User talk:Renamed user 51g7z61hz5af2azs6k6

Hi Formerly 98, It said there was an edit conflict when I submitted.. I added some dates to the comments by the CDC and the newest Harvard Public Health Study/ with Chenang, hoped the references showed properly but see it was all reverted. I will try again to submit but don't want to undo anything so will have to retype. If this is in the wrong location, please correct. Thanks WikiShares (talk) 19:08, 26 March 2014 (UTC)

Welcome!

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Yes, welcome, Formerly. One less for Materialscientist to worry about! Martinevans123 (talk) 17:01, 11 January 2014 (UTC)

Formerly 98, you are invited to the Teahouse

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New proposals at Wikipedia:Pending changes/Request for Comment 2014

Hello. Several new proposals have been submitted at Wikipedia:Pending changes/Request for Comment 2014 since you last commented on it. You are invited to return to comment on the new proposals. Jackmcbarn (talk) 01:14, 16 January 2014 (UTC)

A barnstar for you!

	The Tireless Contributor Barnstar
	Very much impressed with the post-IP contribs. More good stuff :) §FreeRangeFrogcroak 23:28, 10 February 2014 (UTC)

Glyphosate article

Hi! Nice to see you so busy - I looked over your contribs and you are doing some really great work; thanks for sticking around and working! On the Glyphosate article - just want you to be aware of a few things. As glyphosate is so heavily connected to Monsanto and GM food, it has a lot of watchers and there is constantly effort to add pretty flaky studies (like the Entropy article discussed on the Talk page and several other places) and I have been looking for a long time for good information on toxicity. One of the big problems is that while Glyphosate itself appears to be pretty nontoxic (although controversy swirls around whether it is an endocrine disruptor hypothesis (itself controversial), formulations of Glyphosate, like Roundup, contain additives like surfactants (I don't have to explain that to you, I think! :) ) and it seems pretty clear that the additives are more toxic than glyphosate itself; pretty much every study shows this. However, tox information on these additives, like POEA, is very hard to come by. You can see that in the article I have created lots of space, and tags, where the article needs expansion. If you can find any good sources with which to flesh these sections out that would be awesome.

On another note, I have been thinking for a long time that we need an addition to the WP:MEDRS guideline that specifically discusses what kind of sources are reliable for discussions of toxicity, and how they should be used. I am guessing that you understand that realworld, tox studies are carefully designed to give information about how a compound may affect humans... and while you are a med chemist, I am guessing that you understand that for chemicals that are not drugs, the chemical will never be administered to humans so tox information used by regulators is based on carefully designed in vitro and animal studies and careful extrapolations .. and after a product is introduced, on epidemiological studies which are devilshly hard to interpret. WIkipedia articles that deal with non-drug chemicals are where where toxicity content is really off the rails (see Bisphenol A for an example). A lot of the controversy around endocrine disruptors falls in this territory too. A lot of the primary studies that are cited, and even some of the reviews, are done by academic scientists who don't address realworld toxicity issues at all; you find primary sources used, where the experiments involved dumping a crazy amount of the chemical directly on cells and (surprise!) finding toxicity, or animal studies where the chemical is administered intravenously and terrible things happen, when the only human exposure is oral... and then you find review articles where the reviewer doesn't take key tox parameters (like route of administration) into account at all. Problematic! And you have lots of everyday people - and editors - who understand nothing about toxicity and are really scared that these chemicals are hurting them and demand that these crap sources be cited so that the public is well informed about these dangers. Things get emotional when I've tried to explain why so many of these sources are invalid for real toxicological considerations - I get accused of being a whitewasher or a shill for industry. So.. it would be really useful for Wikipedia to have guidance on tox sources and how to use them. It would help avoid ugly arguments with other editors and more importantly, it would become a platform to help ensure that WIkipedia presents really good information to the public on these issues. Hope that all makes sense. I've brought this up several times on the Talk page of MEDRS (for example here) There are parts of MEDRS that are just not applicable (there cannot be systematic reviews of clinical trials b/c there are no clinical trials!) I was finally invited to create an essay and to bring it and propose that it be made an adjunct to MEDRS. I started working on it but stalled out. If you want to work on it with me (or even take it over), that would be fabulous. I got a bunch of tox textbooks and started reading them - that is far as I have gotten. What would be truly awesome would be to find a training tool for toxicologists about how to do a review -- about how to create something like this which is (in my view) what a gold standard tox source looks like. They state their criteria for including or excluding published studies, go through them and apply the criteria, then carefully review the keepers in light of the key toxicology principles and come up with their statements of risk. If there were a training guide in how to create something like that, it would be the perfect basis to use for a tox sourcing guideline. Jytdog (talk) 13:28, 13 February 2014 (UTC)

