Jump to content

Talk:Alternative medicine

Page contents not supported in other languages.
From Wikipedia, the free encyclopedia

This is an old revision of this page, as edited by ForgotMyPW (talk | contribs) at 00:49, 6 April 2019 (→Second proposal). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Peer reviewers: Cmart35.

Template:Vital article

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): RosilandToscano (article contribs).

Unproven vs. Disproven

Reading the lead section and accompanying info-graphic, much of the description of alternative medicine relates specifically to *disproven* alternative medicine, while not applying to *unproven* alternative medicine. In the case of unproven alternative medicine, it is sometimes the case that it goes on to become scientifically validated in particular settings (e.g. marijuana for the purposes of treating seizures). In light of this, much of the article is inaccurate/misleading, for example:

  • The scientific consensus is that alternative therapies either do not, or cannot, work.
  • Alternative practices, products, and therapies range from those which are simply ineffective to those which have known harmful and toxic effects

Thoughts? ForgotMyPW (talk) 00:46, 28 March 2019 (UTC)[reply]

I agree. I'm working on a redraft of the lede down below. I have suggested defining alternative medicine as "treatments that have not been accepted into mainstream medicine." Not all of them have been "disproven". Some have not been disproven (and thus remain "unproven") simply because researchers have better things to do. Anywikiuser (talk) 10:50, 1 April 2019 (UTC)[reply]
Also, it's better wording to say "shown to be effective" rather than "proven". Anywikiuser (talk) 13:49, 1 April 2019 (UTC)[reply]

Biased.

Why is this author allowed to post? — Preceding unsigned comment added by 2601:602:77F:D6EE:ECB8:539C:E130:834B (talk) 03:01, 20 January 2019 (UTC)[reply]

Can you please specify which author and identify some of the edits that you consider biased please.  Velella  Velella Talk   03:10, 20 January 2019 (UTC)[reply]

Yes. We are biased.

In the section above, Morgan Leigh says " 'fake medicine', your biases are showing. "

Jimmy Wales, founder of Wikipedia, once said:

"Wikipedia’s policies around this kind of thing are exactly spot-on and correct. If you can get your work published in respectable scientific journals – that is to say, if you can produce evidence through replicable scientific experiments, then Wikipedia will cover it appropriately.
What we won’t do is pretend that the work of lunatic charlatans is the equivalent of 'true scientific discourse'. It isn’t.[3][4]"

So yes, we are biased towards science and biased against pseudoscience.
We are biased towards astronomy, and biased against astrology.
We are biased towards chemistry, and biased against alchemy.
We are biased towards mathematics, and biased against numerology.
We are biased towards medicine, and biased against homeopathic medicine.
We are biased towards venipuncture, and biased against acupuncture.
We are biased towards cargo planes, and biased against cargo cults.
We are biased towards crops, and biased against crop circles.
We are biased towards laundry soap, and biased against laundry balls.
We are biased towards water treatment, and biased against magnetic water treatment.
We are biased towards electromagnetic fields, and biased against microlepton fields.
We are biased towards evolution, and biased against creationism.
We are biased towards medical treatments that have been proven to be effective in double-blind clinical trials, and biased against medical treatments that are based upon preying on the gullible.
We are biased towards astronauts and cosmonauts, and biased against ancient astronauts.
We are biased towards psychology, and biased against phrenology.
We are biased towards Mendelian inheritance, and biased against Lysenkoism.

And we are not going to change.

--Guy Macon (talk) 09:47, 31 December 2018 (UTC)

Quoted from User talk:Morgan Leigh. Tgeorgescu (talk) 03:57, 20 January 2019 (UTC)[reply]
The very definition of closed-minded.--KitchM (talk) 21:04, 30 March 2019 (UTC)[reply]

Is the graphic at the top not excessively POV?

To be clear, I think alternative medicine is almost all ineffective and a significant percentage of it is outright fraudulent, and I think this article should make every effort to present the overwhelming weight of evidence against it. But isn't it a bit much to have the main image of the article (and thus the first thing most people look at) an infographic debunking the subject? There's nothing like that in the articles about astrology or Young Earth Creationism. I think, if anything, it hurts the cause of evidence-based medicine to have this article read like a polemic rather than an evenhanded dismissal of something any reasonable person *would* dismiss. ❃Adelaide❃ (talk) 11:46, 6 February 2019 (UTC)[reply]

I've never liked it, it is confusing. But whatever. Guy (Help!) 19:32, 7 February 2019 (UTC)[reply]
Me too. It looks like an IQ test that I would probably fail. Johnuniq (talk) 22:23, 7 February 2019 (UTC)[reply]
I agree it can be improved, but removing it is a horrible idea. It presents the mechanisms (possibly in too much detail) for how alternative medicine is "perceived to work". That it takes two minutes to process is the point — you need to read the caption to understand the underlying deception of alternative medicine. It is under no circumstances POV, and is very well supported by the contents of the article. I'll look into what improvements can be made. The scientific community is quite clear on that "alt-med" is not "reasonable" nor a subject for scientific discussion. It's been time and time again proven to be nonsense. This critique looks like all the other nonsense dives at "there might just be something to alt-med, we should't dismiss it", despite the fact that sources are dismissing it, and dismissing the anti-science base of alt-med philosophy. Carl Fredrik talk 13:15, 12 February 2019 (UTC)[reply]

Agree. Took me 2 mins to process. The idea is sound, but the graphics is wrong: i.e. not useful. — Preceding unsigned comment added by Zezen (talk • contribs)

