Wikipedia talk:Manual of Style/Medicine-related articles/RFC on lead guideline for medicine-related articles

Consensus building

Chart moved to main RFC page

Current Position A Position B Position C Position D 1. To facilitate broad coverage of our medical content in other languages, the translation task force often translates only the lead, which then requires citations. Translation is done from simplified forks of our leads, not the leads directly. Citation clutter makes our articles harder to read by our readers. Excess citations may be included in the wikitext inside HTML comments, which are hidden from our readers, and then surfaced in the simplified translation-fork page. To facilitate broad coverage of our medical content in other languages, and to respond quickly to the need to make good medical content available in emergencies, the translation task force often translates only the lead. Adding citations to the lead then helps it stand on its own as a concise overview. Citations in the lead have no effect on readers, but are valuable to editors maintaining text integrity. No evidence that translating leads of medical articles improves medical outcomes has been presented. Remove this and related text from MEDLEAD, and conduct a separate RFC on whether LEAD should be rewritten to accommodate article translation for all articles, not just medical. Retain all text in points 1–7. * No change is needed. * MEDLEAD is in sync with LEAD. Translation is tremendously important. Wikipedia's mission is to provide "every single person on the planet... free access to the sum of all human knowledge". Translation helps achieve that. The medical translation effort has resulted in more than 6 million words of text being translated. 2. Medical statements are much more likely than the average statement to be challenged, thus making citation mandatory. No evidence that this is more true than in biographical, economic or political articles, for example. Claiming citations are thus generally mandatory is in direct contradiction to policy, which is case-by-case. Medical statements are more likely than the average statement to be challenged, so editors are encouraged to add citations in the lead, particularly for complex or controversial topics. Any editor who regularly helps maintain medical articles knows that statements are not only more likely to be challenged, but also require a higher standard of sourcing than the average Wikipedia article. The leads of complex and controversial topics are the prime target for POV-pushing and subtle vandalism, where citations are most needed, cf WP:BLP. Adding sources to the lead is a reasonable practice but not required in all instances if the text in question is supported in the body of the article. Editors are encouraged to add citations in the lead for direct quotes, hard data, or statements likely to be challenged. "Vulvar cancer is a cancer of the vulva, the outer portion of the female genitals" is not likely to be challenged. No evidence that medical statements are more likely to be challenged has been presented. Overciting leads constrains the ability to craft an overall summary of the article's content. While BLP-style citation requirements may be appropriate for all medical content, even BLP does not mandate citations in the lead (see Donald Trump). A separate RFC about applying a BLP-style inline citation policy to medical content would be useful. It's fine to have lots of citations in the leads of medical articles. It's acceptable for medical content guidance to have some differences from general guidelines, because medical content risks misleading our readers to make bad decisions about their own health care. "First, do no harm" trumps "first, do not violate MOS". 3. The lead of an article, if not the entire article, should be written as simply as possible without introducing errors or ambiguity. No need to repeat existing policy or guideline, which does not say "as simply as possible" but "as understandable as possible". There is a difference, as the latter requires good writing more than it requires baby words. The lead of an article should be written as simply as possible without introducing errors or ambiguity. I would not have a problem if the guidance were to focus on making the text as accessible as possible or as understandable/comprehensible as possible. The lead of an article should be as understandable as possible without introducing errors or ambiguity. The clause "if not the entire article" extends beyond the cited quideline, which clarifies that there may be sections that have more technical aspects (pathophysiology comes to mind in medicine) and may not be written as simply as the lead. "The content in articles in Wikipedia should be written as far as possible for the widest possible general audience" is similar to saying "The lead of an article, if not the entire article, should be written as simply as possible without introducing errors or ambiguity." Wikipedia has received a lot of criticism, both in the academic[1][2] and lay press, for being overly complicated. Wikipedia should try to approach a grade 12 reading level for the leads and has made progress towards this in the area of medicine. [3] 4. It is also reasonable to have the lead introduce content in the same order as the body of the text. Per WAID there is no justification for this for any article, let alone medical ones. When writing the lead, editors should ensure that they write a comprehensive summary of all of the main points of the article. One way to achieve this is to follow the order of the content in the body of the article. This is a sensible practice and sufficient justification for the advice. Editors should ensure that the lead is a comprehensive summary of all of the main points of the article. One way to achieve this is to follow the order of the content in the body of the article, although no specific order is required. Prescribing the order of the narrative is CREEPy; the additional yellow-highlighted text is needed to prevent the leads of articles, including Featured articles, from being diminished by imposing a particular order. 5. The British National Formulary for example often uses "by mouth" rather than "oral". Per notes on RFC, the BNF does not prefer "by mouth" to "oral" at all. This deceptive statement should be removed. Examples should not be removed, but should be replaced by better ones. The present example is not deceptive, as the BNF actually does use "by mouth" as well as "oral". Most languages in the world translate "by mouth" exactly, including French, Portuguese and Romanian. Remove. Problems have been raised with every example given of words that can be substituted. This information is not needed in the MEDLEAD section, as it is already covered in the same guideline at the sections on Writing for the wrong audience and Careful language. 6. Avoid cluttering the very beginning of the article with pronunciations or unusual alternative names; infoboxes are useful for storing this data. No medical reason for this. Adequately covered by other guidelines. Avoid cluttering the beginning of the article with pronunciations or multiple alternative names. Remove here, this widespread information is already better covered at the guidelines on first sentences, alternate names and lead pronunciation. Avoid duplicating information across guideline pages that is already covered better elsewhere. This is a matter of deep concensus within the medical community, and is due to the preponderance of alternative names, sometimes upwards of 10 (solved well by using the other names=-parameter in Template:Infobox medical condition (new)). This provision has been included in WP:MEDMOS for years, and overturning it would disrupt readability and searchability of articles — and demand extraordinary efforts to enforce while only resulting in worse articles. I believe this justifies its inclusion despite contradicting suggestions from WP:LEADALT and WP:LEADPRON. 7. Miscellaneous: * Language can often be simplified by using shorter sentences, having one idea per sentence, and using common rather than technical terms. * It is useful to include citations in the lead, but they are not obligatory. * Around a third of readers of English Wikipedia, have English as a second language. * Most readers access Wikipedia on mobile devices and want swift access to the subject matter without undue scrolling. * File:2019 Wikipedia reader native language by language.png Remove. This is gratuitous agenda-pushing and has no place in any guideline. We have other guidelines to recommend writing style. Retain Indifferent, but support minimizing redundancy in guidelines over "one-stop shopping" that replicates other guidelines, and avoid repeating info here that is better covered elsewhere. Most of this information either is better covered elsewhere, or belongs elsewhere. It is acceptable for medical content guidance to have some differences from general guidelines, because medical content risks misleading our readers to make bad decisions about their own health care. "First, do no harm" trumps "first, do not violate MOS".

