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NPOV real issue here

If the main issue debated here is not our professional backgrounds, then the issue that we should focus on is WP policy and adherence to it in this article. We should focus on what we can do to improve the article. The most sacred WP policy is NPOV and this article is anything but neutral. Every word has been carefully chosen and every reference used has been carefully selected with the intention of making this group of patients seem as nutty as possible. The bias is so obvious that even here in this talk page the editors are constantly putting down people who suffer with this affliction and organizations that try to help them. The article violates all WP policy on medical referencing. First there are several original research papers cited. Secondly, there are also predominantly popular press articles cited which some editors argue are acceptable secondary medical sources. They are not. According to WP policy popular press is low quality and should be avoided. The rest are opinion pieces and interviews. Unpublished original research by Dr. Randy Wymore that has not been peer-reviewed is even included. Again, if we adhere to WP policy then the article as it stands is in violation of policy -- repeatedly. Again, it is in conflict of NPOV to insist one POV must rigidly adhere to policy when the side favored by the most vocal editors active on this article have violated all these same policies. There are popular press sources that support the infectious hypothesis and I could argue that these be used as secondary sources, but I know this is not what WP means. In addition, WP policy indicates that when secondary sources are lacking, as is the case in Morgellons then original research articles can be cited. But this means that it must be applied equally to both POVs. For the umpteenth time, by secondary medical source, WP refers to systematic and general reviews, medical text books and the like, NOT popular press. We have already established that NPOV requires significant minority views to be represented. The hypothesis that Morgellons has an infectious etiology is not extreme or fringe. The journals in which the evidence is published are mainstream medical journals. They have been peer-reviewed by mainstream experts in the field of dermatology. Please do not attack these journals further because you know very well that you are wrong. We have repeatedly debated that fact. If NPOV cannot be achieved by applying WP policy equally and fairly to both sides of this debate, then the entire article should be deleted. Either that or at least ONE paragraph that indicates that this disease possibly has an infectious etiology must be allowed. We do not have to give the infectious hypothesis undo weight, but because it is a significant POV it deserves a small mention and policy concerning medical references must be relaxed because secondary sources are lacking and WP policy concerning references has been completely violated to support the delusional hypothesis side of this debate.Erythema (talk) 06:46, 23 June 2013 (UTC)Erythema

WP:FRINGE:

WWikipedia summarizes significant opinions, with representation in proportion to their prominence. A Wikipedia article should not make a fringe theory appear more notable than it is. Claims must be based upon independent reliable sources. A theory that is not broadly supported by scholarship in its field must not be given undue weight in an article about a mainstream idea, and reliable sources must be cited that affirm the relationship of the marginal idea to the mainstream idea in a serious and substantial manner.

This seems pretty clear to me. TechBear | Talk | Contributions 20:40, 23 June 2013 (UTC)

It's perfectly clear. But the only problem is that the microbial theory of Morgellons is not fringe. If you take time to read WP:FRINGE, and take time to read the section on [identifying fringe theories] you will see that its says: "fringe theories in science depart significantly from mainstream science and have little or no scientific support."

Well the idea that microbes can cause disease is certainly mainstream, and you of all people should agree with this, TechBear, if you say you work in HIV research. And I provided 8 studies above that support the microbial theory of Morgellons, so there is reasonable scientific support. Ergo, not fringe. By contrast, there is only the CDC study that found no microbes.

But repeating this over and over again to you when you never listen gets tedious. Drgao (talk) 21:43, 23 June 2013 (UTC)

The personal attack against me that you put into this page's history is being reported. TechBear | Talk | Contributions 02:45, 24 June 2013 (UTC)

It was not intended as a personal attack, but I then deleted afterwards, as I realized it could be misconstrued as such. As mentioned, I have ADHD myself, and know that some people can have difficulties in comprehension. I would like to get to the root of these apparent difficulties in comprehension. I would really like to know why you are not able to understand the comments being made. Are you too busy to take time to read them? Most of you guys do not seem to respond to thrust of the comments I make, which is a bit rude in itself, and it appears you don't follow or don't understand what I am saying. What is the reason for this. Please explain why you ignore the points being made. Drgao (talk) 03:04, 24 June 2013 (UTC)

It is not fringe when it is published in a mainstream medical journal. I would agree that theories about nanites and GMO foods are examples of fringe and extreme. They are not evidence-based medicine. Peer-reviewed journal articles from reliable medical journals are mainstream medicine and are evidence based -- regardless of what side of the fence they lie on. Tech Bear, you like to obsfuscate and skirt around the issues without addressing each point that I make. It is pretty clear that you have a COI when you insist on a different standard of policy application when applied to the POV you oppose than that which is evident in the main article. The policy on the main article is in violation of WP:MEDRS, WP: NO ORIGINAL RESEARCH and WP: VERIFIABILITY and just about any other WP policy that I have read. Even UNPUBLISHED original research is cited and that is in contradiction to verifiability, and Popular Press such as newspapers and even Popular Mechanics. I could rip the main article apart as it has so many WP policy violations. Either apply policy equally to both sides of this debate or get rid of the article. Check out www.columbia-lyme.org/patients/controversies.html . That is a good example of how to write neutrally about a controversial medical topic. There would be no debate here if the WP Morgellons article was written with similar objectivity. You admit to being a scientist and researcher, so I should not have to tell you this. Your COI is blatantly obvious. Do you have a vested interest in supporting the delusional POV and suppressing the opposition? Drgao and I only ask that the evidence of an infectious etiology be included. No, we do not think it should be given undo weight, but as a significant minority POV it deserves a mention. All we are asking is that the article be changed so that it is from a NPOV.Erythema (talk) 22:36, 23 June 2013 (UTC)Erythema

It appears as though there are no justifiable or legitimate arguments against the inclusion of a paragraph about a possible infectious etiology as no one has made any comments to the above. If there are any then I suggest we go through dispute resolution. If not I plan to write up a paragraph and will add it to the main text in the near future.Erythema (talk) 02:31, 25 June 2013 (UTC)Erythema

I do think it would be very helpful to see what, specifically, you'd propose adding so that editors can reach consensus on the addition. -- Scray (talk) 02:46, 25 June 2013 (UTC)

Agree with Scray, go ahead with proposing the content but please put it up for discussion on the Talk page first. As has already been stated, WP:NPOV is talking about views published in reliable sources, meaning WP:MEDRS-compliant sources regarding biomedical information. The Wikipedia policy-based objections to several of the sources brought forward have not yet been overcome. Zad68 03:08, 25 June 2013 (UTC)

Thanks, I really think that it will improve the article. It will be much more neutral. I very much appreciate your willingness to objectively consider this addition. I will write it up and put it on the talk page first. Again, thanks!199.126.50.231 (talk) 15:03, 25 June 2013 (UTC)Erythema

Erythema, you stated that the editors' professional backgrounds are not relevant in this discussion, but within the context of this POV discussion we have a conflict about including information that may or may not be reliable. In addition, the authors of this information have compiled press releases specifically stating that this wikipedia page is not recognising those studies as reliable sources. The purpose of my question earlier about whether editors here have a conflict of interest was a response to that press release in combination with the pressure to put the results of certain studies on the page. If an author on those papers is trying to get their work into this page, then yes it is quite relevant. It is not merely a question about whether editors have a special interest in a topic, that is to be expected in a number of situations. The question is a matter of whether is attempting to directly insert their own work into a page. Are you associated with that research group, or any of the authors?137.111.13.200 (talk) 02:39, 26 June 2013 (UTC)

Tentative Proposal for a New Introduction to the Article

Following your (most welcomed) invitation to propose some new content in the article, I would like to put forward the following reworded introduction to the article.

This is just a tentative proposal, and Erythema may have different or better ideas:

Morgellons (also called Morgellons disease or Morgellons syndrome) is a condition named by Mary Leitao 2002 in which sufferers complain of painful skin lesions, fine thread-like fibers growing within lesions, under the skin and protruding out of the skin, stinging and burning sensations within the skin, and a sensation of something trying to penetrate the skin from the inside out. Sufferers may also experience the mental and cognitive symptoms of anxiety, depression, fatigue, and memory and attention deficits. As a result of these skin symptoms and skin sensations, some Morgellons sufferers believe they are infested with unusual parasite which creates these thread-like fibers.

Most medical experts believe that Morgellons symptoms are best diagnosed as delusional parasitosis. Delusional parasitosis is a form of psychosis in which a sufferer has the strong delusional belief that they are infested with parasites, whereas in fact no such parasites are present. A wide a range of medical experts including dermatologists, entomologists, and psychiatrists, view Morgellons as consistent with delusional parasitosis. Many medical experts suggest that the skin lesions may be self-inflicted, and the that the fibers are clothing fibers, legs from flies or spiders, or similar exogenous material.

The Centers for Disease Control and Prevention (CDC) investigated Morgellons disease in a multi-year study and found no disease organisms present in Morgellons patients, and found that most fibers were composed of cellulose and were thought likely to be cotton. The authors of the CDC study stated that "we were not able to conclude based on this study whether this unexplained dermopathy represents a new condition, as has been proposed by those who use the term Morgellons, or [whether it represents] wider recognition of an existing condition such as delusional infestation."

While no parasite infestation has been found in Morgellons, some researchers believe the skin lesions of Morgellons are real rather than self-inflicted, and believe that the fibers in Morgellons are created within the body, rather than being clothing fibers or similar exogenous material.

I don't know how you feel about placing this info about some experts believing the skin lesions being real in the intro section. If you don't like it there, then it can be placed elsewhere.

However, one change to the intro I suggest you need to make is the removal on the old phrase "CDC researchers ... suggested that patients' sensations were manifestations of "delusional infestation"". Nowhere in the CDC study does it say this, and in fact the CDC study was quite equivocal regarding the two possible alternatives of delusional infestation versus Morgellons being real. Thus I included as verbatim what the CDC study stated in it's conclusion in my new version of the introduction above. So this is more accurate. Drgao (talk) 08:10, 25 June 2013 (UTC)

References

I agree with Drgao that some of the main text could be written in a more neutral manner. According to WP:MEDRS when citing a primary study you should report on only the findings of the study, but not any of the conclusions drawn in the paper. So strictly speaking, some of the main article could be toned down, but at the moment I am pleased that we are working together to make this article more reflective of an NPOV, so I am prepared to compromise. I hope everyone else is prepared to be reasonable and give a little too.Erythema (talk) 23:10, 25 June 2013 (UTC)Erythema

Sorry my computer seems to have malfunctioned and inserted the text incorrectly and messed up the talk page. How about something like this? I have reported only on the findings of the references I cited and this is consistent with WP policy when using original research. I am not bothering to write in all the references until I know if you all agree with it.

Evidence of a possible infectious etiology

Although not generally accepted by mainstream medical practitioners, recent studies report a possible infectious connection. (refs) Savely and Stricker, 2010, reported an association with Morgellons and seroreactivity to Borrelia burgdorferi. (ref) Middelveen and Stricker, 2011, compared Morgellons to a bovine disease, digital dermatitis, a disease that is associated with spirochetal infection and unusual filamentous projections, and found some similarities between the two diseases. (ref) Middelveen et al, 2013a, in a detailed study of 4 patients, reported that histological sections from dermatological material contained hollow filaments composed of collagen and keratin, and also reported the detection of spirochetes by electron microscopy and silver-nitrate staining. (ref) Middelveen et al, 2013b, reported that, based on PCR detection of Borrelia DNA, the spirochetes they detected in Morgellons dermatological specimens were Borrelia spirochetes. (ref) These studies are at a preliminary stage of investigation and require further investigation to gain mainstream acceptance. Erythema (talk) 23:28, 25 June 2013 (UTC)Erthema

I've fixed the page mess up. Drgao (talk) 23:51, 25 June 2013 (UTC)

Thanks Drgao. Sorry, I messed it up. There does not appear to be any objections to your proposed changes and the addition of the paragraph. There is poster published by the University of New Haven about sequencing the Borrelia isolates. www.newhaven.edu/554191.pdf -- so the evidence of infection will be harder to ignore as the publications documenting spirochetal infection accumulate. Science can't be stopped -- it evolves. Can Drgao and I assume that the other editors active on this article are now prepared to be more objective and neutral in presenting information concerning this disease? If not we should proceed with dispute resolution. As far as I am concerned, to maintain neutrality there cannot be double standards of policy for referencing the 2 sides of this debate. So if we cannot make these modest and very neutral changes then perhaps the entire article should be eliminated. Erythema (talk) 02:44, 27 June 2013 (UTC)Erythema

If you are making ultimatums here then the best course of action would be dispute resolution. Nothing has changed to alter the issue of reliability for the sources proposed. Further, it would clarify the pressure to include these particular sources on the page if you could state whether you have any association with the authors of the studies (as per my numerous requests). While you may find it irrelevant, it is actually quite relevant in terms of conflicts of interest.137.111.13.200 (talk) 03:14, 27 June 2013 (UTC)

I see no need for this change, it seems to give undue weight to the opinions of a very few. --Judgeking (talk) 05:12, 27 June 2013 (UTC)

My suggestion at the beginning of this section is a modest proposal for a revised intro to the article. I am not aiming for revolution here, just some minor changes. I'd appreciate some comments and feedback on that proposal, which makes no mention of an infectious etiology, but does point out that some researchers believe the lesions and fibers are real.

Later on in the article, in the "Causes and pathophysiology" I suggest an inclusion of a small paragraph along the lines written by Erthema above, which provides some basic details of the Lyme/Borrelia connection. In fact the article already mentions the Lyme connection in the "Symptoms and diagnosis" section, so in fact providing some details about the Lyme connection is nothing new as far as this article is concerned. Drgao (talk) 06:48, 27 June 2013 (UTC)

The studies that this conversation revolves around selected 4 patients who had already tested positive for borrelia burgdorferi antibodies and were then found to have spirochetes in their lesions, the conclusion being that they were scratching like Morgellons patients and therefore there is a connection between the two. The CDC study selected patients who were scratching and expressing symptoms of what had been called morgellons, and found only 1 in 115 tested positive for borrelia burgdorferi antibodies. It seems to me that the difference in methodology combined with the conclusions of each study quite readily explain why the different articles were published in different places. The details of the studies are a matter for secondary sources, which are reviews of the methods and conclusions. It need not be a matter of discussion here. What should be is the value of the sources, and whether they are given the appropriate amount of weight given their contents and whether they are primary vs secondary sources that either confirm other reports or dramatically contradict them.137.111.13.200 (talk) 07:12, 27 June 2013 (UTC)

The CDC study is also original research. The same concerns you have about original research also apply to this study. The detection of spirochetes was limited to testing for Borrelia burgdorferi using the 2-tiered test which has been shown to lack sensitivity and Warthin-Starry staining. Spirochetes are difficult to detect using a Warthin Starry stain as both the spirochetes and human cellular tissue can pick up stain and artifacts are hard to differentiate from the spirochetes. No PCR or immunostaining were done which would have been far more sensitive and specific. In secondary and tertiary syphilis spirochetes are generally not detectible in lesions, so the fact that spirochetes are detectable in Morgellons lesions from 4 randomly selected patients is significant. Seronegativity using the 2-tiered test protocol is well documented in medical literature. Statistically, 1 in115 is significant because it is a rate higher than expected for that of the general population. How do you know that all the patients in the CDC study really had Morgellons and not actual delusional parasitosis. Patients were selected on the basis of going through old Kaiser records looking for patients that had previous delusional diagnoses. Kaiser had a vested interest in not changing the diagnoses of these patients. In any case, can we really be sure the CDC study was a homogenous group of patients? I have no doubt that some patients really do have delusions of infestation. Can we be sure we are not talking about 2 different groups of people with 2 different medical conditions? You have not answered my concerns about the double standards of policy being applied for the 2 different points of view. Most of the references in the current article are not acceptable as medical references according to the wikipedia policy. Popular press articles are not appropriate secondary medical references according to WP. Neither are opinion pieces. As far as possible COIs I have not proposed to do anything biased. I am asking for a NPOV to be represented and this is lacking. My background is irrelevant as I have not behaved on a manner on this forum that lacks neutrality. I have asked only that the same standard be applied to both sides of the debate -- actually, no, I have agreed to let a lot of the "pro delusional" biased material remain intact. But, no I do not have Morgellons. My background is microbiology/infectious diseases, and I work almost exclusively with Staph aureus infections, but again this is irrelevant because what I am seeking is a NPOV. None of you have answered my inquiry about COIs. Do any of you work for the CDC, the NIH or any other organization that supports the "delusional hypothesis"? The fact that you are so resistant in presenting one small paragraph to represent a significant minority POV suggests a COI. I would like to think that we have evolved to the point in history where different or opposing scientific perspectives are fairly represented. Some of the editors on this article behave like the Spanish Inquisition did toward Copernicus and his De Revolutionibus orbium coelestium. We should proceed with conflict resolution, because much of the current article is not acceptable by WP policy. Furthermore, if you read the CDC study more throughly you will find that you have misrepresented it as it does not actually state that these patients are delusional. Even the tone of the article has been carefully manipulated so that there should be no doubt in the reader's mind that the patients are delusional. Much of this could be toned down.Erythema (talk) 09:38, 27 June 2013 (UTC)Erythema

Furthermore this is not a forum for arguing science, and until now I have kept my discussion to wikipedia policy and its application to the Morgellons article and NPOV. However, 137.111.13.200 engaged in this activity before I did, as did many of the other editors in on this forum (repeatedly), thus leaving me in the position of defending my position. So in regards to the serologic testing the CDC study used, the MarDx ELISA kits used in this study use whole cell Borrelia burgdorferi lysates and whole cell lysates are problematic in such applications as allosteric inhibition of the FAB region of antibodies may occur, causing false negative results.Erythema (talk) 17:06, 27 June 2013 (UTC)Erythema

So I'll respond a bit to drgao and Erythema's queries. First, I'll come out and admit that my knowledge of biological sciences is pretty limited. My highest medical training were CPR and wilderness first aid, which aren't much. The last bio course I took was an intro one in high school. So I freely admit I don't know much about the biological sciences. I'm a practicing scientist in an utterly unrelated field. Fortunately there are some commonalities in all science fields. Dubious research gets published all the time (hence the phrase "publishing in a peer reviewed journal is a necessary, but not sufficient condition for acceptance") in every field. There are several common threads of fringe research that cross all disciplines of research:

1. Fringe research is often published in less well-known journals. The disease associations for Morgellons are published in Clin Cosmet Investig Dermatol. and f1000research which may or may not have rigorous peer review. The CDC study was published in PLoS One, arguable one of if not the most prestigious medical journal. Multiple other studies have appeared in the American Journal of Psychiatry, the official journal of the psychiatric society supporting a psychological diagnosis.
2. If research is accepted, it will be cited by other people. Hinkle 2011 has 9 citations by other groups. Pearson 2012 (CDC study) has 13 citations by other groups. Middelveen and Stricker 2011("Filament formation associated with spirochetal....") has 7 citations, but of those only two of those aren't self-citations, and those two both disagreed with the conclusion of the study. Lack of favorable external citations is bad.
3. Conversely, excessive self-citation is usually not a sign of a healthy research programme
4. Lastly, when the researchers have to make a press release railing against wikipedia's biases in a desperate attempt to get included in the article, that's usually not a good sign (and that's actually how I came to be interested this article)

So that's how I can evaluate, using objective criteria, how accepted an idea is within a scientific field, even one I don't know much about. So how could you convince me this infectious etiology material should be included? Showing me some citations to their studies from outside their research group by other research groups that support their findings would be a good start, and I think would be fairly persuasive to other editors on this page as well. Sailsbystars (talk) 21:40, 27 June 2013 (UTC)

Erythema, the assumption of good faith is the default position, and wikipedia benefits from having discussions that weigh the relevance and reliability of sources regardless of the opinions or positions of the editors involved. Facts do tend to speak for themselves. However, it is important that whenever a potential conflict of interest may arise that editors are forthright in declarations about them. In a typical circumstance I would not think to caution anyone about this. However, recently there has been an attempt to specifically target this page and indeed specific editors in a press release authored by the lead author of the study you are trying to insert. If you are indeed associated with any of the authors on that study, or indeed have a more intimate connection with it then it is obviously better to be clear about this. This page outlines this issue- http://en.wikipedia.org/wiki/Wikipedia:SELFCITE#Citing_yourself. If that is the case the article might well benefit from your input and expertise, but in an open manner.137.111.13.200 (talk) 05:15, 28 June 2013 (UTC)

Sailsbystars, I appreciate that your approach is a conscientious attempt evaluate the quality of the citations. Let us continue to do this: from my own experience of psychiatry, I know that this profession has the habit of jumping to conclusion about physical diseases without sufficient empirical evidence. Given that that to prove that a disease is delusional parasitosis, you would have to perform examinations of the patients to ensure no parasites were present, just how much examination took place in these psychiatric studies? None, I expect. Thus on questions of microbiology, we cannot rely on the views of psychiatrists, who in general don't know the first thing about infectious pathogens.

