Talk:Birth control/Archive2

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Archive This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

Discipline "from both partners"

I plan to delete the words "from both partners" from the sentence "However, with this method, discipline is required from both partners to prevent the progression to intercourse." in the "Avoiding vaginal intercourse" section, on the grounds that I believe the sentence as it stands is false and it is not supported by a citation. I believe that discipline from both partners may not always be required. In some cases, discipline may only be required by the physically stronger person or by the one in a stronger position (e.g. on top). In some cases, discipline may only be required by the more passionate person. No proof has been provided that discipline from both partners is required. Furthermore: if one partner maintains discipline and maintains the intention not to have intercourse and intercourse nevertheless occurs, then that is rape and should be referred to as such. So, it could say something about "the risk of progressing to either consensual sex or rape," if we can find any citation providing any fact about such risk. Even if the sentence were true I object to the current wording as trivializing rape. --Coppertwig 17:09, 1 January 2007 (UTC)

I went ahead and made the change described above. --Coppertwig 03:10, 6 January 2007 (UTC)

"pregnancy rate" rather than "failure rate"

I plan to edit the article to say "pregnancy rate" rather than "failure rate" throughout. "Pregancy rate" is more courteous to people whose lives happened to begin while their parents were trying to prevent pregnancy; it's more neutral, less negative. I'm giving an opportunity for discussion here first before making the change. --Coppertwig 22:06, 7 January 2007 (UTC)

"Pregnancy rate" is more clear, also. "Failure rate" with respect to barrier methods doesn't necessarily mean the woman got pregnant - a "lost" condom or a diaphragm that came out in the middle of coitus would be described as "failures" regardless of pregnancy outcome. Lyrl Talk C 22:13, 7 January 2007 (UTC)

Coppertwig please do not open identical debates on multiple pages at once. I'll copy over your additonal points from Template talk:BirthControl infobox and my responses:

I would like to edit this infobox to change "failure rate" to "pregnancy rate". This is the usage in some birth control literature e.g. [1] and I believe this usage is growing and that it will become standard. The phrase "pregnancy rate" is much more courteous towards those people whose lives happened to begin while their parents were trying to prevent pregnancy. "Failure rate" can be perceived as very negative towards those people; "pregnancy rate" is neutral and its meaning is quite clear -- even slightly clearer than "failure rate", perhaps, which could possibly be misinterpreted in some contexts as a failure to achieve pregnancy. I'm also planning to similarly edit the wording on the birth control and natural family planning pages and perhaps other pages. I'm leaving an opportunity for discussion before making the change. --Coppertwig 22:27, 7 January 2007 (UTC)

I disagree: "which could possibly be misinterpreted in some contexts as a failure to achieve pregnancy" – but the whole point of contraception is NOT to "achieve pregnancy". A pregnancy despite use of contraception is therefore not what is being sought and not a "success" as far as the method goes, indeed it is a negative reflection on the particular method. Terminology usage in the UK is still to describe failure rates. The view that "usage in some birth control literature ... and I believe this usage is growing and that it will become standard" is a personal opinion and thus excluded from article space by WP:NOR, unless you can cite an authorative source explaining that the terminology is to change. The reference given is for a US webpage in 1997, which is hardly indicative of a changing use of terminology (just that this one paper in 1997 so phrased).
Of course I agree none of this implies any judgement on those people so borne, but we do use terms such as "planned pregnancy" or "unplanned pregnancy" when making antenatal referals or supporting people in making a decission on how they wish to proceed (continue with pregnancy or not to) - see current UK FPA's Information about unplanned pregnancy in Northern Ireland. David Ruben Talk 02:32, 8 January 2007 (UTC)
Further, and from 2006, example of terminology usage comes from Family Health International, Using Pills Correctly which describes "Typical failure rates among pill users are as high as 12% to 20% in some surveys." So I am not convinced of a changing international use of terms. David Ruben Talk 02:45, 8 January 2007 (UTC)

