875:. Trying to figure out what is going on in a disease is really hard, too. For example, everybody knows that Alzheimer's is a terrible disease, and we have spent gobs of money trying to figure out what causes it. One of the bad actors is a piece of a protein. The piece is called "A beta" and the whole protein is called "APP". Well, with all the money we have spent, we still do not know what APP does in normal brains, and we still don't understand why the A beta piece gets cut out of it. We don't understand why neurons die in the brains of Alzheimer's patients, nor how to stop them from dying. That is crazy, right? It starts to make some sense when you realize that we have no way (really!) of looking inside a living human being's skull and seeing in detail — way down at the cellular level — what is going on. It's a serious problem! Anyway, we are scrabbling around in the dark. Humans are really, really complicated biological things. There's so much going on.
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get heads three times in a row. Should you stop there and decide that when you flip a coin, you always get heads? Is that "true"? (We all know it is not!) Maybe you should repeat that experiment, and again flip a coin three times. But you could still get heads (or tails) every time. However, if you flip a coin a hundred times, you will likely get about 50 heads and 50 tails. And if you flip a coin a thousand times, you will very likely get about 500 heads and a similar number of tails. The number of "flips" is called the "N" in experimental design. If the N is too small, it doesn't matter how many times you repeat the experiments — none of the experiments are valid. You need a big enough N to get a result you can trust.
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often conduct multiple Phase II trials (Phase IIa, Phase IIb, etc.) with various drug formulations and also in different patient populations or for different diseases, further exploring whether and how it makes sense to take on the much bigger expense and challenge of a Phase III trial. Phase III trials test the drug in large numbers of sick patients, with the goal of getting definitive data about safety and efficacy. These trials, which cost tens of millions of dollars to run, are carefully designed; the goal is to have a big enough "N" (see above!) and to follow patients long enough to get a reliable answer, but not
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always-developing discussion among scientists, and take individual results as some kind of gospel truth, when each paper is really just a stepping stone (sometimes a false one) as we (humanity) apply the scientific method to understanding the world around us. Non-scientists may not know that many research articles in biology turn out to be dead ends, or unreplicable, or even withdrawn. When a research paper is published, we cannot know if it will eventually turn out to be replicable and/or accepted and built on by the relevant field, and if it will not. Reviews tell us that.
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their release into the market and subsequent widespread use. Only after doing as much work as possible in cells and animals (and with many medical devices, in human cadavers) can testing on humans begin. Clinical trials of drugs start with small Phase I studies to explore how much of the drug can be used and to get an initial understanding of whether they are safe enough to continue testing. These tests are important and are dangerous. Terrible surprises happen (rarely, but they happen), such as what occurred in the Phase I trials of an
399:(experiments done on humans) are published, those papers are also primary sources. Some clinical trials are very well done (have enough subjects and are appropriately randomized, blinded, etc.) and some are very poorly done. It is very common to find publications of small clinical trials, the results of which cannot be generalized and which often contradict each other. It is not easy for nonscientists to tell which is which. So we still look for review articles to help us understand even this kind of primary source.
286:, but some are useful). Isolated cells in culture often behave differently than they do in whole organisms. Furthermore, there are significant differences in the genetics and physiology between animals and humans, so the results from animal studies often do not translate into humans. Finally, model systems are often genetically pure, and don't reflect the genetic diversity of the real world. Only a small portion of research is done on actual people, and even then it is done in artificial context of a
1146:– our brains tend to try to make sense out of things. A common mistake that arises from this, is that people often treat two events that happen one after the other, as though the first caused the second, or treat two things that happened at the same time, as being connected somehow. And plenty of times this is useful and helps each of us thrive and survive. But for complex matters like health and medicine (see above, for how complex!) these simple associations don't work.
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700:— we are doing our best to apply the findings of biological science to solve problems. We understand what aspirin itself is, very well (the chemistry, not the biology), but what happens when you put it into an average human body, or a particular person's body, is another question altogether. The science is too weak in biology, especially human biology, to apply and evolve technology with anywhere near the speed of information technology.
824:), and we have organs and organ systems that interact with one another on a meta-level, and systems like hormones that act across our entire body on a meta-meta level. The complexity is absolutely mind-blowing. Add to that the fact that everyone is different, because each of us is the result of a unique blend of our parents' DNA, and each of us grew up and exist in different environments. So you can give one person a dose of the drug
660:. It is still a young science, and our knowledge of even basic things is fragmentary, and even our big-picture ideas are changing all the time. Human biology — our understanding of what is going on inside healthy people and inside sick people — is even harder, and there are serious barriers to furthering our understanding. People in the physical sciences or technology seem to have an especially hard time understanding this.
816:. Think about how easy it would be to contaminate the experiment—to have the tiniest jot of some chemical on one of the instruments you are trying to use to manipulate the bacterium. It is really, really hard, just physically, to perform an experiment in biology; it takes a lot of skill and training, and it is really hard to even design an experiment where you are reasonably certain you are only changing one thing.
