Talk:PANDAS

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[edit] Redirect

Someone should put a redirect to this article at PANDAS (no periods). I can't do this since I don't have a WP account. 72.70.61.181 03:53, 25 November 2006 (UTC)

Done. Sandy (Talk) 04:16, 25 November 2006 (UTC)
Should it not be the other way around? It seems a little out of sorts to have periods between the abbreviations when most other scientific/medical articles I've seen do not. -- Serephine ♠ talk - 03:20, 25 April 2007 (UTC)
True, DNA has no abbreviations. TimVickers 03:22, 25 April 2007 (UTC)
I actually can't remember coming across any period-separated abbreviations. Any objections to me switching the redirect/talk page across? -- Serephine ♠ talk - 03:30, 25 April 2007 (UTC)
It's been a long time since I set this up ... and I was new to Wiki when I worked on it ... but I think I thought <grin> I had to put the periods because of the issue with [[Panda]]s and [[PANDAS]] (that is, distinguishing the plural of the bear). If someone can make it all work, I'm not tied to the periods. SandyGeorgia (Talk) 23:26, 26 April 2007 (UTC)
Done. TimVickers 23:53, 26 April 2007 (UTC)
Cool bananas -- Serephine ♠ talk - 11:53, 27 April 2007 (UTC)
Thanks, Tim. I hope to begin catching up soon from my Wiki absence. SandyGeorgia (Talk) 14:20, 27 April 2007 (UTC)

[edit] Bias in "Controversy"

The "Controversy" section seems to only talk about the people who don't believe in existence. While I understand that the theory is shown in the earlier sections, there is a vast amount of statistical information that is unmentioned, and the first sentence is redundant in telling us that it hasn't been proven. I would put the other side up myself, except I cannot remember were I found it. I don't know, maybe I'm the bias one because I had it...JLAF 10:16, 25 November 2006 (UTC)

That's why it's a controversy section, which is fully referenced, factual, and based entirely on medical consensus. How is unproven "redundant"? Because someone told you you had PANDAS doesn't change the medical consensus. You've made no case here for POV; only that you disagree with the medical facts. Please make a case for POV, or the tag should be removed. SandyGeorgia (Talk) 00:35, 14 March 2007 (UTC)

[edit] Problems with POV tag

A POV tag is not appropriate because one editor disagress with content based on personal anecdote; please give an explanation for alleged POV. Leaving out the fact that there is considerable controversy surrounding the entire hypothesis WOULD be POV; on the contrary, including four sentences about the controversy is necessary to maintain a neutral point of view in face of an unproven and highly contentious hypothesis. In fact, considering the amount of controversy, four sentences is too little, if anything, and undue weight is given to the theory, over the lack of support for the hypothesis. Yes, there is a vast amount of technical information about the theory and about the controversy as well that is not included in this article, simply because no physician has yet come on board to write the article (and since there are very few physicians in the world who understand PANDAS, it's not surprising there is no one on Wiki who can write the article). Because the article is brief is not an argument for POV; you are misunderstanding NPOV. NPOV says that all significant views published by reliable sources should be presented, without giving undue weight to any one view. A group of researchers at NIH have made a name for themselves on the PANDAS hypothesis, which has been promoted on the internet because of desperate parents (not my words, read the journal-published accounts, the statement is from very reliable sources); almost all respected independent researchers continue to have very large problems with the entire hypothesis, which have been the subject of numerous peer-reviewed journal publications. If anything is given short shift in this article, it's the extent of the controversy. If there is POV (which I don't agree), the POV is in favor of the hypothesis, and not in the short controversy section, which is an understated summary of the research and published fact. Please establish a basis for a lack of neutrality in the article. SandyGeorgia (Talk) 14:59, 14 March 2007 (UTC)

