Wikipedia talk:Identifying reliable sources (medicine)
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 | Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Identifying reliable sources (medicine).
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These are some Frequently Asked Questions about Wikipedia's guidelines on sourcing for medical content, manual of style for medicine-related articles, and how the guidelines and policies apply to biomedical content. General
Does Wikipedia have special rules for medical information?
Yes, but the guidelines for medical information follow the same broad principles as the rest of Wikipedia. Examples of this include the requirement for reliable sources and the preference for secondary sources over primary sources. These apply to both medical and non-medical information. However, there are differences in the details of the guidelines, such as which sources are considered reliable. Why do you have special rules for medical information?
Different types of sources have different strengths and weaknesses. A type of source that is good for scientific information is not usually as reliable for political information, and vice versa. Since Wikipedia's readers may make medical decisions based on information found in our articles,[1] we want to use high-quality sources when writing about biomedical information. Many sources that are acceptable for other types of information under Wikipedia's general sourcing guideline, such as the popular press, are not suitable sources for reliable medical information.[2][3][4] (See also: WP:MEDPOP and WP:WHYMEDRS) When do I need to follow MEDRS?
MEDRS-compliant sources are required for all biomedical information. Like the policy on the biographies of living people ("BLP"), MEDRS applies to statements and not to articles: biomedical statements in non-medical articles need to comply with MEDRS, while non-medical statements in medical articles do not need to follow MEDRS. Also like BLP, the spirit of MEDRS is to err on the side of caution when making biomedical statements. Content about human biochemistry or about medical research in animals is also subject to MEDRS if it is relevant to human health. Sourcing
I used a peer-reviewed source, but it was reverted, and the editor said I needed to use a review. I did, didn't I?
Probably not. Most peer-reviewed articles are not review articles. The very similar names are easily confused. For most (not all) purposes, the ideal source is a peer-reviewed review article. Why can't I use primary sources?
Primary sources aren't completely banned, but they should only be used in rare situations. An individual primary source may be flawed, such as being a clinical trial that uses too few volunteers. There have been cases where primary sources have been outright fraudulent. Furthermore, a single primary source may produce a different result to what multiple other primary sources suggest, even if it is a high-quality clinical trial. Secondary sources serve two purposes: they combine the results of all relevant primary sources and they filter out primary sources that are unreliable. Secondary sources are not infallible, but they have less room for error than a primary source. This follows a principle that guides the whole of Wikipedia. If a company announces a notable new product, Wikipedia would not cite a press release on the company's website (a primary source) but instead would cite a newspaper article that covers it (a secondary source). The difference with medical information is that the popular press are not suitable sources. Whenever possible, you should cite a secondary source such as:
So if primary sources can be used in rare cases, what are those rare cases?
Primary sources might be useful in these common situations:
Why can't I use articles from the popular press?
The popular press includes many media outlets which are acceptable sources for factual information about current events, sometimes with significant caveats. It also includes media outlets which are discouraged in all cases because the quality of their journalism is inadequate. However, even high-quality media outlets have disadvantages in the context of medicine. Firstly, news articles on medicine will frequently be reporting a new medical primary source, such as the results of a new study. This means that they are effectively acting as a primary source, which as explained above makes those articles generally unsuitable for medical information. These articles also tend to omit important information about the study. If a medical primary source is to be cited at all, the academic paper should be cited directly. Secondly, media coverage of medical topics is often sensationalist. They tend to favor new, dramatic or interesting stories over predictable ones, even though studies that reflect the current scientific consensus tend to be predictable results. They tend to overemphasize the certainty of any result, such as reporting a study result as a conclusive "discovery" before it has been peer-reviewed or tested by other scientists. They may also exaggerate its significance; for instance, presenting a new and experimental treatment as "the cure" for a disease or an every-day substance as "the cause" of a disease. The sensationalism affects both which stories they choose to cover and the content of their coverage. High-quality media outlets can be good sources of non-medical information in an article about a medical topic. Another acceptable use is using a popular press article to give a plain English summary of an academic paper (use the I have a source from PubMed, so that's reliable right?