I like your enthusiasm, but calling it the "pregnancy rate" is just inaccurate. It's not duplicated anywhere else of which I'm aware. Like Lyrl said, a failure of a method does not necessarily mean pregnancy, it could just mean that the condom broke, etc. A method can fail without a pregnancy occurring. Also, I don't see this usage as any more "courteous" - what about women who chose abortion? Would they appreciate being included in the "pregnancy rate"? This, of course, isn't as relevant as what I mentioned initially. Joie de Vivre 03:11, 8 January 2007 (UTC)

While some people might inaccurately believe that every time birth control fails they'd get pregnant (really the fault of the pro-birth control crowd in the first place) I don't think that we should change every single article from failure rate to pregnancy rate. It seems impractical, especially since, if the original source doesn't include the pregnancy rate, it would make it more difficult to compare findings. Or at least that is what I believe. What would we do in those cases where a study simply lists the failure rate? Use a conversion method devised by another study? Chooserr 04:30, 8 January 2007 (UTC)

In the context of Vasectomies (where this debate is linked), the term failure rate is an applicable term - as the procedure is a surgical sterilization of the male reproductive system, therefore any conception that results is due to a failure in this procedure. To state POV/NPOV in either direction for this sepcific discussion could lead to a long and complex argument, with little gained by any but in the case vasectomies specifically, then it's innaccurate to not descibe it as such. --RedHillian 04:35, 8 January 2007 (UTC)

