Wikipedia, We have a problem

In a nutshell: Acupuncture has been increasingly embraced by conventional care as an efficacious treatment for a variety of conditions. Evidence of this support comes from recommendations for acupuncture in numerous medical guidelines, Cochrane systematic reviews demonstrating clinical effectiveness, and an explosion of research interest into acupuncture’s effectiveness and mechanisms of action.

All of this support notwithstanding, the article devoted to acupuncture on Wikipedia, the most accessed source of medical information on the internet and supposedly an unbiased source of curated information that anyone who follows Wikipedia’s policies can edit, reflects a somewhat different perspective. The page, controlled by a group of staunch anti-acupuncture ‘pseudoskeptics’ – insists that the mainstream support for acupuncture from the medical and scientific community doesn’t exist, even when it is presented to them, and presents their subjective minority opinion as the dominant one. They mainly do this by a) ignoring high-quality sources that contradict their perspective and b) systematically intimidating, bullying and banning anyone who dares to say otherwise. This state of affairs is problematic on many levels, not least of which because it directly impedes access to informed health care choice. I’m hopeful that an open discussion of the evidence and my own recent (and short!) experience as a Wikipedia editor before being indefinitely banned for challenging their version of consensus can result in an improvement to the Wikipedia article vis-à-vis how well it reflects objective reality and better enforcement of Wikipedia’s anti-bullying guidelines.

Making the case for acupuncture’s mainstream support

The pejorative designation of ‘pseudoscience’ is defined by Wikipedia in reference to what is perceived as scientific and medical consensus. To say that ‘acupuncture is pseudoscience’, as the Wikipedia article flatly states, is to say that acupuncture enjoys little to no mainstream medical and scientific support. The administrators and (remaining) editors of the Acupuncture article on Wikipedia have claimed just that. Sure, acupuncture does have some fans, but these people are universally gullible morons who wouldn’t know a null hypothesis if it poked them in the eye, so their argument goes. Anyone with a medical degree and two brain cells to rub together will concur that acupuncture is woo-tastic, pseudo-scientific quackery.

Of course, any statement about what scientific consensus does or does not show needs to be backed by suitable references and Wikipedia provides specific guidance on what it considers to be  Reliable medical sources (or MEDRS, as they’re known in Wiki-speak):

“Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies.”

In other words, one can reliably demonstrate that acupuncture enjoys mainstream scientific and medical support (and does not meet Wikipedia’s definition of pseudoscience) by providing review articles and position statements by expert bodies.

So what do medically reliable sources say on the subject of mainstream medical support for acupuncture?

Acupuncture is recommended in conventional medical guidelines

According to Tgeorgescu, who holds a Masters in Philosophy, is a Member of the Dutch Society against Quackery and long-time Wikipedia enforcer, not only is there no mainstream scientific support for acupuncture (reference not provided), but providing evidence that there is support is grounds for being banned from Wikipedia.

Medical guidelines produced by medical and clinical organisations constitute one of the most direct types of evidence we have to assess ‘medical consensus.’ Acupuncture is recommended by the following mainstream Medical Guidelines and Organisations

  • The World Health Organisation has developed a list of 27 conditions for which it recommends acupuncture after its evidence review1
  • The Joint Commission, which accredits more than 21,000 health care organizations and programs in the United States and globally, recommends acupuncture as a first-line treatment in the management of pain
  • The Agency for Healthcare Research and Quality (AHRQ) guideline on Non-invasive treatments for Low Back Pain found acupuncture to be amongst the most effective treatments 2
  • The Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society on the Diagnosis and Treatment of Low Back Pain recommends acupuncture 3
  • The American Academy of Family Physicians recommends acupuncture4 for a variety of pain conditions
  • The American college of occupational and environmental medicine’s practice guidelines recommend acupuncture5
  • The U.S. Department of Health and Human Services – National Institutes of Health Guidance on Low Back Pain recommend acupuncture6
  • The State of Colorado Division of Workers’ Compensation Medical Treatment Guidelines for Low Back Pain recommends acupuncture7
  • The Institute for Health Economics Evidence-Informed Primary Care Management of Low Back Pain Alberta, Canada recommend a course of acupuncture for chronic low back pain 8
  • Scotland’s National Clinical Guideline for the Management of chronic pain recommends acupuncture for low back pain and osteoarthritis, characterising the strength of the evidence as Grade A (the highest support available)9
  • The National Institute for Health and Care Excellence (NICE) recommends a course of acupuncture for the prevention of migraines and tension-type headaches. In fact, acupuncture is the only treatment recommended for the prevention of tension-type headaches.
  • The 4th Edition of “Acute Pain Management: Scientific Evidence,” Produced by the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine, found Level I evidence for acupuncture for five different clinical indications 10

Wow, the WHO, the AHRQ, NICE and the Joint Commission, pretty much the ‘who’s who’ of prestigious mainstream medical consensus building institutions, all recommend acupuncture? I mean, a couple of acupuncture-recommending guidelines would have been sufficient to demonstrate that the ‘pseudoscience’ designation was controversial and the Wikipedia article needs to be changed to reflect this undisputed reality; the number and strength of the recommendations here are vastly surplus to requirement for that purpose. Sure, there are a few guidelines recommending against acupuncture11, but these guidelines simply provide support of another opinion and obviously don’t negate the existence of all the guidelines clearly supporting acupuncture.