Thanks for your note. Yeah, I think a firm guideline is really needed, and have thought about taking this up with Doc James myself. MEDRS may need to be refined a little bit for tox studies; even for drugs the clinical trials (typically 2000 or so patients) are not statistically powered to detect rare but serious toxicities, and so much of the regulatory action occurs on the basis of accumulating case reports - which would not be MEDRS compliant! So there needs to be some allowance for case reports I think, but only if aggregated in a reputable review or if the basis of regulatory action by a competent national authority. I would probably allow primary research sourced animal studies as well, but they need to be published in MEDLINE indexed journals. These are important but rarely get reviewed.

On the other hand there needs to be some sort of blanket, citable rule against quoting in vitro studies, preferably at all, but at least not the ones that use milimolar concentrations of the test article. That's insane. In med chem we never believe any result seen at concentrations above about 50 micromolar. At concentrations above that all kinds of artifacts occur from compound precipitating out of solution onto the cells, non-specific interactions and the like. In general, given their poor translation to whole animal studiies, I think in vitro data should be excluded.

Simply from a medicinal chemistry point of view, some of the biological activities being attributed to glyphosate make no sense at all. It simply bears no structural resemblence at all to any known ligand of some of these receptors. Formerly 98 (talk) 14:06, 13 February 2014 (UTC)

I'll look for a good source for this. Formerly 98 (talk) 14:06, 13 February 2014 (UTC)

Any thought to contacting the Toxicology Society and see if we can get someone interested in helping out? That input would certainly add credibilty. I found this contact information there for those seeking Toxicology experts:

Michelle Werts

Communications/Media Manager

Society of Toxicology

michelle@toxicology.org

703.438.3115 ext. 164

That is genius, to contact Society of Toxicology! Thank you!! I will do that. And thanks for responding generally. On the in vitro thing, I recently got consensus to add this to MEDRS, in the "Respect secondary sources" section, which is a strong statement on always using reviews. Completely banning primary studies has been talked about a lot on the Talk page but proposals haven't gained consensus. You can search the archives for the discussions of that. Oh and yes there is lots of crazy content in wikipedia about endocrine disruptors. oy. Jytdog (talk) 10:49, 15 February 2014 (UTC)

I think part of the problem is that research in some of these fields is strongly affected by the biases of those doing the research. For example, I suspect that a large fraction of those seeking PhDs and performing research in environmental toxicology are motivated by pre-existing beliefs that current regulatory measures are inadequate, and that there are important problems that need to be demonstrated and publicized. Thus the line between researcher and activist becomes blurred.

My brother was recently diagnosed with prostate cancer and started doing his own biomedical research. One of the pieces of advice I offered him was "If its in the New England Journal of Medicine, JAMA, or the official publication of any major medical society, it's probably true or at least worthy of serious consideration. But anything published in any journal that has the word "nutrition" in the title can probably be safely ignored". Same reasoning as above.