I apologize for opening the same discussion in different places. Thanks, David Ruben, for helping straighten this out. I've just now put notes on multiple other birth control pages alerting people to this discussion, indicating a desire to make the same change on those pages too, and directing them to comment here; I hope I did that right this time.
In reply to David Ruben: I agree that the point of contraception is to avoid pregnancy, but I fail to see how this fact prevents misunderstandings occurring. The writer could be talking about contraceptive methods and the reader could wrongly think that methods to achieve pregnancy were being discussed -- especially on a page such as Natural Family Planning where both types of technique are likely to be discussed on the same page, but also on other pages where a reader might for some reason think both types of technique were being discussed. I don't think we're necessarily constrained to stay with any particular terminology for example the terminology of a particular country; I think we're free to choose another terminology, for example if some of us find it to be more courteous and/or less ambiguous and if others have no strong objections. The view that "usage in some birth control literature ..." True, this is a personal opinion; but since I'm not proposing to make such a statement in the article, it's irrelevant whether it's excluded from article space. It's not excluded here, where the goal is to find a consensus among Wikipedian editors as to what the article should say.
I did Google searches for "failure rate" "birth control" and for "pregnancy rate" "birth control" and got a larger number of pages for the latter. I've also given an example above of a web page using the "pregnancy rate" usage; I've also seen it other places, as well as seen the idea expressed that it's more respectful of people who were born under such circumstances.
"Of course I agree none of this implies any judgement on those people so borne..." Maybe you're missing my point. I think that if someone has been born in spite of birth control (as many people have been), and knows or suspects it, and if that person is depressed, (as many people are), and if that person reads these articles, it may be very difficult for that person to avoid thinking that there is an implication here of a negative judgement on them, such as the idea that that person is a failure. So I'm saying it does imply judgement (at least in the minds of some such people). So, I'm not sure who you're agreeing with here.
I'm OK with the terms "planned pregnancy" and "unplanned pregnancy"; they don't seem too negative to me. It's the term "failure rate" that I would like to eliminate as much as possible in this context.
In reply to Joie de Vivre: So, is it your understanding that when it says in the birth control infobox, for example on the page about the Diaphragm, "failure rates (per year, with spermicide)/Perfect use: 6%/Typical use 10-39%" is it your understanding that this does not mean that there is a pregnancy rate of 6% and of 10-39%, but that those include a rate of something else happening (e.g. diaphragm falling out or something)? I think you've misinterpreted the phrase "failure rate" in the birth control infobox, and that changing it from "failure rate" to "pregnancy rate" will help prevent people misunderstanding it just as you have just misunderstood it. What do other people think? Does it actually mean a pregnancy rate of 6% or is it talking about some other definition of "failure"? This phrase "failure rate" occurs in the birth control infobox which is on many birth control pages; it would be good if the term were clearly defined and understood by everyone.
In reply to Joie de Vivre saying Also, I don't see this usage as any more "courteous" - what about women who chose abortion? Would they appreciate being included in the "pregnancy rate"? I think I don't follow your point here. Maybe you could explain more fully what you're getting at. I suppose different people who have chosen abortions will have different opinions. I think some people may feel a little depressed or belittled or offended on reading "failure rate"; I don't see any reason why anyone would feel particularly bad on reading "pregnancy rate". I think a woman who has chosen an abortion and who herself was born when her parents were using birth control may feel depressed or belittled or offended on reading "failure rate", just as someone who has not had an abortion may also feel on reading that. Actually, I think having had an abortion would tend to make the feeling even worse, even stronger -- the depressed thought that might tend to intrude might be "I'm a failure; I'm worthless, just like the fetus I aborted." It can be difficult or impossible to push such negative thoughts out of one's mind if one is depressed. --Coppertwig 05:30, 8 January 2007 (UTC)
In reply to RedHillian: I don't quite follow. I agree that the term "failure rate" is logically applicable and accurate. However, the term "pregnancy rate" is also logically applicable and accurate (and clearer, less ambiguous, and more respectful). Do you agree that the term "pregnancy rate" is also applicable? If not, why not? Why do you say it would be inaccurate not to say "failure rate"? I don't see how not saying something can be inaccurate.