The graphic is not wrong. It's thoroughly supported by the sources in the article. Carl Fredrik talk 13:15, 12 February 2019 (UTC)[reply]
Yes, but it's noisy and confusing. No problem with having it in the body. Guy (Help!) 13:51, 12 February 2019 (UTC)[reply]
I was about to come along and admit that I agree with you, it might belong better in the body. However, it seems someone jumped the gun and just outright got rid of the image. That doesn't seem right, and I think we ought to decide two things before removing it. 1) Where it should go & 2) What should replace it. The article is undoubtably much worse of with nothing, and the image serves a valuable purpose. Carl Fredrik talk 17:48, 22 February 2019 (UTC)[reply]
I removed it. I don't know where it should go, I am fine with it pretty much anywhere other than the infobox. Guy (Help!) 17:58, 22 February 2019 (UTC)[reply]
I think it should be moved to the definitions section then, but that needs some work. But we should discuss a replacement. Carl Fredrik talk 18:40, 22 February 2019 (UTC)[reply]
We do not need a replacement. Anything is better than this, specifically including no image. Guy (Help!) 21:17, 22 February 2019 (UTC)[reply]
It would be better further down, or not included at all. Anywikiuser (talk) 13:32, 12 March 2019 (UTC)[reply]

Edit reverted

My edit earlier today was reverted and I was told to post here. The "Placebo effect" section doesn't currently address the crucial role of the placebo effect in alternative medicine. The paragraph is more about criticism of integrative (i.e. partly-alternative) medicine. What's the problem? 78.33.33.241 (talk) 11:22, 11 March 2019 (UTC)[reply]

