Wikipedia talk:Manual of Style/Medicine-related articles

To-do list

• Add advice on how to incorporate the psychological, emotional, and social effects of health problems into articles.
  • should be infused throughout
  • may need some subsections, e.g., reaction to a life-threatening diagnosis
  • I support this one—and not just because I'm a psychologist! ;-) ... We have had discussion about this topic before. Let's link to such archived discussions, e.g., this one from 2008. Mark D Worthen PsyD (talk) [he/his/him] 14:36, 5 May 2021 (UTC)
• Add advice on how to present costs.
  • accuracy ("the wholesale list price in Ruritania in 2017 according to Alice", not "the price")
  • WP:MEDMOS2020 results
  • any recommended metrics, such as cost effectiveness, cost per DALY averted,[1] etc.
• Add statement about gender-neutral language.
  • Avoid unexpected neutrality for subjects very strongly associated with one biological sex (e.g., pregnancy, menstruation, and ovarian cancer affect "women"[2]; prostate cancer and orchiditis affect "men") but encourage gender neutrality for all others (e.g., heart disease)?
  • Defer to MOS for any individual person.
• Reading levels
• How to talk about suicide-related content (e.g., the "committed" RFC)
  • I've added a statement about the word "commit", and alternative phrasings. Bibeyjj (talk) 12:10, 28 October 2021 (UTC)
• Clarify how to include "evolution" in anatomy articles (suggest under "Development" subheading). Bibeyjj (talk) 18:52, 6 October 2021 (UTC)
• (Your idea here)

What to do with this to-do list?

It's not clear to me if the above "To-do list" is a WikiProject Medicine effort, i.e., something we, as a WikiProject, have decided (via consensus) to establish, or if it was one (unidentified) editor's idea, or something else. Can someone clarify? Mark D Worthen PsyD (talk) [he/his/him] 03:51, 4 May 2021 (UTC)

This is a collection of items that various conversations and disputes have indicated (a) it might be helpful for MEDMOS to address but (b) exactly what the consensus is or how to address the subject in MEDMOS will require further discussion.

Any editor is welcome to add a suggested topic to the list. It doesn't have to be a subject that you personally care about or relates to an article you were editing. Please add enough context that we can figure out what your subject is later.

If you feel ready to address one of the topics, then please start a new ==section== at the end of the page to ask a question or make a proposal. WhatamIdoing (talk) 06:53, 5 May 2021 (UTC)

Please don't start discussions in this section. Please do add links to prior discussions and examples or other details that you think will be helpful (signed or not, as you choose) when we have the real discussions. WhatamIdoing (talk) 16:35, 5 May 2021 (UTC)

Does Major depressive disorder, a featured article violate WP:MEDSAY?

I have noticed that this article contains a long excerpt from Digital media use and mental health, which lists many systematic reviews and describes them in detail, for example:

• In April 2013, the Journal of Adolescent Health published a systematic review of 33 studies of adolescent girls that found a positive association between screen time and depression.
• In June 2016, Adolescent Research Review published a systematic review of 12 studies of subjects aged 11 to 21 years that concluded that while internet technology may provide adolescents opportunities to seek emotional and social support, the research reviewed did not establish that internet technology lowers rates of adolescent depression.
• In December 2017, Adolescent Research Review published a systematic review of 11 studies comprising 12,646 child and adolescent subjects that found a small but statistically significant correlation between social media use and depressive symptoms.

Do you think these violate WP:MEDSAY? Bendegúz Ács (talk) 18:55, 26 March 2024 (UTC)

@Bendegúz Ács, yes, I do think that is the kind of stylistic problem that MEDSAY says not to put in articles. I've blanked about 10% of the article for being out of compliance with WP:MEDDATE (this is a heavily researched area, so sources should be from the last five or so years), which will cut down on the stylistic work that needs to be done.