Apologies for my skepticism. Formerly 98 (talk) 16:04, 15 February 2014 (UTC)

no need to apologize, i agree; this is why having a guidance to sourcing tox is so important - the primary literature is really messed up.Jytdog (talk) 17:05, 15 February 2014 (UTC)

Some stroopwafels for you!

For great pharmacology-related work, even under fire. Keep doing what you're doing. JFW | T@lk 21:25, 23 February 2014 (UTC)

You're much too kind! Stroopwafels are a particular favorite (my sister-in-law is Dutch) and should probably be reserved for something of truly unusual merit! Thank you for your help and support, I think I'm beginning to figure out how to be productive here. Warm Regards, Formerly 98 (talk) 21:31, 23 February 2014 (UTC)

Talkback

Hello, Renamed user 51g7z61hz5af2azs6k6. You have new messages at Gene93k's talk page.
Message added 19:22, 1 March 2014 (UTC). You can remove this notice at any time by removing the {{Talkback}} or {{Tb}} template.

Primary sources

Have trimmed one of the primary sources you added per WP:MEDRS Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:59, 8 March 2014 (UTC)

Replied. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:41, 8 March 2014 (UTC)

Monomethyl auristatin E

Hi! Would you mind re-correcting the typos, wikilinks and other things I fixed with this edit? Thanks, ἀνυπόδητος (talk) 19:36, 11 March 2014 (UTC)

Rereading the NPOV guidelines, I'm not even 100% sure I'm right on this edit, and was certainly expecting more pushback from you! Here is my question/issue: Does NPOV require every scientific finding to be described in a flat monotone? I do not mean to ridicule your position here, but in order to understand it better, I'd like to hear your thoughts on the following questions:

Was the discovery of penicillin "important", "groundbreaking", "remarkable", or a "watershed event"? Or is it your position that all scientific findings must be described in what I will describe as a completely flat tone?

Wikipedia articles clearly express moral and scientific judgements on a variety of subjects, for example:

Lilly's illegal marketing of Zyprexa is described with a lengthy quote from the NYTimes expressing moral approbation (I agree)

In a close-to-home example, the sofosbuvir article contains quotes from Medicins sans Borders referring to "corporate greed" (I'm on the fence), which you did not edit out, but you did express concern that calling the drug an "important advance" was promotional. I'm not sure what you would have thought if I had added adulatory quotes from the FDA Advisory Committee members who called it a "breakthrough" and made other superlative remarks.

Countless drugs are described in articles as "ineffective" (I agree)

Is there not a moral symmetry between "ineffective" and "important advance" or "remarkable"? Or, (I know this is unfair), is it just that expressing positive judgments is a problem?

I don't mean to be confrontational here, you're clearly a very thoughtful guy and I'd like to understand your position better. Maybe I'll learn something. And again, maybe I was out of line on the revert, let me know your thoughts.

I find some of these results quite inspiring and with tremendous potential to affect people's lives. Maybe I need to keep that in my pocket. But I'm equally struck by the advances made with drugs like ibrutinib and Bristol-Myer's recent results in metastatic melanoma as I am with Lilly's shameful behavior or the price of sofosbuvir. What am I misunderstanding?

Formerly 98 (talk) 20:13, 11 March 2014 (UTC)

I can only return the compliment on thoughtfulness :-) And I certainly don't feel ridiculed by your post here.

Okay, my thoughts (which are not necessarily official Wikipedia NPOV policy...): Somewhere on this website there is an essay about the fact that our article on Adolf Hitler doesn't contain the sentence "Hitler was an evil man" (or the like). The essay argues that it is far better to state what Hitler did and said, and let the readers draw their conclusions, than try to express his badness by superlatives. A hypothetical reader who doesn't know (much) about WWII wouldn't be able to tell whether "Hitler was an evil man" was just the private opinion of one editor, or whether it meant "evil" as in "Mr Burns exploits the employees of his atomic power plant", or "evil" as in "He is responsible for millions of deaths". (Disclaimer: If anybody from Lilly reads this, yes, I dislike you, but no, I'm not comparing you to Hitler.)

