Wikipedia:Manual of Style/Medicine-related articles: Difference between revisions

This page documents an English Wikipedia [[:Category:Wikipedia WP:MEDMOSs|WP:MEDMOS]]. Editors should generally follow it, though exceptions may apply. Substantive edits to this page should reflect consensus. When in doubt, discuss first on this guideline's talk page.

[[Category:Wikipedia wp:medmoss|Manual of Style/Medicine-related articles]]

WikiProject Anatomy has proposed guidelines for articles related to anatomy here.

WikiProject Medicine has proposed guidelines for choosing and using reliable sources here.

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.

This page in a nutshell: Article titles use the scientific or medical name. Write for the average reader and a general audience — not professionals or patients. Explain medical jargon or use plain English instead if possible. Become familiar with the common sections, info boxes and citation templates. Use the highest-quality medical sources available. Avoid trivia sections and External link farms.

See also: Wikipedia:Naming conventions

The article title should be the scientific or recognised medical name rather than the lay term^[1] or a historical eponym that has been superseded.^[2] These alternative names may be specified in the lead. Create redirects to your 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:

• Diseases — The World Health Organisation International Statistical Classification of Diseases (ICD 10).
• Drugs — The International Nonproprietary Name (INN).
• Anatomy — The Terminologia Anatomica.

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 or first-aid manual. While healthcare professionals and patients may find much of interest, they are not the target audience.

How to spot you are writing for (other) healthcare professionals:

• You use the word "patients" or "cases" when describing those who have a medical condition.
• You give 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.
• You remove mention of non-mainstream treatments or practices (sometimes you must write for the enemy).

How to spot you are writing for (other) patients:

• You use the word "you" when describing those who have a medical condition.
• You give 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.

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.

Cindy Higgins, of The Research and Training Center on Independent Living at the University of Kansas, has written a How-to guide: Condensing and translating "researchese" for the general public. It is aimed at journalists rather than editors of an encyclopaedia.

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.

Be careful in your descriptions of medical conditions; the words "disease" and "disorder" may not always be appropriate. Avoid saying that people "suffer" from a chronic illness or symptom, which may imply helplessness. Many patient groups, particularly those that have been stigmatised, prefer person-first terminology. For example: seizures are epileptic, people are not. 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 (e.g. 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".

Ensure your writing does not appear to offer medical advice. However, a disclaimer to this effect is not required^[4] since the general disclaimer can be accessed from any page on Wikipedia.

Infoboxes should be used where appropriate. These include

• {{Drugbox}} — for example Paracetamol.
• {{Infobox Disease}} — for example Down syndrome
• {{protein}}

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.

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.

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.

• Classification
• Signs and symptoms or Characteristics
• Causes or Genetics
• Pathophysiology or Mechanism
• Diagnosis (including Characteristic biopsy findings)
• Treatment or Management
• Prognosis (social impact may also be discussed)
• Prevention or Screening
• Epidemiology
• History (not patient history)
• Cultural references
• See also (avoid if possible, use wikilinks in the main article)
• Notes
• References
• Further reading or Bibliography (paper resources such as books, not web sites)
• External links (avoid if possible)

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 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 detailed dosage and titration information. Such details can be construed as medical advice, they border on trivia, can be country-specific and become quickly out-of-date or easily subject to uninformed edits.

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

• History
• Indications (available forms, if notable)
• Contraindications
• Adverse effects (including withdrawal)
• Overdose (including toxicity)
• Physical and chemical properties
• Pharmacokinetics (absorption, distribution, metabolism and excretion)
• Pharmacodynamics (mechanism of action)
• Interactions
• Legal status (including illicit use, off-label usage or unlicensed preparations if notable and sourced)
• Veterinary use
• References
• External links (avoid if possible)

See also: Wikipedia:Avoid trivia sections in articles.

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

See also: Wikipedia:Biographies of living persons 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.

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.

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, 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 list titles. However, since the individuals in these lists are notable primarily for other reasons than their medical condition, some editors do include those words. For example: List of notable brain tumor patients.

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.

If the disease is very rare, then a manageable set of charitable organisations may be of encyclopaedic interest. Otherwise, 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

• ‹The template Curlie is being considered for deletion.› Tourette syndrome at Curlie

For guidance on choosing and using reliable sources, see WikiProject Medicine: Reliable sources 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. It is not acceptable to write substantial amounts of prose and then add your medical textbook to the References section. 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.

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. Search PubMed for your journal article and enter the ID into this page. If you use Internet Explorer or 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 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 this page. 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, ''et al'': 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 et al: Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA. 2004;291:2847–50. PMID 15199035

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}}.

• Diseases Database: {{DiseasesDB}} and {{DiseasesDB2}}
• eMedicine: {{eMedicine}} and {{eMedicine2}} — clinical overviews of disease entities by experts in the field.
• GPnotebook: {{GPnotebook}} — medical database for British general practitioners (GPs).
• OMIM (Online Mendelian Inheritance in Man): {{OMIM}} and {{OMIM2}} — database of genetic disorders.
• PubMed: {{PMID}} — an alternative method of linking to PubMed that shows "PubMed" as the link, rather than the numeric ID.
• PubMed Central: {{PMC}}
• MedlinePlus: {{MedlinePlus}} and {{MedlinePlus2}} — plain English medical encyclopaedia NIH.
• National Institute of Neurological Disorders and Stroke: {{NINDS}}
• SUNY Downstate Medical Center: {{SUNYAnatomyFigs}} — an excellent source of online anatomic preparations.
• Who Named It: {{WhoNamedIt}} and {{WhoNamedIt2}} — medical eponyms and the people associated with their identification.

Suitable templates for navigation boxes can be found here:

• Drug navigational boxes
• Medical navigational boxes

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.