Revision as of 00:51, 5 May 2009

This article was nominated for deletion on 27 April 2009 (UTC). The result of the discussion was no consensus.

Really?

This article doesn't have a talk page? This guy smells like a doctor who got detoured by a good discovery over into pseudo-science land. Also, are there no doctors who do not support Dr. Barnes? Where's the NPOV? Philip

Recent edits

I'd welcome some discussion about these edits, which are being reinserted by an IP. I'm concerned that they exacerbate a problem from which this article suffers: it reintroduces unreliable sources and primary sources affiliated with the subject. Relevant guidance can be found in our guideline on fringe theories and perhaps our reliable-sourcing guideline for medical topics. Per the latter, I'm concerned that the edits in question mine and juxtapose primary sources to "debunk" the mainstream view; this is an issue of original synthesis. I'd welcome more discussion here in place of edit-warring. MastCell  04:06, 27 April 2009 (UTC)

Re: "current scientific knowledge"

MastCell. No problem with pointing out that the current medical opinion is about 5% for hypothyroidism, based on the NHANES survey (1994) published 2002. I wonder if the wording "current scientfic knowledge" is the right wording though. The reason is that in the NHANES used the upper TSH reference range of 4.6, however since then, the upper range as been lowered by the American Association of Endocrinologists to 3.04 . Therefore the number of people suddenly now pushed into 'mild hypothyroidism' may be significantly more than 5% in that survey. Furthermore, the NHANES survey is not the only recent survey. After the NHANES "The Colorado Thyroid disease prevalence study" was completed (1995), published 2000. It used an even higher upper TSH range than NHANES (5.1mIU/liter) and even still found the elevated rate was 9.5%. If the most current AACE guidelines were applied to the Colorado study, the abnormal results would be significantly higher than 9.5%. So, what I'm suggesting is that the wording "current scientific knowledge" be replaced with "current mainstream medical opinion", or "current consensus in the medical community" etc. Mkronber (talk) 02:00, 30 April 2009 (UTC)

That illustrates some of the pitfalls inherent in using the literature. The Colorado study (PMID 10695693) looked at patients recruited from statewide health fairs. That is a selected population, not representative of the general population, a point the authors make in Table 1 of their article. The Colorado study population had a median age of 56, vs. a median age of 32 in the general Colorado population. The study population was also significantly more female than the general population. It's not a representative population. Both advancing age and female gender are risk factors for elevated TSH; the Colorado study population is skewed toward a high-prevalence group for thyroid disorders. The authors don't hide that fact - they actually emphasize it - but it's the kind of thing that might not be apparent if you skim the article, and might lead one to draw an erroneous conclusion. In fact, the Colorado study population may have a prevalence of 9.5%, and the general population prevalence may be <5% - both can be (and probably are) true.

The exact "normal" upper limit for TSH is a somewhat controversial topic; you cite a press release arguing for a lower TSH value, but other groups have more recently argued that TSH naturally increases with age, and that current TSH norms should be age-adjusted upwards to avoid improperly inflating the number of people diagnosed with subclinical hypothyroidism (e.g. PMID 17911171). I don't think anyone seriously argues that the prevalence is anywhere near 40%, though I'm open to being educated.

But I digress. For the purposes of the article, either of the two alternatives you propose are fine with me. MastCell  07:21, 30 April 2009 (UTC)

I also don't object as long as it's made more clear that these are blood test surveys, and that Dr. Barnes believed any blood test under-represents the prevalence of present or potential future disorder as diagnosed by basal low body temperature. Milo 08:08, 30 April 2009 (UTC)

MastCell: your points are well taken about the studies. And, I agree that here is no question that the mainstream medical opinion is currently anywhere close to 40% (which I also agree should be pointed out in the topic). I think that is that is what makes Dr. Barnes so notable and interesting--his disagreements with the mainstream. He was a doctor that was trained to diagnose hypothyroidism clinically in the 30's, and so when the diagnostic tests came along (basal metabolism, PBI, TSH, T4 etc.) he noticed right away that they were never accurate enough to be considered reliable for diagnosis on their own, and were missing people with clinical signs. Even his own basal temperature test was always used in combination with clinical signs and symptoms in his own methodology, and never on its own. Over time many of the tests were eventually discarded because it became apparent that the didn't match the clinical signs and symptoms of the disease, which is the really the definition of hypothyroidism. Interestingly, what you see in the literature today, both in the Colorado study and other papers (Baiser et al), is a similar commentary: that the laboratory parameters don't accurately match the clinical signs and symptoms. So it seems that the discrepancy is largely explained by a disagreement about the accuracy of the various diagnostic tests--especially with regard to their ability to detect the mild forms of hypothyroidism. A good commentary of this can by found here: Gaby Paper pg.168 Here is a quote: "The firmness with which most physicians assert that a normal TSH level proves euthyroidism is surprising, considering such a notion is based largely on circular reasoning. Ever since the discovery in 1892 that an extract of animal thyroid tissue could cure myxedema, hypothyroidism has been defined as a clinical syndrome that responds to treatment with thyroid hormone. While various laboratory tests have been developed that correlate with thyroid status, hypothyroidism remains a clinical syndrome, and no clear reason has emerged to redefine it in terms of its laboratory correlates." - Dr. Alan Gaby, M.D. Anyway, I digress as well, this topic is biographical and meant simply to accurately reflect what Dr. Barnes believed and wrote, not to argue whether he was right or wrong. Mkronber (talk) 14:21, 30 April 2009 (UTC)

For being "biographical" this article seems to omit a lot of the biography about the man. It seems to be more about his dubious research, with almost nothing about him. --Quartermaster (talk) 15:53, 4 May 2009 (UTC)

Biographical only means that the article is titled with the name of a person rather than a non-personal subject. It can lightly cover any broad subject with which the the person was notably involved, and should cover in detail any issue of notable interest involving that person. Biographical articles are frequently the main article that gestate child articles if the main article gets too large, so this is the place to develop them.