So the most respected conventional medical organisations in the world, after rigorous scientific review, have created consensus time and again around recommending acupuncture for a variety of treatments. These guidelines ubiquitously steer clear of evaluating or recommending Angel Healing, Reiki, or Crystal therapy (no disrespect). The very existence of these guidelines automatically renders the statement “acupuncture is pseudoscience” completely invalid. They provide indisputable evidence that meaningful parts of the mainstream medical community recommend acupuncture. While one is welcome to discuss the quality or methods of the guideline development, one cannot dispute their existence.

Cochrane Reviews

According to Hob, every single Cochrane Review of acupuncture performed has found no significant difference between Acupuncture and sham (no reference provided). In reality, a number of Cochrane reviews have found acupuncture to be superior to sham (for example, migraine, tension-type headache). These reviews are referenced on the Wikipedia acupuncture page and on the very talk page where Hob has written his comment but Hob seems to prefer to ignore their existance.

While the guidelines listed above are surplus to requirement for demonstrating meaningful mainstream consensus for acupuncture’s recommendation, Cochrane Reviews are considered amongst the highest levels of evidence in medicine and provide additional high-quality support.

  • Cochrane Systematic Review published in April, found that for the prevention of tension-type headaches, acupuncture was more effective than usual care and pain medication (48% of those who received acupuncture vs 19% of those who received meds had a positive response) and acupuncture was more efficacious than sham (50% of acupuncture recipients vs 43% of patients who received sham acupuncture had a positive response)12
  • Another Cochrane Review for Acupuncture in the treatment of Migraines found that acupuncture is far more effective than usual care and also more effective than sham needling.13
  • Acupuncture was found to be superior to sham, waitlist and physical therapy for peripheral joint osteoarthritis14
  • Acupuncture is superior to usual care in the treatment of fibromyalgia 15
  • Acupuncture is superior to usual care for cancer-related pain and auricular (ear) acupuncture was found to be superior to placebo for chronic neuropathic pain related to cancer16
  • Acupuncture was found to be superior to anti-spasmodic drugs, which themselves have been shown to be better than placebo, in the treatment of Irritable Bowel Syndrome

Mechanism research

According to Hob Gadling, long-time Wiki-editor, admin, and fighter of Pseudoscience, ‘acupuncture is clearly a magic practice and has neither a viable mechanism nor evidence on its side” (references not provided). When provided high-quality evidence of mechanism (peer-reviewed evidence syntheses) and efficacy (for example, Cochrane Reviews), he has failed to address these but maintains his opinion: definitely pseudoscience. And not only does he think it’s pseudoscience but according to him, this is also the medical and scientific consensus (reference not provided).

  • The International Review of Neurobiology published a 363-page evidence review of acupuncture’s mechanisms and clinical areas where acupuncture has strong evidence of effectiveness. The IRN only publishes reviews on conventional and mainstream medical neurological subjects 17
  • A recent review published in the Neuroscientist has summarised the evidence for acupuncture’s effects through purinergic signalling.18 It notes: “The seminal hypothesis of Geoffrey Burnstock and the astounding findings of Maiken Nedergaard on the involvement of purinergic signaling in the beneficial effects of acupuncture fertilized the field and led to an intensification of research on acupurines.” Incidentally, Wikipedia tells us that the “The Neuroscientist is a peer-reviewed academic journal that publishes papers in the field of Neurology . . . aimed at basic neuroscientists (sic), neurologists, neurosurgeons, and psychiatrists in research, academic, and clinical settings, reviewing new and emerging basic and clinical neuroscience research. The journal evaluates key trends in molecular, cellular, developmental, behavioral systems, and cognitive neuroscience in a disease-relevant format.” The article must have forgotten to mention its studies of quackery and pseudoscience.