But psychiatrists are experts at determining whether a patients suffers from mental ill health or not. So on the question of mental ill health, we can listen to what the psychiatrists say. But on questions of microbiology, we have to listen to the microbiologists. The CDC study was a microbiological one, and they concluded that "we were not able to conclude based on this study whether this unexplained dermopathy represents a new condition, as has been proposed by those who use the term Morgellons, or [whether it represents] wider recognition of an existing condition such as delusional infestation." In other word, the CDC said Morgellons might be a newly recognized real disease, or it might be delusional infestation, but the CDC said they were not able to determine which. Thus unlike the Wikipedia article, even the CDC maintained a NPOV on Morgellons.

Some studies have found that Morgellons patients do suffer from several psychiatric comorbidities. Indeed, in one of the F1000 studies they state precisely that: "Although it is not the authors’ belief that MD is primarily a psychotic disorder, it is evident that psychiatric comorbidity is often present in this patient group.". So even in the F1000 studies that are looking for infectious pathogens, they are not denying there are psychiatric symptoms in Morgellons. In general, if you know anything about research into psychiatric conditions, you will know that scientists have been searching for infectious microbial causes for these psychiatric conditions for over a 100 years. The fact that syphilis spirochetes can cause schizophrenia is evidence enough that psychiatric conditions may have infectious causes.

The very important point I am making is that the issues of psychosis and psychiatric symptom in Morgellons patients are entirely independent of the question of whether there is an infectious pathogen causing them or not. We are not denying the psychiatric symptoms of Morgellons at all. We are just talking about adding some information in the article about the microbiology of this disease.

The Dove Medical Press and F1000 studies were microbiological studies, and they found some evidence of a spirochetal infection in Morgellons patients.

However, the CDC study and the Mayo Clinic study found no evidence. So we need to quote all these microbiology studies, both positive and negative, in order to have a NPOV. At the moment, the article quotes only the negative microbiology studies.

Regarding your claims that the Dove Medical Press and F1000 studies cite themselves too often: remember that in spite of the huge media coverage, Morgellons is a very rare disease, and therefore unlikely to receive much in the way of research funding (unfortunately funding is often allocated according to the prevalence of a disease). Thus it is to be expected that there will only be a small community of researchers interested in this disease, due to lack of funding. Drgao (talk) 07:31, 28 June 2013 (UTC)

Drgao, the quote you've been alleging is from the CDC report does not appear on the CDC's webpage about Morgellons (reference #7 in this wiki's article) nor in the Conclusions section of the CDC's study published in PLOS (reference #8). Could you please provide a link to where you are getting this quotation from? 198.199.134.100 (talk) 09:24, 28 June 2013 (UTC)

The quote is from the CDC study itself, published PLOS ONE. If you scroll down to the very last paragraph of the CDC study (which is in the "Discussion section"), you will see it says "We were not able to conclude based on this study whether this unexplained dermopathy represents a new condition, as has been proposed by those who use the term Morgellons, or wider recognition of an existing condition such as delusional infestation, with which it shares a number of clinical and epidemiologic features." Drgao (talk) 09:55, 28 June 2013 (UTC)

Did you read the Conclusions section of this report and the CDC's summary of the study on their website? If so, could you please explain why they contradict the single out-of-context sentence you've been quoting? 198.199.134.100 (talk) 10:04, 28 June 2013 (UTC)

How is it out of context?. What part of the context is missing in my extract? You say it is out of context, so you must know what contextual information is missing in my quote.

The conclusion of the study says a similar thing, namely: "No common underlying medical condition or infectious source was identified, similar to more commonly recognized conditions such as delusional infestation." In others words, in the conclusion the CDC are saying that what they found was similar to delusional infestation, and so they are hinting that Morgellons might be delusional infestation. But nowhere do the CDC say Morgellons actually is delusional infestation. Drgao (talk) 10:37, 28 June 2013 (UTC)

This is not what you claimed earlier. You claimed "in other word, the CDC said Morgellons might be a newly recognized real disease, or it might be delusional infestation, but the CDC said they were not able to determine which". That is not the conclusion of the CDC study; they did not find any evidence supporting the hypothesis that "unexplained dermopathy" (aka Morgellons) is a real disease. What they did find is that the physical injuries that study participants claimed were the result of Morgellons were self-inflicted. What they did find is that the hairs or fibers that study participants claimed were the result of Morgellons were debris from the participants' environments. What they did find is that an unusually high percentage (50%) of the participants had recently abused drugs, which can cause (among other things) delusional infestation, short-term memory loss, and indifference to the cleanliness of the taker's person and environment. 198.199.134.100 (talk) 23:58, 28 June 2013 (UTC)

You did not answer my question of why you think my quote was out of context. Read the CDC quote again. Tell me what you think they mean. Here is the CDC quote from their PLOS ONE study again for you:

"We were not able to conclude based on this study whether this unexplained dermopathy represents a new condition, as has been proposed by those who use the term Morgellons, or [whether it represents] wider recognition of an existing condition such as delusional infestation"

Tell me what you think they mean by this statement. Drgao (talk) 04:44, 29 June 2013 (UTC)

Sure. "We did not find evidence that Morgellons represents a new psychiatric condition separate from delusional parasitosis." However, my interpretation is not relevant; it matches the conclusion of the study. You gave your interpretation above (which I quoted), which is clearly not the conclusion reached by the study. Have you been diagnosed (by yourself or others) as having Morgellons? 198.199.134.100 (talk) 06:42, 29 June 2013 (UTC)

Hold on, who the hell are you, 198.199.134.100? Are you the same person as 137.111.13.200 that I was discussing with, or someone different? I am not going to have the same conversation all over again with someone new. Drgao (talk) 09:54, 29 June 2013 (UTC)

I'm at a completely different IP address, so no, I'm not that other person. I did just now notice your conversation with that person wherein you demonstrated you have a clear bias on this subject. Just because the CDC was mistaken about CFS does not mean they are mistaken about Morgellons. This is not relevant to this Wikipedia article, though it certainly may be relevant to the article on CFS. When the available evidence has some support in mainstream medical science as indicating Morgellons is a real disease, that is the time that the Wikipedia article can report on it. This is Wikipedia's policy on NPOV and it is very clear. Find research that meets Wikipedia's standards before you advocate changing the article again, please. 198.199.134.100 (talk) 10:24, 29 June 2013 (UTC)

There are too many people coming and going on this talk page. I am not going repeat my same discussion over and over again. If you have interest in this article, stay and discuss it and improve it. I am not going to keep repeating my same discussion with people who come and go and shown no commitment. Drgao (talk) 10:45, 29 June 2013 (UTC)

Well, just because you are a single purpose account who has ownership issues doesn't give you special rights. You'll have to explain. If you don't, you'll be ignored, which might be a good idea, since no matter how many editors explain to you how things work here, they don't seem to get through. We have rules and policies, and if your edits violate any of them, those edits won't stick, no matter how long you camp out here. We "follow" the sources at a respectful distance. If that means Wikipedia is behind the curve, well, that's the way it's supposed to be. You are welcome to write a blog or write on some other website if you can't wait. We don't publish original research, do synthesis, or prematurely jump the gun using primary sources. -- Brangifer (talk) 20:11, 29 June 2013 (UTC)

Your remarks are a little insulting BullRangifer, when you imply that because I have an interest in the infectious etiologies of diseases, this somehow prevents me from being fair and balanced regarding all points of view. I very much support NPOV at all times, putting NPOV ahead of my own views, interests and opinions. So no, I don't have a WP:SPA, in the sense of supporting only one side of things.

There is a less than perfect NPOV in this article. Even the way the CDC study has been a little misrepresented, and cited as if the CDC study only supports the delusional infestation point of view, when in fact, the CDC acknowledged that their study was unable to determine whether Morgellons was a real disease or a delusional infestation. I cannot understand how don't see yourselves that it is wrong to misrepresent the CDC study in this way.

Scray said above: "it would be very helpful to see what, specifically, you'd propose adding so that editors can reach consensus on the addition", and Zad agreed with this. So both myself and Erythema tendered some proposed additions, and we are waiting for Scray and Zad, and of course others here, to comment on these proposed additions. Drgao (talk) 12:50, 30 June 2013 (UTC)

Wikipedia:Dispute_resolution_noticeboard#Talk:Morgellons 198.199.134.100 (talk) 08:00, 30 June 2013 (UTC)

So, 198.199.134.100, you were biased in your above interpretation of the CDC study, and equally biased (not to mention vindictive) in your write up of the dispute. Drgao (talk) 12:50, 30 June 2013 (UTC)

The CDC study has been reviewed in secondary sources, so we need not interpret the conclusions we can look to those sources. Freudenmann et al. (2012) had this to say about it- "The skin lesions were ‘most consistent with excoriations or chronic irritation,some with evidence of secondary infection’. Solar elastosis was found in 51% of cases. Remarkably, hair analysis in a subgroup of 40 cases showed use of illicit drugs in 50% of cases (opiates and benzodiazepines > cannabinoids > amphetamines> other). This important study showed that Morgellons disease should best be seen as a form of DI." DI being delusional infestation. If there was any ambiguity in the CDC conclusion it was whether Morgellons is differentiated from delusional parasitosis in any meaningful way, as neither involve an actual infestation, or whether there is anything specific to Morgellons that might change the approach clinicians might take.137.111.13.200 (talk) 04:46, 1 July 2013 (UTC)

The content of comments should be the focus in these sorts of discussions, and the fact that numerous editors (named and IP) are all saying pretty much the same thing (the sources are not reliable enough to be reflected on the page at this time) should give you reason enough to at least consider the more cautious approach of waiting for the primary sources to be addressed in literature reviews (other than reviews by the authors of that primary source). However, there seems to be a high level of interest in who is editing wikipedia and what interests they might have in the process. There was sufficient interest for Marianne Middelveen to author a press release specifically targeting editors of this page.

I'd like to quote from that press release, if I may- "Anonymous editors have no place in cyberspace.".

Now, if I may, I'd like to quote Erythema from earlier in this page- "Thanks, I really think that it will improve the article. It will be much more neutral. I very much appreciate your willingness to objectively consider this addition. I will write it up and put it on the talk page first. Again, thanks!199.126.50.231 (talk) 15:03, 25 June 2013 (UTC)Erythema"

Now, when Marianne said that anonymous editors have no place in cyberspace she might have been talking about when editors remember to actually sign in, when their IP address isn't recorded on the page. I myself often prefer to use an IP because it allows a degree of transparency, where other users can see my geolocation. So, in answer to anyone's accusation that IP comments are intrinsically of lesser value than named accounts, I suggest you focus on the content. That is, after-all, what these pages are for. It is far too tempting to be distracted by other issues.137.111.13.200 (talk) 00:49, 1 July 2013 (UTC)

TO 137.111.13.200. Don't you think that we need to separate the issues of delusional parasitosis from the issues of whether Morgellons may be associated with a spirochete infection? These issues are not same thing. The delusional parasitosis is backed up by secondary sources, so we cannot argue with it. But even though the delusional parasitosis conclusion is almost certainly right (in the sense that there are no parasites in the skin of Morgellons patients), Morgellons may still be associated with a spirochete infection, even if there are no parasites.

So we are bound by necessity to maintain the delusional parasitosis conclusion in the article; but that does not mean the article cannot comment on a separate issue of whether Morgellons is linked to spirochete bacteria. This is why in the proposed changes I tendered at the beginning of this section, I suggested using the phrase: "While no parasite infestation has been found in Morgellons, some researchers believe the skin lesions of Morgellons are real rather than self-inflicted,..."

Let me give you a parallel example: in schizophrenia, it is not uncommon for patients to have the crazy belief that the government has planted a miniature electronic implant in their body in order to track them! Of course such beliefs are completely delusional. However, as to the question of whether schizophrenia is linked to a microbial infection, this is perfectly legitimate question, and indeed, a link between schizophrenia and bacterial and viral infection has been demonstrated.

So in Morgellons, we can agree with the secondary sources that the patients do not have parasites in their skin; but it is a separate issue as to whether Morgellons is linked to any microbes. Drgao (talk) 11:52, 1 July 2013 (UTC)

It is a matter for secondary sources to judge the proposed spirochete connection- the recent series of papers referencing that theory are co-authors of the study which suggested a link, and the methodology of that study must be reviewed in impartial secondary sources. I can express my surprise that the 4 patients selected for the study had already tested positive for antibodies for borrelia burgdorferi, and that two had received treatment for Lyme disease, but that is beside the point. I am not an authority. I just think it better to defer to the peer-review process in this regard. In answer to the analogy of schizophrenia, if a bacterial infection disrupted the neurochemistry of the brain to a degree that someone thought there were electronic trackers under their skin, don't you think it unwise to treat that as a skin condition?137.111.13.200 (talk) 00:26, 2 July 2013 (UTC)

I definitely agree with your schizophrenia analogy point: many Morgellons patients do suffer from psychosis-type symptoms, which can make their thinking process a little strange. And these patients would likely do well taking some antipsychotic medications (especially because, as it mentions in the article, antipsychotics are effective at treating delusional parasitosis at doses as low as one-fifth to one-tenth the dose typically prescribed for schizophrenia).

Even in in the future, if it were (for the sake of argument) proven that Morgellons is caused by Borrelia burgdorferi bacteria, it might still necessitate the use of antipsychotics, because there are no effective antibiotics for Borrelia burgdorferi in our medical armory. Patients with Lyme disease know this all too well: hIgh doses of antibiotics like doxycycline can help a bit with Lyme disease, but usually it cannot cure Lyme. Borrelia bacteria are too difficult to eradicate.

Personally, I think that Morgellons patients would be far more likely to comply with taking antipsychotic medication if medical authorities explained to these patients that yes, they may be infected with Borrelia burgdorferi, which may be causing their mental and skin symptoms, but since we do not have any effective antibiotics for Borrelia burgdorferi, it means they need to take antipsychotics in order to treat the mental symptoms caused by this bacterium. (Although it would be interesting to see how much improvement high dose doxycycline would make to Morgellons mental and physical symptoms).

That's why, even if just for the sake of Morgellons patients, if this article acknowledged the possibility that there may be an infectious etiology to Morgellons, but also pointed out that antipsychotics are the most appropriate treatment for these patients, it would probably help convince Morgellons patients to trust and comply with the medical authority recommendations for taking these antipsychotics. I know Wikipedia is not here to give medical advice, but I am just making the point that if these patients' views were not so brusquely brushed off by the medical profession, and if the medical profession acknowledged that Morgellons might be caused by an microbial infection, you would get more Morgellons patients trusting and siding with the official medical view, and accepting the idea that they may benefit from low dose antipsychotics. Drgao (talk) 10:03, 2 July 2013 (UTC)

I can see your point, and I think it is well made. However, if an infection is an underlying cause of symptoms that are shared with that of Morgellons, does this mean that anyone with those symptoms and yet who do not have an infection do not have Morgellons? Whatever Morgellons actually is, it has thus far been defined by the symptoms. The CDC study sampled patients by looking at their symptoms, then investigated whether they had any underlying infections. Only one patient tested positive to Borrelia antibodies (and a borderline). The recent study involved 4 patients who all tested positive to those antibodies, who were then screened for spirochetes. That has the chain of investigation backwards, where the sampling of the patients was an overlap of symptoms and an existing infection. I would think a more logical conclusion from the study is that anyone presenting with certain symptoms and tests positive for borrelia antibodies might be likely to have a borrelia infection. I don't understand why you would say they have Morgellons, since the vast majority of people presenting with those symptoms would probably not have an infection (judging from the results of the CDC study). Anyone who thinks they have Morgellons would then be left with no name whatsoever for their condition. The alternative would be to assume that they all have borrelia infections, but that the physiological cause can't be detected. That really doesn't seem to be a defensible approach, though I am not sure anyone is putting that forward as a suggestion.

I appreciate the point that representing Morgellons as possibly driven by an underlying infection might provide a clearer avenue for clinicians to treat the patients with antipsychotics (currently I believe dermatologists treat Morgellons patients, so a referral to a psychiatrist might be necessary in that case), but if that requires the condition to be represented in a way that does not conform to the scientific consensus then the page walks on thin ice.137.111.13.200 (talk) 00:05, 3 July 2013 (UTC)

Quoting 137.111.13.200: "if an infection is an underlying cause of symptoms that are shared with that of Morgellons, does this mean that anyone with those symptoms and yet who do not have an infection do not have Morgellons?"

That is a good point, but it is not necessarily the case. Diseases linked to infections, like multiple sclerosis or chronic fatigue syndrome, are still diagnosed on symptoms, MRI scans, etc, because a range of different viruses and bacteria are thought to be involved with these illnesses, ie, there may well be more than one microbial cause. So you cannot simply test for one microbe, as more than one microbe may be able to cause the same disease. Furthermore, the same microbe may often cause different diseases in different people! Enteroviruses for example are linked to diabetes, chronic fatigue syndrome, and Crohn's disease. The genes of an individual can play a role in what type of disease manifests from an infection. And in some people, the same microbe may not cause any disease at all. So unfortunately, there is often no simple relation that says microbe X causes disease Y.

Also, some microbes are very hard to detect, so tests may come back negative, even if the patient is infected with the microbe. In other words microbial testing may not be a reliable means to test for a disease. The Borrelia bacterium is in fact an example of a microbe which is difficult to detect — some tests for Borrelia (the ELISA test) can be as much as 50% inaccurate: ie, 1 in 2 patients will get either a false positive or false negative result. When testing for Borrelia infection, you need to perform multiple different tests, and then examine all the test results; this then gives you a little more accuracy.

Furthermore, bear in mind that in the search for infectious causes of a disease, just because you find a given infectious microbe within the lesions of a disease, that does not automatically prove that the microbe caused those lesions. It is quite possible that the microbe might be an "innocent bystander" to the disease process, that just happens to accumulate in the lesions, but did not cause the lesions. In other words, don't forget that correlation does not imply causation. This is why researchers use the term association when they find a microbe linked to a disease. The association of a microbe with a disease raises interest in the possibility it might cause the disease, but association does not necessarily imply causation.

So even if the current research looking at Borrelia in Morgellons patients is finally ratified, and the association between Borrelia and Morgellons is established beyond all doubt, this would not yet prove that Borrelia actually causes Morgellons. Once you have established an association between a given microbe and a given disease, it then requires a lot more scientific work to prove whether that microbe actually causes the disease, or whether it is just an innocent bystander that plays no causal role in the disease. So as you can see, there are quite a few complexities — and a lot of hard work — involved with the study of infectious etiologies of any disease.