You may be dubious per Merriam-Webster meaning 2, but per meaning 1, Barnes' solidly evidence-based research is not. For editors deeply interested in statistical research, and the biochemistry of hormone molecular receptors with names like "alpha 1" – that's where this article seems to be heading to meet the objections of casual critics. Milo 00:21, 5 May 2009 (UTC)

I believe that phenomenon has been noted before... :) MastCell  18:36, 4 May 2009 (UTC)

Since the article already details that Barnes was born in a log cabin and was married a second time, I'm not aware of what remaining omitted biography could amount to a lot. Milo 00:21, 5 May 2009 (UTC)

A mess

The article officially looks like a dog's breakfast. There are about 11 extraneous section headers - one for each organ-specific set of maladies which Barnes believed were caused by undiagnosed hypothyroidism. These can all be summed up in one section, particularly since all of the sourcing is to Barnes' own books and organizations directly affiliated with him, and there is no independent perspective on his claims. This is WP:COATRACKery; the article does not exist to expound at length on each of Barnes' claims in his own words, but to neutrally summarize them with the help of independent, reliable, third-party sources. MastCell  19:00, 4 May 2009 (UTC)

He only needs third party sources to be notable, not reliable. It isn't a coatrack, his ideas belong in his article. His ideas in another article would be a coatrack. --Richard Arthur Norton (1958- ) (talk) 19:03, 4 May 2009 (UTC)

That's a curious viewpoint. Would you agree that independent reliable sources would be useful in constructing an encyclopedic article? As to coatracking, skip down to the Mono-Topic Fringe Biography; with every additional section credulously hyping Barnes' claims, devoid of any independent context, you're turning this into exhibit A.

At this point, my major objection is stylistic - the numerous short sections, largely devoid of anything beyond regurgitation of Barnes' claims, are difficult to read. What exactly is the objection to condensing and summarizing them? MastCell  19:16, 4 May 2009 (UTC)

• Sorry, but a personal essay is not Misplaced Pages policy. I prefer Misplaced Pages policy independent of the person making the argument. What alternative person or product is the article trying to promote? I am not following your coatrack logic. --Richard Arthur Norton (1958- ) (talk) 23:29, 4 May 2009 (UTC)

Those few sections that are actually short, appear to need expansion editing and referencing, not summarizing in pursuit of a perceived marginalization agenda. Some of those common, serious conditions are recurrent with, or resistant to, drug treatment. Patients having them deserve to read a full and accurate exposition of Barnes' proportion of success in treating each condition with hormones.

There is nothing odd about such multiple condition cure success. Adrenal steroid hormones and their analogs are well known to cure many conditions by the induced replication of enzymes and other proteins. Since thyroid is another major hormone component required to induce replication, it can be logically expected to have a cure success rate analogous to adrenal steroids, but with less risk.

Accordingly, I judge your new WP:COATRACK claim to be a false light, to incrementally gain the outcome properly unavailable to you at AfD.

Milo 00:51, 5 May 2009 (UTC)

MastCell, this a polite (and required) warning that you're toeing the line on tendentious debating. Before you firmly put your foot over it, please back off.

Independent reliable sources as defined by WP:V/WP:RS are adequately available to back up the major non-independent sources for this article. If you don't like them that would be irrelevant. If you claim them to be lacking for technical evidence that would be wrong (I did the research as you requested at AfD) – but that would likewise be irrelevant.

I don't think you realize how badly you damaged your intellectual reputation with denialism during the AfD. As far as I'm concerned, your opinions per the AfD record on this article are not factually objective, and should be closely scrutinized for agenda bias.
You seem to be engaged in a long-term crusade against those things alternative health and medicine advocate. At best, Misplaced Pages frowns on crusades per Arbcom; at worst it's a bannable offense. In this case, since this subject is not alternative, and has both evidence-based and scientific merit, your oppositional pursuit of it contrary to the facts is perceivable as beyond simple crusading to the pointlessly obsessive. Please consider a Wikivacation instead of further wikistressing the editors here.
If necessary, I'm prepared to sign an RFC/U on you, though I hope it won't come to that. You might or not 'win' an RFC/U, but I think you will not come out of it smelling good, and no doubt it would increase your previously expressed sense of being victimized. Since we actually agree on many positions, I would prefer to not encourage your less reasonable opponents to take you to RFC/U/2 and /3, where you might eventually lose if your present attitude further deteriorates.

I don't like discussing editors instead of edits, but I can foresee where this is going. I want to avoid the need for a pound of cure. Better to set limits now and endure whatever flash powder or gasoline you might choose to throw onto the cinders, than to engage in progressive article editing while having to fend off an attempted backdoor AfD by a thousand tendentious cuts. Milo 00:51, 5 May 2009 (UTC)

1. "Over 13 Million Americans with Thyroid Disease Remain Undiagnosed". American Association of Clinical Endocrinologists. Retrieved 2008-04-16.
2. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC (2000). "The Colorado thyroid disease prevalence study". Arch Intern Med. . 160 (4): 526–34. PMID 10695693. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)