Talk:Low-level laser therapy/Archive 1

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Archive 1 Archive 2

Hair regrowth

Most of the Harvard studies and such covered here: http://overmachogrande.com LLLT is a hair regrowth method with over 2000 scientific studies

Studies at the above url:

  • LLLT Studies
  • 2005 Clinical Client Survey of 375 people
  • 6 Reported Studies of LLLT in Hair Loss
  • Easy to understand flow chart of lllt
  • Effect of Multiple Exposures of LLLT on the Cellular Responses of Wounded Human Skin Fibroblasts
  • Effects of Low Power Laser Irradiation on Intracellular Calcium and Histamine Release
  • Laboratory Methods for Evaluating the Effect of Low Level Laser Therapy (LLLT) In Wound Healing
  • Lasers’ effect on acne linked to increased cytokine (anti-inflammatory, TGF-[beta], collagen…)
  • LLLT and it’s positive effects on destroying bacteria and treating acne, acne scars, and rosacea
  • Long Term (1 year) Results of LLLT - improved hair growth and slowed further progression [with pics]
  • Lymphoedema and Laser Therapy
  • Mechanisms of Laser Induced Hair Regrowth
  • Systemic effects of low-power laser irradiation on the peripheral and central nervous system, cutane

98.111.219.68 (talk) 06:24, 7 September 2013 (UTC)

History and Use

why are there 2 'History and Use'-s? ~Sushi 08:46, 12 July 2006 (UTC)

title indeed ?

I have the same question as the former writer here below. Low Level Laser Therapy is a more commonly used title these days. —The preceding unsigned comment was added by Sissnob (talk • contribs) 10:26, 13 December 2006 (UTC).


Additional Mechanism

how some of the near infrared treatment works with retinal cells can be found on

"Photomedicine and Laser Surgery" Clinical and Experimental Applications of NIR-LED Photobiomodulation Apr 2006, Vol. 24, No. 2 : 121 -128 Also a keyword search with methanol, infrared, retina is useful. Colinvincent 21:59, 2 April 2007 (UTC)

Scientific status

Low level laser therapy (LLLT)is still controversial, but the reasons for controversy may be changing. At the end of the previous century LLLT had enthusiastic proponents claiming success through unsupported mechanisms in an unlikely number of medical disorders like baldness and smoking. From 2001 there has been a rapid increase in published of LLLT papers in Pubmed from a dozen per year to around 200 but LLLT may stay controversial because of a newly established anti-inflammatory LLLT-mechanism. It may be a threathening perspective and cause for dispute that non-patentable LLLT could become an almost risk-free alternative to commonly prescribed anti-inflammatory drugs. In a systematic review of possible LLLT pain-relieving mechanisms, it was shown that 21 out of 24 controlled laboratory trials reported significant and dose-dependent anti-inflammatory LLLT effects in terms of reduced cytokine levels (PGE2, IL1beta, TNF alfa), reduced mRNA and COX expression in irradiated tissue and reduction of edema and hemorrhagic lesions (Bjordal et al. 2006,Photomed Laser Surg, 24 (2) 158-68. This review has been commented upon by the Bandolier website of the pain research group at Oxford university http://www.jr2.ox.ac.uk/bandolier/booth/painpag/Acutrev/Other/LLLT.html. The comment concluded "This systematic review provides a really useful basis to begin thinking sensibly about how to proceed with research." It seems to be a well-hidden secret that 59 randomized placebo-controlled trials have been performed with LLLT in musculoskeletal pain disorders. There are two Cochrane-based systematic reviews finding limited evidence for LLLT efficacy in rheumatoid arthritis and neck pain (Gross et al. J Rheumatol 2007;34:1083-102), while reviews in the Cochrane Database of Systematic review in low back pain and osteoarthrtis were inconclusive.

link to Cochrane: http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME

The latter Cochrane review has been critically reviewed by Bjordal et al. in Photomed Laser Surgery Oct 2005, Vol. 23, No. 5 : 453 -458. 

There are several laser associations with member clinicans and researchers.

World Association for Laser Therapy has a website

www.walt.nu

North American Association for Laser Therapy has also a website

www.naalt.org.

In addition, a useful site for links, research abstracts and LLLT activities is Laserworld at

www.laser.nu.

Both WALT and NAALT have the Medline-indexed journal Photomedicine and Laser Surgery as a common official journal, and PMLS has an impact factor of 1.3 (2005).

