Talk:Acupuncture/Archive 30

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Alexbrn recently reverted my edit to this page in which I added this review as a source for the statement "A 2016 systematic review and meta-analysis found that certain modes of acupuncture were effective for postoperative pain." Alexbrn argued in his edit summary that "Plos One & Chinese" are "not reliable for such bold claims". [1] I disagree, as PLoS one is a respected open-access journal, not a predatory one, and it has an impact factor. Also, the authors of this review are affiliated with Taiwanese universities, and according to the BBC, Taiwan "has for all practical purposes been independent since 1950," so it's not part of China. Thus I think that concerns about Chinese research on acupuncture being biased doesn't apply here. Everymorning (talk) 20:17, 23 September 2016 (UTC)

I read the review, and looked over the 13 studies they included. These are all tiny studies, with inconsistent controls, inconsistent methods, and half of them have no or improper blinding. It's a crap review of crap studies and should not be included. Someguy1221 (talk) 21:51, 23 September 2016 (UTC)

::This comment doesnt constitute a reason to remove the review per WP:OR. Everymorning (talk) 23:20, 23 September 2016 (UTC)

WP:OR restricts which content can be included in an article. It does not restrict how decisions are made on the talk page. In fact, it would be impossible to have a discussion about the reliability of a source or significance of a viewpoint without injecting some kind of opinion or original research. Someguy1221 (talk) 23:28, 23 September 2016 (UTC)

(ec) It's not clear why you mention WP:OR which is a policy regarding article content. WP:OR is not intended to stop editors from thinking, and there is a whole noticeboard (WP:RSN) where people offer opinions on the quality of sources. Articles should not contain every comment ever published on a topic. Johnuniq (talk) 23:30, 23 September 2016 (UTC)

My apologies, I should have known better than to cite OR incorrectly. However, in terms of the reliability of any source, there should be little doubt that peer-reviewed systematic review/meta-analysis > Wikipedia editor's opinion. If you think it is an unreliable source, you should cite a policy pertaining to the size of the studies in a meta-analysis that says they have to be big enough (or whatever your reason(s) is/are). Everymorning (talk) 00:16, 24 September 2016 (UTC)

WP:COMMONSENSE, WP:IAR. If a paper is obvious shit, we shouldn't let it occupy space in an article because we're standing on principle. Someguy1221 (talk) 02:36, 24 September 2016 (UTC)

Or WP:REDFLAG. Exceptional claims need mutiple high quality sources (not one suspect one). Any claim that acupuncture is effective is just such an exceptional claim. Alexbrn (talk) 02:44, 24 September 2016 (UTC)

While Acupuncture is certainly not recognized as an effective practice universally, and personally I don't believe it to be a reliable medical intervention of any sort; said study cited by user:Everymorning was published in a reliable peer-reviewed journal. Thus, we must report it accordingly, despite personal opinions about the study.Trustinskepticsm (talk) 01:19, 24 September 2016 (UTC)

In fact PLoS One has a bit of a reputation for harbouring cranky research (Beall calls it a "a lonely and un-selective digital repository more than a scholarly publication"[2]), and we know that studies on TCM out of China are suspect (Taiwan is independent of the PRC but it is China). So no, this is not a reliable source for assertions about biomedicine. Alexbrn (talk) 01:59, 24 September 2016 (UTC)

We should be very careful not to be conducting a second peer-review of our own: "Editors should not perform a detailed academic peer review. Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions." as per WP:MEDASSESS. Cheers! 19:45, 24 September 2016 (UTC)~ — Preceding unsigned comment added by Jayaguru-Shishya (talk • contribs)

It's not a question of "personal" objections, but of accepted knowledge that this is not a good source for such a bold claim, as has been much discussed in the past. Be reminded that discretionary sanctions apply here. Alexbrn (talk) 19:52, 24 September 2016 (UTC)

Who is the "we" that "know" Chinese research on TCM is suspect? I'll remind YOU that discretionary sanctions are in place here, since you are giving special dispensation to your personal assessment of research based on author's ethnicity or country of origin. "Accepted knowledge" - thats not how science works, you don't get to assume what accepted knowledge is.Herbxue (talk) 15:55, 27 September 2016 (UTC)

The country of origin issue for TCM was originally discussed here, where the result was that it would not be discussed in MEDRS itself but would be codified in the MEDRS FAQ. A subsequent attempt to override this by amending MEDRS was ultimately rejected via the RfC here. Sunrise (talk) 18:12, 27 September 2016 (UTC)

Yes, let's not "go again" on this matter. Alexbrn (talk) 20:23, 27 September 2016 (UTC)

Unfortunately we have to because we are interpreting the outcome differently - the rfc was closed because the consensus as I read it was "no one would ever reject a source based on ethnicity or country of origin, so there is no need to explicitly state you can't do that" whereas you appear to read the outcome to mean "go ahead and reject sources based on country of origin".Herbxue (talk) 20:53, 27 September 2016 (UTC)

If you want to re-open the matter, this is not the place. However I think doing that would be disruptive. Alexbrn (talk) 21:24, 27 September 2016 (UTC)

Ethnicity/nationality issues aside, I think this thread is being unfair on PLoS ONE. There have been a couple of high-profile incidents of "cranky research" slipping though peer-review, but this is true of many journals including Nature and Science. Beall' opinions on PLoS ONE are at the harsher end of the spectrum. PLoS ONE has published plenty of perfectly acceptable research articles, many of which are cited elsewhere on Wikipedia. This meta-review (which I haven't read yet) has passed peer-review, it isn't WP:PRIMARY research and it is published in a high-profile journal (albeit one with a wonky business model) that is included in any academic database you care to mention and has an impact factor, yada yada, etc. If PLoS ONE "having a reputation" is enough to exclude this source, then are we going to purge the rest of Wikipedia? PLoS ONE accepts post-publication comments on articles and in the six months since publication nobody has thought to criticise the methods of this paper by posting a comment. I don't think doubts over the journal are sufficient to exclude this. Let's discuss this sensibly and not shut down the debate. PS: Acupuncture is claptrap (just so you know where I stand) Famous_dog (c) 07:16, 28 September 2016 (UTC)

Did I get this correct? Alexbrn reverted the addition of the article once[3], and soon after reverted it once more[4]. After that, he notified me of the 'discretionary sanctions imposed upon the article, although he just edit warred himself? I expect a self-revert, and that we can continue the discussion here at the Talk Page. I am not really familiar with the reasons why Alexbrn wants to reject this article. Cool down guys and discuss, cheers! Jayaguru-Shishya (talk) 12:37, 28 September 2016 (UTC)

There is nothing to discuss. Neutrality is a non-negotiable pillar of Wikipedia and we ain't toppling it to boost acupuncture. This has been discussed to death and community consensus is wide and clear. Check back at Wt:MED if in doubt. Alexbrn (talk) 12:39, 28 September 2016 (UTC)

Neutrality in this case would be following MEDRS. Now, if you want to reject the source based on what someguy1221 said above, then fine, we can discuss the actual quality of the source. But your reasons for rejecting this source are not legit.Herbxue (talk) 17:01, 28 September 2016 (UTC)

Jayaguru-Shishya, this is not a high-quality source. The WP:REDFLAG policy provides guidance on what to omit, and that ties into WP:WEIGHT and WP:FALSEBALANCE. Remember that Wikipedia is not neutral. Manul ~ talk 18:25, 28 September 2016 (UTC)

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In order to qualify as reliable a review needs to do two things:

1. Be published outside China by authors not associated with Chinese institutions, and draw mainly on studies which meet the same criteria. It is well documented by now that the Chinese have a massive problem with research. Not only are virtually all their acupuncture studies positive ([5]), but in fact large numbers of Chinese studies on reality-based medicine are actually fraudulent ([6]). At this point any Chinese-dominated work on acupuncture, and arguably any biomedical topic, should be ignored on Wikipedia. If the finding is robust then a paper free from the Chinese problem will become available.
2. Exclude, or at least explicitly separate, electroacupuncture. We know by now that it does not matter where you put needles, or whether you actually insert them or not, and we know that there is no evidence for the existence of qi or meridians. However, we also know that electrical stimulation of nerves has a definite effect. Mixing electroacupuncture with acupuncture is thus extremely misleading, since electroacupuncture is merely a mechanism for delivering electrical nerve stimulation and is probably indistinguishable from TENS other than in its higher chance of causing infection.

We've had the conversation about Chinese studies before, and I think the problem of mixing electroacupuncture with normal needling has also been mentioned before. Guy (Help!) 15:37, 6 October 2016 (UTC)

JzG recently reverted my addition of this meta-analysis, arguing in his edit summary that it was "Yet another crappy Chinese study" and that "the paper freely admits the studies are junk." Neither of these seems to be true AFAICT: for example, as I noted in my edit reverting JzG's revert, contrary to his claim that this meta-analysis is somehow "Chinese", the authors are affiliated with 2 different South Korean universities. Also, the abstract (I don't have access to the full text) does not say that the included studies are "junk", only that "there were high levels of heterogeneity in several of the measured parameters" and that more well-designed studies are needed. This can be addressed by including a mention of the limitations of the meta-analysis (which I included). JzG's argument for removing this source seems to rely on a flagrant misrepresentation of it, which is why I restored it. Everymorning (talk) 00:57, 7 October 2016 (UTC)

That meta-analysis is a case-study in doing a bad meta-analysis. If you look at their data, it's plain as day that the larger the study and the better the control, the smaller the effect was, trending toward sham acupuncture being equal to acupuncture. If you eliminate the tiny studies, the poorly controlled studies, and the studies with high risk of bias, there is no effect at all for acupuncture. This is precisely the sort of gimmick that the good folks at SBM have been complaining about for years. Someguy1221 (talk) 02:30, 7 October 2016 (UTC)

Are we now in some sort of alternative reality where the opinion of a Wikipedia editor is considered superior to that of the editors of the Laryngoscope? Is there a policy guideline to support your argument, or are you just trying to dress up your opinion as fact? Perhaps you should submit a letter to the editor of the journal, or publish your own meta-analysis, if you know so much about how to do it right. Everymorning (talk) 03:45, 7 October 2016 (UTC)

Someguy1221, you are suggesting that the source should be excluded because it included small studies that you feel invalidate the statistical outcomes. However, MEDRS specifically says "The best evidence for treatment efficacy is mainly from meta-analyses of randomized controlled trials (RCTs)." AND Do not reject a high-quality type of study (e.g., a meta-analysis) ... because of personal objections to the inclusion criteria, references, funding sources, or conclusions" Are there any policy-based reasons for exclusion? or are there any equally high-quality sources that directly contradict the conclusions of this proposed new source? 2001:56A:75B7:9B00:441:A41B:9784:50F1 (talk) 03:52, 7 October 2016 (UTC)

Reviews of reviews have already been published (some are used on this article) describing the sorts of mistakes that are almost required to make an acupuncture review come out positive. It's lunacy to add new reviews with the exact same problems every time a new one comes out. There's no need to wait for Ernst or another actual scientist to cite this new review just to come to the same conclusion as before: "basing reviews on small, biased, unblinded, poorly controlled studies is pseudoscience." Someguy1221 (talk) 04:01, 7 October 2016 (UTC)

Whatever its wider merits, isn't this paper of (South) Korean - and not Chinese - origin? Alexbrn (talk) 04:54, 7 October 2016 (UTC)

Right it's not Chinese, and neither are any of the twelve papers analyzed (the first four in the list being from the U.S., Israel, Norway, and Germany, respectively). Considering the paper itself says that "the efficacy of acupuncture cannot be considered to have been evaluated sufficiently", the push to include it seems puzzling. Besides, the analyzed papers deal with different treatments -- acupuncture, electroacupuncture, and acupressure -- so the meta-analysis doesn't appear very useful in any case. And isn't there (or shouldn't there be) a general rule about not including a paper without reading it? Manul ~ talk 12:49, 7 October 2016 (UTC)

There was a discussion once at Wikipedia Talk:MEDRS about the country of origin, but can someone please refresh my memory about the outcome? Jayaguru-Shishya (talk) 20:13, 7 October 2016 (UTC)

No change was made to MEDRS excluding country of origin from consideration, was the outcome. For obvious reasons since some nation states are well-known for producing unreliable material in certain areas. Alexbrn (talk) 20:18, 7 October 2016 (UTC)

Including China and Russia, yes. I apologise for carelessness in this, I mistook it for another paper.