Though the infectious etiology angle on Morgellons is not only issue to consider. There is also the issue of whether the fibers and lesion are genuine, or not. This is an independent issue to the issue of an infectious cause. Although we must state that Morgellons is a delusional parasitosis (because secondary sources say this), the lesions and fibers might still be genuine, even if there are no parasites. So it would not be contradictory to say that Morgellons patients suffer delusional parasitosis — because there are no parasites in the skin — yet the lesions may still be real; and certainly there is substantial group of researchers who say the lesions and fibers are genuine. Thus I don't think we would be contravening the rules to include the views of the researchers who say the lesions and fibers are real. Drgao (talk) 14:25, 3 July 2013 (UTC)

relevance

I can’t help but notice that there has been a great deal of deviation from what is really the relevant issue on the Morgellons article. What is relevant is making this article better. It needs a NPOV. It is extremely biased. This is very obvious, in both the main article and in this talk page. Much of what I read here is derogatory to the patients who suffer from this disorder. Under attack as well are the reputation of medical journals that publish papers indicating this is not delusional, the authors who publish these papers, and institutions that fund such research. All of that shows bias and is completely irrelevant to the task at hand. What needs to be addressed is the NPOV issue, particularly the fact that there are double standards of what constitutes acceptable medical references applied to the two different POVs of this illness. Both sides of the debate need to be acknowledged. Because the delusional POV is dominant it should be given more weight. Having said that, the infectious POV needs representation as a significant minority viewpoint. There are newspaper articles, TV interviews and the like that support this (the infectious) POV. Much of the current article uses popular press articles as secondary resources. They are not, according to WP, reliable medical references. Some of these need to be eliminated – probably all should be, but fat chance of that with such bias at play. There is an issue with verifiability with such material. For example, the Popular Mechanics article has an interview with “an anonymous dermatologist”. That is not verifiable. You will recall that the 3 most important policies of WP are: NPOV, no original research, and verifiability. There are provisions for original research to be used when secondary sources are lacking as is the case with Morgellons, but it is biased to include only those of which report from the POV you favor. If original research is included for one POV it should be acceptable to include original research from the other POV. Dispute resolution seems to be the best option at this point.Erythema (talk) 22:18, 2 July 2013 (UTC)Erythema

Please read WP:NPOV again, we don't do fair and balanced here. Go read WP:OR again as well, because I think you are misinterpreting it. Dbrodbeck (talk) 23:24, 2 July 2013 (UTC)

In case you hadn't noticed Erythema, I want you to clarify whether you are or are not Marianne Middelveen. http://en.wikipedia.org/wiki/Wikipedia:Conflict_of_interest#Citing_yourself. Please address this.137.111.13.200 (talk) 23:35, 2 July 2013 (UTC)

Your blatantly obvious attempt at deflection won't work with me. I am not intimidated by bullying. I have never behaved in a biased manner, so who I am is irrelevant. I have been willing to abide by WP policy and have only asked for fair application. In fact I have consistently asked that there be a more neutral POV. All you need to know about who I am is that I have a science background and I am thoroughly disgusted by the lack of application of WP policy to this page and the blatantly obvious bias -- that none of you deny. There has not been one well-argued, reasonable objection to any of my proposed changes. If you want editors to identify themselves then everyone will have to disclose their identities. I suspect many of the editors have CDC, Kaiser or Mayo connections. What is interesting is the obvious bias shown by most of the editors on this page, and their reluctance to show even a small amount of neutrality. The fact that this talk page is a public forum seems to have eluded you.Erythema (talk) 15:15, 3 July 2013 (UTC)Erythema

I have no connection to anyone of those groups. Indeed, if you go to my user page you can see my real name and my employer (who I of course do not speak for). NPOV does not mean fair and balanced, it is not how it works here. If you feel that editors are behaving inappropriately you can bring it up at WP:ANI. You should keep in mind that you have been here for a little more than a month, and that many experienced editors have explained policies to you and/or provided links to policies. You should entertain the idea that maybe you are just wrong in your interpretation. Dbrodbeck (talk) 16:04, 3 July 2013 (UTC)

Do you realize what you are saying? What are you talking about when you say that NPOV does not mean fair and balanced? That is not what WP says in WP policy. You are, however, correct when you say that it is not how it works here. It certainly doesn't. WP policy has been completely disregarded on this topic. I may have been on WP for only one month, but I seem to be more familiar with WP policy than some of my fellow editors who have been at it for years. First, NPOV, here's what WP says, Editing from a neutral point of view (NPOV) means representing fairly, proportionately, and, as far as possible, without bias, all of the significant views that have been published by reliable sources on a topic. All Wikipedia articles and other encyclopedic content must be written from a neutral point of view. NPOV is a fundamental principle of Wikipedia and of other Wikimedia projects. This policy is nonnegotiable and all editors and articles must follow it. Secondly, on-line medical journals have been repeatedly attacked by many of the editors. Here's what WP:MEDRES says about free on-line journals, A Wikipedia article should cite the best and most reliable sources regardless of whether they require a fee or a subscription. When all else is equal, it is better to cite a source with a full text is freely readable so that readers can follow the link to the source. Thirdly, a WP violation of policy that has been repeated throughout the Morgellons article is the continual use of popular press as reliable secondary medical resources. Here's what WP says about that, The popular press is generally not a reliable source for scientific and medical information in articles. Most medical news articles fail to discuss important issues such as evidence quality,[11] costs, and risks versus benefits,[12] and news articles too often convey wrong or misleading information about health care.[13] Articles in newspapers and popular magazines generally lack the context to judge experimental results. They 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 can be a biased source even when issued by an academic medical center.[14] News articles also tend neither to report adequately on the scientific methodology and the experimental error, nor to express risk in meaningful terms. For Wikipedia's purposes, articles in the popular press are generally considered independent, primary sources. Let us stick to the relevant topic: NPOV and the continuous violation of WP policy on this topic. Fourth, I could also go quote the no original research policy, but I've already gone into it in detail in earlier discussions. What is important in this discussion is the double standard of application of this policy. WP policy is that when secondary resources are lacking the use of primary resources is acceptable. However if you really want to maintain a NPOV then it must be equally applied. Erythema (talk) 16:57, 3 July 2013 (UTC)Erythema

Hi, Erythema. The policy on due and undue weight gives a good explanation of why "balanced" isn't the same as "NPOV." In a nutshell, when the overwhelming majority of the medical reliable sources hold one view, it is not neutral to give equal weight to the opposing view, because that would misrepresent the body of medical literature as a whole. Cheers, Dawn Bard (talk) 17:10, 3 July 2013 (UTC)

(edit conflict)I know exactly what I am saying yes. NPOV does not mean we include all opinions equally. It just does not work that way. Please read WP:UNDUE. WP:OR is currently not being violated. Again, really, if you think editors are behaving inappropriately there is a remedy available to you, WP:ANI. Dbrodbeck (talk) 17:14, 3 July 2013 (UTC)

Read the policy. It does not say that minority POVs can be ignored. It says that different POVs should be represented PROPORTIONATELY. This does not mean you can exclude a POV if you do not like it. Yes, the delusional POV is predominant and should therefore be given greater weight, but the infectious POV is a significant minority POV and deserves a mention. NPOV also states that opinion should not be reported as fact and that is prevalent in the Morgellons article. Here is WP policy: Achieving what the Wikipedia community understands as neutrality means carefully and critically analyzing a variety of reliable sources and then attempting to convey to the reader the information contained in them fairly, proportionately, and as far as possible without bias. Wikipedia aims to describe disputes, but not engage in them. Editors, while naturally having their own points of view, should strive in good faith to provide complete information, and not to promote one particular point of view over another. As such, the neutral point of view does not mean exclusion of certain points of view, but including all notable and verifiable points of view. Observe the following principles to achieve the level of neutrality that is appropriate for an encyclopedia. Due and undue weight. Neutrality requires that each article or other page in the mainspace fairly represents all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint in the published, reliable sources.[3] Giving due weight and avoiding giving undue weight means that articles should not give minority views as much of, or as detailed, a description as more widely held views. I plan to take this to dispute resolution or perhaps WP:ANI, but lack the time to do so at the moment. I am confident that the Morgellons article does not represent what Jimmy Wales had in mind for neutrality when he and Larry Sanger created WP. Erythema (talk) 17:33, 3 July 2013 (UTC)Erythema

I think we need to be more precise and meticulous regarding citing or quoting Wikipedia rules. Editors need to precisely point out, and perhaps better still quote, the rules that they are invoking in their arguments.

So below I quote the relevant rules from WP:WEIGHT that form the basis of the explanation of why we are obliged to include in the article the viewpoint that Morgellons lesions and fibers are genuine, and that Morgellons may be due to an infectious process. In these rules I have quoted below, the bold text added for emphasis is mine.

Due and undue weight

Neutrality requires that each article or other page in the mainspace fairly represents all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint in the published, reliable sources.

From Jimbo Wales:

• If a viewpoint is in the majority, then it should be easy to substantiate it with reference to commonly accepted reference texts;
• If a viewpoint is held by a significant minority, then it should be easy to name prominent adherents;
• If a viewpoint is held by an extremely small (or vastly limited) minority, it does not belong in Wikipedia regardless of whether it is true or not and regardless of whether you can prove it or not, except perhaps in some ancillary article.

Keep in mind that, in determining proper weight, we consider a viewpoint's prevalence in reliable sources, not its prevalence among Wikipedia editors or the general public.

Of particular note is the advice given by Jimmy Wales that if a viewpoint is a significant minority, you should be able to name prominent adherents.

Well, there is no difficulty at all in naming prominent adherents of the viewpoint that the Morgellons lesions and fibers are genuine: Mary Leitao, who is mentioned in the first sentence of the article, hold this view, and expresses this view in this MEDLINE indexed study. And there are many other studies that express this same viewpoint.

Thus with such a prominent adherent as Mary Leitao, it is clear that this is a significant minority, and thus it is obligatory to include the viewpoint that the Morgellons lesions and fibers are genuine and may be linked to an infection in the article. I see no other interpretation of WP:WEIGHT. — Preceding unsigned comment added by Drgao (talk • contribs) 19:56, 3 July 2013

The pathogen conjecture for Morgellons remains on the fringe of scientific consensus, so leaving it out of WP current coverage remains due weight per the policies you've cited. -- Scray (talk) 20:48, 3 July 2013 (UTC) I realized we do have some treatment of the pathogen conjecture, hence my amendment. -- Scray (talk) 22:38, 3 July 2013 (UTC)

The significant minority viewpoint of which Mary Leitao is a prominent adherent states that the fibers and lesions are genuine, so we are obliged to represent this viewpoint. This viewpoint also states that Morgellons disease may be linked to an infectious process, so again, as this significant minority viewpoint says there might be infectious microbes involved, the article must also state this. Drgao (talk) 21:00, 3 July 2013 (UTC)

Agree with Scray. Calling her view significant is over the top. It is at best WP:FRINGE Dbrodbeck (talk) 22:02, 3 July 2013 (UTC)

Scray has contradicted Jimmy Wales's own guidance on determining a significant minority viewpoint that needs to be included in the article. Are you also contradicting this guidance then Dbrodbeck? You also appear to be confused about what I said. The viewpoint under discussion is that the fibers and lesions are genuine, and that there may be infectious processes in Morgellons. Jimmy Wales has said that a viewpoint is a significant minority if you can name prominent adherent. Therefore I named Mary Leitao as an example of a prominent adherent of the viewpoint, thus proving the viewpoint in question is a significant minority that must be included in the article. Drgao (talk) 22:21, 3 July 2013 (UTC)

You are misinterpreting her view as representative of a significant minority. Dbrodbeck (talk) 22:35, 3 July 2013 (UTC)

(edit conflict)I had to review the article to confirm that we do give some attention to the pathogen conjecture - a due amount. Nonetheless, I disagree with your (Drgao's) description of that adherent. -- Scray (talk) 22:38, 3 July 2013 (UTC)

What, do you mean this sentence: "Although it has been suggested by Morgellons advocacy websites that Morgellons is related to an infectious disease, such as a tick-borne disease or from plants, these claims have not been substantiated by available evidence or corroborated by physicians independent of these advocacy websites"

That is not due amount, by the rules which says that "in determining proper weight, we consider a viewpoint's prevalence in reliable sources" There are many studies that represent the "lesions are genuine" viewpoint, probably just as many as there are studies on the delusional viewpoint, so the "lesions are genuine" viewpoint needs more space.

That sentence does not even provide references the appropriate studies like this one. It should not mention websites, but refer to the appropriate studies. That sentence is also incorrect in saying that it has not been substantiated by available evidence: the new studies finding Borrelia in the lesions provides some preliminary substantiating evidence.

And where did you get this idea that it was an "infectious disease from plants"?. I have never heard that plant theory. It is complete nonsense, there are no references for it, and needs to be removed. Drgao (talk) 23:08, 3 July 2013 (UTC)

Once again, the studies that represent the "lesions are genuine" viewpoint are not considered reliable sources. How many times must we go around in this circle with you before you understand this? 198.199.134.100 (talk) 23:39, 3 July 2013 (UTC)

You are going to go around in circles forever, because there are no official Wikipedia rules that indicate these sources are not reliable. We need to use Wikipedia rules, not personal opinion. If everyone here truthfully followed Wikipedia rules, we would have no problems. Drgao (talk) 00:34, 4 July 2013 (UTC)

You've had it explained to you by other editors why these studies do not meet Wikipedia's official criteria as reliable sources. If they do eventually become accepted as reliable sources, we will be happy to support the inclusion of their views in the article at that time. 198.199.134.100 (talk) 01:12, 4 July 2013 (UTC)

Mary Leitao is a notable adherent to the "fibers are real and not clothing" theory, but the view is not published in WP:MEDRS sources. It's noted in reliable sources (newspaper articles) as her view, and that view should be reported as her view, without any suggestion that it's justified. — Arthur Rubin (talk) 02:41, 4 July 2013 (UTC)

Next step

We have now talked about these sources enough and for long enough that it's clear that agreement won't be reached at this article's Talk page. There is clearly not a consensus to include the proposed material. The next logical step available to those still interested in including the material is WP:DRN - Dispute resolution. I recommend those interested open a DRN case at this point. I see that there was one previous attempt to use DRN but the requested resolution wasn't appropriate for DRN. DRN should take this dispute if it is framed appropriately. Zad68 02:16, 4 July 2013 (UTC)

I just want to point out that Erythema is most likely the author of the study that editors are being pressured into including on the page. This would not be a problem if a conflict of interest were declared, as per wikipedia's policy. I mention this because such an instated conflict of interest is quite pertinent to a discussion about how the current conflict has arisen, and how it may be resolved.137.111.13.200 (talk) 03:29, 4 July 2013 (UTC)

Possibly true but not sure what should be done about it... Zad68 03:33, 4 July 2013 (UTC)

A note to everyone here, I have started a Dispute Resolution case here: Wikipedia:Dispute_resolution_noticeboard#Talk:Morgellons. Everyone who has made more than one comment here about this issue in the past 8 weeks or so has been invited to participate. Zad68 03:33, 4 July 2013 (UTC)

I am thankful that Zad68 has started dispute resolution. I had been planning to do this myself, but hadn't the time to look through the process so that I could follow correct procedure. I would like to point out that all I have asked for is that the WP:NPOV to be applied and that the editors of this topic read and apply this policy and other WP policies in an appropriate manner. First that significant minority views be acknowledged, secondly that if the No Original Research policy is applied then it should be applied to all relevant POVs not just those that are favored, and thirdly if WP:MEDRS indicates that popular press is not suitable as medical references this also be applied to all relevant POVs. Speculate all you like on my identity, but it is irrelevant. Ask yourselves if I have behaved in a manner that is not supported by WP policy. I have not asked to do any editorial changes that are inconsistent with WP policy or the spirit in which they were intended. I have behaved in an unbiased and objective manner. If I had violated WP policy in a significant manner, I am confident this would have been pointed out to me and I would have been blocked. I have done my best to read all WP policy and to adhere to it. All I asked for was that a significant minority view be PROPORTIONATELY represented. I am amazed at the response that I have received. I am a new user and WP recommends that experienced users be polite and welcoming. I have been treated in a manner just short of hostility.Erythema (talk) 08:13, 5 July 2013 (UTC)Erythema

I am a regular volunteer at the Dispute Resolution Noticeboard. The process there is on hold waiting for all involved editors to give opening statements. I would very much appreciate it if you would either give your opening statement or let us know that you do not intend to participate. Regards, TransporterMan (TALK) 00:54, 6 July 2013 (UTC)

Studies supporting the genuine skin disease view of Morgellons, and studies supporting the delusional parasitosis view

Following a PubMed search on Morgellons disease, and a Google search for peer-reviewed published studies on Morgellons disease, below is a summary of all the published peer-reviewed literature on Morgellons, categorized according to whether the studies support: (1) the viewpoint that Morgellons is a genuine skin disease, or (2) the viewpoint that Morgellons is delusional parasitosis.

As you can see below, there is 1 secondary study, and 9 primary studies supporting viewpoint (1) the genuine skin disease view of Morgellons. And there are 3 secondary studies, and 15 primary studies supporting viewpoint (2) the delusional parasitosis view of Morgellons.

Thus from these figures, it is clear that viewpoint (1) should be given around ⅓ of the article text space, and viewpoint (2) around ⅔ of the article text space, because WP:WEIGHT requires that articles represent all significant viewpoints published by reliable sources in proportion to the prominence of each viewpoint in the published, reliable sources.

At present, viewpoint (1), the genuine skin disease view of Morgellons, occupies at most only a few percent of the text space in the article, and so clearly its allocated space needs to be significantly enlarged.

VIEWPOINT (1) Published studies supporting the view that Morgellons is a genuine skin disease, that may have an infectious cause:

Review studies (secondary source):

• The mystery of Morgellons disease: infection or delusion? (2006) MEDLINE Full paper

Primary studies:

• Morgellons: a novel dermatological perspective as the multisystem infective disease borreliosis (2013).
• Association of spirochetal infection with Morgellons disease (2013).
• Characterization and evolution of dermal filaments from patients with Morgellons disease (2013)
• [www.omicsonline.org/2155-9554/2155-9554-3-140.pdf Morgellons Disease: A Chemical and Light Microscopic Study (2012)].
• Filament formation associated with spirochetal infection: a comparative approach to Morgellons disease (2011)
• Delusions may not always be delusions (2010, Editorial) MEDLINE Full paper
• Morgellons disease: Analysis of a population with clinically confirmed microscopic subcutaneous fibers of unknown etiology (2010)
• Morgellons disease, illuminating an undefined illness: a case series (2009)
• Myiasis, fillan, and the morgellons (1946) MEDLINE Full paper

VIEWPOINT (2) Published studies supporting the view that Morgellons is delusional parasitosis, and not a genuine skin disease:

Review studies (secondary source):

• Morgellons in dermatology (2010) MEDLINE
• Delusional infestation (2009) MEDLINE
• Delusional disorders in dermatology: a brief review (2008) MEDLINE

Primary studies:

• Delusions of parasitosis (2013)
• Morgellons syndrome: a disease transmitted via the media (2013) MEDLINE
• New findings in delusions of parasitosis (2012) MEDLINE
• Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic (2012) MEDLINE
• Delusional infestation: clinical presentation in 147 patients seen at Mayo Clinic (2012) MEDLINE
• Delusional infestation with unusual pathogens: a report of three cases (2011) MEDLINE
• Morgellons disease and delusions of parasitosis (2011) MEDLINE
• Psychosis, ivermectin toxicity, and "Morgellons disease" (2011) MEDLINE
• An oral ulceration associated with Morgellons disease: a case report (2011) MEDLINE
• Morgellons disease, or antipsychotic-responsive delusional parasitosis, in an HIV patient: beliefs in the age of the Internet (2010) MEDLINE
• Successful treatment of Morgellons disease with pimozide therapy (2010) MEDLINE
• Intraoral Morgellons disease or delusional parasitosis: a first case report (2010) MEDLINE
• Delusional parasitosis and the matchbox sign revisited: the international perspective (2010) MEDLINE Full paper
• Delusional parasitosis facilitated by web-based dissemination (2008) MEDLINE
• Morgellons disease and the 'tweezer sign' (2008) MEDLINE Full paper

Neutral viewpoint published studies (studies which do not take sides):

Review studies (secondary source):

• Disorder or delusion? Living with Morgellons disease (2009) MEDLINE
• The challenge of Morgellons disease(2006) MEDLINE Full paper

Primary studies:

• Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy (2012) MEDLINE
• Hypnosis in the treatment of Morgellons disease: a case study (2011) MEDLINE
• Morgellons: contested illness, diagnostic compromise and medicalisation (2010) MEDLINE
• Morgellons: disease or delusions? (2007) MEDLINE

Unkown affiliation (these are published studies with no free to read abstract, so I cannot determine their affiliation):

Primary studies:

• Do they understand Morgellons disease? (2009) MEDLINE
• Morgellons disease as internet meme (2009) MEDLINE
• AKA 'Morgellons' (2008) MEDLINE

All MEDLINE indexed studies above are indicated as such. Drgao (talk) 02:13, 5 July 2013 (UTC)

Time for a re-shuffle of those sources.

