Wikipedia talk:Identifying reliable sources (medicine)

WP:DUE

Should we add some text about WP:DUE when we address primary sources? Currently we have issues like this [1]

Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above (see: Wikipedia:No original research). WP:DUE must also be keep in mind as many comments made may be of undue weight when added to a general medical article.

Comments?Doc James (talk · contribs · email) 07:09, 20 January 2012 (UTC)

Comment. Whatever else, I'd say that many comments made may be of undue weight is not clear enough to be really helpful here. - Smerdis of Tlön - killing the human spirit since 2003! 05:22, 22 January 2012 (UTC)

How about "nearly all comments made" --Doc James (talk · contribs · email) 18:26, 28 January 2012 (UTC)

We do need some sort of clarification of the UNDUE issue with respect to primary sources-- you can find a study to say just about anything, and adding such to articles gives undue weight to obscure topics. On matters that are well covered in secondary reviews, if something is left out, there's usually a reason. I hope we can find some wording to address this problem. SandyGeorgia (Talk) 19:05, 28 January 2012 (UTC)

If I might make a suggestion, how about something like: "When citing primary sources, particular care must be taken to adhere to Wikipedia's undue weight policy. Secondary sources should be used to determine due weight." Jakew (talk) 19:30, 28 January 2012 (UTC)

Sure that sounds good. Doc James (talk · contribs · email) 19:57, 28 January 2012 (UTC)

That sounds good to me, so I have added it. WhatamIdoing (talk) 20:09, 28 January 2012 (UTC)

I had a query about this particular change: what about tertiary sources? These often make a direct effort to provide a fair and balanced approach to a discipline whereas secondary sources make no effort to provide fair weighting when considered amonst others!

The last comment here [2] seems wise. Mindjuicer (talk) 00:08, 18 February 2012 (UTC)

The "last comment" says "See what the reference texts and textbooks say about the two views. Balance them accordingly". For most of MEDRS's purposes, reference texts and textbooks are secondary sources. WhatamIdoing (talk) 19:24, 20 February 2012 (UTC)

Sorry, missed your reply until now.

What about other tertiary sources, such as guidelines from national health boards and the WHO?

My concern is that WP guidelines such as this are used as weapons on many pages. Prominence of secondary sources is easily contested and can be skew. What is the reason for excluding tertiary sources which, by definition, should provide a balanced overview? --Mindjuicer (talk) 18:42, 23 February 2012 (UTC)

This guideline clearly identifies position statements/guidelines from recognized expert bodies as secondary sources, not tertiary sources. MastCell ^Talk 19:17, 23 February 2012 (UTC)

Am I missing something? Medical and scientific organizations says nothing about secondary sources. Nor does WP:MEDASSESS.

Also, I think it's clear that secondary sources can be tertiary sources as well. Or more accurately, the same publication may contain primary, secondary and tertiary statements. --Mindjuicer (talk) 20:04, 23 February 2012 (UTC)

Guidelines produced by national bodies that assess individual studies are by definition secondary sources. Your statement above declared them to be tertiary sources, which is not necessarily correct. Yobol (talk) 20:07, 23 February 2012 (UTC)

Look in the "Definitions" section (it's the first one). Look under "Secondary sources". You'll find: Examples include literature reviews or systematic reviews found in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations. Emphasis mine. MastCell ^Talk 22:31, 23 February 2012 (UTC)

@Yobo1, agreed. The problem here may be the widespread assumption that if a publication appears to be more like a tertiary source then it cannot be a secondary source.

But are we not assuming that a) all secondary source publications are inherently more reliable than all tertiary source publications in spite of the latter's considered opinion on weighting and b) secondary sources will be reliably interpreted for due weight?

@MastCell, d'oh. Thanks. --Mindjuicer (talk) 23:18, 23 February 2012 (UTC)

"Secondary" is not an alternative spelling for "good". Neither is "tertiary". We've seen plenty of lousy secondary sources—and plenty of lousy tertiary sources, and plenty of lousy primary sources.

We fundamentally have no choice but to assume that editors will (attempt to) assign due weight to all of their sources. There is no viable alternative. Figuring out what's DUE is difficult, but there's nothing special about a secondary source that makes it harder to identify DUE weight compared to a tertiary source. WhatamIdoing (talk) 01:45, 24 February 2012 (UTC)

Let's take a NHS review compared to a meta-analysis. The review has due weight built in -- all you have to do is mirror it (along with other reliable 'overview' sources). However, the meta-analysis would merely draw conclusions on a small aspect of the treatment modality. There's no indication of due weight at all without first comparing it to all other secondary sources, with the importance of each potentially raising a separate argument.