I'll rephrase - the single purpose of a vasectomy is to prevent pregnancy. It is a complex procedure requiring work that is only entrusted to a few highly trained and skilled professionals. Barring surgical reversal (where conception is the specific desired result), there is the intention of creating a sterile male, unable to reproduce, therefore any pregnancy resulting afterwards is as a result of the operations failure rather than any other choice. Regardless of personal feelings (which require a Point of view), the terming of this (at least withing the page vasectomy as anything other than failure is Un-encyclopedic. As has also been noted elsewhere in this thread, failure does not always mean conception either, failure in the case of a vasectomy could mean that viable spermatoza were detected in a semen sample from a patient, well after the sample should have been clear, a clear failure but no pregnancy. --RedHillian 06:11, 8 January 2007 (UTC)
In reply to Chooserr: Please see my reply to Joie de Vivre. --Coppertwig 05:37, 8 January 2007 (UTC)
Please read WP:NOR before any wholesale changes are made to multiple articles. Understanding of the studies and terminology is paramount before any change is made. Personal feelings aside when one reads failure rate, this is an encyclopaedic project, not personal opinion portrayed as fact. Unless you can find citations from reputable studies that state pregnancy rate, any change from failure rate would be POV and original research. We should not be going down that path, no matter how we feel. --Bob 06:26, 8 January 2007 (UTC)
I think regardless how good our personal arguments are for or against the usage of these terms, what matters most is WP:V. What term do our sources use? A quick google search finds that the FDA [2] and the ACOG use the term 'failure rate'. Who exactly uses the other term in regards to birth control? --Andrew c 21:59, 8 January 2007 (UTC)
Here are a few examples of "pregnancy rate" in the literature (there are more):
  • Cumulative pregnancy rates during lactational amenorrhoea were 2.9 and 5.9 per 100 women at 6 and 12 months, compared with 0.7 at 6 months for the LAM.
    1: Lancet. 1992 Jan 25;339(8787):227-30. Links Contraceptive efficacy of lactational amenorrhoea. Kennedy KI, Visness CM.
  • Breakage and slippage rates were determined, and typical-use and consistent-use pregnancy rates were calculated using life-table analysis, adjusted for use of emergency contraception.
    Evaluation of the Efficacy of a Polyurethane Condom: Results from a Randomized, Controlled Clinical Trial. Ron G. Frezieres, Terri L. Walsh, Anita L. Nelson, Virginia A. Clark, Anne H. Coulson Family Planning Perspectives, Vol. 31, No. 2(Mar. - Apr., 1999), pp. 81-87
  • Progestogen-only contraceptive implants are highly effective. In most studies, 5-year cumulative pregnancy rates are less than 1.5/100 women for Norplant and Norplant II.
    Contraception. 2002 Jan;65(1):29-37. Implantable contraceptives for women: effectiveness, discontinuation rates, return of fertility, and outcome of pregnancies. Glasier A.
"Pregnancy rate" and "failure rate" do not always refer to the same quantity. Where they refer to the same quantity, I prefer the term "pregnancy rate" for reasons I've mentioned above. Where they refer to different quantities, a distinction needs to be made. Another alternative is to cite the "effectiveness rate" -- this term is also frequently used outside Wikipedia; for example a method may have a pregnancy rate of 1% which means an effectiveness rate of 99%.
Maybe the Birth Control infobox does not report pregnancy rates. I consider the method and use pregnancy rates to be important quantities that people want to know and that should be in the infobox. Here's another idea: modify the Birth Control Infobox so that editors can easily list either "pregnancy rate", "failure rate" or "effectiveness rate", (or more than one of these), depending on which is most appropriate to the given method. Also, modify the infobox so that "pregnancy rate" (or "failure rate") becomes a link which goes to a definition of the term, a different definition for each method if necessary, (usually in a subsection of one of the birth control method pages or this page), or to say for example on the Condom page "pregnancy rate (per year, latex; definition)" with "definition" being a link to the definition. (Or similarly for "effectiveness" or "failure" rate.) Clearly (based on this discussion) it is not adequate to simply say "failure rate" and assume that everybody understands what it means.
I think the meaning is clearer if "pregnancy rate" is stated. Everybody knows what a pregnancy is. But who knows what a writer or editor meant to include in "failure rate", unless the definition is stated? For example, if a vasectomy does not reduce the fertility of a man but he does not get anyone pregnant because he knows he's still fertile and continues to use other methods of contraception, is that a "failure" or not? It could easily be considered a "failure" by some people but not by others. Perhaps the man considers it a "success" because his primary objective of not getting anyone pregnant was achieved. So, if we say "failure rate" some readers may think they know what we mean but be wrong. This is to be avoided.
Some of the citations used in these Wikipedia articles say "failure rate," but they generally define what they mean, which can vary from one article to another. Here on Wikipedia we're supposed to be writing concise summaries, not copying the literature word-for-word. If they give a long, complex definition that includes a description of which cases they excluded and why, we don't have to copy the entire definition. But we do have to provide accurate reporting. Just saying "failure rate" because the original article did, without providing a summary of their definition, may be very misleading. Saying "pregnancy rate" or "percent who continue to be fertile 12 months after a vasectomy" has a clear meaning in English. Just saying "failure rate" without supplying a definition does not. --Coppertwig 00:34, 9 January 2007 (UTC)