341:" thing is important – that means it has been tested in enough people so that we have a good sense of whether the outcome is meaningful – if it is probably true or is a fluke – you can flip a coin 5 times and get heads every time) This uncertainty and difficulty also goes for basic research that suggests that X or Y might be toxic or bad for you. It is hard to figure out what is true in the field of
1246:, great faculty, and great students. There is a whole world of conflict of interest there. Likewise, individual scientists compete with each other for grant funding (it is really, really hard to win research grants today!) and for publication in high-profile journals. Splashy press releases help raise an investigator's profile. A lot of "science journalism" —too much of it—is unreliable.
993:, sometimes fund head-to-head trials comparing treatments. Another way is that doctors and scientists sometimes pull together all the published clinical trials for a given condition, with all the various treatments that were used, and try to compare how well the treatments worked, and how safe they are, using complex statistical methods. These articles are called
730:. In simple terms, there are four different nucleotides: adenine, guanine, thymine, and cytosine, and we often describe the chain they make when they link together by using the first letters of their names: A, G, T, and C. So DNA is a long chain of As, Gs, Ts, and Cs. We can describe a given instance of a DNA molecule as a chain of letters: AAGTCTTGACT, etc.
345:; toxicologists think very carefully about things like how people are exposed to a substance, at what dose, and over what amount of time, and try to come up with useful ways to model that in lab studies. Dumping a ton of a chemical directly on cells and killing them, tells you nothing about whether skin contact will harm you, nor at what dose!
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rearrangements of DNA segments. But genomes remain consistent enough from organism to organism within a species that we can indeed meaningfully talk about "species"). The simplest bacteria (which are some of the simplest living organisms) have DNA that is a chain 139,000 nucleotides long (ATCTG, etc., times ~139,000). Microscopic, mind you!
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might become convinced that it was the switch that made the difference and that "modern chemical medicine" is bad and "natural medicine" is good. (But again, see the "correlation is not causation" fallacy). This goes on and on. People have experiences, and want to generalize from them. When scientists hear about this, they say, "Oy".
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headaches—that's a correlation. But what does this really mean? Does wearing clothes while you sleep make you sleep poorly, or maybe cut off blood to your head or something? Well...the study didn't measure how much beer people drank the night before! Right? Now it all makes sense. In this case, the beer drinking is what we call a "
1412:? There was huge media hype around that. And yep, people rushed to add content to Knowledge based on the hyped primary source (note the edit date, and the date the paper came out), only to delete it later when the paper was retracted. There is no reason to be jerking the public around like that – we have
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Knowing that people are keenly interested in health-related matters, the media loves to grab science news and pump it up — this sells newspapers and pulls eyes to TV shows and websites. This is something that has been happening more and more over the past thirty years or so, and is driven in part by
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The reviews are written primarily for other scientists in the field — reviews are one of the key tools that the scientific community uses to map itself, to step back and see where things stand. For
Knowledge, these reviews are "secondary sources", and they are dramatically more reliable than primary
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of drugs is important, and is difficult—again because you are back to doing epidemiological studies that are not controlled, and it is hard to determine whether problems that arise in the population taking the drug (who are sick!) are caused by the drug or not (the correlation and causation problem).
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In any case, after Phase I trials establish dose levels and give a high-level insight into safety, Phase II trials start. These are conducted on larger (say 10–100) groups of patients who are actually sick, and the goal is to get an insight into safety and efficacy in actual patients. Companies will
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Now, think about science. Newton could stand in his back yard, drop an apple, and measure how long it took the apple to hit the ground. He could change the experiment — climb a ladder and drop it from higher, and time that. But of course, all that is pretty... uncontrolled. What if it's windy one
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The result of all of this is that the world is awash with content about health. All kinds of media holler at us every day, about "new THIS" and "shocking THAT". Very often that content is dead wrong, or dramatically overstates what we can confidently say, based on the science. And many people have
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Why does this happen? Newspapers want to tell stories that sell. And maybe these science/health topics are considered "soft" stories—public interest more than hard news, and are not subject to the same strict editorial and fact checking that real hard news stories are. They generally run with press
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In addition to this, there are some problems with academic science and publishing even in the most reputable journals. Academic scientists are on a kind of hamster wheel. Their research is funded by grants that last for a few years at most. They need to string together grant after grant, in order
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And remember, this is just a bacterium. You can kill it, chop it, dump chemicals on it...pretty much whatever you want to try to create a controlled experiment and then see what happens. What if you want to understand an organism that has multiple cells, like a human? And remember, our cells also
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so different — innovators in medicine have to deal with regulators and whether insurance companies will pay for things, with serious ethical issues involved in experimenting on animals and humans, and with the huge amounts of money and time and risk in bringing new products to market. All these make
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information to the public. We have nothing to do with hype or eyeballs or the 24-hour news cycle. We go slow, and say what is certain (which includes saying "we don't know" or "there is insufficient evidence to say X"). All of
Knowledge stands on, and is based on, the consensus of whatever field a
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There is a lot of money involved in health-related matters — everything from hype around basic research to drive donations to universities or sales of newspapers/attention to TV news, to companies trying to sell treatments of all kinds. With our 24-hour news cycle and the need to keep people coming
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your child. Or say your child is prone to earaches and your doctor keeps prescribing antibiotics, yet your child still gets earaches and now has an upset stomach, and so you turn to alternative medicine to try to mitigate things... and then after you make the switch your child stops suffering. You
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Now from time to time, scientists sit down and read a bunch of research papers. They think about them and write what we call "reviews", where they try to fit all the primary research together in a way that makes sense. The scientist doing the review will generally cite the primary studies that are
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Another thing scientists do are "epidemiological studies". These are studies of a lot of living people where you measure a bunch of things and try to find correlations. But correlations are dangerous. For example, say a study found that college kids who sleep in their clothes tend to wake up with
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making progress, our answers are still pretty crappy, pretty fragmentary. (This is why we do experiments on animals. A lot of people, including scientists, struggle ethically with whether it is acceptable to do experiments on animals, and if so, how. It is not an easy question. How will we learn
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Turn back to a bacterium. Tens of thousands of nucleotides in even the simplest genome, dozens of genes encoding for many different proteins, etc., etc., and everything interacting with each other, and the whole bacterium interacting with whatever is floating around it, including...other bacteria.