The problem is you think there is a difference between integrative Alt-Med and non-integrative Alt-Med. -Roxy, the dog. wooF 11:29, 11 March 2019 (UTC)[reply]
That wasn't what my edit was about. 78.33.33.241 (talk) 11:35, 11 March 2019 (UTC)[reply]
You asked a question, "What's the problem", which I answered. -Roxy, the dog. wooF 11:41, 11 March 2019 (UTC)[reply]
I was asking why an edit was reverted. It wasn't you who did that. 78.33.33.241 (talk) 11:44, 11 March 2019 (UTC)[reply]
Well, the main reasons I reverted are that I think the comment "Critics of alternative medicine argue that any improvements patients experience after an alternative treatment are merely the result of the placebo effect" is both uncited and, at best, drawing a long bow, and that I think any definition of placebo effect inserted into the article needs to be discussed, as it's a significant change. PepperBeast (talk) 00:31, 12 March 2019 (UTC)[reply]
Yes, but was it really necessary to do something as drastic as reverting it, just because of one sentence?
A few proposals: there is a journal cited in the lede which lists possible mechanisms for why alternative medicine may be seen as working (Zelle, Muenstadt et. al., 2012) which could be used to explain the link between placebos and alternative medicine. This source is cited in the lede and obviously was an influence on the top image. Essentially, the 'Mechanism of Action' section needs to be an in-depth explanation of these reasons.
I don't think there is a dispute over the definition of the placebo effect. The only dispute likely is over what its mechanism is and how impactful it is, if at all. In my edits I cited an ambitious meta-analysis that I found on the placebo article (Hróbjartsson & Gøtzsche, 2010) to get an overview on both. I'm keeping that proposal as it is.
The last proposal is to move out all existing content from that section. The paragraphs on integrative medicine don't belong there. They belong as a paragraph in the section on integrative medicine, but for the most part they're repeating the criticism that all forms of alternative medicine get so can be condensed. Only one argument is specific to integrative medicine (the infiltration argument). Likewise, the last paragraph of that section is all to do with the history of alternative medicine in the US and doesn't belong there either.
Hope these proposals help. 78.33.33.241 (talk) 09:50, 12 March 2019 (UTC)[reply]
I don't consider a single revert and request that you discuss something to be "drastic". WP:BRD PepperBeast (talk) 20:12, 12 March 2019 (UTC)[reply]
The proposed wording:
The paragraph starting "The Scientific Review of Alternative Medicine points to confusions..." will be moved under the 'Mechanism of action' heading, but not the 'Placebo effect' heading. The 'Efficacy' section is about the evidence that AM doesn't work; the 'Mechanism' section should be about why.
The entire 'Placebo effect' section should be replaced by this:
See also: Placebo
A placebo is a medical treatment with no intended therapeutic value, generally used as a control in medical experiments, to isolate treatment effects from the effect of no treatment. An example of a placebo is an inert pill, but it can include more dramatic interventions like sham surgery. Reported changes in symptoms in the placebo group in experiments, or differences between placebo and no-treatment groups, have led to the idea of a so-called placebo effect is whenwhere patients feel they experience an improvement after being treated with a placebo an inert treatment. Analysis of placebo studies suggests that pPlacebos do not have a physical effect on diseases or improve overall outcomes, but they can reduce feelings of pain and nausea by affecting how patients perceive their condition.patients may report changes in subjective outcomes such as nausea.[1] The opposite of the placebo effect is the nocebo effect, when a patient who expects a treatment to be harmful perceives harmful effects after taking it.
The placebo effect is - a combination of subjective effects, regression toward the mean, observer bias, expectation effects, natural course of disease and other confounding factors - is likely to be one of the primary explanations for why alternative therapies may be credited for improving a patient's condition even though there is no objective effect, and in some cases the treatment may even be harmful.[2][3][4] David Gorski argues that such treatments should be treated as a placebo, rather than as medicine.[3] Almost none have performed significantly better than a placebo in clinical trials.[5][6][7][8] Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication.[2]
  1. ^ Hróbjartsson A, Gøtzsche PC (January 2010). Hróbjartsson A (ed.). "Placebo interventions for all clinical conditions" (PDF). The Cochrane Database of Systematic Reviews. 106 (1): CD003974. doi:10.1002/14651858.CD003974.pub3. PMID 20091554. {{cite journal}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  2. ^ a b Cite error: The named reference :0 was invoked but never defined (see the help page).
  3. ^ a b Cite error: The named reference Gorski2010 was invoked but never defined (see the help page).
  4. ^ Cite error: The named reference Novella2010 was invoked but never defined (see the help page).
  5. ^ Cite error: The named reference ATRAMM was invoked but never defined (see the help page).
  6. ^ Cite error: The named reference Skep_Dic_comp_med was invoked but never defined (see the help page).
  7. ^ Cite error: The named reference $2.5 billion was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference Abdulla1999 was invoked but never defined (see the help page).
A new paragraph added under the heading 'Complementary or Integrative Medicine':
Besides the usual issues with alternative medicine, integrative medicine has been described by its critics as an attempt to bring pseudoscience into academic science-based medicine,[1] leading to the pejorative term "quackademic medicine".
A new subsection in 'Risks and problems' will be created titled 'Use of health and research resources'
Research into alternative treatments has been criticized for "...diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology."[2][1] Research methods expert and author of Snake Oil Science, R. Barker Bausell, has stated that "it's become politically correct to investigate nonsense."[3] A commonly cited statistic is that the US National Institute of Health had spent $2.5 billion on investigating alternative treatments prior to 2009, with none being found to be effective.[3]
The last paragraph will be moved to the 'History' section.
I'm tempted to add a section on 'natural recovery' to the 'Mechanism of action' section and include the reasons cited by writers like Ernst, Gorski and others as to why the placebo effect does not justify use of AM. The trouble is, it seems any attempt to change the article gets reverted. 78.33.33.241 (talk) 11:49, 13 March 2019 (UTC)[reply]
The above has been updated. 78.33.33.241 (talk) 15:54, 13 March 2019 (UTC)[reply]
I have marked it up with some changes to more clearly identify the fact that according to the best available evidence the placebo effect is not actually a thing. Guy (Help!) 16:12, 13 March 2019 (UTC)[reply]
Thank you for your input. It seems as though the reasons why a patient might report better outcomes after a placebo can divided into three categories: 1) mind tricks from the placebo treatment; 2) reporting biases which create differences between how the patients felt and how they said they felt; and 3) natural recovery that would have happened without the placebo treatment. I haven't given 2) much consideration, to be honest. 3) probably ought being discussed separately from placebos. I might propose a paragraph on that as well. 78.33.33.241 (talk) 16:53, 13 March 2019 (UTC)[reply]
I think the wording that's more commonly used today is "regression to the mean" to describe what you're calling "natural recovery." --Shibbolethink (♔ ♕) 17:54, 13 March 2019 (UTC)[reply]
So the edited draft has the advantage in that it avoids saying that the psychological effects of placebos are a fact. Can a mind trick be a "real" thing? I'm up for wording that avoids directly answering this question.
The main issue I have with the edited draft is that regression to the mean and reporting bias should be treated as being separate from any psychological effects of the placebo. I'll propose a paragraph/section on regression to the mean. The issue of reporting biases (e.g. answers of politeness) is harder to separate, though a good meta-analysis should be able to see through it. I agree this should be discussed under the 'placebo effect' heading, but treat it as a separate phenomenon.
Other issues: The phrase "so-called" doesn't sound neutral. I also still think pain should be mentioned as well as nausea, among the subjective outcomes that can be affected. 78.33.33.241 (talk) 09:59, 14 March 2019 (UTC)[reply]
A further proposed change: A new heading of 'Other factors' to go under 'Mechanism of action':
A patient who receives an inert treatment may report improvements afterwards that it did not cause.[4][5] Assuming it was the cause without evidence is an example of the regression fallacy. This may be due to a natural recovery from the illness, or a fluctuation in the symptoms of a long-term condition.[5] The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result.
There are also reasons why a placebo treatment group may outperform a "no-treatment" group in a test which are not related to a patient's experience. These include patients reporting more favourable results than they really felt due to "politeness" or "experimental subordination", observer bias and misleading wording of questions.[5] In their 2010 systematic review of studies into placebos, Asbjørn Hróbjartsson and Peter C. Gøtzsche write that "even if there were no true effect of placebo, one would expect to record differences between placebo and no-treatment groups due to bias associated with lack of blinding."[4]
If there's enough content to go in the 'Other factors' section, it can be split into more than one section. Anywikiuser (talk) 12:00, 15 March 2019 (UTC) [Just to be transparent, I'm the same person as 78.33.33.241. For security reasons involving a public computer, I have not logged in when making edits on that computer. Anywikiuser (talk) 13:07, 15 March 2019 (UTC)][reply]
Redraft:
A placebo is a medical treatment with no intended therapeutic value. An example of a placebo is an inert pill, but it can include more dramatic interventions like sham surgery. The placebo effect is the concept that patients will perceive an improvement after being treated with an inert treatment. The opposite of the placebo effect would be the nocebo effect, when patients who expect a treatment to be harmful will perceive harmful effects after taking it.
Placebos do not have a physical effect on diseases or improve overall outcomes, but patients may report improvements in subjective outcomes such as pain and nausea.[4] A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect.[6][4] The study was found to have flawed methodology in a 1997 reassessment.[5] This and other modern reviews suggest that other factors like natural recovery and reporting bias should also be considered.[4][5]
All of these are reasons why alternative therapies may be credited for improving a patient's condition even though the objective effect is non-existent, or even harmful.[7][1][2] David Gorski argues that alternatives treatments should be treated as a placebo, rather than as medicine.[1] Almost none have performed significantly better than a placebo in clinical trials.[8][9][3][10] Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication.[7]
I have adjusted the wording to avoid treating the placebo effect as a fact. 78.33.33.241 (talk) 16:20, 18 March 2019 (UTC)[reply]