If one takes a driving test, and does not meet the required standard of competence then it is not termed as continued pedestrian activities, but as a failure. By your own arguments, we are supposed to be writing a conscie summary for an encyclopedic article, hence WP:NPOV. In your hypothectical question of the gentleman with then non successful vasectomy; then yes, it is still a failure as he has not become permanantly sterilised despite the cost and discomfort of the operation. --RedHillian 01:31, 9 January 2007 (UTC)
In the case of vasectomies, then, failure rate can mean either 1)the portion of men whose semen analysis comes back "fertile" after the vasectomy or 2)the portion of men whose semen analysis comes back "infertile" after the vasectomy but go on to impregnate their partner anyway (perfect-use failure rate). The meaning is not clear. Changing the term to "pregnancy rate" would specify that 2) was meant.
I'm not enthusiastic about the term "effectiveness rate" because nothing/no birth control has an "effectiveness" of 10-15% per year in preventing pregnancy. The infertility rate (at 10-15% of the population) has an impact on the number of pregnancies, and just subtracting the pregnancy rate from 100 does not take that into account.
As far as what the term in the infobox currently refers to, on the pages on which I've been involved (a large majority) it currently refers to "pregnancy rate". I don't think I've seen anyone so far argue that that field should be used to refer to something else. Lyrl Talk C 02:20, 9 January 2007 (UTC)
I remembered, though, for emergency contraception, the failure rate has a rather complex definition that does not lend itself to expression as a pregnancy rate. If a change to "pregnancy rate" were accepted, there would have to be an opt-out option for EC. Lyrl Talk C 02:32, 9 January 2007 (UTC)
If the infobox means "pregnancy rate", then I submit that it would be a good idea to edit it to say "pregnancy rate". Two people in this discussion (Joie de Vivre and Chooserr, see above) have claimed that it does not mean "pregnancy rate" but means something else. If they have misunderstood it, then I guess many other readers of the pages have also misunderstood. This is a serious problem.
Look at the Condom page, for example. It already uses all of the terms "pregnancy rate", "failure rate" and "effectiveness". In some cases, the meaning is clear, and in some cases it is not. It says The method failure rate of condoms is 2% per year.[1] The actual pregnancy rates among condoms users vary depending on the population being studied, with rates of 10-18% per year being reported. (Note that the phrase "pregnancy rate" was already being used here before I came along.) Without actually going and looking at the citation it is not 100% clear whether "method failure rate" could mean that there was a certain rate of condoms breaking (but not usually leading to pregnancy). Note that the citation for the 2% "failure rate" gives a URL to a page which does not use the word "failure" anywhere on it. Therefore, this instance of the word "failure" should be changed. The citation says Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception and the percentage continuing use at the end of the first year. To my mind, "pregnancy rate" is a much better concise summary of this long phrase than is "failure rate".
I hereby clarify or modify my original intention: I don't intend to change the phrase "failure rate" everywhere it appears. I only wish to change it when another phrase such as "pregnancy rate" is equally clear and accurate (but more courteous) or more clear and accurate in the context. For example, in the section "causes of failure" on the condom page, I might not edit "fail", "failure" or "failure rate" because it seems to be talking about condoms breaking, not pregnancy. (Or is it?) But the Condom page gives a use "pregnancy rate" in the main text and a similar number for "failure rate" in the infobox; I would like to change the infobox to say "pregnancy rate" at least in this instance, which would only be making it agree with the text. --Coppertwig 02:55, 9 January 2007 (UTC)
In reply to RedHillian re driving test etc.: I don't disagree with your first two sentences but by themselves they don't disprove anything I've said; you might want to try explaining your arguments more fully. Re vasectomy, I see that in your opinion it (what precisely? see below) would be a failure; this confirms my opinion that to some people it would be a failure, and doesn't change the idea that there are likely also people who would not consider it a "failure". Personally, I would look at it like this: The overall goal is to prevent pregnancy. As a step towards this goal, sterilization is attempted. The attempted sterilization doesn't work and can therefore be referred to as "an attempted sterilization that didn't work" or as "a failure" or as "continuing fertility after vasectomy" or by any of a number of other phrases (it is not necessary to use the word "failure"). In the example I give, the attempt to prevent pregnancy did nevertheless work, so the attempt to prevent pregnancy can be referred to as "an attempt to prevent pregnancy, which worked" or as "a success" or as "managing to avoid pregnancy" or by any of a number of other phrases. So if we ask, "was it a failure?" I would say the answer to this question depends on what exactly is referred to as "it". In the Birth Control infobox, "it" is not defined so the meaning is not clear. --Coppertwig 03:23, 9 January 2007 (UTC)
OK, summing up - are you agreed with me that in the specific case of page Vasectomy, the term failure rate is applicable as an encycolpedic and neutral entry? I fully appreciate that in the case of some of the other pages on this topic, the termong may not be so clear? If so, I'm quite happy to get back in my box and leave this discussion before it gets too messy! --RedHillian 04:36, 9 January 2007 (UTC)