Discussion of chart

Since I don't know how to best adjust the RFC format to account for changing consensus, I'm starting this section here to see where we all stand. RexxS, I've incorporated some of your suggestions into my column. If you all can fill in your columns, we can eventually figure out how (or if) to position this summary on the page. And we may even develop new consensus (one can hope). Because of the way I formatted the RFC, I really don't know how to do this without making a mess.

On point 2, I just don't believe there is any evidence that medical statements are more likely to be challenged (than, for example, political statements). We don't have to cite "Bill Clinton was President of the United States", even in a BLP lead, so we can't require citations on medical content in a lead.

I would love to see an RFC with WPMED members coming together, finally, to support BLP-style requirements for inline citations on all biomedical content, but the leads of medical articles have been rendered less readable by unfortunate formulaic editing to comply with these requirements. Similar for 3: altering the flow of carefully crafted prose in FAs has rendered lead prose less than optimal. SandyGeorgia (Talk) 01:22, 28 December 2019 (UTC)

I hope perhaps we can find a compromise on citations in leads in the text I write above. Our translations are done from simplified forks, not the leads themselves. Obviously those writing those fork pages would find it handy to have a reference for text they want to cite in the short lead-only articles they are writing. But similarly our readers do not want little ^[1][2] noisy gnats flying around all the little stubby sentences. Can we agree that as writers we can include those citations inside HTML comments. They can be surfaced to the reader on the fork page, and on the article page if for some reason someone really does challenge the statement that valproate is an anticonvulsant, for example.

The main driving force for whether to include something in MEDMOS surely has to be an evidence-based claim that this is specifically a medical-article problem with a medical-article-specific solution. If the recommendation is (claimed to be) identical to our general policy or guidelines (e.g. making technical articles understandable, or how to write) then frankly medical editors have no place lecturing the community about how to do it. Leave that to the wider community which draws from a wider and stronger talent of editors. -- Colin°^Talk 12:05, 28 December 2019 (UTC)