Overall, I wonder whether a complete re-write would be ideal. It might be easier to start over than to try to transform the existing catalog of published papers into an encyclopedia article. WhatamIdoing (talk) 20:34, 26 March 2024 (UTC)

I also find this article to be full of excessive undue details that make it hard to read, so I agree that a complete rewrite may be the best way to deal with it. What worries me more than Digital media use and mental health is that so much of its subpar content is excerpted in Major depressive disorder, which is a featured article, supposedly "[one] of the best articles Wikipedia has to offer". There is a call for a review of that status in the article's talk page from 2022, and based solely on the issue I found, I could agree that it's needed. Considering that I don't have too much interest in investing more time in fixing the article, do you think the best course of action in this case is to submit it to a review? Bendegúz Ács (talk) 18:07, 27 March 2024 (UTC)

I think it would be faster to ask @Casliber about it directly. WhatamIdoing (talk) 06:02, 1 April 2024 (UTC)

Watching high traffic articles can be difficult, especially when busy with outside endeavours for protracted periods. I'll try and take a look Cas Liber (talk · contribs) 06:57, 3 April 2024 (UTC)

(update) I have removed the offending section for the time being, due to it being in the wrong section of the article and in far too much detail for the scope of the article. The material should be distilled to 3-4 sentences and placed in either causes or management section. Cas Liber (talk · contribs) 12:39, 4 April 2024 (UTC)

@Bendegúz Ács: thanks for highlighting this. Took me a while to figure out what happened. Cas Liber (talk · contribs) 12:40, 4 April 2024 (UTC)

Thanks to you too for fixing it, this is a useful experience for me to understand both the guidelines and the editing process. Bendegúz Ács (talk) 21:18, 8 April 2024 (UTC)

Should articles about human anatomy not include Human in the title?

According to this guideline, articles about human anatomy should not include "human" in the title if "non-human references" to these topics are not common, even if it is necessary to disambiguate them from articles about non-human anatomy.

Should Wikipedia's articles about the human brain and skeleton be titled Human brain and Human skeleton, while its articles about human pregnancy and human kidneys are simply titled Pregnancy and Kidney?

I don't see any logical reason for these less-specific titles, and would prefer to give these articles more-specific and less-ambiguous names. Jarble (talk) 16:35, 30 July 2024 (UTC)

Pregnancy has been discussed many times, and unless you are able to answer all of the usual objections, then I doubt it would be worth your time to try to get the article title changed. In particular, I suggest that you type pregnancy into your favorite web search engine and figure out the percentage of results that are human vs non-human. For me, I get:

• 10 ordinary search results, 100% of which are human
• 12 images, 100% of which are human
• 5 news stories, 100% of which are human
• 100 books, 100% of which are human

100% of the search results being about humans is practically the definition of '"non-human references" to these topics are not common'. WhatamIdoing (talk) 18:15, 30 July 2024 (UTC)

• No. Starts like "In humans, the kidneys are two reddish-brown..." are fine, or a hatnote - ideally more of these would be worked into the text (I see you have been going around adding them). Note that Kidney gets 1,400 views a day, Mammalian kidney gets 37. Johnbod (talk) 18:40, 30 July 2024 (UTC)

  And https://wikinav.toolforge.org/?language=en&title=Kidney indicates that 0.3% of the page views for Kidney result in someone clicking through to Mammalian kidney. That suggests that about 99.7% of readers aren't looking for non-human results. WhatamIdoing (talk) 19:04, 30 July 2024 (UTC)

@Johnbod and WhatamIdoing: References to non-human anatomy are much less common than references to human anatomy, but articles that only describe human anatomy often include human in the title.

According to this guideline, should Wikipedia's article about the human brain be titled Brain because references to non-human brains are relatively uncommon? Jarble (talk) 13:36, 31 July 2024 (UTC)

Choosing "Brain" for an article entirely about the human brain would violate neither this guideline nor the Wikipedia:Article titles policy.

Whether it's better depends largely on editors' understanding of the contents of each article. I would generally encourage editors to pick the Brain/Human brain combination if the general article has significant information about the human brain as well as non-human brains. I would generally encourage editors to pick the Brain/Brain (non-human) combination if the general article does not have much information about human brains. WhatamIdoing (talk) 15:31, 31 July 2024 (UTC)

Disability terms

I've reverted some recent changes here. I think there is a danger that stuff that belongs on the Wikipedia:WikiProject Disability/Style advice page is creeping into here. And I don't think the shortcuts proposed are a good idea. This page isn't the MOS for autism or writing about deaf people.

