Dr Reeves
Welcome to Wikipedia from the Wikiproject Medicine!
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Feel free to drop a note below if you have any questions or problems. I wish you all the best here in Wikipedia! Jytdog (talk) 23:58, 14 July 2017 (UTC)
We can chat here
editFor sources, we tend to stick with journals that are pubmed indexed and have an impact factor. Thus trimmed one of the refs. Doc James (talk · contribs · email) 21:21, 13 July 2017 (UTC)
Just place the disclosure here. Best Doc James (talk · contribs · email) 21:46, 13 July 2017 (UTC)
Dr Reeves, you are invited to the Teahouse!
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Hi Dr Reeves! Thanks for contributing to Wikipedia. We hope to see you there!
Delivered by HostBot on behalf of the Teahouse hosts 20:04, 14 July 2017 (UTC) |
Quick note
editHi Dr Reeves. You are off to a pretty good start by using reviews instead of primary sources, per WP:MEDRS. The only thing I ask you is to be please be mindful of the various "rules" and norms discussed in the Welcome message I just placed at the top of this page.
And with regard to prolotherapy and its ...alternative-ness, please do be mindful of Wikipedia:Conflicts of interest (medicine), which includes things that are not part of usual COI considerations in medical publishing. One thing discussed in that guidance document, is the use of Wikipedia to advocate for medical theories in which editors are personally invested. This often arises in light of Wikipedia's neutral point of view policy, which obligates editors to give the most "weight" (space and importance) to mainstream views. This can be difficult to achieve for editors when they believe strongly in a given notion, that others may not share. I hope that makes sense.
Doc James or I would be happy to discuss more if you have any questions. But again, welcome! Jytdog (talk) 00:03, 15 July 2017 (UTC) __________________ Let me know where best to reply. Is this ok?
I am grateful for your feedback, Jytdog. (And Doc James of course.) This update will be more impactful and useful if balanced and I appreciate the importance of giving the most "weight" (space and importance) to mainstream views. Unfortunately, I have been disappointed for quite a number of years now by a lack of evidence basis of the "mainstream view". To be sure, the literature on prolo is thin, as all studies are self-funded and performed with the volunterism of the primary investigators with no proprietary support for dextrose, but the quality of the RCTs is high per Cochrane risk of bias. This quality is reinforced by selection of three of the RCTs for review on POEMS by Essential Evidence Plus with identical bias ratings to recent prolotherapy review articles. In addition there are now 37 residency or fellowship programs in neuomusculoskeletal medicine that require training in prolotherapy and active residency training in prolotherapy is underway in PM&R training programs at Walter Reed and in the Harvard and University of Wisconsin systems.
This evening, I am working on arguably the toughest section now (low back/sacroiliac pain), and I will including the Cochrane reviews mentioned in the original comments, and placing them in the perspective of more recent studies in hopes of balance. This section is the hardest for me, so I am eager to hear perspective about how I am perceived as meeting the NPOV policy.
Kind regards Dr Reeves (talk) 03:25, 15 July 2017 (UTC)
July 15 I just uploaded the low back/SI pain comments. Prior reviews comments were essentially untouched, but clarified/ updated, and the conclusions were not really any different or reaching. Hope I am on the right track here. Dr Reeves (talk) 15:52, 15 July 2017 (UTC)
I see that changes have been made already in some of the sections. (IE: Knee OA) How do you have time to do this? Thank you. I will see if I can tweak a little but again this gives me an idea of the nudging that you are doing with changes, which I will keep in mind. Dr Reeves (talk) 16:12, 15 July 2017 (UTC)
The knee OA was further modified. Just added one review article. What struck me was a P.I. orthopedic surgeon who seriously proposed to disqualify all injection studies for systematic review if they have less than 50 PARTICIPANTS PER ARM and misused the Cochrane bias tool to downgrade every study to low grade automatically on that basis. I mentioned in the summary because it does taint the review rather dramatically, but if I have gone overboard, set me straight there. Dr Reeves (talk) 20:14, 15 July 2017 (UTC)
I reviewed editing changes by colleagues. Thank you. I can see how better balance has been obtained with the changes and I was unnecessarily overeditorializing. Dr Reeves (talk) 11:45, 16 July 2017 (UTC)
It is generally understood and corroborated by recent review articles that the mechanisms of prolotherapy is multifactorial. Some of the references listed can be deleted but I did not do so and defer to other editors about deleting the multiple references listed. Instead, I added two sentences for update and listed the most updated review indicating a multifactorial reference and a recent review that summarized basic science findings in multiple RCTs. In this case there were 3 consecutive RCTs performed by the Orthopedic Research Lab at Mayo Clinic done in development of their animal model of carpal tunnel syndrome in which they used non inflammatory dextrose (10%), proved that no white cells were found and demonstrated doubling of the transverse carpal ligament thickness and a stronger ligament with normal histology. 1. Oh S, Ettema AM, Zhao C, et al. Dextrose-induced subsynovial connective tissue fibrosis in the rabbit carpal tunnel: A potential model to study carpal tunnel syndrome? Hand. 2008;3(1):34-40. 2. Yoshii Y, Zhao C, Schmelzer JD, Low PA, An KN, Amadio PC. The effects of hypertonic dextrose injection on connective tissue and nerve conduction through the rabbit carpal tunnel. Arch Phys Med Rehabil. 2009;90(2):333-339. 3. Yoshii Y, Zhao C, Schmelzer JD, Low PA, An KN, Amadio PC. Effects of hypertonic dextrose injections in the rabbit carpal tunnel. J Orthop Res. 2011;29(7):1022-1027. 4. Yoshii Y, Zhao C, Schmelzer JD, Low PA, An KN, Amadio PC. Effects of multiple injections of hypertonic dextrose in the rabbit carpal tunnel: a potential model of carpal tunnel syndrome development. Hand (N Y). 2014;9(1):52-57.