Wikipedia:Identifying reliable sources (medicine)

Further information:Wikipedia:Verifiability,Wikipedia:No original research,andWikipedia:Manual of Style/Medicine-related articles

See also:Wikipedia:Identifying reliable sources (science)andWikipedia:Biomedical information

Biomedical informationmust bebased onreliable,third-partypublishedsecondary sources,and must accurately reflect current knowledge. This guideline supports thegeneral sourcing policywith specific attention to what is appropriate for medical content inanyWikipedia article, including those onalternative medicine.Sourcing for all other types of content – including non-medical information in medical articles – is covered by the general guideline onidentifying reliable sources.

Ideal sources for biomedical information include:review articles(especiallysystematic reviews) published in reputablemedical journals,academic and professional books written by experts in the relevant fields and from respected publishers, andguidelinesor position statements from national or international expert bodies.Primary sourcesshould generally not be used for medical content,as such sources often include unreliable or preliminary information; for example, early lab results that do not hold in laterclinical trials.

See thereliable sources noticeboardfor questions about reliability of specific sources, and feel free to ask at WikiProjects such asWikiProject MedicineandWikiProject Pharmacology.

Definitions

Further information:Primary, secondary, and tertiary sources,Identifying and using primary sources,andParty and person

Types of sources

In the biomedical literature:

• Aprimary sourceis one in which the authors directly participated in the research and documented their personal experiences. They examined the patients, injected the rats, ran the experiments, or supervised those who did. Many papers published in medical journals are primary sources for facts about the research and discoveries made.
• Asecondary sourcesummarizes one or more primary or secondary sources to provide an overview of current understanding of the topic, to make recommendations, or tocombine resultsof several studies. Examples includeliterature reviewsorsystematic reviewsfound in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations.
• Atertiary sourcesummarizes a range of secondary sources. Undergraduate- or graduate-level textbooks, edited scientific books, lay scientific books, and encyclopedias are tertiary sources.

Biomedical v. general information

Further information:Wikipedia:Biomedical information

Biomedical informationrequires sourcing that complies with this guideline, whereas general information in the same article may not.

For example, an article onDr Foster's Magic Purple Pillscould contain both biomedical and non-biomedical claims:

• Dr Foster's pills cure everything.A biomedical claim! Strong MEDRS (MEDical Reliable Source) sourcing is definitely required here (seeWP:MEDASSESS)
• The pills were invented by Dr Archibald Foster and released onto the market in 2015.This isnot biomedical information,and it only requires ordinaryRS
• They are purple and triangular, packaged one to a box,as no-one ever manages to swallow a second one.

Basic advice

Avoid primary sources

Per the Wikipedia policies ofneutral point of view,no original research,andverifiability,articles need to be based on reliable,independent,publishedsecondaryortertiarysources. Forbiomedical content,the Wikipedia community relies on guidance contained in expert scientific reviews and textbooks, and in official statements published by major medical and scientific bodies. Note that health-related content in the generalnews mediashould not normally be used to source biomedical content in Wikipedia articles. (News sources may be useful for non-biomedical content, such as information about "society and culture" – seeWP:MEDPOP.)

Primarysources should NOT normally be used as a basis for biomedical content. This is because primary biomedical literature is exploratory and often not reliable (any given primary source may be contradicted by another). Any text that relies on primary sources should usually have minimalweight,only describe conclusions made by the source, and describe these findings so clearly that any editor can check the sourcing without the need for specialist knowledge. Primary sources should never be cited in support of a conclusion that is not clearly made by the authors (seeWP:Synthesis).

Respect secondary sources

Further information:Wikipedia:Identifying and using primary sources

Primary sources should not be cited with intent of "debunking", contradicting, or countering conclusions made by secondary sources.Synthesis of published material advancing a positionisoriginal research,and Wikipedia is not a venue foropen research.Controversies or uncertainties in medicine should be supported by reliable secondary sources describing the varying viewpoints. Primary sources should not be aggregated or presented without context in order to undermine proportionate representation of opinion in a field. If material can be supported by either primary or secondary sources – the secondary sources should be used. Primary sources may be presented together with secondary sources.