References

  1. ^ a b c d Cite error: The named reference Gorski2010 was invoked but never defined (see the help page).
  2. ^ a b Cite error: The named reference Novella2010 was invoked but never defined (see the help page).
  3. ^ a b c Cite error: The named reference $2.5 billion was invoked but never defined (see the help page).
  4. ^ a b c d e Hróbjartsson A, Gøtzsche PC (January 2010). Hróbjartsson A (ed.). "Placebo interventions for all clinical conditions" (PDF). The Cochrane Database of Systematic Reviews. 106 (1): CD003974. doi:10.1002/14651858.CD003974.pub3. PMID 20091554. {{cite journal}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  5. ^ a b c d e Kienle GS, Kiene H (December 1997). "The powerful placebo effect: fact or fiction?". Journal of Clinical Epidemiology. 50 (12): 1311–8. doi:10.1016/s0895-4356(97)00203-5. PMID 9449934.
  6. ^ Cite error: The named reference beecher1955 was invoked but never defined (see the help page).
  7. ^ a b Cite error: The named reference :0 was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference ATRAMM was invoked but never defined (see the help page).
  9. ^ Cite error: The named reference Skep_Dic_comp_med was invoked but never defined (see the help page).
  10. ^ Cite error: The named reference Abdulla1999 was invoked but never defined (see the help page).

What happened to this article?

I remember skimming the introductory sections of this article a few years ago and seeing a pretty nuanced description that ended with mentioning that alternative medicine is outside mainstream science and not respected by evidence-based medicine despite claims its practitioners would make. Now the entire introductory paragraphs, along with that new image about how alternative medicine 'works', read like they were ripped straight out of a RationalWiki article.

Why does every sentence in the introduction of this topic need to emphasize that 'alternative medicine is not accepted by scientists'? Why are their literally no sources for this absurdely long wall of text in the introductory section (for example, "Promoting alternative medicine has been called dangerous and unethical." Who is saying this?) except for the final line? Why arent the problems regarding the definition of alternative medicine even alluded to in the introductory section? Why is it so hard to find any reference in this article to anyone that actually believes in alternative medicine and what their responses are to critics?

Apologies, I missed the FAQ at the top of the page about the references and see that there are actual references made for these lines. In the case of the Diamond reference ("There is really no such thing as alternative medicine, just medicine that works and medicine that doesn't[...]"), this is almost a direct quote from him. I have made that specific citation visible for this reason. Rosencrantz24 (talk) 21:24, 16 March 2019 (UTC)[reply]

This article is excessively POV and does not read at all like an encyclopedia article, but one you might find ripped out of an advocacy site (one of the only two sources for the introductory section of this article is a site literally called sciencebasedmedicine.org). At the very least, the entire introductory section needs to be rewritten and properly sourced. Rosencrantz24 (talk) 06:04, 16 March 2019 (UTC)[reply]

Uhm...side note....WP:MOSLEAD is pretty clear that "The necessity for citations in a lead should be determined on a case-by-case basis by editorial consensus. Complex, current, or controversial subjects may require many citations; others, few or none. The presence of citations in the introduction is neither required in every article nor prohibited in any article." I think consensus on this issue is pretty clear from the many many discussions about it we've had on this talk page. These are not controversial things. The minority viewpoints that believe altmed are valid are not worth it... If you want to add citations, be my guest. But I think consensus is probably against you completely revamping the lead to suit a POV you yourself say you don't have.--Shibbolethink (♔ ♕) 19:38, 16 March 2019 (UTC)[reply]
Well apparently the header of this talk page disagrees with whatever consensus you are claiming is present here, as it clearly states that this topic is controversial. I admit to not being aware of that protocol before, but this article clearly seems to me to be a controversial one so I fail to see how that is relevant. Rosencrantz24 (talk) 20:23, 16 March 2019 (UTC)[reply]
So why don't you add some citations? I doubt anyone will disagree with that. But I can guarantee there are people who will disagree with your removing the NPOV. And yes, I know you would disagree that it is a NPOV. But that is exactly the nature of the disagreement so many would have with you.--Shibbolethink (♔ ♕) 21:17, 16 March 2019 (UTC)[reply]

Yes. We are biased.

In the section above an editor says that he wants "allow the various competing viewpoints to speak for themselves". presumably he is talking about some "competing viewpoint" other than the viewpoint shared by most scientists and philosophers -- that quantum mysticism is pseudoscience and quackery.

Jimmy Wales, founder of Wikipedia, once said:

"Wikipedia’s policies around this kind of thing are exactly spot-on and correct. If you can get your work published in respectable scientific journals – that is to say, if you can produce evidence through replicable scientific experiments, then Wikipedia will cover it appropriately.
What we won’t do is pretend that the work of lunatic charlatans is the equivalent of 'true scientific discourse'. It isn’t.[5][6]"

So yes, we are biased.

We are biased towards science and biased against pseudoscience.
We are biased towards astronomy, and biased against astrology.
We are biased towards chemistry, and biased against alchemy.
We are biased towards mathematics, and biased against numerology.
We are biased towards medicine, and biased against homeopathic medicine.
We are biased towards venipuncture, and biased against acupuncture.
We are biased towards quantum entanglement, and biased against quantum mysticism.
We are biased towards cargo planes, and biased against cargo cults.
We are biased towards crops, and biased against crop circles.
We are biased towards laundry soap, and biased against laundry balls.
We are biased towards water treatment, and biased against magnetic water treatment.
We are biased towards electromagnetic fields, and biased against microlepton fields.
We are biased towards evolution, and biased against creationism.
We are biased towards medical treatments that have been proven to be effective in double-blind clinical trials, and biased against medical treatments that are based upon preying on the gullible.
We are biased towards astronauts and cosmonauts, and biased against ancient astronauts.
We are biased towards psychology, and biased against phrenology.
We are biased towards Mendelian inheritance, and biased against Lysenkoism.