I firmly believe that statements in medical articles are more likely to be challenged than those in the average Wikipedia article. My evidence comes from working on maintaining medical articles, where there is an ever-present stream of POV-pushers who either want the world to know that their aunt was cured of cancer by swallowing toads whole, or who want their client's latest snake oil recognised as the cure for autism. The only effective counter to that sort of nonsense is having good sources to hand, and for most of us that means citing the text. There's no shortage of POV-pushers on political articles as well, of course. Naturally, I don't need a source to revert a vandal who changes "Bill Clinton was President of the United States" to "Bill Clinton was President of Ecuador". But when an editor changes "Carles Puigdemont was the 130th President of the Government of Catalonia" to "Carles Puigdemont was the 129th President of the Government of Catalonia", you or I are going to need some sources to figure out which is right (if either). Similarly I don't need a source to revert a vandal who changes "Glandular fever is an infectious disease" to "Glandular fever is a punishment from God for underage sex", but I do need a source to be certain when I see an editor change "Infectious mononucleosis is a disease caused by the Epstein–Barr virus" to "Infectious mononucleosis is a disease caused by the Epstein–Barr and several other viruses". Other editors may have the facts at their fingertips, but I want to see what the sources say. All of that applies even more to the lead (the favourite attack point of POV-pushers), and stripping citations out of a well-cited lead simply makes life harder for every editor struggling to hold back the tide of POV-pushing and subtle vandalism that we meet every day. And for what benefit? so that our readers are not annoyed by a tiny superscript at the end of most sentences in the lead? Those self-same tiny superscripts at the end of most sentences in the rest of the article. I'm sorry, I just don't buy that argument.

The main driving force for whether to include something in MEDMOS is whether the best guidance differs sufficiently from the general guidance in MOS, and consensus will decide that. By comparison, I see no demand for evidence-based claims that the guidance in MEDRS addresses a medical-article problem with a medical-article-specific solution. The guidance there represents consensus, not the result of some rigorous "before-and-after" trial to test out whether using secondary sources improved just medical articles. If the guidance in MEDMOS were nothing more than a reflection of what MOS says, there would indeed be no point in it. But medical articles are not pop music or soccer or Pokemon articles, and the stakes are unfortunately higher. We don't cavil at BLP requiring inline citations for any statement that is contentious or likely to be challenged, including in the lead; so I don't accept the drive to remove all advice encouraging editors to add citations to the lead of medical articles just as they would to the rest of the article. Removing that advice would give equal weight to the practice of removing citations from the lead, and that really is not appropriate in so many of our medical articles. The presupposition for medical articles is not dissimilar to that for BLPs, except that getting information wrong in BLPs could damage a person's reputation; whereas getting information wrong in medical articles could damage a person's health. The solution is the same in both cases: strengthen the sourcing, and make it easy for editors to maintain the articles. --RexxS (talk) 21:16, 28 December 2019 (UTC)

RexxS, you really should have joined me long ago in advocating for a BLP-style, inline citation requirement for all medical content. I, too, regularly edit medical content and deal with quackery, and do not believe the typical anti-vaxxer & co. regularly inserts content into leads more so than the body of articles. Wherever they insert quackery, we should be able to deal with it. We don't fix that problem by destroying well-crafted leads.

Once I have a go-ahead from WhatamIdoing, I was planning to post this table to a new section on the RFC page, to see if it will prompt more coherent responses from the "me, too, I like it" !voters, who haven't made it clear what they are voting for. This table offers a menu. Everyone OK with that? I don't see a way to otherwise address my poor formulation of the RFC. SandyGeorgia (Talk) 22:09, 28 December 2019 (UTC)

The only other editor (that is, not in this chart) who has actually engaged the content so far is Ian Furst, but his positions don't offer anything not covered in this table more comprehensively by others. SandyGeorgia (Talk) 22:11, 28 December 2019 (UTC)

I think User:RexxS and I agree on much of this. If it's not clear, imo I think our prose in the LEAD sections could be improved. However, I don't think that MEDMOS/LEAD is the cause of the problem but a reflection of our response to the (1) quackery/opinion pushing issue and (2) poor summaries that previously existed (until this RfC I had no idea that translation was even a factor in how I was intended to write leads). I don't think anyones positions are too far apart either. I don't think you'll find consensus to remove citations in the leads (I will not support it - my specific problem is the opinion pushing and commercial interests). I also don't think you'd find opposition to rewriting the leads with an eye for improving the style. Ian Furst (talk) 22:22, 28 December 2019 (UTC)

Ian, is there anything in your position that is not represented in this chart? I didn't want to leave you out, but didn't find anything new, in terms of putting this forward on the main RFC page. SandyGeorgia (Talk) 22:27, 28 December 2019 (UTC)

I'm not entirely sure of your point about "Infectious mononucleosis is a disease caused by the Epstein–Barr and several other viruses". Are you disputing the bit in bold or saying we need a cite in the lead to say that? The Infectious mononucleosis article confirms other viruses can be the cause and elaborates on them in the body text. If someone adds something to the lead that isn't covered by the body, it can actually be removed simply because of that. Force them to write something for the body that is significant enough to repeat/summarise in the lead. And they'll need a citation for the body if you think it is worth challenging.