The paper does indeed show that the studies are junk - hence its inability to reach the positive conclusions the authors would like - though they bravely spun it a bit anyway.

One question I always have after reading things like "acupuncture cannot be considered to have been evaluated sufficiently" - how many weak and conflicting studies do they need before they consider it's been studied "sufficiently"? We know it doesn't matter where you put the needles, or whether you put them in at all, we know that different traditions have entirely different acupoints, we know the primary claimed mechanism of action is wrong because it relies on manipulating things that do not exist, and we have no solid evidence it works for most things. Why would it work for postoperative nausea? If you accept it to be distraction therapy, as the evidence rather strongly suggests, then that makes perfect sense, and you can deliver the same result using other techniques without the risk of infection, but if you think it's one of the various speculative mechanisms promoted by trypanophiles, then why would it work for that and not for other conditions where the pathways are the same? It makes no sense. The only possible conclusion from a statement like "acupuncture cannot be considered to have been evaluated sufficiently" is that they fully intend to keep asking until they get the answer they want, because every time they get the other answer it must be wrong so more studies are needed. Which is why some call it pseudoscience, of course. Guy (Help!) 13:51, 11 October 2016 (UTC)

Well, this is not a forum, but since you are editorializing here, I will too. There are issues with blinding acupuncture that cannot be dismissed. If the operator can't feel what they are doing to the tissues, and feeling the tissues react, it is not true verum. Problems exist in trials for surgery as well. For some reason, all the focus here is on studies based on a model designed for testing drugs. NCCIH has designated sham vs verum studies as low priority compared to high priority areas that address more important questions such as "can this help patients in pain take less opioid drugs" and what are the biological mechanisms of acupuncture, or what non-specific effects (including the placebo effect) are potentially valuable if utilized in a more focused way? The lack of evidence for point specificity in analgesia should cause traditional acupuncturists to rethink the purpose of needling specific areas of the body - there exists great heterogeneity in the 2,000 years of traditional assumptions about, and ways of stimulating the channels, regions, points, etc - the new-agey beliefs about energy movement are relatively recent and Western phenomena. As Western acupuncturists dig deeper into the meaning of the Han dynasty texts, using translations by dispassionate scholars like Unschuld, we increasingly see the tradition consisted of pragmatic approaches that rely on immediately observable effects rather than assumptions about the body regulating itself after an hour of lying down with a lavender eye pillow. In short, we have over-focused on inappropriate study designs, and there was probably poor execution of technique in most controlled trials due in part to the conditions required to establish controlled variables, and in part due to a fledgling understanding of how acupuncture works by Western acupuncturists participating in trials resulting in poor execution of the actual procedure. My conclusion: "More studies are needed"Herbxue (talk) 18:49, 11 October 2016 (UTC)

Those issues have been addressed by using sham acupoints, stage-dagger needles, and toothpicks, to name but three blinding methods. When these are used, the purported effect vanishes. Yes, it is difficult to fully blind, but the better the job you do, the less positive the outcome. As expected, given that there is no remotely plausible mechanism of action. Guy (Help!) 00:10, 12 October 2016 (UTC)

I've just translated Herb's comments into english for the common dog. He seems to be saying that modern western acupuncturists ought to stick pins into patients to see what happens ("immediately observable effects"). I do hope my regular veterinarian doesn't practise medicine in this way? -Roxy the dog™ bark 11:23, 12 October 2016 (UTC)

You both missed my points because you haven't really bothered to get to know the subject. Guy, I am saying the better you blind, the less the procedure resembles true acupuncture, therefore I expect it to be less effective. Roxy, I am talking about expected immediate effects, things like muscle twitches, borborygmus, increased salivation, or pain relief occurring during or immediately after needling. In the west, because training has not been great and patients are litigious, an emphasis on safety and comfort has de-emphasized robust technique. This is why in the west acupuncture often resembles a facilitated nap with unobtrusive gentle needling. In China, the procedure is typically done much more aggressively and they expect to see results more quickly.Herbxue (talk) 15:30, 12 October 2016 (UTC)

Your point seems to be that although there is no good evidence that acupuncture works, there are a lot of excuses why there isn't. As an aside, it's the same with astrology, homeopathy and water witching - they don't have any evidence either but lots of excuses. That is a known pseudoscience pattern. --Hob Gadling (talk) 12:08, 26 October 2016 (UTC)

I think I found the Wikipedia Talk:MEDRS discussion I mentioned earlier: Systematic bias. I participated that discussion in collaboration with another editors, quoting sources dealing with the possible country-specific systematic bias, but the discussion couldn't come into any conclusion in regards of excluding sources by country. Correct me if I'm wrong? Cheers! Jayaguru-Shishya (talk) 16:59, 12 October 2016 (UTC)

Reality has a systemic bias against forms of treatment based on things that don't exist. Wikipedia's not going to fix that. We might fix the problem of assuming P=0.05 means something works. An excellent article by David Colquhoun: [7] Guy (Help!) 22:27, 12 October 2016 (UTC)

You're wrong - the consensus was clear (so the guidelines was not changed as was being pressed for). This is why we don't use dodgy Chinese research here. Feel free to check back at WT:MED if you're unclear. Alexbrn (talk) 11:46, 26 October 2016 (UTC)

The GERAC trials should be incorporated into this article ( https://en.wikipedia.org/wiki/German_acupuncture_trials ).

That is a good suggestion. It seems the author has locked this article. Kaplans123 (talk) 23:34, 14 November 2016 (UTC)

The piece is inaccurate and is written from a western biomedical point of view. It clearly has not been written by an acupuncturist or Chinese Medicine practitioner and should be deleted immediately and replaced with a piece written by a suitably qualified person. It disrespects the ancient history and traditions of Oriental Medicine. Over the past few days there has been a discussion on Facebook about how appalled acupuncturists are by this article and how Wikipedia has failed to acknowledge various requests to have this page deleted or modified. This is a serious plea to respect the practice and tradition of Oriental medicine of which acupuncture is a significant part. Thank you. — Preceding unsigned comment added by Lee-Anne Armitage (talk • contribs) 11:24, 13 December 2016 (UTC)

There is no such thing as a "western biomedical point of view". There is just biomedical science - as used by practitioners in the West, the East and ... everywhere. Assuming that people from a particular region need their unscientific views respected is patronizing and a kind of racism of low expectations. Wikipedia doesn't go in for that. See WP:MEDRS, WP:FRINGE etc. Alexbrn (talk) 12:29, 13 December 2016 (UTC)

I doubt that a source with a single citation can be taken to claim something is commonly described] 176.221.76.3 (talk) 19:56, 25 October 2016 (UTC)

can the statement be removed or some better sources requested on the page? 212.200.65.116 (talk) 23:21, 28 October 2016 (UTC)

See WP:RS/AC. Tgeorgescu (talk) 01:14, 29 October 2016 (UTC)

Awesome, see (Redacted). In 1983, the Southern Medical Journal advised its readers that a scientific basis might underlie the popular practice of ancient Chinese acupuncture. Recent studies have proven this to be correct. So I found a statement per WP:RS/AC that states the opposite. Please include this one as well. In fact, since this one is waaay more cited than current example in the lead, one can easily conclude that this is a common description, and not the current statement in the lead. Thank you for pointing out this WP:RS/AC to me. 212.200.65.108 (talk) 08:09, 29 October 2016 (UTC)

Why would a random website such as www.geocities.ws be used as a WP:RS let alone a WP:MEDRS? Johnuniq (talk) 08:30, 29 October 2016 (UTC)

The website is simply a host for an article published in SMJ in 1998. Not a top quality journal there, but the real problem is that the review is both outdated and heavily reliant on Chinese acupuncture studies. Someguy1221 (talk) 08:31, 29 October 2016 (UTC)

PMID 9853722 is a paper from the last century (I have redacted the likely copyright-violating link)? Not WP:RS/AC, not even WP:RS for health content. Alexbrn (talk) 08:33, 29 October 2016 (UTC)

Don't you see hypocrisy here. You all claim to be scientific, unbiased, evidence based, whatnot, and yet this is a fine reliable health resource while the other one is not?? You are just POV pushers like any other editor believing in what they would like to be the case, and not objectively accepting other information when presented. So much of your own adherence to WP:RS. You just prefer your source because it has a buzzword pseudoscience in it. There, people wrote about this phenomena... 212.200.65.108 (talk) 08:44, 29 October 2016 (UTC)

We subject sources on the side of pseudoscience and pseudomedicine, such as acupuncture, to a far higher degree of scrutiny than we do sources on the side of actual science and medicine. Some sources used in the article may not meet the strict criteria of MEDRS, but no one cares, because these do not say anything controversial - if we were to exclude them in exchange for actual MEDRS-compliant sources, the article content would not change significantly. But articles that find something promising in acupuncture and appear on their face to be MEDRS compliant, on the other hand, are basically universally found to have serious problems that invalidate their reliability. Someguy1221 (talk) 08:50, 29 October 2016 (UTC)

You use cherry picking for your sources. It obviously is controversial as I provided a better source for the opposite view. and pro-pseudo statements therefore need to be backed up by much better sources as well. Even worse, you use a very low quality source to 'prove' it is commonly perceived as pseudoscience, and then with that 'fact' you enforce more strict sources for backing up it is not pseudoscience!? How honest is that? 212.200.65.108 (talk) 09:04, 29 October 2016 (UTC)

To promote neutrality, an asymmetrical requirement for sourcing is baked into our encyclopedia's policy: WP:EXCEPTIONAL claims need exceptionally strong sources. Any claim that sticking needles in people has the claimed therapeutic benefits is exceptional; OTOH the claim that this woo is pseudoscience is pretty obvious, so any old source would do (as it happens though, we have good ones even for this commonplace). Without new sources on the table, we are done here. Alexbrn (talk) 09:42, 29 October 2016 (UTC)

You are just repeating already stated circular reasoning, so yes, you are done here until you learn a bit of logic, or provide some good source. Your claim for something being 'exceptional' relies on a crappy source. 212.200.65.108 (talk) 09:50, 29 October 2016 (UTC)

O it's not entirely circular: the enlightened basis of what we do is the real world: scientific plausibility, common sense & reason. Acupuncture boosters, Bigfoot spotters, 9/11 conspiracists, cultists etc. don't like this but it's their problem with reality which causes friction, not Wikipedia itself. If exceptionally strong sources appear, then we can follow them: until then, Wikipedia shall take a properly skeptical stance. Alexbrn (talk) 09:56, 29 October 2016 (UTC)

I like when editors here speak in third person, Wikipedia this, Wikipedia that, when in fact it is personal preferences being on work. It is also fun thing to observe that for such a common knowledge you claim exists, it is easier to argue here than find a single decent reference. You use bunch of buzzwords without really understanding their meaning. You being PhD in English I doubt have personal experience with this scientific stuff and can claim anything about it but can only rely on your personal beliefs, or 'authority sources', which btw, you have not been able to provide. Richard Feynman for example didn't hide behind authority of others but has personally explored and has seen for himself what works and what doesn't, all the unlikely pseudo-scientific areas because that is how scientific mind works, they explore and are open to discover, they are not like you hiding behind plausible authorities that they cannot even cite. 212.200.65.108 (talk) 10:08, 29 October 2016 (UTC)

We're citing two high-quality medical textbooks focusing directly on the topic of pseudoscience. Despite the fact we don't need such super-strength sources, we have them and we use them. We reflect what our sources say; OTOH the "personal" WP:PROFRINGE preference here is yours. Alexbrn (talk) 10:26, 29 October 2016 (UTC)

which ones? 212.200.65.108 (talk) 10:37, 29 October 2016 (UTC)