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says "Neutrality assigns weight to viewpoints in proportion to their prominence. However, when reputable sources contradict one another and are relatively equal in prominence, describe both approaches and work for balance. This involves describing the opposing views clearly, drawing on secondary or
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When you do an experiment, you try very hard to execute it perfectly, so that you actually do what you intended to do and get a valid result. But how do you know if the result you got is true or is just some random answer? This comes down to statistics. If you flip a coin three times, you might
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A "genome" is, basically, all the DNA in a cell. (A given species will have a pretty consistent genome on a high level, but every instance of that species will be slightly different — there will be many small variants — some of them a single nucleotide change, some of them being whole deletions or
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science. Don't get me wrong — biologists do experiments — they poke and prod living things in various ways, to help them try to flesh out the pictures we are still forming about what is going on in living things. But we are not in possession of a set of "laws of nature" such as those that govern
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to serve us, to the point where we now have amazing things like smartphones — computers we can hold in our hands and interact with in intuitive ways, capabilities that just a couple decades ago would have taken an entire room full of equipment to provide and that only cutting-edge scientists could
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back to websites, there is huge hype around basic science that is not ready for showtime in any responsible way. This is why you see the phrase so often: "If you have questions, discuss them with your doctor." Your doctor (if they are not a quack) will almost always tell you, "We don't know yet."
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This is starting to become a matter of concern in the scientific community. Drug discovery scientists at Bayer reported in 2011 that they were able to replicate results in only ~20–25% of the prominent studies they examined; scientists from Amgen followed with a publication in 2012 showing that
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There is much we don't know even about existing therapeutics and other treatments. For example, there was a ton of great basic research (done in cells and model organisms) that showed a connection between oxidative damage and cancer; this research suggested that taking antioxidants might prevent
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studies in animals and cells to try to understand the risks of substances that have beneficial uses outside of medicine. Scientists do test new drugs, medical devices, and diagnostic tests on humans to determine if they work well enough (that is, are "effective"), and are safe enough, to justify
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Sometimes—rarely, but probably more commonly as we move into the 2010s and beyond—companies test new drugs against existing drugs. They do that because payors (insurance companies, national health payment systems like
Medicare or NHS in the UK) are starting to demand this kind of information to
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And repeating a high N experiment costs a LOT of money and time. So scientists often use the minimum N they can that will enable them to publish. And many journals allow scientists to publish results — and conclusions drawn from them — with small Ns. As a result, there are many, many papers
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Finally, there is a lot of money involved in health-related matters. Conflict of interest is a serious issue in publishing, and almost every journal requires its authors to report any possible conflicts of interest so that reviewers and readers can consider those conflicts when they judge the
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was his hand above the ground? He could take it inside, where there is no wind. He could put the apple in a holder attached to a ruler, and release it from a precisely determined height. What he is doing there, is thinking about how to design a controlled experiment, so he is only testing
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Biology is still a young science, and even our knowledge of basic things is fragmented; our big-picture ideas change all the time. Those from physical sciences or technology sometimes have an especially hard time understanding this — biological systems can't be mapped out and expected to act
914:", and suddenly we can see that the correlation we saw before is really meaningless. Just because the two things happen to occur together does not mean one caused the other. So while it is tempting to say that the correlation implies causation, it is a very dangerous thing to assume (see
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The scientific literature is not really intended for the general public. The
Internet has made it more available to the public, as has the open access movement. Both are a mixed blessing. The downside is that everyday people may take research papers out of context from the ongoing and
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Because biology is so complex, it is often very difficult to make good inferences. This is a very simplified map of a few pathways in a cell. Try to visualise the billions of cells in a human body and thousands upons thousands of pathways and you may realize why referencing criteria are
476:. Our role is to read and understand the reliable secondary and tertiary sources, in which experts have pulled the basic research together into a coherent picture, and summarize and compile what those sources say, in clear English that any reader with a decent education can understand.