Some editors will argue over anything they can, just to break momentum. So in the same way that MEDRS indicates a strong DUE preference for secondary sources over primary sources, should it not also indicate that "Secondary sources should be used to determine due weight, especially those that provide an overview of the subject"? I'm looking for language that doesn't raise a weak overview source over strong non-overview sources. --Mindjuicer (talk) 03:21, 25 February 2012 (UTC)

should articles about medical conditions only deal with medical information? what about social practices?

Should articles about medical conditions only deal with medical information? Or can they also report about what people actually do with their disease, (as far as this practice meets WP:notability), even if the medical community has not written anything about it? The current guidelines WP:MEDRS do not deal with this topic: they deal with non-academic sources http://en.wikipedia.org/wiki/Wikipedia:Reliable_sources_%28medicine-related_articles%29#Other_sources as sources of medical information, but they do not deal with them as sources of information about social practices related with a medical condition. This is different: I think that medical information should clearly be separated from social practices, but I also think that both can be part of the same article. For example, evolution article has a section "Social and cultural responses".Mokotillon (talk) 14:47, 24 January 2012 (UTC)

Mokotillon, to avoid fragmenting the discussion, can we post a request once and merely link to the discussion in other places if required. Let's discuss this at WT:MED where there are likely to be more watchers. Colin°^Talk 16:26, 24 January 2012 (UTC)

Open Access Journals: Should I be asking this here instead?

I posted this inquiry about open access pay-to-play journals at the Project Medicine talkpage Wikipedia_talk:WikiProject_Medicine#Open_Access_Journals_and_related_issues, but perhaps it belongs here instead. If so, let me know and I'll move it here instead. Thanks Fladrif (talk) 16:28, 24 January 2012 (UTC)

Listing and reliability

Following a recent discussion at RSN[3], there now seems to be an assumption that a research review appearing in a new or open access journal must be listed in specific indexes (MEDLINE, ICMJE, CSE) in order to qualify as a reliable source. Is this a course of action that should be incorporated in policy? Can we determine that a research review is not high quality if not on these lists? Spicemix (talk) 20:55, 29 January 2012 (UTC)

I wouldn't call this an assumption; it looks more like a consensus. And, it would probably be a good idea to formally incorporate it into policy. Commercial publishers are churning out new medical journals literally by the dozen every single day, most on the author-pays open access model. Most will probably fail either for lack of interest or lack of scholarship, some will continue to be published but remain obscure, and a few will eventually come to be regarded as reputable and reliable. The requirement of MEDRS is that a journal must be "reputable". By definition, that means that it has gained acceptance in the medical community as reliable. If it is not indexed in the core indexes for medical publications like MEDLINE, PUBMED, ICMJE and CSE it can hardly be considered to have that acceptance - inclusion in those indexes is a very low bar indeed. Being listed is not an automatic qualification; not being listed should, however, be an automatic disqualification. If it is not widely cited by other researchers, it cannot be considered to be "reputable". If a journal is brand new and so obscure that it can't even get in those indexes, it definitely should not be used as a source on medical articles. After it is indexed, and after it is widely cited, it will then, and only then, meet the threshold of consideration as being "reputable".Fladrif (talk) 18:55, 31 January 2012 (UTC)

It could be added to the guidelines, but reading the summary by the editor whose closed the discussion, it seems that the reason the journal is not listed in the indices is that it is not a reliable source. TFD (talk) 23:58, 31 January 2012 (UTC)

A couple of thoughts:

• It's not just open access journals or disreputable groups that charge for publishing. Some highly reputable journals have page fees. PNAS charges all authors $70 a page, plus other assorted fees. Circulation has a similar list of charges. Stroke charges for all publications, including letters to the editor. Blood charges $50 to even submit a paper for review. Charging for publication is not an indication of poor quality.
• In terms of the "vanity press" argument, I don't see any particular difference between paying the publisher hundreds (or thousands) of dollars to publish your paper and letting them charge readers $30 a copy to read it vs paying an open access journal the same amount of money to publish your paper, in return for a promise that they won't charge the readers.
• I understand that index listing takes a little while (as does acquiring a reputation), so new journals should probably not be evaluated strictly on that basis.
• Some really lousy journals are listed on those indices. See, e.g., Medical Hypotheses#Abstracting_and_indexing: they don't even pretend to do peer-review.