Findings are often touted in the popular press as soon as primary research is reported, before the scientific community has analyzed and commented on the results. Therefore, such sources should generally be omitted (seerecentism). Determiningweightof studies requires reliable secondary sources (not press releases or newspaper articles based on such sources). If conclusions are worth mentioning (such as largerandomized clinical trialswith surprising results), they should be described appropriately as from a single study:

"A large study published in 2010 found that selenium and Vitamin E supplements, separately as well as together, did not decrease the risk of getting prostate cancer and that vitamin E may increase the risk; they were previously thought to prevent prostate cancer." (citingPMID20924966)

Given time a review will be published, and the primary sources should preferably be replaced with the review. Using secondary sources then allows facts to be stated with greater reliability:

"Neither vitamin E nor selenium decreases the risk of prostate cancer and vitamin E may increase it." (citingPMID29376219,PMID26957512)

If no reviews on the subject are published in a reasonable amount of time, then the content and primary source should be removed.

A reason to avoid primary sources in the biomedical field – especially papers reporting results ofin vitroexperiments – is that they are often notreplicable(see alsoreplication crisis) and are therefore unsuitable for use in generating encyclopedic, reliable biomedical content. Scientists at Bayer reported in 2011 that they were able to replicate results in only ~20 to 25% of prominent studies they examined;scientists from Amgen followed with a 2012 publication showing that they were only able to replicate 6 (11%) of 53 high-impact publications and called for higher standards in scientific publishing.Further, the fact that a claim is published in a refereed journal need not make it true. Even well-designed randomized experiments will occasionally produce spurious results. Experiments and studies can produce flawed results or even fall victim to deliberate fraud (e.g.theRetracted article on dopaminergic neurotoxicity of MDMAand theSchön scandal.)

Summarize scientific consensus

Scientific journalsare the best place to find both primary and secondary sources. Every rigorous scientific journal ispeer reviewed.Be careful of material published in journals lacking peer review or that report material mainly in other fields. (See:Martin Rimm.) Be careful of material published in disreputable journals or disreputable fields. (See:Sokal affair.)

Wikipedia policies on theneutral point of viewandnot publishing original researchdemand that we present prevailingmedicalorscientific consensus,which can be found in recent, authoritativereview articles,in statements andpractice guidelinesissued by major professional medical or scientific societies (for example, theEuropean Society of Cardiologyor theInfectious Disease Society of America) and widely respected governmental and quasi-governmental health authorities (for example,AHRQ,USPSTF,NICE,andWHO), in textbooks, or in scholarlymonographs.Although significant-minority views are welcome in Wikipedia, such views must be presented in the context of their acceptance by experts in the field. Additionally, the views oftinyminorities need not be reported.

Finally, make readers aware of controversies that are stated in reliable sources. A well-referenced article will point to specific journal articles or specific theories proposed by specific researchers.

Assess evidence quality

When writing about anyhealth effect,assessing evidence quality helps distinguish between minor and major views, determinedue weight,and identify acceptedevidence-basedinformation. Even in reputable medical journals, different papers are not given equal weight. Studies can be categorized into levels in ahierarchy of evidence,and editors should rely on high-level evidence, such assystematic reviews.Low-level evidence (such ascase reportsorseries) or non-evidence (such asanecdotesor conventional wisdom) are avoided.Medical guidelinesor position statements by internationally or nationally recognized expert bodies also often contain recommendations, along with assessments of underlying evidence (seeWP:MEDORG).

There are different ways to ranklevel of evidence in medicine,but they similarly put high-level reviews and practice guidelines at the top.
Left:Procter & Gamble.Right: Canadian Association of Pharmacy in Oncology.