A recent review by Dr Thomas Lundeberg, a rehabilitation physician and former Professor of physiology at the Karolinska Institute, one of the top medical schools in the world, and Irene Lund, adjunct at the Karolinska Institute’s department of Department of Physiology and Pharmacology, summarises acupunctures mechanisms thusly:

“The effects of acupuncture may be attributed to:

1) Peripheral effects (release of adenosine and nitric oxide, NO, by axonal and dorsal root reflexes).
2) Spinal effects (modulation of sympathetic tone and motor reflexes)
Modulation of endogenous descending pain inhibitory and facilitatory systems
3) Change in the functional connectivity of the brain. Activation or deactivation of:
a) limbic structures involved in stress/illness responses
b) the hypothalamus-pituitary-adrenal, HPA, axis
c) the prefrontal and frontal cortices.
4) Restoration of the default mode state.
5) Modulation of parasympathetic activity.
6) Activation of the reward and mirror systems
7) Modulation of activation of the immune system
8) Expectation, attention, conditioning and extinction of conditioned responses”19

Increasing use in Mainstream settings

Acupuncture has been used in the US military for over a decade and its use is expanding. 8 out of the top 10 rated cancer hospitals in the United States offer acupuncture treatment on site. Following trials that showed that acupuncture was twice as effective as usual care for low back pain relief, it is covered by national health insurance in Germany.

Ok, so there clearly are mainstream medical researchers and health-care policy makers from some of the most respected institutions in the world who do officially endorse acupuncture, as suitably demonstrated above. Surely when presented with all of this evidence, the pseudo-Skeptical admins would have to concede despite their own personal feelings that significant parts of the mainstream medical establishment do recommend acupuncture . . .

“Acupuncture is Pseudoscience,” says Wikipedia

Acupuncture clearly enjoys a staggering amount of mainstream scientific support. So how does one decide exactly what pseudoscience is?

Well, Wikipedia has a specific policy on when it is appropriate to apply the label. We find this policy under the content guideline on something called “Fringe Theories.”

“We use the term fringe theory in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field. For example, fringe theories in science depart significantly from mainstream science and have little or no scientific support.”

In other words, whether or not a theory is ‘fringe’ depends on the ‘prevailing’ or ‘mainstream’ views of the field. If a theory (or treatment) enjoys mainstream scientific support, it is neither fringe nor pseudoscience. Wikipedia’s guidance on the matter goes even further to articulate what can and cannot be branded with the unfortunate mark of pseudoscience. The guidance describes the grand ‘spectrum of fringe theories’ thusly:

“Not all pseudoscience and fringe theories are alike.” Oh, no. “In addition, there is an approximate demarcation between pseudoscience and questionable science, and they merit careful treatment.

  • Pseudoscience: Proposals that, while purporting to be scientific, are obviously bogus may be so labeled and categorized as such without more justification. For example, since the universal scientific view is that perpetual motion is impossible, any purported perpetual motion mechanism (e.g. Stanley Meyer’s water fuel cell) may be treated as pseudoscience. Proposals which are generally considered pseudoscience by the scientific community, such as astrology, may properly contain that information and may be categorized as pseudoscience.
  • Questionable science: Hypotheses which have a substantial following but which critics describe as pseudoscience, may contain information to that effect; however it should not be described as unambiguously pseudoscientific while a reasonable amount of academic debate still exists on this point.”

Taking into account all of the medical guidelines, position papers, Cochrane reviews and increasing research interest, acupuncture very clearly falls into the latter category. Yes, acupuncture does court a small but vocal group of detractors – these groups are usually distinguishable by a variant of the word ‘Skeptic’ in their title (as in Guerilla Skepticism on Wikipedia, a group devoted to training and sending groups of self-styled ‘Skeptics’ to edit Wikipedia articles to be more in line with their particular world-view), a most ironic use of the word ‘Science’ in their name (as in Science-Based Medicine) and can be seen to frequently use terms like ‘woo’ and ‘quackery,’ which are almost entirely absent from the vocabulary of the majority of those involved with healthcare and scientific research. They almost exclusively reference narrative opinion pieces by other Skeptics, such as this cherry-picking tired old hag, who’s seen more action than a brothel in a seaport, rather than primary or valid secondary sources such as Cochrane, displaying an embarrassing lack of familiarity with Ye Olde Evidence Hierarchy. These groups engage, according to the mainstream medical community, in something called ‘pseudoskepticism‘ and are to rational scientific inquiry what religious extremists are to mainstream religion and spirituality.

Denial: Not Just a River in Egypt

Having been presented with Wikipedia-appropriate high-quality medical references, including the medical guidelines, systematic reviews, and mechanism research syntheses listed above, how does this reliable information about acupuncture mesh with the skeptical world-view? Well, it doesn’t.