Janmagnus57 14:25, 20 May 2007 (UTC)

OR, NOT

Please watch the conclusions, they are violations of WP:OR, and note that wikipedia is not many things, including a how-to manual. Report and cite, do not discuss and conlude. Particularly, do not state that one thing (laser, modality, whatever) is better than another without a) a source, and b) a good reason. WLU 20:37, 2 November 2007 (UTC)

Restored after prod

Since article deleted under prod can be restored on request as a matter of course, I have restored the Photobiomodulation article as Low level laser therapy]]. There's a redirect from the older title. The choice of title was because of the latest Cochrane article, and the clear preference of title in the Medline search [1] .

As for the contents, the most recent Cochrane review, [2] must be included in the references, along with its conclusions: "onclude that there are insufficient data to draw firm conclusions on the clinical effect of LLLT for low-back pain" This is considered of much higher authority than any specialized journal with respect to the consensus in the profession, given that the Cochrane group is widely accepted for the specific purpose of establishing the medical consensus. Other views can of course be mentioned. DGG (talk) 20:48, 2 July 2008 (UTC)

How come my edits have been deleted?

I wrote edits expanding this page with citations and they were erased? Also, links to other web sources were deleted? What's going on here?

"Low level laser therapy has been used in clinical practice for decades — although much more in Asia and Europe than in the U.S. It has been in more widespread use in the U.S. since the 1990’s, and has begun to be used extensively in the past five years as more instruments have become available. [4]"bb 23:14, 7 October 2009 (UTC) —Preceding unsigned comment added by Boodabill (talk • contribs)

Moved to bottom per talk page guidelines. Please see WP:ES, my reasoning is there. Your edits were unsourced, or sourced to non-reliable sources, or added inappropriate external links, which is why I removed them again. Please also have a look at edit warring; I don't think you're edit warring, but we should keep reverts to three at the most and really shouldn't get to that point. WLU (t) (c) Wikipedia's rules:simple/complex 00:52, 8 October 2009 (UTC)

Scientific status?

How well established is this technique? Is it solidly established scientifically? If so, more references would be useful. Is it fringe science? Is it pseudoscience? It looks rather like one of the latter two to my eye, but I'm not an expert. From the description and claimed benefits, this technique appears to be distinct from light therapy, but the distinction between the two needs to be discussed.--Srleffler 01:06, 14 September 2006 (UTC)

Got the same feeling and some of the references are deep linked or locked from viewing. --83.94.195.21 (talk) 16:49, 1 January 2010 (UTC)
Damn - I just spent 2 hours preparing a neat response to your concern that this might be a psudoscience and accidentally quit the page and there seems to be no way to recover it
I'm new to Wiki and dont tknow the syntax
I have other things to get on with so I'll be brief
Photobiomodulation is phenomenon supported by hundreds of sustentative peer reviewed papers published in reputable scientific medical journals
you seem to like people at SPIE so start here :http://spie.org/Conferences/Calls/07/pw/bios/index.cfm?fuseaction=BO111
and here
http://spie.org/Conferences/Programs/06/pw/bios/index.cfm?fuseaction=6140
and USA Natioanl Institute of Health
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=PureSearch&db=pubmed&details_term=photobiomodulation[All Fields] OR ("low-level laser therapy"[Text Word] OR "laser therapy, low-level"[MeSH Terms] OR LLLT[Text Word])
My very old and out of date pages
http://www.thorlaser.com/LLLT/index.htm
Upcoming conferences
http://www.thorlaser.com/conferences/
Academia salad 11:31, 17 September 2006 (UTC)

Thanks for your reply. The SPIE conference abstract seems like a good answer to my question: not pseudoscience or fringe science, but still controversial. I'll add these to the article. The Thor links are probably not good references because they have a commercial interest in this technology.--Srleffler 00:01, 18 September 2006 (UTC)

Scientific status of LLLT in Wound Care?

Why has the this topic been neglected? There is good double blind placebo controlled evidence but no mention of it here. 174.115.45.149 (talk) 02:10, 23 July 2010 (UTC)

Per WP:MEDRS, we do not like using primary sources - in this case that means single experiments. Single experiments can be biased, or cherry picked to only highlight positive trials, or have a variety of flaws that prevent their use as good science, or simply be flukes due to publication bias. When a review article is produced, then its conclusions can be properly indicated. Wikipedia is not a soapbox to promote a topic, and should not be used to predict the future. When it is clear that LLLT is accepted as a valid treatment for wounds, as indicated by high-quality secondary sources, it can be clearly and prominently included - but we have to wait for that point, not anticipate it. If LLLT is actually useful for wound healing, we will find out with time, never fear. WLU (t) (c) Wikipedia's rules:simple/complex 11:19, 23 July 2010 (UTC)
If you are talking about this edit and PMID 19588536 as a source, the detail is way too excessive in the edit, and the single trial, featuring 14 patients in each group, is pretty small to draw a dramatic conclusion. At best I would summarize it as "a small trial found some evidence to support LLLT helping heal diabetic leg ulcers". But I'd much, much rather wait for a larger trial or review article. WLU (t) (c) Wikipedia's rules:simple/complex 11:26, 23 July 2010 (UTC)

the Cochrane review problems

Bjordal, J.; Bogen, B.; Lopes-Martins, R.; Klovning, A. (2005). "Can Cochrane Reviews in controversial areas be biased? A sensitivity analysis based on the protocol of a Systematic Cochrane Review on low-level laser therapy in osteoarthritis". Photomedicine and laser surgery. 23 (5): 453–458. doi:10.1089/pho.2005.23.453. PMID 16262573.