The best evidence forefficacyof treatments and other health interventions comes mainly frommeta-analysesofrandomized controlled trials(RCTs).Systematic reviews of literature that include non-randomized studies are less reliable.Narrative reviews can help establish the context of evidence quality.

Lower levels of evidence in medical research come fromprimarystudies (seeWP:MEDDEF). Roughly in descending order, these include: individual RCTs;quasi-experimentalstudies; prospectiveobservational(non-experimental) studies, such asprospective cohort studies(one type oflongitudinal study);case controlstudies;cross-sectional studies(surveys), and othercorrelationstudies such asecological studies;otherretrospectiveanalyses (includingretrospective cohort studies); and non-evidence-based expert opinion or clinical experience. Case reports and series are especially avoided, as they areuncontrolled.

Speculative proposalsand early-stage research should not be cited to imply wide acceptance. For example, results of an early-stageclinical trialwould not be appropriate in the 'Treatment' section of a disease article because future treatments have little bearing on current practice. The results might – in some cases – be appropriate for inclusion in an article specifically dedicated to the treatment in question or to the researchers or businesses involved in it. Such information, particularly when citing secondary sources, may be appropriate in research sections of disease articles. To prevent misunderstanding, the text should clearly identify the level of research cited (e.g., "first-in-human safety testing" ).

Several formal systems exist for assessing the quality of available evidence on medical subjects.Here, "assess evidence quality" essentially means editors should determine the appropriatetype of sourceandquality of publication.Respect the levels of evidence: Do not reject a higher-level source (e.g., a meta-analysis) in favor of a lower one (e.g., any primary source) because of personal objections to the inclusion criteria, references, funding sources, or conclusions in the higher-level source. Editors should not perform detailed academic peer review.

Avoid over-emphasizing single studies, particularlyin vitroor animal studies

In vitrostudies and animal models serve a central role in research, and are invaluable in determining mechanistic pathways and generating hypotheses. However,in vitroand animal-model findings do not translate consistently into clinical effects in human beings. Wherein vitroand animal-model data are cited on Wikipedia, it should be clear to the reader that the data are pre-clinical, and the article text should avoid stating or implying that reported findings hold true in humans. The level of support for a hypothesis should be evident to a reader.

Using small-scale, single studies makes for weak evidence, and allows forcherry pickingof data. Studies cited or mentioned in Wikipedia should be put in context by using high-quality secondary sources rather than by using the primary sources.

Use up-to-date evidence

See also:Template:Update

Keeping an article up-to-date while maintaining the more-important goal of reliability is important. These instructions are appropriate for actively researched areas with many primary sources and several reviews, and may need to be relaxed in areas where little progress is being made or where few reviews are published.

• In many topics, a review that was conducted more than five or so years ago will have been superseded by more up-to-date ones, and editors should try to find those newer sources, to determine whether the expert opinion has changed since the older sources were written. The range of reviews you examine should be wide enough to catch at least one full review cycle, containing newer reviews written and published in the light of older ones and of more-recent primary studies.
• Assessing reviews may be difficult. While the most-recent reviews include later research results, this doesnotautomatically give more weight to the most recent review (seerecentism).
• Prefer recent reviews to older primary sources on the same topic. If recent reviews do not mention an older primary source, the older source is dubious. Conversely, an older primary source that is seminal, replicated, and often-cited may be mentioned in the main text in a context established by reviews. For instance, the articleGeneticscould mention Darwin's 1859 bookOn the Origin of Speciesas part of a discussion supported by recent reviews.

There are exceptions to these rules of thumb:

• Historysections often cite older work.
• Cochrane Libraryreviews andNICE guidelinesare generally of high quality and are periodically re-examined even if their initial publication dates fall outside the 5-year window.
• A newer source that is of lower qualitydoes not supersedean older source of higher quality.