Refs 6 & 7 currently. Alexbrn (talk) 10:40, 29 October 2016 (UTC)

I see, those I objected to. O.k., I counted scholarly citations from all references in the article about pseudoscience (including your two high-quality medical textbooks and super-strength sources), and the single source I provided has more citations than all those combined! That speaks for itself. Now I see how much your claim that it is pseudoscience is controversial. So yes, POV pushing from your side. Your "super-strength" sources have 1 and 2 citations respectively. So you don't base your opinion even on the authority but on your personal belief. 212.200.65.108 (talk) 10:44, 29 October 2016 (UTC)

At least try stuff from the 21st century (and try to avoid amateurish assessments of MEDRS sources). Alexbrn (talk) 10:50, 29 October 2016 (UTC)

I should ask you to mentor me, to teach me how to perceive single citation as a super-strong source. 212.200.65.108 (talk) 10:57, 29 October 2016 (UTC)

Maybe Cochrane review you are all so fond of here: [8]. I doubt they deal with pseudoscience, or maybe they do? 212.200.65.108 (talk) 11:08, 29 October 2016 (UTC)

Оh, wait! Did I just devastate your world view about sticking needles in people having therapeutic benefits, a.k.a. not entirely pseudoscience! I am so sorry. 212.200.65.108 (talk) 11:11, 29 October 2016 (UTC)

No. -Roxy the dog™ bark 11:16, 29 October 2016 (UTC)

it is called dogma, when in spite of evidence you keep your eyes closed. very scientific! didn't expect anything else from POV pushers. 212.200.65.108 (talk) 11:19, 29 October 2016 (UTC)

WP:SOCKPUPPETRY? Carl Fredrik 💌 📧 11:21, 29 October 2016 (UTC)

Probably true believer activism. -Roxy the dog™ bark 11:24, 29 October 2016 (UTC)

I've never heard anyone outside Wikipedia say "POV-pusher". Sockpuppetry and true believerism go hand in hand as far as I've seen. Carl Fredrik 💌 📧 11:28, 29 October 2016 (UTC)

(edit conflict) P.S. Cochrane is a generally a good (not perfect) source — but you can't just throw it out there like that. You have to make a suggestion based upon it to have any chance of changing things. And it doesn't validate acupuncture at all, or contest the idea that it is just theatrical placebo. Placebo is a strong effect, but that doesn't mean we should lie and say that acupuncture does things it doesn't. If it works due to placebo then it doesn't really work does it? Carl Fredrik 💌 📧 11:28, 29 October 2016 (UTC)

Force is strong with you guys. No arguments, so lets start with sockpuppetry nonsense. 212.200.65.108 (talk) 11:27, 29 October 2016 (UTC)

It's not nonsense if it's demonstrably true. Carl Fredrik 💌 📧 11:30, 29 October 2016 (UTC)

I would assume Cochrane researchers know how to do their job, or maybe you can have a criticism of their findings published somewhere, but doing it here and speculating it is placebo when in fact don't mention that, would be WP:OR. So yes, I proposed on the very begining of this section better sources be found for this unlikely statement of accupuncture being pseudoscience, and since none of you provided it, I found a very good source claiming the opposite, so please remove the lead statement as it is not well sourced, and obviously false. 212.200.65.108 (talk) 11:32, 29 October 2016 (UTC)

What lede statement? What replacement? Make an edit request showing what you want changed. No, it isn't OR if its corroborated by other sources. If a Cochrane review makes no comment as to how or why something works, and other sources do, then we follow the sources that do. Carl Fredrik 💌 📧 11:35, 29 October 2016 (UTC)

It is OR. For example, here they mention placebo and no effect beyond it. Statement that it is 'commonly described as pseudoscience'. 212.200.65.108 (talk) 11:37, 29 October 2016 (UTC)

Haha page 32 of the Cochrane review, when explaining the conclusions: "acupuncture might be a particularly potent placebo". Either clearly propose something or stop wasting time and go away. Carl Fredrik 💌 📧 11:39, 29 October 2016 (UTC)

Thanks for that. I looked into the whole review. So they do state it might be placebo. Citation #90 from the article states the opposite though. So given there is so much contradictory info, lead statement does need better sourcing. 212.200.65.108 (talk) 12:17, 29 October 2016 (UTC)

Above was actually taken out of the context. One should read the whole conclusion before providing portion of a sentence. sci-hub.cc provides full text.147.91.1.44 (talk) 16:17, 4 November 2016 (UTC)

That is irrelevant, the benefit of a systematic review is that it includes all of the papers, which means that it weighs far heavier than any of the individual papers that it cites. Carl Fredrik 💌 📧 12:46, 29 October 2016 (UTC)

It is a meta-analysis. "Acupuncture for chronic pain: individual patient data meta-analysis"... "29 of 31 eligible trials, with a total of 17,922 patients analyzed..." 176.221.76.3 (talk) 17:52, 29 October 2016 (UTC)

If you wish to discuss the merits of a specific source please link or at least name it. Carl Fredrik 💌 📧 17:59, 29 October 2016 (UTC)

current citations 6 and 7. these sources are quite bad. 176.221.76.3 (talk) 18:14, 29 October 2016 (UTC)

I thought we were talking about sources that did not exist in the article? No, those sources are fine. Carl Fredrik 💌 📧 19:26, 29 October 2016 (UTC)

Of course they are. Single citation was always a proof of common acceptance. 212.200.65.104 (talk) 00:58, 30 October 2016 (UTC)

Specifically regarding the opening phrase: "Acupuncture is a form of pseudoscience" - there are several issues. One, the term 'pseudoscience' is by definition derrogatory and subjective so aside from the merits, the choice of term lacks neutrality and is controversial, which is to be avoided in Wiki articles. It represents one side of a controversial topic and actually represents the less popular side of the debate. There are fewer doctors, scientists and mainstream medical practitioners who believe acupuncture to be pseudoscience than those who don't. The references you use to support your viewpoint actually represent the fringe perspective. Whether or not you believe acupuncture to be pseudoscience yourself, if your aim is to provide neutral encyclopedic information, the current wording in the opening sentence is incompatable with this aim. A more neutral and appropriate possibility would be something to the effect of 'Acupuncture is a therapy that involves the insertion of small filiform needles into the body. Some scientists believe it fulfills the criteria of 'pseudoscience' whereas others do not" Ellaqmentry (talk) 18:05, 13 December 2016 (UTC)

"There are fewer doctors" - Even if that claim were right: Science is not done by majority vote, it is done by data and their publication in scientific journals. Gather all the Cochrane meta-analyses done about acupuncture and show that they agree that acupuncture is better than placebo, and you win. You can't because they all say the opposite, so you lose. Bye. --Hob Gadling (talk) 23:20, 13 December 2016 (UTC)

I agree that science should not be done by majority vote but by fair review of the evidence. However, the administrator and others have stated that the burden of evidence required to support claims is based on whether or not something is classified as an 'exceptional claim.' This determination is made by "majority vote" and what is considered accepted by mainstream medical perspective. That acupuncture is clinically effective is consistent with the prevailing mainstream medical view. It is recommended by the WHO, the NIH, the American Medican Association, UK's NICE, as well as national guidelines of Canada, Australia and New Zealand, which actually makes it more mainstream than many biomedical and surgical practices. Before we get to the copious clinical evidence that it is more efficacious than placebo and conventional care for many conditions (which I'm happy to provide), which is precisely why it is recommended by mainstream medical organisations, the editing practices of the page need to reflect the reality that acupuncture is accepted by mainstream medicine and administrators need to stop abusing their position by pretending that their own viewpoint, which is part of a small group of extreme self-styled Skeptics, is representative of a wider medical or scientific consensus; it is not.Ellaqmentry (talk) 13:57, 14 December 2016 (UTC)

"Before we get to the [..] evidence [..] the editing practices of the page need to reflect the reality that acupuncture is accepted by mainstream medicine"? OK, I am not holding my breath waiting for the "evidence". But what does "reflect the reality" mean? What exactly do you want the article to say, and do you have sources for it?

Acupuncture is clearly a magic practice and has neither a viable mechanism nor evidence on its side. Still, it is used by lots of folks who do not know how to tell valid methods from superstition. Those people clearly do not agree that acupuncture is pseudoscience, but the situation is exactly the same as with other pseudosciences: their proponents do not agree that they are pseudoscientists. We get that all the time, for instance from Intelligent Design proponents.

Since you complain about "self-styled Skeptics": could you please tell us where one can get oneself styled as a Skeptic to avoid the self-styling? This epithet is nothing but an ad-hominem attack: everybody who disagrees with you is defined as an "extreme self-styled Skeptic" and can be safely disregarded. Abracadabra! and nobody who needs to be taken seriously disagrees with you. Defining away opponents like this is a common tactic used by pseudoscientists; it is a form of the poisoning the well fallacy. --Hob Gadling (talk) 15:07, 14 December 2016 (UTC)

By "reflect the reality," I refer (again) to the mainstream view that acupuncture is an effective medical treatment - recommended by the guidelines of mainstream medical institutions around the world and studied at degree level at universities. One can get oneself styled as a Skeptic by participitating in groups with the word 'Skeptic' or 'Skepticism' in the title, which rather than promoting healthy scientific skepticism and inquiry or being consistent with the views of scientists and investigators actually performing or reviewing research, engage in circular logic to uphold their viewpoint at all costs, whilst pretending that they represent a mainstream scientific view. The perspective that acupuncture "is used by lots of folks who do not know how to tell valid methods from superstition" is an untennable perspective and is not based in reality. Over 30,000 MDs outside of China and South East Asia practice acupuncture as part of their medical practice. Multiple Cochrane reviews demonstrate that acupuncture is superior to sham and to conventional care (the majority of others are under-powered to detect such differences) and guideline development committees who employ rigorous methods to evaulate the evidence-base to decide where limited funds should be spent recommend acupuncture. It's literally you and a couple dozen people, some with MDs, some just arm-chair internet researchers, who say it's 'clearly magic', despite the copious basic science research-evidence to the contrary.

But my point isn't about which viewpoint is more consistent with the evidence - simply, that to state 'acupuncture is a pseudoscience' violates Wikipedia's neutrality guidelines as it incorrectly presents a viewpoint as fact when in reality the statement is contentious and disagreed with by the majoriy medical view. As you've asked what I would like the article to say, as stated previously, you could accurately say that there is a small but vocal group of people who believe acupuncture to be pseudoscience but a much larger group encompassing more of the mainstream, mainly comprised of researchers, policy makers, clinicians and MDs, who do not. Simply stating 'acupuncture is a pseudoscience' because that's what you believe and you've found a couple of cherry-picked references of some people who agree with your minority view, violates Wikipedia's guidelines on neutrality. That statement is highly contested and should be clearly expressed as one side of a debate. Ellaqmentry (talk) 20:59, 14 December 2016 (UTC)

You are becoming more and more repetitive and boring. Of course, your statements do not become true by repeating them. Acupuncture is not "mainstream", and you will not find a reliable source that says it is. You continue tooting in the same horn as every other pseudoscience proponent on WP, contradicting the rules laid down e.g. in WP:FRINGE. Nuff said. --Hob Gadling (talk) 21:28, 14 December 2016 (UTC)

• I have no comment on the merits of this discussion, but please stay away from accusations of sock puppetry. If you believe the IP(s) are socks, then take it to SPI. Otherwise, it's simply distracting and can be interpreted as a personal attack.--Bbb23 (talk) 18:18, 29 October 2016 (UTC)

I removed the statement that "acupuncture is a pseudoscience" from the lede. Two partisan, skeptic sources were used to support this assertion while there are thousands of studies showing some degree of efficacy of acupuncture. Pseudoscience isn't studied at the university level, nor is it supported or recognized by the NIH. As a side note, if you want to bring in editors who haven't edited here in a year, keep up edits like this. LesVegas (talk) 19:57, 14 December 2016 (UTC)

It's OK, I replaced the well sourced text, removed by an acupuncturist acupuncture apologist. Roxy the dog. bark 20:17, 14 December 2016 (UTC) Text modified - Previous text was wrong, I have since discovered. Roxy the dog. bark 12:42, 15 December 2016 (UTC)

Yes, the sourcing here is impeccable. The WP:BATTLEGROUND-like threat by LesVegas is a concern: all editors should remember this page is subject to discretionary sanctions. Alexbrn (talk) 21:06, 14 December 2016 (UTC)

Seasons greetings Alexbrn! I'm very sorry and did not in any way intend that to come off battlegroundishly. I want nothing more than for everyone to work together, logically and merrily, to achieve consensus. On that note, I would point out that RoxytheDog seems to have referred to me as an acupuncturist, which is absolutely untrue. Anywho, my point was that I don't really want to edit here anymore so I'm hoping we can achieve some reasonable consensus about the lede and, possibly, the rest of the article so that I don't have to. Would you mind commenting on my point about the NIH, other sources and meta-analyses which suggests can't write with such partisan language-and in Wikipedia's voice- no less? LesVegas (talk) 00:32, 15 December 2016 (UTC)

So before being defined as alternative medicine, a guy thinks it is more defining feature it being 'pseudoscience'. There is something called information theory, quite useful concept to apply here as well. Does one provide more information to the user by stating first or later? 185.62.108.2 (talk) 08:46, 11 November 2016 (UTC)

It seems like we might be in agreement that there is a possible bias in this author's article. Kaplans123 (talk) 23:40, 14 November 2016 (UTC)

Yeah, Wikipedia is unabashedly biased towards a scientific viewpoint. This is intentional. Carl Fredrik 💌 📧 14:03, 14 December 2016 (UTC)

Our lede says:

The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent.