From the Abstract:

OBJECTIVE: The aim of this study was to test if a conclusion in a systematic review of low-level laser therapy (LLLT) for osteoarthritis from the Cochrane Library was valid and robust. ...

RESULTS: Only clinicians who had performed LLLT trials with negative results were invited into the review group. ... The statistical analysis held 18 questionable selections such as omissions of trials, data, and subgroup analyses. These selections systematically favored the negative review conclusion.

Without altering the review protocol, the sensitivity analysis of combined results changed to significantly positive for continuous and categorical data when data from all included trials were combined. Further sensitivity analyses with inclusion of valid non-included trials, performance of missing follow-up, and subgroup analyses revealed consistent and highly significant results in favor of active LLLT.

CONCLUSIONS: In this example, the Cochrane review conclusion was neither robust nor valid. --Dyuku (talk) 22:40, 22 July 2010 (UTC)

That is interesting, but in this case I would say not very applicable - the Cochrane Review cited in the page is published in 2008, three years after this study. I've raised the point at WT:MED - more input would be interesting on that point. WLU (t) (c) Wikipedia's rules:simple/complex 22:47, 22 July 2010 (UTC)
"Bjordal et al. in Photomed Laser Surgery Oct 2005" has been sitting on this very same talk page since 2007, it seems (see above)... I just did my due diligence... :) --Dyuku (talk) 23:01, 22 July 2010 (UTC)
I have never heard of the journal this was published in but it sounds like it exists to promote low level laser therapy http://www.liebertpub.com/products/product.aspx?pid=128 . The Cochrane collaboration is a world renowned organization whom nearly everyone has heard of. If other major reviews found benefits from LLLT that would give weight to these accusations other wise I would go with Cochrane as it does reflect the mainstream scientific opinion. Doc James (talk · contribs · email) 23:59, 22 July 2010 (UTC)
I have heard of Photomed Laser Surgery and it is a reputable peer reviewed journal...whose topics are diverse and only occasionally include LLLT studies. Sounds like you are new to the field I suggest you look the journal up on-line, and do a little reading. I also read the Cochrane Reviews and despite it's supposed reputation have frequently found there to be biases in their publications. The Lancet is also reputable and published the best meta-anlaysis on the topic so far, that found a RR of improvement of 4.05 for LLLT in acute and chronic neck pain. Dec 2009 Chow et al. —Preceding unsigned comment added by 174.115.45.149 (talk) 00:38, 23 July 2010 (UTC)
The impact factor of this journal is only 1.756. I see no problems with using the Lancet review though. Doc James (talk · contribs · email) 00:41, 23 July 2010 (UTC)
The Cochrane review is from 2005, so it makes sense to be looking for a newer review (particularly given there is a published criticism of it). The Chow 2009 Lancet review seems convincing to support claims about neck pain; Tumility 2010 similarly for tendinopathy (with its caveats); Bjordal 2006 for acute inflammatory pain. It looks like the conclusions of Huang 2009 suggest possible mechanisms for the biphasic dose response, and confirm an effect. It is telling that each of these are cautious; some stress the controversial nature of LLLT in mainstream medicine, and none seem to be certain of mechanism. The impression remains that more research is required before LLLT will become well-understood. I'd strongly suggest jettisoning the over-emphatic claims and re-writing to couch the article in terms closer to those found in the reviews above. --RexxS (talk) 02:49, 23 July 2010 (UTC)

The Lancet is already on the page (reference 3, Chow et al 2009, PMID 19913903) and is about neck pain. The Cochrane Review is about low back pain. Very different conditions, much more tissue in the lower back. I wonder if LLLT works basically like the application of heat? Anyway...

