01:44, 9 January 2013 (UTC)

I would say money is dominant, then perhaps science. May I remind Aspheric that he calls the "Cochrane/BMJ" definition is not that, but rather a rather strongly-biased definition that came out of a 1995 definition by an "expert panel" at NIH's "Institute of Alternative Medicine" or IAM (not to be confused with IOM), which was later in 1998 to become NCCAM division of NIH, and is quoted out of context here. All this is in the last archives of this page from 6 weeks ago: [61]. The Cochrane definition of alternative medicine is actually very vague. It's the grant-hungry 1995 OAM (what is now NCCAM) that proposed to define CAM as a bunch of "healing resources." Which OAM/NCCAM, with enough grant money, will be glad to help you sift. They've since backed off that stance, as you can see in the later NIH/NCCAM reference 2 above, one which is far more suitable for this article.

As to "conventional medicine" being defined by various state boards as the "standard of care" by your fellow MD's and DO's, that is more or less tautological. Conventional medicine is what state boards let M.D.'s and D.O.'s get away with. People with ND and DC degrees and even TCM degrees are given more leeway, but they are not considered to be practicing conventional modern (Western) medicine. That is defined by what MD's and DO's normally do.

With that caveat, it is certainly NOT defined by what is "science based". For one thing, it's hard to tell what level of induction supports a practice well-enough to say if it's now "science based". Partly that's why the FDA exists, but the FDA doesn't control and define the bounds of all conventional medical practice in the US (yet). Incidentally, the state licensing board's reliance on "standard of practice" is a very "Wikipedia-like" move that keeps state boards themselves from having to know what is "science based." They don't have to do a job like the FDA's-- all they need to do is look out and see what most physicians do, very much like NPOV vs. "truth" on Wikipedia.

State boards (which don’t have the FDA’s resources) just need to do opinion-polls of current practice standards, and if a physician is within them, he's safe from the licensing boards. He might be wrong, but he's conventional. So, if your doctor in the past prescribed you Rezulin and it destroyed your liver, or Vioxx and it gave you a heart attack, the state board is not going to be interested, because his fellow MD's were all doing the same, science or no. As for the FDA, it is pretty much immune to lawsuits, being a regulatory branch of government. Federal judges don’t like to rule against the FDA, as that’s not good for careers. As a plaintiff you can argue that the FDA is more interested in money than science all you like (since they are mostly funded by pharma fees), but it will get you nowhere.

So, that's what we mean by “conventional,” as referring to social context and not science. If medicine was entirely based on good science, it would hardly ever back-track, or need to. It would add frills and new understanding, as happens in physics and chemistry, but the old ways would still continue, very much as we still teach (for example) Newton’s laws in physics classes, even though we know they aren’t strictly always correct in some situations. I WISH medicine was that way, but I’m here to tell you that it is not. There’s too much guesswork and money involved at the level of “current practice standards,” for that ever to be true. SBHarris 03:41, 9 January 2013 (UTC)

-IP has proposed that science is dominant in the world in the 20th and 21st century. Is there some reliable and relevant source, other than bland assumption, as a basis for this claim about "science", as clearly and unambiguously defined? The remark about "science is still dominant politically" looks like POV and agenda pushing. Qexigator (talk) 10:03, 9 January 2013 (UTC)

--Why is it assumed that "state boards" specifically refers to the member states of the USA federal republic? There are other English language states outside USA (not to mention others, older and younger than USA) which in a general sense have state boards with similar functions. If this article is intended to be USA focussed, that should be made clear in the topic title, for clarity in communicating the information. Qexigator (talk) 10:18, 9 January 2013 (UTC)