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There are different kinds of reviews—some of these are kind of impressionistic, where a senior scientist in a field sits back and reflects. Others are more serious and more detailed, and actually do statistics and analyze and criticize the papers they are pulling together. That latter
692:— that DNA "makes" RNA which "makes" proteins — has turned out to be far more complicated than biologists originally thought. We still don't fully understand what something as basic as aspirin does in the human body, much less what it does in a particular person's body. We understand
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kind—systematic, critical reviews—are by far the most valuable, both for us at
Knowledge, and for anybody trying to understand what the hell is going on. Some of these systematic critical reviews are written especially for doctors to help them understand where things stand. The
564:. We have to let the best sources teach us. And yes, it takes commitment – both in time, and to the values of Knowledge – to really try to find the best secondary sources, access them, absorb them, and learn from them how to distribute WEIGHT in a Knowledge article.
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What makes this even more challenging is that because this is a volunteer project, Knowledge editors often come here and stay here due to some passion. This passion is a double-edged sword. It drives engagement and the creation of content, but too often brings with it
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and it will perform just as you expect it to, but if you give the same dose to another person, and it can be wildly more potent or less potent. (Some drugs are more sensitive to individual differences than others, but all drugs act differently in different people.)
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be some clear benefit to society from any experiment done on a human, and the research subject must be protected as much as possible from any risk of harm. For this reason, scientists don't test things like pesticides directly on humans. Instead, we rely on
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Even scientific breakthroughs in biology take many years, and a great deal of money, to turn into anything useful. Even then, many new drugs, medical devices or diagnostic tests based on the best of science fail in adequately powered clinical trials, when
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in
Knowledge articles on these kinds of reliable, independent, secondary sources. We should stay away from primary sources, and from reports in the popular media hyping research publications. Folks are always happy to talk about specific sources at
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justify drug pricing. This testing provides really valuable data. Outside of that, there are two ways we get insight into what available treatment ~might~ be best for a given patient with a given problem. One is that federal agencies like the US
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The mapping work — determining how the exploration is going and where we stand — is done in review articles. (Ignored articles aren't usually explicitly mentioned in reviews either — they are busy with building up accurate maps, not debunking dead
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in every cell in every living thing. It interacts physically with other actual chemicals, which in turn interact with other chemicals, and so on and so on. The sum of those actual interactions is what we call "life", and even "consciousness".)
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sources. They give us the consensus (or, if not consensus, the emerging consensus, or a clear picture of what the main contending theories are) in any given field about what is true and what is not, and what is still unknown or uncertain.
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This is what biology is like. People do research in mice, or in cells in petri dishes, or they cut up dead people. We do controlled experiments that make sense, and we can start to put stories together about what is going on. And while we
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Physics deals with dead matter. We can poke and prod without doing harm, and what we are looking at is what we are looking at. Life (made of physical matter, of course) is way more complicated. In comparison, "dead" is easy; life is hard.
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to keep their labs going. Scientists who run labs spend a huge amount of time seeking out funding opportunities and writing research proposals to try to win them. Generally, in order to win the next grant, you publish high-profile,
740:(We need to be careful here — people use a lot of metaphors in biology, and they are starting to slip into thinking about "genomes" as pure information—as literally some kind of code, like software. But in the real world, any genome
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This is the raw stuff of science. It is messy, and scientists know that they are groping their way toward the truth, together. These papers are very important to science, but they are of almost no value to the general public.
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as well as into the mass of data we have built up about how groups of people respond to various treatments—to try to understand, bit by bit, what we are and how we are affected by diseases and by the drugs meant to treat them.
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we try to figure out human biology? We use models — mostly other organisms on which we can do experiments, and based on the results, we can then try to make guesses about human biology. You might have heard the joke about
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It's easy to fall prey to people pushing theories like the now-completely-discredited vaccine theory. (a drastic "correlation is not causation" mistake). Worse, when people fall prey to baloney like that, they start to
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Within the long, long chemical chains of DNA, certain segments function as a kind of code (we call these segments "genes"). The cell has machinery (yes! — actual mini-machinery that is amazing to behold and consider — see
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and multiple organ failure in the six patients to whom it was given. While all of them survived, they required treatment in intensive care and the long-term effects on them are unknown.) Phase I disasters like that are
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Scientists also analyze published results and try to make sense of them, often with complex statistical modelling. All of these efforts show us stretching, reaching out, into the microscopic, churning darkness where
960:, but the point is, they do happen, even with the most careful planning. Putting a drug in a human for the first time is one of the scariest and most intellectually and ethically challenging experiments imaginable.
1071:— if a scientist cannot win grant funding to keep a lab going, the lab will be closed down and dispersed. It is as harsh as being in sales — you eat what you kill. You can see the potential for problems here.
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given article falls within. We always have to think carefully about what sources we use to generate content, and this is especially true for health-related content. For health-related content, the field is
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and look? We do not have any technology that allows us to non-invasively look deep inside a living thing on a microscopic level in real time. That technology just doesn't exist in the real world—we have no
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This is really important. Only egregiously bad papers are actually retracted; there are loads and loads of papers that draw conclusions that turned out not to be true, but that remain in the literature.
