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Wikipedia: 信頼できる情報源(医学)

en:Wikipedia:Identifying reliable sources (medicine) (18:11, 25 July 2013‎ UTC) を翻訳

この文書の要旨: 生体医学の題材についての理想的な情報源は信頼できる、独立した、公刊された資料、例えば評価の高い医学雑誌、分野の専門家による広く認知された標準的な教科書、あるいは全国的／国際的に認知された専門家の団体による[医療ガイドライン]や意見表明報告書などに掲載された、一般的（英語版）あるいは系統的なレビューです。

「Wikipedia:検証可能性#信頼できる情報源」、「Wikipedia:独自研究は載せない#資料」、および「:en:Wikipedia:Manual of Style (medicine-related articles)」を参照

ウィキペディアの記事は、医学的アドバイスを提供することを意図していませんが、健康に関する情報について、重要かつ広く使用される情報源となっています^[1]。したがって、あらゆるタイプの記事において、生体医学的情報は、信頼できる、第三者的な、公開された情報源に基づいており、正確に現在の医学知識を反映していることが重要です。

そのような内容の理想的な情報源としては、評価の高い医学雑誌に掲載された文献レビュー（英語版）やシステマティック・レビュー、関連分野の専門家によって書かれ、信頼できる出版元から出版された学術書・専門書、全国的／国際的に認知された専門家の団体による診療ガイドラインや意見表明報告書、などがあります。

このガイドラインでは、あらゆる種類の記事中の、医療・健康関連(代替医療を含む)のコンテンツに適した情報源に対して特別な注意を払うことにより、資料を選ぶためのWikipedia:検証可能性に関わる一般的なポリシーを、補助しています。他のすべてのタイプのコンテンツ--医学関連記事の中の非医療情報すべてを含む--の情報源については、この特定のガイドラインではなく、Wikipedia:信頼できる情報源にある一般的ガイドラインでカバーされます。

特定の情報源の信頼性について照会したい場合は、reliable sources noticeboardを参照するか、ウィキプロジェクト医学やウィキプロジェクト薬学などの関連するウィキプロジェクトで質問してください。

定義[編集]

「一次資料、二次資料」、「一次資料と二次資料を見分けて使用する(英語)」、および「第三者の資料と二次資料の違い(英語)」も参照

医学の一次資料は、著者が直接研究に参加したり、彼らの個人的な経験を文書化したものです。彼らは、患者を検査したり、ラットに注射したり、試験管を満たしたりするか、少なくともそれらをした人々を監督しています。医学雑誌に発表された多くの（すべてではありませんが）論文は、研究・発見についての事実に関する一次資料です。
医学の二次資料は、通常、医療のトピックについて、現在わかっていることの概要を提供する、推奨する、あるいは複数の研究結果を組み合わせるために、ひとつまたはそれ以上の一次資料や二次資料を要約したものです。例としては、医学雑誌や学術専門図書に掲載された文献レビュー（英語版）／システマティック・レビュー、医療ガイドラインや主要な医療機関が発行した意見表明報告書、などです。
三次資料は、通常、一定範囲の二次資料を要約したものです。大学生向けの教科書、一般向けの科学本、百科事典、などが三次資料の例です。

すべてのウィキペディアの記事は、信頼性があり、公刊された二次資料に基づくべきです。時には二次資料の補助として、信頼性の高い一次資料を注意深く使用することはできますが、誤用の可能性が残っていることがあります。そのため、一次資料に頼る編集は、その情報源の結論のみを説明すべきであり、専門知識を持たない編集者がその編集部分をチェックできるようにこれらの知見を明確に記述する必要があります。特に、この説明は密接に、著者による、または他の信頼できる二次資料によるデータの解釈に従うべきです。一次資料は上で定義されたように、著者によって、または信頼性のある二次資料で明確に結論されたこと以外を支持するために引用されるべきではありません（Wikipedia:独自研究は載せないを参照してください）。一次資料を引用する場合は、ウィキペディアの過度の重み付け(観点の偏り)方針に準拠するように特に注意しなければなりません。重み付けを決定するのには、二次資料を使用すべきです。