So how do the admins on the acupuncture page justify continuing to present their view as the undisputed consensus view in the face of so much evidence to the contrary? I’ve observed a number of well-worn patterns, here are the most common:

Label supporters of Acupuncture as Idiots

According to user ‘Hob Gadling’:

“Acupuncture is clearly a magic practice and has neither a viable mechanism nor evidence on its side. Still, it is used by lots of folks who do not know how to tell valid methods from superstition. Those people clearly do not agree that acupuncture is pseudoscience, but the situation is exactly the same as with other pseudosciences: their proponents do not agree that they are pseudoscientists. We get that all the time, for instance from Intelligent Design proponents.” 5:07, 14 December 2016 (UTC)

Yes, superstitious folks unfamiliar with valid research methods, like those morons at Harvard, the utter simpletons found at The National Institute of Neurological Disorders and Stroke and the irredeemable idiots over at the Mayo Clinic all recommend acupuncture.

User ‘Guy’ tells us: “At this point everyone other than the pathological believers is basically ready to move on. The great tragedy of science: the slaying of a beautiful hypothesis by ugly fact. Guy 23:18, 15 December 2016 (UTC)”

Fascinating. And yet, according to the recent study produced by Harvard and IBM, “Acupuncture research has grown markedly in the past two decades, with a 2-fold higher growth rate than for biomedical research overall. Both the increases in the proportion of RCTs and the impact factor of journals support that the quality of published research has improved. . . These findings provide a context for analyzing strengths and gaps in the current state of acupuncture research, and for informing a comprehensive strategy for further advancing the field.”20 Looks like the ‘pathological believers’ at Harvard are developing a comprehensive strategy to further advance acupuncture.

“. . . Of course, your statements do not become true by repeating them. Acupuncture is not “mainstream”, and you will not find a reliable source that says it is. . . –Hob Gadling 21:28, 14 December 2016 (UTC)

Difficult to know quite how to respond, given that we had already presented dozens of very reliable sources that said just that (my mistake for thinking that repetition would somehow help the reality sink in).

“It’s implausible, there’s no remotely plausible mechanism, most of the claims made for it are patent nonsense, it’s practiced by people who for the most part have absolutely no valid medical training and do not use any kind of infection control techniques, and it shows absolutely no sign of getting its house in order . . . Guy 09:05, 22 December 2016 (UTC)

Fact-check: Globally, the majority of those who practice acupuncture are licensed doctors with medical degrees, including over 35,000 MDs outside of South East Asia.

Invent your own evidence

“Science is not done by majority vote, it is done by data and their publication in scientific journals. Gather all the Cochrane meta-analyses done about acupuncture and show that they agree that acupuncture is better than placebo, and you win. You can’t because they all say the opposite, so you lose. Bye. —Hob Gadling 23:20, 13 December 2016 (UTC)”

Fact check: Multiple Cochrane reviews show that acupuncture is better than sham acupuncture and much better than usual care. But because the public are being misinformed about their healthcare choices by a source they mistakenly trust, you’re right, we all lose.

User Alexbrn tells us: “the enlightened basis of what we do is the real world: scientific plausibility, common sense & reason. Acupuncture boosters, Bigfoot spotters, 9/11 conspiracists, cultists etc. don’t like this but it’s their problem with reality which causes friction, not Wikipedia itself. If exceptionally strong sources appear, then we can follow them: until then, Wikipedia shall take a properly skeptical stance.” 09:56, 29 October 2016 (UTC)

“I think it is fair to say by now that there is no robust evidence that acupuncture works for anything, and any area where the balance of P=0.05 is still positive, is an artifact.” Guy 20:24, 14 December 2016 (UTC)

“there is no good evidence it works for most conditions, and all we have left are a handful of conditions where counting the papers shows a majority passing P=0.05 on subjective endpoints (which is entirely consistent with the expected 5% false positive rate inherent in P=0.05) . . .” Guy 09:05, 22 December 2016 (UTC)

Translation: the Cochrane Reviews that demonstrate that acupuncture is superior to sham and usual care are wrong. Because Guy says so. Of course, all of the high-quality reviews of medical interventions ever gathered have an equal chance of being wrong – any of these results could equally be ‘artifacts.’ Thus using Guy’s logic, we would chuck out everything we think we know about medical science. Guy is happy to delete the entire corpus of medical knowledge in order to maintain the view that acupuncture doesn’t work, demonstrating what lengths people are willing to go to in order to protect a cherished belief.

“However there are ample sources in this article that acupuncture is pseudoscience and that it has no scientific base whatsoever. Carl Fredrik 00:23, 16 December 2016 (UTC)”

“”Wikipedia is heavily biased for mainstream science” (or mainstream anything) is exactly how I’d expect an encyclopedia to work. On science subjects, Wikipedia should present articles with a balance that is supported by reliable peer-reviewed sources that exercise proper editorial control and are based on accepted scientific method – mainstream science by definition. (talk) 08:23, 21 December 2016 (UTC)” says User “Boing! said Zebedee”, while failing to acknowledge the panoply of reliable peer-reviewed sources that exercise proper editorial control and are based on accepted scientific method supporting acupuncture’s efficacy.