I may know nothing about PANDAS but I can clearly see the article attempting to persuade me that there is controversy regarding PANDAS, and that I should believe the viewpoint disputing it, rather than accepting it. WP:NPOV says that if the reader can detect an attempt to persuade him one way or another, the NPOV rule hasn't been followed. Reswobslc 17:10, 14 March 2007 (UTC)
Well, there is a massive controversy; that's fact that can't be ignored. Can you give some examples, suggestions of sentences that might be adjusted to fix this perception? SandyGeorgia (Talk) 17:47, 14 March 2007 (UTC)
Hypothesis, not a diagnosis—undisputed fact. Unproven—fact. Controversial—fact. What wording would you change, and still remain factual? SandyGeorgia (Talk) 18:17, 14 March 2007 (UTC)
See WP:NPOV for generic examples. Specifically for this article: The PANDAS theory is a highly controversial, unproven hypothesis would be better stated as The (existence/legitimacy/recognition) of PANDAS is controversial, and is considered an unproven hypothesis by (name or description of group). (Group) alleges that PANDAS has engendered the use of dangerous methodologies for children.... In the introduction, don't qualify PANDAS as hypothetical. Just let the article describe it as whatever the person who thought of it says it is. The opposing side gets its turn in its own section. Have you ever watched Judge Judy and seen a defendant insist "no I didn't" and "that's not true" after every sentence of the plaintiff? It gets annoying. You don't want to do that on Wikipedia. Let the article describe what PANDAS is or claims to be, and then factually (as explained in WP:NPOV) describe the controversy in its own section. Reswobslc 05:31, 15 March 2007 (UTC)
I'm well versed in WP:NPOV from other areas of Wiki; the examples you give don't work for this article.
If someone can produce an ICD or DSM code for PANDAS, hypothetical can be removed from the lead. Here's some ICD codes; notice how they mention PANDAS.[1] Please review the enormous body of research that refers to it correctly as the hpothesis that it is. Reporting the referenced facts in the lead does not equate to POV. The lead should accurately reflect that it is, currently a hypothesized condition. That's fact, not controversy. Leaving it out would be POV.
You offer "The PANDAS theory is a highly controversial, unproven hypothesis would be better stated as The (existence/legitimacy/recognition) of PANDAS is controversial, ..." all of the above, take your pick, and then expand the list to name every single aspect of the hypothesis, since it is the entire hypothesis that is controversial. That wouldn't be good writing; it's the entire thing; the hypothesis is controversial. Again, referenced fact to numerous journal reports, just about anything you can read. There is no aspect of the hypothesis that isn't controversial; again, this misunderstanding may be arising because others don't know PANDAS,and the article isn't yet comprehensive, going into all the detail. I have read every medical journal report published on PANDAS in the last 10 years, but I don't feel qualified to write the comprehensive article since it's highly technical territory, and I'm not a physician. We shouldn't label articles POV when we don't understand them or know the condition or the research.
You offer and is considered an unproven hypothesis by (name or description of group). It is not considered an unproven hypothesis by any group; it is an unproven hypothesis, as acknowledged by just about every reference you can find. Listing the groups would again be poor writing. Where's the ICD or DSM code making it a medical condition? Sometimes a general statement that is true, is true, and is best left generalized. Arguing that the article isn't yet comprehensive does not equate to POV.
(Group) alleges that PANDAS has engendered the use of dangerous methodologies for children.... No, this seems to be another issue coming from lack of understanding. No group alleges it; the NIH (which is behind the hypothesis) and the TSA (whose medical board comprises the most of the rest of the researchers working on unraveling the controversy and could be considered "the other side") JOINTLY issued a warning about the methodologies. NO group considers it such; both sides of the controversy issued the warning JOINTLY. It's not a matter of one or another side "alleging"; the different parties to the controversy agree, and the referenced sources document that.
Let the article describe what PANDAS is or claims to be, ... It does. It is a hypothesized condition. Hypothetical is the accurate word, unless you can find a better one. ... and then factually (as explained in WP:NPOV) describe the controversy in its own section. It is. The controversy is confined to the controversy section, which is now labeled POV! The controversy is given less weight here than it merits, based on the research.
You seem to be arguing (accurately) that the article fails in comprehensiveness. It does; it's a hard article to write, very technical, and there is no one on Wikipedia versed in PANDAS. I don't feel qualified to expand the article, but failure in comprehensiveness does not equate to POV. The referenced facts are accurately stated, it is a hypothesized condition, the controversy is confined to the controversy section, and the only side that is not given due weight is the controversy. I'll be traveling for two weeks, so may not be able to respond for a while. I do appreciate that someone is trying to help, and I can see that the article needs to be better spell out some of the medical issues that others might not understand or be aware of, but don't want to change wording based on misunderstanding of the research or the facts—still open to wording that remains accurate. Dropping hypothesis from the lead would be inaccurate and misleading. The controversy section is accurate, albeit brief. To fix the article correctly would require an expert in PANDAS, and Wiki doesn't have a physician who speaks PANDAS. SandyGeorgia (Talk) 14:53, 15 March 2007 (UTC)
Hi there, I've tried to reword this a little to deal with some of Sandy's concerns. TimVickers 17:34, 15 March 2007 (UTC)

[edit] Hypothesis?

As this is not an established medical diagnosis and is instead a proposed mechanism in a sub-set of patients, I think it is entirely accurate to describe it as a hypothesis. It may be a correct hypothesis, or it may be incorrect, however at present it is a proposal that covers an area of research with much contradictory evidence. Describing it as a fact would be POV, describing it as a myth would be POV, but describing it as a hypothesis is simply saying what it is. TimVickers 18:13, 15 March 2007 (UTC)

Very nice changes from both Tim and Reswobslc; not a single quibble from me. Thanks so much for the effort ! It would be still be stupendous if we could write the article more comprehensively, but that would be quite an undertaking. SandyGeorgia (Talk) 18:19, 15 March 2007 (UTC)