Also, may I draw people's attention to PMID 20011653 which states "Despite many reports of positive findings from experiments conducted in vitro, in animal models and in randomized controlled clinical trials, LLLT remains controversial in mainstream medicine." This isn't settled yet, and shouldn't be portrayed as such. The results are promising and accumulating, but certainty does not yet exist. Bjordal et al being on the talk page since 2007 doesn't mean it should be included now when there is a newer Cochrane review, we don't get to misrepresent the topic because of missed opportunities in the past. May I point out that the page lists LLLT as effective for many different types of pain, for which there is moderately good evidence? It's not like we're trying to portray this as quackery, just trying to keep page at the best evidence for different conditions. And Cochrane doesn't say "ineffective", it says "not enough positive evidence". They're different things and we shouldn't be falling over ourselves to point out how Cochrane is wrong. I'm not against LLLT at all, but we must wait for the evidence to accumulate rather than running ahead of it. Even Bjordal has made this point.

As a side note, sweet mother of Dog that guy is prolific... Some interesting results are coming out regarding LLLT, but let's wait for a systematic review of them. A review article about LLLT in general is probably forthcoming and should be very interesting. If the newer review makes the same point about the new Cochrane review being flawed, then we can certainly include it.

Also interesting - LLLT appears to be about as supported as acupuncture ([3]) and acupuncture is notorious among some circles (i.e. me and the people who agree with me) for possibly being just an elaborate and dramatic placebo. However, because of the differences between "effective" and "noneffective LLLT (i.e. a good quality placebo) the evidence base is probably ultimately stronger here. Though it's amusing how adding "laser" to a treatment modality makes it sexier :) WLU (t) (c) Wikipedia's rules:simple/complex 13:41, 23 July 2010 (UTC)

Also please note this review - "Based on the heterogeneity of the populations, interventions, and comparison groups, we conclude that there are insufficient data to draw firm conclusion on the clinical effect of back schools, low-level laser therapy, patient education, massage, traction, superficial heat/cold, and lumbar supports for chronic LBP." Cochrane is not alone in this criticism. I'll add this reference. WLU (t) (c) Wikipedia's rules:simple/complex 13:43, 23 July 2010 (UTC)

Types and amount of sources

The page should be relying on secondary sources; since this is a medical topic that means review articles and meta-analyses. There were far too many primary sources (single experiments), petri dish and animal models that were extended as if they applied to humans in clinical situations. For actual use as a medical intervention, the uses of LLLT should be verified using review articles and meta-analyses. For basic methodology, which is still quite controversial I believe, we should still restrict ourselves to review articles which summarize entire methods rather than single studies. Single studies are too easily cherry-picked to support single viewpoints, while review articles are more even-handed. WLU (t) (c) Wikipedia's rules:simple/complex 12:51, 27 May 2010 (UTC)

This certainly applies to the anon attempting to insert these single studies into the page. Wait until they're replicated, extended, and in particular, summarized by a review article. Chances are Cochrane will produce an update at some point, incorporating these studies when they do so. WLU (t) (c) Wikipedia's rules:simple/complex 18:37, 22 July 2010 (UTC)
Cochrane Library review only made some tentative conclusions re low back pain. Thus, its importance should not be overemphasised. There's no prohibition in Wiki against primary sources as published in peer-reviewed journals, especially in a relatively new and growing field such as LLLT.
As to "cherry-picking", we must assume good faith. That's what peer-review is for, to prevent such bias. If there are no review articles in certain areas, then primary sources must suffice and be welcomed. (And review articles are not always even-handed.) --Dyuku (talk) 22:20, 22 July 2010 (UTC)
Actually there is - please see WP:MEDRS for both points. The Cochrane Collaboration is among the most respected publishers of evidence-based medicine in the world, and we are not supposed to use primary sources, particularly low-n primary sources, to "prove" points. At best I would give those sources a single sentence but since it's less than 40 people I'd be reluctant to do even that. WLU (t) (c) Wikipedia's rules:simple/complex 22:42, 22 July 2010 (UTC)
Who's trying to "prove" points? Certainly not me. Please try to assume good faith. --Dyuku (talk) 22:53, 22 July 2010 (UTC)
Allow me to restate - "Individual primary sources should not be cited or juxtaposed so as to "debunk" or contradict the conclusions of reliable secondary sources, unless the primary source itself directly makes such a claim". Assuming good faith goes both ways - I am not objecting out of spite, I am justifying my edits in terms of my interpretation of wikipedias policies. WLU (t) (c) Wikipedia's rules:simple/complex 23:01, 22 July 2010 (UTC)

It is alot harder to achieve statistically significant p values for low n value studies...the pharmaceutical industry doesn't do large n value studies because it likes to spend money they do it because the difference between treatment and placebo (or active comparator) are so samll that you need a large sample size to detect them. The fact that LLLT studies have small n values and highly significant p value is a point in the treatment's favour. Limiting your references to reviews and meta analyses leads to bias. I do agree that in vitro and animal studies should not be included in discussions of human medicine unless they are backed up by human studies. —Preceding unsigned comment added by 174.115.45.149 (talk) 00:30, 23 July 2010 (UTC)