Bold face was put in SBHarris' comment. SBHarris, you can change it back, but this particular phrase is key to the endless problems in this article. A small handful of editors (recall agf is not a suicide pact) appear to be deliberately trying to use Wikipedia to commit fraud, that being a deliberate deception that alt med differs from real medicine only in it being unconventional, when in fact it is oten unconventional only because it is not based on science. That is the same basic fraud of snake oil salesemen and any other pseudoscience fraudster. Argument here is pointless, since editors like Pulah and theothers clearly understand what is going on, but perpetually reintroduce the same nonsense as if they are so naive as to believe what they are writing. It is very clear what is going on in this talk page and in the aricle, where Pulah and a few others have destroyed the article body by putting the word "conventional" in so many times that they appear to think that endless repetition will make its own reality like Nazi propoganda discussed in the NYAS article of the lead. agf is not a suicide pact, and it is time to finally put a stop to this pretension to being sincere in believing and arguing for a claim that alt med may be science based, but is just not conventional as what defines it. That is a deliberate lie in the context of the overwhelming number of times this has been refusted to the same handful of editors, but they simply come back and pretend the archived talk pages never existed. Read the NYAS article, which describes this exact process. 64.134.228.26 (talk) 15:49, 9 January 2013 (UTC)

IP 64... proposes "quoted out of context here" is key to the problems in the article, but the rant-like remarks which follow make it difficult to see whether or not that amounts to a reasoned contribution to the discussion. In my view, an inclination to see others as intent on committing fraud is actually one of the key problems. My response to IP 72... in section below also applies. Or is all this a dispute local to USA or N.America? Qexigator (talk) 17:16, 9 January 2013 (UTC)

For the record, I don't think the concept of alternative medicine can be usefully defined as a set of specific practices, except in the "west" or at least the developed world where partly science-based stuff competes with older systems based on religion, ceremonial magic, wishful thinking, and folk tradition. Ayurveda is not alternative in India, and TCM is not alternative in China. I simply want to avoid the trap that assumes all Western medicine is science-based (only half of it is), and that all alternatives are based on paranormal ideas (most are, but not quite all). Herbalism and orthomolecular treatments in particular are not based on paranormal assumptions. They are quite different (or can be in theory) in character from magic or "psychic energy" based treatment. Of course this is confused by the fact that nearly all herbal and folk traditions come with a magical overlay. But this isn't a needed component. SBHarris 18:21, 9 January 2013 (UTC)

--And for the record let me say that, while it is not the whole story, this could be part of the reasoning which may help towards improving the article. It seems likely that in the "west", where there is a predominance of what may more or less be commonly meant by "science based", some of the practices deriving from earlier times or other places may be, somehow or other, efficacious in their own way, and should not be demeaned by reason only of not being "standard practice" under state medical boards. Actually, as a non-specialist, I have the impression that some "standard" medical practices in the not distant past (20c.) would now be regarded with less favour than some of those from other cultural traditions. Qexigator (talk) 19:24, 9 January 2013 (UTC)

"Unconventional" is a symptom, not a cause

Is there any alternative medicine that is based on proven science? No.

Is there any alternative medicine that is not based on what is in the lead in this article? No.

Being "unconventional" is a symptom of alt med not being based on science.

Merely becoming "unconventional" does cause a practice to therfore become alternative medicine.

So why constantly try to trick a user of this encyclopedia into thinking that what causes a practice to be called alternative medicine is it being "unconventional", when that is just the symptom of it not being based on science? 71.202.76.76 (talk) 00:51, 9 January 2013 (UTC)

"So why constantly try to trick a user ..." Numerous editors have drawn attention to the flaws in the article. Can you help to improve it by pointing out whereabouts in the above discussion, or in the sources, is this supposed trick? Qexigator (talk) 01:07, 9 January 2013 (UTC)

Yes. Many cardio procedures of the 60's have been supplanted by more modern and improved procedures. So the old procedures when used are very unconventional. This article implies they may be considered to be alternative medicine. a reader of this article would be lead to believe something that is false, for no good reason at all. If you believe in the supernatural energies of chiropractors and acupuncturists, why try to mislead anyone to think anything else about your belief, such as that it is merely an "unconventional" belief, when in fact it is unvonventional because it is not based on science. 71.202.76.76 (talk) 01:52, 9 January 2013 (UTC)