Sometimes terms are just controversial or are widely used without problem in one country and not in another. Sometimes the POV is important and a medical or educational-system context has a different POV than a social one. The term "special needs" is only a euphemism for disabled if you are using it as a euphemism for disabled. In the UK in particular, "special educational needs" is exactly what it says on the tin: an indication to educational bodies that this child needs extra help than typical children would get, and is an official term that enables funding and allowances.

While we are here, I think WAID has mentioned before that the idea that "most deaf people" consider themselves part of the "deaf community" is incorrect. That may be true for people deaf from birth or at an early age. Most old people with deafness struggle to even accept they are deaf, never mind identify with any community. Deafness from birth is around 1 or 2 per 1000 births. Whereas half of those over 75 have disabling deafness. For them, this is just one feature of getting old. So I don't know if we can easily reword that "most deaf people" or perhaps just drop it. The purpose here is to just give an example of groups who think differently about their disability, not to be exhaustive. -- Colin°^Talk 10:21, 20 November 2024 (UTC)

Well I already used MOS:AUTISTIC (because anyone would be excited to use their own redirect rule) so It needs to link somewhere. Also I added it to the page last week and no one removed it so maybe you didn't need to revert too much. But I was very scared to add a new redirect maybe your right and I did do it wrong. You said you don't think the shortcuts are a good idea so maybe adding them to Wikipedia:WikiProject Disability/Style advice is better? ill do that now. Anthony2106 (talk) 10:40, 20 November 2024 (UTC)

Just because you created a shortcut and used it doesn't mean the community think such a shortcut is a good idea. There are thousands of medical conditions someone might have an opinion on the wording for, but it doesn't mean there's enough material or enough consensus to actually have a Manual Of Style agreed about it. The longer guidelines get, the more they become TLDR. In the conversation you used it, the editors there agreed already what wording to use without needing a MOS page. And linking to the whole guideline or essay might have been enough. Shortcuts are best reserved for very frequently used links to specific paragraphs. -- Colin°^Talk 20:19, 20 November 2024 (UTC)

@Colin Did I put it in the correct place now? Also I think the shortcut is a great idea as every time I change "person with autism" to "autistic person" I gotta say way each time. But if I didn't have MOS:AUTISTIC I could probably just say "as per WP:AUTISM"

Also I think there is enough consensus to say identity first is better for autism. Anthony2106 (talk) 05:03, 21 November 2024 (UTC)

My point is that you shouldn't be making changes rapid fire like this to MOS. I agree with you on the identity first language, BUT, you really really need to slow down. ^SMason_Garrison 05:07, 21 November 2024 (UTC)

@Smasongarrison Ok I've learnt for next time so before making shortcuts ill ask Anthony2106 (talk) 05:09, 21 November 2024 (UTC)

Great! Being bold is generally a good thing, MOS is an exception. ^SMason_Garrison 05:11, 21 November 2024 (UTC)

@Smasongarrison so is MOS:AUTISTIC in a good place now that ive moved it? Anthony2106 (talk) 05:21, 21 November 2024 (UTC)

I don't know. Shouldn't it be a WP not MOS? ^SMason_Garrison 05:26, 21 November 2024 (UTC)

@Smasongarrison whats the difference? Anthony2106 (talk) 05:27, 21 November 2024 (UTC)

One is a shortcut to a manual of style and the other is just a general shortcut, typically to an essay. MOS holds a lot more weight because it makes it clear that it's policy. ^SMason_Garrison 05:42, 21 November 2024 (UTC)

Except that the MOS isn't policy. It's a {{style guideline}}. So according to your rationale, MOS: holds less weight, because it makes it clear that it's not a policy.