Really? Isn't it rather that they're pretty much firmly decided that acupuncture is ineffective overall, with a possible exception in one area: pain relief? Alexbrn (talk) 17:07, 14 December 2016 (UTC)

I agree. This change would be an improvement, reflecting the body much better. Roxy the dog. bark 18:10, 14 December 2016 (UTC)

The systematic reviews are all extremely consistent in stating that high quality studies show acupuncture to be ineffective for all purposes, in that it is no better than placebo. Different systematic reviews have come to different ultimate conclusions based on their handling of the low quality studies. Someguy1221 (talk) 19:25, 14 December 2016 (UTC)

This is true. I think it is fair to say by now that there is no robust evidence that acupuncture works for anything, and any area where the balance of P=0.05 is still positive, is an artifact. Guy (Help!) 20:24, 14 December 2016 (UTC)

This 'debate' about what the published evidence about acupuncture shows overall would be seriously aided by referring to some actual research. What systematic and unbiased approach are you taking to ascertain the body of evidence on acupuncture for various conditions?

Also, it is incompatible to acknowledge the evidence that demonstrates that acupuncture is both effective and efficacious (not a placebo) in the treatment of pain and to say that it is a pseudoscience. As the evidence of effectiveness comes from peer-reviewed clinical research and systematic reviews and the designation of pseudoscience comes from opinion, the latter should be removed from the wiki article or acknowledged as opinion. Ellaqmentry (talk) 22:19, 14 December 2016 (UTC)

That argument didn't work for homeopathy, did it? Tgeorgescu (talk) 23:04, 14 December 2016 (UTC)

E.g. there is a Nobel prizewinner who claims he is able to transfer homeopathic medicines through telephone wire. Tgeorgescu (talk) 01:22, 15 December 2016 (UTC)

Tgeorgescu, the anecdote you're sharing has zero relevance to the current discussion. The evidence for acupuncture's effectiveness and efficacy for pain comes from myriad systematic reviews, is recommended in many guidelines, and the mechanism is understood.68.14.89.3 (talk) 01:43, 15 December 2016 (UTC)

Mechanism? Do you mean magical thinking? Tgeorgescu (talk) 01:44, 15 December 2016 (UTC)

Hi IP. The truly fantastic thing about those myriad systematic reviews is that even the ones with a relatively positive assessment of the practice admit that effectiveness tends toward zero as the size and quality of a study increases, and then the authors use "more research is needed" as an escape hatch. And don't mistake the thousands of studies on the mechanism of acupuncture for actual evidence of a mechanism - you have to prove a thing exists before you can prove how it works. Someguy1221 (talk) 01:50, 15 December 2016 (UTC)

Someguy1221, which reviews are you referring to? Please provide references illustrating trend that larger studies of acupuncture show smaller effect than smaller studies. "you have to prove a thing exists before you can prove how it works." That's the opposite of established medical research methods, which uses something called the 'bench to bedside' model of translational medicine (mechanism research -> clinical research).Ellaqmentry (talk) 14:15, 15 December 2016 (UTC)

I've never seen a review that doesn't show this. So just pick any of them. Sometimes the authors don't admit it, even when it's plain as day in their own data. And I don't know what you're getting on about with regard to research. You can't study "How does X accomplish Y" before you've proven that Y even happens, and then claim this somehow proves that Y happens. At best you're just wasting your time. Critics call this "tooth fairy science". Someguy1221 (talk) 10:26, 19 December 2016 (UTC)

Someguy1221, statements about what the evidence does or does not show require sources to support them. If you've "never seen a review that doesn't show this" then providing a reference should be easy. As regards to research, you seem to be repeating verbatim the circular logic and fallacious reasoning over at Science-based medicine. The first thing to note is that in pharmaceutical research, as referenced above, studies show how something might work first (basic science) and then do trials to find out if it works in actual people. So what Harriet Hall calls "tooth fairy science" is indeed how the majority of evidence for all mainstream healthcare is accumulated.

Second, the arguments against acupuncture start with an argument based on 'biological plausibility.' Biological plausibility is an argument about how something may or may not work and about known mechanisms. It confounds an explanatory model (qi) with clinical efficacy, something you only do if you're trying to argue against something regardless of what the clinical research shows. Thus, to say that you can't start by looking at mechanisms is to say that you can't argue against an intervention by starting with biological plausibility, which I would agree with, but which is precisely what these small groups of vocal anti-acupuncture people do. In this case, there are many well-studied mechanisms for how the insertion of filiform needles triggers a biological response in the body to bring about disease resolution (which I've referenced elsewhere on this page). The flip side of the circular illogic is that when robust evidence demonstrates that acupuncture is more effective or efficacious than the control (i.e. Cochrane reviews that show that it works for migraines, etc), "Skeptics" say that the reason for why it works is that it works via a placebo response (a hypothesis, that has zero support when using studies that use an active control, such as sham acupuncture).

On this very page, we have strong MEDRS evidence that acupuncture does work and we also have MEDRS showing how it works. And while this discussion is interesting and relevant for improving other areas of the acupuncture page, none of this is relevant to the question about what scientific consensus holds about acupuncture. The myriad medical guidelines recommending acupuncture provide strong MEDRS evidence that important swathes of the medical community agree that acupuncture is an effective treatment that belongs in mainstream medicine. Thus, the wording in the opening paragraph, is in violation of WPs NPOV policy.Ellaqmentry (talk) 16:57, 19 December 2016 (UTC)

"On this very page, we have strong MEDRS evidence that acupuncture does work and we also have MEDRS showing how it works." Hahahaha. Roxy the dog. bark 17:05, 19 December 2016 (UTC)

I notice this document from the National Institute for Health and Care Excellence has now been published[9]. As a practice guideline it is our one of our highest-quality types of WP:MEDRS, and the guidance is explicit:

1.2.8 Do not offer acupuncture for managing low back pain with or without sciatica.

How shall this be incorporated? E.g. Shall all the other back pain stuff be swept away to make room for this up-to-date knowledge? Alexbrn (talk) 21:25, 14 December 2016 (UTC)

Good find. Practice guidelines are indeed one of our highest-quality types of WP:MEDRS. If you include the 2016 NICE Guideline on Low Back Pain, you obviously need to include all of the other low back pain and clinical guidelines that mention acupuncture. Acupuncture is recommended in the following clinical guidelines for the treatment of low back pain:

- The US Agency for Health Research and Quality

- Joint guidelines of The American College of Physicians and the American Pain Society

- American college of occupational and environmental medicine's occupational medicine practice guidelines

- The National Institute of Neurological Disorders and Stroke at The National Institutes of Health

- The State of Colorado Division of Workers’ Compensation Medical Treatment Guidelines for Low Back Pain

- The Institute for Health Economics Evidence-Informed Primary Care Management of Low Back Pain Alberta, Canada

- Scotland’s National Clinical Guideline for the Management of chronic pain

- The National Collaborating Centre for Primary Care with the Royal College of General Practitioners in the UK

- The Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine

- The World Health Organisation

You should also mention the NICE Guidelines for Migraine and Headache, which recommend a course of acupuncture. Ellaqmentry (talk) 22:04, 14 December 2016 (UTC)

Is wikipedia a reliable source for wikipedia articles? Roxy the dog. bark 22:20, 14 December 2016 (UTC)

Not if the administration of the current acupuncture page is anything to go by . . . Ellaqmentry (talk) 22:22, 14 December 2016 (UTC)

Well, actually, it was a rhetorical question. But may I ask are you actually a new editor, or have you had a name change. Another commenter seems to suggest you are not new? Roxy the dog. bark 22:25, 14 December 2016 (UTC)

His/her 3rd edit was adding {{this is a new user}} on his/her user page. Obviously new users don't know about such template. Tgeorgescu (talk) 22:27, 14 December 2016 (UTC)

Yes, I'm a new editor.Ellaqmentry (talk) 14:18, 15 December 2016 (UTC)

So, you are denying being A1candidate/RoseL2P. Odd, because you sound exactly like him/her. Tgeorgescu (talk) 01:05, 16 December 2016 (UTC)

Tgeorgescu, I'm not sure what to tell you. The first time I ever edited anything on Wikipedia in my entire life was a couple of days ago under my current name (except for one or two edits where I didn't realise I wasn't logged in so it used an IP address). If I sound like other knowledgable and articulate researchers, then so much the better. Ellaqmentry (talk) 13:47, 16 December 2016 (UTC)

With all due respect Ella, you dont appear at all like a knowledgeable and articulate researcher. Roxy the dog. bark 14:17, 16 December 2016 (UTC)

Roxy, I'm in a discussion with people who are referring to medical researchers at Harvard and Stanford as 'pathological believers.' I'll take that as a compliment.Ellaqmentry (talk) 14:34, 16 December 2016 (UTC)

Really, could you point me at that discussion, I'd like to read it. Roxy the dog. bark 14:48, 16 December 2016 (UTC)

Roxy, when I answer questions that folks ask that have already been answered on the page, I get accused of being "repetitive and boring" so perhaps you should use your looking skills to find the discussion. Especially as I'm pretty sure the discussion on this page is intended to be focused on improving the Acupuncture article and not on little old me. You're possibly getting off topic.Ellaqmentry (talk) 15:15, 16 December 2016 (UTC)

• • Dear All: Please deal with the discussions on the article and back off the personal comments. This is not the page for accusations. And its a common practice to sidestep discussion with personal attacks. I would hope editors here have enough experience to remember that and enough faith in their own points and perspectives to stay on track.(Littleolive oil (talk) 15:09, 16 December 2016 (UTC))

I have placed a tag on the lede because of a statement "acupuncture is pseudoscience". We cannot use Wikipedia's voice to definitively declare that acupuncture is a pseudoscience based on two controversial skeptical centered sources, especially when there are countless others that contradict this statement.