“The comparison is to the point: although propagated by quackademics, both therapeutic touch and acupuncture lack mainstream scientific support. That’s the reality of mainstream science. So, if you claim that they have lots of mainstream scientific support, that’s a mystification.” Tgeorgescu 20:51, 21 December 2016 (UTC)

Sure, Tgeorgescu, I have ‘mystified’ over a dozen medical guidelines into existence. I’m just that good.

It only works for pain

A user called ‘Roxy the dog’, who agrees that acupuncture is pseudoscience, decisively breaks out from the pack and acknowledges the existence of the scientific resources that elucidate some of acupuncture’s biological mechanisms. His/her comment: “Doesn’t the hatted list of ‘sources’ demonstrate a pain response, and nothing more? 12:37, 15 December 2016 (UTC)”

User ‘Alexbrn’, ferociously anti-acupuncture, shares a similar sentiment: “Really? Isn’t it rather that they’re pretty much firmly decided that acupuncture is ineffective overall, with a possible exception in one area: pain relief? 17:07, 14 December 2016 (UTC)”

Yeah, because that would be useless. An effective treatment for pain. Roxy and Alex agree that acupuncture lacks any useful function whatsoever and that it be branded as “pseudoscience” because all it does is provide efficacious pain relief <facepalm>.

When all else fails, silence your critics

As a new editor, I thought that presenting new high-quality medical references to the discussion on acupuncture’s Talk page in order to ensure that the article reflected the most up to date scientific perspective would be appreciated. Boy was I wrong.

“@Ellaqmentry: You have done absolutely nothing right. A cursory inspection of the talk page archives should have shown you that your arguments have been made and rejected for years. . . if you persist in making those comments, you are likely to become another (editor banned from Acupuncture) . . .” — Arthur Rubin 16:57, 19 December 2016 (UTC)

In response to these comments, I asked Arthur to please not bully me. He responded by vandalising my user page, removing the ‘new user’ tag I had put there so that folks would know I was new to the community.

“You have to take into account that Wikipedia is heavily biased for mainstream science. Those who manifestly work against this bias are subjected to discretionary sanctions.” Tgeorgescu 23:02, 20 December 2016 (UTC)

“Let me put it simply: if you continue to claim that acupuncture has mainstream scientific validation, you have no future as an Wikipedia editor.” Tgeorgescu 21:05, 21 December 2016 (UTC)

“To reiterate and clarify: if you continue to claim that acupuncture has mainstream scientific validation, you have no future as an Wikipedia editor. That is true not “regardless of whether or not it actually has”, it is true because it hasn’t. . . ” Guy 23:04, 21 December 2016 (UTC)

We Follow the Sources

So what’s the other side of this coin? How do the acupuncture article admins justify branding acupuncture pseudoscience according to indisputable medical consensus in the face of so much evidence to the contrary? The comments you are about to read were made with the benefit of the above research references.

The Acu-Wiki admins have provided two sources that they feel prove without a shadow of a doubt that the medical and scientific consensus pretty much unanimously agree that acupuncture is pseudoscience: the first is an introductory undergraduate textbook for non-science majors.21 The second is a primer on science in education.22 Neither of these sources is peer-reviewed, referenced or bills itself as a representation of scientific or medical consensus.

But let’s hear what the pseudoskeptical admins say about the strength of their sources. In each of the following, the author is referring to these two non-medical, non-referenced, non-peer-reviewed books.

“No, those sources are fine.” 19:26, 29 October 2016 (UTC) Says Carl Fredrik, a 4th year medical student, when questioned about their validity.

User Someguy1221 was slightly more circumspect about the sources supporting acupuncture as pseudoscience: “We subject sources on the side of pseudoscience and pseudomedicine, such as acupuncture, to a far higher degree of scrutiny than we do sources on the side of actual science and medicine. Some sources used in the article may not meet the strict criteria of MEDRS, but no one cares, because these do not say anything controversial – if we were to exclude them in exchange for actual MEDRS-compliant sources, the article content would not change significantly. But articles that find something promising in acupuncture and appear on their face to be MEDRS compliant, on the other hand, are basically universally found to have serious problems that invalidate their reliability.” 08:50, 29 October 2016 (UTC)

Translation: because there’s nothing controversial about saying that acupuncture is pseudoscience (aside from the fact that Wikipedia editors have been arguing about this since 2001) we do not have to use appropriate references to support the statement. Conversely, high quality, appropriate references supporting acupuncture’s acceptance or efficacy are flawed because they support acupuncture. Ah, Someguy1221, your head sounds like a fascinating place to live.

But by far the largest advocate of ‘the sources,’ Alexbrn, who has a PhD in English but no scientific or medical background to speak of, was downright exuberant about the strength of the aforementioned sources.