Not necessarily. PubMed is merely a search engine and the majority of content it indexes is not WP:MEDRS. Searches on PUBMED may be narrowed to secondary sources (reviews, systematic reviews, meta-analyses, etc.) so it is a useful tool for source hunting. It is a common misconception that because a source appears in PubMed it is published by, or has the approval of, the National Institutes of Health (NIH), National Center for Biotechnology Information (NCBI), or the US government. These organisations support the search engine but lend no particular weight to the content it indexes. Can I use websites like Quackwatch?
Quackwatch is a self-published website by an author who is an expert in problems with complementary and alternative medicine. Whenever possible, you should use a scholarly source instead of Quackwatch. However, if no scholarly sources are available, and the subject is still notable, then it might be reasonable to cite Quackwatch with WP:INTEXT attribution to the POV. Can I cite Chinese studies about Traditional Chinese Medicine?
As of 2014, there are concerns regarding positive bias in publications from China on Traditional Chinese Medicine.[5][6] Such sources should be used with caution. The problem also includes issues with the academic system in China.[7] Can I cite NCCAM (now NCCIH)?
Yes, but again only with WP:DUE weight. Unlike other branches of the National Institutes of Health, which are generally accepted as authoritative in their fields, NCCAM has been the focus of significant criticism from within the scientific community.[8] Whenever possible, you should cite the established literature directly. What if I can’t find any MEDRS-compliant sources on a subject?
MEDRS contains a section about finding sources which may be helpful. Alternatively, a more experienced editor may be able to help you find them (or to confirm that they do not exist). Neutrality
What is a fringe medical claim?
A fringe medical claim is one that differs significantly from the prevailing views or mainstream views in the scientific medical community. This is similar to Wikipedia's general definition of a fringe claim. A claim can still be a fringe medical claim even if it has a large following in other areas of public life (such as politics and the popular press). How should fringe medical claims be described?
When fringe claims have been widely reported in the press, have a large popular following, and/or have a long history, it may be appropriate to describe them in terms of that reporting, popularity, or history. However, weight should be determined by MEDRS-compliant sources, and the context (or lack thereof) should not make implications about medical statements that are not supported by such sources. Guidance on the additional considerations relevant to fringe subjects can be found at WP:FRINGE, as well as at other places such as WP:WEIGHT and WP:EXCEPTIONAL. In the case of alternative medicine, medical statements are often derived from an underlying belief system, which will include many propositions that are not subject to MEDRS. These propositions are subject to the usual sourcing requirements and the usual requirements for determining fringe status. If a treatment hasn't been shown to work, can we say it doesn't work?
There are three possible situations:
In the first case, we cannot say that it does not work, but we can say that there is no evidence to determine whether it works. After multiple, high-quality independent studies have been published, the understanding may transition from "no evidence" to "some evidence" of either an effect or no effect. You should follow the lead of review articles and other secondary sources for determining when this threshold has been crossed. Reports may conflict with each other. For example, a clinical trial may produce no evidence of an effect, but the treatment's manufacturer might produce testimonials claiming a positive effect. You should follow the lead of review articles and other secondary sources for determining how to balance these claims. Should medical content be attributed?
In other words, is it necessary to say in the article's text the source which supports a medical statement (with attribution)? Or can it simply be stated as an unchallenged fact, with the source only mentioned in the citation (without attribution)? A statement without attribution will come across as being a stronger claim than one with attribution. A result or statement from a reliable secondary source should be included without attribution if it is not disputed by any other recent secondary sources. You should do a search to check that the secondary source you are citing is the most up-to-date assessment of the topic. If there have been two recent secondary sources that contradict each other, then you should attribute the disputed findings. On the other hand, if the findings of one or more recent secondary sources are disputed by one or more secondary sources from many years ago, but not by any recent ones, the recent findings can be stated without attribution. You should also take into account the relative weight secondary sources have. For example, Cochrane Collaboration reviews provide stronger evidence than a regular secondary source. In the rare cases where primary sources can be used, they should be attributed. Why not say there is a call for more research?