Other issues that have been discussed above and are not yet resolved: The proposal to change many instances of "failure rate" in many birth control articles with "pregnancy rate"; the proposal to modify the Birth Control infobox to allow "pregnancy rate" to be displayed (instead of or in addition to "failure rate" and perhaps "effectiveness"); and specificially the proposal to change this sentence on the Condom page: "The method failure rate of condoms is 2% per year" to say "pregnancy" rather than "failure" on the grounds that the citation given for this statement says "pregancy" and does not say "failure". (The pages on which I put notes directing people to this discussion are this page, the Birth Control infobox, and many but not all of the articles that can be reached by the Birth Control navigation template. I didn't put such notices on pages that don't use the word "failure" or that use the word "failure" but where it was apparent to me at the time that it likely didn't mean "pregnancy rate" in that context.)
In reply to RedHillian re the vasectomy page: I am not happy with the vasectomy page and I think it definitely needs to be modified. The problem, which IMO is much more serious than the courtesy issue I originally raised here, is that it provides a summary "infobox" which displays a "failure rate" with no link to any definition of "failure rate", and also mentions "failure rate" in the text without defining it. It's clear from the above discussion that some people (e.g. myself and Lyrl, apparently), on first encountering this wording in the article, assume that "failure rate" obviously and certainly means the rate of pregnancies, while other people (e.g. Joie de Vivre and Chooserr), encountering the same wording, assume that it obviously and certainly refers to a quantity which can be quite different both numerically and semantically from the rate of pregnancies. Assuming that the general readership of the page also contains many people who react similarly, this is a dangerous situation which can easily lead to people believing they have received certain information when in fact the information they have is false and is based on a misunderstanding of the intent of what was written. (Of course, it's not possible to avoid all misunderstandings, but when it seems likely that large numbers of people are going to misunderstand, as in this case, the article needs to be edited.) Because of the profound effects of birth control on individual peoples' lives, it's urgent that such major ambiguities be corrected.
One thing that would help: Note that on the Condom page, after "failure rate" in the infobox it says "(per year, latex)". So obviously it's possible to add information to this line in the infobox. On each page that uses this infobox, a couple of words can therefore be added clarifying what "failure rate" means in each case. For example, for Condom, it can be edited to say in the infobox "failure rate (pregnancies per year, latex)". For Vasectomy, it can say "failure rate (return of fertility, per year)" if that is what it means, or "failure rate (pregnancies per year)" if that is what it means. (This would clarify it, which is the more urgent and important thing; later I would also like to change "failure rate (pregnancies per year)" to "pregnancy rate (per year)" for reasons of courtesy and conciseness.) --Coppertwig 13:07, 9 January 2007 (UTC)
I think we may be beginning to head towards a consensus here. David Ruben, you said "I disagree" above, but it's not clear to me exactly what you disagree with. If you disagree with any of the edits that have been proposed in this discussion, and if you still disagree with them in light of the rest of the discussion, please state clearly which proposed edits exactly you disagree with.
If I don't see any objections to this specifically, I'll edit the Condom page to change the sentence I mentioned above to say "pregnancy" rather than "failure" as its citation does. Many other similar edits are also still under discussion.
I've made two test versions of the Template:BirthControl infobox. I have a version with a bugfix (User:Coppertwig/BirthControl infobox1) and a version which also has a default of "Pregnancy rates" and option to fill in "Failure" or other word as a "rate_type" parameter value to give "Failure rates" (User:Coppertwig/BirthControl infobox2). The bugfix allows the default values (usually question marks) to be displayed as they should when blank or null parameter values are set. I can put "rate_type = Failure" into the infobox call on most pages and then install the new version of the infobox, and "Failure rates" will still appear the same as it does now on those pages with "rate_type = Failure". I propose to have "Pregnancy rates" appear on the Condom page, though, on the grounds that the numbers displayed apparently come from a citation that does not use the word "failure" and for reasons discussed above. Later I intend to look more closely at some of the other pages and comment on which words are most appropriate on those pages.
RedHillian: to answer your question slightly more directly: I don't believe we're restricted to any list of "encyclopedic" terms. We're free to use the English language including occasional words from other languages if appropriate, and in each specific context we can choose words based on clarity, style and other considerations within a consensus-building process. Because I don't think in terms of a restricted list of allowed words here (as opposed to the Simple English projects) I don't see how I can give a yes or no answer to your question. However, I hope the paragraph directed to you about the vasectomy page above is a sufficient answer. --Coppertwig 04:43, 10 January 2007 (UTC)