I find the exact opposite, that limiting the research to review articles decreases bias. Doc James (talk · contribs · email) 00:40, 23 July 2010 (UTC)

It really depends on the review/meta analysis. The funding source has a BIG impact. LLLT studies are not usually well funded, unlike the pharmaceutical industry. There is little control over LLLT publications (LLLT studies are usually academic and published regardless of outcome) in contrast the pharmaceutical (healthcare) industry keep a tight control over their studies, creating a negative puiblishing bias (worked in the industry for over 12 years now and saw how studies that failed remained unpublished "data on file". This results in biased literature reviews, and meta-analyses. Prospective double-blind placebo controlled trials avoid this issue and you can look to the p values to determine the study's statistical significance. In LLLT it is very hard to do a good meta- anlysis because the primary studies are so varied in design, apparatus, and methodology, you are stuck comparing apples to oranges. We know that LLLT has a bell shaped dose response curve (skewed)...so you have under-dosed and over - dosed LLLT studies dragging down the positive studies done in the optimum dose range. 174.115.45.149 (talk) 02:01, 23 July 2010 (UTC) —Preceding unsigned comment added by 174.115.45.149 (talk) 01:48, 23 July 2010 (UTC)

Those are precisely the points that a good meta-analysis would take into consideration. The authors' analyses are subject to peer-review and the editorial overview of the publishing journal, and we ought to be leaving criticism of secondary sources to them. Wikipedia works by requiring our editors to judge the quality of secondary sources by the quality of those two processes, and not by substituting our own editorial analysis of the content. The views that those sources present are what we report on, and there's no room here for applying another layer of individual interpretation. --RexxS (talk) 03:14, 23 July 2010 (UTC)
Please don't use "the evil pharmaceutical industry" as a reason to edit anything without a specific source for criticism. May I remind everyone that companies also make lasers and I'm not arguing that you can't use studies funded by "big laser" in the article? Everyone makes a profit from every single intervention. It's explicitly noted that LLLT appears to have a specific dose/wavelength-response relationship and that they're still figuring out the ideal wavelength. And per RexxS, we don't normally get to judge primary and secondary sources - we simply defer to the latter. If another source criticizes the secondary source, that can also be included. I will include a comment about wound healing based on this source, but it will be a very, very general one that places heavy emphasis on the fact that conclusions are both general, preliminary, and the parameters still not positively identified. WLU (t) (c) Wikipedia's rules:simple/complex 13:51, 23 July 2010 (UTC)

Reference to Blood irradiation therapies

The article Blood irradiation therapies deals extensively with LLLT. I placed a one-sentence quote from Blood irradiation therapies article to LLLT article, and it was removed. What's the problem now? --Dyuku (talk) 21:50, 23 July 2010 (UTC)

WP:PROVEIT. WLU (t) (c) Wikipedia's rules:simple/complex 22:21, 23 July 2010 (UTC)
Blood irradiation therapy is also borderline quackery with a substantial following in Russia and China with few English language publications. Pubmed turns up 10 results for "blood irradiation therapy", with one review article from 1993 in China. The other sources are mostly from the 1950s, the only one that isn't is again from China. Nothing necessarily wrong with results from China, but they're hard to review, and China has a tendency of producing no negative results for therapies they've got a hankering for. Quackwatch lists a couple BIT providers as quacks [4]. WLU (t) (c) Wikipedia's rules:simple/complex 22:29, 23 July 2010 (UTC)
Perhaps you simply don't know where to look, or under which search terms. I found this meta-analysis from 2008,
  • Zhao, S. D.; Liu, T. C. Y.; Wang, Y. F.; Liu, S. H. (2008). "Meta-analysis on intravascular low energy laser therapy": 728012. doi:10.1117/12.823336. {{cite journal}}: Cite journal requires |journal= (help)
Further discussion of this should go to Blood irradiation therapy talk page. But in general, I would recommend you follow some simple procedures, such as,
  1. Be civil to other users.
  2. Assume good faith.
  3. Don't revert good faith edits.
  4. Be gracious.
You, on the other hand, seem to follow slash-and-burn policy: delete everything, and let God sort them out... --Dyuku (talk) 19:13, 24 July 2010 (UTC)
That's a conference presentation, which is not considered a WP:MEDRS. WLU (t) (c) Wikipedia's rules:simple/complex 07:40, 25 July 2010 (UTC)

Bibliography

Bibliography section is a widely accepted feature of Wikipedia. Why did User:WLU remove Bibliography section from this article? --Dyuku (talk) 21:46, 23 July 2010 (UTC)