The claim "My evidence comes from working on maintaining medical articles" rather confirms a bubble-mindset might be at play here. Have a look at Barack Obama, an article so attacked for years that it remains semi-protected three years after he was president. The 700-word lead has exactly 5 citations, one of which is how he pronounces his own name, two of which seem worried about when he stopped being president and where he now resides, and only two seem in any way "worth challenging". If Obama can stay mostly citation free, I don't think we need worry about some rare disease or obscure medication. Editors who like to play wack-a-mole with our woo-pushers on controversial articles will necessarily get a rather distorted view of what most of Wikipedia's medical articles have to deal with.

OMG, Donald Trump doesn't have ANY inline citations in its 500-word lead. I rest my case. -- Colin°^Talk 22:29, 28 December 2019 (UTC)

PS, Ian, it is not about removing citations from leads. No matter what is resolved in this RFC, a WikiProject cannot force citations to leads when that is not a reflection of policy. All you can do with this is assure that WPMED will continue to not produce top content, because we can't please two masters. (Articles with overcited leads, like Dementia with Lewy bodies, would be laughed out of FAC, which is why I won't take it there.) Leads have been rewritten to enforce this style, and they have been deteriorated. That is demonstrable. And for what aim, when the translation project has their own content forks and this idea that citing leads helps prevent Jenny McCarthy from having her way is a strawman?? The pity in that is that the best possible insurance against quackery is becoming a Featured article, because then you can argue WP:OWN#Featured articles. And yet, these tendencies have most decidedly alienated writers of Featured articles. I haven't had quackery inserted at Tourette syndrome for over a decade, and the lead is not overcited. But I have had considerable errors introduced by the advocates of this policy. Yes, please read that again. This argument is a complete strawman. If we want tighter more defensible articles, we should be working on improving their content overall, not whacking vandals who (we assert) hit leads. Get MMR vaccine controversy to FA status and watch how fast you can shut down the anti-vaxxers.

OMG, I don't need to rest my case on Donald Trump; I have Tourette syndrome as a proof. The advocates of this guideline have damaged that article more than any vandal or quack ever did, and the lead is not overcited. SandyGeorgia (Talk) 22:55, 28 December 2019 (UTC)

I don't have anything else to add and can [edit; previously had can't here and that was a typo] wait for the reworded RfC. Twice, my argument against removing citations has been described as a straw man so I'd like to say that these are my beliefs about the topic and, in no way, am I attempting to create a false narrative. We all monitor articles and we all know the damage that can be done by subtle changes from opinion pushers so i won't belabor the point. Wrt the lead of Donald Trump; it has 100's (?) of people monitoring the article, is locked, has 5 footnotes (with citations listed there) and at least 7 different "DO NOT EDIT..." remarks in the markup of the lead. They've taken another avenue to stop garbage from entering the lead. Most of the articles I watch have myself and 1 or 2 other people (at most). I understand that you disagree with my point (or did I convence? :-)) but it is not an intentional mislead on my part. Ian Furst (talk) 23:00, 28 December 2019 (UTC)

My sincere aplogogies, Ian Furst; I did not intend for that general comment to be aimed at you specifically, and I'm sorry that it hit you that way. I have one person monitoring TS (moi-- I just removed some cited garbage from the article that stood the entire summer while I was away -- citations don't prevent garbage from being added); I repeat-- the only damage done to that article has been from advocates of forcing an order of the narrative into the lead, which destroyed the narrative carefully crafted to tell a story in the way people who want info about TS may want to read it. My apologies again; please take this new post on board, and re-read my posts above. SandyGeorgia (Talk) 23:06, 28 December 2019 (UTC)

PS, this is what I meant by saying a fallacious argument has been presented in MEDLEAD. There is no evidence that translating articles improves health outcomes. And there is no evidence that citing leads will stop Jenny McCarthy-ites from inserting quackery into articles. On the other hand, I have more than N=1 that these recommendations lead to article deterioration, particularly in leads. Not only that, they lead to alienating editors whom we can ill afford to lose if we are to deal with Jenny McCarthy. SandyGeorgia (Talk) 23:18, 28 December 2019 (UTC)

"There is no evidence that translating articles improves health outcomes." I'd like an entire RfC on this topic but I think it takes us away from the main topic which, I think, is how should a MEDLEAD be written. I would be interested in group opinion. Maybe we could have a survey asking the medical editors to rank or assign importance to each of the attributes we've been arguing about. At Wikimania I thought we had at least 20 medical editors so I assume we could get 30 or so responses for a survey. 1-5 how important is XXXX to the lead of an article? I'd happily answer it, as long as it asked questions from both sides of the table. Ian Furst (talk) 01:10, 29 December 2019 (UTC)

Chart to RFC page?