(I don't think most editors distinguish between the two pseudo-prefixes.) WhatamIdoing (talk) 05:44, 21 November 2024 (UTC)

Policy/guide whatever you want to call it. My point is that WP is a general shortcut, while MOS is more specific. ^SMason_Garrison 13:45, 21 November 2024 (UTC)

I've replaced "most deaf or autistic people" [prefer identity first terminology] with "some deaf of autistic people". The former statistically wrong for deafness, where the huge majority of people who are deaf are old people. And the identity preferences for autism likely reflect the proportion of that group with language and internet access who participate in polls and discussions. Around a quarter to a third of autistic people have no or little language, and their opinion on identity language is unknown or a meaningless question. -- Colin°^Talk 20:30, 20 November 2024 (UTC)

In the case of age-related disabilities, the choice of language can indicate the meaning. For example: people with hearing loss are usually well past retirement age, but Deaf people often get jobs working remotely. The same statistical pattern affects vision loss. An elderly person who is saving up for overdue cataract surgery is not the same as people who grew up without vision. My impression is that US people who have no light perception or very little vision prefer being called "blind", and that describing them as, e.g., "a person with a visual impairment" or "a person with limited vision" can feel like minimizing their situation ("I don't have limited vision; I have no vision!").

I despair of making accurate statements about adults on the autism spectrum. Unless it gets many years of attention from experts in nosology, we're probably going to continue seeing "person with a mostly healthy body except for brain malformations, no speech, and some stimming" get lumped into the same group as "person who prefers a comfortably predictable environment and is better suited to engineering than sales", and we'll continue seeing diagnosis based on providers' personal impressions instead of facts, which means that a given person could be diagnosed with autism by one provider but anxiety by another, and no way to prove that one is correct.

Until that gets sorted, I would encourage all of our autistic editors and their allies to remember that "when you've met one autistic person, you've met one autistic person", and that when we're making general statements about people on the spectrum, those the validity of those statements should IMO be checked (at minimum) against:

• toddlers,
• adults with high IQ and good verbal skills, and
• adults in need of institutional care due to multiple, severe co-morbid behavioral problems.

For example, "They should have paid jobs in the community" is not true, because toddlers should not have jobs, and "They should go to school every day" is not true, because adults are usually done with school. Those sentences should be re-written to be accurate (e.g., "School-age kids with autism should attend school"). But "They should be loved and included in their families" does not need to be re-written, because that's true for everyone. WhatamIdoing (talk) 22:43, 20 November 2024 (UTC)

Yeah but when you say "They should have paid jobs in the community" people know your talking about someone older. And when the hell do you get diagnosed with anxitey when trying to get diagnosed with autism that just makes no sense. The APA style guide says to use identy first language when mentioning autism so does the autism wikipedia project Isn't it just common knolage by now? Anyway I thought it would save some time to have a redirect instead of just talking about it over and over. Maybe now I've put it in the correct place. Anthony2106 (talk) 00:59, 21 November 2024 (UTC)

The "gold standard" diagnostic test for autism (ADOS) has a 34% false positive rate.[3] That means that every third time the test tells you that a kid has autism, they actually don't. In some populations, the Positive Predictive Value for ADI-R and ADOS is approximately as good as flipping a coin.[4] That means if you tested every kid, and n% were told they have autism, then half(!) of those kids would be incorrectly diagnosed. In one study, 39% of kids who lived in an orphanage screened positive for autism, which tells us either that autism isn't primarily hereditary, or it is hereditary in ways that make you far more likely to end up in an orphanage, or that the tests are not very good.[5]

Diagnosers can't tell the difference between motor symptoms due to Antipsychotic#Adverse effects and stimming (or ticcing, for that matter), so 30% of schizophrenia patients get told that they have autism, too.[6] About 30% of people with anorexia nervosa test positive for autism;[7] nobody knows whether to call it a comorbidity or a bad test. Diagnosers are also bad at telling the difference between anxiety and autism. (For example, when people feel frightened, they don't have neurotypical patterns of eye contact, they don't have smooth speech rhythms, and they don't use natural hand gestures. If they feel frightened during the diagnostic test, they will display behaviors that will be recorded as "autistic", when they are actually "neurotypical frightened behaviors".) The rates for this depend on gender: autistic females are told they have an anxiety disorder, and anxious males are told they have autism.