And we are not going to change. --Guy Macon (talk) 14:41, 3 February 2019 (UTC)[reply]

I read this before and I fail to see how this is relevant. Why are there now zero sources for the wall of text at the beginning of this article? Why is there not a single mention of someone like Deepak Chopra AT ALL in this article despite his name being frequently referenced when talking about alternative medicine? Why is a gigantic graphic about how alternative medicine does not work the front image of this article?
Again, this article gives the impression that its writers are trying their hardest to convince you that alternative medicine is bad and does not work which is not what an encyclopedic article should be trying to do. An encyclopedic article should be more objective, which is significantly different than suggesting that alternative medicine is on the same level of scientific medicine, an impression I do not recall this article ever giving (although I am not aware of a lot of the history of this article so correct me if Im wrong).
I am not a supporter of alternative medicine, but this article is a mess. I support removing the leading image and rewriting the introductory section as has been suggested by others in this talk page. Rosencrantz24 (talk) 18:32, 16 March 2019 (UTC)[reply]
I totally agree. This article is like throwing out the baby with the bath water. It is a thoughtless bias of the worst kind. - --KitchM (talk) 21:09, 30 March 2019 (UTC)[reply]
Hello @KitchM:. Ok, that's great. So what change to the article are you proposing? Please be specific. --McSly (talk) 22:05, 30 March 2019 (UTC)[reply]

Sources and references?

There might be sources somewhere in the text to part of the many statements in the intro. But if not I wonder about sources and references to the following statements. It also seems as if the text, or the intro, is at least slightly biased...

"Alternative medicine is used by a significant number of people, though its popularity is often overstated."

"Large amounts of funding go to testing alternative medicine, with more than US$2.5 billion spent by the United States government alone."

"None have shown any effect beyond that of false treatment, and most studies showing any effect have been statistical flukes."

"Alternative medicine is a highly profitable industry" (Profitable compared to what?)

"with a strong lobby". (Strong compared to what?)

"This fact is often overlooked by media or intentionally kept hidden"

"with alternative practice being portrayed positively when compared to "big pharma"."

"The lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine."

"Alternative therapies may even be allowed to promote use when there is demonstrably no effect"

"Regulation and licensing of alternative medicine and health care providers varies between and within countries."

"Despite laws making it illegal to market or promote alternative therapies for use in cancer treatment, many practitioners promote them."

"Alternative medicine is criticized for taking advantage of the weakest members of society."

"Terminology has shifted over time, reflecting the preferred branding of practitioners."

"For example, the United States National Institutes of Health department studying alternative medicine, currently named National Center for Complementary and Integrative Health, was established as the Office of Alternative Medicine and was renamed the National Center for Complementary and Alternative Medicine before obtaining its current name."

"Therapies are often framed as "natural" or "holistic", in apparent opposition to conventional medicine which is "artificial" and "narrow in scope", statements which are intentionally misleading."

"When used together with functional medical treatment, alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) treatment."

"Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment by making prescription drugs less effective, such as interference by herbal preparations with warfarin."

"Alternative diagnoses and treatments are not part of medicine, or of science-based curricula in medical schools, nor are they used in any practice based on scientific knowledge or experience."

"Alternative therapies are often based on religious belief, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or lies."

"Alternative medicine is based on misleading statements, quackery, pseudoscience, antiscience, fraud, and poor scientific methodology."

"Promoting alternative medicine has been called dangerous and unethical."

"Testing alternative medicine that has no scientific basis has been called a waste of scarce research resources."

"Critics state that "there is really no such thing as alternative medicine",

--Mats33 (talk) 16:09, 31 March 2019 (UTC)[reply]

According to WP:LEDE, those sources belong in the body of the article, not in the lead section. Tgeorgescu (talk) 04:59, 1 April 2019 (UTC)[reply]
A few weeks ago I proposed a re-write to the lede. So far I have just done an outline, but I will probably flesh it out in the coming days. Anywikiuser (talk) 08:25, 1 April 2019 (UTC)[reply]
I agree that the third paragraph is probably a bit strong - we could remove the sentence " Alternative medicine is criticized for taking advantage of the weakest members of society." without losing any information. Absolutelypuremilk (talk) 09:20, 1 April 2019 (UTC)[reply]
I don't know. According to our best WP:RS, it is not different from quackery. Tgeorgescu (talk) 09:31, 1 April 2019 (UTC)[reply]
That is my opinion as well, but it seems a bit unnecessary compared to the rest of the lede which focuses on the facts. Absolutelypuremilk (talk) 12:42, 1 April 2019 (UTC)[reply]

My 'attitude', and that of Wikipedia (arrived at through consensus) is that we don't write about bullcrap except in articles on the subject of bullcrap - and when we do we say 'this is bullcrap' in big shiny letters...

— AndyTheGrump, [7]
Quoted by Tgeorgescu (talk) 09:33, 1 April 2019 (UTC)[reply]
A neutral point of view is still needed even for the most contemptible subjects. This article feels very in-your-face in how it's trying to discourage the reader from alternative medicine. The most spectacular example of bias has to be: "This fact is often overlooked by media or intentionally kept hidden, with alternative practice being portrayed positively when compared to "big pharma"."
There was another user who said it best in a previous discussion (now archived) on this page. The article on Adolf Hitler still manages to portray a neutral point of view, and it doesn't feel as though it is deliberately trying to portray him in a negative light. But I can't see how anyone would be able to see him in anything but a negative light if their only knowledge of him came from that article. We can surely do better for alternative medicine. Anywikiuser (talk) 10:38, 1 April 2019 (UTC)[reply]
WP:NOTNEUTRAL. WP:SPOV is WP:NPOV for scientific matters.