I think I've figured out how to get the chart on the page. First, I would like to replace editor names with Position A, Position B, Position C, and Position D, to avoid personalization in responses. Then, I would put the chart directly under the RFC question, saying that these are some positions that have come forward. Does anyone object? SandyGeorgia (Talk) 02:20, 29 December 2019 (UTC)

No. -- Colin°^Talk 11:17, 29 December 2019 (UTC)

I find it necessary that if put up for an RfC the entire process of selection of positions and discussion underlying it is included. So, yes I object — and I see others doing so as well. (E.g. comment [4] by AlmostFrancis)
An RfC can not proceed perpetually or until a certain position is reached, posting a new RfC question is WP:Disruptive WP:Gaming, and WP:Deadhorse.
Carl Fredrik ^talk 11:22, 29 December 2019 (UTC)

I have no idea what you're saying, CFCF; could you try re-phrasing? AlbertFrancis's misguided statements about a fully public conversation on the talk page of an RFC where anyone can see it are irrelevant. And the question is directed to the editors whose views are being summarized as to where I should put them. I am reading your comment (perhaps incorrectly) as if I can't put them on the RFC because they were generated on a talk page, so please clarify what I am getting wrong. (Obviously, since I have had no response from WhatamIdoing, I would have to take her views out of the table, but I think the table covers the range of options so far, even if I leave off WAID). If you see something that is misrepresented or not included, please specify. The table above does not pose a new RFC question: it summarizes the range of options, representing every response that engaged the entire text in dispute. SandyGeorgia (Talk) 11:33, 29 December 2019 (UTC)

I do not find AlbertFrancis's comments to be misguided, but rather quite insightful. I see it only as an assumption of WP:bad faith that you disregard his view as such. What is pointed out is your engagement in Wikipedia:Tendentious editing.
Directing your question only to the editors you have chosen to include in your table is violation of policy, and speaks of WP:ICANTHEARYOU.
My point is 1, you have made a biased selection of positions and included them in your table — and 2, posting the table directly under the first RfC question will mislead and confuse. Doing so would not be standard RfC procedure, and neither would extending the RfC with a new question at the bottom, when there seems to be clear evidence of consensus.
The point about the discussion being "fully public" is not relevant, because you are still engaging in obfuscation, by for example removing the clear traces of bias in selecting positions to include (i.e. names in the table). It was not long ago I pointed to "fully public" converstation and was told to provide diffs. Your actions here are intentionally obfuscation, mine was not.
If anything should be done — this entire talk-page and its history should be moved to the discussion portion of the main RfC page.
Carl Fredrik ^talk 11:46, 29 December 2019 (UTC)

Ignoring the dubious and extremely battleground parts of your post (which is most of it), is there any position left out of the table that has been given anywhere on the RFC? The question was directed at the editors whose names would be replaced by "positions", specifically to avoid representing any individual. CFCF, do you join with us in attempting to solve problems we all see? Anyone who is watching this page is, by definition, also watching the talk page; moving that which is right under our noses to the main page seems hardly useful. Of course, I will also add a link to the talk page when adding the table; that is standard (at least to me). I do not see from your position an attempt to solve a problem through consensus building; I see battleground. Again, if I have left out any position on the table, please let me know. SandyGeorgia (Talk) 11:55, 29 December 2019 (UTC)

(edit conflict)

CFCF, do you join with us in attempting to solve problems we all see?

The primary position that you have failed to include is the one I explained in my opposition to change on the main page — and that is that there are no issues (needing an RfC). And this is also something I find comes across in most of the discussion here — that issues are mostly semantical, and not of the type to be solved in or require an RfC. This RfC was constructed on the premice that MEDMOS was "out of sync" — to which the answer seems to be "that isn't a valid question". This does not mean that consensus will find "MEDMOS to be perfect and should never change", but rather that the RfC is invalid and discussion about each point should occur as is necessary with respect to ordinary editing practice (WP:BRD).
The reason I am so opposed to the RfC is that you posted it with the motivation of:

Limited engagement, stalled discussion, broader RFC launched. SandyGeorgia (Talk) 22:27, 22 December 2019 (UTC)

That editors were opposed to your position and clearly articulated their opposition to change — is never a reason to run an RfC, and I have already expressed that this is "an irresponsible waste of editor time".
Extending the RfC because it did not result in the consensus you wanted — on top of that — is not only irresponsible, it is WP:Disruptive.
This has little to nothing to do with BATTLEGROUND, but is entirely an issue of WP:GRIEFING. Carl Fredrik ^talk 12:10, 29 December 2019 (UTC)

CFCF, it is not good to edit a post to extend its meaning after others have already responded to it. You imply there is evidence of consensus on a fairly new RFC with very little response to date. I suggest the consensus you see is in the eyes of the beholder. Are you interested in helping us develop a useful consensus? Do you understand that if we leave a guideline in place that can't be enforced by policy (citations in the lead), we leave a problem to fester? SandyGeorgia (Talk) 12:04, 29 December 2019 (UTC)

Do you understand that if we leave a guideline in place that can't be enforced by policy (citations in the lead), we leave a problem to fester?