“Most of these dodgy areas have studies trying to validate them (cf homeopathy and osteopathy). As far as pseudoscience goes, we have two excellent sources that address the categorisation and are explicit. Acupuncture is pseudoscience. Wikipedia reflects such sources. “Alexbrn 12:32, 15 December 2016 (UTC)

“Incorrect. Both sources, which are strong WP:MEDRS23 assert that acupuncture is pseudoscience. We follow such sources, not the musings of random WP:SPA wikipedia editors. Alexbrn 14:42, 15 December 2016 (UTC)

“Whatever way you look at it, reliably-published medical books (referring to the two non-medical books above) which specifically consider the non-scientific are the best possible sources available. To find sources on the question of acupuncture and its relation to pseudoscience, try searching collections with the search terms “acupuncture” and “pseudoscience” maybe? All you are doing is producing fallacious arguments and hand-waving. Stick to following sources and all shall be well. Alexbrn 15:01, 15 December 2016 (UTC)”

“More hand-waving and fallacy. We have two top-rate sources that are bang on topic, and they are explicit in what they say. No amount of trying to question how they came to be, to personalize the matter, or to big up your own credentials is remotely relevant to the formation of consensus here, which is based exclusively on the WP:PAG. Wikipedia reflects what the best sources say; they say acupuncture is pseudoscience, so Wikipedia shall too. It’s really very simple. The only thing that might give pause is an equally strong source which explicitly considered the pseudoscience categorisation and rejects it.” Alexbrn 15:52, 15 December 2016 (UTC)

“This “majority view” stuff is baloney. The sources we have which consider the pseudoscience question place acupuncture in that category. Show me sources that consider the question which don’t. Lots of nonsenses are studied at Masters level and beyond: homeopathy, ayurveda, cranial therapy … these novel arguments are irrelevant in any case since we follow the sources.” Alexbrn 15:56, 15 December 2016 (UTC)

“Luckily we have excellent sources which directly consider acupuncture’s relationship to pseudoscience. They tell us it is pseudoscience – Wikipedia accordingly follows because that is the way this place works.” Alexbrn 16:27, 15 December 2016 (UTC)

“Besides, my personal opinion counts for nothing: what matters is what our good sources say on the pseudoscience question. Here, they’re nice and clear.” Alexbrn 18:01, 15 December 2016 (UTC)

“On pseudoscience, all the sources we have agree, and nobody has produced any RS (reliable sources) in opposition . . . ” Alexbrn 18:50, 15 December 2016 (UTC)

And, my personal favourite:

“We’re citing two high-quality medical textbooks focusing directly on the topic of pseudoscience. Despite the fact we don’t need such super-strength sources, we have them and we use them. We reflect what our sources say; OTOH the “personal” WP:PROFRINGE preference here is yours.” 10:26, 29 October 2016 (UTC)

Super-strength, high-quality medical textbooks. Wow. I think the only accurate descriptor in that sentiment is “books”. It was shortly after this discussion about the super-strength medical textbooks that Alexbrn would recommend on the administrator forum that I be indefinitely banned from editing on Wikipedia and the community, already having banned anyone else of a different opinion, would agree.

Wikipedia, the Encyclopedia that anyone can edit, so long as you don’t violate consensus.

But surely with Wikipedia being the ‘Free Encyclopedia’ that anyone can edit, the contents of the acupuncture page reflects the consensus opinion of the global community of English-speaking editors who have participated in its development. If there were reasonable evidence that the contents were incorrect, one could just present this and have it changed, no?

Sadly this is not the case.

13 December 2016: I created my first and only editor account on Wikipedia.

13 – 19 December 2016: I made a total of 20 comments on Wikipedia’s acupuncture discussion page. I made no edits to the Acupuncture article itself. My comments were respectful, relevant, and referenced.

19 December 2016: An administrator who goes by Someguy1221, created a new notice in the administrator’s noticeboard accusing me of being a “Sock-puppet”, which is when an editor who has been banned from editing creates a new account to circumvent the ban.

According to Wikipedia’s policy on accusing someone of this type of misconduct:

“Before opening an investigation, you need good reason to suspect sock puppetry.

Evidence is required. When you open the investigation, you must immediately provide evidence that the suspected sock puppets are connected . . . You must provide this evidence in a clear way. Vaguely worded submissions will not be investigated. You need to actually show why your suspicion that the accounts are connected is reasonable.”

No evidence was provided for his allegation that I’m a Sock, which is a violation of Wikipedia’s policy on making such an accusation.

Someguys1221 also accused me of being a “Point of View Pusher,” which is where someone makes an ‘aggressive’ presentation of a particular point of view in a Wikipedia article; I never made a single edit to any Wikipedia article, aggressive or otherwise.

For my alleged crimes, Someguy1221 recommended that I be indefinitely banned from using Wikipedia or Topic banned from participating in the editing of the Acupuncture article.