The root cause of the problem is the false equivalence given to the views of anti-fluoridationists and the scientific community. The scientific consensus, by definition, incorporates all significant valid viewpoints. It develops over time in response to new data. In maters of science, the scientific consensus view is inherently the neutral point of view for Wikipedia purposes. To "balance" that with anti- views is to compromise fundamental policy.

— Guy, [8]
Quoted by Tgeorgescu (talk) 11:08, 1 April 2019 (UTC)[reply]

Proposed re-write of lede

The lede for this article is currently 7 paragraphs long with nearly 700 words. Some points are repeated, like the $2.5bn figure and the fact it differs from experimental medicine. Manual of style advice for ledes is that they should not usually exceed four paragraphs. For sure, this needs condensing. As this is a contentious topic, I'd rather float proposals and seek other editors' input. Here is a proposed plan:

  • Paragraph one: A quick definition of alternative medicine.
  • Paragraph two: This paragraph explains the difference between conventional and alternative medicine. Conventional medicine relies on trials to show medicine is effective. By definition, alternative medicines are not supported by these methods. How research promoting alternative medicine either falls short of these standards or ignores them altogether. Some of it is based off alternative views of how the human body and diseases work to modern scientific beliefs. Difference with experimental medicine.
  • Paragraph three: This paragraph looks at it from a human perspective. Briefly touches on the reasons why some people are drawn to it. The effects of taking them: at best, the placebo effect makes the patient feel less symptoms, but has no effect on the underlying illness. The

real problems: it can divert them from effective advice and treatment, and some alternative medicines are actively harmful.

  • Paragraph four: This paragraph looks at it from a wider perspective. Size of the global industry? Is it growing or shrinking? Criticism includes that it diverts resources from worthier causes. Regulation and the attitudes of governments and healthcare providers (it varies by country).
  • Paragraph five: More detailed notes about defining it, which notes how it's a somewhat loose concept, and has had several names. Difference/overlap with traditional medicine. A quick definition of complementary/integrative medicine. End with the quote: "There is really no such thing as alternative medicine, just medicine that works and medicine that doesn't."Let me know if think something different is needed. Anywikiuser (talk) 19:25, 11 March 2019 (UTC)[reply]

So to begin the draft: (References are to be concealed in comment brackets, as they are in the current lede)

Alternative medicine, also known as complementary and alternative medicine (CAM) and by other names, refers to a variety of treatments which have not been accepted or validated for use in mainstream medicine.[n 1][n 2][n 3][n 4]
Modern medicine relies on the scientific method to determine if treatments should be used.[2] A treatment can only be considered effective if it performs better than a placebo, in a clinical trial with blinding to control for observer biases.[3] Alternative medicine includes treatments have either been found in clinical trials to be ineffective, or have not been validly tested at all.[4] They are commonly based off non-scientific or pseudoscientific explanations for how disease works, such as those that come from traditional medicine or superstition.[5][6][4][7] Alternative medicine generally differs from experimental medicine, which refers to treatments that are being considered for scientific acceptance.
Reasons for the appeal of alternative medicine include how it is often advertized as "natural" or as "holistic".[8][9][10] Other factors include distrust and disillusionment towards conventional medicine,[11] and favourable media coverage.[9] Patients may perceive improvements after taking alternative treatments due to regression to the mean (i.e. a natural recovery or change in symptoms) and the effect of taking a placebo.[3] Research into placebos suggests they do not have a physical effect of diseases, but can improve how patients perceive their condition,[3] especially in the short term.[12] Most alternative treatments have little effect beyond that of a placebo.[5][13][8] It is rare for them to be effective, and some can be actively harmful.[8][14] Alternative medicine can also divert patients from receiving effective treatment.[15]
The prevalence and role of alternative medicine varies greatly by country. The global complementary and alternative medical industry was estimated to be worth US$59.8bn in 2018.[16] In some parts in the world with poor access to effective medicine, the most common treatments given are traditional medicine, which can overlap with alternative medicine.[17] In the Western world, use of alternative medicine has risen since the 1960s.[5][18][19][8] Attempts to include it in mainstream medical clinics, schools and funding plans have been opposed by the proponents of evidence-based medicine, who have furthermore called it a waste of healthcare funding and resources.[20][14][21][22][n 1]
The phrase "alternative medicine" came into use in the 1970s.[5][23][24][2][25] There is no universally agreed definition for the term; it generally encompasses treatments that have originated from outside of scientific research and used without proper evidence.[n 1][n 2] One argument is that the term itself is misleading, and that "There is really no such thing as alternative medicine, just medicine that works and medicine that doesn't."[26][27] Other terms include fringe medicine, pseudomedicine and questionable medicine. The term quackery implies medicine that is intentionally fraudulent.[28] The terms complementary medicine and integrative medicine refer to alternative medicine that is combined with conventional treatments.
  1. ^ Cite error: The named reference IGPIAMAYP was invoked but never defined (see the help page).
  2. ^ a b Cite error: The named reference NCHAMA was invoked but never defined (see the help page).
  3. ^ a b c Cite error: The named reference CochraneHrob2010 was invoked but never defined (see the help page).
  4. ^ a b Cite error: The named reference NSF_2002 was invoked but never defined (see the help page).
  5. ^ a b c d Cite error: The named reference ATRAMM was invoked but never defined (see the help page).
  6. ^ Cite error: The named reference Hines_Sampson_Coulter_Sagan was invoked but never defined (see the help page).
  7. ^ Cite error: The named reference AMCER was invoked but never defined (see the help page).
  8. ^ a b c d Cite error: The named reference Abdulla1999 was invoked but never defined (see the help page).
  9. ^ a b Cite error: The named reference ConsumerHealth9th was invoked but never defined (see the help page).
  10. ^ "Directive 2004/24/EC of the European Parliament and of the Council". Official Journal of the European Union. 2004-04-30. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  11. ^ Cite error: The named reference Beyerstein2001 was invoked but never defined (see the help page).
  12. ^ "Placebo Effect". American Cancer Society. 10 April 2015.
  13. ^ Cite error: The named reference $2.5 billion was invoked but never defined (see the help page).
  14. ^ a b Gorski, DH; Novella, SP (September 2014). "Clinical trials of integrative medicine: testing whether magic works?". Trends in Molecular Medicine. 20 (9): 473–76. doi:10.1016/j.molmed.2014.06.007. PMID 25150944.
  15. ^ (Edzard),, Ernst, E. More harm than good? : the moral maze of complementary and alternative medicine. Smith, Kevin,. Cham, Switzerland. pp. 129–130. ISBN 9783319699417. OCLC 1019807158.{{cite book}}: CS1 maint: extra punctuation (link) CS1 maint: multiple names: authors list (link)
  16. ^ "Complementary and Alternative Medicine Market Size, Share & Trends Analysis Report By Intervention". March 2019. Retrieved 2019-04-02.
  17. ^ Cite error: The named reference WHO_tradmed_fact was invoked but never defined (see the help page).
  18. ^ The New Age of Alternative Medicine, Why New Age Medicine Is Catching On, Claudia Wallis, Time Magazine, 11-4-1991, [1]
  19. ^ New Age Medicine, Encyclopedia of New Age Beliefs; John Ankerberg, John Weldon, 1996, pp. 470–508, [2]
  20. ^ Cite error: The named reference Wadman was invoked but never defined (see the help page).
  21. ^ IOM Report 2005, pp. 17, 196–252.
  22. ^ Cite error: The named reference Salomonsen_AHA was invoked but never defined (see the help page).
  23. ^ Cite error: The named reference QMHCHF was invoked but never defined (see the help page).
  24. ^ Cite error: The named reference CHBHAMA was invoked but never defined (see the help page).
  25. ^ "The Alternative Fix – Introduction". www.pbs.org. Frontline – PBS.
  26. ^ Cite error: The named reference Dawkins2003a was invoked but never defined (see the help page).
  27. ^ Cite error: The named reference Helmuth was invoked but never defined (see the help page).
  28. ^ "quack". Dictionary.com Unabridged (Online). n.d. Retrieved 2007-02-07.

