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WikiProject Medicine has developed a guideline for choosing and using reliable sources Wikipedia:Reliable sources (medicine-related articles).

This page proposes style guidelines for editing medical articles. Of course, the general rules from the Wikipedia:Manual of Style also apply when writing medical articles.

Contents

[edit] Naming conventions

See also: Wikipedia:Naming conventions

The article title should be the scientific or recognised medical name rather than the lay term (unscientific, and/or slang name)[1] or a historical eponym that has been superseded.[2] These alternative names may be specified in the lead. Create redirects to the article to help those searching with alternative names. For example, heart attack redirects to myocardial infarction.

The article title is subject to the same sourcing standards as the article content. Where there is a dispute over a name, editors should cite recognised authorities and organisations rather than conduct original research.[3] Where there are lexical differences between the varieties of English, an international standard should be sought. Some examples include:

[edit] Titles requiring disambiguation

See also: Wikipedia:Disambiguation

When one single term is used to describe two different topics, article titles must be disambiguated to resolve naming conflicts. To accomplish this, disambiguating words are used in parentheses after the article titles. When disambiguating a medicine- or anatomy-related article from an article about a totally different topic, the appropriate disambiguating words are "medicine" or "anatomy," respectively.

For example, "nail" may refer to several items, including a fingernail or a pin-shaped metal object used in construction. In this case, the appropriate article titles are Nail (anatomy) for the fingernail, and Nail (fastener) for the piece of hardware. Because neither of these articles can be considered a primary topic for the term, Nail is a disambiguation page that lists both articles.

When the medical or anatomical context is the primary use of the term, the article should not use a disambiguation word. For instance, the primary and most common use of the word "foot" is for the body part at the end of the leg. Thus, Foot is the appropriate title of the article; while Foot (length) is an article about the unit of measurement called foot. Use of "anatomy" is not appropriate.

In cases when a medical- or anatomy-related term is a secondary use for a more common usage, only the medical (or anatomical) article requires a disambiguation. Most commonly, "percussion" is used to describe an instrument that makes sound when struck, so Percussion links directly to the article about the instrument; the medical-usage of the term is located at Percussion (medicine).

When there are two or more distinct uses for the same term within medicine or anatomy, using the disambiguation word "medicine" or "anatomy" will not be sufficient for distinction between topics. In this situation, the general medical specialty (for medicine) or specific body part (for anatomy) should be used. For example, "foramen ovale" may refer to either the structure of the skull or the heart. Therefore, the appropriate article names are Foramen ovale (skull) and Foramen ovale (heart), respectively. Since neither anatomical structure is a primary topic for the term, Foramen ovale is a disambiguation page.

[edit] Audience

See also: Wikipedia:Make technical articles accessible, and Wikipedia:Explain jargon

Wikipedia is written for the general reader. It is an encyclopaedia, not a comprehensive medical or pharmaceutical resource, nor a first-aid (how-to) manual. Although healthcare professionals and patients may find much of interest, they are not the target audience.

Signs of writing for (other) healthcare professionals:

  • You give technical advice, particularly for the steps in a thorough diagnostic workup.
  • You use jargon when there are suitable plain English words (for example, consider using "kidney" rather than "renal").
  • You are tempted to lift text from your medical textbooks or include mnemonic devices.
  • You remove mention of non-mainstream treatments or practices (sometimes you must write for the enemy).
  • You use the word "patients" or "cases" when describing those who have a medical condition.

Signs of writing for (other) patients:

  • You use the word "you" when describing those who have a medical condition.
  • You give practical advice, particularly for when medical help should be sought or is required.
  • You are tempted to lift text from a patient information leaflet or website.
  • You mention treatments or practices that you've read about in a newspaper or from personal experience.
  • You add "helpful" external links, such as forums, self-help groups and local charities.
  • You emphasize or de-emphasize verifiable facts so that readers will make the "right" choice in the real world.