基本的なアドバイス[編集]

二次資料を優先しよう[編集]

「Wikipedia:独自研究は載せない#一次資料と二次資料」を参照

個々の一次資料は、信頼できる二次資料の結論に対して"仮面をはぐ"、あるいは反論するように、引用あるいは並置されるべきではありません。特定の観点を推進するように発表済みの情報を合成することは、独自研究の一形態であり、公開研究の場ではないWikipediaの記事では避けるべきです。論争や医学の不確実性の領域について記述するには、様々な視点を説明する信頼性の高い二次資料によって示さなければなりません。また一次資料の使用と提示の際には、過度の重み付け(観点の偏り)に関するウィキペディアの方針も尊重すべきです。すなわち、分野の専門家の意見に比例した記述を弱体化させるような形で、少数意見を支持する一次資料を集約したり、文脈抜きに提示するべきではありません。

オリジナルの一次的な研究報告がリリースされると、得てしてすぐに、学会がその新しい結果を分析する機会が得られる以前に、その科学的知見が人気のあるマスコミでもてはやされることがあります。その後しばらくは、新しすぎてレビュー記事や他の二次情報に全く反映されないことでしょう。もしそれが、|第I相・第II相の臨床試験や小規模な研究であったり、臨床的に重要な結果を直接的に測定しているわけではない研究、動物モデルあるいは細胞・組織についての実験室での成果などによる知見である場合には、おそらくヒトの健康を理解することには間接的にしか寄与しないでしょうから、こういった場合には完全に省いてしまうべきです。そうでない状況、例えば無作為割付け比較試験などの場合、総説論文(en:review article)その他の二次資料として公刊されるのに十分な時間が経過するまでは、一時的にその一次資料を引用すると役に立つかもしれません。一次資料を使用する場合、ウィキペディアでは、結果の重要性や結論を誇張してはいけません。疑わしい場合は、そのような研究に与える重みを決定するためには（それらに基づくプレスリリースや新聞記事などではなく）信頼性のある二次資料が必要になるため、一次研究への（新しもの好き精神にのっとった）言及は省きましょう。もしもその研究の結論が、言及するに値するものであるなら、それは単一の研究からのものであることがわかるように説明するべきです。例えば、

「2009年の米国のある研究では、自閉症スペクトラムと正式に診断された年齢の平均は5.7歳であった (PMID 19318992 を引用)。」

というように。十分な時間がたって、その領域のレビューが公開されるようになったら一次文献に優先してレビューが引用されるべきです。多くの場合、二次資料を使用すると、より高い信頼性で事実を記載することができます。

「米国では、正式な自閉症スペクトラム診断の平均年齢は5.7歳である（レビューを引用）。」

というように。もし妥当な期間内にその主題についてのレビューが発表されなかった場合には、一次資料に関連づけられた文章を削除すべきです。同じ一つの素材が、ある一次資料とある二次資料とのどちらでも支持されうる場合は、他の点で質が同程度であるならば、通常は二次資料を引用するほうが望ましいでしょう。

Summarize scientific consensus[編集]

Scientific journals are the best place to find primary source articles about experiments, including medical studies. Every rigorous scientific journal is peer reviewed. Be careful of material published in a journal that lacks peer review or that reports material in a different field. (See: Martin Rimm.) Be careful of material published in disreputable journals or disreputable fields. (See: Sokal affair.)

However, the fact that a claim is published in a refereed journal need not make it true. Even a well-designed randomized experiment can (with low probability) produce spurious results. Experiments and studies can produce flawed results or fall victim to deliberate fraud (See: the Retracted article on dopaminergic neurotoxicity of MDMA and the Schön scandal.)

Wikipedia policies on the neutral point of view and not using original research demand that we present any prevailing medical or scientific consensus, which can be found in recent, authoritative review articles or in textbooks or in some forms of monographs. Although significant-minority views are welcome in Wikipedia, such views must be presented in the context of their acceptance by experts in the field. Additionally, the views of tiny minorities need not be reported.