Since I don't have a good overview for how large the AM industry is, I haven't done a 'paragraph 4'. Anywikiuser (talk) 10:11, 1 April 2019 (UTC) Paragraph 4 now added. Anywikiuser (talk) 11:40, 2 April 2019 (UTC)[reply]

I object to the phrase " It is a loosely-defined concept, and a treatment that is considered "alternative" in one country may not be in another." because it's bollocks. -Roxy, the dog. wooF 11:55, 2 April 2019 (UTC)[reply]
Thanks for your input. As some of the cited sources here note, it is hard to pin down a precise definition. A common definition is that it is 'not part of mainstream medicine'. Unfortunately, AM has sometimes permeated mainstream medicine, especially when packaged as 'complementary'/'integrative'. Another definition is to say it's medicine which is not evidence-based. That would allow something more consistent, but not all conventional medicine is evidence-based. Anywikiuser (talk) 13:35, 2 April 2019 (UTC)[reply]
it hasn’t become mainstream medicine at all. The conmen and quacks have attached themselves to real medicine, surely, but that does not legitimise their fraudulent practice. Roxy, the dog. wooF 14:02, 2 April 2019 (UTC)[reply]
Agree, Wikipedia has already taken a side, see WP:LUNATICS. Some might not like it, but Wikipedia already is a front for QuackWatch and organizations of skeptics. Wikipedia's choice in respect to SCAM industry has already been made and there is no coming back. Tgeorgescu (talk) 20:37, 2 April 2019 (UTC)[reply]
Despite being one third shorter, it still has five paragraphs. I realise the usual advice is no more than four, but this is quite a long article, and the first paragraph is a short one. Anywikiuser (talk) 21:28, 2 April 2019 (UTC)[reply]
  • In essence good effort, but some problems. The reason this article is so convoluted is because it has been exceedingly difficult to write in a way that rigorously enough defends the science from all the quacks that keep popping up. A major issue with the proposed text is the new definition, which is inaccurate. For starters, there is no such thing as "mainstream" medicine — it's just medicine, and "alternative" medicine simply purports to be medicine when it isn't. Second, the total lack of biological plausibility is what defines "CAM", and is why it isn't medicine. The proposed definition is circular, stating that there is a lack of biological plausibility is not. This might be difficult to express tersely, and I think that is something we're just going to have to accept. Carl Fredrik talk 23:23, 3 April 2019 (UTC)[reply]
It's not easy to find a 'quick' definition that can be universally accepted. Looking at the definitions cited by this article, there are obviously more than one:
  • Harrison: "...a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine" This source argues that the 'not used in the mainstream' definition is no longer entirely true, and that 'not evidence-based' definition is also problematic.
  • NSF: "...all treatments that have not been proven effective using scientific methods."
  • Angell: "What most sets alternative medicine apart, in our view, is that it has not been scientifically tested and its advocates largely deny the need for such testing." This sources also agrees that the 'not used in mainstream' definition is no longer entirely true. Later on: "Alternative medicine also distinguishes itself by an ideology that largely ignores biologic mechanisms, often disparages modern science..."
  • Tzu Chi: "Alternative therapies are those lacking scientific validation that are excluded from medical school training programs and uninsured by health plans."
  • IOM: "...a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period."
  • NCCIH: "CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine."
  • WHO: "...a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system."
As you can see, the 'not used in mainstream medicine' is used by some sources but others find it problematic. Perhaps the best 'quick definition' is to say "treatments which have originated from outside of scientific research and been used despite a lack of evidence that they are effective." Anywikiuser (talk) 08:58, 4 April 2019 (UTC)[reply]
But those aren't really good definitions either, because non-alt therapies such as Taxol originated outside the realm of traditional pharmaceutical research, and we lack evidence for many medical practices, including many surgical procedures. This bizarre fact stands despite, just a few months ago, science went so far as to producea randomized trial on parachute jumping:
The point being that the sole workable definition, which lies at the bottom of most of what you cite above, is that of: Alternative practices being those that lack biological plausibility and which are untested or untestable. The source currently used to express this in the lede is from Edzard Ernst's latest book "More Harm than Good". Carl Fredrik talk 21:32, 4 April 2019 (UTC)[reply]
Just as a minor note, the "parachute use" trial you mentioned is actually from the BMJ Christmas edition (described here, briefly mentioned at The BMJ#Journal content). While the article is legitimate, its main purpose is satire - in this case it's following the tradition of this article, also from the BMJ Christmas edition, which satirized the blind use of systematic reviews. :-) Sunrise (talk) 22:59, 4 April 2019 (UTC)[reply]
On a major note, I was being sarcastic. Carl Fredrik talk 11:30, 5 April 2019 (UTC)[reply]