It is common for scientific publications to say something like this, either directly or indirectly. There are several reasons for this. It could be argued that more research is always a bonus, even if the topic has already been thoroughly researched. Sometimes, these statements may be made partly because authors need to convince readers that the topic is important in order to secure future funding sources. As such, saying this does not communicate much information, and it may also mislead readers into thinking that the existing information on a topic is less reliable than it really is. How can Quackwatch be considered a reliable source?
As noted above, Quackwatch does not meet the usual standard as a reliable source, but it can be used (with attribution) for information on a topic of alternative and complementary medicine if there are no scholarly sources available for the same purpose. The guidelines on fringe theories includes the concept of parity: if a notable fringe theory is primarily described by self-published sources, then verifiable and reliable criticism of the fringe theory does not need to be published in a peer-reviewed journal. It only needs to come from a better source. Finding and using sources
How can I find good sources using PubMed?
National Library of Medicine (NLM), PubMed, NCBI, & MEDLINE help, tutorials, documentation, & support
Full, searchable list of all tutorials - training materials in HTML, PDF and Video formats YouTube channel for the National Library of Medicine: Tutorial videos from the National Center for Biotechnology Information (NCBI), part of the U.S. National Library of Medicine. Includes presentations and tutorials about NCBI biomolecular and biomedical literature databases and tools. PubMed FAQs
National Library of Medicine (NLM) Catalog
NLM Catalog Help - This book contains information on the NLM Catalog, a database which provides access to NLM bibliographic data for journals, books, audiovisuals, computer software, electronic resources, and other materials via the National Center for Biotechnology Information (NCBI) Entrez retrieval system. The NLM Catalog includes links to full text materials and the library's holdings in LocatorPlus, NLM's online public access catalog. NLM Catalog (rev. December 19, 2019). Finding journals that comply with WP:MEDRS standards
For full comprehensive instructions, go to: Searching for Journals in NLM Catalog Determine if a specific journal is indexed in MEDLINE
If you know the full or abbreviated name for a journal, and you want to see if it is indexed in MEDLINE, see the instructions at searching by journal title, which I will also reproduce here:
Review the list of Abridged Index Medicus journals
Via a search of the NLM Catalog: List of Abridged Index Medicus journals, also known as "Core clinical journals". Stand alone list: List of current Abridged Index Medicus (AIM) journals (118 journals as of 5 May 2020) Create a list of all Index Medicus journals
Search the NLM Catalog using ====Create a list of all journals indexed in MEDLINE}}
Search the NLM Catalog using MEDLINE, PubMed, and PMC (PubMed Central): How are they different?
MEDLINE, PubMed, and PMC (PubMed Central): How are they different? Are there ways to find good sources other than PubMed?
Besides being a secondary source, what else indicates a source is of high quality?
I found what looks like a good source, but can't access the full text – what next?
Most scholarly journals are behind paywalls. Some options to access these articles include visiting a local university library, visiting The Wikipedia Library, and WikiProject Resource Requests. Note that paywalled articles are frequently pirated and made available on the open web. When linking to a journal article, care must be taken not to link to such a pirate copy, as such a link would be a copyright violating link in contravention of Wikipedia's policy. In general if you find such a copy and it is not accompanied by text explicitly stating that it is made available with the permission of the copyright holder, assume that it is potentially infringing, and do not link to it. This holds for all edits in Wikipedia, not just in article space. Google Scholar
Search for the title of the article on Google Scholar. On the results page, click on "All n versions" (where n = the number of available versions of that article) at the bottom of a listing. The resulting page might contain PDF or HTML versions of the article. Unpaywall
Consult Unpaywall.org for journal articles available without a subscription. Install the UnPaywall extension for Chrome or Firefox to immediately identify articles with a free version. After you install the extension, look to the right side of the page (when you are on the website for an article) for either a grey locked symbol (no free version) or a green unlocked symbol (click on that symbol to access the full text version of the article). Librarian's advice
An article by librarian John Mark Ockerbloom, titled, "Why Pay for What’s Free? Finding Open Access and Public Domain Articles" offers helpful suggestions.[9] How do I reference a medical article?