I am tempted to place a POV tag on the entire article, but in the spirit of good will and good faith, let's just start here with this. LesVegas (talk) 23:50, 14 December 2016 (UTC)

"Is acupuncture pseudoscience" is a question that has been asked at least once in 25 of the 30 archives of this talk page. This is a very old debate, and seems to have consistently come out with a consensus of "yes". Someguy1221 (talk) 00:11, 15 December 2016 (UTC)

Greetings, Someguy. I have never seen this consensus, but I have also been away for some time. Would you mind showing me where this consensus was achieved? LesVegas (talk) 00:25, 15 December 2016 (UTC)

You can do that yourself by searching for "pseudoscience" in the archive search menu on this page. No attempt to remove pseudoscience as a statement or a category has ever succeeded, though the wording and precise category has jostled around over the years. Let me ask you something else: What would it take to convince you that "pseudoscience" is an NPOV way to describe acupuncture? Someguy1221 (talk) 01:51, 15 December 2016 (UTC)

LesVegas (see diff for background) has POV tagged Acupuncture on these occasions:

1. 19:51, 4 September 2014
2. 22:21, 4 September 2014
3. 01:00, 6 September 2014
4. 20:07, 3 May 2015
5. 22:16, 4 August 2015
6. 01:10, 10 August 2015
7. 17:44, 11 August 2015
8. 17:26, 20 August 2015
9. 05:38, 22 August 2015
10. 06:51, 22 August 2015
11. 17:07, 22 August 2015
12. 23:47, 14 December 2016

Acupuncture is presented as a procedure that remedies various ailments. That is, it makes claims about how the world works, namely that needles inserted following certain patterns will benefit the body. Per WP:REDFLAG, such claims, with no scientic mechanism or repeatable validation are the definition of pseudoscience. The sources presented are entirely adequate for verification. I do not think the article or the lead should over-egg the pudding and there is no need to emphasize that acupuncture is a pseudoscience. I haven't formed a final opinion on the recent edits but the current version (23:50, 14 December 2016) looks good. However, the tag has to go unless someone can quickly produce policy-based evidence that there is a POV problem. Johnuniq (talk) 03:21, 15 December 2016 (UTC)

LesVegas, by using the phrase "skeptical centered sources", you have provided a perfect reason for me to tout Wikipedia:Skeptical point of view (WP:SKEPTICPOV). I think it addresses one of the root issues here. Manul ~ talk 03:53, 15 December 2016 (UTC)

So frequent POV tags precisely show there is no consensus on the topic! 159.148.153.97 (talk) 11:55, 15 December 2016 (UTC)

One person constantly adding the tag is not evidence of a lack of overall consensus.--72.0.200.133 (talk) 15:43, 16 December 2016 (UTC)

Johnuniq: "Per WP:REDFLAG, such claims, with no scientic mechanism or repeatable validation are the definition of pseudoscience." Acupuncture has multiple documented and repeatedable mechanisms of action and has repeatedable validation. Here are some of the well-documented mechanisms, which have been published in both primary and secondary peer-reviewed sources and have been repeated by various investigators:

Adenosine and Purinergic Signalling

Multiple studies demonstrate that acupuncture exerts both local and central affects through adenosine signalling. A 2012 study using adenosine A-1 receptor knock-mice as controls, showed that adenosine was necessary for mediating acupuncture's clinical anti-inflammatory effects. These results have been verified in human studies.^[1][2][3]

Heart Rate Variability

HRV is a measure of autonomic balance and a reliable indicator of all-cause mortality in most populations. Acupuncture has been demonstrated to improve HRV and autonomic signalling.^[4][5]

Local fibroblast mediated response in connective tissue

Many studies demonstrate that when acupuncture needles are inserted into connective tissue, they initiate chemical signalling through mechano-transduction of fibroblasts leading to long-term tissue remodeling and distal effects.^[6][7][8][9]

This last body of research (there are many more studies) is important. Your hypothesis, that when you insert filiform needles into the body, that nothing happens and the body has zero response to this stimulus, is completely unsupported by primary or secondary sources and is biologically implausible. On the other hand, that inserting filiform acupuncture needles stimulates a cascade of cellular signalling is well-documented.

Ellaqmentry (talk) 12:19, 15 December 2016 (UTC)

Most of these dodgy areas have studies trying to validate them (cf homeopathy and osteopathy). As far as pseudoscience goes, we have two excellent sources that address the categorisation and are explicit. Acupuncture is pseudoscience. Wikipedia reflects such sources, and the POV tag is - once again - disruptive. Alexbrn (talk) 12:32, 15 December 2016 (UTC)

You do not have two sources demonstrating that acupuncture is pseudoscience, only that some people are of that opinion. The sources in question ignore the vast majority of peer-reviewed published research on the subject and cannot be considered to be evidence-based. As acknowledged earlier, clinical guidelines are much stronger evidence - the case that acupuncture is a valid intervention has much stronger support than your personal opinion that it's pseudoscience. The statement that 'acupuncture is pseudoscience' lacks neutrality.Ellaqmentry (talk) 14:37, 15 December 2016 (UTC)

Incorrect. Both sources, which are strong WP:MEDRS assert that acupuncture is pseudoscience. We follow such sources, not the musings of random WP:SPA wikipedia editors. Alexbrn (talk) 14:42, 15 December 2016 (UTC)

But is it fair to use western opinions like WP:MEDRS to judge an eastern practise? The practise is more than a 1000 years old, a fad or pseudoscience will not last that long. The same with folklore knowledge of herbs and weather (example: Ice Saints). Strange enough proven to be useful in history, but unproven by modern science. The Banner talk 17:38, 19 December 2016 (UTC)

1) I don't think 'fairness' should enter into any discussion really. We don't do fair and balanced. 2) the length of time that something has been around is irrelevant as far as it being pseudoscience, see astrology for instance. Dbrodbeck (talk) 18:55, 19 December 2016 (UTC)

Sorry to issue you such a blatant correction, Dbrodbeck, but the correct answer was "Yes." (Those 'Western opinions' are formed from systemic, methodical experimentation, which doesn't much care which hemisphere you're from.) MjolnirPants Tell me all about it. 20:18, 19 December 2016 (UTC)

Alexbrn, to ensure requisite transparency and to demonstrate that your two sources in support of your opinion that acupuncture is pseudoscience are not cherry-picked for the sole purpose of using Wikipedia to present your personal opinion as fact, please share your search strategy (search terms, parameters, and databases) for identifying sources. Also, you have shared that you consider these sources to be 'strong' - please share rubric for evaluating the strength of evidentiary sources. Ellaqmentry (talk) 14:54, 15 December 2016 (UTC)

Check out WP:MEDRS for our guidance on sources for biomedical information, though WP:RS and WP:FRINGE are also pertinent here. Whatever way you look at it, reliably-published medical books which specifically consider the non-scientific are the best possible sources available. To find sources on the question of acupuncture and its relation to pseudoscience, try searching collections with the search terms "acupuncture" and "pseudoscience" maybe? All you are doing is producing fallacious arguments and hand-waving. Stick to following sources and all shall be well. Alexbrn (talk) 15:01, 15 December 2016 (UTC)

"try searching collections with the search terms "acupuncture" and "pseudoscience" maybe?" No, Alexbrn, I'm not asking how to formulate and conduct a valid search. I have two Masters degrees and have ample experience preforming medical literature reviews. I was asking how you performed your search, which obviously misses the vast majority of the relevant literature on the subject. It seems clear that you have no formal training in conducting medical reviews or critical review of literature and it is really dangerous, not to mention against Wikipedia's guidelines, for you to use your own opinion as a filter for what Wikipedia-valid content is published in this article.

"Whatever way you look at it, reliably-published medical books which specifically consider the non-scientific are the best possible sources available." No, according WP:MEDRS "Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies." The two textbooks that you cherry-picked provide support for your opinion. The list of medical guidelines and the myriad systematic reviews of acupuncture demonstrating efficacy and effectiveness provide support for the view that acupuncture is a valid medical procedure. Please change lede wording to reflect that the statement 'Acupuncture is pseudoscience' is an opinion, is contraversial and is contradicted by the dozens of specifically referenced high quality MEDRS sources.Ellaqmentry (talk) 15:44, 15 December 2016 (UTC)

More hand-waving and fallacy. We have two top-rate sources that are bang on topic, and they are explicit in what they say. No amount of trying to question how they came to be, to personalize the matter, or to big up your own credentials is remotely relevant to the formation of consensus here, which is based exclusively on the WP:PAG. Wikipedia reflects what the best sources say; they say acupuncture is pseudoscience, so Wikipedia shall too. It's really very simple. The only thing that might give pause is an equally strong source which explicitly considered the pseudoscience categorisation and rejects it. Alexbrn (talk) 15:52, 15 December 2016 (UTC)

Alexbrn, this conversation continues because you are violating WP:PAG. That the only sources that provide evidence about whether or not acupuncture is pseudoscience are documents that actually use the word 'pseudoscience' is entirely incorrect. I'll provide a simple example. If someone accused Johnny of being an absolute freakin' moron and put their thoughts in writing using that phraseaology, we would not have to rely solely on published opinions that used that phraseology to support the opposing view. Multiple lines of evidence, such as his academic record and trusted testimonials and photos of him doing clever things could be used wihtout any appearance of that verbiage.

Equally, WP:PAG on WP:MEDRS have stipulated that systematic reviews and guidelines or position statements from expert bodies constitute reliable evidence for medical procedures. Obviously, this means that their endorsement indicates that acupuncture is not pseudoscience, even if the word 'pseudoscience' fails to appear in the title or transcript. Indeed, the sources that I provided are peer-reviewed whereas the two you have provided are not so according to Wikipedia and the international scientific community, the sources that I have provided are of higher quality than yours. Also, please revisit Wikipedia's policy on Neutral point of view, which states: "All encyclopedic content on Wikipedia must be written from a neutral point of view (NPOV), which means representing fairly, proportionately, and, as far as possible, without editorial bias, all of the significant views that have been published by reliable sources on a topic." The sources I have provided are reliable (more reliable than yours, by objective criteria) and must be represented.Ellaqmentry (talk) 16:31, 15 December 2016 (UTC)

The conclusion "their endorsement indicates that acupuncture is not pseudoscience" is WP:OR. --Hob Gadling (talk) 16:42, 15 December 2016 (UTC)

@Ellaqmentry: Text here must be directly supported by sources. That is a core policy. Trying to draw inferences from other sources is not allowed, especially if that runs against the grain of the good sources which are relevant. Strictly, the question of whether acupuncture is a pseudoscience is not WP:Biomedical information but something more in the realm of philosophy of science, so WP:MEDRS is not required. But as it happens the sources we have are good medical sources too: we have, if you like, over-strength sources. This is not a problem :-). As you have already been told by another editor, NPOV means we represent accurately what relevant, quality sources say. The lede is currently fine as we have good sources on the intersection of acupuncture and pseudoscience, and we represent them accurately. Alexbrn (talk) 16:47, 15 December 2016 (UTC)

@Alexbrn: In Wikipedia's taxonomy, Acupuncture is listed under Biology and Health Sciences. Your opinion that it falls under the realm of philosophy is invalid; there are no philosphy subjects in this section. You also stated on 14 December: "As a practice guideline it is our one of our highest-quality types of WP:MEDRS, and the guidance is explicit . . . How shall this be incorporated?" Your more recent statement that WP:MEDRS is not required directly contradicting your perspective from 48 hours earlier, suggests that you're confused, unstable or both. Or that you would like to publish negative guidelines of acupuncture and ignore positive ones. Acupuncture is a medical treatment with a large body of MEDRS supporting its use, its efficacy and its biological mechansisms of action. The existance of this body of support directly refutes the opinion that it is a pseudoscience.Ellaqmentry (talk) 18:08, 15 December 2016 (UTC)

I never said acupuncture was a type of philosophy, I said rather "the question of whether acupuncture is a pseudoscience is not" was "more in the realm of philosophy of science". Likewise, I never said WP:MEDRS was "required" for these statements but that you should check it out "for our guidance on sources for biomedical information". Misrepresenting earlier discussion and attempting to personalize this matter is disruptive and likely to get you sanctioned. For further thoughts on sourcing maybe see our List of topics characterized as pseudoscience article. Alexbrn (talk) 18:17, 15 December 2016 (UTC)

The subject of the article is a medical intervention. In which case the expression of a purely philosphical opinion has no place in the introduction as, in addition to representing only one side of a controversial issue, it lacks relevance and appropriateness. Wikipedia gives a precise definition of pseudoscience: "Pseudoscience is a term used to describe a claim, belief, or practice presented as scientific, but which does not adhere to the scientific method." The scientific method is defined as "a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge.[2] To be termed scientific, a method of inquiry is commonly based on empirical or measurable evidence subject to specific principles of reasoning."

