every paper has a review section built into the background section, which goes through the same peer-review process that a review does. usually these are much better and more up to date than review articles since they're written by scientists trying to put their findings into context, rather than reviews which are often handed by professors to their PhD students/postdocs who need to fill their CV with papers after a few 'dry' research years, and often peddle their group's take on a given topic rather than being neutral.
I can't tell you the number of times that I've read something in a review then gone on to read the original cited paper and found that the review inaccurately summarized the paper. often the review author didn't even read the paper, just summarized something from the title or abstract. this happens for primary papers too, but reviews are in no way more reliable, and in my opinion the farther you get from the source data the more errors propagate.
it's also a bad policy for seemingly controversial topics. the medical establishment is composed of humans with plenty of biases and groupthink, so a perfectly good idea can be shunned or ignored for decades if it's inconvenient to the establishment. this creates a chicken and egg problem for finding funding to study those ideas, or to know they even need to be studied.
in grad school we learned to 'embrace the controversy' in grant writing. instead of picking a side, steel-man the different opinions and evidence for each, and cite the differences as a reason for further study & explain how you'll figure it out.
wikipedia doesn't need that last part, but I think it will be a good habit for editors to learn to truly critique a primary paper.
the only thing reviews have going for them is they are more accessible/skimmable to the average reader. my guess is that the rule about citing was written to make it easier to be an editor. anyway, technically the wikipedia regulations don't outright ban primary literature as long as you give the necessary caveats, but there are plenty of megalomaniacal admins don't care about nuance (e.g. MrOllie)
The parts of a source that do secondary source things are considered a secondary source. I highly doubt many of those sections are entirely de novo without reference to prior evidence syntheses though, considering how much time a proper systematic review takes.
> it's also a bad policy for seemingly controversial topics. the medical establishment is composed of humans with plenty of biases and groupthink, so a perfectly good idea can be shunned or ignored for decades if it's inconvenient to the establishment.
The hierarchy of medical evidence being bad is not really something that Wikipedia (or any encyclopedia) can solve. Something that overturns the establishment of a field would not really be an encyclopedia.
> technically the wikipedia regulations don't outright ban primary literature as long as you give the necessary caveats, but there are plenty of megalomaniacal admins don't care about nuance (e.g. MrOllie)
If you have any specific examples that you believe merit review you are free to forward them to me.
Sure, I have been wanting another opinion for a while. Do you want me to post here or via email?
A few years ago (April 25, 2023) I made my first significant edit to wikipedia on the Linus Pauling article, which was not up to date on its discussion of how Vitamin C affects cancer (2005-09 era papers).
The crux of the issue is that route of administration affects what Vitamin C does in the body, with opposing effects (pro-oxidant vs anti-oxidant and also changes how much vitamin C can get in the blood by orders of magnitude), so it’s almost a different drug depending on how take it. See review article in a few paragraphs.
The Wikipedia article focused on the lack of benefit of oral Vitamin C supplementation while barely mentioning recent successes in human trials or that attempts to repeat Pauling’s cancer trial didn’t use IV vitamin C.
So after this sentence in the article lead “None of his ideas concerning the medical usefulness of large doses of vitamins have gained much acceptance in the mainstream scientific community.” I added this: “However, attempts to replicate Linus Pauling's work did not use the exact method of delivery and specific molecules as the original experiments promoted by Pauling.”
https://en.wikipedia.org/w/index.php?title=Linus_Pauling&dif...
And cited this secondary source, which itself cites reviews of multiple human clinical trials as well as a mouse study offering a potential mechanism: Archived link: https://web.archive.org/web/20230414222229/https://www.cance.... The article now lives at this URL: https://frederick.cancer.gov/news/intravenous-high-dose-vita...
I also replaced this sentence from the main text: “Results from most clinical trials suggest that modest vitamin C supplementation alone or with other nutrients offers no benefit in the prevention of cancer”, with this:
“Although there is no consensus in the literature on whether IV high dose vitamin C can affect cancer treatment outcomes, recent pre-clinical mouse studies have revealed a beneficial effect when high dose IV vitamin C is combined with immunotherapy. The effect was only observed in immunocompetent mice, suggesting that the anti-tumor effect depends in part on a functional immune system, rather than unspecific pro-oxidant activity.”
With this primary source: Vitamin C selectively kills KRAS and BRAF mutant colorectal cancer cells by targeting GAPDH https://www.science.org/doi/10.1126/scitranslmed.aay8707
https://en.wikipedia.org/w/index.php?title=Linus_Pauling&dif...
MrOllie reverted all of the edits and saying they were profringe, “blatantly fail WP:MEDRS requirements” yet couldn’t actually go into detail as to how they broke the WP:MEDRS rules, and how anything I wrote was ‘fringe’.
He was really hard to talk to, did not seem engaged in good faith discussion and seed to be wrong on the merits: https://en.wikipedia.org/wiki/User_talk:MrOllie/Archive_17#c...
I reported him and was then quickly blocked by Bbb23 for a week for ‘edit warring’, with no discussion of anything else. Bbb23 refused to talk to me at first, and asked me not to write on his talk page.
https://en.wikipedia.org/wiki/User_talk:Pazimzadeh?markasrea...
Thankfully Bbb23 has retired and it’s clear from from his page that I wasn’t the only one he wasn’t so nice to.
To be fair, I did not understand how wikipedia works at all at the time. There are many thing I could have done better - for example at the time I didn’t know you’re supposed to edit the article talk page for controversial topics, and didn’t know what edit warring even was and how that's counted. I also would have worded my edits slightly differently focusing on human trials more, leaving the negative effect of oral Vitamin C, and would have emphasized the secondary sources more. And would have edited the Vitamin C page instead of Linus Pauling's.
But upon close reading of WP:MEDRS and my edits, I don’t think my additions actually violated either the spirit or the letter of the rules. I used a secondary source which itself cites reviews of human clinical data, and I clearly used hedging language when discussing mouse studies. While it's a controversial topic, nothing that I said was pro-fringe either, or unsaid in the NIH Cancer post I cited. Even the primary source I did use was from the single most rigorous/mainstream journal Science.
Anyway, the experience turned me off of attempting edit Wikipedia for along time, and it feels like there is a cabal of senior editors/admins with poor/lazy reading skills that don’t positively contribute anything to wikipedia but are happy to aggressively police what they consider wrong and seem to have each others’ backs. It’s great to see that Bbb23 is gone though.
To start with, I think the "fringe" aspect played a bigger part in your interaction than the sourcing guidelines (MEDRS) and policies (OR § PRIMARY). I do find it unfortunate that there isn't a better way of informing people wanting to edit the first time, but anything in a contentious topic, whether it's officially designated as such and listed in the list of contentious topics... Well they're probably not the best places to get started because there are a lot of people who do want to pick individual primary sources and overemphasise their weight relative to the body of other primary sources (such as those as reviewed by MEDRS secondary sources).
So if you're editing in a field with a lot of interest from, uh, altmed type people, you're probably going to see much stricter application of the relevant guidelines than other medical topics without such interest unfortunately, and the editors working in such areas are probably very tired of anything that even vaguely looks like promoting altmed. Megavitamin therapy at the moment would still be that even if it's vastly more plausible to actually have a mechanism of action unlike certain other types of altmed.