Almost all medical articles are indexed by the PubMed search engine and have a Digital object identifier (DOI) assigned to them. All articles included in PubMed are assigned an eight-digit PubMed identifier (PMID). These identifiers can be used to refer to articles, which is preferred to URLs as it makes a reliable link which is resilient to changes beyond our control – i.e. the publisher being acquired by another publisher and it's "normal" web URLs changing as a consequence. Once you have the PMID, there are a number of tools such as this one which you can use to generate a full citation automatically. In article references, the "doi" and "pmid" parameters are preferred to the "url" parameter for such reasons. On Talk pages, when referring to journal articles, is it good practice to make any link using these types of identifier also:
Conflict of interest
Are there special considerations for conflicts of interest for health content?
See WP:MEDCOI. What if I am being paid to edit medical content?
See WP:PAID. References
References
Other helpful resources
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Feedback for sum-up diagram
[edit]
I am creating a new section to discuss the feedback you may have about this diagram. That way, you don't have to read the previous conversation (in the section "Proposal of sum-up diagram "), where we discussed previous versions of the diagram. Please only provide comments on how the diagram could better illustrate and sum-up the MEDRS guidelines. This section is not the right place to suggest changes to the guideline itself. I'm looking forward to reading your suggestions.
Scientific letters
[edit]This page says when determining how to treat a source, see how the source is classified in PubMed and that a page that is tagged as "Comment" or "Letter" is a letter to the editor (often not peer-reviewed).
However, some sources classified "Letter" in PubMed aren't "letters to the editor" - they are "scientific letters". These are short research articles, peer-reviewed, with a fast turnaround, like this.
See the distinctions:
- Here
Scientific Letter: Manuscripts that aim to announce scientific discoveries and data or preliminary reports that are of clinical significance are accepted for publication as scientific letter. Scientific letters do not contain subheadings and should not exceed 900 words. Number of references should be limited to 10 and the number of tables and figures should be limited to 2.
- note "letter to editor" is described separately. - Here
5.4. SCIENTIFIC LETTERS Articles that include original data and describe the experience of the authors will be included in this typology.
- note that 5.5 is "letters to the editor". - A paper on the difference -
There is however an other type of academic, scientific and technical document, the titles of which have never been studied. We are referring to “scientific letters”, also known as “scientific communications”. Scientific letters (SLs), which may be categorized as a “primary source” like the research article, are short descriptions (4-5 pages) of important current research findings which allow researchers to rapidly publish (4-6 weeks) the results of their investigation. Like research papers (RPs), SLs are peer-reviewed and must meet the same high standard of quality with the addition of timeliness and brevity
I suggest that this should be clarified such that if in doubt the article classification should be clear from the article itself and the the publishing standards of the journal it is in. Eg. adding a sentence such as:
If in doubt, refer to the journal's classification of the original publication alongside the journal's own submission guidelines to determine what type of article it is and whether it has been peer-reviewed.
Void if removed (talk) 11:35, 27 May 2025 (UTC)
I don't see the example paper you give on PubMed, so can't determine what category it would be. It may be useful for this discussion to look at several examples of letters to the editor and scientific letters, from journals that accept them. Which article types are classified as "comment", which as "letter" and which as something else.