In short, when you rely on professional judgment, you get human errors.

BTW, APA Style doesn't say to use identity-first language. The relevant page is here: https://apastyle.apa.org/style-grammar-guidelines/bias-free-language/disability and says that either may be used, with a preference for the style preferred by any individual or community being described.

It links to a blog post by an intern at the Autistic Self Advocacy Network that I found rather muddled. For example, "When we say “person with autism,” we say that...autism is detrimental to value and worth as a person, which is why we separate the condition with the word “with” or “has.”"

And yet if we say "person with blonde hair" or "person who has brown eyes", we do not say that blonde hair and brown eyes are detrimental to the value and worth of that person, even though we have separated the conditions with the word 'with' or 'has'. There is probably a name for this class of logical error in the List of fallacies. WhatamIdoing (talk) 04:56, 21 November 2024 (UTC)

@WhatamIdoing My edit wasn't about identity first language I just wanted to make a link to link to a part of a page and got carried away thinking "maybe wikipedia should have its own style guide" ok i'm sorry you don't haft to go all technical on me.

also a non-autistic woman on drugs in the show The Rookie was stimming a lot. so those adverse affects could lead to a misdiagnosis? I guess I understand you now. Anthony2106 (talk) 05:14, 21 November 2024 (UTC)

Yes, that's the kind of problem they're dealing with. Also, the nosology of autism is just a mess. They actually don't know whether schizophrenia and (some subset of) autism are the same thing 'underneath the hood'. There's a genuine question among researchers about this.

I don't mind the Wikipedia:Shortcut, especially if you only list one on the page. (There can be more, but it's usually best to only 'advertise' one. And to answer your question above, you should only make MOS: shortcuts for subpages of the Wikipedia:Manual of Style, but it's also 100% okay to make a WP: shortcut for MOS subpages. This page, for example, is variously referred to as WP:MEDMOS and as MOS:MED, depending on the editor's personal preference. Neither one is actually better/worse than the other.) WhatamIdoing (talk) 05:36, 21 November 2024 (UTC)

I undid your edit as @WhatamIdoing said Deaf people emplys someone who is not old. And you said most autistic people don't care what one is used so they wouldn't mind identity first. Anthony2106 (talk) 01:04, 21 November 2024 (UTC)

I've reverted to most because this discussion needs to happen on the talk page not in a mass revert war. ^SMason_Garrison 01:36, 21 November 2024 (UTC)

@Colin I think that the ident of "deaf" is actually to describe the "Deaf" community, who very much identify with being Deaf. However, I think that y'all need to sort this out on the talk page and get consensus before any more changes are made. ^SMason_Garrison 01:38, 21 November 2024 (UTC)

"Some" vs. "most" isn't really about Anthony2106's edits, since it was changed from "some" to "most" in this 2022 edit and stayed that way until Colin's edit he links above.

Either way, I think "some" is more appropriate than "most". The idea we're trying to communicate with this section is that identity-first person-first (oops, typo) language is not always preferred. That's plenty clear with "some", and avoids the question of whether "most" is empirically true (which frankly I doubt, even the article Oolong linked in their 2022 edit to justify the change showed <50% of survey respondents with autism endorsed "autistic", "autistic person", or "is autistic" to describe themselves (Fig. 2). And that's despite a survey making no effort to get a representative sample, and naturally selecting for folks who are able and willing to respond to it). Ajpolino (talk) 02:39, 21 November 2024 (UTC)

There have been several surveys on this question, and the number is closer to 80 . But regardless, I think that this should be a discussion before a change is made. My intent was to revert it to what it was before the rapid fire changes were made. ^SMason_Garrison 02:59, 21 November 2024 (UTC)

Let's take this apart.

First, about a third of the diagnosed group is unable to meaningfully express an opinion on the subject. That means that for "most" people to prefer ______, we'd need to find that it is the preference of at least 75% of the people who are capable of responding (because $50.01\%/66.7\%=75\%$). If we assume that the "nearly 80%" who endorsed "autistic person" is a representative sample of the 67% who are capable of responding to a survey, then that's the expressed preference of 53% of the diagnosed group, which is "most", but only barely.