When mentioning technical terms (jargon) for the first time, provide a short plain-English explanation in parentheses if possible. If the concept is too elaborate for this, wikilink to other articles (or Wiktionary entries). For terms related to anatomical position, you can link to Anatomical terms of location, e.g. [[Anatomical terms of location|lateral]]. Alternatively, if the technical word is not used again in the article, it may be appropriate to use plain English and place the technical term within brackets. The etymology of a word can be interesting and can help the reader understand and remember it. Provide links only where they may help the readers and are reasonably focused on the topic.

Sometimes, information is specific to one country: for example, drug licensing and health service provision. Maintain an international perspective, for example by seeking out English-language sources from other countries.

A guide for journalists on how to translate the writings of researchers into something more understandable to the general public is available on the University of Kansas website here (PDF).

[edit] Careful language

Medical usage of common terms often differs from that of the general public. This is particularly common with medical terms being used in legal contexts, with related but significantly different meanings.

  • "Approved" and "indicated" mean different things, and should not be used interchangeably. Indications refer to common medical uses for a drug. Approval is a regulatory issue, which varies from country to country. Off-label refers to the use of a drug for a purpose other than which it was approved for.
  • The phrase "psychologically addictive" has so many conflicting definitions that it is essentially meaningless. Replace the term with something specific. If you want to convey that a drug does not cause tolerance, or that its withdrawal syndrome is not life-threatening, then state that.
  • Sometimes positive and negative medical test results can have, respectively, negative and positive implications for the patient. For example, a negative breast cancer-screening test is very positive for the woman being screened.
  • The term "drug abuse" is vague and carries negative connotations. In a medical context, it generally refers to recreational use that carries serious risk of physical harm or addiction. However, others use it to refer to any illegal drug use.
  • The term "significant" can refer to either statistical significance or clinical significance. Statistical significance means that the results are unlikely to be due to chance. Clinical significance means that the results are large enough to be noticed by the patient and will make a difference in the effect of the disease or condition on the patient. For example, a reduction of 1 ounce of body weight may be statistically significant in a large population, but has no clinical significance for the individual. Linking to statistical significance may be useful.
  • Avoid using the potentially ambiguous term doctor to refer specifically to physicians. Avoid using doctor or physician in ways that incorrectly exclude other licensed healthcare professionals, such as nurses, physician assistants, and midwives.

Be careful in your descriptions of medical conditions; the words "disease" and "disorder" may not always be appropriate. Avoid saying that people "suffer" from or are "victims" of a chronic illness or symptom, which may imply helplessness: "survivor" or "individual with" are alternate wordings. Many patient groups, particularly those that have been stigmatised, prefer person-first terminology -- arguing, for example, that seizures are epileptic, people are not. An example of person-first terminology would be "people with epilepsy" instead of "epileptics". In contrast, not all medical conditions are viewed as being entirely disadvantageous by those who have them. Some groups view their condition as part of their identity (for example, some deaf and autistic people) and reject this terminology. For more advice, see Guidelines for Non-Handicapping Language in APA Journals.

Do not confuse patient-group prevalence figures with those for the whole population that have a certain condition. For example: "One third of XYZ patients" is not the same as "One third of people with XYZ".

[edit] Writing style

The overall writing style of an article should reflect Wikipedia's nature as an encyclopedia. For example:

  • Do not address the reader directly. Ensure that your writing does not appear to offer medical advice. However, a disclaimer to this effect is never required[4] since the general disclaimer can be accessed from any page on Wikipedia. Statements using the word should frequently provide inappropriate advice (e.g., "People with this symptom should seek medical care") instead of plain statements of facts.
  • Do not publish your own views about studies.
  • Do not provide a detailed analysis of an individual study unless the analysis itself is taken from a published reliable source. Wikipedia should concisely state facts about a subject. It should not discuss the underlying literature at any length. Generally speaking, the facts will be found in the conclusions or results section of a study, not in the detailed methodology. Articles that rely on secondary sources are less likely to fall into the trap of discussing the size of a single study, its methodology, its biases, and so forth. Thus, "washing hands after defecating reduces the incidence of diarrhea in the wilderness", not "An uncontrolled survey involving 132 experienced long-distance backpackers on the Applachian trail in 1997 concluded that washing hands after defecating reduces the incidence of diarrhea in the wilderness."
  • Do not hype a study by listing the names, credentials, institutions, or other "qualifications" of their authors. The text of the article should not needlessly duplicate the names, dates, titles, and other information about the source that you list in the citation. Always omit professional titles and academic degrees. It is necessary to specifically include such information only when a specific individual is being cited as an example of a person holding a minority view: You might write, "The AIDS Denialist Society says that HIV is entirely harmless", but just use a plain statement for the widely accepted fact, "HIV causes Acquired Immune Deficiency Syndrome."
  • Most mnemonics and rules of thumb are non-notable constructs that exist primarily for the purpose of helping medical students pass tests. Consider providing the information that these contain, without necessarily providing the artificial and distracting structure of the memory aids.
  • Rely on wikilinks to help articles stay focused and to avoid placing undue weight on peripheral details. For example, when writing about a blood test, avoid including normal venipuncture procedures or the type of Vacutainer generally used. Instead, consider linking to normal procedures, and supplying any important and unique information in the article.
  • Remember that Wikipedia is not a procedural manual. Avoid "how-to" instructions. For example, if writing about a specific surgery, avoid including lists of equipment that will be needed, or instructions and advice on how to hold, store, use or clean that medical equipment.
  • Wikipedia is not a collection of case studies, and excessive examples should be avoided. Collections of case studies may be transwikied to WikiBooks or WikiUniversity.

[edit] Infoboxes

Infoboxes should be used where appropriate. These include

Full instructions are available on the page for each infobox. A suitable picture for the infobox is encouraged. For drugs, the 2D structure in SVG format is preferred, but PNG is acceptable. The easiest way to populate the drugbox and protein templates is to use Diberri's template-filling web site. Search DrugBank for the drug and enter the ID[5] in this page, or search HUGO for the protein and enter the ID[6] in this page.

[edit] Sections

The following lists of suggested sections are intended to help structure a new article or when an existing article requires a substantial rewrite. Changing an established article simply to fit these guidelines might not be welcomed by other editors. The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition. Do not discourage potential readers by placing a highly technical section near the start of your article.

[edit] Diseases/disorders/syndromes

Clinical articles can achieve a level of consistency by limiting their top-level headers to those specified below. However, the spectrum of medical conditions is huge, including infectious and genetic diseases, chronic and acute illness, the life-threatening and the inconvenient. Some sections will necessarily be absent or may be better merged, especially if the article is not (yet) fully comprehensive.

A disease that is now only of historical significance may benefit from having its History section moved towards the top. Establishing the forms of the disease (Classification) can be an important first section. However, if such classification depends heavily on understanding the etiology, pathogenesis or symptoms, then that section may be better moved to later in the article. If a disease is incurable, then the Prognosis section can be moved up and a section called Management is more appropriate than Treatment.

The following list of suggested headings contains wikilinks; the actual headings should not.

[edit] Drugs

The lead should highlight the name of the drug as per normal guidelines. The BAN or USAN variant may also be mentioned, with the word in bold. The initial brand name(s) and manufacturer follows, in parentheses. Indicate the drug class and family and the main indications. The External links section is a magnet for online pharmacy spam and should be avoided if possible.

Try to avoid cloning drug formularies such as the BNF and online resources like RxList and Drugs.com. Extract the pertinent information rather than just dumping low-level facts in a big list. For example, a long list of side effects is largely useless without some idea of which are common or serious. It can be illuminating to compare the drug with others in its class, or with older and newer drugs. Do not include dose and titration information except when they are notable or necessary for the discussion in the article. Wikipedia is not an instruction manual or textbook and should not include instructions, advice (legal, medical or otherwise) or "how-to"s; see WP:NOT#HOWTO.