An oral ulceration associated with Morgellons disease: a case report- "Patients suspected of suffering from MD or DP should be referred for psychiatric evaluation".

Intraoral Morgellons disease or delusional parasitosis: a first case report- The fibres? Synthetic polymer.

Successful treatment of Morgellons disease with pimozide therapy- Pimozide is an antipsychotic.

Psychosis, Ivermectin Toxicity, and “Morgellons Disease”- Patient self-diagnosed with MD, started taking ivermectin (an anti-parasitic which he ordered from a vet, upon the suggestion of an "expert" in MD). Was admitted to hospital for ivermectin poisoning. Symptoms of delusional infestation decreased in response to anti-psychotics.137.111.13.200 (talk) 07:17, 5 July 2013 (UTC)

In the DP column you can add-

Psychosomatic factors in pruritus-Tey et al., 2013. They actually came to this conclusion partially from what Harvey et al. reported in "Morgellons disease, illuminating an undefined illness: a case series" 2009, by the way.

Morgellons: contested illness, diagnostic compromise and medicalisation- Fair, 2010. This is from the journal of the sociology of health and illness, and gives a reasonable summary of the trajectory of Morgellons from us vs them, to medical investigation, and now back to us vs them. It touches upon DP as much as Morgellons. Fittingly.137.111.13.200 (talk) 07:47, 5 July 2013 (UTC)

Claiming that the sole "secondary study" of viewpoint one (currently reference #17 in the Wikipedia article) is anything of the sort is absolutely ludicrous. It's relegated to being an "opinion piece" in the journal, it's written by non-PhD-holding medical professionals (including a person who is likely mentally unstable in regards to this issue, as determined by the PhD-holding medical professionals she first contacted about the alleged disease), it makes the claim that a brief mention in a 323-year-old monograph of potentially similar symptoms should be considered the first recorded occurrence of the alleged disease, and it was written two years before any clinical studies of Morgellons published their findings. 69.23.116.182 (talk) 09:53, 5 July 2013 (UTC)

Incidentally, "*Morgellons disease: more questions than answers (2012) MEDLINE" is a letter to the editor of Psychosomatics, and the reply to this letter "Comments on: Stricker and Middelveen" (http://www.sciencedirect.com/science/article/pii/S0033318212000874) was printed in the same issue. Neither should be included, as they are not peer-reviewed in any meaningful sense. They are interesting to read, however.137.111.13.200 (talk) 05:43, 6 July 2013 (UTC)

"The challenge of Morgellons disease(2006)", listed above as a neutral secondary source, both clearly expresses the viewpoint that the sufferers are delusional and challenges the credibility of the MRF, noting that none of the members are dermatologists. However, it's also not a secondary source; it references no primary sources, as no studies had been done at that time. I'd also point out that it's been repeatedly mentioned that primary sources must be MEDLINE indexed to even begin to be considered as meeting WP:MEDRS standards for reliability, which eliminates several of the articles listed as supporting a non-delusional viewpoint. Some of the remaining articles are clearly marked as "opinion" or "editorial" and therefore do not qualify as a primary source. Another one is from 1946 and so cannot represent current medical thought when so many recent sources are available... it also only mentions Morgellons in reference to the brief 1692 passage (the one Leitao got the name "Morgellons" from), noting that it sounded like acne ("comedones"). Unless I'm mistaken, between what I've had the time to look into and what 137.111.13.200 has been able to look into, every single source listed as supporting "viewpoint 1" is of insufficient reliability and/or not even supporting of that viewpoint. 198.199.134.100 (talk) 09:49, 6 July 2013 (UTC)

Thanks very much 137.111.13.200 and 198.199.134.100 for those corrections — I have reshuffled the above studies at the top of this section accordingly. Though I don't myself think that the study: Psychosomatic factors in pruritus-Tey et al., 2013 should be included, because this is not a study on Morgellons itself. I also think that the study: Morgellons: contested illness, diagnostic compromise and medicalisation- Fair, 2010 should not be included, because this is not about the nature and etiology of Morgellons, but rather about the relationship between patient empowerment and medical authorities.

The review paper: The challenge of Morgellons disease(2006), to me seems neutral, though with a bit of a leaning towards the DP perspective; it says in the concluding paragraph: "Although it is clear that one must always keep an open mind, it would seem to me to be appropriate for the treating physician to wait until the tried and true drugs, such as those mentioned above [antipsychotic drugs], prescribed in an adequate dose, and for an adequate period of time, have failed in a particular case, before one becomes too involved in ascribing a pathogenic function to cellulose fibers and the like, as is currently being suggested." In other words, the reviewer himself is suggesting keeping an open mind, and he is saying: "try some antipsychotic drugs, and if that does not work, then you might get involved in considering pathogenic effects of the cellulose fibers".

The British Medical Journal publication in 1946 of the article Myiasis, fillan, and the morgellons, which speculates that Morgellons may be caused by an infestation of Hypoderma larvae, I suggest is relevant, as it is the first medical publication I could find of that considered the etiology of Morgellons. This article is also important, because it demonstrates that historically Morgellons was considered a genuine physical disease, possibly caused by infestation. No mention is made in 1946 that this disease might be "all in the mind," which is what the current psychiatrists are saying today (and incidentally, the psychiatrists saying this are from the psychosomatic school of thought — psychosomatics being a controversial and some would say disreputable area of psychology). So this 1946 publication stands testament to the fact that the infection/infestation theory of Morgellons has a long history, and that considering Morgellons as a genuine physical disease is the conventional view. Drgao (talk) 21:51, 7 July 2013 (UTC)

The paper Psychosomatic factors in pruritis reviewed primary sources and reported on the consensus that Morgellons is most likely a form of DP. The article wasn't aimed at adjudicating whether there was an underlying physiological cause of Morgellons, since there were sufficient sources suggesting that question had already been answered. It provides an example of a secondary source reviewing literature and expressing a judgement in print about the consensus. Seems cut and dried to me. I don't think this is the place to debate the field of psychosomatics, though. And considering that the consensus is that Morgellons is a form of DP, the sociological history of Morgellons (ie. from 2002) is very relevant to its nature and etiology, specifically as a psychiatric disease that seems to be spread through information.

In the quote from "The challenge of Morgellons disease", it would seem you may have missed the word "although". Although one must always keep an open mind, I think it unlikely that Morgellons has any physiological genesis. Again, seems cut and dried.

Morgellons as it is discussed on this page came about it 2002, the name was taken from a 17th century letter. There are no medical sources which support the assertion that the phenomena given that name and the 2002 condition are related other than by name, which is meaningless. Incidentally, there is an interesting review of Browne by Kellett printed in 1935 (http://penelope.uchicago.edu/letter/kellett.html) which gives a reasonably thorough overview of "the Morgellons" as well as the naming issues.137.111.13.200 (talk) 01:18, 8 July 2013 (UTC)

Template:POV

Why was the NPOV tag removed? This article is undergoing dispute resolution for NPOV issues. It should not be removed until the dispute has been resolved.Erythema (talk) 15:12, 6 July 2013 (UTC)Erythema

The current dispute is about whether or not the proposed additions (items not currently in the article) and their cited sources meet WP:MEDRS and WP:NPOV standards. If you still have editing privileges here once that dispute is resolved, feel free to dispute the neutrality of the existing article. 69.23.116.182 (talk) 23:07, 6 July 2013 (UTC)

Why would I not have editing privileges? I have done nothing contrary to WP policy. I have examined medical literature. I have done my best to assess the data in a thorough and unbiased manner. I have only asked that all relevant POVs are proportionately represented in an unbiased manner. I have followed WP policy to the letter, as has Drgao. -- unlike others. Erythema (talk) 18:49, 7 July 2013 (UTC)

Please stop accusing others of not following policy. If you believe that others have not followed policy please report them to ANI, thanks. Dbrodbeck (talk) 18:58, 7 July 2013 (UTC)

Erythema, I believe in a previous post you suggested that if certain material is not included in the page then the entire page should be deleted. if you are an author of the material you are trying to have inserted in the main page and you do not make a declaration about that then "unbiased" would not be the word that best describes your approach. http://en.wikipedia.org/wiki/Wikipedia:Conflict_of_interest#Citing_yourself. You may be new to wikipedia, but it would appear that you have no intention of following guidelines which serve to protect the credibility of editors when a potential conflict of interest arises, even when these guidelines are repeatedly pointed out .137.111.13.200 (talk) 02:06, 8 July 2013 (UTC)

Due weight

It apparently bears repeating that due weight for any position is determined by secondary sources, nor primary ones. In the case of a WP:FRINGE theory such as the existence of a separate, non-psychiatric cause for "Morgellons", it is instructive to see what the highest quality sources and authorities say (and don't say) about Morgellons.

• The US Centers for Disease Control and Prevention says, "This comprehensive study of an unexplained apparent dermopathy demonstrated no infectious cause and no evidence of an environmental link. There was no indication that it would be helpful to perform additional testing for infectious diseases as a potential cause." (emphasis mine)

• The Infectious Diseases Society of America, the largest organization of infectious disease physicians in the US, has only one mention of Morgellons on its website. This mention is a link to an editorial in an infectious diseases journal that says, in part, "This extensive study should put a final nail into the proposition that this syndrome has an infectious etiology and that it is associated with the emergence of parasites from the skin lesions." (empahsis mine)

• The American Academy of Dermatology, the largest organization of dermatologists in the US, has no mention whatsoever of "Morgellons" on its website.

• The Robert Koch Institute also does not have Morgellons mentioned on its website.

• Harrison's Principles of Internal Medicine, considered "the most recognized book in all of medicine", also does not appear to have any mention at all of "Morgellons".

In summary, the highest quality medical sources and authorities either completely ignore "Morgellons" as a separate disease, or explicitly deny there is any infectious cause for it. Clearly, any suggestion that "Morgellons" as an infectious cause falls under WP:FRINGE.

Let's now review other WP:MEDRS compliant sources. In this case, MEDLINE indexed sources, labelled as "Review" by PubMed, from the past 5 years per WP:MEDDATE.

• Dermatologic infestations, from a dermatology journal directly equates "Morgellon" with delusional parasitosis, and does not even mention any possibility that there could be an infectious cause.

• Morgellons in dermatology, from a dermatology journal directly calls "Morgellons" a new type of delusional parasitosis. It acknowledges that advocates have been pushing proposals about possible infectious causes, but flatly denies any real evidence for these proposals.

• Delusional infestation, from an infectious diseases journal also calls "Morgellons" a variation of delusional parasitosis. This review also acknowledges proposals by advocates for an infectious cause, but also note that these proposals lack any basis in evidence.

• Disorder or delusion? Living with Morgellons disease, from a psychosocial nursing journal describes the possibility of "Morgellons" as having an infectious origin, though does not comment on how strong or weak the evidence for this possibility is. As a nursing journal it is also commenting on the existence of a disease, and therefore is out of its normal scope of practice, so is probably least reliable of all sources.

• Delusional disorders in dermatology: a brief review, from a dermatology journal describes "Morgellons" as being within the spectrum of delusional infestations. This review also describes alternative proposals for infectious causes of "Morgellons" as "has not been substantiated."

• An interesting article on a MEDLINE indexed sociology journal here had an interesting take on it from a sociological perspective. It also notes that "the overwhelming majority of medical experts" see "Morgellons" as a form of delusional infestation, and as an example, quotes a dermatologist as saying "‘[Morgellons] is not a mysterious disease … If you polled 10,000 dermatologists, everyone would agree with me [that Morgellons is DP]’" (or delusional parasitosis).

Clinical textbooks are also considered reliable sources under WP:MEDRS.

• The American Psychiatric Publishing Textbook of Psychosomatic Medicine: Psychiatric Care of the Medically III, published by a division of the American Psychiatric Association, directly equates "Morgellons" with delusional infestation

• Pediatric Psychodermatology: A Clinical Manual of Child and Adolescent Psychocutaneous Disorders, a textbook published by Walter de Gruyter, also equates "Morgellons" with delusional infestation.

I could not find one high quality secondary source that states that "Morgellons" has an infectious etiology. Given the clear overwhelming consensus in the medical community that there is no infectious cause to "Morgellons" (and indeed, most high quality sources don't even seem to think it exists as a separate entity at all), it is incumbent on those who want to add material about a possible infectious source to cite high quality secondary sources. They have yet to do despite weeks of protestations by WP:SPAs. Yobol (talk) 01:24, 11 July 2013 (UTC)

Firstly, there is a secondary source that suggests Morgellons may be linked to an infectious etiology (specifically Lyme disease), which is this paper:

The mystery of Morgellons disease: infection or delusion? (2006) MEDLINE Full paper

Secondly, the issues here are not just whether Morgellons has an infectious etiology, they are also about whether Morgellons is a real physical disease or not, and whether the fibers found under the skin in Morgellons are genuine or not. As I stated above, regarding these matters there are two opposing viewpoints among researchers:

VIEWPOINT (1) is that Morgellons is a genuine physical skin disease in which the fibers are genuine, and that may have an infectious cause.

VIEWPOINT (2) is that Morgellons is delusional parasitosis (ie, the physical symptoms are all in the mind), and thus not a genuine physical skin disease.

The secondary source I cited supports the idea that Morgellons is a genuine physical skin disease, and also supports the idea that Morgellons may have an infectious cause. (But even if Morgellons turns out not to have an infectious cause, it can still be a genuine physical skin disease).

I have also listed many primary sources above that support the idea that Morgellons is a genuine physical skin disease that may have an infectious etiology.

Thus given that there is a very significant body of research supporting the idea that Morgellons is a real physical skin disease, and supporting the idea that Morgellons might have an infectious cause, this viewpoint needs to be included in the article, if were are to provide a NPOV.

I also draw you attention to the very large $300,000 CDC study on Morgellons in which the authors concluded that ""We were not able to conclude based on this study whether this unexplained dermopathy represents a new condition, as has been proposed by those who use the term Morgellons, or [whether it represents] wider recognition of an existing condition such as delusional infestation." So the CDC have clearly stated that they have not been able to determine whether Morgellons is a genuine physical skin disease (viewpoint 1), or whether Morgellons is delusional parasitosis (viewpoint 2). Thus if the CDC have not been able to decide which, this article definitely needs to present both views. Drgao (talk) 01:06, 13 July 2013 (UTC)

The Savely/Leitao source is not reliable for two reasons: 1) it is too old per WP:MEDDATE (now going on 7 years old, instead of the 5 as suggested by WP:MEDRS) and 2) it is not authored by an independent source as required under WP:FRINGE (see here), but by the people who created the term (Leitao) and those who were promoting it as a real illness under the organization known as the "Morgellons Research Foundation". As you can see from the high quality secondary sources I have provided, there is no real controversy about Morgellons - it is, or is a form of, delusional infestation. Listing a bunch of low quality primary sources does not, and cannot, change our Wikipedia article. WP:MEDRS specifically says we cannot use primary sources to rebut high quality secondary sources. I have yet to see anyone provide any high quality secondary sources that meet WP:MEDRS and WP:FRINGE that state Morgellons is "real" or has an infectious cause. If you have them, bring them forward.

As to the CDC study, the study was not designed to determine whether it was a new condition or not, so it is not surprising that it could not conclude it. The fact that numerous secondary sources directly equate "Morgellons" with delusional infestation, or completely ignore it altogether, and you choose to ignore them and focus on cherry-picked insinuations from primary articles speaks volumes as to whether you are here to summarize the high quality secondary sources (as we should be doing) or here to push an agenda based on cherry picked data and innuendo. Yobol (talk) 01:35, 13 July 2013 (UTC)

The primary and secondary sources you provided are not high quality, as they are strongly connected to the psychosomatic school of thought in psychiatry. This makes your secondary sources a little unreliable, as psychosomatics is a controversial area in which researchers do not properly adopt the scientific method of proving assertions by empirical evidence, but rather just speculatively make their assertions without solid evidence. For example, have any of these psychosomatic researchers actually proved that the skin sores in Morgellons are self inflicted by scratching as they claim? It would be easy enough to prove this, using cameras, say, that would observe Morgellons patients scratching their skin and creating the lesions themselves. But no; these psychosomatic researchers do not provide any empirical evidence for this or any of their assertions; they just make assertions based on their opinions. That is not science. So your references are not very reliable, given that they are based on speculation, and not empirical evidence.

If you can show me the empirical evidence in your sources that prove that Morgellons is a delusional infestation, then that would be acceptable; but the psychosomatic researchers in your sources have just speculated that Morgellons is a delusional infestation. That's not science.

Also, the fact that your secondary sources say that there is no controversy about Morgellons, and blankly state it a form of delusional infestation, again shows that these sources are not very reliable. The $300,000 CDC study on Morgellons remained open and undecided as to whether Morgellons was a real physical disease or a delusional infestation. Thus how are the secondary sources you cited able to go further than the CDC conclusion? What further evidence do your secondary sources have that allows them to blankly conclude a delusional infestation, when the CDC was not able to come to that conclusion? Well, I tell you: they do not have any further evidence, so your secondary sources just speculate that it is delusional infestation. Speculation is not the same as hard empirical evidence.

The Savely/Leitao paper may be 7 years old, but they were spot on with their analysis, and this paper is as correct as ever. Savely/Leitao indicated a link to Lyme disease (ie, Borrelia burgdorferi infection), and the latest research has validated this link, by finding Borrelia burgdorferi in the skin lesions of Morgellons patients. Thus with Savely/Leitao we have this very astute secondary source that has also been backed up by more recent primary sources. So this source stands, and it means the view Morgellons is a real physical disease, that may be linked to an infection, is backed up by a secondary source.

Your point about the Savely/Leitao paper not being independent because Leitao created the term "Morgellons" is wrong on two counts: firstly, Leitao did not create the term Morgellons; it has been in use for hundreds of years, and was mentioned in 1946 in this publication (full paper here), which incidentally speculated in 1946 that Morgellons might be caused by an infestation, which shows that the infestation/infection view of Morgellons goes back a long way. Secondly, even if Leitao had created the term Morgellons, it is irrelevant: many researchers coin terms in the various fields of science, but that does not make their publications not independent. Drgao (talk) 10:40, 13 July 2013 (UTC)

When you get to the point in the argument where someone calls major medical organizations like the Infectious Diseases Society of America and the American Academy of Dermatology or major textbooks like Harrison's Principles of Internal Medicine unreliable or of poor quality, you know you aren't dealing with someone who shares an objective reality on what is reliable or high quality. When reliability is decided by the conclusions the sources come to, rather than things like their reputation in the relevant scholarly community, against Wikipedia policies and guidelines, and frankly, common sense, there is no point in continuing the discussion, as the level of agenda-driven Wikilawyering and POV pushing has reached insurmountable levels. Cheers. Yobol (talk) 12:09, 13 July 2013 (UTC)

You are misquoting what I said. I said that the secondary sources you cited are strongly influenced by psychosomatic research. Psychosomatics is primarily interested in diseases whose symptoms are "all in the mind", or produced by the mind. Therefore it is not surprising that these sources support the delusional infestation, "all in the mind" view of Morgellons. It is what you would expect from psychosomatic researchers. It is unfortunate that we do not have any secondary sources from a neutral camp. Drgao (talk) 12:28, 13 July 2013 (UTC)

F1000 Research

I have noticed some editors throwing around words like "prestigious" with regards to the new "journal" F1000 research, so it might be useful to get an independent assessment of F1000 research.