Is it a representative sample? The answer is definitely "no". It's 55% university graduates, many with advanced degrees. Only 17% identify as cisgender males, even though when these university grads were kids, about 75% of diagnoses went to boys. They give the numbers by country, and the US is underrepresented. The recruitment methods were: an existing autism research program, social media advertising, and sending e-mail messages to autism advocacy groups. These recruitment methods can be expected to produce a biased sample.

So it's a hopelessly biased sample group, but the survey should give us some idea of what that particular group likes, even if it's not what the entire population likes. Almost 80% endorse "autistic people", but they are doing so as one acceptable option among many acceptable options, which isn't the same thing as preferring it. Only 40.4% of respondents said that "Autistic person" was their favorite term. Another 31.7% preferred "Autistic" alone (with no 'person'). Another 9.5% – including a lot of Canadians, but very few from the UK – preferred "neurodivergent person".

So if we are trying to say that "most people prefer 'autistic person'", we actually only have evidence that 40% of a biased sample, from the 67% of the population that's capable of responding, prefer that term. Which is frankly not very convincing evidence that "most" people have the same preference. WhatamIdoing (talk) 05:31, 21 November 2024 (UTC)

lets @ them: @User:Oolong Anthony2106 (talk) 05:17, 21 November 2024 (UTC)

I'd like to direct a little more attention back to the overlooked part of this sentence, namely deaf people: "Some groups...prefer identity-first language (for example, most deaf or autistic people)".

So here's what we know:

• Most Deaf people – that's with a capital D – see themselves as part of a cultural group, of which the difference in their hearing and mode of communication is only one part, and they want to be recognized as Deaf people from the Deaf culture.
• Most people who are unable to hear are not Deaf people. They are culturally hearing people, who are just having some problems with their hearing. They may be Legally deaf (which is a thing; the definition varies by place but it usually means that you can't hear an ordinary conversation at all, it usually means you can't hear a Vacuum cleaner, and it may mean you can't hear a gas-powered lawn mower, but you might be able to hear a jack hammer or a chain saw) or they may be completely deaf or (the most likely) they may be hard of hearing.
• There are about 75 people with mild hearing loss, and 7 with moderately severe hearing loss, for every 1 person who has complete hearing loss.
• For every 1 person in their 20s who has moderate or stronger hearing loss, there are 150 people in their 70s with that level of hearing loss. This suggests that very few people who experience hearing problems are deaf or HOH their whole lives.

And consequently: Most deaf people aren't Deaf people. Only a very small number of deaf people are Deaf people. WhatamIdoing (talk) 06:08, 21 November 2024 (UTC)

I think that you're missing the point of the entire sentence. Those are two examples of communities that have a preference for identity first language. The solution is to provide different examples not logic your way to the word "some" by playing around with fractions. ^SMason_Garrison 13:49, 21 November 2024 (UTC)

I agree that the Deaf community and those people for whom autism forms an explicit part of their self-identity have a preference for identity-first language.

Part of "the point of the entire sentence", though, is that the people who have these identities are not the only people who have these medical diagnoses. "Some groups view their condition as part of their identity" – and other people do not. The Gallaudet University alum, with lifelong deafness and good ASL skills, likely views their deafness as part of their identity. The 85-year-old retired industrial worker likely does not. And there are a lot more of the latter than the former, which means that saying "most" of them view their condition as part of their identity is factually wrong. Note the difference between these two sentences, both of which are true:

• Most of the people who view their condition as part of their core self-identity prefer identity-first language.
• Most of the people who have this condition do not prefer identity-first language.

"Some groups view their condition as part of their identity and prefer identity-first language (for example, most deaf or autistic people)" is factually and mathematically wrong. Most people with these two medical conditions do not hold this preference. It is only the minority subgroup of people with these two self-identities that hold this preference. WhatamIdoing (talk) 17:11, 21 November 2024 (UTC)