Finally, make readers aware of controversies that are stated in reliable sources. A well-referenced article will point to specific journal articles or specific theories proposed by specific researchers.

Assess evidence quality[編集]

ショートカット:

WP:MEDASSESS

Knowing the quality of the evidence helps editors distinguish between minority and majority viewpoints, determine due weight, and identify information that will be accepted as evidence-based medicine. In general, editors should rely upon high-quality evidence, such as systematic reviews, rather than lower-quality evidence, such as case reports, or non-evidence, such as anecdotes or conventional wisdom. The medical guidelines or position statements produced by nationally or internationally recognised expert bodies often contain an assessment of the evidence as part of the report.

The best evidence comes primarily from meta-analyses of randomized controlled trials (RCTs).^[2] Systematic reviews of bodies of literature of overall good quality and consistency addressing the specific recommendation have less reliability when they include non-randomized studies.^[3] Narrative reviews can help establish the context of evidence quality. Roughly in descending order of quality, lower-quality evidence in medical research comes from individual RCTs; other controlled studies; quasi-experimental studies; non-experimental, observational studies, such as cohort studies and case control studies, followed by cross-sectional studies (surveys), and other correlation studies such as ecological studies; and non-evidence-based expert opinion or clinical experience. Case reports, whether in the popular press or a peer reviewed medical journal, are a form of anecdote and generally fall below the minimum requirements of reliable medical sources.

Speculative proposals and early-stage research should not be cited in ways that suggest wide acceptance. For example, the results of an early-stage clinical trial are unlikely to be appropriate for inclusion in the Treatment section of an article about a disease because a possible future treatment has little bearing on current treatment practice. However, the results might—in some cases—be appropriate for inclusion in an article dedicated to the treatment in question or to the researchers or businesses involved in it. Such information, particularly if citing a secondary source, might also be appropriate for a well-documented section on research directions in an article about a disease. To prevent misunderstandings, the text should clearly identify the level of research cited (e.g., "first-in-human safety testing").

Several formal systems exist for assessing the quality of available evidence on medical subjects.^[4]^[5] "Assessing evidence quality" means that editors should determine the quality of the type of study. Editors should not perform a detailed academic peer review. Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions.

Avoid over-emphasizing single studies, particularly in vitro or animal studies[編集]

In vitro studies and animal models serve a central role in biomedical research, and are invaluable in elucidating mechanistic pathways and generating hypotheses. However, in vitro and animal-model findings do not translate consistently into clinical effects in human beings. Where in vitro and animal-model data are cited on Wikipedia, it should be clear to the reader that the data are pre-clinical, and the article text should avoid stating or implying that the reported findings necessarily hold true in humans. The level of support for a hypothesis should be evident to the reader.

Use of small-scale, single studies make for weak evidence, and allow for easy cherry picking of data. Results of studies cited or mentioned in Wikipedia should be put in sufficient context that readers can determine their reliability.

Use up-to-date evidence[編集]

ショートカット:

WP:MEDDATE

Here are some rules of thumb for keeping an article up-to-date, while maintaining the more-important goal of reliability. These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or few reviews are being published.

Look for reviews published in the last five years or so, preferably in the last two or three years. The range of reviews you examine should be wide enough to catch at least one full review cycle, containing newer reviews written and published in the light of older ones and of more-recent primary studies.
Within this range, assessing them may be difficult. While the most-recent reviews include later research results, do not automatically give more weight to the review that happens to have been published most recently, as this is recentism.
Prefer recent reviews to older primary sources on the same topic. If recent reviews do not mention an older primary source, the older source is dubious. Conversely, an older primary source that is seminal, replicated, and often-cited in reviews can be mentioned in the main text in a context established by reviews. For example, the article genetics might mention Darwin's 1859 book On the Origin of Species as part of a discussion supported by recent reviews.

These rules of thumb have several exceptions:

History sections often cite older work for obvious reasons.
Cochrane Library reviews are generally of high-quality and are routinely maintained even if their initial publication dates fall outside the above window.