Thus, MEDRS are required to determine whether or not acupuncture has been subjected to rigorous investigation according to the scientific method. According to the high quality, peer-reviewed (super duper-over strength) MEDRS, acupuncture has been repeatedly tested via the scientific method and has been determined to be efficacious. MEDRS are necessary to answer the philosophical question of whether or not an intervention can be classified as pseudoscience as it is precisely these sources that provide evidence that an intervention does or does not meet the criteria. These references define what can be considered pseudoscience. Interventions that are recommended in guidelines and have demonstrated efficacy in Cochrane reviews are, by definition, not pseudoscience.

"But as it happens the sources we have are good medical sources too: we have, if you like, over-strength sources." This sentiment, from a person who has indicated zero knowledge of formal critial review methodology, would be amusing if it weren't actually trying to influence the public's perception of medical evidence. One of these sources is from a textbook that bills itself as: "An Introduction for Non-Science Majors" (is that how you came across it?) and is entirely devoid of referencing for its claims and lacks peer-review. The idea that this is an 'over-strength' scientific source is even embarrasing to self-respecting Skeptics. Incidentally, it begins its chapter on pseudoscience thusly:

"The strength of the scientific approach relies on the continued scrutiny of data and interpretations of those data and in the peer-review approach to reviewing manuscripts and resaerch. Above all, however, it is the acceptance of the idea that our current understanding of things may be wrong, and if new knowledge is acquired, theories are amended. There is no system of beliefs that is able to make such a claim and that is where science and religion diverge." p38 ^[1] Ellaqmentry (talk) 19:12, 15 December 2016 (UTC)

Big wall of text there, sadly nothing based on the WP:PAGs, and quite a bit which is disruptive and nasty. Good sources say something, we reflect it. Simple. Alexbrn (talk) 19:18, 15 December 2016 (UTC)

Alexbrn, you say that acupuncture is pseudoscience, but as opposed to what? If a medical intervention is not pseudoscience, then how is it classified?Ellaqmentry (talk) 19:27, 15 December 2016 (UTC)

I am saying nothing, other than that we follow the WP:PAGs and reflect our expert sources. Your question has no relevance in the context of WP:TPG. This conversation is now concluded, in the absence of new pertinent sources. Alexbrn (talk) 19:31, 15 December 2016 (UTC)

Typically, a medical intervention is classified as pseudoscience as opposed to something that is evidence-based, has been subjected to the scientific method, has demonstrated efficacy and is recommended in medical guideliens. Thus, MEDRS that demonstrate acupuncture does these things is relevant to the subject and need to be included. You are not following WP:PAG because you are excluding relevant sources because they contradict your personal opinion. As articulated elsewhere, a resource does not need to use the term 'pseudoscience' to be relevant to the discussion, especially when it supports the opposite perspective.Ellaqmentry (talk) 19:38, 15 December 2016 (UTC)

Doesn't the hatted list of 'sources' demonstrate a pain response, and nothing more? Roxy the dog. bark 12:37, 15 December 2016 (UTC)

First of all, if the references demonstrated a pain response, then that would be sufficient to evidence that acupuncture is a legitimate medical intervention with a known biological mechanism, particularly when taken with systematic reviews showing superiority to sham and usual care and the myriad clinical guidelines recommending acupuncture for pain. However, the mechanisms evidenced above go beyond a pain response. If you'd like to learn more about biochemistry, I'd be happy to provide you with sources for further reading.Ellaqmentry (talk) 14:37, 15 December 2016 (UTC)

Ellaqmentry, you are right that "The statement that 'acupuncture is pseudoscience' lacks neutrality", but that's a good thing because Wikipedia is not neutral. That link will explain what "neutral" means in Wikipedia jargon (yes, it's weird that it is different from the usual meaning of "neutral"). A couple policies to focus on here are WP:REDFLAG and WP:BESTSOURCES. We have to assess the weight of the scientific literature as a whole. Manul ~ talk 15:33, 15 December 2016 (UTC)

Manul As outlined above (please read previous comments and references), the statement 'Acupuncture is a pseudoscience' is the minority view and contradicts the dominant scientific view. I have already supported this statement with reference to the number of mainstream medical institutions and clinical guidelines that recommend acupuncture. Acupuncture is taughts at Masters degree level globally. That inserting filiform needles stimulates a biochemical cascade that leads to clinical resolution is not an exceptional claim, it is an extremely well-studied phenomenon and better understood than the analgesis mechanism of paracetomol. The article lacks neutrality because it mis-represents the personal opinions of the administrators as the dominant opinion and censors high quality MEDRS that happens to disagree with the opinion of the administrators.Ellaqmentry (talk) 15:52, 15 December 2016 (UTC)

This "majority view" stuff is baloney. The sources we have which consider the pseudoscience question place acupuncture in that category. Show me sources that consider the question which don't. Lots of nonsenses are studied at Masters level and beyond: homeopathy, ayurveda, cranial therapy ... these novel arguments are irrelevant in any case since we follow the sources. Alexbrn (talk) 15:56, 15 December 2016 (UTC)

1. Question: Is it standard practice to assign ICD9/ICD10 codes to obvious pseudoscience?
2. Question: Is it routine practice for the NIH to fund studies, and offer consensus statements for obvious pseudoscience?
3. Question: Is it the norm for Cochrane Reviews to state efficacy and make recommendations based on that efficacy, for obvious pseudoscience?
4. Question: Is it routine practice for hundreds to thousands of studies and reviews to be published year after year, studying obvious pseudoscience's affect on certain conditions?
5. Question: Is it routine practice to take the word of a couple of books as the WORD OF GOD, while ignoring Cochrane, the WHO, NIH, and others?LesVegas (talk) 16:11, 15 December 2016 (UTC)

Which is all beside the point: the principles that apply here are the WP:PAGs, not "LesVegas' special criteria" (which are not helpful, and would end up whitewashing all kinds of woo if used). Luckily we have excellent sources which directly consider acupuncture's relationship to pseudoscience. They tell us it is pseudoscience - Wikipedia accordingly follows because that is the way this place works. Alexbrn (talk) 16:27, 15 December 2016 (UTC)

Sure, I agree that we should honor our policies and guidelines. WP:Impartial WP:YESPOV and WP:Balance are the ones "my special criteria" illustrates, so why don't we focus on those? LesVegas (talk) 17:11, 15 December 2016 (UTC)

Of course, and WP:PSCI especially applies to pseudosciences, why is why the text is prominent in the lede. We have good text, good sources, and good alignment with policy. Since no policy-based rationale has been presented against the current lede, the tag shall now be removed. We're done. Alexbrn (talk) 17:37, 15 December 2016 (UTC)

"would end up whitewashing all kinds of woo if used" Alexbrn - wow, all kinds of woo! That sounds like a lot. Name one treatment besides acupuncture that according to your (non-medical, non-evidencebased) is woo and meets all of those criteria. Also, could you please educate us as to what criteria a treament would need to meet in order to not be considered pseudoscience? 68.14.89.3 (talk) 17:42, 15 December 2016 (UTC)

Might be something for an internet forum, but not here. Suffice it to say we have parallel arguments over at Homeopathy, Chiropractic etc. Besides, my personal opinion counts for nothing: what matters is what our good sources say on the pseudoscience question. Here, they're nice and clear. Alexbrn (talk) 18:01, 15 December 2016 (UTC)

I would like to note that the policies and examples I have outlined were completely ignored by Alexbrn. Just because a couple of sources declare it pseudoscience, doesn't mean the entire scientific community has declared it pseudoscience. Fringe doesn't supersede the rest of NPOV policies. The tag will have to stay until the lede is rewritten in accordance with neutral tone that takes into account multiple viewpoints of the scientific community (like Cochrane, the NIH, WHO, etc) and, if editors prefer ignoring these points then the tag will just have to stay on, per our policies on tag removal. Every time articles like this are tagged, controlling editors jump to remove it. Tags are an opportunity for other third party editors to take a gander at the article. The Skeptic Opinion has now been duly noted; let's see what the rest of the community thinks about this. LesVegas (talk) 18:19, 15 December 2016 (UTC)

On the contrary, articles on fringe topics have a constant trouble with problematic editors trying to use tags to hold them to ransom. On pseudoscience, all the sources we have agree, and nobody has produced any RS in opposition. Basically the tag is a form of protest against reality as reflected in the RS we use, and its deployment without policy-based reasoning disruptive. Alexbrn (talk) 18:50, 15 December 2016 (UTC)

I just found that Wikipedia has a very clear definition of pseudoscience, which is as follows:

"With regard to characterizing topics as pseudoscience, the Wikipedia Arbitration Committee ruled as follows (at Wikipedia:Requests_for_arbitration/Pseudoscience): - Obvious pseudoscience: Theories which, while purporting to be scientific, are obviously bogus, such as Time Cube, may be so labeled and categorized as such without more justification. - Generally considered pseudoscience: Theories which have a following, such as astrology, but which are generally considered pseudoscience by the scientific community may properly contain that information and may be categorized as pseudoscience. - Questionable science: Theories which have a substantial following, such as psychoanalysis, but which some critics allege to be pseudoscience, may contain information to that effect, but generally should not be so characterized. - Alternative theoretical formulations: Alternative theoretical formulations which have a following within the scientific community are not pseudoscience, but part of the scientific process."

Thus, the classification is based on establishing majority and minority scientific views. Your two references support the contention that there are people who believe acupuncture to be pseudoscience. But they do not support the view that it is pseudoscience. On the contrary, references previously provided support the contention that significant swathes of the mainstream scientific community believe acupuncture to be an effective intervention, as evidenced by recommending it as a treatment in their guidelines, and disagree with the viewpoint that it is pseudoscience. According to Wikipedia's policies, the statement "Acupuncture is pseudoscience" needs to be ammended or removed as it violates NPOV and the categorisation needs to be removed.Ellaqmentry (talk) 21:12, 15 December 2016 (UTC)

An interesting 2013 article from The Guardian covering the topic [10] discusses the ongoing disagreement amongst the medical community and quotes the UK's NHS as saying: "The NHS Choices website says there is "reasonably good evidence" that acupuncture is effective at treating a range of conditions, including back pain, dental pain, headache, nausea after operations and osteoarthritis of the knee." I'm not suggesting the addition of this article as a source to argue for/against acupuncture being pseudoscience, but there does still seem to be controversy about it within the medical community (in short, not everyone agrees and it's not clear that an overwhelming majority agrees) though it's certainly a prominently held view. On a side note, I found it interesting that a PubMed search of "acupuncture pseudoscience" only got one hit (which is really neither here nor there but I thought it was interesting nonetheless). TylerDurden8823 (talk) 21:16, 15 December 2016 (UTC)

And from 2016: NICE no longer recommends acupuncture. The main issue here is that treatments like acupuncture and homeopathy were grandfathered in at the advent of evidence-based medicine, and going back and removing a treatment where there is substantial emotional and financial investment by practitioners is always hard work. You can never definitively prove that unicorns don't exist, only that no evidence has yet been provided for their existence. The use of the trials to try to prove efficacy - without ever actually testing the underlying premise - further complicates it. The truth is that every observation in acupuncture is fully consistent with bias, but there is a world of difference between this and what the acupuncturists demand before it is withdrawn, which is categorical proof that it is bias. One might, in uncharitably inclined, speculate as to whether this is a deliberate ploy, given that proof of a negative is known to be even more difficult than finding a blocked qi meridian at autopsy. Guy (Help!) 13:47, 19 December 2016 (UTC)

Things have moved on since. What we know at this point:

1. It doesn't matter where you put the needles.
2. It doesn't matter if you put the needles in or not.
3. The usual claimed mechanism - manipulation of qi in meridians - is bullshit as neither of those things exist.
4. There is no plausible mechanism (pace the attempts to co-opt purinergic signalling, basically the equivalent of Chopra saying "quantum!").
5. For most conditions the evidence shows acupuncture doesn't work.
6. For the small number of conditions where there is currently net positive evidence,
   1. Measures are always subjective;
   2. Outcomes are always consistent with the null hypothesis;
   3. No reason is advanced why it might work for these and not similar conditions for which there is net negative evidence;
   4. Effect size is always small.
7. Many studies come out of China and these are never negative (https://www.ncbi.nlm.nih.gov/pubmed/9551280).
8. Popularity of acupuncture owes a great deal to a propaganda coup played on Nixon's party during their visit to Maoist China. Much of "traditional" Chinese medicine is in fact a creation of Mao.