I understand only that you are attempting to belittle me here — as I contest that your statement is true. For starters, the guideline does not mandate citations, only recommends them. Second, I strongly contest that it is a problem, as evidenced by how it has not been a problem for the last five to ten years. Carl Fredrik ^talk 12:15, 29 December 2019 (UTC)

CFCF, it is not good to edit a post to extend its meaning after others have already responded to it. You imply there is evidence of consensus on a fairly new RFC with very little response to date. I suggest the consensus you see is in the eyes of the beholder. Are you interested in helping us develop a useful consensus? Do you understand that if we leave a guideline in place that can't be enforced by policy (mandatory citations in the lead), we leave a problem to fester? Do you acknowledge that every "me, too, I like it" respondent has argued against Wikipedia policy, that we can mandate citations anywhere in articles, so that we have an unusable RFC result, because the RFC was poorly framed (by me) to examine each of seven issues? SandyGeorgia (Talk) 12:10, 29 December 2019 (UTC)

Re, I understand only that you are attempting to belittle me here ... User:CFCF, 12:15, 29 December 2019 (UTC) I am not trying to belittle you; please avoid ascribing motive. I am trying to focus us on how we can develop a useful consensus for a guideline that has been disputed for over five years.

As I understand it, you are stating that I have left off a position/column which is "No change needed/No RFC needed". Please let me know if that is correct phrasing or what column you want me to add to fairly represent whatever it is you believe I have left off. SandyGeorgia (Talk) 13:20, 29 December 2019 (UTC)

The 'no change' option

It's important not to dismiss the option to leave the present guidance unchanged. There isn't a problem with a local consensus to make citations in the lead compulsory, even though I don't believe that it's the best way to encourage editors to add them – although I may well be in a minority in that belief. It is the fundamental tenet of the governing policy WP:CONLOCAL that "Consensus among a limited group of editors ... cannot override community consensus on a wider scale". But there is no community consensus forbidding citations in the lead, and there is the precedent of WP:BLP requiring good quality inline citations for all statements that are controversial or likely to be challenged (with no exceptions for the lead). That is a clear example of one area (BLP) forming a consensus to require citations, and we cannot dismiss the possibility that a similar consensus applies for medical articles. Personally, I like having citations in the lead, for reasons I've expanded on elsewhere, but I'd be quite satisfied with softening the wording to encourage editors to add them, rather than try to compel them (which is sometimes counter-productive). --RexxS (talk) 16:19, 29 December 2019 (UTC)

Have I helped the situation by adding a blank column in the chart? I don't know what wording I might add to support status quo.

I do not see anywhere in BLP that citations in leads are mentioned. It is a policy page that appears to respect other guideline and policy pages. For a guideline to mandate something that policy does not creates a problem that will fester. That is not the situation with the BLP page: it does not contradict other policy pages.

I was just looking at Dengue fever, an FA I promoted at FAC when it had no citations in the lead (promoted version). (Disclosure: I actually had dengue fever, and one now-banned editor claimed that means I have a COI on the topic, FWIW.) It now has text out of sync between the lead and the body and the infobox, with some information that is also outdated. Citing an article doesn't mean it's accurate. The entire first two paragraphs are cited to two sources, repeated for every line. In fact, most of the lead is cited to those two sources. Why is it necessary to have a citation for every single line when the lead is basically cited to two sources? I believe it is still commonly accepted that, when an entire paragraph is cited to one source, the citation can be added at the end. Second, there are multiple instances of simple statements being laden with multiple citations, as if those are controversial statements. This citation overkill is not resulting in more accuracy; it is giving the impression of accuracy that is not present and making it harder to verify whence comes the text.

While I respect and understand that some editors believe this kind of citation practice is helpful, I maintain that it has done nothing to improve the overall content. Since most editors can't access full text of journal articles, neither does it help them verify or correct the text. If this is the best we can do on a Featured article, what can we expect at B-class articles? SandyGeorgia (Talk) 16:49, 29 December 2019 (UTC)

It's worth trying the blank column so that the "no change" position is acknowledged, so thanks for accommodating that. Others can refine it if they have a better idea.

I'm sorry I wasn't clearer. My point about "(with no exceptions for the lead)" relies on the BLP policy not mentioning that there is an exception for the lead. The general guideline WP:CITELEAD takes the stance that there is no exception for leads to the policy that material that is likely to be challenged should be supported by an inline citation. FWIW, the BLP page mandates something that more general policy does not: "This policy extends that principle, adding that contentious material about living persons that is unsourced or poorly sourced should be removed immediately and without discussion." so there doesn't seem to be a problem with extending requirements in a particular area, as long as it doesn't contradict a more general policy or guideline. There's certainly no policy or guideline requiring that leads should not have citations (quite the opposite), so mandating citations for medical articles would seem to be within the remit of editorial consensus. Of course, I'd rather we didn't, but if that should turn out to be the result, I would feel obliged to accept it.