We dont need to trick a reader into believeing that alternative medicine is unconventional, this is what the majority of reliable sources say, so it is what the wikipedia article should say per WP:UNDUE. Puhlaa (talk) 01:10, 9 January 2013 (UTC)

Pulah, what is an example of an alternative medicine that is based on science? What is an example of a basis for an alternative medicine that is not one of the listed things in the first paragraph. For example, the basis of chiropractic and acupuncture is belief in supernatural energies, undetected by any mere physicist. It is not alternative medicine because it is unconventional. If a vast majority of people start using chiropractic, so that it becomes conventional practice, this article implies that it will no longer be alternative medicine, even though it is still based on belief in the supernatural. That is simply false, and therefore misleading. 71.202.76.76 (talk) 01:39, 9 January 2013 (UTC)

Sure IP editor, I can provide some examples. An acupuncturist treating someone in pain is using acupuncture 'based on science' according to this source. Similarly, a chiropractor who uses these guidelines to decide what to do with a headache patient is practicing chiropractic 'based on science'. Both of these health care professionals are still considered to be practicing CAM, even though their treatment approaches are 'based on science'. According to the majority of high-quality sources in our lead, they are still considered CAM because they are not part of the conventional/dominant health care system. Alternatively, this source suggests that 55% of the treatments used in medical hematology/oncology are NOT 'based on science'. According to the majority of high-quality sources in our lead, those medical treatments used in hematology/oncology that are NOT 'based on science' are still considered mainstream because they are part of the conventional/dominant health care system.Puhlaa (talk) 03:39, 9 January 2013 (UTC)

That is overtly stated to be a a review of significance of "factors in addition to the specific effects of needling" (calling those factors "acupuncture", when acupuncture is supposed to be just the needling), and not of the spernatural energies upon which acupuncture is based, (including the Chinese astrology upon which its meridians are located). You should try actually reading all of your source before wasting others' time linking to it, as they go into much more detail about this inside the review. Chasing down supernatural claims has always been, and remains, a big waste of time. 24.130.156.204 (talk) 00:19, 10 January 2013 (UTC)

Per IP: ...simply false, and therefore misleading. In my view, it has long been evident from previous discussions that practitioners of the sciences of language, meaning and reasoning (linguistics, semantics etc.) would not find it too difficult to unpack fallacies such as those in IP's assertions about the use of "conventional", "unconventional", "supernatural", "belief", "based on science". But the actual purpose of editors is presumably (see Ex hypothesi above) to improve the article itself, allowing for the problems of which most are aware about the ambiguities and equivocations and evasions inherent in everyday populist usage, and in specialist academic and professional usage, leaving aside the abuses of propaganda or of fraud which may be employed by friendly or hostile proponents or opponents of any aspect of medical practice (that is, actually friendly or hostile to health and welfare in the treatment of illness), however named. (As before mentioned, I make no comment on the merits of sources being cited). Qexigator (talk) 10:10, 9 January 2013 (UTC)

"Biology-based practices" does not refer to being based on the science of biology, and may include use of toxic chemicals having nothing to do with biology

The article says

"Biology-based practices: use substances found in nature such as herbs, foods, vitamins, and other natural substances."

• NCCAM coins a new use of the word biology, which has nothing to do with the science of biology. "Biology-based" as coined in the NCCAM primary source (which admits to being a primary source coining terms in a non peer reviewed proposed classification scheme to try to make sense out of nonsense), may refer to use of pure toxic chemicals from a completely nonbiological source, such as use of the poison lead in Traditional Chinese Medicine, and to other nonbiological substances. The article was amended so the user would not be misled into thinking that use of the poison lead in TCM, a "biology based" alternative medicine in NCCAM's classification, does not in any way refer to something "based on the science of biology".