[reset indent] - Coppertwig I do not see consensus in the above for this change (either for all BC articles or various rephrasing in specific articles). This edit to Essure therefore seemed a little premature. Absence of people responding back to your replies is not evidence of their change of view & agreement; although I agree you do discuss well :-) We could perhaps do with some additional editor views, but before perhaps adding a request at Wikipedia talk:WikiProject Clinical medicine, are there any points/issues/framework for further discussion that we wish to agree upon first (eg set up outline for a straw poll on various aspects of the above discussions) ? David Ruben Talk 02:07, 4 February 2007 (UTC)

First, let me clarify what I'm doing here. Note that the first three changes listed below make little or no difference to how any of the articles display and do not in themselves change "failure rate" to "pregnancy rate" anywhere.
  • Default values: the current version of the template BirthControl infobox has one behaviour if a parameter is not specified at all (usually displaying a question mark), and a different behaviour if a parameter is assigned a blank value. The version User:Coppertwig/BirthControl infobox1 modifies this so that the default value (usually a question mark) is displayed whether the calling page does not mention the parameter or assigns it a blank value. I think that most or all pages using this template do assign values, so it will make little or no difference now, but will I hope be a convenience for future users and maintainers of the template. This modification has nothing to do with whether the infobox says "Failure" or "Pregnancy" and perhaps should be in a separate discussion; I mention it here because I propose to make both changes to the infobox simultaneously.
  • Adding "rate_type = Failure" to various pages: This change by itself, which I did a few hours ago, makes no difference to how the articles look. As long as this line is left as-is, then going from version infobox1 to version infobox2 will make no difference to how the articles look. However, if this line is deleted or changed, then the articles can be modified to say something else instead of Failure: perhaps Pregnancy as in "Pregnancy rate", or Failure with a footnote attached and the footnote can explain the definition of Failure, or some other text.
  • Installing version User:Coppertwig/BirthControl infobox2 at Template:BirthControl infobox: I haven't done this yet but am proposing to if there is no objection. As explained above, this change should have no effect on the phrase "Failure rate" in the infobox as long as the rate_type line is left as-is. I plan to modify the documentation for the infobox too, so that people using it on new pages would tend to copy in a rate_type line. This modification is not intended to have any immediate effect on how the articles look, but it adds flexibility allowing the following changes to be made. I propose to skip version infobox1 and just install version infobox2.
  • Changing "Failure rate" to "Pregnancy rate" in the infobox on the Condom page: I propose to make this change, which as I pointed out above will make the wording of the infobox conform more closely to the citation its information is based on, since the citation says "pregnancy" but does not say "failure". I put a note some time ago on the Condom talk page about this, directing discussion to take place here. The above changes, which do not in themselves change the way the pages look, allow this change to be made.
  • On the Vasectomy page, I think it would be good to attach a footnote to the word "Failure" in the infobox, with an explanation of what is meant by "Failure". I would have to read the references to see what is meant (pregnancy rate? rate of continuing fertility?). Again, the version infobox2 allows such a footnote to be added. For an example of what this looks like, see User:Coppertwig/Sandbox4.
The change I made, adding "rate_type = Failure" does not in itself change the way the articles look. The next change, installing the version infobox2, should make no change to how the "Failure rate" header displays. The change from "Failure rate" to "Pregancy rate" in the infobox on the Condom page has already been discussed above and I don't see any objection to it after I pointed out that this brings the wording closer to what is in the citation. Related changes on the Vasectomy page and other pages may require further discussion. People are welcome to comment here on any of these changes. --Coppertwig 13:39, 4 February 2007 (UTC)
If you want to ask for more opinions from Wikipedia talk:WikiProject Clinical medicine that's fine. What question were you thinking of asking? The question could be whether to change the heading in the birth control infobox specificially on the Condom page from "Failure rate" to "Pregnancy rate". It seems unnecesary to me to seek a lot of opinions about internal changes to the template that won't affect the display, but you can if you want.