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Human biology is even harder because there are constraints as to what we can do. We can't cut up healthy living humans and examine them microscopically to see what is going on in real time (unless you were
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that are limited in time and in the number of patients who are treated, and there is often more to learn about drugs after they are on the market, and are used by millions of people over years and years.
317:). Nor is it even possible to collect data on certain processes such as surgery. To really assess quality of care it would be necessary to perform placebo surgery, which is widely considered unethical.
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that some
Swedish surgeons had "carried out the world's first synthetic organ transplant". They put that in bold print at the top of their article. The problem is that this was dead wrong.
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People take things that happen to them very seriously, and try to generalize from them. But this is not valid scientifically (tiny sample and cognitive biases) and people too easily mistake
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in the regions of DNA between genes — we used to think the DNA in those regions was just inert. But we are learning more and more that all kinds of interesting things are happening there.
530:— in selecting a given primary source and giving it a lot of weight (or any weight at all, actually) — they are performing original research. It is sometimes hard to get people to see this.
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papers using the grant you have now. So there is a huge force pushing academic scientists to move from one experiment to the next and to draw conclusions from their research that are
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NPOV depends mightily upon editors' grasp of secondary sources. We have to find good ones – recent, independent ones – and absorb them, and see what the mainstream positions are
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Biologists are working like crazy to understand "life" and are under all kinds of pressure to get grants and publish papers. They publish boatloads and boatloads of papers.
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So when you pick up any given published paper, we don't know what is going on well enough to judge whether the conclusions will "stick" or not. Even scientists don't know.
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This is really, really problematic—especially in the case of vaccines, where there are serious risks not only to your child but to other people and their children, in
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And people have all kinds of strong ideas about health – it is a fundamental thing we all care about, both for ourselves and our loved ones. Something goes wrong with
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The physical sciences have given us deep insight into material reality, and because the science there has progressed so far, we can do amazing things. For example,
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933:, and large bodies of international and national law and regulation concerning this. A principle that all these bodies of law and regulation share is that there
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The artificiality of the studies presents a serious problem in translating results to any natural setting, much less translating them to human health or biology.
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the 24-hour news cycle and its hunger for stories. But the popular press is really, really unreliable for health news. For example, the BBC—very respected! —
353:, so we could really learn if taking Vitamin E (a great antioxidant) could actually prevent cancer in actual humans. Guess what? People taking Vitamin E got
183:", a shorthand reference to Knowledge's guideline about sources considered reliable for health-related content. This essay explains why these standards exist.
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Here is an example of what we should not be doing. Remember that scientist who published work showing that you could turn adult cells into stem cells using
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for diagnosing and treating diseases or conditions. When these organizations make statements, they are summarizing the evidence that exists and providing
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they were only able to replicate six (11%) of fifty-three high-impact publications and called for higher standards in scientific publishing. The journal
542:, as expressed in reliable, secondary sources. (Independent ones!) It is so hard for people to differentiate what they see and what they "know" from what
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to put out hype-y press releases when their scientists and doctors do things. Making a splash draws great attention, enhances reputation, and attracts
441:– which the community created after long and arduous discussion – we reach for review articles published in the biomedical literature, or statements by
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those sources, in putting egos aside and letting the secondary sources speak, is the key that saves
Knowledge from our personal, limited perspectives.
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mainstream view on it; you can trust those are true as well, and those statements also make great secondary sources for health content on
Knowledge.
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Horvath CJ, Milton MN (April 2009). "The TeGenero incident and the Duff Report conclusions: a series of unfortunate events or an avoidable event?".
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written for the general public. Scientists do experiments using their model systems, as discussed above, and publish the results in order to talk
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Alive, and constantly changing. And all microscopic and invisible to the naked eye. Think about trying to do an experiment and trying to change
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Biological processes occur on a microscopic scale, with thousands of different kinds of molecules interacting all the time. At the same time, the
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to report the latest and best). It is not a journal or a book, pulling together all the primary sources into a coherent picture — that is what
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This is a good analogy to how experiments in biology are performed. Sometimes it's so dark that we can't even begin to look where we want to.)
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People who are not experts in the field have no way of knowing which research papers have been left in the dust by the scientific community.
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written by experts in the field, published by respected publishers). MEDRS (MEDical
Reliable Source) explains how to find such sources for
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Prinz F, Schlange T, Asadullah K (August 2011). "Believe it or not: how much can we rely on published data on potential drug targets?".
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In Knowledge, these research papers are "primary sources." Hopefully, you now have a good understanding of why these papers are not
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It contains the advice or opinions of one or more Knowledge contributors. This page is not an encyclopedia article, nor is it one of
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published in the scientific literature that turn out to have conclusions that cannot be considered true because the N is too small.
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is being discussed and addressed throughout the health and biomedical sciences; it is especially acute in the field of psychology.
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Sometimes editors wanting to use primary sources are agenda-driven — there is something in the real world that is very important
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descriptions of reality. They shouldn't be used by the general public for anything, much less creating encyclopedic content.