Similarly NCCAM calls pure lead crystals, and arsenic crystals, "natural substances", and calls many chemicals that are synthesized in China and marketed as TCM, "natural" substances. Let the encyclopedia user beware, Wikipedia seems to have thrown its once proud consistency standards out the window, and jumped on the alt med nonsense bandwagon with NCCAM. This article body has been like this for years, and has gotten worse than some previous versions, not better. So much for the theory of slow evolution to improvement. Its more like a slow evolution to truth by consensus, not by scientific rigor and test and peer review and consistency. 71.202.76.76 (talk) 01:32, 9 January 2013 (UTC)

Cochrane reviews

I see this is Deja Vu to many and am impressed by the patience and persistence of editors here. Music therapy for scizophrenia [[62]] and Tai Chi for rheumatoid arthritis [[63]] are further examples from the Cochrane collaboration of alternative therapies that have some evidence to support their use. With time these therapies may become more mainstream and cease to be 'alternative'. There are others will always remain alternative but will still be used for a variety of reasons.

SBHarris makes some excellent points above and previously.

• Medicine is not just science but a mix of many things (including art, tradition, fashion and occasionally vested interests)
• CAM is a broad term which includes a few possibly reasonable and many dodgy claims
• The theoretical definition of CAM is problematic

Regarding the last point, I agree it's not ideal but it's the best we have. I've included a further bold edit trying to include the reasons for the operational definition, noting the poor science and highlighting the difficulty defining such a broad and mixed area. I've reverted some of the more recent edits as I don't think they've been fully considered.

I'm not sure it'll satisfy anyone/everyone but positives and negatives may help point the way forward Aspheric (talk) 20:13, 9 January 2013 (UTC)

Alternative medicine is a broad term for any therapy, practice, theory or belief that is not integrated into the dominant health care system. It includes concepts of health promotion and disease prevention. The term alternative or complementary medicine is often self defined and the boundary between alternative and conventional medicine is not always clear or fixed.. Alternative medicine is sometimes grouped with complementary medicine which, in general, refers to the same interventions when used in conjunction with mainstream techniques, under the umbrella term complementary and alternative medicine, or CAM. .

Alternative medicine are poorly researched in comparison to conventional medicine but evidence for some complementary therapies does exist. Shifting norms and the lack of a consistent definition and have hampered research in the field and masked potential problems with safety and efficacy. Integrative medicine (or integrative health) is the combination of the practices and methods of alternative medicine with evidence based medicine. Critics maintain that the terms “complementary” and “alternative medicine” are deceptive euphemisms meant to give an impression of medical authority.. The terms "complementary medicine" or "alternative medicine" are used inter-changeably with traditional medicine in some countries. Traditional medicine refers to an indigenous cultures' approach to health and disease.

This is undoubtedly an improvement on previous lead. Noting for ease of reference but without comment first half-dozen sources:

1_source [64] "BMJ 1999;319:693 Complementary" by Catherine Zollman and Andrew Vickers was published 11 September 1999. Extract from "Definitions and terms": Complementary medicine...a group of therapeutic and diagnostic disciplines... largely outside the institutions where conventional health care is taught and provided.... [it] is an increasing feature of healthcare practice, but considerable confusion remains about what ...the disciplines included under this term should hold in relation to conventional medicine. In the 1970s and 1980s these disciplines...became known collectively as “alternative medicine.” The name “complementary medicine” developed as the two systems began to be used alongside (to “complement”) each other. ...“complementary” has changed ... to defining the group of disciplines itself. Some authorities use the term “unconventional medicine” synonymously.

2_source [65] is a USA government policy document dated March 2002 purporting (in chapter 2) to give an Overview of CAM in the United States: Recent History, Current Status, And Prospects for the Future.