The following list of suggested headings contains wikilinks; the actual headings should not.

[edit] Medical tests

Articles about diagnostic tests or other medical tests may follow this suggested order. Many articles will only need some of these sections. This might also be a useful model for certain procedures.

While a general description of procedures may have encyclopedic value, articles about tests and other medical procedures should not provide step-by-step directions, patient instructions, disclaimers or warnings. Wikipedia is not an instruction manual and does not give medical advice.

  • Types, if more than one kind or variant of the test or procedure exists
  • Indications, including contraindications
  • Mechanism, how the test or procedure works, if it's interesting
  • Preparation
  • Procedure
  • Interpretation of results, including accuracy and specificity of test results
  • Adverse effects
  • Legal issues, such as whether special counseling is mandated, if any
  • History of the test

[edit] Anatomy

  • Location and structure including size, whether it's a paired structure, attachments/insertions/"parents", subclinical variation
  • Function
  • Clinical relevance for discussing diseases and other medical associations with the structure
  • Etymology
  • Development for discussing developmental biology, i.e. embryological/fetal, associated with structure)
  • Comparative anatomy for discussing non-human anatomy in articles that are predominantly human-based)
  • Additional images in a gallery format
  • References
  • External links (avoid if possible)

[edit] Medical specialties

  • Scope including typical diseases/medical conditions; include any important sub-specialties
  • History development of field, including notable founders
  • Investigations investigations, diagnostics, and related techniques used in specialty
  • Treatments
  • Training may be subdivided by country if necessary
  • Ethical and medicolegal issues any ethical issues that are specific to this field
  • See also (avoid if possible; use wikilinks in the main article)
  • References
  • Further reading (paper resources such as books, not websites)
  • External links (avoid if possible)

This list of sections deliberately does not include: lists of professional organizations, training programs, publications, and companies working in the field.

[edit] Trivia

See also: Wikipedia:Trivia sections.

Avoid lists of trivia by working these tidbits of information into the main body text. Sections on history or on popular culture may help to structure such factoids.

In addition, sections containing many references to various studies are preferably not simply titled "Research" without further specification, since such header tends to make the section a miscellaneous and unorganized dump of random studies that have any link to the subject. Unless the contents relate to principles or techniques in researching, and could fit into the main article Research, the titles of such sections are better specified with what the studies and their results are aimed at. That is likely also what the readers want to know about.

[edit] Notable cases

See also: Wikipedia:Biographies of living persons, Wikipedia:Trivia sections, and Lists of people.

Articles on medical conditions often include lists of notable individuals who have (or had) the disease. This may be manageable if the disease is rare. For common conditions, it can become a distraction from the main article and contain much unreferenced and dubious material. If you do include such a list, ensure your entry criteria are well defined so that future editors may know if their additions are welcome. One restriction that some editors favour is to include only those individuals who have lastingly affected the popular perception of a condition, such as through public awareness campaigns or enduring media coverage.

Unsourced additions, particularly for living persons, must be removed. Responsibility for justifying controversial claims rests firmly on the shoulders of the editor making the claim. Be very firm about high-quality references, particularly about details of personal lives. Entries in the list must be notable (a straightforward test of which is the presence, or realistic hope, of a Wikipedia article). Non-notable relatives of notable people should not be included. Questions may be directed to the noticeboard for biographies.

If the list is (or could be) long enough to support a separate article, then consider splitting it off. The format can be prose, such as Sociological and cultural aspects of Tourette syndrome #Notable individuals, or a list, such as List of people with epilepsy. Regardless, such articles must be well verified or they may quickly end up deleted. Wikipedia's Naming conventions generally discourage the use of words such as "notable" or "famous" in such list titles.