I strongly agree that citing an article doesn't mean it's accurate. But what it does mean is that someone else can check whether the text accurately reflects the source. An expert can also tell whether the sources used are the best available now. It doesn't matter if I don't have immediate access to the full text (although I usually do); somebody at WT:MED will have access and they are always helpful. That's an unavoidable consequence of our verifiability policy, so I don't mind. What does irk me is when a subtle change is made and I have to search through the article and try to guess which of several sources would or would not support the change made. Even having a citation at the end of each paragraph in the lead would make that task far easier, as long as the text in that paragraph can be supported by the source. Surely we should be encouraging sensible citation practices, not the sort of overkill you seem worried about? The best way to combat problems of too many citations is to give better advice, not to remove the advice we already have. --RexxS (talk) 19:45, 29 December 2019 (UTC)

Well, considering the charges lodged against me here for attempting to summarize discussion on a talk page, it might not be helpful for me to continue the discussion. Anyway, I could fill in the first row of the "No change" column myself, but the !voters who opted for that option didn't provide much to work with, so I hope someone besides me will fill that in-- otherwise I'll add the chart with that left blank. "Reject RFC, confusing, no change needed" isn't particularly helpful in addressing an impasse. SandyGeorgia (Talk) 19:53, 29 December 2019 (UTC)

CFCF would you care to fill in the chart for the new column I have added? As the under construction template indicates, you are free to edit. SandyGeorgia (Talk) 17:32, 29 December 2019 (UTC)

SandyGeorgia, I love you, but what ever gave you the idea that I'd choose the two-letter spelling for the word okay? ;-) Beyond that, I have no particular objections to the table, especially if the missing POV is added. WhatamIdoing (talk) 22:17, 29 December 2019 (UTC)

;) alrighty then! SandyGeorgia (Talk) 22:22, 29 December 2019 (UTC)

I think I got all the pieces; please check. SandyGeorgia (Talk) 05:18, 30 December 2019 (UTC)

CFCF does the chart above now satisfy you? SandyGeorgia (Talk) 14:50, 30 December 2019 (UTC)

Ping

Barkeep49, could you please take a look in here? A collegial discussion to try to advance consensus was progressing, but seems to have derailed. I am always happy to know where I am going wrong and what I should strike or re-do, and value your opinion. Yesterday, I clearly insulted Ian Furst with careless wording, and have apologized sincerely for the unintended effect, and believe that to be behind us. Other than that, I wonder if you believe a talk page discussion aimed at summarizing different positions was deceptive or tendentious, as charged. And if so, what should be done next with this talk page? SandyGeorgia (Talk) 13:27, 29 December 2019 (UTC)

FYI, I took little offense at previous discussions and all is well with me. Ian Furst (talk) 13:33, 29 December 2019 (UTC)

Thanks, Ian; I appreciate your graciousness, because I was posting in a hurry, and was careless in my wording. For Barkeep, I started the chart on this talk page after RexxS and I were coming to some agreement on some points, here, and was looking for a way to summarize and re-convene. SandyGeorgia (Talk) 14:15, 29 December 2019 (UTC)

SandyGeorgia, I thought the chart here was a good spur of discussion in a collaborative manner. Ideally the conversation being had here happens before an RfC rather than during it (to avoid making a close harder) but this area is one that inflames passions and I think you and Ian both acted reasonably above and don't really find fault - it's more in the nature of editing in a multinational collaborative project. Best, Barkeep49 (talk) 17:01, 29 December 2019 (UTC)

Thank you, Barkeep; sometimes it can be hard to see our own faults. I appreciate the feedback, and am open to any proposed solution to fix the mess I made in the framing of this RFC. Unfortunately, discussion was not happening before I submitted the RFC :( Regards, SandyGeorgia (Talk) 17:03, 29 December 2019 (UTC)

Indeed it was not. Best, Barkeep49 (talk) 23:05, 29 December 2019 (UTC)

Yes in sync

User:John Cummings and User:BEANS X2: What do your votes that say "yes in sync" mean? Do you mean that you think that MEDMOS is already in sync with other guidelines, or that these seven changes should be made so that it will become in sync, or something else?