For individuals who write books and articles, bibliographies are appropriate - this is generally the intent of a bibliography section per the guide to layout. See WP:MOS-BIBLIO for instance. What may be appropriate would be a further reading section - but the choices used are inappropriate. Further reading should not duplicate references - leaving out Tumilty et al 2010. Bjordal we discussed above - it's a criticism of a Cochrane review that has now been supplanted. The rest are good choices for sources, not further reading. These are articles, not books. Further reading is usually books. Deppe 2007 (PMID 17268764) can and should be integrated, as can Sculean 2005 and Cobb 2006. Capon 2003 is too old and there's a newer paper integrated today, Reddy 2004 also duplicates a source added today and doesn't really add much anyway (any article that concludes with "more research is needed" isn't useful for much). Ditto for Posten, 2005 which essentially duplicates Da Silva et al. 2010. WLU (t) (c) Wikipedia's rules:simple/complex 22:13, 23 July 2010 (UTC)
To be fair, older articles do sometimes contain a section called Bibliography (not in the sense of WP:MOS-BIBLIO), which contains general references that have been used in writing the article, or for giving the reader a source for the background to the article – a kind of half-way house between Further reading and References sections – and perhaps that what Dyuku was thinking of. Nevertheless, sources in such sections are generally used multiple times in the article along with {{Harvnb}} referencing, and – as WLU points out – not duplicating full citations already used in the article. If Dyuku thinks that sources may be useful in expanding the article, I'd always recommend listing them here, on the talk page, where editors can discuss how best to make use of them. --RexxS (talk) 23:20, 23 July 2010 (UTC)
Do you mean splitting the footnotes and references section, like satanic ritual abuse? I normally use that only when there is a book cited in the article, multiple times to different pages; I'd never use it for a journal article because they tend to be short so tracking down a verification isn't that hard. But perhaps that's an idiosyncrasy. Anyway, in this case the articles are very much run-of-the-mill easily integrated into the body - I've pasted them below:
  • Tumilty, S. .; Munn, J. .; McDonough, S. .; Hurley, D. A.; Basford, J. R.; Baxter, G. D. (2010). "Low Level Laser Treatment of Tendinopathy: A Systematic Review with Meta-analysis". Photomedicine and Laser Surgery. 28 (1): 3–16. doi:10.1089/pho.2008.2470. PMID 19708800. Already integrated
  • Bjordal, J.; Bogen, B.; Lopes-Martins, R.; Klovning, A. (2005). "Can Cochrane Reviews in controversial areas be biased? A sensitivity analysis based on the protocol of a Systematic Cochrane Review on low-level laser therapy in osteoarthritis". Photomedicine and laser surgery. 23 (5): 453–458. doi:10.1089/pho.2005.23.453. PMID 16262573. About a Cochrane review that has now been replaced
  • Deppe, H.; Horch, H. H. (2007). "Laser applications in oral surgery and implant dentistry". Lasers in Medical Science. 22 (4): 217–221. doi:10.1007/s10103-007-0440-3. PMID 17268764. Is about lasers in general, not LLLT specifically, perhaps full text might be more useful
  • Sculean, A.; Schwarz, F.; Becker, J. (2005). "Anti-infective therapy with an Er:YAG laser: influence on peri-implant healing". Expert Review of Medical Devices. 2 (3): 267–76. doi:10.1586/17434440.2.3.267. PMID 16288590. Integrated, but is this about lasers in general or LLLT specifically?
  • Cobb, C. M. (2006). "Lasers in Periodontics: A Review of the Literature". Journal of Periodontology. 77 (4): 545–564. doi:10.1902/jop.2006.050417. PMID 16584335. Integrated (and equivocal)
  • Capon, A; Mordon, S (2003). "Can thermal lasers promote skin wound healing?". American journal of clinical dermatology. 4 (1): 1–12. doi:10.2165/00128071-200304010-00001. PMID 12477368. Da Silva is from 2010 and shows no real progress has been made
  • Reddy, G. K. (2004). "Photobiological Basis and Clinical Role of Low-Intensity Lasers in Biology and Medicine". Journal of Clinical Laser Medicine & Surgery. 22 (2): 141–141. doi:10.1089/104454704774076208. PMID 15165389. This appears to add absolutely nothing to the article - it's from 2004, the abstract only mentions wound healing (which Da Silva indicates is still equivocal) and concludes only that more research is needed
  • Posten, W; Wrone, DA; Dover, JS; Arndt, KA; Silapunt, S; Alam, M (2005). "Low-level laser therapy for wound healing: mechanism and efficacy". Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 31 (3): 334–40. doi:10.1111/j.1524-4725.2005.31086. PMID 15841638. Superseded by Da Silva as well