3_source [66] idated May 1995, reports Complementary medicine (CM), defined as health care which lies for the most part outside the mainstream of conventional medicine, is gaining popularity in Britain and elsewhere. The debate about the usefulness of CM is often regrettably emotional, and thus unproductive. In the pursuit of a more fruitful way ahead, the [full text] highlights some of the main arguments from both 'sides' and tries to disguise them as misconceptions.

4_Paywall access.

5_source [67] blurb promoting author's book. Q_What advice can you offer GPs who are looking to integrate CAM into their work? A_Use our book as a reference - there is no other source of information which is as concise and sound.

6_source [68] dated 2003, author Barrie R. Cassileth, Ph.D., Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center,NY. Many cancer patients use therapies promoted as literal alternatives to conventional medical care. Such “alternative” modalities are unproven or were studied and found worthless. These can be harmful. An even greater proportion of cancer patients uses “complementary” therapies along with mainstream cancer treatment. Most are helpful adjunctive approaches that control symptoms and enhance quality of life. Qexigator (talk) 21:46, 9 January 2013 (UTC)

I gave up on editing here quite some time ago, but great job on the new opening sentences in the lead! Gandydancer (talk) 22:03, 9 January 2013 (UTC)

Aspheric, I commend your willingness to still return and expend more efforts here, even after all the resistance to change that you have endured. I think that your edit does an excellent job of dealing with the complex issues surrounding an explanation of CAM, good job! I support the inclusion of this text. Puhlaa (talk) 20:19, 9 January 2013 (UTC)

• This is just the same old stuff that keeps getting reintroduced in an effort to mislead users into thinking alt med is something it is not, and keeps getting rejected. It ignores all previous discussion on exactly the same points, repeatedly brought up by the same handful of editors. See archives. 24.130.156.204 (talk) 00:09, 10 January 2013 (UTC)

Noted that the revised lead has been peremptorily and unhelpfully reverted without reason or explanation, but that a later edit[[69]] has moved the classification section to top after the lead, which in its way is an improvement, followed by Examples linking to an extensive list, followed by Terminology (a fairly recent edit). The lead however (as reverted) is still such as to vitiate the entire article, as mentioned in Ex hypothesi above. Qexigator (talk) 10:13, 10 January 2013 (UTC)

I think we're making some progress but it's helpful to detail specific reasons for reversions / changes so we can see which direction the article needs to move. '24' can you clarify where you think it misleads so I can correct this. I realise this is Groundhog day for some but I hope some of it covers new ground. ThanksAspheric (talk) 12:28, 10 January 2013 (UTC)

Examples and classes of alternative medicines

The following was added to make the article have at least something about what alternative medicine is for the encyclopedia user, rather than being solely weighted to being about terminology, promotion and prevalence of use, and debate over efficacy. The content was pulled from linked articles, and the sources supporting that content still needs to be brought over for verifiability, but the edits should be noncontroversial (except to those who may want the article to be nothing more than a either a promotion or a debate.) 99.127.226.172 (talk) 13:08, 10 January 2013 (UTC)

• "Alternative medicine practices are diverse in their foundations and methodologies. Methods may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, new or different concepts of health and disease, and any bases other than being proven by scientific methods. Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices. Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based."

Discussion? Suggested sources beyond the previously cited NCCAM and lead sources? 99.127.226.172 (talk) 13:04, 10 January 2013 (UTC)

• "Whole medical systems may be based on traditional practices, such as Traditional Chinese medicine, Ayurveda in India, or practices of other cultures around the world. Whole medical systems can also be based on belief systems that underly a system of practices and methods, such as in Naturopathy or Homeopathy. Ayurvedic medicine is a traditional medicine of India, and includes a belief that use of traditional herbs and having the spiritual balance of the religions of Hinduism and Buddhism, including by suppressing natural urges of food intake, sleep, and sexual intercourse, can be used to heal. Traditional Chinese Medicine is based on belief in a supernatural energy called qi, considerations of Chinese Astrology, and traditional use of substances found in China. In both Traditional Chinese Medicine and Ayurveda, the thousands of years of traditional use in the respective cultures is cited as part of the basis of claims of efficacy and validity.