19 December 2016: Guy, a Wikipedia administrator who disagreed with my perspective on acupuncture’s mainstream support, indefinitely blocked me from editing Wikipedia articles. Given his involvement in the discussion, this was a clear violation of Wikipedia’s policies which state that admins who are involved should not do the blocking. After this, he had another administrator block me instead.

Since this time, I have been indefinitely banned from editing any part of the Wikipedia project, even though I have not violated a single one of Wikipedia’s policies in either letter or spirit. It seems that simply making the argument that acupuncture enjoys mainstream medical support is sufficient grounds for being banned from editing Wikipedia.

Unfortunately, my experience of being banned for providing high-quality evidence that acupuncture enjoys mainstream support is not an isolated incident. A Wikipedia editor who goes by the username A1candidate provided the following contribution. Following this contribution, he/she was also banned from editing the acupuncture article.

“Acupuncture should not be classified as fringe science because

  1. The American Heart Association‘s consensus statement says that acupuncture’s mechanism of effect appears to be through sensory mechanoreceptor and nociceptor stimulation induced by “connective tissues being wound around the needle”.[1]
  2. Britain’s National Health Service says that acupuncture is used in the majority of pain clinics and hospices in the UK and it is “based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue”.[2]
  3. Cancer Research UK says that “medical research has shown that acupuncture works by stimulating nerves to release the body’s own natural chemicals.” [3]
  4. The New England Journal of Medicine says that “some physiological phenomena associated with acupuncture have been identified” [4]
  5. Harrison’s Principles of Internal Medicine says that “the emerging acceptance of acupuncture results in part from its widespread availability and use in the United States today, even within the walls of major medical centers where it is used as an ancillary approach to pain management” Chapter e2, Page 5, McGraw-Hill, 2011, ISBN 978007174890224

Additionally, on 16 December, a long-time editor called LesVegas was also banned from editing the acupuncture page. The reason given? That he had repeatedly tagged the acupuncture article as violating Wikipedia’s neutral point of view policies – specifically, because it incorrectly refers to acupuncture as pseudoscience.

Directly before being banned from editing, he posted a comment to the page of Jim Wales, founder of Wikipedia, asking the following:

“. . .I can’t help but wonder if your strong and necessary response to some pseudoscience pushers has, unwittingly, emboldened a group of editors who see it as their mission to disparage all fields they deem pseudoscience. Take a look at the Acupuncture article, for instance. In the lede it says that “acupuncture is a pseudoscience”, definitively as if it came from the Mouth of God (and not merely the opinions of a couple of scientific authors.) Since there are numerous Cochrane Reviews which show acupuncture’s efficacy for various conditions, as well as WHO, NHS and NIH consensus statements about acupuncture’s efficacy for certain conditions, how can such a statement fall within our neutrality guidelines? Of course the entire scientific community hasn’t established the consensus that acupuncture is pseudoscience. States don’t have licensing boards for obvious pseudoscience, nor do scientists publish hundreds if not thousands of studies on obvious pseudoscience each year like they do with acupuncture . . . Whenever high-quality systematic reviews or meta-analyses show acupuncture in a positive light, they are rejected or deleted by these same editors who cherry-pick their own reviews and give them prominence . . . Do you believe articles like Acupuncture, which give QuackWatch more prominence than the NIH, fall within the spirit of this project? LesVegas (talk) 01:09, 16 December 2016 (UTC)”

Hours after posting this, LesVegas was indefinitely banned from editing the acupuncture article or anything remotely related to it.

Indisputably Pseudoscience? There’s No Contest

While every issue has multiple perspectives, what’s amazing is how woefully lopsided this particular debate is. The view expressed by the Wikipedia admins, which they are systematically bullying and banning Wikipedia compliant editors to defend, is one backed by un-referenced, easily disproven, error-prone opinions and fabrications. The majority of the remaining Wikipedia ‘community,’ after banning dissenters, appears to have no background in medicine or medical research. The crux of their argument relies on denying the existence of dozens of documents that demonstrate medical consensus in favour of acupuncture that clearly do exist. And this behaviour is from individuals claiming to speak on behalf of scientific rigour and rationality! It would be quite funny if it didn’t actually cause serious, systematic harm by steering people away from one of the most effective and safest treatment options ever studied. Meanwhile, as opposed to other areas of medicine, where topic experts are encouraged to participate if not relied upon for accuracy, acupuncture researchers and medical professionals who use this intervention and are versed in the literature are discouraged and banned from editing.

While Jimmy Wales and other decision-makers at Wikipedia have historically been anti-complementary medicine, the maintenance of the perspective that acupuncture is incontrovertibly pseudoscience in the face of so much evidence to the contrary comes at a steep price. It depends on censorship, denialism, and the compromising of every standard for judging scientific consensus and efficacy, not to mention escalating violations of Wikipedia’s own policies of conduct. The silly thing is that real scientists and the most rational people regularly update their theories on how things work based on new evidence. Hopefully, in the not too distant future, the acupuncture article will benefit from these rational perspectives.