Since the initial comment here says that the primary issue is length, it would be a much more effective approach to identify specific parts of the current lead that are redundant or over-detailed, then propose edits to remove or replace them. Changing the definition, for instance, is a separate discussion that will take a great deal of time without much impact on length. Mixing it in with all the other changes will only make the discussion more confusing and distract attention from other edits that might then be missed during the review.

This is, by the way, what I was thinking when I made these edits to shorten the current lead to 5 paragraphs - that the problem is solved much more easily than by a rewrite. For instance, the $2.5 billion figure was mentioned as an example of duplicated content, but fixing it was entirely uncontroversial and straightforward. Sunrise (talk) 22:42, 4 April 2019 (UTC)[reply]

Second proposal

One of the reasons I was so quick to turn down your version Anywikiuser, despite agreeing that the current version is too long — is that I have been thinking of rewriting this lede for a few months now. I've spend a disordinate amount of time on the following version, so please rest assured that each statement is backed up by either sources already in the article, or some which I will provide in the coming days. Note that I have tried to follow the current structure of the lead, while cutting some duplicate passages and totally rewriting others. The only thing my version lacks is any mention of "supernatural" or "superstitious" underpinnings of the "alternative". I guess this could be expanded upon.

Alternative medicine are generally practices that lack biological plausibility and which are untested or untestable, and in a few cases categorically proven ineffective. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine, are among many rebrandings of the same phenomenon. While the aim is to achieve the healing effects of medicine, alternative therapies share in common that they reside outside medical science. They are distinct from experimental medicine which employs scientific method to test plausible medical therapies through responsible and ethical investigation producing evidence of effect or of no effect. Traditional medical practices become "alternative" when used outside their original settings and in the face of better options with proper scientific explanation and evidence-base.

In some cases, laws of nature are violated by the claims of alternative practices; in others the practice is plausibly effective but so dangerous to the patient that any use is unethical. Alternative practices range from ineffective to harmful and toxic.

Much of the perceived effect of an alternative practice arises from a belief that it will be effective (placebo effect), or from the treated condition resolving on its own (the natural course of disease). This is further exacerbated by how alternative treatments are most often turned to upon the failure of medicine. At this point the condition will be at its worst and most likely to spontaneously improve. In diseases that don't get better by themselves, such as cancer or HIV, multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. While this may be because advanced disease causes patients to lose hope in medicine, it has also been shown that some alternative treatments actively interfere with medicine.

The alternative sector is a highly profitable industry with a strong lobby. Often juxtaposed to the derided "big pharma", the alternative-industry profits from less regulation and is allowed to promote practices which are proven to have no effect. Despite many countries having laws against marketing or promoting alternative therapies for many conditions, there is active promotion of use in cancer, autoimmune disease, HIV and among children. Billions of dollars have been spent studying the "alternative", with little to no positive results. Some of the successful practices are only considered alternative under very specific definitions, such as those which include all physical activity under the umbrella of "alternative medicine".

Take it for what it is, Carl Fredrik talk 12:33, 5 April 2019 (UTC)[reply]

Implemented. I mostly cut from what was already present, making it shorter but with the same meaning. Carl Fredrik talk 13:13, 5 April 2019 (UTC)[reply]
This has many of the same problems as the original lede. See my discussion of "Unproven vs. Disproven" above. I think Anywikiuser's version has gotten closer to fixing this issue, and closer to WP:NPOV.

The word "clearly"

We should remove the word clearly from the first sentence of the Definitions and terminology section which says "...whose effectiveness has not been clearly established using scientific methods...". It has not been established full stop, clearly or otherwise. Moriori (talk) 00:54, 4 April 2019 (UTC)[reply]

Done. Anywikiuser (talk) 08:58, 4 April 2019 (UTC)[reply]


Cite error: There are <ref group=n> tags on this page, but the references will not show without a {{reflist|group=n}} template (see the help page).

Retrieved from "https://en.wikipedia.org/enwiki/w/index.php?title=Talk:Alternative_medicine&oldid=891155040"