"

Discussion? Suggested sources beyond the previously cited NCCAM and lead sources? 99.127.226.172 (talk) 13:04, 10 January 2013 (UTC)

• "Bases of belief may include belief in existence of supernatural energies undetected by the science of physics, or in properties of the energies of physics that are inconsistent with the laws of physics. Biofield therapies are intended to influence energy fields that, it is purported, surround and penetrate the body. No empirical evidence has been found to support the existence of the putative energy fields on which these therapies are predicated. An example is acupuncture, part of Traditoinal Chinese Medicine, where it is believed that a supernatural energy called qi flows through the universe and through the body, and helps propel the blood, blockage of which leads to disease. It is believed that insertion of needles at various parts of the body determined by astrological calculations can restore balance to the blocked flows, and thereby cure disease. Chiropractic was developed in the belief that manipulating the spine affects the flow of a supernatural vital energy and thereby affects health and disease. In the Western version of Japanese Reiki, the palms are placed on the patient near Chakras, centers of supernatural energies, in a belief that the supernatural energies can transfered from the palms of the practitioner, to heal the patient."

Discussion? Suggested sources beyond the previously cited NCCAM, lead sources, and sources in linked articles from which the info was taken? 99.127.226.172 (talk) 13:04, 10 January 2013 (UTC)

• "Bioelectromagnetic-based therapies use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in an unconventional manner. Magnetic healing does not claim existence of supernatural energies, but asserts that magnets can be used to defy the laws of physics to influence health and disease."

Discussion? Suggested sources beyond the previously cited NCCAM, lead sources, and sources in linked articles from which the info was taken? 99.127.226.172 (talk) 13:04, 10 January 2013 (UTC)

• "Mind-body medicine takes a holistic approach to health that explores the interconnection between the mind, body, and spirit. It works under the premise that the mind can affect "bodily functions and symptoms"."

Discussion? Suggested sources beyond the previously cited NCCAM? 99.127.226.172 (talk) 13:04, 10 January 2013 (UTC)

• "Substance based practices use substances found in nature such as herbs, foods, vitamins, and minerals, and includes traditional herbal remedies with herbs specific to regions in which the cultural practices arose. "Herbal" remedies in this case, may include use of nonherbal toxic chemicals from a nonbiological sources, such as use of the poison lead in Traditional Chinese Medicine."

Discussion? Suggested sources beyond the previously cited NCCAM? 99.127.226.172 (talk) 13:04, 10 January 2013 (UTC)

• "Manipulative and body-based practices feature manipulation or movement of body parts, such as is done in chiropractic manipulation."

Discussion? The example of osteopathy was removed, since it is now proven (however minimal the efficacy), and is now considered science based medicine, not alternative. Disagreement? 99.127.226.172 (talk) 13:04, 10 January 2013 (UTC)

Dicussion? Suggested sources beyond previously cited NCCAM? 99.127.226.172 (talk) 13:41, 10 January 2013 (UTC)

• "Religion based healing practices, such as use of prayer and the laying of hands in Christian faith healing, rely on belief in intervention by God for healing."

Discussion? Suggested sources beyond NCCAM? 99.127.226.172 (talk) 13:41, 10 January 2013 (UTC)

• "Some alternative medicine practices may be based on pseudoscience, ignorance, or flawed reasoning. Homeopathy was developed prior to knowledge of the theory of molecules and basic chemistry, which proved that is "remedies" contained nothing more than distilled water. Practitioners of elecricity and maagnetism based healing methods may deliberately exploit a patient's ignorance of physics in order to defraud them."

Discussion? This is an example from source in the lead. Suggested additional examples and sources? 99.127.226.172 (talk) 13:41, 10 January 2013 (UTC)