The "in sync" thing was from a previous draft of the RFC question, and it really doesn't make much sense now. We need to be able to tell whether (for example) you think that "It is also reasonable to have the lead introduce content in the same order as the body of the text" belong in MEDMOS. That's not mentioned in any other guideline, so it's not "in sync" with anything. But it's still okay if you think it should be included. We just need to know. WhatamIdoing (talk) 01:16, 8 January 2020 (UTC)

WhatamIdoing, I think we should put MEDLEAD back in sync with the general lead guidelines. >>BEANS X2t 08:13, 8 January 2020 (UTC)

I think the confusion comes from the strange way the RFC is built, to be clear, I do not want any changes to the current guidelines and rules, thanks. John Cummings (talk) 00:26, 9 January 2020 (UTC)

Wrapping this up

RexxS see the section just above this (where it is even more apparent that we are getting GIGO because of my bad formulation of the RFC). Your discussion with WhatamIdoing about local consensus is what we should be addressing, and is at the core of our five-year-long differences; we are not going to get those answers from this malformed RFC. At the same time, we now have another (malformed) RFC running at WT:MEDMOS, attempting to resolve the same underlying tension (guidelines enforced as if they were policy), and another pending which, IMO is attempting to address a related issue (policy overlooked as if it were guideline).

WPMED has work to do to resolve these underlying issues; this RFC will not accomplish any of what we need to address, and we will have three RFCs going, which only furthers the chances independent editors will not engage. I don't see a way in the instructions to wrap this up. WP:RFCEND says:

There are several ways in which RfCs end:

1. The question may be withdrawn by the poster (e.g., if the community's response became obvious very quickly). In this situation, the editor who started the RfC should normally be the person who removes the {{rfc}} template.
2. The RfC participants can agree to end it at any time, and one of them can remove the {{rfc}} template.
3. The dispute may be moved to another dispute resolution forum, such as mediation.
4. Any uninvolved editor can post a formal closing summary of the discussion. The editor removes the {{rfc}} tag at the same time.
5. The discussion may just stop, and no one cares to restore the {{rfc}} tag after the bot removes it.

When an RfC is used to resolve a dispute, the resolution is determined the same way as for any other discussion: the participants in the discussion determine what they have agreed on and try to implement their agreement. Like other discussions, RfCs sometimes end without an agreement or clear resolution. Please remove the {{rfc}} tag when the dispute has been resolved, or when discussion has ended.

References

I could withdraw, but SNOW is not apparent, considering the mess. It seems the best we can do is No. 2, since No. 3 would not be optimum at a point where WT:MEDMOS was bloated to 800KB two days ago. This is depressing, but there is good news in this malformed RFC, that will hopefully serve us all when we do address these differences.

Initially, people were in what I later defined as Column A (delete it all) or Column D (keep it all). Our discussion on this talk page led to exactly what should have been happening all along, which is consensus building by listening to each other. Editors like Ian Furst and you actually engaged the problem, and your positions moved away from Column D, to Column B. I listened to you and moved away form Column A to Column C. So, several of us moved away from the polarization, towards Column B and C, which really are not that far apart.

Separately, we have perhaps a majority of respondents who either did not digest the issues, or did not engage them.

Considering that: how can we close this up and wrap up this discussion in a useful way? Open to suggestions. @Barkeep49: I would hope it would be OK for someone to summarize where we stand, and put this thing out of its misery. SandyGeorgia (Talk) 16:08, 8 January 2020 (UTC)

PS, Barkeep, I pinged you here out of concern that this could be part of the stall at the AN thread, and resolving this might help. SandyGeorgia (Talk) 16:17, 8 January 2020 (UTC)

My suggestion, if RexxS and others agree with you, is do nothing. Let the RfC tag expire (or even if no one objects to this post, boldly remove it and see if that sticks). Keep an eye on WP:ANRFC to make sure it's not listed (and/or just ask Cunard not to list it) and if it is listed reply indicating that you don't think it needs a formal close. And then just continue discussion. Best, Barkeep49 (talk) 16:40, 8 January 2020 (UTC)

FWIW I've been trying to engage for the past couple of days (prices, leads, heading order, MEDRS) but the debate is moving faster (and on more topics) than I can track or create an informed opinion on. By the time I think I know what is going on there is a change in tack. Prices pre-RfC discussion, for instance, had 60k+ words and everyone was posting to all the sections. It's clear that people are after discussion (not opinion) but it's moving to fast for me to be meaningfully part of it. Also, much of the discussion seems to be around peoples actions rather than the formatting problem which I do not want to be involved with at this time. For the moment, my preference is to wait for clear RfC questions and offer an opinion or accept the status quo and cont' to edit. Ian Furst (talk) 16:57, 8 January 2020 (UTC)

No worries, Ian Furst; I just didn't want this RFC to be in the way of the other RFC, with WPMED popping out all over the place, but it looks like letting this one run is the best course. SandyGeorgia (Talk) 00:37, 9 January 2020 (UTC)