Use independent sources[編集]

Many medical claims lack reliable research about the efficacy and safety of proposed treatments or about the legitimacy of statements made by proponents. In such cases, reliable sources may be difficult to find while unreliable sources are readily available. Whenever writing about medical claims not supported by mainstream research, it is vital that third-party, independent sources be used. Sources written and reviewed by the advocates of such marginal ideas can be used to describe personal opinions, but extreme care should be taken when using such sources lest the more controversial aspects of their opinions be taken at face value or, worse, asserted as fact. If the independent sources discussing a medical subject are of low quality, then it is likely that the subject itself is not notable enough to have its own article or relevant enough to be mentioned in other articles.

Choosing sources[編集]

Montage with central stripe reading "PLoS MEDICINE". Other images are orange segments, a woman in a blue shawl carrying a food package labeled "USA", a pregnant woman holding hands with a child, a hand holding several different pills over a lap covered by a colorful dress, patients in a hospital, and pills on a leaf. — *PLoS Medicine* and other open access journals can be useful as sources for images in Wikipedia articles. Because the above image was published under the terms of a Creative Commons license, it can be uploaded to Wikimedia Commons and used on Wikipedia. Click on the above image to find its source.

A Wikipedia article should cite the best and most reliable sources regardless of whether they require a fee or a subscription. When all else is equal, it is better to cite a source with a full text is freely readable so that readers can follow the link to the source. Some high-quality journals, such as JAMA, publish a few freely readable articles even though most are not free. A few high-quality journals, such as PLoS Medicine, publish only freely readable sources. Also, a few sources are in the public domain; these include many U.S. government publications, such as the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention.

When searching for biomedical sources, it is wise to skim-read everything available, including abstracts of papers that are not freely readable, and use that to get a feel for what reliable sources are saying. However, when it comes to actually writing a Wikipedia article, it is misleading to give a full citation for a source after reading only its abstract; the abstract necessarily presents a stripped-down version of the conclusions and omits the background that can be crucial for understanding exactly what the source says. To access the full text, the editor may need to visit a medical library or ask someone at the WikiProject Resource Exchange or WikiProject Medicine's talk page to either provide an electronic copy or read the source and summarize what it says; if neither is possible, the editor may need to settle for using a lower-impact source.

Biomedical journals[編集]

Peer reviewed medical journals are a natural choice as a source for up-to-date medical information in Wikipedia articles. They contain a mixture of primary and secondary sources. Journal articles come in many types, including original research ranging from vast studies to individual case reports, reviews, editorials and op-ed pieces, advocacy pieces, speculation, book reviews, letters to the editor and other forms of commentary or correspondence, biographies, and eulogies. It is usually best to use reviews and meta-analyses where possible. Reviews in particular give a balanced and general perspective of a topic, and are usually easier to understand.

As mentioned above, the biomedical literature contains two major types of sources: primary publications describe novel research for the first time, while review articles summarize and integrate a topic of research into an overall view. In medicine, primary sources include clinical trials, which test new treatments. Broadly speaking, reviews may be narrative or systematic (and sometimes both). Narrative reviews often set out to provide a general summary of a topic based on a survey of the literature. Systematic reviews tend to use sophisticated methodology to address a particular clinical question in as balanced (unbiased) a way as possible. Some systematic reviews also include statistical meta-analysis to combine the results of several clinical trials to provide stronger quantitative evidence about how well a treatment works for a particular purpose. Systematic reviews and meta-analyses can provide strong clinical evidence, which may in turn be incorporated into medical guidelines or institutional position papers (ideal sources for clinical evidence). More general narrative reviews can be useful sources when outlining a topic.