P=0.05 means a 20% false positive rate is expected. Guess what? About one in twenty frequently investigated conditions has a small net positive evidence base.

At this point everyone other than the pathological believers is basically ready to move on. The great tragedy of science: the slaying of a beautiful hypothesis by ugly fact. Guy (Help!) 23:18, 15 December 2016 (UTC)

Very interesting observation! can you point to any resources talking more about Mao-traditional medicine relation? Or is it you conjecture? 80.233.239.118 (talk) 12:09, 16 December 2016 (UTC)

Guy, before we get into the specifics of your (unreferenced, easily refutable) points, none of these points addresses the fact that acupuncture does not meet Wikipedia's criteria for pseudoscience (WP:NPOV Pseudoscience, which is based on scientific consensus. As pointed out earlier, acupuncture is recommended by the WHO, NIH, NICE, and the clinical guidelines of over a dozen countries outside of South East Asia and is supported by hundreds of systematic reviews. The 'pathological believers' you're referring to are over 30,000 MDs, researchers out of medical Harvard and Stanford, etc, etc (this is without mentioning over a million acupuncturists globally). What you are saying is easily refutable and represents a sharp break with reality. All you have managed to demonstrate is that you and some other people (a fairly short list that I can easily rattle off the top of my head because they always cite each other's opinion pieces as if they were actually pieces of original research) feel very strongly that acupuncture is pseudoscience, which is your prerogative. The wording in the lede violates Wikipedias NPOV policy because it erroneously presents the views of the editors as the consensus view when it is not. At the very least, we can say that this issue is controversial in the mainstream scientific community and thus both sides need to be presented.Ellaqmentry (talk) 13:43, 16 December 2016 (UTC)

• It doesn't matter where you put the needles, It doesn't matter if you put the needles in or not. From the original study: "The best controlled studies show a clear pattern, with acupuncture the outcome does not depend on needle location or even needle insertion." [11]
• The usual claimed mechanism - manipulation of qi in meridians - is bullshit as neither of those things exist. From [12]: " Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and other related theories, which are difficult to reconcile with contemporary biomedical information" (good science never asserts a negative, of course). From [13], "Research on the nature of acupuncture points and meridians is often difficult to evaluate because of the diverse nature of the claims made, incomplete data provided in published studies and the variety of parameters involved in the assessment of these claims. Many of the studies purporting to have identified acupuncture points or meridians come from China; the role of publication bias in Chinese literature needs to be considered in light of the fact that no trial published in China from 1966 through 1995 found a test treatment to be ineffective. Obvious contradictions exist between current acupuncture practice and the historical record, as well as on the “correct” number of points and meridians reported by current practitioners of acupuncture. From a pragmatic standpoint, one might surmise that if such structures did exist and could be reliably demonstrated, they would revolutionize the study of anatomy and physiology; no such revolutions have yet been forthcoming. Nevertheless, whatever the clinical efficacy of needling, there is, as yet, no compelling evidence to show that acupuncture points or meridians exist as discrete entities."
• There is no plausible mechanism (pace the attempts to co-opt purinergic signalling, basically the equivalent of Chopra saying "quantum!"). "Centuries of advancement in our understanding of biology has made the notion of life energy unnecessary. Further, no one has been able to detect life energy or formulate a scientifically coherent theory as to what life energy is, where it comes from, and how it interacts with matter or other forms of energy. Withn science, the vitalists lost the debate over a century ago.Without chi, there is no underlying basis for acupuncture as a medical intervention." [14]
• For most conditions the evidence shows acupuncture doesn't work. - sourced in the article.

• For the small number of conditions where there is currently net positive evidence, Measures are always subjective (easily verified from the study endpoints); Outcomes are always consistent with the null hypothesis (again easily verified from endpoints, as they are subjective); No reason is advanced why it might work for these and not similar conditions for which there is net negative evidence (feel free to show any evidence to the contrary); Effect size is always small (acknowledged even by woo-mongers, e.g. [15]).
• Many studies come out of China and these are never negative (https://www.ncbi.nlm.nih.gov/pubmed/9551280).
• Popularity of acupuncture owes a great deal to a propaganda coup played on Nixon's party during their visit to Maoist China. Much of "traditional" Chinese medicine is in fact a creation of Mao. See barefoot doctors.
• P=0.05 means a [corrected: 5]% false positive rate is expected. This is rthe definition of the term so requires no reference.

That word refuted does not mean what you think it means. Refuted means proven wrong, you mean repudiated. Yes, velóniphiles repudiate these facts, but they are still facts. Remember that the burden of proof lies with the acupuncturists. And appeal to tradition is not proof, neither is appeal to anecdote. The most important lesson of the 20th Century in medicine is just how easily we fool ourselves. Guy (Help!) 13:41, 19 December 2016 (UTC)

A 20% false positive rate? TylerDurden8823 (talk) 23:46, 15 December 2016 (UTC)

No, it's 1 in 20, but Guy also said that, so it seems to be a simple mistake. However there are ample sources in this article that acupuncture is pseudoscience and that it has no scientific base whatsoever. Carl Fredrik 💌 📧 00:23, 16 December 2016 (UTC)

Carl, you're missing the point. In order for the statement 'acupuncture is pseudoscience' to be valid, it's not sufficient to provide 'ample sources . . . that acupuncture is pseudoscience' as what you are providing is evidence of an opinion. You would need to demonstrate that this opinion represents scientific consensus. I have provided copious evidence that it does not. Those who are arguing for the current wording have provided none. Yes, you think it's pseudoscience. Yes, some others think it's pseudoscience. But that position does not represent consensus, it represents one side of a mainstream scientific perspective and that needs to be reflected in the text. Many mainstream medical institutions and practice guidelines recommend acupuncture. The present wording violates WP NPOV policy. Ellaqmentry (talk) 15:05, 16 December 2016 (UTC)

Just making sure we're reading the same statistics books :) Also Carl, the edit you just performed made it so that the first paragraph says it's pseudoscience nearly two sentences in a row. Did you realize it already said acupuncture is pseudoscience about one or two lines down? TylerDurden8823 (talk) 00:27, 16 December 2016 (UTC)

Yeah, having it in the first line too is too much pseudoscience I think. Alexbrn (talk) 03:49, 16 December 2016 (UTC)

Thanks, I was just writing a ponderous explanation for why removing the recent edit would be desirable. Johnuniq (talk) 04:41, 16 December 2016 (UTC)

You got me. Yes, 5% or one in 20. Guy (Help!) 08:54, 16 December 2016 (UTC)

NCCAM research, it's not acupuncture this time: [16]. Tgeorgescu (talk) 03:59, 16 December 2016 (UTC)

It appears same few users persistently add their POV to the lead of these articles for months. They consider and respect no other editor's input. They do not collaborate nor try to make consensus. I think they should be mentioned on relevant ArbCom / ANI pages and banned from this article. 80.233.239.118 (talk) 08:31, 16 December 2016 (UTC)

Yes, it's happened before and may need to happen again. Alexbrn (talk) 08:36, 16 December 2016 (UTC)

Yes, and hopefully it happens again for more users.. including the other site of POV. 80.233.239.118 (talk) 08:44, 16 December 2016 (UTC)

Any editor can raise complaints about behaviour at WP:AIN. Here is not the place. Alexbrn (talk) 08:49, 16 December 2016 (UTC)

In order to answer the claim of "mainstream acceptance" of acupuncture, if aromatherapy helps one feel better, MDs won't deny such aid to poor suffering people, but there is a strong consensus that aromatherapy does not heal anything. Feeling better is subjective, so if a trick helps, then one feels better. Healing is objective. Tgeorgescu (talk) 23:33, 20 December 2016 (UTC)

So, those mainstream medical organization say something like "let the patient have surgery/antipsychotics/chemotherapy and then have half an hour of acupuncture". Then don't say something like "let the patient have acupuncture instead of surgery/antipsychotics/chemotherapy". The difference is enormous. Tgeorgescu (talk) 22:00, 25 December 2016 (UTC)

Yeah, but the doctor could just as well have said that we should let patients have 5-star meals. Sure it tastes good, the patient is likely to feel better — but it doesn't do anything to help with their disease. If you want acupuncture because it feels nice you can get it, but you shouldn't go around believing it'll help you combat your disease. Carl Fredrik 💌 📧 22:49, 25 December 2016 (UTC)

Yup. It's tolerated, but not accepted as such. Guy (Help!) 02:03, 26 December 2016 (UTC)

Agree with both. Tgeorgescu (talk) 05:27, 26 December 2016 (UTC)

Peter A. Daempfle (2013). Good Science, Bad Science, Pseudoscience, and Just Plain Bunk: How to Tell the Difference. Rowman & Littlefield. ISBN 978-1-4422-1726-3. The second reason is that many conditions are psychogenic in origin. If the patient "believes" they are being treated, then they start to feel better. Migraine headaches and back pain often have roots in stress and anxiety.

Quoted by Tgeorgescu (talk) 23:49, 30 December 2016 (UTC)

Daempfle is referring to chiropractors and acupuncturists. Tgeorgescu (talk) 23:51, 30 December 2016 (UTC)

The acupuncture method was created by ancient people and practiced for many many centuries. The theory and practice are great but still not being accepted by modern science. We cannot cheat ourselves by devalue this practice. We need to have detailed introduction of this practice from the people of practice. --occasional user — Preceding unsigned comment added by 121.72.8.187 (talk) 08:35, 13 January 2017 (UTC)

I've reverted because, well, they would say that, wouldn't they. Roxy the dog. bark 16:25, 16 January 2017 (UTC)

Yeah, if something is indistinguishable from placebo at the start of treatment, it's not likely to decrease in effectiveness a year later. lol I find this rather amusing, I have to say. MjolnirPants Tell me all about it. 16:33, 16 January 2017 (UTC)

I'm intrigued by how this conclusion was reached, but the paper is so new I can't yet get library access. Everymorning (the adding editor) - could you say a bit about what's in the full paper's conclusion? Alexbrn (talk) 16:45, 16 January 2017 (UTC)

I can't get past the paywall either. I was just basing what I added on what I could glean from the abstract. Everymorning (talk) 17:12, 16 January 2017 (UTC)

Hmm, that's a bit naughty as abstracts sometimes don't fully/properly represent the article a whole, so doing this might misrepresent a source. See WP:NOABSTRACT. Alexbrn (talk) 17:20, 16 January 2017 (UTC)

In this case, it seems fine as far as gleaning information from the article goes (although you have a very good point, Alex). That being said, it's a bit of a cherry picked detail that leaves out an important disclaimer. I still find this funny, for the record. MjolnirPants Tell me all about it. 17:28, 16 January 2017 (UTC)

Thanks for pointing me to WP:NOABSTRACT, Alex; I was not previously aware of it or of the fact that you should read the full text before citing a paper. I apologize and I'll try to always read the full text going forward. I have access to ScienceDirect, but as this journal isn't an Elsevier journal I can't read the full text. Everymorning (talk) 17:41, 16 January 2017 (UTC)

Have all your additions of reviews and meta analysis to this article shown the same editorial rigour? Roxy the dog. bark 18:38, 16 January 2017 (UTC)