Bloggers with impressive credentials have written a number of articles about F1000, though one stood out in particular. Whole post is worth a read, but the money quote, "Responsible researchers should therefore approach every paper from F1000 Research as if it has never been through peer review, and before using it in their research they should essentially review it themselves." (emphasis mine)

Perhaps we shouldn't be using this source as reliable to challenge the medical consensus? Yobol (talk) 02:18, 11 July 2013 (UTC)

Welcome back Yobol. What was actually said was that the F1000 is a prestigious group of experts in their field. The F1000 and F1000 Research are 2 different entities. The F1000 Research was proposed by the F1000 as an innovative way to publish. Their feeling was that peer-review should be transparent. There seems to be a consensus, even within this Talk group, that the F1000 is a prestigious group. If you don't believe me please read the Wikipedia entry on this subject and if you think it is not accurate you can edit it. There is debate on blogs and such about F1000 Research and this is probably because it is a novel concept, but even those blogs agree that reviewers for F1000 are reputable scientists. Furthermore papers do not get approved status until they pass peer-review. In any case, I agree with Drgao that blogs are not good sources of information. The reliability of F1000 Research peer-review should be evaluated by what the F1000 say in the reviewers' guidelines. There is nothing in the guidelines to suggest they want anything other than objective assessment.Erythema (talk) 22:13, 11 July 2013 (UTC)

I have no desire to argue endlessly with WP:SPAs in a vain attempt to change the opinion of someone who is here to drive an agenda. I am just providing information for neutral parties without an agenda to see. They can take it or leave at their choosing. Yobol (talk) 00:43, 12 July 2013 (UTC)

Dove Press Reputation

One of the hallmarks of a reliable source on Wikipedia has always been articles should be based on sources with "reputation for fact-checking and accuracy. What is the reputation of Dove Press?

A review published in The Charleston Advisor called Dove Press a "predatory" publisher, noting "It’s clear that Dove Press, like the other publishers we review here, are mere vanity presses."

Other sources have been equally as harsh, with some pretty embarrassing details like authors adding their children as co-authors to published articles.

Perhaps we shouldn't be using this source as reliable to challenge the medical consensus? Yobol (talk) 02:27, 11 July 2013 (UTC)

Understatements of the year! Very appreciated, Yobol. Zad68 02:32, 11 July 2013 (UTC)

This, and the info on F1000 is very helpful, thanks. Dbrodbeck (talk) 02:36, 11 July 2013 (UTC)

So why are so many of Dove Medical Press's journals MEDLINE indexed, if Dove are not reliable? Perhaps the editors here criticizing Dove need to contact MEDLINE, and explain their views to MEDLINE. Drgao (talk) 11:10, 11 July 2013 (UTC)

MEDLINE indexes a number of journals with dubious reputations including Homeopathy and Medical Hypotheses (the former being specifically disallowed as an independent source per WP:FRINGE); as with most things, MEDLINE indexing can be a good general guideline but specifics can be tricky. Since the Dove Press journals that published the material about "Morgellons" aren't even MEDLINE indexed anyways, this would seem to be a moot point. Yobol (talk) 11:33, 11 July 2013 (UTC)

What we need to do here is to look at WP policy and to apply it. There are provisions for relaxation of the No original research policy when secondary sources are lacking. Morgellons is such a situation. Original Research has been used in the main article to support one POV, so for NPOV minority POVs must be fairly represented. That cannot mean double standards of policy application. Now about references: There is nothing in WP policy saying that Dove Press is not reliable. There are no lists of accepted and rejected journals. All the policy says is that medical references should be in peer-reviewed medical journals. There is no mention of journals having to be PubMed or MEDLINE indexed, so indexing is not relevant. As Drgao mentioned before there are many Dove Press articles that have been cited in Wikipedia, so if they are not acceptable references then they should be removed from all articles. There is nothing in Dove Press reviewers' guidelines suggesting that they want anything but an honest and objective evaluation. On-line journals have been repeatedly criticized, yet WP policy favors them because they are accessible to readers. If you say that Dove Press is not reliable or reputable please show some hard evidence. What you are presenting as evidence in terms of lack of reliability is just opinion. Please substantiate your claims. WP policy seems to take a dim view of unsubstantiated statements that are harmful to individuals or organizations. There is nothing in WP policy that indicates a medical journal must first meet Yobol's (or Dbrobeck's, or Sailsbystars's etc. for that matter) approval in order to be considered reputable. There is, however, policy that states that popular press articles aren't appropriate medical references. I shouldn't need to remind anyone that plenty of these have been used in the Morgellons article. Why don't we take a break from debating and give the dispute resolution process a chance. We are repeating the same arguments.Erythema (talk) 22:40, 11 July 2013 (UTC)

Once again, Wikipedia's guideline regarding MEDLINE is not "include anything with a MEDLINE index", it's "do not include anything that does not have a MEDLINE index". MEDLINE indexing is part of the minimum requirements for consideration to be a reliable source, not the totality of the requirements. 198.199.134.100 (talk) 22:51, 11 July 2013 (UTC)

You are wrong there. There is nothing in WP:MEDRS that says MEDLINE is the minimum requirements for a reliable source. Drgao (talk) 01:24, 12 July 2013 (UTC)

It's a primary source that dramatically contradicts the consensus, the fact that it is not indexed in MEDLINE isn't even the primary issue here. That it isn't indexed in MEDLINE however means that the likelihood of researchers in the field reading it is decreased, which means it will take longer for a third-party review to take place, which is what is required for inclusion in this area. This is not a context where primary sources are lacking: two very large studies investigated this and found no infectious aetiology. The source being discussed contradicts existing findings, and possibly for methodological reasons. I just don't understand the rush here. What is wrong with waiting for a review of this from a secondary source? Any argument that says these findings are important enough to be included in the article as an alternative explanation than that given by the medical consensus should also means that the primary sources will be reviewed by a secondary source. So if you don't have faith that a review will take place then is that because no-one cares about it? If so, then why should it be included?137.111.13.200 (talk) 02:21, 12 July 2013 (UTC)

Thank you, 137.111.13.200. The above is real discussion. It is reasonable and makes sense. Although I would like to see a small mention of the infectious hypothesis, so that significant minority POV is represented, what 137.111.13.200 said is a reasonable and objective argument. However, the CDC and Mayo studies are both primary sources too, and I have concerns about the quality of many of the references used in the article as it is now, especially the popular press articles. I believe that many of the references are not appropriate secondary sources and this is causing questionable neutrality. If the infectious evidence is not going to be included then the wording of some of the text needs to be toned down significantly and text supported by inappropriate references should be deleted. One example is Dr Wymore fiber studies. These are unpublished primary studies, they have not been peer-reviewed. We have no idea of what methodology he used and have no way of knowing the reliability of his data. Also although the CDC and Mayo studies were large, there should be a qualifying remark to the effect that these are primary studies. There are also many opinion pieces used as references and these are used to make unsubstantiated statements. If other significant POVs are not included at this point then the article needs some work in regards to NPOV.Erythema (talk) 00:24, 13 July 2013 (UTC)

The CDC and Mayo studies have been reviewed in secondary sources. The CDC study is mentioned also because it is relevant to how the medical community/government reacted to lobbying. That sets up the inclusion of the conclusions of the CDC study for an additional reason, which makes any attempt to remove it or de-emphasise it moot. It is ironic that the study that at one time was being used to indicate legitimacy for Morgellons ended up suggesting it is not due to an infection, but irony isn't a good enough reason to direct references to a study from one of the most recognised medical bodies in the US.137.111.13.200 (talk) 11:11, 13 July 2013 (UTC)

You did not address the issue of the other references cited in this article, all the popular press in particular, especially the Popular Mechanics with an interview with an anonymous dermatologist, and the interview with Randy Wymore reporting unpublished primary research. Such sources are poor quality evidence, not acceptable medical references, and are not verifiable. Do not try to tell me that WP:MEDRS policy accepts these sources as medical references, because it specifically says secondary medical references are peer-reviwed review articles published in medical journals, medical textbooks and medical guidelines, and it is repeatedly stressed in WP policy that popular press articles are low quality references. Again, if different significant minority views aren't represented and double standards are applied then the entire article must undergo a thorough evaluation for NPOV and reliability of evidence presented.Erythema (talk) 19:34, 13 July 2013 (UTC)

Are you referring to the section about the role of the internet on Morgellons? As in, the role of the media? Where coverage of Morgellons is actually feeding back into the incidence? These aren't medical references because this section is related to sociology. Though it does indeed end up relating to the medical community: imagine if you work treating people with Morgellons, and the more people hear about the bugs under everyone's skin the more people start coming to your practice, and the more people donate to the foundation you are associated with. Gee, it is almost worth writing a press release to get your work displayed in as many prominent places as possible. Let's play more "what if", if there was an underlying physiological cause of Morgellons then it is likely the CDC and Mayo studies would have picked it up. If Morgellons is a form of delusional parasitosis then sufferers would be extremely resistant to the suggestion that they suffer from a delusion. To the point of self-medicating and poisoning themselves, or using sharp implements to "remove" the parasites, or killing themselves, rather than seeking psychiatric help. Am I drawing the issues into sharp enough relief for you?137.111.13.200 (talk) 03:01, 14 July 2013 (UTC)

No, this is nothing to do with the role of the media or the role of the internet on Morgellons. The pro-delusional infestation editors are using the most shoddy references to support their medical claims. For example, the article currently states that the "fibers may also be peripheral nerve endings". But where does this specific piece of medical information about nerve endings come from? From a review study on MEDLINE perhaps? Or a primary medical study that investigated the nature of the fibers in Morgellons? No, in fact the source of that statement comes from unsupported speculation in a newspaper article in the Dallas Observer! Talk about shoddy, inappropriate sources! Drgao (talk) 11:11, 15 July 2013 (UTC)

You seem confused, Erythema raised the reference to Popular Mechanics, which is in the "Role of the internet" section. Honestly, this adversarial attitude is getting tiresome, and it is doing nothing to raise the quality of the page.137.111.13.200 (talk) 00:25, 16 July 2013 (UTC)

The psychosomatic psychiatric view of Morgellons is on shaky grounds scientifically

The people saying that Morgellons is psychiatric in origin tend to be psychiatrists of the psychosomatic school of thought. Psychosomatics is a controversial branch of psychology that makes the rather unscientific assumption that if no causes have been detected for a given disease, then the symptoms of that disease may be "all in the mind", or produced by the mind.

Psychosomatic researchers do not take into account that a cause may not have yet been found: psychosomatic researchers instead say "if a cause has not been detected, then we think the disease must be all in the mind, or produced by the mind". That is the assumption these psychosomatic researchers work with.

The main trouble with this psychosomatic assumption is that it is not empirically testable, and therefore it is not scientific. You cannot test whether a disease is all in the mind, or produced by the mind. Science requires that hypotheses or theories be empirically testable, otherwise they are not considered scientific theories. Therefore psychosomatics is not very scientific, and it is unsafe to accept the conclusions of psychosomatic researchers as true.

The "authoritative sources" that this article completely panders to in fact derive from a group of unscientific psychiatrists of the psychosomatic school. Most people are easily fooled by psychosomatic ideas, and fall for these psychosomatic "theories" hook, line and sinker.

Note that closely related terms for psychosomatic diseases include functional disorders, and somatoform disorders.

Psychosomatic researchers in the past have claimed that the diseases: irritable bowel syndrome (IBS), interstitial cystitis, and chronic fatigue syndrome were all psychosomatic functional disorders — that is, diseases being "all in the mind", or produced by the mind. These days, thank goodness, researchers are veering away from these unscientific psychosomatic "theories", and in fact all of these diseases have now been linked to microbial infection. Indeed, if you look at the irritable bowel syndrome Wikipedia article, you see that although it classifies IBS as a functional disorder, the article also lists all the various pathogenic microbes that have been linked to IBS.

Thus unlike this Morgellons article, the IBS article has a NPOV, because it includes the research on the pathogenic microbes linked to IBS. Drgao (talk) 11:07, 11 July 2013 (UTC)

We don't get to say that it is 'on shaky ground'. We need reliable secondary sources. Your view, or mine, of psychiatry is a non issue. Dbrodbeck (talk) 11:20, 11 July 2013 (UTC)

Note that Wikipedia is not a forum for the general discussion of a topic, but a place to discuss additions to the article, citing specific sources. Please refrain from derailing the improvement of this article with digressions like this. Thanks. Yobol (talk) 11:35, 11 July 2013 (UTC)

Equally, Dbrodbeck, if you do not have reliable secondary sources that say Dove Medical Press or F1000 are unreliable, please refrain from making assertions that they are. It is hypocritical to demand secondary sources for what I assert, but then not provide secondary sources for what you assert. Drgao (talk) 11:53, 11 July 2013 (UTC)

In my case, the opinion that psychosomatic research is on shaky ground is not just mine, but can be found in secondary sources such as Angela Kennedy's book: Authors of our own misfortune?: The problems with psychogenic explanations for physical illnesses. Drgao (talk) 11:53, 11 July 2013 (UTC)

There are sources above, you have to click them is all. (As an aside, the 'source' you have provided is a self published book, which is not useful here). Dbrodbeck (talk) 12:00, 11 July 2013 (UTC)

Can you provide me with the Wikipedia rules that say a self published book is not valid? Drgao (talk) 12:09, 11 July 2013 (UTC)

WP:SELFPUB. The source is useful about itself, that is about it. Dbrodbeck (talk) 12:27, 11 July 2013 (UTC)

Also:

• As far as I can determine, Kennedy has absolutely zero formal scientific or medical training.
• The book itself does not mention Morgellons at all.

That is really all that needs to be said about the author and the book - not useful for this article. Zad68 12:55, 11 July 2013 (UTC)

OK, I accept that the book is not directly useful for the article — but it might possibly be of interest to some of you guys, just to indicate that psychosomatic research is not without its controversies, vis-a-vis the unscientific axioms of psychosomatics. Psychosomatic psychiatry has been a disaster for a number of diseases, in terms of biomedical research programs being abandoned because the shrinks proclaimed the diseases were "all in the mind." If ever a disease gets categorized as psychosomatic by the shrinks, then sadly, research into any physical causes for that disease may be cut right back. Drgao (talk) 01:14, 12 July 2013 (UTC)

By the way 198.199.134.100, if you are reading this: you misrepresented my views on Morgellons in your dispute page opening comment. You said that I "sincerely believe Morgellons is a non-delusional condition." In fact, that is incorrect; my views are much more nuanced, and if you care to read all that I wrote above on this page, you will discover what my views actually are. Not that my personal views matter for the purpose of this article. But you should not be misrepresenting my views in your dispute page comments. I suggest you amend your comments. Drgao (talk) 01:14, 12 July 2013 (UTC)

No. 198.199.134.100 (talk) 01:48, 12 July 2013 (UTC)

More specifically, I suggest you reread the "initial ground rule" for the mediation, especially the fourth one. I'll assume good faith that you forgot about that, instead of assuming you fully understood the rules and were trying to trick me into being removed from the mediation. 198.199.134.100 (talk) 01:57, 12 July 2013 (UTC)

Well perhaps you should read initial ground rule number three, which says: "Do not comment about one another. If you wish to comment or complain about another user's conduct, motivations, identity, or anything else, take it to an administrator (I'm not one, by the way)". So you already broke that rule. Drgao (talk) 00:38, 13 July 2013 (UTC)

Those ground rules were written after I wrote my opening statement, which should be blatantly obvious to you. If you want to continue this off-topic childishness, don't do it here. 69.23.116.182 (talk) 16:04, 14 July 2013 (UTC)

I think you are opposing something that doesn't exist. The clearest definition of psychosomatics is given in the description of the journal of Psychosomatics- "Psychosomatics has been dedicated to helping its readers achieve excellence in the clinical care of patients with medical and psychiatric comorbidity". That psychiatric pathology interacts with physiological pathology is, as you yourself have represented, not new. Nor does it necessitate the absence of any underlying physiological illness. The wording on the page incorrectly uses the phrase "psychosomatic illness". This is not a medical term, and should be replaced with either "somatoform disorder" or the more general "psychiatric disorder". Why does the IBS article discuss microbes? Because they were found to be involved in IBS though medical studies. If you still have to ask why the Morgellons page doesn't represent an underlying cause of Morgellons symptoms it is because two major medical studies have not found any underlying physiological causes.137.111.13.200 (talk) 01:27, 12 July 2013 (UTC)

When researchers look for the microbes that are linked to diseases, it is not unusual to have some studies with negative results, and other studies with positive results. For example, studies examining the link between enteroviruses and chronic fatigue syndrome (CFS) have had varied results: this study found enteroviruses in CFS patients, but this study did not. However, although there were contradictory results, the Wikipedia article on the pathophysiology of chronic fatigue syndrome still mentions the enterovirus link to CFS, but states that the studies have be contradictory. This is what we should say in the Morgellons article: we need to say that some studies have found a link to Borrelia bacteria, but other studies have not. That is an accurate description of the current state of affairs. Drgao (talk) 00:38, 13 July 2013 (UTC)

The point is that if we say "some studies have found this, some have found that", who are we to be saying that? We should cite reliable secondary sources who are equipped to make those judgements. That way we don't have to make judgements about whether to include studies with poor methodology, we can use the reviews of experts to do that for us. When they are lacking we perhaps can be tentative about primary sources, though in this case there are ample secondary sources indicating that there is no specific underlying infectious aetiology, with some recent studies with dubious methodology contradicting that. Seems like we should defer to experts and wait for a third-party review. Isn't that an accurate description of wikipedia's guidelines?137.111.13.200 (talk) 11:19, 13 July 2013 (UTC)

We have various secondary sources that both support and that refute the idea that Morgellons is a real physical disease that may be linked to microbial infection. The secondary source that supports the real physical disease linked to microbes viewpoint comes from the medicine/biology camp of researchers; the secondary sources that support the delusional infestation view of Morgellons comes from the psychosomatic camp of researchers (psychosomatics in primarily interested in diseases whose symptoms are "all in the mind", or produced by the mind). Therefore it is not surprising that the former camp supports the real physical disease linked to microbes view, and the latter camp supports the delusional infestation, "all in the mind" view of Morgellons. It is what you would expect from these camps, given their area of expertise. We don't really have any secondary sources that come from a neutral camp. So all we can do is detail the views of both camps. Drgao (talk) 11:48, 13 July 2013 (UTC)

You seem to be talking about a totally different topic here, Morgellons has been found through two large medical studies not to be related to an underlying infection, and this has been expressed through numerous secondary sources. Whatever axe you have to grind about "psychosomatics" is irrelevant.137.111.13.200 (talk) 02:33, 14 July 2013 (UTC)

You are mistaken there: as I have explained before on this page, finding no microbes in a given disease does not conclusively prove that the disease is unassociated with an underlying infection. This is like sending a spacecraft to Mars, and concluding that there is no life on Mars just because that one spacecraft did not find any signs of life. You cannot say that. In other words, you cannot prove a negative. However you can prove a positive, and so the fact that recent studies have now found a link between Morgellons and Borrelia burgdorferi bacteria says far more than those studies that found nothing. Drgao (talk) 22:05, 14 July 2013 (UTC)

And as we've explained to you before on this page, the studies you're referring to are published in journals of laughable quality, by researchers with clear bias on the issue. As such, the information in those studies does not belong on Wikipedia. If and when studies supporting the disease hypothesis begin to be published in reputable sources, the stance of the article here can be revisited. 69.23.116.182 (talk) 22:16, 14 July 2013 (UTC)

That is simply not true. Those journals meet WP:MEDRS standards. I can find no rules in WP:MEDRS that would exclude those journals. Can you?

And as I point out in this section: the studies you support (the viewpoint 2 studies) are very biased: they are strongly influenced by the psychosomatic camp of researchers, who often unscientifically assume that any unexplained disease symptoms are either all in the mind, or produced by the mind. So this is a terrible bias in the way these psychosomatic researchers view diseases; their approach has more than a tinge of pseudoscience.