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These fields are different worlds, scientifically speaking. (I am not even getting into structural differences that make the
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As mentioned above, scientists write reviews from time to time, which are dramatically more reliable than primary sources.
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knowledge regarding its subject". Secondary sources are where conclusions stated in primary sources are "accepted" or not.
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about biology if we cannot do experiments with living beings, especially ones that are similar to us? How do we actually
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So, it is hard to tell what is going on. We use models, we do big studies and make correlations...and all of these are
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by cherry-picking primary sources. Editors should cite primary sources rarely, and then only with good reason and care!
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The call to use independent secondary sources is deep in the guts of Knowledge. This is a meta-issue — a question of
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Also, from time to time, major scientific or medical organizations come out with statements on important issues—the
726:— it is a chemical made up of many subunits all connected in a chain. Each of those subunits is a chemical called a
572:
for one position or another. This is a quandary. The discipline of studying secondary sources and editing content
230:
views (often identified by omission from the secondary sources) carry little to none. It is very easy to engage in
1270:
270:
1266:
is a group of doctors and scientists who concentrate on doing this. These reviews are very very valuable to us.
298:, and rarely produces results that transfer painlessly to the real world. (You might have heard the joke about
1227:
to jerk the public around like this. A newspaper has an excuse, but Knowledge does not — we need to provide
434:
1837:
1741:
even the most highly cited randomized trials may be challenged and refuted over time, especially small ones
1709:
Ioannidis JP (July 2005). "Contradicted and initially stronger effects in highly cited clinical research".
380:
Because the work is exploratory, much of it turns out to be false leads or dead ends and is simply ignored
1263:
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322:
808:
so that he will know exactly what is changing and can later make sense of the results of his experiment.
506:
Sometimes they are everyday people, who don't understand that the scientific literature is where science
377:
to be taken as health advice by everyday people – it is not meant to be taken out of context and applied.
778:
1855:
Begley CG, Ellis LM (March 2012). "Drug development: Raise standards for preclinical cancer research".
1562:
Begley CG, Ellis LM (March 2012). "Drug development: Raise standards for preclinical cancer research".
1093:
announced in April 2013 that in response to these and other articles showing a widespread problem with
925:. These are also scientific experiments where the scientists are trying as hard as they can to change
929:, again so they can actually make sense of the results. There are intense ethical issues involved in
1864:
1571:
1413:
1334:
1318:
553:
instead of acting like barroom philosophers who shoot from the hip or letting media hype drive them.
283:
1392:
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1378:
If you believe a particular primary source is of high value, you can always ask for advice at the
1921:
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1733:
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1594:
1545:
1379:
1314:
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1290:
1147:
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are appropriate in some cases, relying on them can be problematic. For more information, see the
569:
488:
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295:
149:
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think is important, right now, nor even about what the media is hyping today. It is about what
273:
and other organisms. This becomes mind-bogglingly complex at the level of the actual molecules.
166:
1880:
1812:
1726:
1685:
1587:
1538:
1501:
1139:
Part of this is pretty obvious, but other parts are more complex and deserve some discussion.
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and create extensive or strong content based on them generally fall into one of three groups.
454:
367:
338:
737:
But ... who cares? Why does that matter? Well, DNA is kind of the "blueprint" of the cell.
584:
allows primary sources to be used, it is "only with care, because it is easy to misuse them."
468:
Our mission is to express the sum of human knowledge – "accepted knowledge", in the words of
1913:
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1804:
1718:
1677:
1669:
1635:
1579:
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on Knowledge are often surprised when their edits are reverted with the rationale of "Fails
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Zillions of interactions, all happening on a microscopic scale, and changing all the time.
602:
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The ignored articles are not marked in any way, for us to know which ones they are. The
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Or let's take stories about food. Let's see, should I drink coffee or not? Maybe I will
1868:
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1630:
Baker M (27 August 2015). "Over half of psychology studies fail reproducibility test".
1496:
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1363:
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These papers are not retracted, nor are they labelled in any way. They just sit there,
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is a direct result of our advances in physics and materials science and our ability to
587:
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Sometimes they are scientists, who treat Knowledge articles like they themselves are
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The primary scientific literature is very exploratory, and not reliable. The use of
58:. Some essays represent widespread norms; others only represent minority viewpoints.
1890:
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1367:
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say things like "that paper is bunk. We are going to ignore it." Instead, they
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articles, which is a different genre. Each article is meant to be "a summary of
878:
Since we can't chop up living human beings or do crazy experiments on them, how
591:
tertiary sources that describe the disagreement from a disinterested viewpoint."
1934:
357:, and the trend was so clear that they had to stop the clinical trial early.
196:(MEDRS) is not different from other guidelines, because all Knowledge content
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actually listen to and be taught by reliable, independent, secondary sources
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The primary literature is written by scientists, for scientists. It is not
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349:
cancer. So the NIH funded a huge (adequately powered!) clinical trial, the
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do in review articles in journals, and what historians do in their books.
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and your doctor tells you that they are autistic. How did this happen??