[edit] Etymology

Etymologies are often helpful, particularly for anatomy. Features that are derived from other anatomical features (that still have shared terms in them) should refer the reader to the structure that provided the term, not to the original derivation. For example, the etymology section of Deltoid tuberosity should refer the reader to the deltoid muscle, not to the definition 'delta-shaped, triangular'. The etymology in Deltoid muscle, however, should identify the Greek origin of the term.

In articles that focus on anatomy, please include the Latin (or Latinized Greek) name of anatomical objects, as this is very helpful to interwiki users and for people working with older scientific publications.

Many articles about eponymous diseases and signs include the origin of the name under the history section.

[edit] External links

A link made in the infobox (such as to eMedicine) should not be repeated in this section. Large disease-related organisations and government health departments sometimes produce web pages containing substantial information that would be of interest to readers wishing to further study the topic. Such links are chosen for the information content, not because the organisation is particularly worthy or helpful. All links must meet Wikipedia's external links guidelines, which in particular exclude discussion forums.

Please avoid links such as these:

  1. Links that merely duplicate information that is already included in the article or in another external link
  2. Links to web-based or email-based support groups for patients, professionals, or other affected people (even if run by a charitable organization)
  3. Links to local, state, or regional charities or to meetings or events in a single location
  4. Links to personal experiences or survivor stories
  5. Links that are recruiting for clinical trials, selling products, or raising money

If the disease is very rare, then a manageable set of charitable organisations may be of encyclopaedic interest. In these cases, please prefer links that provide information that is likely to be interesting to readers worldwide, such as a detailed article on the specific topic.

Normally, however, it is better to link to an external web page that lists such charities, rather than trying to provide such a list ourselves. The Open Directory Project contains many such links, for which the {{dmoz}} template is useful. For example, on the Tourette syndrome page:

*{{dmoz|Health/Conditions_and_Diseases/Neurological_Disorders/Tourette_Syndrome/Organizations/}}

gives

[edit] Citing medical sources

For guidance on choosing and using reliable sources, see Wikipedia:Reliable sources (medicine-related articles) and Wikipedia:Reliable sources.

For general guidance on citing sources see Wikipedia:Citing sources, Wikipedia:Footnotes and Wikipedia:Guide to layout.

Medical articles should be relatively dense with inline citations, using either <ref> tags (footnotes) or parenthetical citations. It is not acceptable to write substantial amounts of prose and then add your medical textbook to the References section as a non-specific or general reference. It is too easy for a later editor to change the body text and then nobody is sure which statements are backed up by which sources. Unlike many established scientific disciplines, medicine attracts controversy and opponents on even the most basic and commonly held facts. Where possible, it is preferable to reference review articles or other secondary sources instead of primary sources (see Wikipedia:Reliable sources (medicine-related articles)).

The Cite.php footnote system is preferred as a method of indicating your sources but is not mandatory—see Wikipedia:Footnotes for details. Some editors format their citations by hand, which gives them control over the presentation. Others prefer to use citation templates such as {{Cite journal}}, {{Cite book}}, {{Cite web}}, {{Cite press release}} and {{Cite news}}.

Abstracts of most medical journals are freely available at PubMed, which includes a means of searching the MEDLINE database. The easiest way to populate the journal and book citation templates is to use Diberri's template-filling web site or the Universal reference formatter. Search PubMed for your journal article and enter the PMID (PubMed Identifier) into Diberri's tempate filler (under repair as of 1 October 2009) or the Universal reference formatter. If you use Internet Explorer or Mozilla Firefox (2.0+), then Wouterstomp's bookmarklet can automate this step from the PubMed abstract page. Take care to check all the fields are correctly populated, since the tool does not always work 100%. Some editors prefer to expand the abbreviated journal name. AMA citation guidelines suggest that if there are more than six authors, include only the first three, followed by et al.[7] The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (URM) citation guidelines list up to six authors, followed by et al if there are more than six.[8] If the full text is freely available online, add this to the "url" parameter in the template (or hyperlink your article title, if doing it by hand). There is no requirement to include a "Retrieved on" date for convenience links to online editions of paper journals, but "Retrieved on" dates are needed on other websources. For books, enter the ISBN into Diberri's tool. A terse link to a PubMed article may be generated by typing PMID xxxxxxxxx in a similar manner to ISBNs, however full citations are preferred. For example:

<ref name=hedley2004>Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM: Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. ''JAMA''. 2004;291:2847–50. PMID 15199035</ref>

produces the footnote

  • Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM: Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA. 2004;291:2847–50. PMID 15199035

but for more than six authors

<ref name=Rose2002>Rose ME, Huerbin MB, Melick J, Marion DW, Palmer AM, Schiding JK, ''et al.'' Regulation of interstitial excitatory amino acid concentrations after cortical contusion injury. Brain Res. 2002;935(1-2):40-6. PMID 12062471</ref>

produces

  • Rose ME, Huerbin MB, Melick J, Marion DW, Palmer AM, Schiding JK, et al. Regulation of interstitial excitatory amino acid concentrations after cortical contusion injury. Brain Res. 2002;935(1-2):40-6. PMID 12062471

Multiple references to the same paper can be achieved by ensuring the reference is named uniquely. Diberri's tool can format a reference with the PMID or ISBN as the name. An alternative is to use a Harvard-style reference, for example: name=Hedley2004.

There are a number of templates that help format citations for common medical web sites. Full instructions are available on their respective pages. Note that the most common ones are integrated in {{Infobox Disease}}.

[edit] Navigation boxes

Suitable templates for navigation boxes can be found here:

Navigational boxes should follow a standardized style. Items should be separated by a middot template ({{·}}) followed (but not preceded) by a single space; the use of hyphens as list separators is not recommended. As when choosing article titles, drugs should be referred to by their International Nonproprietary Names, using piped links when required. More information about creating navigational templates can be found in the documentation of Template:Navbox.

Manually added footnotes may be used to indicate the regulatory status of a drug; for instance, one may wish to note that a drug is still in development, is only used in veterinary medicine, or has been withdrawn from the market. The recommended order of footnote symbols is: *, †, ‡, §. Working examples may be seen in several navboxes, including {{HIVpharm}} and {{QuinoloneAntiBiotics}}.

[edit] Categories

At the end of the article, place [[Category:THECATEGORY]] for the categories it belongs in, but use the lowest appropriate sub-level. Useful top-levels to start looking under can be found on Portal:Medicine/Categories.

Stub articles may be categorised according to the list on this page.

[edit] Footnotes

  1. ^ This convention was documented at the now-defunct WikiProject Clinical medicine,[1] and was the result of several discussions in 2004.[2][3][4]
  2. ^ Arguments for and against eponyms, plus background information, can be read at the List of eponymous diseases.
  3. ^ Examples of original research include counting Google or PubMed results, comparing the size or relevance of the varieties of English, and quoting from personal or professional experience.
  4. ^ Templates for deletion: Medical
  5. ^ DrugBank IDs follow the format APRDxxxxx, and may be found in the page's URL.
  6. ^ HUGO IDs follow the format hgnc_id=xxxx, and may also be found in the page's URL.
  7. ^ Delaney, Robert (November 8, 2006). "AMA Citation Style, American Medical Association Manual of Style, 9th edition". Long Island University C.W. Post Campus, B. Davis Schwartz Memorial Library. http://www.liu.edu/cwis/cwp/library/workshop/citama.htm. Retrieved 2008-04-16. 
  8. ^ "International Committee of Medical Journal Editors (ICMJE) Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Sample References". United States National Library of Medicine work=MEDLINE/Pubmed Resources. http://www.nlm.nih.gov/bsd/uniform_requirements.html. Retrieved 2009-10-08. 



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