Use independent sources

Many treatments or proposed treatments lack good research into their efficacy and safety. In such cases, reliable sources may be difficult to find, while unreliable sources are readily available. When writing about medical claims not supported by mainstream research, it is vital thatthird-party,independent sources be used. Sources written and reviewed by the advocates ofmarginal ideasmay be used to describe personal opinions, but extreme care should be taken when using such sources lest more controversial opinions be taken at face value or, worse, asserted as fact. If independent sources discussing a medical subject are of low quality, then it is likely that the subject itself is notnotableenough to have its own article or relevant for mention in other articles.

Symposia and supplements to academic journalsare commonly sponsored by industry groups with a financial interest in the outcome of the research reported. They may lack independent editorial oversight andpeer reviewwith no supervision of content by the parent journal.Such articles do not share the reliability of their parent journal.Indications that an article was published in a supplement may be fairly subtle; for instance, a letter "s" added to a page number,or "Suppl." in a reference.

Bias

Personal conflicts of interest

Further information:Wikipedia:Conflicts of interest (medicine)

People most interested in improving only a single article may have a connection to its subject.

Use your best judgement when writing about topics where you may have a conflict of interest: citing yourself on Wikipedia is problematic. Citing your own organization, such as a governmental health agency or an NGO producing high-quality systematic reviews, is generally acceptable – if the conflict of interest is disclosed, it is done to improve coverage of a topic, and not with the sole purpose of driving traffic to your site. All edits should improve neutral encyclopedic coverage; anything else, such as promoting an organization, isnot allowed.

According to theconflict of interest guideline–conflicts of interest(COI) must be disclosed. Editing on topics where one is involved or closely related, especially when there is potential financial gain, is discouraged. Medicine is not an exception. One way to contribute with a COI is to post on talk-pages, suggesting edits. Another alternative is thearticles for creationpathway.

These methods are often best when writing about oneself, one's organization orcompany– but may be less so when there is a potential conflict of interest in aresearch field.For example, one may legitimately be anauthorityon a certain topic – avolunteerwho reads the talk-page will not always have the knowledge to assess the sources properly. Then it is better to followordinary editing protocol,disclosing any COI and to be carefulnotto overemphasize your own sources.

Choosing sources

PLoS Medicineand otheropen access journalscan be useful as sources for images in Wikipedia articles. Because the above image was published under the terms of aCreative Commons license,it can beuploadedtoWikimedia Commonsandusedon Wikipedia. Click on the above image to find its source.

Non-free content

See also:FUTON biasandWP:MEDCOPY

A Wikipedia article should cite high-quality reliable sourcesregardless of whether they require a fee or a subscription.Some high-prestige journals, such asJAMA,publish a few freely readable articles even though most are not free. A few high-quality journals, such asPLoS Medicine,publish only freely readable sources. Also, a few sources are in thepublic domain;these include many U.S. government publications, such as theMorbidity and Mortality Weekly Reportof theCenters for Disease Control and Prevention.

Don't just cite the abstract

Whensearching for biomedical sources,it is wise to skim-read everything available, including abstracts of papers that are not freely readable, and use that to get a feel for what reliable sources are saying. However, when it comes to actually writing a Wikipedia article, it is misleading to give a full citation for a source after reading only its abstract; the abstract necessarily presents a stripped-down version of the conclusions and omits the background that can be crucial for understanding exactly what the source says, and may not represent the article's actual conclusions.

To access the full text of a book or journal article, the editor may need to use theWikipedia Library,visit a medical library, pay to read it, or ask someone at theWikiProject Resource ExchangeorWikiProject Medicine's talk pageto either provide an electronic copy or read the source and summarize what it says; if none of this is possible, the editor may need to find a different source.

Biomedical journals

Peer-reviewed medical journals are a natural choice as a source for up-to-date medical information in Wikipedia articles. Journal articles come in many different types, and are a mixture of primary and secondary sources. Primary publications describe new research, while review articles summarize and integrate a topic of research into an overall view. In medicine, primary sources include clinical trials, which test new treatments. In addition to experiments, primary sources normally contain introductory, background, or review sections that place their research in the context of previous work; these sections may be cited in Wikipedia with care: they are often incompleteand typically less reliable than reviews or other sources, such as textbooks, which are intended to be reasonably comprehensive. If challenged, the primary source should be supplemented with, or replaced by, a more appropriate source.