Some are still, in my opinion, superseded by newer sources and therefore not worth including. Others could be integrated with relatively little effort, I may do so in a bit (others are of course welcome). All are so specific that I'd be reluctant to include them as a general reference, with a possible exception for Reddy, 2004. WLU (t) (c) Wikipedia's rules:simple/complex 01:06, 24 July 2010 (UTC)
Have a look at Brougham Castle for example. It has Footnotes, References, Bibliography using mainly Harvard referencing. Or the section naming and referencing style in Carucage. Other articles have similar sections but name them differently, like Buckingham Palace or Oxygen toxicity. I personally also use the same scheme as you for citing multiple pages from the same source, and I'd agree that it's most useful for books, so you're by means idiosyncratic in your usage. The point remains that a section called Bibliography was not uncommon in older articles, often those not using inline citation templates, so you can see how Dyuku may have been confused about the purpose of such a section.
Anyway, I agree with your assessment of the eight sources above, although I think Reddy 2004 is getting a bit long-in-the-tooth now. --RexxS (talk) 02:06, 24 July 2010 (UTC)
Just a passing comment: The section title 'Bibliography' is being discouraged as confusing. Apparently, people in different academic fields (and perhaps also in different countries?) have incompatible ideas about what should be found under that title. As I understand it, the historians see 'Bibliography' and think, Ah, here's the list of sources consulted in building this article -- and the humanities folks see the same title and think, Finally, someone has assembled a complete list of every reputable work written on this subject. So the community is giving up on finding the One True Meaning, and is encouraging people to choose alternate headings. WhatamIdoing (talk) 02:41, 24 July 2010 (UTC)
Thanks for the comments. Ya, I looks at the examples given and shudder - begging for standardized titles. But that wasn't the use of the section on this page. I can understand the impulse but none of those articles are appropriate for such a section. Quite clearly, like a news story in an external links section, it's simply being used as a holding pen for sources that should simply be integrated. WLU (t) (c) Wikipedia's rules:simple/complex 13:35, 24 July 2010 (UTC)
My main concern was that the article should include some important literature/refs not mentioned in the main text. I posted this under 'Bibliography' section, not being aware that the use of 'Bibliography' sections is being discouraged by the style gurus. So it seems that 'Further reading' sections are being recommended instead. Fine with me! :) So then I'm providing the same titles under the 'Further reading' section. All these titles are relevant, and should be included in the article.
Just now there's been a big discussion on how the use of review articles (i.e. secondary sources) is being strongly recommended. So, great, I'll cite you a whole bunch of review articles. And all of this is being blanked because of some stylistic quibble? Why did the User:WLU simply not correct the name of the section, as he could have done? Why was the whole thing simply deleted? This sort of an aggressive, take-no-prisoners editing style is extremely unproductive IMHO.
Yes, it is better for these refs to be eventually incorporated into the main article, sure. But let's not create the situation where the perfect is the enemy of the good. I would certainly like to see more collegiality in this editing process. --Dyuku (talk) 19:44, 24 July 2010 (UTC)
Then integrate them if they are important. Post suggested references on the talk page, not on the main page. WLU (t) (c) Wikipedia's rules:simple/complex 07:42, 25 July 2010 (UTC)
I've integrated the few that I found relevant (Cobb, 2006, Sculean 2005). The rest were either old, or inappropriate - and even Cobb/Sculean are basically another "we think it's useful, but haven't identified the wavelength or proven it works." I've included my comments on each study above. The field, if progressing, is doing so rather slowly but there is still some evidence of progress. I don't know if it's pure quackery (even Barrett doesn't say so) but it's not at the point that it can be considered a miracle cure, and doesn't need a set of eight equivocal literature reviews in its further reading section. WLU (t) (c) Wikipedia's rules:simple/complex 08:09, 25 July 2010 (UTC)