I agree with that essay, and I think citing the number of lives penicillin saved in WWII much more impressive than any superlative attribute we could find. On the other hand, I'd say that "ineffective" isn't a personal judgement like "groundbreaking". It just means a drug isn't better than placebo, give or take 5%. A better symmetry would be an article saying that a drug performed "disappointingly" or "abysmally" in Phase III trials, and such a phrasing I would edit out.

I think I didn't edit out the Medicins sans Borders quote because I don't know anything about the cost issue, and I was concentrating on the pharmaceutical properties of the drug. I'm always a bit uncomfortable about quotations as they might convey the impression that they express Wikipedia's opinion, when they are really the opinion of other people. You can always find and quote someone who is of any opinion whatsoever, but it's difficult to argue the point if the editor who added the quotation says "but it's just a quote, and it's sourced". So I'm afraid I tend to edge away from quotations and leave them alone unless they are really horribly unfair.

As I said, that's my personal stance. But then I'm European, and we are practically Vulcans compared to people from the US. (Come to think of it, I don't even know where you come from.) --ἀνυπόδητος (talk) 20:50, 11 March 2014 (UTC)

Thank you, this was helpful. Obviously this is an issue I struggle with. I'm a California boy BTW. And I agree about the quotes, they are troubling. I'd like to see them disallowed, as they are commonly used to promote fringe opinions and/or as a backdoor method for expressing one's personal judgments, and since most people ignore fringe remarks, there are usually not countervailing opinions available for quotation.Formerly 98 (talk) 21:14, 11 March 2014 (UTC)

Your recent edits

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upsetting, i know..

About all this.... There are some real characters on Wikipedia, and it is easy to get sucked into dark places when working here, especially if you work on articles that are controversial. To be able to survive a long time and be happy here, you have to be clear inside yourself on why you are here and how you want to conduct yourself - on what you want to accomplish within the policies, guidelines, and mission of Wikipedia - and avoid getting emotionally involved in drama. Held in the right way, WP:DGAF and Wikipedia:IAD are very useful. I know it can be very frustrating and hard and things can really get under your skin. There are many emotional stances one can take that lead to misery and only a few that are enduringly robust. Anyway, good luck! Jytdog (talk) 12:11, 17 March 2014 (UTC)

notice of discussion on admin page

Hi, I have began a discussion on the admin notice board. I cited the imposition of personal opinion vs the Verifiability Policy. This is the link to the page it is listed on. https://en.wikipedia.org/wiki/Wikipedia:Administrators%27_noticeboard/Incidents#Water_Fluoridation_is_a_controversial.2C_page._Senior_Editors_are_not_following_Wiki_Verifiability_Policy_-_attempting_to_judge_quality_of_research_selectively._Censoring_HSPH_study_issued_with_a_press_release_by_the_institution. I also cited other concerns of speedy reversion on the topic. The page seemed heavily patrolled and key new information studies are being reverted.

WikiShares (talk) 05:21, 28 March 2014 (UTC)

Formerly, you do seem to have a knack of running into difficult people... Cheers anyway, ἀνυπόδητος (talk) 18:50, 28 March 2014 (UTC)

very nice

this] was a very clueful statement, on several levels. and kindly stated. Jytdog (talk) 23:52, 31 March 2014 (UTC)

Cost

I left an inquiry at the WikiProject Pharmacology/Style guide about using the section heading "Cost." https://en.wikipedia.org/wiki/Wikipedia_talk:WikiProject_Pharmacology/Style_guide#Cost

If you have any opinions about it, you might want to comment. --Nbauman (talk) 04:12, 6 April 2014 (UTC)

Thanks

Thanks for the work that you've been doing on the RS noticeboard, and especially in addressing our questions from the Corexit article. Geogene (talk) 16:37, 15 April 2014 (UTC)