So I don't think that we want to treat all "paid" journals the same, and I don't think that "open access" or "being indexed" is a good marker of quality.

Finally, it's worth remembering what WP:RS's FAQ page says:

"Are there sources that are "always reliable" or sources that are "always unreliable"?

No. The reliability of a source is entirely dependent on the context of the situation, and the statement it is being used to support. Some sources are generally better than others, but reliability is always contextual."

Even the journals that we say are generally "unreliable" are reliable for certain (limited) purposes, and those that we say are generally "reliable" are completely unreliable for other purposes. The issue is complicated, and simplistic rules aren't going to be helpful. WhatamIdoing (talk) 01:05, 1 February 2012 (UTC)

I agree wholeheartedly that being listed on these indices is no guarantee that a journal is a reliable source or accepted; there are indeed many journals with no peer review on these lists. But getting listed is such a low bar that not being listed on any of them has got to be a red flag that it is not yet accepted at a level that we would regard as reliable. Can anyone identify clearly reliable peer-reviewed medical journals that aren't listed on these indices? Just like being peer reviewed or not is a bright-line distinction, not being indexed on any of the leading indexes should be a bright line disqualification of a source.

Also, it is clear that the consensus at RSN and contentious complaints from advocates on the RSN talkpage and even at ANI was that Nutrition and Metabolism was not a reliable source for medical claims being made by proponents in the Transcendental Meditation research article, and not being listed on these indices was only one of many factors. Nor was being an open access publication the only or deciding factor. What User:Spicemix is not disclosing is that the same factor of appearing on none of these leading indices is one of several factors under discussion at another RSN thread involving Health Science Journal [4] One uninvolved editor has opined that it is not a reliable source for similar claims at the same article; no-one has attempted to defend the source as reliable nor to defend the use to which it is being put in the article. It seems that there is a pattern of TM research being reported in obscure and recent journals, and this question seems directed to the possibility that unindexed obscure journals will fail as sources for those seeking to push that research on Wikipedia. Fladrif (talk) 01:53, 1 February 2012 (UTC)01:48, 1 February 2012 (UTC)

You're missing the point of the FAQ: There are no bright lines. What makes a source be reliable or not depends on how you use it, not just on whether it's peer-reviewed. A non-peer-reviewed source can be perfectly reliable. This guideline recommends multiple types of non-peer-reviewed sources: practice guidelines, position statements, medical textbooks, and more. None of those typically undergo peer review.

Additionally, it's not enough to say "This is a poor publication, so everything in it is unquestionably rubbish." We sometimes accept self-published personal blogs as reliable sources. We accept business' websites as reliable sources. Surely even the worst-run academic journal isn't as completely lacking in editorial oversight as someone's personal blog. You've got to consider all the facts and circumstances. If Einstein published an article in Rubbish Journal, we'd still accept the article, because the creator of the work is sufficiently strong to outweigh our concerns about the publisher. (We'd probably wonder why he was publishing in that journal, but we'd accept it.) "Source" has three meanings on Wikipedia. "Publisher" is only one of the three. You only need one of them to be good enough.

I'm not defending the particular instances at hand; they look pretty dubious to me. But it's a bit more complicated than that. We can't just say "journals must be indexed" and expect that to weed out garbage. We can, however, reasonably predict that any statement like that will result in people saying "See, it's indexed, and therefore obviously reliable". WhatamIdoing (talk) 04:23, 1 February 2012 (UTC)

WaId makes some good points here, and that last is very persuasive. Still, it seems that absent indexing, absent a record of citations, and absent the publishing history that might eventually establish a new journal's impact, we don't have much grounds for saying that journal has a track record of responsible publication practices. A presumption against such journals should simply say the journal doesn't add credence to the authors. Effectively we would treat its contents as self-published until such time as it should establish a good reputation. LeadSongDog come howl! 06:27, 1 February 2012 (UTC)

I think that applies to any new publication, whether it claims to be an academic journal or a local newspaper. You can't have "a reputation for fact-checking and accuracy", to use the wording from WP:RS, until you have a reputation in the first place. WhatamIdoing (talk) 00:32, 2 February 2012 (UTC)

I'd like to mention that there are at least a few truly excellent journals that have embraced the open-access model. The flagship example would have to be the Public Library of Science (PLoS) family of journals. Even the lowest-impact member of this open-access, Creative-Commons-licensed seven-journal family, PLoS ONE, still pulls a respectable impact factor of 4.4. The oldest journals in the group (PLoS Biology and PLoS Medicine, started in 2003 and 2004, respectively) have impact factors of around 13. Interestingly, a few high-impact 'traditional' journals have moved to open-access; BMJ, for instance, has made all of its research articles open-access since 2008.