The $300,000 CDC study on Morgellons concluded that it was not possible to tell if Morgellons was a real physical skin disease, or a delusional condition. The CDC said there was insufficient evidence to decide. Yet these pseudoscientific psychosomatic researchers that you support did not care about the lack of evidence, because they just went ahead and speculated about the nature Morgellons, saying without evidence that it is delusional. So the $300,000 CDC study actually contradicts your secondary sources. Drgao (talk) 22:44, 14 July 2013 (UTC)

"you cannot prove a negative". Oh no, I understand perfectly. There may well be a teapot somewhere out there in space. I'm not sure why $300,000 is so important here, but the conclusion of the study is "No common underlying medical condition or infectious source was identified, similar to more commonly recognized conditions such as delusional infestation." What about a different approach: How about I select 4 patients who have Borrelia burgdorfi antibodies, find that they shockingly have an association with Borrelia burgdorfi, then claim that since they are itching too they have Morgellons and Morgellons is thus caused by Borrelia burgdorfi? I'd be laughed at, but I'd make the case that my results should be jammed in this page. Someone would probably argue that my methodology and conclusions should be reviewed by third-parties before it was included here, but I'd probably still argue. Maybe if I had more money I'd do a better job. Maybe a constant reference to a study that was well-funded sets up a David and Goliath dynamic, making people sympathetic to my cause. Whatever, that has nothing to do with this issue, which relates to adequate and reliable sourcing!137.111.13.200 (talk) 02:07, 15 July 2013 (UTC)

TO 137.111.13.200. I suggest you read the study in question again, because you have completely misunderstood it. Contrary to what you said, that study did not select four patients who were already known to have Borrelia burgdorferi antibodies. Rather, in the study the researchers selected four Morgellons patients at random, and then found that these patients have antibodies to Borrelia burgdorferi. You will be laughed at if you keep making mistakes like that! Drgao (talk) 11:01, 15 July 2013 (UTC)

And furthermore, instead of making facetious "teapot in space" comments in response to the information I provided above on the inherent difficulty in definitely proving that there are no infectious pathogens linked to a disease, you might be better off reading this article on identifying and confirming an infectious cause of a chronic disease. Once you have more knowledge about pathogen hunting, you might be able to have an informed discussion on the subject. Drgao (talk) 16:19, 15 July 2013 (UTC)

I suggest you read the article in question again, specifically the part where it states that the "randomly-selected" patients' histological reports had been previously detailed in "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544355/#!po=16.6667", which in turn states that two of the patients had been used as case studies a year earlier in "www.omicsonline.org/2155-9554/2155-9554-3-140.php". They dropped the third patient from that particular study and didn't use him in the more recent ones, I'm sure it had nothing to do with the fact he had been diagnosed as having delusional parasitosis. I'll give the authors the benefit of the doubt, and suggest that "randomly-selected" was perhaps a typo, and that they really meant to type "cherry-picked".

The teapot in space wasn't a response to any information you provided, since you didn't. It was a response to the fatuous argument that because you can't prove a negative then you must entertain every alternative notion as being as likely. Your criticisms of my apparent ignorance about pathogen hunting are misplaced- it seems you want to be criticising the $300,000 CDC study, and the Mayo study, and pretty much every other respected researcher in this field who doesn't agree with your particular interpretation of what constitutes "evidence".137.111.13.200 (talk) 00:14, 16 July 2013 (UTC)

Actually it would be interesting to find out whether patient 2 was actually Cindy Holman of the Holman foundation. Maybe SierraParis can shed some light?137.111.13.200 (talk) 03:13, 16 July 2013 (UTC)

TO 137.111.13.200. I have had another look at the study: Association of spirochetal infection with Morgellons disease, and it seems I misread this study myself. So the mistake is in fact mine. It would appear that the authors of the study started out with four Morgellons patients that were also previously tested positive for Borrelia. In this study, they did not test for a general Borrelia infection, but rather they specifically tested the tissue extracted from the skin lesions, and found that this skin lesion tissue was infected with Borrelia.

So what this study has in fact demonstrated is that in a Morgellons patient who is also known to have Lyme disease, this patient will likely have Borrelia in the skin lesion tissue (thus suggesting that Borrelia could be the cause of the lesion). However, what the study did not prove is a general association between Morgellons and Borrelia infection. What I would like to know is if there is a such an association between Morgellons and Borrelia: that is, do all Morgellons patients have Borrelia infection? Or did these four patients in the study with Morgellons just happen to have Borrelia as well? It seems that researchers needs to go out and test a few dozen Morgellons patients and see it they all have Borrelia.

The study mentions that the CDC probably did not do a good job of selecting Morgellons patients in their cohort, as the CDC did not have confirmed clinical evidence of Morgellons disease in the patients they tested. So the CDC may not have been actually testing true Morgellons patients when they tested them for Lyme. Furthermore, they say that the CDC Lyme testing may have been clinically insensitive. Thus the fact that the CDC did not find Borrelia infection in their tests may not really prove anything.

I know this discussion is somewhat academic now that TransporterMan has determined that the studies published in F1000, Dove Press, and OMICS cannot be included in this Morgellons article, but I just wanted to fully understand this issue. Drgao (talk) 23:12, 16 July 2013 (UTC)

The personal hitting below the belt is sinking a bit low, don't you think? WP policy protects the right of editors to have anonymity. Why don't you stop insinuating who's who? Now you are sinking even lower -- trying to guess the identity of patients in medical studies. That is downright unethical. As I have said before, as long as editors are not behaving in a biased manner why should you care about who they are? TransporterMan has made a decision so why not give it a rest? If this work is reproducible then it will be repeated and given time will be cited in a secondary source.Erythema (talk) 04:19, 17 July 2013 (UTC)

Post-publication review: cuts both ways. If the "randomly-selected" patients in the study included the founder of the foundation that partially funded the study, then I would have thought that might have been mentioned in the conflicts of interest declaration. Perhaps you can explain why the third case-study patient was not included in the follow-up studies, if not due to the diagnosis of delusional parasitosis. These are questions about the methodological rigour of the studies discussed. Not appropriate?137.111.13.200 (talk) 08:03, 18 July 2013 (UTC)

Drgao- Stricker and MIddelveen have two points- they think they are better qualified to detect borrelia than the CDC, and that in "true Morgellons" the fibres are coming out of unbroken skin, that were the points they made relating to the CDC and Mayo studies. It seems then the onus is on them to work out what those fibres are. Most studies have found them to be clothing and hair. They don't seem to realise that through their targeted and limited patient-selection they are less likely to have sampled a representative group of Morgellons patients than either the CDC or Mayo studies.137.111.13.200 (talk) 09:00, 18 July 2013 (UTC)

In their study Characterization and evolution of dermal filaments from patients with Morgellons disease Stricker and MIddelveen have done precisely that: they used various analytical techniques including electron microscopy to analyze the fibers, and they found the fibers are made of human keratin and collagen, produced by a type of cell in the skin called a fibroblast cell. Keratin is of course the main structural component of hair, nails and skin. Stricker, MIddelveen, et al think the infection of the skin may have made these fibroblast cells go awry, and produce much more keratin and collagen than they would normally. It is not unusual for infections to alter body physiology and metabolism.

My guess is that the number of Morgellons patients in these studies is limited because of cost considerations (they seem to have a small budget), and perhaps because true Morgellons is very rare. Because of the Internet phenomenon of Morgellons, perhaps most people who think they have Morgellons do not. I believe the CDC study used self-selected Morgellons patients, which may not be the most accurate way of defining your study cohort. Certainly Stricker, MIddelveen, et al should try to get larger cohorts in their studies. Drgao (talk) 11:11, 18 July 2013 (UTC)

This study is not from a reputable source and does not merit inclusion in the article. This has already been determined in mediation. Please advise now if you are going to continue to disregard what you agreed to in the mediation process. 198.199.134.100 (talk) 02:47, 19 July 2013 (UTC)

Please advise if you are actually going to read the talk page discussions you contribute to before asking such questions. Drgao (talk) 10:47, 19 July 2013 (UTC)

What empirical evidence supports the viewpoint that Morgellons is a delusional infestation?

Following the decision in the dispute resolution discussion (click on "show" on that page to view the discussion), which determined that that most of the studies which support the pro-real physical disease viewpoint of Morgellons cannot be cited in this article due to what was considered as insufficient quality (a decision which I had agreed to abide by, and which I will abide by), I would now like to focus attention on the quality of the pro-delusional infestation viewpoint studies (which I list below), to consider whether the scientific rigor of these studies is sufficient to merit inclusion and citation in this article.

Many of these studies I cannot read, as I do not have institutional access to them, so I would like to ask the help of people here who do have institutional access to read these studies to perhaps copy and paste the relevant paragraphs in these studies which detail the empirically derived evidence that the studies provide to support the delusional infestation hypothesis of Morgellons.

By empirically derived evidence, I of course mean data which has been obtained from experiment, testing and observation.

The finding of no infectious microbes in Morgellons patients is not considered empirical evidence of delusional infestation, since Morgellons could quite conceivably be a real physical disease (with skin lesions and fibers), yet one which is not caused by any microbe or parasite. That is to say, Morgellons may be a real physical disease whose cause is not related to microbes (the cause of the Morgellons skin symptom might be genetic or toxicological, for example). Thus to repeat: finding no microbes in Morgellons patients does not provide any evidence that Morgellons is not a real physical disease.

I am also interested in the inclusion criteria the pro-delusional infestation viewpoint studies used to define their study patient cohort. Given that Morgellons is also an Internet phenomenon, it is very likely that many patients who self diagnose with Morgellons may not actually have true Morgellons. Therefore, it would be extremely important for any researchers to use strict and rigorous inclusion criteria for the patients they select in a Morgellons study — inclusion criteria that were based on the actual skin symptoms (lesions, fibers, etc), and not merely on patient self diagnosis. Self diagnosis of Morgellons can in no way be considered a reliable method of selecting Morgellons patients for study, given the Internet phenomenon side of Morgellons. Thus any study which used self diagnosis of Morgellons as their official inclusion criteria cannot be considered a reliable study.

What I want to achieve here is a vetting of the pro-delusional infestation viewpoint studies, to find which of these studies are built on solid scientific evidence, and which are unreliable, and unfit for citing and inclusion in the Morgellons article.

Just to repeat: I am fully compiling with the dispute resolution decision given by TransporterMan, and I will abide by this decision. Specifically, I will not bring up the subject of the pro-real disease viewpoint of Morgellons studies that TransporterMan has decided cannot be used in the article (until of course such time as new studies are published in the future, as per the agreement).

What I want to do here is examine the suitability of the pro-delusional infestation viewpoint studies for inclusion in this article, and weed out any such studies that are insufficient in quality, or insufficient in scientific rigor. Drgao (talk) 14:49, 22 July 2013 (UTC)

PRO-DELUSIONAL INFESTATION VIEWPOINT STUDIES: Published studies supporting the view that Morgellons is delusional parasitosis, and not a genuine skin disease:

Review studies (secondary source):

• Morgellons in dermatology (2010) MEDLINE
• Delusional infestation (2009) MEDLINE
• Delusional disorders in dermatology: a brief review (2008) MEDLINE

Primary studies:

• Delusions of parasitosis (2013)
• Morgellons syndrome: a disease transmitted via the media (2013) MEDLINE
• New findings in delusions of parasitosis (2012) MEDLINE
• Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic (2012) MEDLINE
• Delusional infestation: clinical presentation in 147 patients seen at Mayo Clinic (2012) MEDLINE
• Delusional infestation with unusual pathogens: a report of three cases (2011) MEDLINE
• Morgellons disease and delusions of parasitosis (2011) MEDLINE
• Psychosis, ivermectin toxicity, and "Morgellons disease" (2011) MEDLINE
• An oral ulceration associated with Morgellons disease: a case report (2011) MEDLINE
• Morgellons disease, or antipsychotic-responsive delusional parasitosis, in an HIV patient: beliefs in the age of the Internet (2010) MEDLINE
• Successful treatment of Morgellons disease with pimozide therapy (2010) MEDLINE
• Intraoral Morgellons disease or delusional parasitosis: a first case report (2010) MEDLINE
• Delusional parasitosis and the matchbox sign revisited: the international perspective (2010) MEDLINE Full paper
• Delusional parasitosis facilitated by web-based dissemination (2008) MEDLINE
• Morgellons disease and the 'tweezer sign' (2008) MEDLINE Full paper

We ignore all the primary sources. You provided three relatively up-to-date MEDLINE-indexed review articles that support article content along the lines that Morgellons is a form of DI. We do not have to go any further. As the WP:MEDRS guideline states, we as article editors do not do the review of the primary sources ourselves, we rely on the reliable secondary sources to do that and we just summarize what the secondary sources say. Once that is done, the work is complete and the discussion is over. Zad68 15:02, 22 July 2013 (UTC)

Agreed, the proposal to use the primary sources to judge the secondary sources is WP:OR, and not the role of editors. We summarize what the high quality secondary sources say, not try to debunk them when we don't like their conclusions. Yobol (talk) 15:08, 22 July 2013 (UTC)

Both Yobol and Zad are correct here. Dbrodbeck (talk) 15:20, 22 July 2013 (UTC)

What you are saying is not correct, as the dispute resolution process itself demonstrated: the publication The mystery of Morgellons disease: infection or delusion? (Savely, et al, 2006) is a secondary review article (as you can clearly see here), yet TransporterMan determined that, to quote: "the Savely 2006 article is reliable as, and only as, an opinion piece, and generally only reliable as support for what statements attributed to its authors." Thus even though Savely 2006 is a secondary source, because Savely 2006 was based on opinion rather than empirical evidence, TransporterMan determined that Savely 2006 could not be used in the Morgellons article to present its viewpoint as a fact.

So it is clear from TransporterMan's logic and conclusion that editors must determine whether a secondary source is based on opinion or on empirical evidence, and only if the latter can the secondary sources be used in the article to present their viewpoint as fact.

Thus what I want to do is to determine whether the three pro-delusional infestation secondary sources are also based on opinion, or whether they are based on empirical evidence. If they are only based on opinion, then by the same criterion used by TransporterMan, these three secondary sources should also be prohibited from being used in the Morgellons article to present the delusional infestation as fact.

Secondary sources get their empirical evidence from primary studies; therefore, if the primary studies which underpin the three pro-delusional infestation secondary sources are not themselves based on solid science and empirical evidence, it means the three secondary sources are just opinion pieces, like Savely 2006.

The same rules must apply to both sides of this discussion. So if Savely 2006 is considered an opinion piece due to lack of empirical evidence, and prohibited in the article from supporting the pro-real physical disease viewpoint, then equally, if the three pro-delusional infestation secondary sources also turn out to be opinion pieces due to lack of empirical evidence, they must also be similarly prohibited. Drgao (talk) 15:58, 22 July 2013 (UTC)

Again, we should be summarizing the conclusions of high quality secondary sources, rather than second guessing them. Savely is not a high quality secondary source, as it is out of date (per WP:MEDDATE), and is not an independent source as required by WP:MEDRS. Do you have any objections to the high quality secondary sources based on policy and guidelines? Yobol (talk) 16:02, 22 July 2013 (UTC)

I am abiding by TransporterMan's logic and conclusions, which involved scrutinizing a secondary source (Savely 2006), determining that the conclusions of that source were opinion, not fact, and then and on this basis, limiting that source's usage in the article. TransporterMan has demonstrated that secondary sources cannot just be taken on face value, but must be scrutinized for their factual basis. If TransporterMan's logic is correct and to be abided by, then the same scrutiny must apply to the three pro-delusional infestation secondary sources. And if the conclusions of these three sources are shown to be opinion rather than empirically derived, then presumably their use in the article must be similarly limited.

So I am asking people here with institutional access to these articles to kindly quote the empirical evidence that the three pro-delusional infestation secondary sources rely on to demonstrate and prove that Morgellons is a delusional infestation. The scrutiny I want to engage in is no different to the secondary source scrutiny undertaken by TransporterMan. If the three pro-delusional infestation secondary sources are based on empirical evidence, then you have nothing to worry about. Drgao (talk) 17:13, 22 July 2013 (UTC)

So, you have no policy or guideline based objections to the high quality secondary sources, then? Yobol (talk) 17:18, 22 July 2013 (UTC)

I most certainly do: I want to see evidence that these secondary sources are empirically based rather than opinion. Please stop wasting time, and show me the evidence that the three pro-delusional infestation secondary sources are not opinion pieces. If you can show me the evidence of an empirical basis to the conclusions of these three publications, I will accept that these sources are legitimate. It seems to me that you have no such evidence, otherwise you would show me it, and that would settle this. Drgao (talk) 17:36, 22 July 2013 (UTC)

Please cite the relevant policy or guideline justifying your decision to evaluate the secondary sources based on available primary sources. Yobol (talk) 17:43, 22 July 2013 (UTC)

Don't be tedious, I already explained quite clearly that I am using precisely the same logic as TransporterMan. Since I am abiding by this logic, I presume its procedure and basis is correct.

Furthermore, this is a medical science article. And you need to heed this. Science is not like faith: statements of science must be supported by empirical evidence. If there is no empirical evidence, then the statement is only considered a hypothesis or conjecture.

So I am asking you for the empirical evidence that underpins the statement that Morgellons is a delusional infestation. This is a very simple request, and a very reasonable one in any discussion on scientific subjects, such as this medical science article. Nothing is hidden in science: if I ask for the empirical evidence that underpins a scientific statement, you should be able to refer me to the paper in which the empirical evidence was published. I will not accept on faith that there is empirical evidence. I want to see the empirical evidence.

Am I to assume that you do not have the requisite empirical evidence, and therefore these delusional infestation statements on Morgellons must be considered hypothesis and opinion rather than fact? Stop dodging the issue, and please comply with my requests for the underpinning empirical evidence, or else we will be forced to conclude that these secondary sources just express hypothesis and opinion. Drgao (talk) 18:30, 22 July 2013 (UTC)

As you are unable or unwilling to provide any policy or guideline justification for this little digression, I see no need for further discussion. We discuss things base on policy and guidelines, not what on an individual editor's interpretation of another editor's "logic". This appears to be one big WP:SOAPBOX/WP:NOTFORUM violation, and would urge other editors not to respond until Drgao is able to provide cogent justification under Wikipedia guidelines and policies to continue this discussion. Yobol (talk) 18:34, 22 July 2013 (UTC)

Agree that without a complaint based in policy or guideline this discussion is unproductive. Zad68 18:41, 22 July 2013 (UTC)

Then are you saying that TransporterMan's determination regarding Savely 2006 was not based on policy or guideline, and is therefore not correct, and thus to be ignored? You cannot have in both ways. If TransporterMan's approach was correct, then so is mine. Drgao (talk) 18:46, 22 July 2013 (UTC)

If you want to discuss TransporterMan's determination, you should take it up with him. Yobol (talk) 18:49, 22 July 2013 (UTC)

What I am saying is also completely based on WP:MEDRS guidelines, which state that only reliable sources are to be used. No scientific source is reliable if it cannot back up its statements with empirical evidence. This is such a fundamental requirement of science, that I should not even need to mention it. Provide the empirical evidence, or accept that your sources are not reliable. Drgao (talk) 18:57, 22 July 2013 (UTC)

If you have concerns that any particular source in the article isn't a reliable source for the content it's supporting, you can raise the question at WP:RSN. Be sure to notify WP:MEDICINE. Zad68 19:01, 22 July 2013 (UTC)

• I get the impression that you think we're here to do science; on the contrary, we are here to write an encyclopedia based on reliable sources (based on policies we've already discussed). -- Scray (talk) 19:18, 22 July 2013 (UTC)
• As do I, this discussion is pointless without a policy based reason for it, and there is not one, we ought to move on. Dbrodbeck (talk) 21:47, 22 July 2013 (UTC)

Scray, I don't think you would want to cite pseudoscientific literature in this article, even if it did support the viewpoint you favor. In fact, any publication that uses pseudoscientific methods is not appropriate for citing in a Wikipedia article on medical science, and that is why is it important to check the scientific validity of a study. That is the objective of this section: to have someone with full access to these pro-delusional infestation studies to kindly copy and paste the text that demonstrates whether or not these studies are based on empirical evidence. That is, to determine whether these studies follow or flout the scientific method.

You guys seem to want to derail my first objective here, rather than be helpful regarding this objective. Can I ask: who here has full access to these studies? And who would be willing to assist?

If we find that the study conclusions are not based on empirical evidence, then we can discuss what stance to take regarding how these studies can be used in the article.

So calling all editors with full access to the studies listed above in this section: please help determine whether these study conclusions are based on empirical evidence or not.