• Good to see you here :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:44, 16 April 2014 (UTC)

Thanks Doc. I certainly get frustrated at times, but I suppose everyone here does. I appreciate all your help. Formerly 98 (talk) 09:37, 16 April 2014 (UTC)

Issues

There are copy and paste issues at oseltamivir and thus I reverted back to before the users first edit. Unfortunately this also removed some of your contributions.Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:51, 16 April 2014 (UTC)

Good to have your input. I'm not sure you'll agree with a lot of my edits either, but Truebreath was not responding to my requests to engage on the Talk page, and I was getting sucked into something approaching an edit war. I posted a comment to the Talk page directed to you, but whatever you decide is fine. Formerly 98 (talk) 14:03, 16 April 2014 (UTC)

Ref

Review states "Despite the fact that SSRIs alone have proven efficacious in treating PTSD for some individuals, the National Institute of Clinical Excellence (NICE) conducted a meta-analysis of approved drugs (paroxetine and sertraline), illustrating that the effect size in medication trials, unfortunately, does not exceed the 0.05 criterion to establish clinical efficacy in this regard"

Read More: http://informahealthcare.com.ezproxy.library.ubc.ca/doi/full/10.1517/14656566.2011.604030

Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:17, 24 April 2014 (UTC)

I overcut, conflating "sertraline" with "medication", as both are used in the same sentence. Nonetheless, upon additional research, I think the cut should be restored in its entirety.

• The more recent meta analysis cited in the lede states that sertraline is effective in PTSD
• The first of the two deleted sentence clearly misquotes the NICE guideline, which states several circumstances in which PTSD should be treated with medication.

thanks Formerly 98 (talk) 08:39, 24 April 2014 (UTC)

Agree with the removal of the first sentence. NICE however is still notable IMO. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:51, 24 April 2014 (UTC)

Fair enough. Normally I'd kick the older analysis in favor of the newer one, but I"m a NICE fan too. Formerly 98 (talk) 08:57, 24 April 2014 (UTC)

May 2014

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Few minor points

• Paraphrasing is better than using quotes
• Use person rather than patient per the MOS

Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:08, 6 May 2014 (UTC)

And why did you remove "No studies as of 2010 show improved clinical outcomes in children with high cholesterol though statins decrease cholesterol levels." Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:10, 6 May 2014 (UTC)

Agree that literature now leans towards benefit. Have summarized a bit. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:26, 6 May 2014 (UTC)

Thanks. I had no good reason for leaving out the kid study other than that it did not contain outcomes data (for obvious reasons). I see your point though, thanks for putting it back in.

Appreciate your help with this. Formerly 98 (talk) 15:48, 6 May 2014 (UTC)

your edits on Glaxo

(moved discussion to article Talk page)

IPs

Actually I linked both sides for the viewpoints on IPs. (See: WP:IPHUMAN.) I mentioned the IP v. registered user aspect because it weakens Steeletrap's argument that Binksternet was being bitey to the "newbie". Steeletrap actually erred in one of her "admonitions" to Binkster. She said Binkster had posted a big red warning sign when he had actually posted the blue notification icon. (All of this is done by Twinkle templates.) For me, I think there are a variety of IPs. Once in a while I will edit from my IPad as an IP because I'm too lazy to logout and log back in and then log out so that I can log back in on my regular computer. Some IPs are school IPs where the kids want to experiment or be cute. Some business IPs have COI with the articles they edit. But IPs enjoy a lower status on WP compared to newly registered users and users with a lot of experience. We've got good IPs, bad IPs, and ugly IPs (aka, vandals) With this in mind, I hope you will remove or strike the sentence "but freely admits he considers IP users not human and perfectly fine to abuse." This is just not the case. Thanks. – S. Rich (talk) 17:06, 24 May 2014 (UTC)

@Srich32977:I struck it and apologize, but still think that was an inappropriate defense of what is in some cases simply abusive behavior. Most new users start as IP addresses and register after deciding they will stay on. And jumping onto the talk page of a new user with threats of blocking over a minor difference of opinion about what genre a song belongs to is not appropriate, especially when demanding "sources" for such assignments when no sources were provided for the old ones. Its both WP:BITE and WP:OWN.