All of these journals are, of course, indexed in MEDLINE, and I doubt that anyone would have a problem considering them to be reliable sources by any reasonable interpretation. Nevertheless, I feel it's worthwhile to bear in mind that "open-access" doesn't have to be a dirty word, and that there are some remarkably good scientific periodicals that are published that way. TenOfAllTrades(talk) 14:53, 1 February 2012 (UTC)

Others release all articles after a set time period, making them sort of open access and sort of not. I believe that Blood makes all articles free after a year, and I've seen others that do this after five or ten years. (Actually, I don't understand why they don't all make articles free after five or ten years.) WhatamIdoing (talk) 00:32, 2 February 2012 (UTC)

Many thanks to all for these comments. They make clear just how many factors need to be considered when evaluating reliability.

RSN has indicated that Journal of Nutrition and Metabolism can't yet be considered a reliable source, so we'll have to wait and see there, but there are some interesting issues that arise from that decision.

The primary source, Paul-Labrador, evaluated in the review looks very strong. It was conducted at the Cedars-Sinai Medical Center, one of the top ten medical research centers in the US, and is published in a journal of the AMA. It's included in many research reviews.

Also the review itself, despite being published in an unestablished journal, has some strong points. It is systematic, and was funded by NIH. It's peer reviewed, and the authors, Anderson and Taylor, are well credentialed. It comes out of the University of Virginia School of Medicine.

Is there any guidance on what weight these factors should have? Spicemix (talk) 13:43, 3 February 2012 (UTC)

There is strong consensus, developed over multiple threads on talk pages and noticeboards, including RSN, MEDRS, Project Medicine, and Fringe Theories, over many years, and involving many involved and uninvolved editors, that primary sources should not be used at all for medical claims in the TM articles. Fladrif (talk) 19:18, 3 February 2012 (UTC)

Psychology

Based on comments at Talk:Dissociative identity disorder today, it appears that we may need to specifically mention "psychology" as a topic area that is covered by this guideline. It's being asserted that since talk therapy involves no medications, then MEDRS doesn't apply.

I don't want to deal with this now, but perhaps in a few weeks someone will remind me about this. I think we'll want to solicit opinions from the folks at WP:PSY when deciding whether and how to address this perceived loophole. WhatamIdoing (talk) 04:23, 2 February 2012 (UTC)

Meta-analysis

The claim that meta-analyses of independent RCTs provide the best evidence needs a citation (to a high-quality most reliable source).

Thanks!  Kiefer.Wolfowitz 12:36, 5 February 2012 (UTC)

[5], considered by some to be the "bible" of EBM, states meta-analyses of RCTs to be Level 1a evidence, or highest level. Yobol (talk) 03:00, 7 February 2012 (UTC)

Additionally, per Wikipedia:Policies and guidelines#Not_part_of_the_encyclopedia, no such citation is needed. There are no reliable sources on the subject of what the Wikipedia community believes is the best evidence for supporting such claims in a Wikipedia article. WhatamIdoing (talk) 04:57, 7 February 2012 (UTC)

@Yobol,

Thanks for the clarification and citation.

FYI, "meta-analysis" graces the (long) list of (non–Harry-Potter) philosopher's stones in David A. Freedman's Statistical models. I've not read Ingram Olkin making such claims..., so the citation is very helpful.

@WhatamIdoing?

Please read "helpful" or "desirable" for my flawed "necessary".

The guidelines already cite 10 or so references, which provide further reading or substantiate a point that might be questioned by a sophisticated editor. Yobol's reference is similarly useful to the guidelines.

Thanks to you both! Cheers,  Kiefer.Wolfowitz 06:23, 7 February 2012 (UTC)

I updated the article using this source. Page 99 states that systematic reviews of non-randomized studies are worse than meta-analyses of RCTs.  Kiefer.Wolfowitz 06:39, 7 February 2012 (UTC)

Research reviews

MEDRS strongly recommends the use of research reviews, but gives little guidance as to how to determine whether a particular research review is reliable. Currently the only criteria are peer-reviewed secondary sources and publications on Brandon/Hill. Would it be useful to identify other considerations? For example impact factor seems already to be widely referred to. Listing on major indexes has recently been suggested at RSN[6], as have citation of the review and citation of other work by the authors. Other possibilities, raised here[7], are the standing of the authors of the review (well credentialed, widely published?) and the status of their research center; also a consideration of the quality of the research included in the review (publication of the primary sources in top medical journals? the primary research conducted at top medical centers?). Support from the NIH or other respected organization is another suggestion.