Drgao (talk) 22:06, 22 July 2013 (UTC)

You've missed the whole point of using reliable sources. We as anonymous editors (who can claim any amount of experience we wish) should not be in the position of reviewing primary studies. That's a job for experts with proven credentials; it's "peer-review", not "random person on the internet who claims they know a lot about the topic-review", "bloke I met in the pub-review", "my father always said-review", etc. 198.199.134.100 (talk) 02:28, 23 July 2013 (UTC)

Perhaps you can clarify the foundations of your criticisms. Towards the beginning of your comment here you said: "The finding of no infectious microbes in Morgellons patients is not considered empirical evidence of delusional infestation, since Morgellons could quite conceivably be a real physical disease (with skin lesions and fibers), yet one which is not caused by any microbe or parasite". Just to help us understand what you are getting at, and the connection between this statement and your request for someone to perform a literature review, what exactly would you consider to be empirical evidence of delusional infestation?137.111.13.200 (talk) 06:14, 23 July 2013 (UTC)

I agree with Drgao about Transporterman's approach. I believe Scray, Dbrodbeck, and zad68 along with these anonymous identities are sock-puppets of the same psychologist who has a personal stake in avoiding the reality of this discussion. If your income depends upon one conclusion over another then please stay out of the discussion and stop utilizing sock-puppets. I think this calls for a dispute resolution with the elimination of the sock-puppets from the dispute72.253.225.48 (talk) 10:31, 23 July 2013 (UTC)

Does that also apply to the anonymous identities and presumed sockpuppets arguing for Drgao's point of view, too? TechBear | Talk | Contributions 11:51, 23 July 2013 (UTC)

Hey, 72, if you have evidence of sockpuppetry, open an SPI, short of that, zip it, that is a personal attack. Dbrodbeck (talk) 11:59, 23 July 2013 (UTC)

TO: 137.111.13.200. Your question of what would constitute empirical evidence of delusional infestation is a good one, but providing an answer is not so easy, in that it generally takes considerable expertise and much thinking to devise a scientific experiment or observational approach that can yield solid evidence to either confirm or refute a given hypothesis. Though of course all scientific statements of fact must be founded in such empirical evidence, and if a statement is not backed up by empirical evidence, it is not a scientific statement.

However, I will try to answer your question, and suggest that the following type of scientific experiment could determine whether Morgellons is a delusional infestation, or whether it is a real physical skin disease. Given that undoubtedly the most unique symptom of Morgellons is the growth of fibers both under the skin and protruding out of the skin, in order to determine whether such fibers are genuine and endogenously produced in the body, or just clothing fibers or similar extraneous material that have worked their way into the skin, one could set up an experiment in which say one arm of a Morgellons patient were permanently covered in a lint-free material for several weeks or months, such that no extraneous material or clothing fibers could get to the skin. You could even use a plaster cast type covering of the arm, if you wanted to be very rigorous. Then, when this material covering was removed from the arm after several weeks or months, if completely new lesions or areas appeared on skin of the covered arm manifesting subcutaneous fibers, this would prove that Morgellons was a real physical disease. However, if no new lesions or skin areas with subcutaneous fibers appeared on the covered arm, but they did appear on all other parts of the body, this would tend to indicate that the lesions were probably self-inflicted, and that and the fibers were extraneous material or clothing fibers.

But it is not my job to speculate upon or devise scientific experiments that could be used to prove or disprove the delusional infestation view. However, it is my function as an editor here to ensure that scientific statements made in studies are backed up by appropriate empirical evidence, otherwise the quality and validity of those studies will be called into question. If a study makes a bold statement that the fibers are clothing fibers or similar extraneous material, and the lesions are self-inflicted, then I want to see what empirical evidence that statement is based on. If there is no empirical evidence, then the statement is not scientific, and does not belong in a medical science article in Wikipedia. Drgao (talk) 20:20, 23 July 2013 (UTC)

It's also not our job to judge the empirical evidence found by the primary sources when there are existing reliable secondary sources that do so. If those studies are later retracted (such as with Wakefield's vaccine study) or contested by new findings from sources that meet Wikipedia's guidelines, then we can edit the article to reflect that at that time. Once again, Wikipedia is not interested in a "random person on the internet-review" of studies when reliable, reputable seconday sources exist. Our evaluation of the empirical evidence is not useful for this article. 198.199.134.100 (talk) 23:13, 23 July 2013 (UTC)

The vast majority of studies I've read don't say that the lesions are self-inflicted, they say the most likely explanation is that the lesions are self-inflicted, if they say anything at all about the cause of the lesions rather than just suggest that the condition be treated as if it were DP. The consensus isn't driven by people who say it is DP and then evaluate the data accordingly, it is derived by looking for causes and not finding any. That leads to the suggestion that it is likely a form of DP, and that treatment for DP should be considered. This is why they don't say it IS DP, they say it seems likely that it is, for exactly the reasons that you have stated earlier (limited capacity to detect some physical causes). However, in lieu of any reliable evidence for an alternative explanation, the consensus is stated without requiring every fringe theory to clog up the page and possibly misinform readers who may act on bad information and self-medicate to their detriment.137.111.13.200 (talk) 00:12, 24 July 2013 (UTC)

"If your income depends upon one conclusion over another then please stay out of the discussion and stop utilizing sock-puppets". What's a sock-puppet?137.111.13.200 (talk) 00:19, 24 July 2013 (UTC)

TO: 137.111.13.200. Well, it is a very different thing to offer the opinion that Morgellons is likely a from of delusional infestation, compared to blankly stating that Morgellons is definitely and definitively delusional infestation. If you read the Wikipedia article, it blankly (and erroneously) says that Morgellons is delusional infestation, period. So this Wikipedia article goes beyond what the pro-delusional infestation secondary sources say.

The intro sentence to the Wikipedia article says: "Morgellons ... is ... a condition ... where sufferers have the delusional belief that they are infested with parasites, whereas in reality no such parasites are present." That is, the article is stating Morgellons is definitely delusional infestation, rather than following the sources, which say that Morgellons is likely delusional infestation, or might be best treated as delusional infestation until a better explanation comes along.

Indeed, the one pro-delusional infestation secondary source that is free to read: Delusional Infestation (Freudenmann and Lepping, 2009) says that: "the self-described symptoms of Morgellons patients meet our minimal criteria of DI detailed above and are 'very similar, if not identical, to those of delusions of parasitosis'. Therefore, the practical conclusion for the medical community must be to treat Morgellons as DI as long as there is no better explanation."

So the Morgellons article should reflect this: it should say that the experts have concluded to Morgellons is likely delusional infestation, and suggested it should be treated as DI as long as there is no better explanation. There is a big difference in saying that, and erroneously saying that Morgellons is delusional infestation, period. Drgao (talk) 01:32, 24 July 2013 (UTC)

Ah, the myth that every statement which doesn't explicitly include a denial of a position of absolute certainty is therefore a statement of absolute certainty. Usually, that rears its head in discussions of religion and spirituality. In scientific/medical issues, it's understood that there's no such thing as absolute certainty and that its not necessary to qualify every single statement with "probably", "most likely", or similar language. When a doctor tells you, "you have the flu", they really mean, "based upon your observed symptoms and my medical experience, my evaluation is that you most likely have the flu". Your doctor could be wrong, but they probably aren't, and treating your symptoms as though they were the flu is the best course of action until it appears to not be working. 198.199.134.100 (talk) 03:33, 24 July 2013 (UTC)

TO: 198.199.134.100. The comments you make are so far off the mark, it makes me wonder why you engage in these debates. It is in fact very important in science to quality the level of certainly of your statements. That is why studies generally precisely specify the degree of certainly/uncertainty of their findings by means of p-values. I take it you know what a p-value is?

There are many statements in science whose truth is probable, but not certain. It is never acceptable to present something as certain when it is only known to be probable. You may have shoddy standards of accuracy yourself, but those standards are not appropriate for Wikipedia. Drgao (talk) 14:55, 24 July 2013 (UTC)

This isn't a debate. This is you not understanding Wikipedia's policies and us trying to explain them to you. No statement in science is ever a statement of absolute certainty and this is your last warning for personal attacks. 69.23.116.182 (talk) 15:01, 24 July 2013 (UTC)

Firstly: it is not a personal attack if I my remarks refer to the comments made. It is only a personal attack if my remarks attack the person. Hence the name "personal attack".

Secondly, the comment you made is also garbage. As I tried to explain, science uses p-values to precisely express the level of certainly. Even in studies where no p-values are given, researchers often use words like "possible", "probable" and "almost certain" to indicate how sure they are about their supposition.

And in complete contrast to what you said, many statements in science are completely certain, beyond any reasonable doubt. For example, it is completely certain that poliovirus is the cause of poliomyelitis. But for example, as to whether Epstein-Barr virus is a cause of multiple sclerosis, well, some researchers would say that this is possible, others would say that this is probable, but it would be wrong to say that multiple sclerosis is definitely caused by Epstein-Barr virus, because we do not know this for certain. In science, something which is only probable should never be presented as being a total certainty. Drgao (talk) 15:35, 24 July 2013 (UTC)

Can I ask again for people not to derail the thrust of the discussion in this section, which is about what empirical evidence there is for the delusional infestation theory of Morgellons. I would be grateful if those with access to the pro-delusional infestation secondary source studies could copy and paste the relevant text related to the empirical evidence for delusional infestation, or any text in which the study authors express their opinion as to the likelihood that Morgellons is an example of delusional infestation. Drgao (talk) 15:49, 24 July 2013 (UTC)

If anyone does have access to the full text of these two secondary studies: Morgellons in dermatology (2010) and Delusional disorders in dermatology: a brief review (2008), and would be willing to email them to me, I would be most grateful. You can send a text only email to me via this page. Drgao (talk) 18:47, 24 July 2013 (UTC)

A discussion about Wikipedia editors reviewing the empirical evidence is inappropriate for this page, because there are reliable, reputable seconday sources that have reviewed the findings of the primary studies. This has been repeatedly explained to you, to no avail. The next step is to seek sanctions for disruptive editing. 198.199.134.100 (talk) 23:10, 24 July 2013 (UTC)

At this stage, I simply want to know what the empirical evidence is, and I want know what the authors have stated in those pro-delusional infestation secondary studies regarding their opinion on the likelihood that Morgellons is a delusional infestation. I also want to know if the authors of those studies are just offering an expert opinion that Morgellons is a delusional infestation, or whether they have based their opinion on rigorous tests or experiments that were performed on Morgellons patients. Finally, once I have this information, I want to make sure that this Wikipedia article on Morgellons accurately reflects what is stated these pro-delusional infestation secondary studies. So if anyone has institutional access to these two studies cited just above, please could you kindly make the details available. Many thanks. Drgao (talk) 00:30, 25 July 2013 (UTC)

From my reading of the literature there aren't pro-delusional infestation studies or reviews, there are just studies and reviews that express their findings and conclusions. I don't know why you insist on framing this as an Us vs Them dynamic. You've already said that the only empirical evidence you would accept of DI being the cause of Morgellons is a study inhibiting patients from being able to inflict or worsen lesions. Is this what you are waiting for?06:52, 25 July 2013 (UTC) — Preceding unsigned comment added by 137.111.13.200 (talk)

TO: 137.111.13.200. These studies conclude that delusional infestation is the most likely cause of Morgellons, so I refer to them as "pro-delusional infestation studies". I am not deliberately creating an us vs them context; I just use the phrase "pro-delusional infestation studies" as a shorthand to refer to these studies. I can change my shorthand to something else if you prefer.

I did not actually say that the only empirical evidence I would accept for delusional infestation is a study inhibiting patients from being able to inflict or worsen their skin lesions. I just gave that as an example of what a good study methodology might be. Another interesting study would be to give Morgellons patients antipsychotic, as per the regular treatment for delusional infestation, and noting whether this cured them of their belief that they have skin symptoms, and their belief they have fibers under their skin, or whether they persisted with those beliefs even after being given antipsychotics. I read about the results of one antipsychotic study like this on Morgellons patients, but its findings regarding the efficacy of antipsychotics for Morgellons were weak, suggesting that antipsychotics did not in fact help much. I forget now what that antipsychotic study was (I read it a while ago), so unfortunately I cannot provide a reference. Drgao (talk) 15:21, 25 July 2013 (UTC)

Successful treatment of Morgellons disease with pimozide therapy. Psychosis, Ivermectin Toxicity, and “Morgellons Disease” Pimozide at Least as Safe and Perhaps More Effective Than Olanzapine for Treatment of Morgellons Disease Morgellons disease, or antipsychotic-responsive delusional parasitosis, in an HIV patient: Beliefs in the age of the internet To name a few.137.111.13.200 (talk) 01:05, 26 July 2013 (UTC)

Yes, I have seen those studies — though thanks for citing them. But unfortunately I do not have access to read them, so just what they meant by "success" I am not sure. I believe I read that efficacy of antipsychotics for Morgellons was limited in another study that talked about the studies you cited.

It's also interesting that many antipsychotics are also very potent antihistamines, and so conceivably may well be reducing a real physical itch that Morgellons patients have in their skin (perhaps due to these purported keratin and collagen fibers growing subcutaneously). In other words, if these antipsychotics did help some Morgellons patients, it may possibly be due to their antihistamine action, which reduces skin itching, rather than their ability to reduce hallucinations. So, as is often the case in science, the answers are nuanced. Indeed, in Delusional Infestation, Freudenmann and Lepping, 2009 they talk about the fact that it is almost impossible to distinguish between what they call illusions [sensations arising from within the skin] and hallucinations [which arise purely in the mind]. To quote Freudenmann and Lepping: "This makes the distinction between illusions and hallucinations almost impossible".

137.111.13.200, I have to say I have enjoyed working with you. I get the sense that you are generally ready to consider and rationally discuss the finer details of scientific papers, for the purpose on making a better and more accurate article, and I do appreciate that. It is a pity that I likely will be banned soon, before these discussions have borne fruit.

I always thought Wikipedia would be an intellectually stimulating place, rather than a place where people just fight each other for authority. Drgao (talk) 13:13, 27 July 2013 (UTC)

Ah, the irony. Most of the editors that have been involved here have discussed the quality of your references. You are the only one fighting for authority. TechBear | Talk | Contributions 13:35, 27 July 2013 (UTC)

I think a happy ending to this dispute could have easily been achieved. I think another group of editors may well have come to a different conclusion that you guys. Instead of you working so hard to ban outright the use of those studies I brought to the discussion, a different set of editors may well have taken a different view, and decided to include a small section in the article detailing those infectious etiology studies, and simply mentioned in that section that the quantity of the journals was not considered the highest, and moreover, that the infectious etiology study sizes were very low (just four patients). Sadly for me, the Morgellons article now contains even less (I think none at all) information on a possible infectious etiology, so my efforts have been not only in vain, but have in fact worsened the situation.

Unfortunately, Morgellons is not the only article in which I have encountered adversarial resistance against the inclusion of a small amount of information regarding an infectious etiologies: I encountered exactly the same adversarial stances from the majority of editors on the chronic fatigue syndrome article. Only a minority on the CFS article support the inclusion of the infectious etiology angle. I guess this previous bad experience of struggling just to get a few lines on the infectious etiologies has made me a bit short-tempered; a fault of my behavior I know, but I can't help feeling this way when the changes I propose to article are so modest, and as I mentioned, I am sure other editors may well have decided their quality was sufficient.

As a completely separate issue (and please note that I am not being contentious here, so please be thoughtful in any response): I do think that people on Wikipedia should look into the situation regarding the need for, to quote you guys "experienced editors," to decide whether a source is reliable or not. You apparently have to read and ingest all the various policies and guidelines, and then through some mysterious process of information assimilation, you become an adept in deciding on source reliability, and you then claim to have powers of decision over and above us lesser mortals (ie, less experienced editors). Of course, in any area, experience is always important, and generally helps you make wise and appropriate decisions. But I am sure that you see where potential problems come in when, you experienced editors just say to less experienced editors that your inscrutable higher powers of judgement are superior. Areas of human culture such as science and law are so beneficial and successful because they are transparent and rational. All facts and decisions in these areas are plain for all to see. This prevents disputes, because in science and law, the processes of proof are open for all to understand and view.

I am sure you can see the problem — and even the potential for abuse — when experienced editors say that only they can decide on source reliability, as only they have the right understanding. For a relatively inexperienced editor (and not just me, I am talking in general), it is important to see the explicit logic behind decisions made by experienced editors. That way there can never be any abuse and corruption by "experienced editors". I am not suggesting that you guys are abusing your experienced status, so don't misinterpret me here. But you can see that without an explicit set of rules determining source reliability, the potential for abuse is there. Without an explicit see of rules, how can I know that you are not abusing your status? Anyway, given all the adversarial nature of all our prior discussions, I doubt that even on this issue, we won't have any agreement or harmony. Drgao (talk) 15:54, 27 July 2013 (UTC)

That's a bit off topic for this talk page and really belongs at the Village Pump WP:VP or the WP:TEAHOUSE, but briefly, yes, our policies and guidelines may seem baffling to to unitiatiated, and do require some study and experience to assimilate, but that is to be expected for a project of this size and complexity. However, once you read them and understand them, they become second nature. They have an internal logic and funtion extremely well as a coherent whole. They're as explicit as you are going to get considering the nature of the beast.

Yes, newbies are often confused, but that's the same for anything, from card games to rocket science. Your mention of science and law is baffling, because the rules of operation in both fields take long years of hard study to master, and are very far from intuitive. Both are completely inscrutable to the uninitiated. Whenever I have to explain simple concepts in nature conservation, for example, to the general public, I have to dumb it down a lot. I have to dumb it down with undergrad students, too, and even with grad students.

Like with any other thing, newbies do simply have to trust the old hands a lot, and rely on their experience. There are two ways of verifying their reliability: when many of them agree on the same thing, and when what they say is consistent with what the policies and guidelines say. It's not foolproof, that's true, but when you have more than a dozen experienced editors unaimously disagreeing with you, and only a couple of newbie SPA's agreeing with you, it's a sure sign that you got something majorly wrong. If you're not willing to trust the experience of your fellow editors, it's unlikely that you will ever learn and be able to work collaboratively with other editors. Dominus Vobisdu (talk) 16:36, 27 July 2013 (UTC)

Related RSN discussion

Drgao has started a discussion at WP:RSN asking whether several of the same sources that we discussed in our WP:DRN discussion are reliable sources. Editors here may be interested in following or contributing to that discussion, which may be found here. Zad68 18:03, 25 July 2013 (UTC)

Are there any behavioral guidelines for Wikipedia editors which discourage stalking other editors? Why should you want to get all the editors here to stalk on my Wikipedia activity, activity which is my business, not yours, and has nothing to do with this article? Are you not satisfied with completely thwarting all my efforts to include the infectious disease hypothesis for Morgellons in this article? Do you now have the intention of making a habit of thwarting my activity elsewhere? There must be some rules in Wikipedia that guard against stalking. Drgao (talk) 19:16, 25 July 2013 (UTC)

The idea that your forum shopping at a highly visible noticeboard is noticed by another editor who regular edits there is "stalking" is laughable. There are a number of behavioral guidelines you should be familiar with by now, specifically the one on tendentious editing. Yobol (talk) 19:28, 25 July 2013 (UTC)

I regularly monitor and sometimes respond to WP:RSN discussions. I was actually surprised and disappointed when this RSN discussion you started appeared there without any courtesy notification to your fellow editors here. Zad68 19:29, 25 July 2013 (UTC)

TO: Zad68. I did not want to inform my fellow editors here, because I have no intention of breaking the agreement that I entered into with the dispute resolution, and no doubt it would be construed as me doing just that. I also did not want to inform my fellow editors here, because had those studies been deemed acceptable by RSN, I may have included them in some other Wikipedia articles, and the last thing I want is you guys coming over there and giving me the same nightmare as I have experienced here. Those are the reasons, otherwise I would have been courteous.

TO: Yobol. You know very well that I am not being tendentious (refusing to get the point): regarding the inclusion of the pro-delusional infestation studies prohibited by the dispute mediation, I have dropped that entirely. The fact that I am pursuing other issues on the Morgellons page is perfectly acceptable and it is not tendentious. There are many things that I think are wrong in the Morgellons article, and pursing these one by one is not tendentious. Drgao (talk) 20:19, 25 July 2013 (UTC)

You've been advised by an administrator at WP:RSN that this behavior is indeed tendentious (and block-worthy) and refused to listen to them as well. If you wish to continue to edit articles here, then this discussion is over. 198.199.134.100 (talk) 00:41, 26 July 2013 (UTC)

If your intention was to use the sources on other pages, you perhaps confused people by asking this question at the RSN page- "I would like to know whether three studies from the peer-reviewed medical journal Clinical, Cosmetic And Investigational Dermatology published by Dove Medical Press can be used in the Wikipedia article on Morgellons disease."137.111.13.200 (talk) 01:15, 26 July 2013 (UTC)

As I explained on my talk page, I mentioned the Morgellons article because at the top of the RSN page it tells you to specify the article in which the source is being used, and you cannot just get an answer from RSN on the general reliability of a source. If you had yourselves assumed good faith, like you always preach to me, then you would not have assumed I was doing anything untoward at the RSN. But because you assumed the worse, you started accusing me of breaking my agreement with TransporterMan, which I did not. So don't forget about good faith. Drgao (talk) 04:50, 27 July 2013 (UTC)

TO: Dominus Vobisdu (The following is in answer to Dominus Vobisdu's comment here.)