Reviews may benarrativeor systematic (and sometimes both).Narrative reviewsprovide a general summary of a topic based on a survey of the literature, which can be useful when outlining a topic. A general narrative review of a subject by an expert in the field can make a good secondary source covering various aspects of a subject within a Wikipedia article. Such reviews typically do not contain primary research but can make interpretations and draw conclusions from primary sources that no Wikipedia editor would be allowed to do.Systematic reviewsuse sophisticated methodology to address a particular clinical question in as balanced (unbiased) a way as possible. Some systematic reviews also include a statistical meta-analysis to combine the results of several clinical trials to provide stronger quantitative evidence about how well a treatment works for a particular purpose. A systematic review uses areproduciblemethodology to select primary (or sometimes secondary) studies meeting explicit criteria to address a specific question. Such reviews should be more reliable and accurate and less prone to bias than a narrative review.Systematic reviews andmeta-analysesof randomized controlled trials can provide strong evidence of the clinical efficacy of particular treatments in given scenarios, which may, in turn, be incorporated intomedical guidelinesor institutional position papers (ideal sources for clinical recommendations). It is normally best to use reviews and meta-analyses where possible. Reviews give a balanced and general perspective of a topic and are usually easier to understand. However, whereas a narrative review may give a panorama of current knowledge on a particular topic, a systematic review tends to have a narrower focus.

Journals may specialize in particular article types. A few, such asEvidence-based Dentistry(ISSN1462-0049), publish third-party summaries of reviews and guidelines published elsewhere. If an editor has access to both the original source and the summary and finds both helpful, it is good practice to cite both sources together (seeCiting medical sourcesfor details). Others, such asJournal of Medical Biography,publish historical material that can be valuable forHistorysections, but is rarely useful for current medicine. Still others, such asMedical Hypotheses,publish speculative proposals that are not reliable sources for biomedical topics.

List of core journals

TheAbridged Index Medicusprovides a list of 114 selected "core clinical journals".Another useful grouping of core medical journals is the 2003 Brandon/Hill list, which includes 141 publications selected for a small medical library(although this list is no longer maintained, the listed journals are of high quality). Core general medical journals include theNew England Journal of Medicine,The Lancet,theJournal of the American Medical Association(JAMA), theAnnals of Internal Medicine,The BMJ(British Medical Journal),and theCanadian Medical Association Journal.Core basic science and biology journals includeNature,ScienceandCell.

Predatory journals

Further information:WP:RS § Predatory journals

Avoid articles from journals witha poor reputation for fact-checking and accuracy.A journal article is probably not reliable for biomedical claims if its publisher has a reputation for exhibiting "predatory"behavior, which includes questionable business practices and/or peer-review processes that raise concerns about the reliability of their journal articles. (See alsoWP:RS#Predatory journalsand the#Referencessection below for examples of such publishers.) Other indications that a journal articlemaynot be reliable are its publication in a journal that is not indexed in the bibliographic databaseMEDLINE,or its content being outside the journal's normal scope (for instance, an article on the efficacy of a new cancer treatment in a psychiatric journal or the surgical techniques for hip replacement in aurologyjournal). Determining the reliability of any individual journal article may also take into account whether the article has garnered significant positive citations in sources of undisputed reliability, suggesting wider acceptance in the medical literature despite any red flags suggested here.

An archive ofBeall's List,an early list of potentially predatory journals, can be found atBeall's List – of Potential Predatory Journals and Publishers;updates are added separately by an anonymous post-doctoral researcher. On Wikipedia, theCiteWatchcompilation (updated twice monthly) and theUnreliable/Predatory Source Detectorscript can be leveraged to facilitate the detection of predatory journals.