I just find a striking dichotomy between the sometimes aggressive nature of Bink's interactions with others and the sensitivity he feels to being on the recieving end of perceived mistreatment. I understand that you do not agree. Formerly 98 (talk) 18:01, 24 May 2014 (UTC)

Thanks, and your gracious apology is accepted. Yes, Bink can get aggressive and snarky and bitey. And I think it is a waste of time to template the one-time IPs who do lousy edits. (I usually just revert and move on.) Between the two, Binkster is a more valuable contributor by far. Steeletrap has contributed as well, and I've asked her to help on certain economics related topics. But Steeletrap has a POV that impacts her editing and that POV got her topic banned. And antipathy is now a factor in her relationship with Binkster. Why she won't just agree to a voluntary IBAN and move on confounds me. I'm sure that if she would, Binkster would agree to make it mutual. – S. Rich (talk) 18:23, 24 May 2014 (UTC)

@Srich32977: No need for thanks, I mis-characterized your statement, was out of line, and it wasn't a particularly graceful apology. But thanks for your remarks. Formerly 98 (talk) 18:54, 24 May 2014 (UTC)

Starting a formal discussion at Talk:Isotretinoin

Hello Formerly 98. You made a complaint about this article at ANI. I've now closed it since it is evident that no further admin action will be taken. Let me know if you need any assistance in starting up a formal discussion (such as an WP:RFC) at Talk:Isotretinoin. If you take the initiative towards an agreement that will improve your credibility in case any further disputes occur. Thanks, EdJohnston (talk) 16:35, 25 May 2014 (UTC)

Thank you for your time and effort. Things got a little out of hand that last day before the protection of the article and we definitely dont want to go back there. I'll look into the Rfc today and see if we can get some more eyes on this. Formerly 98 (talk) 17:07, 25 May 2014 (UTC)

@EdJohnston: Any objection if I take this over to the Pharmacology Project with a request for input instead? I think a lot of the issues are MEDRS related and will be better understood over there. Formerly 98 (talk) 19:23, 25 May 2014 (UTC)

It might be simpler to open the discussion at Talk:Isotretinoin and then post at the Pharmacology Project requesting their input. If you want agreement on a change to the Isotretinoin article there is no substitute for a discussion there. An RfC has an automatic publicity mechanism since it gets announced at various places. EdJohnston (talk) 20:36, 25 May 2014 (UTC)

Steeletrap

You told Steeletrap not to be the world's or Wikipedia's policeman. Steeletrap is female and so can't be a policeman. Robert McClenon (talk) 01:18, 26 May 2014 (UTC)

@Robert McClenon: Ooops. I guess I was obnoxious in more ways than I meant to be. When one is preaching, one ought to get it right. Oh well, tomorrow is another day. Formerly 98 (talk) 01:36, 26 May 2014 (UTC)

Indentation errors

Mind if I fix those? I ask because it'd look really catty to simply "correct" you by myself. Steeletrap (talk) 02:35, 26 May 2014 (UTC)

@Steeletrap: Please feel free. Glad to hear that the ban may be off the table, would be nice if a longer term fix is possible. I understand that these things are difficult and have some tough relationships here myself, as you may have noted already by perusuing this page.Formerly 98 (talk) 02:51, 26 May 2014 (UTC)

I hope he agrees to the deal I've put forward.