A further consideration could be whether the journal carrying the review is put out by a prominent association, organization, or university.

Would the inclusion of factors such as these be helpful? Spicemix (talk) 13:20, 7 February 2012 (UTC)

I'm not sure that the benefits would outweigh the costs. We have a fairly serious problem with POV pushers who want to discredit apparently good sources, and this would pretty much turn into a checklist of reasons to reject any publication that I personally disagree with. That's why the last paragraph of WP:MEDASSESS tells editors not to personally evaluate studies.

Impact factor and citations, in particular, are poor markers for quality. They tell you something about the publication's popularity or prominence. A review that gets cited ten times as an example of flawed thinking has the same citation count as a review that gets cited ten times for its brilliance. WhatamIdoing (talk) 19:30, 20 February 2012 (UTC)

Many thanks for this helpful response. Spicemix (talk) 11:24, 25 February 2012 (UTC)

Status of this page

{{rfctag|policy}}

Following up from a conversation elsewhere, I'd like to begin a discussion here on making several changes to this guideline:

1. Upgrade it to a policy page
2. Emphasize the importance of accuracy, the risk of harm, and the need for the strictest application of WP:V (in the same vein as WP:BLP)
3. Provide guidance for enforcement (perhaps including the creation of an actual noticeboard, a la BLP/N)

I think at least #1 should be pretty straightforward (the guideline has broad support, relative stability over the long-term, and serves the purpose of codifying in more detail the general policies on verifiability and reliable sourcing). The others will take some work and some back and forth. I'd suggest #1 be completed first, and then work can commence on improving the new policy to better describe the importance of MEDRS and support those working to enforce it. Any objections to posting the proposed policy template on the page as a first step? Nathan ^T 19:49, 26 February 2012 (UTC)

Something else to consider. There's more to ensuring appropriate coverage of health and medicine articles than identifying reliable sources, and the guideline as it is goes beyond its current title. Might WP:Health and medicine articles be a more appropriate title for the long-term goal of focusing more resources in this topic area? Nathan ^T 20:04, 26 February 2012 (UTC)

Nathan, you've basically got two different proposals here, and that will confuse the results below. How about discussing this some more and then starting a formal RFC? -- Brangifer (talk) 17:10, 27 February 2012 (UTC)

I support these measures; the prominence of Wikipedia as a trusted source of health information places a significant burden of responsibility on our medical article editors to ensure the greatest accuracy. I think a more stringent, careful attitude to content in this area, and less tolerance for borderline editing is called for relative to the rest of the encyclopaedia, and Nathan's suggestions represent steps in the right direction in this respect. Skomorokh 14:31, 27 February 2012 (UTC)

• Support per previous.  Kiefer.Wolfowitz 14:38, 27 February 2012 (UTC)

• Support. I thought it was policy until recently, to tell the truth! It certainly should be. I'd also support the rename — as Nathan points out, the scope is broader than identification of reliable sources. Jakew (talk) 16:33, 27 February 2012 (UTC)

• I've been beating this drum for a couple of years now, so I'm excited at the possibility that there might actually be support for something like this. I'm actually much less concerned about whether WP:MEDRS is a guideline vs. a policy. I want to know whether the community is ready to take this issue seriously. If so, then it doesn't really matter whether this is policy, a guideline, or even an essay; good things will happen. On the other hand, official "policy" status would probably head off at least one level of wikilawyering.

  Not to look a gift horse in the mouth, but the cynic in me has some reservations. We've built something here that works. WP:MEDRS (in its guideline form) has been accepted by the community and even formed the basis of ArbCom findings. We have a group of knowledgeable, sensible editors who (while we often disagree on individual issues) share a commitment to high-quality medical information and thus "enforce" the guideline in a de facto sense. There is obviously still a vast quantity of wrong, misleading, or outright dangerous crap in this site's medical articles, but we have the tools right now to fix any of them that we turn our attention to (and we have fixed quite a few already).

  More visibility is good, but along with a debate about policy status we're going to get the downsides of "community" involvement—namely, attention from the growing class of Wikipedians who lack or have lost interest in actual content and instead crowd onto whatever project-space discussion seems the most politically active. This guideline works because it was formulated, revised, and implemented by people with in-the-trenches experience. If it becomes a policy, then I'm worried it's going to become like most of our other policies—ossified, impossible to change without three preceding RfCs, and divorced from the reality of actual editing.