222:
sources. Mainstream views, as determined by the sources, carry the most
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773:
from, or it can go off and do things on its own—like become part of a
1655:"PSYCHOLOGY. Estimating the reproducibility of psychological science"
247:
1917:
1876:
1583:
1452:"This is why you shouldn't believe that exciting new medical study"
769:
function as a kind of code that other machinery "reads" and builds
696:, but our knowledge is far from perfect. Medicine like aspirin is
549:
It is hard for people to think like scholars, with discipline, and
404:
A lot of people have strong opinions about health-related matters.
1196:
on their work with artificial bladders—work they started in 2001.
325:(in other words, applying the basic biological research to create
165:
1135:
A lot of people have strong opinions about health-related matters
788:
All those things (DNA, RNA, proteins, and many other things) all
1282:
781:, or do many other things. We used to think there was a lot of
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719:
29:
1223:, and is just from the past couple of years. I think it is
428:
But as an encyclopedia, Knowledge is committed to providing
1762:
Stimulus-triggered acquisition of pluripotency (STAP cells)
522:, and they want that idea expressed in WP and given strong
1018:
Primary scientific literature is exceptionally unreliable
1074:
But how exactly does this hamster wheel affect science?
479:
In articles related to health, editors who want to cite
226:. Significant minority views are given less weight, and
1774:
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871:
So, trying to understand normal basic human biology is
862:
855:
848:
799:
day, or really humid so the air is thicker? How high
647:
157:
1613:"Psychology's Replication Crisis Can't Be Wished Away"
765:, by reading off the nucleotides on DNA. The RNA can
370:
sources is really dangerous in the context of health.
1838:"Scientists' Elusive Goal: Reproducing Study Results"
822:
their own DNA that is producing mRNA etc all the time
495:
a story from primary sources. But articles here are
761:
for an animation) that creates a different polymer,
546:— as expressed by experts in a given field — knows.
1117:
just ignore papers that turn out to be false leads.
425:strong ideas that are not based on science at all.
1337:which highlights potentially unreliable citations.
906:. These are real questions, and very hard ones.)
748:abstract information. DNA is an actual, physical
200:be generated by summarizing high quality sources (
1281:, other governmental organizations like the UK's
1111:part of this description. Generally, reviews do
1097:, it was taking measures to raise its standards.
897:what is going inside a living being if we do not
194:Knowledge:Identifying reliable sources (medicine)
1904:"Announcement: Reducing our irreproducibility".
1471:"Why most published research findings are false"
918:if you want to dig into that whole thing more).
1711:The Journal of the American Medical Association
323:Translating insights from biology into medicine
1760:. Wikimedia Foundation, Inc. 30 January 2014.
351:Selenium and Vitamin E Cancer Prevention Trial
1950:
885:searching for keys where the light is better.
407:It is about us and our loved ones, after all.
300:searching for keys where the light is better.
8:
1781:. Wikimedia Foundation, Inc. 11 April 2014.
1516:
1514:
1425:See, for example, points 5 through 8 of the
619:what it means to be an editor on Knowledge.
282:(cultured cells, worms, flies, lab mice). (
1957:
1943:
1935:
1653:Open Science Collaboration (August 2015).
1279:Centers for Disease Control and Prevention
1275:Agency for Healthcare Research and Quality
987:Agency for Healthcare Research and Quality
715:Going a little deeper into the science...
1495:
1486:
1207:, and hey, if I am woman maybe I will be
1194:Another team published an article in 2006
1001:is an example of a group that does this.
820:interact with each other (where each has
597:says, "Base articles largely on reliable
361:Welcome to biology. Welcome to medicine.
1219:. Every one of those links is from the
607:Primary, secondary, and tertiary sources
216:in the reliable sources, especially the
2065:Knowledge essays about reliable sources
1442:
1347:
1150:is very weak, and as discussed above,
779:directly interfere with other molecules
688:physics. Even what we once called the
624:Secondary sources about health matters
1238:Also, hospitals and medical colleges
931:doing medical experiments with humans
453:Knowledge is an encyclopedia. It is
238:Why is this especially important for
7:
457:(we aren't in a hurry, and we don't
290:where the researchers try to change
210:biomedical or health-related content
2060:Knowledge essays about verification
1273:, US government agencies like the
916:correlation does not mean causation
609:section of the NOR policy, and the
294:at a time. This is all part of the
1082:Increasing N costs money and time.
690:central dogma of molecular biology
329:) is another level of difficulty:
56:thoroughly vetted by the community
52:Knowledge's policies or guidelines
25:
1183:The popular press and health news
254:is based on the basic science of
214:in proportion to their prominence
187:Summary of the long content below
33:
1250:conclusions that authors draw.
246:What we understand about human
2070:Knowledge essays about editing
1523:Nature Reviews. Drug Discovery
1380:WikiProject Medicine talk page
712:from information technology.)
510:– it is where scientists talk
445:medical or scientific bodies.
1:
991:National Institutes of Health
833:Human biology is harder still
718:Most everybody has heard of "
683:Biology remains primarily an
528:In the very act of doing that
463:scientists and other scholars
1965:Knowledge biomedical editing
1912:(7446): 398. 25 April 2013.