Some baseline methods to identify questionable journals have reached consensus in the academic community.

Sponsored supplements

See also:WP:SPONSORED

Symposia and supplements to academic journalsare often (but far from always) unacceptable sources. They are commonly sponsored by industry groups with a financial interest in the outcome of the research reported. They may lack independent editorial oversight andpeer review,with no supervision of content by the parent journal.Suchshillarticles do not share the reliability of their parent journal,being essentially paidads disguisedas academic articles. Such supplements, and those that do not clearly declare their editorial policy and conflicts of interest, should not be cited.

Indications that an article was published in a supplement may be fairly subtle; for instance, a letter "S" added to a page number,or "Suppl." in a reference.However, note that merely being published inasupplement is notprima facieevidence of being published in asponsoredsupplement. Many, if not most, supplements are perfectly legitimate sources, such as theAstronomy & Astrophysics Supplement Series,Nuclear Physics B: Proceedings Supplements,Supplement to the London Gazette,orThe Times Higher Education Supplement.A sponsored supplement need not necessarily have a COI with its medical content; for instance, public health agencies may also sponsor supplements. However, groups that do have a COI may hide behind layers of front organizations with innocuous names, so the ultimate funding sources should always be ascertained.

Books

High-quality textbooks can be a good source to start an article, and often include general overviews of a field or subject. However, books generally move slower than journal sources, and are often several years behind the current state of evidence. This makes using up-to-date books even more important. Medical textbooks published by academic publishers are often excellent secondary sources. If a textbook is intended for students, it may not be as thorough as a monograph or chapter in a textbook intended for professionals or postgraduates. Ensure that the book is up to date, unless a historical perspective is required. Doody's maintains a list of core health sciences books, which is available only to subscribers.Major academic publishers (e.g.,Elsevier,Springer Verlag,Wolters Kluwer,andInforma) publish specialized medical book series with good editorial oversight; volumes in these series summarize the latest research in narrow areas, usually in a more extensive format than journal reviews. Specialized biomedical encyclopedias published by these established publishers are often of good quality, but as a tertiary source, the information may be too terse for detailed articles.

Additionally, popular science books are useful sources, but generally should not be referenced on Wikipedia to support medical statements (see#Popular press). In addition, mostself-publishedbooks or books published byvanity pressesundergo no independent fact-checking or peer review and, consequently, are not reliable sources. However, books published byuniversity pressesor theNational Academy of Sciencestend to be well-researched and useful for most purposes.

Medical and scientific organizations

Guidelines and position statements provided by major medical and scientific organizations are important on Wikipedia because they present recommendations and opinions that many caregivers rely upon (or may even be legally obliged to follow).

Statements and information from reputable major medical and scientific bodies may be valuable encyclopedic sources. These bodies include theU.S. National Academies(including theNational Academy of Medicineand theNational Academy of Sciences), the BritishNational Health Service,the U.S.National Institutes of HealthandCenters for Disease Control and Prevention,and theWorld Health Organization.The reliability of these sources ranges from formal scientific reports, which can be the equal of the best reviews published in medical journals, to public guides and service announcements, which have the advantage of being freely readable but are generally less authoritative than the underlying medical literature.

Guidelines by major medical and scientific organizations sometimes clash with one another (for example, the World Health Organization and American Heart Association on salt intake), which should be resolved in accordance withWP:WEIGHT.Guidelines do not always correspond to best evidence, but instead of omitting them, reference the scientific literature and explain how it may differ from the guidelines. Remember to avoidWP:original researchby only using the best possible sources, andavoid weasel words and phrasesby tying together separate statements with "however", "this is not supported by", etc. The image below attempts to clarify some internal ranking of statements from different organizations in the weight they are given on Wikipedia.

Guidelines are important on Wikipedia because they present recommended practices and positions of major authorities.