I oppose having a vote covering wording in multiple pages at the same time. I think each page needs to be considered individually, without having to deal with constraints imposed by people who were voting about birth control in general, possibly without having considered the specifics of particular pages: for example, some methods are single-use; some might have purposes other than just avoiding pregnancy, such as the vasectomy page where the purpose may also be avoiding having to use other forms of birth control, some might have specific wording used in the citations, etc. There may be other things one would discover one has to consider when editing a particular page. I don't think the editors of each page should be constrained by an overall vote. --Coppertwig 17:18, 4 February 2007 (UTC)
Re the vasectomy page: In the infobox I see failure rates of 0.1% and 0.15%, but I don't see any supporting citation anywhere on the page. We need (a) a supporting citation, and (b) the definition of "failure", which will depend on what definition is used in the citation (which could be pregnancy rate, or rate of continuing fertility, or something else.) --Coppertwig 17:25, 4 February 2007 (UTC)
Here's a citation re vasectomy: The risk of pregnancy after vasectomy Here's another one: " How reliable is a vasectomy? Long-term follow-up of vasectomised men. The Lancet, Volume 356, Issue 9223, Pages 43-44 N. Haldar, D. Cranston, E. Turner, I. MacKenzie, J. Guillebaud" --Coppertwig 17:50, 4 February 2007 (UTC)
And I also propose to make the following change, as I suggested earlier and I don't think anyone has objected: on the Condom page, changing "failure" to "pregnancy" in "The method failure rate of condoms is 2% per year.[1] The actual pregnancy rates..." (near the end of the section on effectiveness in preventing pregnancy), which will also make this part conform more closely to the citation, which as I mention above says "pregnancy" and does not say "failure". --Coppertwig 21:37, 4 February 2007 (UTC)
I don't have immediate easy access to the text of the vasectomy studies I mentioned above, so I'm hoping maybe someone else will pull the relevant information out of them. (Or find other citations.) The abstract of the first one is available online but I don't think the full text is -- I could be wrong. --Coppertwig 01:51, 7 February 2007 (UTC)
David, I do not see opposition to the changes I propose in the list immediately after "First, let me clarify what I'm doing" above. Someone may hold a vote if they wish provided case-by-case editing of each page is one of the options. Someone may seek to involve more people in this discussion if they wish. I've already made edits on many pages with a link to here in the edit summary, and put two notes each on the Condom and Vasectomy talk pages as well as the original notes on a number of other talk pages, directing discussion here. If someone thinks I should follow some procedure before proceeding, that one will need to tell me specifically what that one thinks I should do. Anyone is welcome to comment here on the proposed changes, stating reasons for any opposition. II don't think I've assumed that anyone has changed their views; I think the proposed edits are consistent with most or all of the views that have been expressed in this discussion. In particular, David, although you've asked me to wait, it isn't at all clear to me that you've expressed opposition to any of the proposed edits; if you do oppose them, please clarify that and give reasons. --Coppertwig 01:56, 10 February 2007 (UTC)
Coppertwig, thanks for pausing :-) I only requested this as there did not seem a "positive consensus" to so proceed and there had been almost a month since the last posting in this discussion. Whilst I personally would prefer the term "failure rate" to apply across the contraception articles (both for being a better term, in my opinion, and for the consistency), it is equally true that there was no clear "negative consensus" either, and in particular no one has sought to post additional comments this month. So in the best tradition of wikipedia, Coppertwig be bold and tryout your proposed changes on the selected pages you mention above :-) David Ruben Talk 03:53, 10 February 2007 (UTC)
It's hard to sift through the above conversation because there is a lot to read. It seems like almost every editors initial concern was over unanimously changing failure rate to pregnancy rate due to Coppertwig's concerns of the former having negative connotations. Other editors said that we should follow our cited sources, and that one user not likeing the word "failure" is not enough to change medically acceptable language. However, it seems like Coppertwig's proposal has changes. It appears that a handful of articles' cited sources use pregnancy rate instead of failure rate, and that it is more accurate to use one term over the other in specific, case by case, situations. This make a lot more sense than the initial proposal to change the phrasing unanimously. One thing that may help engage other users would be to try and make posts a lot more concise. It's hard to follow a discussion when one user is taking up a lot more space than everyone else. Good luck.-Andrew c 17:18, 10 February 2007 (UTC)
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