1488:10.1371/journal.pmed.0020124
1287:American Medical Association
1213:it alters my estrogen levels
1152:correlation is not causation
722:", but what is it? It is a
534:Knowledge is not about what
69:Knowledge biomedical editing
1975:Editing for medical experts
1450:Belluz J (August 5, 2015).
1231:information to the public.
978:Post-marketing surveillance
951:; it unexpectedly caused a
613:section of the BLP policy."
449:Secondary sources generally
76:Editing for medical experts
2086:
1836:Naik G (2 December 2011).
1395:. For health matters, see
1163:What happened to my child!
1067:. "Publish or perish" is
1024:
838:
637:
491:and these editors want to
147:
27:Essay on editing Knowledge
1970:
1640:10.1038/nature.2015.18248
1308:is about. We should base
1271:World Health Organization
989:or, less frequently, the
611:Misuse of primary sources
412:correlation for causation
335:actually tested on humans
1809:10.1177/0192623309332986
1611:Yong E (March 4, 2016).
1217:it will screw up my baby
921:Scientists also conduct
790:interact with each other
1674:10.1126/science.aac4716
435:evidence-based medicine
175:Editors who are new to
2012:Plain and simple guide
1995:Biomedical information
1723:10.1001/jama.294.2.218
1264:Cochrane Collaboration
1144:pattern making animals
999:Cochrane Collaboration
177:health-related content
172:
113:Plain and simple guide
96:Biomedical information
18:User:Jytdog/Why MEDRS?
2007:Conflicts of interest
1797:Toxicologic Pathology
1469:Ioannidis JP (2005).
971:All three phases are
708:medicine a different
169:
108:Conflicts of interest
54:, as it has not been
2017:WikiProject Medicine
1775:"Induced stem cells"
1754:"Induced stem cells"
1052:to other scientists.
382:by other scientists.
284:All models are wrong
276:Most research is on
118:WikiProject Medicine
1869:2012Natur.483..531B
1842:Wall Street Journal
1576:2012Natur.483..531B
1285:or nonprofits like
1254:About sources again
1046:These articles are
947:cancer drug called
269:interacts with the
1535:10.1038/nrd3439-c1
1295:medical guidelines
1291:Cancer Research UK
1148:Anecdotal evidence
995:systematic reviews
759:this youtube video
489:literature reviews
386:replication crisis
296:scientific process
240:biomedical content
173:
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2046:
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1758:Knowledge: The đź’•
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2027:How to edit
1481:(8): e124.
1414:no deadline
1335:user script
1205:drive safer
1201:live longer
1142:Humans are
973:experiments
899:cut it open
665:Moore's law
656:Biology is
629:Biology is
437:. And per
355:more cancer
309:rationally.
271:environment
202:independent
128:How to edit
42:This is an
2054:Categories
1990:Why MEDRS?
1529:(9): 712.
1437:References
1354:Including
1235:releases.
1215:and maybe
1159:your child
1035:WP:MEDPRI2
1020:in biology
940:toxicology
912:confounder
904:tricorders
728:nucleotide
698:technology
673:technology
648:WP:BIOHARD
493:synthesize
368:WP:PRIMARY
343:toxicology
327:technology
91:Why MEDRS?
2032:Resources
2022:Talk page
1925:256745496
1696:218065162
1397:WP:MEDMOS
1360:WP:VERIFY
1065:important
1061:important
841:Shortcuts
806:one thing
676:operate.
658:difficult
631:difficult
595:WP:VERIFY
562:WP:FRINGE
524:WP:WEIGHT
219:secondary
158:WP:WMEDRS
133:Resources
123:Talk page
2037:Outreach
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1823:33854812
1816:19244218
1737:16749356
1730:16014596
1689:26315443
1591:22460880
1549:16180896
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1505:16060722
1325:See also
1319:WT:MEDRS
1306:WP:MEDRS
1277:and the
1229:reliable
1225:terrible
1168:advocate
1126:ignored.
1105:reliable
1027:Shortcut
849:WP:NOTRI
826:coumadin
783:junk DNA
775:ribosome
771:proteins
710:universe
640:Shortcut
601:. While
574:based on
570:advocacy
544:humanity
501:accepted
439:WP:MEDRS
430:reliable
375:intended
267:organism
252:medicine
181:WP:MEDRS
150:Shortcut
138:Outreach
1891:4326966
1865:Bibcode
1662:Science
1598:4326966
1572:Bibcode
1497:1182327
1364:WP:NPOV
1331:WP:UPSD
966:too big
949:TGN1412
801:exactly
767:in turn
724:polymer
705:markets
588:WP:NPOV
540:we know
520:to them
508:happens
474:editors
339:powered
260:complex
256:biology
1906:Nature
1857:Nature
1632:Nature
1564:Nature
1366:, and
1315:WT:MED
1244:donors
1091:Nature
580:While
470:WP:NOT
392:ends.)
248:health
228:fringe
224:weight
198:should
171:tough.
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1658:(PDF)
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1368:WP:RS
1356:WP:OR
1342:Notes
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443:major
395:When
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