*Health technology assessmentsorHTAs are the gold standard when it comes to assessing evidence quality. They take into account various aspects such as effect, risks, economic costs, and ethical concerns of a treatment. They seldom make recommendations, but instead explain most effective treatments and potential hazards and discuss gaps in knowledge. Their name is somewhat of a misnomer as they do not need to concern "technology" as perceived by the public – but rather any intervention intended to improve health.

Popular press

The popular press is generally not a reliable source for scientific and medical information in articles. Mostmedical news articlesfail to discuss important issues such as evidence quality,costs, and risks versus benefits,and news articles too often convey wrong or misleading information about health care.Articles in newspapers and popular magazines tend to overemphasize the certainty of any result, for instance, presenting a new and experimental treatment as "the cure" for a disease or an every-day substance as "the cause" of a disease. Newspapers and magazines may also publish articles about scientific results before those results have been published in a peer-reviewed journal or reproduced by other experimenters. Such articles may be based uncritically on a press release, which themselves promote research with uncertain relevance to human health and do not acknowledge important limitations, even when issued by an academic medical center.For Wikipedia's purposes, articles in the popular press aregenerally considered independent, primary sources.A news article should therefore not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source.

Conversely, the high-quality popular press can be a good source for social, biographical, current-affairs, financial, and historical information in a medical article. For example, popular science magazines such asNew ScientistandScientific Americanare not peer reviewed, but sometimes feature articles that explain medical subjects in plain English. As the quality of press coverage of medicine ranges from excellent to irresponsible, use common sense, and see how well the source fits theverifiability policyandgeneral reliable sources guidelines.Sources for evaluating health-care media coverage include specialized academic journals such as theJournal of Health Communication.Reviews can also appear in theAmerican Journal of Public Health,theColumbia Journalism Review,and others.

Other sources

Reliable sources must be strong enough to support the claim. A lightweight source may be acceptable for a lightweight claim, but never for an extraordinary claim.

Press releases, newsletters, advocacy and self-help publications, blogs and other websites, and other sources contain a wide range of biomedical information ranging from factual to fraudulent, with a high percentage being of low quality.

Conference abstracts present incomplete and unpublished data and undergo varying levels of review; they are often unreviewed and their initial conclusions may have changed dramatically if and when the data are finally ready for publication.Consequently, they are usually poor sources and should always be used with caution, never used to supportsurprising claims,and carefully identified in the text as preliminary work.

Medical information resources such asWebMDandeMedicineare usually acceptable sources for uncontroversial information; however, as much as possible Wikipedia articles should cite the more established literature directly.UpToDateis less preferred as it is not possible to reference specific versions of their articles, and archives do not exist.

Searching for sources

Search enginesare commonly used to find biomedical sources. Each engine has quirks, advantages, and disadvantages, and may not return the results that the editor needs unless used carefully. It typically takes experience and practice to recognize when a search has not been effective; even if an editor finds useful sources, they may have missed other sources that would have been more useful or they may generate pages and pages of less-than-useful material. A good strategy for avoiding sole reliance on search engines is to find a few recent high-quality sources and follow their citations to see what the search engine missed. It can also be helpful to perform a plain web search rather than one of scholarly articles only.

PubMedis an excellent starting point for locating peer-reviewed medicalliterature reviews on humans from the last five years.It offers a free search engine for accessing theMEDLINEdatabase of biomedical research articles offered by theNational Library of Medicineat theU.S. National Institutes of Health.PubMed can be searched in a variety of ways.For example, clicking on the "Review" tab will help narrow the search to review articles. The "Filters" options can further narrow the search, for example, tometa-analyses,topractice guidelines,and/or to freely readable sources. Once you have a PMID from Pubmed, you can plug that PMID intothis toolto get a correctly written citation. Although PubMed is a comprehensive database, many of its indexed journals restrict online access. Another website,PubMed Central,provides free access to full texts. While it is often not the official published version, it is a peer-reviewed manuscript that is substantially the same but lacks minor copy-editing by the publisher.