No, in fact, the vast majority have not, because as mentioned above, I was not aware of this policy until today. Everymorning (talk) 19:31, 16 January 2017 (UTC)

This is not something that one should need a policy document to be aware of and abide by. One should never cite a work as a source for a fact without being familiar with the source's actual contents and the context in which the claim is made. This is basic, responsible writing and fact-checking, not a special, out of the ordinary requirement for Wikipedia. TenOfAllTrades(talk) 20:39, 16 January 2017 (UTC)

I reverted the last addition because it introduced studies by Chinese authors. Those who don't follow the literature on quackery are often not aware of this, but Chinese research is, well... um... problematic. Various studies have found results such as 0% of interventions being ineffective (implausible), rampant bias, and, in the latest high profile case, outright fraud. If 80% of data is fabricated, the results are pure pseudoscience. Guy (Help!) 20:48, 16 January 2017 (UTC)

I would read the full texts of every paper I ever add to an article, if I could. However, I usually can't, because I usually don't have a subscription to the journal or its publisher. The exceptions are generally just open access journals and ScienceDirect. Also, re TenOfAllTrades, the abstract of a paper is part of its "actual contents", and the "context in which the claim is made" can generally be found in the abstract, even if it is not discussed in detail. But if anyone thinks I am making a serious mistake by not reading sources enough before citing them, they are welcome to report me to ANI and ask for a topic ban if they think this would be necessary. Of course, this shouldn't be discussed further here. Everymorning (talk) 21:04, 16 January 2017 (UTC)

I'm sure it happens all the time, but good medical editors should of course be following WP:MEDRS. As it says there, it's often necessary to use a library to get access to a full paper. But as you rightly say, this is not the place. Alexbrn (talk) 21:13, 16 January 2017 (UTC)

I think going to ANI would be silly, there is no need. Roxy the dog. bark 21:16, 16 January 2017 (UTC)

I think you could read a study from China and still be wrong, due to data fabrication. That's not your fault. Guy (Help!) 21:22, 16 January 2017 (UTC)

Everymorning, for future reference, if you need help getting access to an article you should just ask. Many editors of Wikipedia's medical articles have access to a lot of articles and are happy to share. For example, Phoebe can be quite helpful if you don't have access to a journal article, among others. I have access to a lot of material too so feel free to ask me if you're hitting the paywall. TylerDurden8823 (talk) 04:37, 18 January 2017 (UTC)

Oh god, this meta-analysis made me want to vomit. On first reading, it seems like acupuncture is actually good for something, but this is from Vickers, so I kept reading to figure out how he tortured the data to give a positive result. He avoids the pitfalls present in most positive meta-analyses. The trials were large, and many used sham controls with nominally proper blinding (though we know from experience some centers carrying out the actual work unblind the treatments against protocol). The main result being reported in this analysis is not that acupuncture works per se, but that when it works, its effect is long lasting, providing pain relief over controls even a year after treatment. Vickers arrived at this conclusion by excluding every trial that showed no effect. Then he further excluded all trials of neck pain, since the trials of neck pain that showed a positive result of acupuncture happened to show a regression toward the control effect size over time. It's just an extended exercise in cherry-picking and motivated reasoning. In other words, this paper is about a benefit of acupuncture that is found in every acupuncture trial, after you exclude the ones that didn't show it. Someguy1221 (talk) 04:52, 18 January 2017 (UTC)

“but Chinese research is, well... um... problematic.”oh, Thanks.The incident has successfully angered many people-- Clear Sky Talk 12:18, 18 January 2017 (UTC)

People might be more justified in getting angry about the fake Chinese acupuncture research this is being used to prop up this quackery. But unless there is some reliable source we can use to describe this, I think we're done here as no concrete proposal is being made. Alexbrn (talk) 12:25, 18 January 2017 (UTC)

Hmm, interesting stuff. Gone are they days when teachers tell students not to use Wikipedia — now the Chinese office of foreign affairs feels it needs to issue an official statement when they think we're wrong. Fascinating. Carl Fredrik 💌 📧 12:48, 18 January 2017 (UTC)

To be fair (and only to address the general principle, not to suggest that Wikipedia inaccurately reflects reality in this instance) those two things need not be mutually exclusive. There are lots of sources of information out there that are widely-read – and widely-believed – that nevertheless should not be relied upon. Popularity is not a good proxy for trustworthiness. TenOfAllTrades(talk) 13:23, 18 January 2017 (UTC)

Indeed. A climate change denialist trope published on Breitbart by James Delingpole does not become true even if the House science committee tweets it. Guy (Help!) 13:49, 18 January 2017 (UTC)

We already know that the trypanophile community hates the fact that Wikipedia says this. Thing is, it's not actually our problem to fix. Numerous reliable sources on the demarcation between science and pseudoscience, characterise acupuncture as the latter - and none as the former. So it really doesn't matter what we think about it. We follow sources, so like the Hitch-Hiker's Guide, where we are incorrect we are at least definitively incorrect. That is not a comment on whether we are incorrect in this case. Guy (Help!) 13:19, 18 January 2017 (UTC)

Don't sell yourself short Guy - you consistently go above and beyond the sources.Herbxue (talk) 05:38, 19 January 2017 (UTC)

Diffs or it didn't happen.Roxy the dog. bark 06:18, 19 January 2017 (UTC)

If I did, I would have changed it to say that acupuncture is a quasi-religious practice and that the study of acupuncture is rife with pseudoscience, because, as I have said many times, I don't think acupuncture itself is pseudoscience. Pseudomedicine, yes, but not pseudoscience, because in most cases it fails the essential test of trying to look sciencey. My personal views don't matter any more than yours do. We go with sources even though we both think they are wrong, albeit for different reasons. Guy (Help!) 10:37, 19 January 2017 (UTC)

I was thinking that calling a therapy or a field of medicine pesudoscience weird too. Well, the sources say so. --Artoria2e5 contrib 02:04, 22 January 2017 (UTC)

• Hmmm, I wonder if any of us would be arrested if we traveled to China? Guy, take a trip and let us know how it goes. ;) MjolnirPants Tell me all about it. 13:58, 18 January 2017 (UTC)
  • I should probably just return to China during some vacation. I heard that they are more forgiving towards foreigners. (as long as they are not accused of spying?) --Artoria2e5 contrib 02:07, 22 January 2017 (UTC)

Blast! I forgot to update Chinese Wikivoyage for an unbelievably long time! I was just one of the original founder of it! But since when did the topic change to traveling?? Whoa. Super Wang 08:41, 22 January 2017 (UTC)

And one more thing. @Artoria2e5: Foreigner? You told me you speak Chinesec natively. @MPants at work: Dear guy, take a peek at Wikivoyage and make your decision. You can even wander around China's military grounds supposing you were a Cuban or North Korean. Looking forward to your visit -- as long as you were not a spy. :lol Super Wang 08:50, 22 January 2017 (UTC)

Now should I explain that communists taught me to believe in science, to seek truth, and not to waste others' time (you know Lenin's quote well), or send you to one of WP:WikiVoice, WP:PSCI, and WP:FALSEBALANCE, or just tell you that the foreigner mention is just saying a Chinese will have the not-so-serious "test" better done? Whatever. Good luck with WikiVoyage. People should get to use more of these Wikimedia projects. --Artoria2e5 contrib 14:17, 22 January 2017 (UTC)

Comment I think the time has come to close this thread. It has become, towards the latter half, just mindless drivel. ... anyone care to do the needful? -Roxy the dog. bark 17:20, 22 January 2017 (UTC)

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

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

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

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

Fast forward to March 2016:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How about the following:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Richard Keatinge – [24]/[25]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

That is a statement of faith, not fact. Guy (Help!) 10:34, 3 February 2017 (UTC)

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

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

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

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

I think actually that there are multiple sources of bias.

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

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

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

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

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

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

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

It does show bias against the practice of acupuncture when people take into account the socio-political background of its country of origin. Let's leave the taunts at that. Whether China is a communist country or not doesn't make acupuncture any more (or less) real. If it works, it works. Statements like "there is a culture of not challenging respected authorities, which in most cases means not going against the status quo." aren't helpful in such discussions at all. 116.15.149.91 (talk) 22:58, 7 February 2017 (UTC)

I can see your problem. Science is biased against ideas that are incorrect, and reality is biased against therapeutic claims based on nonsense. Wikipedia is biased in favour of reliable sources, whereas quackery is heavily biased in favour of unreliable ones. Hence quacks think their nonsense is science, and Wikipedia follows all credible sources in saying that it's not. Guy (Help!) 23:14, 7 February 2017 (UTC)

Please be civil and refrain from ad hominem attacks. Thank you very much. I'm not even declaring that acupuncture works. I am simply refuting the blanket statement there is a consensus over acupuncture amongst scientific and medical community in the West. 116.15.149.91 (talk) 23:27, 7 February 2017 (UTC)

Falsely accusing other editors of incivility is a policy violation that can result in sanctions, up to and including being blocked from editing. Continuing to cast aspersions upon Guy as if he had said anything at all uncivil will result in a thread discussing your edits being started at the administrator's noticeboard. WHat you are doing is attempting to use an ad hominem argument by implying that the other party is uncivil, and therefore upset and irrational. It does not work on those who have been following the discussion, and it is both disruptive and extremely dishonest. Knock it off. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 23:33, 7 February 2017 (UTC)

Please refrain from uncivil threats. Feel free to report me to the administrator's noticeboard. 116.15.149.91 (talk) 23:38, 7 February 2017 (UTC)

Is this trial study from the West flawed? And in what way is it flawed?

"Researchers at the University of York have found than acupuncture treatment can boost the effectiveness of standard medical care, lessening the severity of chronic pain and depression.

In a new study, investigators determined acupuncture provides more than a placebo effect.

For the research, professor Hugh MacPherson worked with a team of scientists from the UK and US. The reviewers analyzed the results of 29 high quality clinical trials focused on patients treated with acupuncture and standard medical care.

In the majority of these trials, patients with chronic pain treated with acupuncture and standard medical care were tested against those who were provided with standard medical care alone, such as anti-inflammatory drugs and physical therapy. The trials involved approximately 18,000 patients diagnosed with chronic pain of the neck, lower back, head, and knee.

The report, published in the National Institute for Health Research (NIHR) Journals Library, determined that the addition of acupuncture compared to standard medical care alone, significantly reduced the number of headaches and migraine attacks and reduced the severity of neck and lower back pain." [26] 116.15.149.91 (talk) 23:26, 7 February 2017 (UTC)

Eh, I can't even be bothered to read that one. We've discussed Vickers and his "studies" so many times here, and his papers have also been dissected by skeptic sites quite a lot. Every time he declares to have "proof" that acupuncture works, there is always something disastrously wrong. Either his "blind" studies were actually totally unblinded, or he tortured the data to an absurd degree to get the conclusion he wanted to begin with. Anything with his name on it has no credibility, but he does a good job of demonstrating how full of pseudoscience the field is. Someguy1221 (talk) 23:28, 7 February 2017 (UTC)

Who is Vickers? The researcher in question is a certain Dr Hugh MacPherson from University of York. 116.15.149.91 (talk) 23:33, 7 February 2017 (UTC)

Read WP:MEDRS. Then read it again. Then read it a third time. While you're busy reading it, those of us who actually care more about improving the encyclopedia will enjoy a much-needed respite from this blatant POV pushing. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 23:36, 7 February 2017 (UTC)

MacPherson is one of several authors of the paper. Vickers is another. But thanks for showing us you didn't even read the first page of the study. Someguy1221 (talk) 23:43, 7 February 2017 (UTC)

In case you are mistaken, I'm not the same person as Everymorning. 116.15.149.91 (talk) 23:52, 7 February 2017 (UTC)

No-one said you were. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 23:56, 7 February 2017 (UTC)

• if anybody new to this page is unaware, Vickers, the biostatician from MSK, has been discussed on this talk page a bunch of times. Please review the discussions there. You can find them in this search. Jytdog (talk) 05:42, 9 February 2017 (UTC)