Earlier we say "Every rigorous scientific journal is peer reviewed."
but fail to caveat this with "but not every article in a peer-reviewed journal is peer reviewed"
. That gotcha has come up so often, I don't know why we don't say this. Maybe we did and it got lost, or I can't find it. I think we should say that. And then at the bottom section on using pubmed, we could give advice on which sorts of articles are always peer reviewed (in a peer-reviewed journal), which are never, and which one might need to refer to the editorial/submission guidelines of each journal.
We may also need some words to say that "peer review" is just one form of review, peculiar to academic journal publications, and isn't perfect nor inherently superior to in-house review by a respected publication or organisation's own experts. It doesn't indicate scientific consensus, doesn't indicate research would meet the quality standards of a systematic review selection process, and doesn't analyse all aspects of an article with the same rigour. Maybe we should find some sources on this. -- Colin°Talk 16:39, 27 May 2025 (UTC)
- So for example, here is a scientific letter in the South African Journal of Psychiatry, titled "Changes in schizophrenia symptoms, tryptophan metabolism, neuroinflammation and the GABA-glutamate loop: A pilot study". You can see at the top it is classed as a "scientific letter", and if you look at the whole journal issue, it is listed as a "scientific letter" separate from the "letters to the editor".
- However, here it is in PubMed and if you scroll to the bottom you can see the type is "Letter".
- The journal guidelines are here, where a "scientific letter" is described as
Original research that is limited in scope can be submitted as a scientific letter rather than a full original research article.
. Meanwhile "letters to the editor" are in a different section. - On further investigation, I find an older scientific letter here, however, is not categorized as a letter in pubmed here, but as a journal article. I'm wondering if this is some quirk of PubMed that will eventually be corrected for the newer paper? Void if removed (talk) 17:07, 27 May 2025 (UTC)
- AIUI the publishers send their classifications to PubMed, which accepts whatever they tell them. I would not expect it to be updated.
- Labeling proper research as "letters" has a long history. It does make things confusing for us. But mostly we're able to sort this out in the individual case. The trend towards journals posting article history (e.g., dates for milestones) is particularly helpful, because if they say that the article was sent for peer review on a particular date, then you know that it was peer reviewed. WhatamIdoing (talk) 17:34, 27 May 2025 (UTC)
- It should be obvious though that the classification in the journal is accurate, and PubMed can be wrong, right? Void if removed (talk) 19:48, 27 May 2025 (UTC)
- It should be obvious that editors ultimately need to use their best judgment and all the known facts to determine what something actually is, instead of relying on any label on any website. Typos and misclassifications can happen anywhere. WhatamIdoing (talk) 02:00, 28 May 2025 (UTC)
- It should be obvious though that the classification in the journal is accurate, and PubMed can be wrong, right? Void if removed (talk) 19:48, 27 May 2025 (UTC)
- Maybe we should just remove "For example, a page that is tagged as "Comment" or "Letter" is a letter to the editor (often not peer-reviewed)." as it would appear to be an unhelpful example. Then a more general comment can be made somewhere that not every article is peer-reviewed, for example, editorials, letters to the editor, news and current affairs reporting. Any other/better examples? Void's proposed text could fit somewhere, though I'm not keen on "If in doubt". Alternative? -- Colin°Talk 07:38, 28 May 2025 (UTC)
- I think it's important to say somewhere that "comments" and "letters to the editor" are not usually (i.e., basically never) peer-reviewed, but your wording is IMO an acceptable way to say it.
- Editorials and news are occasionally peer reviewed, though most of the few I've seen have been internal peer review rather than the traditional external peer review. WhatamIdoing (talk) 22:11, 28 May 2025 (UTC)
Healthline vs WebMD?
[edit]You are invited to comment at WT:MED#Healthline vs WebMD?, as part of it relates to the content of MEDRS. Sunrise (talk) 04:14, 30 June 2025 (UTC)
I hope this is the right place?
Is anyone available to assess this edit [1]. I'm not convinced that some, if not all the references are MEDRS compliant. Thanks in advance. Knitsey (talk) 16:05, 22 July 2025 (UTC)