Research papers that describe original experiments are primary sources; however, they normally contain previous-work sections that are secondary sources (these sections are often incomplete^[6] and typically less useful or reliable than reviews or other sources, such as textbooks, which are intended to be reasonably comprehensive). A general narrative review of a subject by an expert in the field can make a good secondary source covering various aspects of a subject within a Wikipedia article. Such reviews typically do not contain primary research, but can make interpretations and draw conclusions from primary sources that no Wikipedia editor would be allowed to do. A systematic review uses a reproducible methodology to select primary (or sometimes secondary) studies meeting explicit criteria to address a specific question. Such reviews should be more reliable and accurate and less prone to bias than a narrative review.^[4] However, whereas a narrative review may give a panorama of current knowledge on a particular topic, a systematic review tends to have a narrower focus.

Some journals specialize in particular article types. A few, such as Evidence-based Dentistry (ISSN 1462-0049), publish third-party summaries of reviews and guidelines published elsewhere. If an editor has access to both the original source and the summary, and finds both helpful, it is good practice to cite both sources together (see: Formatting citations for details). Others, such as Journal of Medical Biography, publish historical material that can be valuable for History sections, but is rarely useful for current medicine. Still others, such as Medical Hypotheses, publish speculative proposals that are not reliable sources for biomedical topics.

The Abridged Index Medicus provides a list of 114 selected "core clinical journals" (this subset of the medical literature can be searched in PubMed using a 'journal categories' filter).^[7]^[8] Another useful grouping of core medical journals is the 2003 Brandon/Hill list, which includes 141 publications selected for a small medical library^[9] (although this list is no longer maintained, the listed journals are of high quality). Core general medical journals include the New England Journal of Medicine, The Lancet, the Journal of the American Medical Association (JAMA), the Annals of Internal Medicine, the British Medical Journal (BMJ), and the Canadian Medical Association Journal. Core basic science and biology journals include Science, Cell, and Nature.

Books[編集]

Medical textbooks published by academic publishers are often excellent secondary sources. If a textbook is intended for students, it may not be as thorough as a monograph or chapter in a textbook intended for professionals or postgraduates. Ensure that the book is up to date, unless a historical perspective is required. Doody's maintains a list of core health sciences books, which is available only to subscribers.^[10] Major academic publishers (e.g., Elsevier, Springer Verlag, Wolters Kluwer, and Informa) publish specialized medical book series with good editorial oversight; volumes in these series summarize the latest research in narrow areas, usually in a more extensive format than journal reviews. Specialized biomedical encyclopaedias published by these established publishers are often of good quality, but as a tertiary source, the information may be too terse for detailed articles.

Additionally, popular science and medicine books are useful sources, which may be primary, secondary, or tertiary, but there are exceptions. Most self-published books or books published by vanity presses undergo no independent fact-checking or peer review and, consequently, are not reliable sources. Books published by university presses or the National Academy of Sciences, on the other hand, tend to be well-researched and useful for most purposes.

Medical and scientific organizations[編集]

Statements and information from reputable major medical and scientific bodies may be valuable encyclopedic sources. These bodies include the U.S. National Academies (including the Institute of Medicine and the National Academy of Sciences), the British National Health Service, the U.S. National Institutes of Health and Centers for Disease Control and Prevention, and the World Health Organization. The reliability of these sources range from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature.

Popular press[編集]

The popular press is generally not a reliable source for scientific and medical information in articles. Most medical news articles fail to discuss important issues such as evidence quality,^[11] costs, and risks versus benefits,^[12] and news articles too often convey wrong or misleading information about health care.^[13] Articles in newspapers and popular magazines generally lack the context to judge experimental results. They tend to overemphasize the certainty of any result, for instance, presenting a new and experimental treatment as "the cure" for a disease or an every-day substance as "the cause" of a disease. Newspapers and magazines may also publish articles about scientific results before those results have been published in a peer reviewed journal or reproduced by other experimenters. Such articles may be based uncritically on a press release, which can be a biased source even when issued by an academic medical center.^[14] News articles also tend neither to report adequately on the scientific methodology and the experimental error, nor to express risk in meaningful terms. For Wikipedia's purposes, articles in the popular press are generally considered independent, primary sources.

A news article should therefore not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source, for example, with the |laysummary= parameter of {{cite journal}}.