  I realize that this is a cynical, if not frankly elitist, viewpoint, but after six years on this site, that's where I am. MastCell ^Talk 17:24, 27 February 2012 (UTC)

(ec) ::That's a fair point. (And the part about "editors" who don't add much content certainly applies to me -- at some point a couple of years ago, the feeling of negativity I got from reading and interacting in the metapedia overwhelmed my desire and ability to contribute regularly). I agree that the WP:MED / WT:MEDRS crowd of dedicated regulars should drive any changes to MEDRS and lead any effort to make enforcement more effective. It's also clearly true that drawing in a wider audience of Wikipedians will net both experienced and serious editors and people whose contributions will be less appreciated.

Drawing the parallels with BLP... For a long time it was the preserve of a small number of administrators and editors who worked tirelessly, and without much support or recognition. Over time, a number of factors contributed to repeated crises and controversies - administrator and editor burnout, decisive but controversial decision-making, attention from the media and external critics, and the involvement of high-profile internal actors (like Jimbo and the WMF board). While the ultimate outcome clearly benefited BLPs and their subjects, to say the process was painful for many community members is an understatement.

My hope is that the final product of BLP, and its status in the community, can be attained for MEDRS with more peaceful means. It may be that the best time to push for broader awareness of MEDRS and related issues is when the guideline, and its use, is at a sort of stable equilibrium and enjoys broad (if quiet) support. It may also be that the potential benefits aren't worth the chance at upsetting a system that, while far from perfect, "works" and represents years of heroic effort. It's for the participants in this discussion to decide if the uncertainty and risk to the status quo is worth the attempt to achieve a more complete solution. My personal opinion is that it's been unfair of the project to expect this Sisyphean task of monitoring and improving to be handled by a small group of people, and I think that you have suffered far more than is necessary to accomplish something everyone should agree is important. At some point we need to find a better way, a way that doesn't burn out great Wikipedians one after another year after year. Nathan ^T 18:35, 27 February 2012 (UTC)

• All very accurate, we need to take this slow, and be very aware of how any proposal is formulated. An excellent interim step would be some sort of education of admins about how to determine reliable medical sourcing. I'm waiting for Colin to weigh in here, as I have some of the same concerns as MastCell, and the page isn't ready to be simply converted to policy. We need a careful discussion of how to give MEDRS more teeth, to make it work more like BLP vios, and wider visibility, regardless if it's policy. SandyGeorgia (Talk) 17:51, 27 February 2012 (UTC)

• Somewhat related to these concerns, I'm a bit worried about the tendency for some editors to demand the best sources as an end, rather than as a means. No matter what the subject is, the source needs to be strong enough to support the claim being made. It does not need to be any stronger than that. We don't need a review article to support a lightweight claim like "Cancer is a disease". A very basic, non-medical dictionary is going to be good enough for that.
  What we ultimately want is accurate, up-to-date information in the article. Using reviews and textbooks and other top-quality sources is nothing more than a means for getting accurate, up-to-date information into the article. If you can get accurate, up-to-date information into the article while using a relatively weak (but still adequately reliable) source, then that's actually okay: perfectly good material shouldn't be removed merely because it's followed by a merely adequate source instead of a stellar one—or, indeed, by no source at all. It must be possible to supply a reliable source for all material in articles; the source need not actually be named at the time of the original edit. WhatamIdoing (talk) 18:18, 27 February 2012 (UTC)

• Yep. I regret that someone launched an RFC here before we had a chance to hammer out how the page would have to be formulated to give it teeth akin to BLP, addressing concerns such as those raised by WhatamIdoing. For example, the BLP page clarifies when certain types of sources can be used in BLPs. Sometimes we can use a primary source for basic info; sometimes not. SandyGeorgia (Talk) 18:21, 27 February 2012 (UTC)

And there we go ... a premature RFC before those knowledgeable have weighed in, and we even have an RFC proposal. Surefire way to crater anything useful. [8] Thanks. Do folks ever consider that before launching an RFC, you should have formulated what the RFC is about? And why do folks start "voting" before there's even something to "vote" on? SandyGeorgia (Talk) 18:24, 27 February 2012 (UTC)

Thank you ASCII, much appreciated. Now we can hammer something out more carefully, and then hopefully launch an RFC. Colin is out for the day, not feeling well, so I hope we can all put our heads together and come up with something after he's back on board. SandyGeorgia (Talk) 18:29, 27 February 2012 (UTC)