When looking at an individual abstract on the PubMed website, an editor can consult "Publication Types", "MeSH Terms", etc. at the bottom of the page to see how the document has been classified in PubMed. For example, a page that is tagged as "Comment" or "Letter" is aletter to the editor(often not peer-reviewed). The classification scheme includes about 80 types of documents.For medical information, the most useful types of articles are typically labeled "Guideline", "Meta-analysis", "Practice guideline", or "Review". Even when an article is one of the most useful types and recently published, it can be helpful to check the journal onDOAJand other databases as well as the status andpublishing trackof authors if they make extraordinary claims. There isno magic number,but it is useful to compare the authors to others in the same field of study.

Templates

• {{Medical citation needed}}– adds:some text.
• {{Medical citation needed span}}– adds:some text.(same as above, except the text is highlighted)
• {{Unreliable medical source}}– adds:some text.
• {{Primary source inline}}– adds:some text.
• {{More medical citations needed}}– maintenance tag for articles lacking reliable medical sources
• {{Reliable medical sources please}}– a note for user talk pages with links to this page
• {{Reliable sources for medical articles}}– for talk pages

See also

• Help:Wikipedia editing for medical experts
• Wikipedia:Reliable source examples § Physical sciences and medicine
• Wikipedia:Conflicts of interest (medicine)
• Wikipedia:Identifying reliable sources (science)
• Wikipedia:Identifying and using style guides § Topical academic style guides(essay)
• Wikipedia:Why MEDRS?,an essay about why this guideline exists
• Wikipedia:MEDFAQ,Frequently Asked Questions about MEDRS
• Users' Guides to the Medical Literature
• Dispatches: Sources in biology and medicine.The Wikipedia Signpost(2008-06-30)
• Replication crisis
• WP:CITEWATCH,a bot-compiled listing of potentially unreliable publications cited by Wikipedia (seethisSignpostarticlefor details)
• WP:UPSD,auser scriptwhich highlights potentially unreliable citations.

Further reading

• Greenhalgh T (2006).How to Read a Paper: The Basics of Evidence-based Medicine(3rd ed.). BMJ Books.ISBN978-1405139762.The Greenhalgh citation inReferencesis taken from an earlier version of this book, which wasserialized inBMJ.Other parts of that serialization include:
  • Greenhalgh T (July 1997)."How to read a paper. Getting your bearings (deciding what the paper is about)".BMJ.315(7102):243–6.doi:10.1136/bmj.315.7102.243.PMC2127173.PMID9253275.
  • Greenhalgh T (August 1997)."Assessing the methodological quality of published papers".BMJ.315(7103):305–8.doi:10.1136/bmj.315.7103.305.PMC2127212.PMID9274555.
  • Greenhalgh T (August 1997)."How to read a paper. Statistics for the non-statistician. I: Different types of data need different statistical tests".BMJ.315(7104):364–6.doi:10.1136/bmj.315.7104.364.PMC2127256.PMID9270463.
  • Greenhalgh T (August 1997)."How to read a paper. Statistics for the non-statistician. II:" Significant "relations and their pitfalls".BMJ.315(7105):422–5.doi:10.1136/bmj.315.7105.422.PMC2127270.PMID9277611.
  • Greenhalgh T (August 1997)."How to read a paper. Papers that report drug trials".BMJ.315(7106):480–3.doi:10.1136/bmj.315.7106.480.PMC2127321.PMID9284672.
  • Greenhalgh T (August 1997)."How to read a paper. Papers that report diagnostic or screening tests".BMJ.315(7107):540–3.doi:10.1136/bmj.315.7107.540.PMC2127365.PMID9329312.
  • Greenhalgh T (September 1997)."How to read a paper. Papers that tell you what things cost (economic analyses)".BMJ.315(7108):596–9.doi:10.1136/bmj.315.7108.596.PMC2127419.PMID9302961.
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