Conversely, the high-quality popular press can be a good source for social, biographical, current-affairs, and historical information in a medical article. For example, popular science magazines such as New Scientist and Scientific American are not peer reviewed, but sometimes feature articles that explain medical subjects in plain English. As the quality of press coverage of medicine ranges from excellent to irresponsible, use common sense, and see how well the source fits the verifiability policy and general reliable sources guidelines. Sources for evaluating health-care media coverage include the review websites Behind the Headlines, Health News Review [1], and Media Doctor, along with specialized academic journals, such as the Journal of Health Communication; reviews can also appear in the American Journal of Public Health, the Columbia Journalism Review, the Bad Science column in The Guardian, and others. Health News Review's criteria for rating news stories^[15] can help to get a general idea of the quality of a medical news article.

Other sources[編集]

Press releases, blogs, newsletters, advocacy and self-help publications, and other sources contain a wide range of biomedical information ranging from factual to fraudulent, with a high percentage being of low quality. Conference abstracts present incomplete and unpublished data and undergo varying levels of review; they are often unreviewed self-published sources and these initial conclusions may have changed dramatically if and when the data are finally ready for publication. Consequently, they are usually poor sources and should always be used with caution, never used to support surprising claims, and carefully identified in the text as preliminary work. Peer reviewed medical information resources such as WebMD, UpToDate, Mayo Clinic, and eMedicine are usually acceptable sources in themselves, and can be useful guides about the relevant medical literature and how much weight to give different sources; however, as much as possible Wikipedia articles should cite the more established literature directly.

Searching for sources[編集]

詳細は「Wikipedia:WikiProject Medicine/Resources」を参照

Search engines are commonly used to find biomedical sources. Each engine has quirks, advantages, and disadvantages, and may not return the results that the editor needs unless used carefully. It typically takes experience and practice to recognize when a search has not been effective; even if an editor finds useful sources, they may have missed other sources that would have been more useful or they may generate pages and pages of less-than-useful material. A good strategy for avoiding sole reliance on search engines is to find a few recent high-quality sources and follow their citations to see what the search engine missed. It can also be helpful to perform a plain web search rather than one of scholarly articles only.

PubMed is an excellent starting point for locating peer reviewed medical sources. It offers a free search engine for accessing the MEDLINE database of biomedical research articles offered by the National Library of Medicine at the U.S. National Institutes of Health.^[16] There are basic and advanced options for searching PubMed.^[8] For example, clicking on the "Review" tab will help narrow the search to review articles. The "Limits" tab can further limit the search, for example, to meta-analyses, to freely readable sources, and/or "core clinical journals". Although PubMed is a comprehensive database, many of its indexed journals restrict online access. Another website, PubMed Central, provides free access to full texts. While it is often not the official published version, it is a peer reviewed manuscript that is substantially the same, but lacks minor copy-editing by the publisher.^[17]

When looking at an individual abstract on the PubMed website, an editor can click on "Publication Types, MeSH Terms" at the bottom of the page to see how PubMed has classified a document. For example, a page that is tagged as "Comment" or "Letter" is a non-peer reviewed letter to the editor. The classification scheme includes about 70 types of documents.[2] For medical information, the most useful types of articles are typically labeled "Guideline", "Meta-analysis", "Practice guideline", or "Review".

References[編集]

^ Laurent, MR; Vickers, TJ (2009). “Seeking health information online: does Wikipedia matter?”. J Am Med Inform Assoc 16 (4): 471–9. doi:10.1197/jamia.M3059. PMC 2705249. PMID 19390105.
^ Pages 102–105: Straus SE, Richardson WS, Glasziou P, Haynes RB (2005). Evidence-based Medicine: How to Practice and Teach EBM (3rd ed.). Edinburgh: Churchill Livingstone. ISBN 0-443-07444-5
^ Page 99: Straus SE, Richardson WS, Glasziou P, Haynes RB (2005). Evidence-based Medicine: How to Practice and Teach EBM (3rd ed.). Edinburgh: Churchill Livingstone. ISBN 0-443-07444-5
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