I'm really glad you showed up to the thread. I was being railroaded for political reasons. You criticized my conduct, but also saw the emerging "consensus" for what it was. Steeletrap (talk) 02:56, 26 May 2014 (UTC)

@Steeletrap:I try to avoid being the subject of those things for exactly the same reason I avoid playing other random games of chance like Russian Roulette. Its all politics and luck of the draw, and there's nothing fair about them. This one was turning into a lynch mob.

When you have the unfortunate experience of being pulled into one, I think its always best to try to present yourself as being more agreeable and willing to apologize/compromise than your accuser. Being right isn't as helpful as being perceived as flexible and easy to work with. I hope you work this out. I certainly don't sit in judgment of either you or Bink, I see what may be some personal failings here none that I don't see in myself. I'd also suggest not taking too much heat trying to clean up after Bink's behavior toward newbies. There's too much of that stuff here for any one person to take it on themselves to fix, and maybe just maybe he heard some of what I said today. Formerly 98 (talk) 03:28, 26 May 2014 (UTC)

Look forward to perhaps working with you

Had a pharmacol post at med school (alongside chem at the UG campus), but am fundamentally a drug discovery chemist. If we can collaborate on anything, I would look forward. Cheers, Le PRof Leprof 7272 (talk) 14:43, 28 May 2014 (UTC)

Cite book templates

We often use these for formatting references. This page WP:MEDHOW shows how they work. Best Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:23, 12 June 2014 (UTC)

Cite journal is a much nicer way to format references that the cite web template when you are dealing with journals. All you need is the PMID and it will fill in the rest of the details. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:13, 12 June 2014 (UTC)

@Jmh649: I normally use one of the online programs (Dberri) with the PMID, but have been having intermittent trouble getting onto pubmed the last few days. Anything like that on your end? Formerly 98 (talk) 16:38, 13 June 2014 (UTC)

Pubmed has been working well for me... Deberri is a good tool. Works for the ISBNs of books aswell. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:20, 14 June 2014 (UTC)

OK thanks, maybe its my router dying. Formerly 98 (talk) 00:27, 14 June 2014 (UTC)

Hi Formerly

...respect your work. Please see Talk at Atorvastatin article, before reverting edits (in re "and coworkers"). Thanks. Le Prof Leprof 7272 (talk) 23:27, 14 June 2014 (UTC)

Collapsible tables

This should be nearly never used. They cause issues for those who are using screen readers. What I typically do is either leave the table displaced or if there is too much content move it to a subpage called "List of brand names of X" Best Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:02, 17 June 2014 (UTC)

@Jmh649: Fair enough. I saw you do that on another article but I don't know how to do that, if you could give more detailed instructions that would be great. Hope you had a good weekend. Formerly 98 (talk) 00:07, 17 June 2014 (UTC)

You mean move content to a subarticle? Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:12, 17 June 2014 (UTC)

@Jmh649: Believe it or not I've never created anything here. I just tinker with what others have started. I think it's that fundamental lack of creativity that characterizes chemists everywhere. :>) Formerly 98 (talk) 00:24, 17 June 2014 (UTC)

June 2014

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Your guidance on Desiccated Thyroid Extract Wikipedia article

Hi, I came across your username in the history section of the Desiccated Thyroid Extract article. Would you mind helping out a fairly new editor to improve the article? My interest comes from personal experience with a Thyroid issue and my desire to contribute edits that make the article more useful to the reader. I am currently working on a few things: 1) Citations 2) Replacing poorly sourced citations and 3) adding information to the chemical data box. Since you are a chemist, would you be willing to add more information to the data box or suggest a few reliable sources to obtain this type of information? I have drafted an outline of categories at the bottom of my sandbox based on another drug's data box but am unsure of how appropriate they are. Any feedback or assistance would be appreciated. Thank you!