The main problem I have with the term "hypothesis" is that it is an invalidating term - unless the people who came up with PANDAS are touting it as a hypothesis or theory themselves. It doesn't appear that way. If NIH calls it a "diagnosis", then "controversial diagnosis attributed to the NIH" is factual - anything less is not. Reswobslc 01:40, 16 March 2007 (UTC)

To accept the description of one side of this controversy is to attribute their opinions undue weight. I see hypothesis as a neutral and technical term colloquially equivalent to "Idea" and "Theory". From one of the more positive reviews linked on the page "To indicate their shared clinical features (and presumed etiopathogenesis), the subgroup was identified by the acronym PANDAS—Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections." link. TimVickers 01:51, 16 March 2007 (UTC)
Hypothesis, Idea, and Theory are not accurate, unless the NIH themselves are calling it that. I could do drugs and say I saw a pig fly, but if I were to seriously insist that as true, it would be a "claim", "assertion", or "statement" (all of which connote that I think I'm for real) rather than a hypothesis, idea, or theory (all of which connote that I'm just tossing out a guess without any serious weight). On the other hand if a pig really was flying, and I speculated that maybe it was shot from a cannon, then that's a hypothesis. It appears to me the NIH thinks this is for real, and "hypothesis" is totally inaccurate because it suggests that they don't think it's real - which appears inconsistent with what they claim on their web site. If NIH thinks it's for real, you can't suggest otherwise - any more than if I were to go and edit the Catholicism or Islam article to call their beliefs "hypotheses" just because the majority of the world doesn't agree with them. Reswobslc 02:34, 16 March 2007 (UTC)

I'm in a quandary here, scientific ideas move from hypotheses, through models to theories. As the PANDAS "idea" is not proven we can't describe it as fact and you object, possibly rightly, to us describing it as a hypothesis as although this is the correct scientific term for an idea that is currently being tested through research, it has negative connotations for the non-specialist. I propose we instead substitute the term "model" which is both reasonably accurate and in my eyes quite neutral. What do you think? TimVickers 02:46, 16 March 2007 (UTC)

Sure. In fact, it would be helpful to convey the nature of the controversy, so people understand the viewpoints of the two "sides". Clearly the NIH must think of this as more than just a mere "hypothesis" otherwise there wouldn't be a "controversy" about it. Help the reader understand what the NIH thinks, and then help us understand what everyone else thinks. Reswobslc 02:59, 16 March 2007 (UTC)

OK, but I'd never describe a hypothesis as "mere" I spend all my working hours testing hypotheses so I know they are powerful things! TimVickers 03:31, 16 March 2007 (UTC)

I'm catching a plane; sorry if this is not coherent, just some thoughts. Res seems to be making attributes to the word "hypothesis" that aren't a reflection of what is meant by the use of the word. A hypothesis doesn't imply what you're suggesting, and isn't negative in a medical or scientific sense. No one suggests it's not a valid hypothesis, worthy of testing; in fact, everyone (serious) is working on it. It's a difficult hypothesis to validate because of the controls needed and the fact that both conditions are fairly common (tics and strep). No one is saying that whatever is going on in a subset of kids with tics and OCD isn't "real"; most informed researchers and specialists agree that something may be going on that relates to autoimmunity in up to 20% of children with tics. (I can produce some research statements on that when I return from travel.) The questions revolve around whether the current hypothesis is correctly formulated—no single piece of it has yet to be validated and replicated in controlled studies. In terms of the NIH using the word "diagnosis" in one website, we don't give undue weight to one version or one website—we aren't obliged to parrot a word that is obviously wrongly-used. Factually speaking, it's not a diagnosis—where's the ICD or DSM code? It's a proposal for research purposes. A serious proposal, but not a diagnosis in the correct sense of that word. I can do far more work on conveying the nature of the controversy if someone like Tim is on board to help tweak my wording to keep it medically accurate; as a layperson, I know the controversy inside and out, and where to find all the info (see the Sandbox I set up). I can even help write the article to a more comprehensive state. But I can't work on it for the next two weeks, and I can't do it without help, because it gets into bacterial and buggy territory I don't feel trained to write. Another factor to keep in mind in terms of conflict of interest; the NIH gives buckets of research money to the TSA, and this is their baby, so the TS/OCD folk have to tread very carefully with their criticism. Criticism of the PANDAS hypothesis has been fairly muted, all things considered. Regards, SandyGeorgia (Talk) 09:06, 16 March 2007 (UTC)

Another note—just saw this: "... as some scientists think this sub-set of patients do not differ in any significant way from the remainder of the patient population and that infections do not increase the risk of Tourette syndrome." I have heard the researchers say (seminar) that they agree something may be going on with autoimmunity in a subset of children. When I can dig into my notes and papers, we should convey somewhere that they are examining the idea that a subset of tic/OCD children may have an autoimmune component. Do a PubMed search on Tourette, setting limits to the last 60 days - there was something out of the Yale group (Leckman et al) about t cells, that falls out of this research. SandyGeorgia (Talk) 09:12, 16 March 2007 (UTC)