Notes:
1. World Health Organization. (2002). Acupuncture: Review and analysis of reports on controlled clinical trials.
2. Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., et al. (2016). Noninvasive Treatments for Low Back Pain.
3. Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., & Owens, D. K. (2007). Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478–491. http://doi.org/10.7326/0003-4819-147-7-200710020-00006
4. Kelly, R. B. (2009). Acupuncture for pain. American Family Physician
5. Hegmann, K. T., Hughes, M. A., & Biggs, J. J. (2011). American college of occupational and environmental medicine’s occupational medicine practice guidelines. Elk Grove Village.
6. NINDSs. (2014). Low Back Pain (pp. 1–32).
7. State of Colorado Department of Labor and Employment. (2014). Low Back Pain Medical Treatment Guidelines, 1–117.
8. Toward Optimized Practice (TOP) Low Back Pain Working Group. (2016). Evidence-informed primary care management of low back pain, 1–49.
9. Network, S. I. (2013). SIGN 136; Management of Chronic Pain. Health Improvement Scotland; December.
10. Schug, S. A., Palmer, G. M., Scott, D. A., Halliwell, R., & Trinca, J. (2016). Acute pain management: scientific evidence, fourth edition, 2015. The Medical Journal of Australia, 204(8), 315–317. http://doi.org/10.1016/j.acpain.2006.05.002
11. Alper, B. S., Shah, A., & Malone-Moses, M. (2016). Point-of-care application of: Guidelines and evidence on acupuncture for chronic low back pain. European Journal Integrative Medicine. http://doi.org/10.1016/j.eujim.2016.07.029
12. Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Shin, B.-C., et al. (2016). Acupuncture for the prevention of tension-type headache. (K. Linde, Ed.). Chichester, UK: John Wiley & Sons, Ltd. http://doi.org/10.1002/14651858.CD007587.pub2
13. Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Vertosick, E. A., et al. (2016). Acupuncture for the prevention of episodic migraine. (K. Linde, Ed.). Chichester, UK: John Wiley & Sons, Ltd. http://doi.org/10.1002/14651858.CD001218.pub3
14. Manheimer, E., Cheng, K., Linde, K., Lao, L., Yoo, J., Wieland, S., et al. (2010). Acupuncture for peripheral joint osteoarthritis. (E. Manheimer, Ed.). Chichester, UK: John Wiley & Sons, Ltd. http://doi.org/10.1002/14651858.CD001977.pub2
15. Deare, J. C., Zheng, Z., Xue, C., & Liu, J. P. (2013). Acupuncture for treating fibromyalgia. The Cochrane …. http://doi.org/10.1002/14651858.CD007070.pub2
16. Paley, C. A., Johnson, M. I., & Tashani, O. A. (2015). Acupuncture for cancer pain in adults. The Cochrane …. http://doi.org/10.1002/14651858.CD007753.pub3
17. Zeng, B.-Y., Zhao, K., & Liang, F.-R. (2013). INTERNATIONAL REVIEWOF NEUROBIOLOGY. Neurobiology of Acupuncture (1st ed., Vol. 111). Elsevier Inc.
18. Tang, Y., Yin, H. Y., Rubini, P., & Illes, P. (2016). Acupuncture-Induced Analgesia: A Neurobiological Basis in Purinergic Signaling. The Neuroscientist, 1–16. http://doi.org/10.1177/1073858416654453
19. </code>Lund, I., ; Lundeberg, T. (2016). Mechanisms of Acupuncture. Acupuncture and Related Therapies. http://doi.org/10.1016/j.arthe.2016.12.001<code class=”shortcode”>
20. Ma, Y., Dong, M., Zhou, K., Mita, C., Liu, J., & Wayne, P. M. (2016). Publication Trends in Acupuncture Research: A 20-Year Bibliometric Analysis Based on PubMed. PLoS ONE, 11(12), e0168123. http://doi.org/10.1371/journal.pone.0168123
21. Baran GR, Kiana MF, Samuel SP (2014). Chapter 2: Science, Pseudoscience, and Not Science: How Do They Differ?. Healthcare and Biomedical Technology in the 21st Century. Springer. pp. 19–57. doi:10.1007/978-1-4614-8541-4_2.
22. Good R (2012). Khine MS, ed. Chapter 5: Why the Study of Pseudoscience Should Be Included in Nature of Science Studies. Advances in Nature of Science Research: Concepts and Methodologies. Springer. p. 103. ISBN 978-94-007-2457-0.
23. Wikipedia Medically Reliable Sources (they’re not)