Presto808 (talk) 01:34, 26 June 2014 (UTC)

Happy with your imput in "surrogate outcome"

But you have put a red flag of imbalance above this article;

There is no doubt that treatment of bloodpressure lowers stroke, and that the use of antihypertensives saves lives. I thought this was obvious. But we need to be critical. Dual RAS didn't. Alpha blockers didn't. Intensive blood pressure lowering under 140/90 didn't. In diabetes lowering blood pressure under 130/80 harmed. The adagio "the lower (surrogate) the better" is dangerous in hypertension. That kind of problems are described in the text.

Otherwise the farmacological treatment of BMI and HbA1c surrogates has costed billions of dollars and didn't apport proven benefit, (excepted for metformin). The farmacological treatment of BMI almost always didn't work or harmed.

The predecessor of the statins the fibrate atromidin costed lives.

The use of surrogate outcomes and compound outcomes in medical litterature may mislead readers (doctors and patients) if the limitations of these endpoints are not adequately explained. I try to explain the limitations of different surrogate and compound endpoints.

I will try too make the text more balanced in developping the first part.(benefits of surrogate endpoints). But hard outcomes for recent medications are hard to find.

I will remove the primary sources. but this will take some time.

I hope then you can remove your flag.....

You said "Antibiotic trials are performed on the basis of the well established surrogate endpoints of physical signs and symptoms of infection. If we required a mortality endpoint in every clinical trial, the shortage of new antibiotics would become more acute, as the cost of developing drugs for infections that have mortality <10% with the current standard of care would rise into the billions of dollars."

I think The absence of physical signs and symptoms of infection (does the patient feels healthy, is the patient functioning, is he alive, did he had adverse events) are hard endpoints for treatment of an infection, not a surrogate. The surrogate is the culture and antibiogram, the minimaly inhibitory concentration (MIC) and the body temperature. I never said only mortality was a hard endpoint; you can see this in the examples cited in the text.

You said "The new hepatitis C drugs that were developed recently provide 90% viral clearance vs 50% for the old. How many patients should die of cirrhosis while we run 10 to 15 year trials to demonstrate that cirrhosis is prevented in those rendered virus free with the new regimens, just as was true of the old?" I agree; this must be put in the item benefits. But look at the hepatitis B story; hard endpoints are still lacking.

You said "The article as currently constituted notes that proof of reduction of cardiovascular death was not obtained for many years after the approval of simvastain based on surrogate markers. The implication seems to be that approval should have been withheld until the 4S trial was completed 5 years later. How many additional deaths would have occurred if the approval of statins had been delayed for an addtional 5 years? This is a terrible example and I don't understand exactly how the editor who wrote this thought it supported their POV."

I agree; but it was not me who made this text. The example is terrible; but it was preceded by the atromidin disaster. Please don't use abreviations; what is POV?

You said "Like most things in life, what is needed in clinical development is a thoughtful, balanced approach that balances potential risk with potential benefit." I agree

You say "No one waited until the protease inhibitors had demonstrated effects on mortality to approve them or begin using them. They were given to every HIV patient in the country based on serum viral load measurements, and within 2 years the rate of HIV deaths in the US was cut in half." I agree, but this is a fast deadly disease. In this case there were problems with the choice of an adequate surrogate endpoint; initially CD4 counts were used.

You said: "Similarly, no one is going to wait 15 years to make sure that clearing the HCV virus from patients using the new drugs prevents cirrhosis just like curing their infection with the old one does." I agree, HIV and HCV are two successes of surrogate treatment. This must be further examined in benefits. Do you have proof of hard endpoints for HCV? Please put them in the text.

You said: "Diabetes drugs are a very different story, in which the risk of using the old drugs is small, and the risk of approving new ones based on serum HbA1c alone is high." i agree; but intensive treatment (glycemic controle below HbA1c 6,5) is harmfull.

Finally could you give some input on the part: problems with surrogate endpoints? is it unbalanced?

--Truebreath (talk) 10:57, 22 June 2014 (UTC)

I did already some additions in the part: benefits of surrogate outcomes. Can you agree? --Truebreath (talk) 14:47, 26 June 2014 (UTC)