The explanation of why I did not inform other editors of my RSN inquiry is given above in this section.

Yes, other editors have the perfect right to do turn up on the RSN page and make comments out of their own free will; but then don't blame me, as MastCell did, that I have become a major drain on the time of other editors. I did not ask for all these contributions and comments, so if you gave your time, that's your concern and your decision, not my fault. My business on the RSN page was my own, and I did not ask for your help; in fact your presence has not helped at all; quite the reverse: it only succeeded in getting my RSN inquiry abruptly closed.

And you are completely wrong about me not listening to other editors: the reverse is the truth: I desperately want to hear what other editors have to say, and I keep asking and asking them to explain where I can find objective rules for determining whether a source is reliable or not. But no matter how many times I ask, nobody explains it to me. You keep referring me to all sorts of policies like WP:MEDRS, etc, but there is nothing explicitly mentioned there about how to objectively judge the reliability source, just some general guidelines, nothing precise. No matter how many times I ask this question, I still do not get answers. Just vague referrals to WP:MEDRS etc, which does not give the precise answers I need. I would love for someone to explain it, but nobody does. So I am listening, but you are not giving me the info.

I tried to get a better understanding of the process of judging the reliability source by opening the inquiry on the RSN page, but instead of helping me out, the inquiry was abruptly closed, in part I think because of all your unsupporting comments. So please do not say I am not listening; I am listening and I am asking questions, but nobody gives me precise answers.

It is pointless to keep referring me to WP:MEDRS etc, which I have read but it did not answer my question. I can only assume that you do not know the answer, and that is why you cannot tell me. Drgao (talk) 02:31, 26 July 2013 (UTC)

WP:CONSENSUS is the answer. You're asking the wrong question. 198.199.134.100 (talk) 02:43, 26 July 2013 (UTC)

Do others here agree with 198.199.134.100 that source reliability is merely the determined by group opinion, by consensus? And if so, can you point me to the Wikipedia policy text which says that source reliability is determined by consensus? Or is 198.199.134.100 wrong here? Drgao (talk) 02:56, 26 July 2013 (UTC)

This discussion is doing nothing to improve the quality of the information on the page. If you have specific questions about specific sources that you have not yet asked then ask them. This talk page isn't meant to be devoted to dead horses.137.111.13.200 (talk) 03:20, 26 July 2013 (UTC)

Yes, WP:CONSENSUS is a big part of it, but the real answer is that all of the content policies and guidelines I generously provided you with are, as I said, part of an organic whole. They are not meant to be cherrypicked and quoted chapter and verse style like you think, as the chapters and verses only make sense in terms of the whole. If you don't grasp the whole first, you're not going to understand the chapters and verses.

Also, when you request help at RSN, you request help from ALL of the other editors on WP, including myself and the other editors that have been posting on this talk page and the DRN. Consensus is determined by the whole community, not just by the part you like. Whyever did you think that you had the right to participate in a discussion here on WP and certain other editors didn't. This was particularly disturbing, and showed without a doubt that you were totally clueless about how WP works. It's a collaborative project, and you have to work together with your fellow editors here in accordance with the behavioral policies and guidelines which I likewise generously provided you with. You don't have your own "business" here on WP. Your business is everyone else's business, too. Like I said, there's nothing private here on WP. If working collaboratively with people you disagree with is not your cup of tea, then I strongly suggest you find another hobby.

As 198.199.134.100 said, you were, and still are, asking the wrong questions. And you were asking in the wrong way. You would have known that if you took the time to read the policies and guidelines I listed and understand them as an organic whole. As a WP editor, it is your responsibility to know them and act according to them.

And no, you haven't been listening. Again, your questions have been answered time and time again, including in painstaking detail by me. You just couldn't understand the answers because you haven't taken the time to read the policies and guidelines. Take a break for a week or two and bone up on them until you understand them as an organic whole, and then you will be able to understand all the answers you have received.

I have worked in the past with several of the editors involved before, like Zad68, Dbrodbeck, Yobol, Arthur Rubin and MastCell, and all of them are experienced and capable WP editors in good standing. When you have this many experienced editors disagreeing with you, take that as a sign that you got something wrong and listen to what they have to say. On WP, your best helpers are experienced editors like them.

Also, your RSN was closed, and rightly so, before I even arrived on the scene, by AndyTheGrump, another experienced editor. He did you a favor by closing it before you dug yourself in deeper and got blocked. MastCell did you a favor as well by not blocking your sweet little tush for still being disruptive. I did you a favor, and so did all of the editors you have been fighting with. When you read the policies and guidelines and understand them, you'll see how well you have been treated. Most disruptive editors in your position would have been blocked long ago. Dominus Vobisdu (talk) 03:34, 26 July 2013 (UTC)

Why the hostility DV? Why are you opposed to a dialogue with Drgao? Where does the hostility arise? Simply because Drgao discusses an alternate point of view does not imply that Drgao is being disruptive at all. Is it commonplace among these experienced editors to address another editor with words like "your sweet little tush"? I find that condescending especially when newer editors and those with less experience are supposed to be welcome to voice their concerns on the talk page...that is if you are following Wikipedia policy. Drago has expressed his concerns with the content of the current article. According to Wikipedia policy, that is exactly where the talk page should be useful. Could you possibly be more constructive to the dialoge rather than condescending to editors who may or may not have less experience in Wikipedia editing than yourself? Sierraparis (talk) 18:17, 27 July 2013 (UTC)

QUOTE: "Again, your questions have been answered time and time again, including in painstaking detail by me". Bullshit. Your powers of explanation are the worst I have ever come across. You write tons, but say nothing. You obfuscate, but never explicate. Drgao (talk) 04:58, 27 July 2013 (UTC)

Prevailing group opinion does not mean that it is following the spirit of WP or WP policy. When legitimate concerns contrary to prevailing thought are raised by an editor, such as Drgao, why are so many of you on this page resistant to objective discussion? Drgao is trying to improve the Morgellons page by examining the content to see if it adheres to WP policy. Editors may have an opinion about a topic, but this is supposed to be put aside when editing to achieve a NPOV. Why not objectively look at WP policy and adhere to it throughout the article as Drgao suggests?Erythema (talk) 04:27, 26 July 2013 (UTC)

We've endeavored to explain to the both of you why these are not legitimate concerns and why you're not understanding WP policies, but neither of you listen. Most of what DV just said is a perfectly acceptable reply to what you just said. Your reply didn't advanced the discussion at all. The next step is opening ANI cases for the both of you. 198.199.134.100 (talk) 04:34, 26 July 2013 (UTC)

An objective discussion has taken place, involving third-party dispute resolution, and the material was deemed unfit to be presented here. WP policy clearly states that authors should declare possible conflicts of interest if they intend on inserting their material into pages. Are you Erythema willing to at least make a declaration that you are NOT an author or co-author of "Morgellons disease: a chemical and light microscopy study"? Of the 7 billion other people in the world that you could be, I wouldn't have thought it a significant blow to anonymity to make that declaration. To do so would be to adhere to WP policy.137.111.13.200 (talk) 07:13, 26 July 2013 (UTC)

137.111.13.200, you do come across as a little paranoid and suspicious. I wonder if the other editors here support your inquiries into people's identities. Drgao (talk) 04:54, 27 July 2013 (UTC)

Please copy and paste for us where in wiki policy does it suggest that it's okay for anyone to attempt to identify other Wikipedia editors? Or even more unethical, where do you get permission to make false identifications to suit your own agenda? I don't believe you have introduced us to your full name and affiliations (drum roll here and the faint sound of a didgeridoo). Would you be willing to fully deny that you are being paid to edit wiki? I believe that YOU are behaving against wiki policy in this instance. The way you are behaving toward Drgao is also against wiki policy. Drgao has brought up some very valid points and questions which might be useful in improving the article. Actually you have bullied Drgao rather than offer any useful dialogue. It seems you be your policy to bully anyone whose opinion may differ from that of your own but bully behavior is not endorsed by wiki policy. I cannot see anywhere where Erythema or Drgao have suggested adding anything to the article since the dispute resolution. If you read the comments of Drgao it is clear that he is questioning whether the current article is using resources that meet Wikipedia policies. In my opinion, an article from Popular Mechanics which interviews an "anonymous dermatologist" adds nothing to the article. If this meets wiki standards then why not use the National Inquirer? I don't think anyone has tried to add any other point of view because any point of view which differs from the group of editors group think is not possible with this group of editors. I believe secondary sources will soon be available but I seriously doubt this group of editors will allow the article to be updated then either. No, it's not Drgao nor Erythema causing the disruption here. Most likely it is the group of editors who work together to be sure that Morgellons is presented as delusions of PARASITOSIS. It is apparent that these editors have no experience with actual Morgellons patients. Most of the Morgellons patients I have spoken to have no idea what is causing their symptoms. How can these patients meet the criteria for delusional PARASITOSIS when they have never considered or mentioned parasites? I know we are not here to be reviewers of studies but I think it is fairly evident that the Wikipedia editors here other than Erythema and Drgao have an agenda and their viewpoints are far from being neutral. We shall see what happens when secondary sources become available. Hopefully then, the viewpoints that differ from your own will be considered so that an unbiased article on this topic can be presented. Sierraparis (talk) 21:19, 26 July 2013 (UTC)

Anyone who claims that knowing "Morgellons patients" is or should be a requirement for editing this article needs to be banned from editing or commenting on this article. It is so far from the five pillars as to be incompatible with editing. In addition, anyone who makes that claim and edits the article, even if unaware of the pillars, has, essentially, outed himself, so speculation as to the identity is relevant. — Arthur Rubin (talk) 21:36, 26 July 2013 (UTC)

Excuse me Mr. Rubin but when have I ever expressed intent to make edits on this article? I am stating that anyone expressing viewpoints that differ from those of your own are being bullied and attacked. The article on Morgellons expresses your viewpoint only and since you are very uneducated o this topic, it is wrong for the bully behavior to be allowed to continue. You and your group may continue to control Wikipedia but my role as a journalist is not to make edits to the article but rather to point out to the world exactly what is happening here. Mr 137 needs to reveal his identity if he continues to ask that of others. Wikipedia article itself should be deleted in it's entirety since it is impossible to engage in a constructive dialogue with any of you agenda driven editors. Don't worry yourself about me. I have gathered enough information on the way this article is being handled and it is far from what Wikipedia policy suggests. Sierraparis (talk) 23:16, 26 July 2013 (UTC)

My role is as an editor, not a 'journalist' or anything else. Go read WP:NPA and a whole bunch of other policies. Oh and if you have a problem with editor behaviour, take it to WP:ANI rather than making unfounded allegations here. Dbrodbeck (talk) 23:23, 26 July 2013 (UTC)

It's possible to argue that knowing Morgellons patients may make one ineligible to edit the article, per WP:COI. It is inconsistent with Wikipedia policies to assert that not knowing Morgellons patients might make one ineligible to edit the article, and it's reasonable to argue that anyone taking that position is ineligible to talk about the article. What you call "bullying" (preventing editors from adding material from non-WP:MEDRS sources to the article is encouraged by policy and guidelines. This is not a matter of "good faith", it's a matter of "competence". — Arthur Rubin (talk) 23:30, 26 July 2013 (UTC)

Having closely followed Wikipedia guidelines and havingI disclosed that I have spoken to several patients with this condition, I am not in violation of any Wikipedia policies. In fact, Wikipedia policy encourages me to discuss my concerns about the neutrality of this article on the talk page which is exactly what I have done. I have also found this on the WP:COI and I believe this may apply to some of the editors here. Copied and pasted for everyone's convenience from WP:COI. "When investigating COI editing, be careful not to reveal the identity of editors against their wishes. Wikipedia's policy against harassment takes precedence over this guideline." This information may be particularly useful for 137......

May I suggest please that for future clarity, when you are making accusations that other editors are in violation of policies, please copy and paste the specific violations rather than vaguely telling others over and over and over to go read the rules. I have read the rules and I do not find myself, Drgao or Erythema in violation of any of them. I believe that some editors here may be implying rules which they themselves may have misunderstood.Sierraparis (talk) 18:03, 27 July 2013 (UTC)

I don't think Drago or Erythema is in violation of policy; they merely misinterpret the reliability of sources. And the hostility is, in part, because they are making or suggesting the same edits as an editor who self-identified as Mary Leitao, and that one of them suggested that he/she is an author of one the references he/she wanted to add. You, on the other hand, in suggesting that knowing Morgollans patients should be a requirement for editing the article, are in clear violation of the pillars. Knowing Morgollans patients shouldn't disqualify you from editing the article; wanting the article to be helpful only to Morgollans patients should disqualify you. Please see WP:RIGHTGREATWRONGS. — Arthur Rubin (talk) 18:59, 27 July 2013 (UTC)

I believe you may have misunderstood me. I do not wish for the article to be helpful only to Morgellons patients. My concern is that the article should present a NPOV. Currently it does not. I do believe that a familiarity of the literature on the topic would be helpful in determining what does and does not meet the requirements for editing. I do not understand how an article in Popular Mechanics meets the requirements outlined by Wikipedia policy. Especially since the article interviews an anonymous dermatologist. Mr. Rubin, please note the spelling of the topic. I am not the best at spelling either and am simply offering a friendly suggestion. Sierraparis (talk) 20:26, 27 July 2013 (UTC)

Go read WP:NPOV it does not mean we treat everything equally. It just does not work that way. Dbrodbeck (talk) 20:34, 27 July 2013 (UTC)

Also, read WP:FRINGE. "Neutral" here on WP does not mean what you think it means. There is a strong bias toward established mainstream consensus, and against fringe and extreme minority views. The Popular Mechanics article is used to support the history of the phenomenon in the popular literature and internet. It is fine for that purpose. It isn't being used for medical information, and thus is not subject to the stricter rules of WP:MEDRS. Dominus Vobisdu (talk) 20:55, 27 July 2013 (UTC)

Since most Internet discussions on the topic of Morgellons revolve around the ongoing research and the presence of Borrela bergdorferi found within the lesions, then would it not be prudent then to include these discussions and their origins as they do represent predominate Internet discussions and essentially are part and parcel of the role of the Internet? Sierraparis (talk) 23:23, 27 July 2013 (UTC)

Can you cite a source that states that "most Internet discussions on the topic of Morgellons revolve around the ongoing research and the presence of Borrela bergdorferi found within the lesions"? AndyTheGrump (talk) 00:10, 28 July 2013 (UTC)

I've seen it on multiple Morgellons websites and blogs but is it a publication you seek as a citable source?Sierraparis (talk) 04:25, 29 July 2013 (UTC)

Off-topic diatribe - WP is not a soapbox
The following discussion has been closed. Please do not modify it.
Sierraparis- It is unethical to solicit "donations" from people who are most likely suffering from delusions, and then use the money to get your poorly designed and executed studies in vanity-journals, and then to write press releases specifically targeting editors on the Morgellons page because they aren't helping you promote yourself. I can think of few examples of a less ethical practice than extracting money from vulnerable people who need psychiatric help, essentially telling them not to believe the diagnosis that has the best chance of helping them get better. If I were trying to insert my own work in wikipedia the very first thing I would do is declare that I have a conflict of interest. I would then provide the information on the talk page, along with reasoning as to why it should be included, and defer to other editors to judge whether the material should be included. I don't need to be lectured on the proper way to approach this issue. If I were to hide my identity, it would clearly suggest that I felt doing so would allow me to disingenuously argue more vehemently as if I were a dispassionate observer. And if someone asked me to declare that I was not the author it would only be a threat to my anonymity if I were. By now I think at least that should be clear. By the way, if you are associated with the Charles E. Holman Foundation and you are lobbying here then that is also a clear conflict of interest. If you want to raise funds for your foundation through the dissemination of dubious literature then don't expect to use wikipedia as a platform, regardless of how many press releases you write.137.111.13.200 (talk) 23:56, 28 July 2013 (UTC) Blimey! And a g'day to you too Bruce! May I remind you that it is WP policy to be polite and welcoming to new users. You are a bit too obsessed about trying to find out other editors' identities. You might want to cool off with a Foster and a Vegimite sandwich. Sierraparis (talk) 04:41, 29 July 2013 (UTC)

Websites and blogs are not generally considered reliable sources, which is the standard one would use for a claim like this. Need not satisfy WP:MEDRS for a claim about what's being discussed online. -- Scray (talk) 04:53, 29 July 2013 (UTC)

Thanks Scray. So what you are saying is that blogs, websites pr on line groups could potentially be used as sources under "Role of the Internet"?Sierraparis (talk) 05:15, 29 July 2013 (UTC)

I linked to WP:RS (reliable sources) hoping you might read it. I did say that websites and blogs are not generally considered reliable. One section of WP:RS that is especially relevant is this one: Wikipedia:RS#Questionable_sources, but I urge you to look at the whole thing - it's central to the issues at hand (of course, WP:MEDRS is specifically relevant in the context of medically-related claims). -- Scray (talk) 05:50, 29 July 2013 (UTC)

Lead sentence

I thought this edit was an improvement, because it addressed some redundancy in the language and the paragraph continues to represent consensus in the biomedical literature. Just wanted to let others consider. -- Scray (talk) 12:57, 1 July 2013 (UTC)

I think that would be an improvement. Drgao (talk) 13:35, 1 July 2013 (UTC)

It's not bad, I agree that the current wording is awkward, but given the ongoing talk discussion I thought it best to refer to this page. Reading the new wording, it seems to provide better flow to the opening paragraph without straying from the current medical consensus. Sailsbystars (talk) 14:50, 1 July 2013 (UTC)

That was my sense - and an appropriate reaction (when there's contention on Talk, it's best to discuss before editing). I just thought that we should, at some point, consider this and didn't want to forget about it. -- Scray (talk) 17:00, 1 July 2013 (UTC)

I agree that the edit above was a clear improvement. As it is now, the sentence is awkward and, as you say, redundant. Cheers, Dawn Bard (talk) 15:09, 4 July 2013 (UTC)

Yeah I think it is an improvement. Dbrodbeck (talk) 15:17, 4 July 2013 (UTC)

Restored - I think this was a nice WP:BRD cycle, so each step was prudent in retrospect. Even though there is ongoing drama (e.g. DRN discussion), I think this edit is balanced and demonstrates that we can improve the article without drama. -- Scray (talk) 15:25, 4 July 2013 (UTC)

I'd like to point out that this edit does make a non-trivial semantic change to the article. It changes "sufferers have the delusional belief that they are infested with parasites, whereas in reality no such parasites are present" to "sufferers believe that they are infested with parasites". In the previous, it's made clear that it's a delusional belief. In the current, the idea that the belief is delusional has been removed. People who have the flu believe they are infected with a virus, and they genuinely are infected with a virus. People who suffer from Morgellons believe they are infested with a parasite. Previous wording used to make it clear the belief was delusional; new wording does not. As we have the DRN going I'm unwilling to make a change to the article but just wanted to point this out. Zad68 13:16, 5 July 2013 (UTC)

Zad68, I think I share your view of this problem, so please re-read the lede paragraph (not just the diff) and see whether it's an improvement. The sentence is factually correct, and in context the paragraph is better in my opinion. -- Scray (talk) 14:04, 5 July 2013 (UTC)

Understood and I did read the whole lead before and after. My take on it is that the wording change does improve readability, but the assertion that the belief is delusional is significantly softened by the change. Again, I'm not going to make any edits along that line at this time, especially as we have the DRN outstanding, but just pointing it out. Zad68 14:11, 5 July 2013 (UTC)