LOW LEVEL Energy?

.3 to 19 J/cm sq.? At 19 J/cm sq., depending on the laser wavelength, you can easily burn a person! —Preceding unsigned comment added by 132.183.44.160 (talk) 13:37, 13 May 2011 (UTC)

Why was the text I added deleted - and is not acceptable with added references?

On January 7, I added this paragraph to this page:

"In 2002, Erchonia Medical became the first company to obtain FDA approval for a low level laser, after submitting randomized double blind sutides with placebo control establishing its efficacy to treat chronic neck and shoulder pain. Erchonia has obtained a total of five FDA approvals for its low level lasers: for pre-liposuction fat emulsification and post-surgical pain swelling and bruising - 2004; for moderate acne - 2005; for post breast augmentation pain - 2008; for non-invasive body contouring - 2010. Each of these FDA approvals were obtained pursuant to randomized double-blind studies with placebo control."

My additions were deleted. I am assuming they were deleted because I did not provide cites to support these statements. I have added four links to online copies of the FDA clearance letters that confirm the assertions made. I have a copy of the fifth FDA clearance letter, for acne, but do not yet have an online link to it. Is my revised addition below, with the online links added, sufficient to make it onto the page? If not, what else do you need? Thanks.

In 2002, Erchonia Medical became the first company to obtain FDA clearance for a low level laser to treat chronic neck and shoulder . http://www.erchonia.com/sites/default/files/k012580_0.pdf Erchonia has obtained a total of five FDA approvals for its low level lasers: for pre-liposuction fat emulsification and post-surgical pain swelling and bruising - 2004 (http://www.erchonia.com/files/uploads/1/file/K041139_EML.pdf); for moderate acne - 2005; for post breast augmentation pain - 2008 (http://www.erchonia.com/sites/default/files/K072206.pdf); for non-invasive body contouring - 2010 (http://www.erchonia.com/files/uploads/1/file/K08209%20Non-Invasive%20Body%20Contouring%20(Correction%20from%20FDA).pdf). Each of these FDA approvals were obtained pursuant to randomized double-blind studies with placebo control.Lesisko (talk) 07:49, 5 March 2012 (UTC)

Today I changed the page to include a history of FDA clearances that Erchonia Medical obtained for its low level lasers; added description and reference to online article in The Lancet supporting efficacy of low level lasers for neck pain; and added descriptions and references to two articles published on Wound Healing and Post-Operative Wound Healing.

The way this page is being edited, it appears that the editors have a bias against the efficacy of low level lasers. I will be happy to provide copies of articles and FDA clearances that prove the efficacy of Erchonia low level lasers. I can also forward pictures and videos that show the rapid healing effects created by Erchonia lasers. By obtaining FDA clearances pursuant to original research, Erchonia has achieved the gold standard that allopathic medicine requires. Erchonia lasers work differently from the other low level lasers in the market. Their lasers work at 635 nm wavelength (its acne laser has one diode at 635 nm and the other diode at 405 nm), while lasers from other companies work at 810 nm and above. A person cannot legitimately argue against the efficacy of Erchonia low level lasers at 635 nm given the FDA clearances and published research. Before deleting any new content I have added, please give me an opportunity on this talk page to respond to any objections anybody has to the additions i have posted. Thank you.Lesisko (talk) 23:37, 7 March 2012 (UTC)

Wikipedia is not a place to promote a specific product or company. It doesn't matter that one company has produced a LLLT machine, what matters are the studies that back up the use of the therapy. If these claims have studies to back them - cite the study. If it's a single trial, per WP:MEDRS we shouldn't use them. Review articles only. It's too easy to cherry-pick primary studies. I don't have a bias against LLLT, I have a bias against people promoting health treatments beyond the evidence base and acceptance within the general scholarly and medical community. WLU (t) (c) Wikipedia's rules:simple/complex 15:10, 14 May 2012 (UTC)

Quackwatch

Quackwatch is considered a reliable source, and it clearly states that it considers LLLT to be little more than a heat delivery mechanism. Claiming they are wrong without a reference, particularly given LLLT is a poorly-supported intervetion with no clear treatment indications, is inappropriate. Sources can not simply be removed because a person disagrees with them. WLU (t) (c) Wikipedia's rules:simple/complex 18:47, 13 September 2011 (UTC)

Who decides who and what is a "reliable source" on wikipedia? Is this decided on a page by page basis? Specifically, why does a blog named quackwatch.com written by a person with an MD after his name, but who is not currently licensed to practice medicine, considered more reliable than other bloggers and physicians who have used low level lasers in their practice and know their efficacy through years of experience treating patients? Lesisko (talk) 08:00, 5 March 2012 (UTC)
See WP:RS and in particular WP:MEDRS. You can also discuss specific sources at WP:RSN. Quackwatch is considered an acceptable parity source for medical topics that are considered fringe or as-yet unproven. See here, here and here. WLU (t) (c) Wikipedia's rules:simple/complex 15:12, 14 May 2012 (UTC)

Evidence from Pubmed

What this article should conclude is that the evidence is mixed - as is the evidence for just about every other treatment it seems!! Some "studies" say knee arthroscopy makes no difference but it certainly helped me and others I know. If I search for "Cold laser" on Pubmed many of the reports are positive not negative, and most commonly mixed. The negative conclusion seems overstated to me. — Preceding unsigned comment added by 81.171.97.9 (talk) 19:17, 1 October 2014 (UTC)

Journal

The "Journal of Acupuncture and Meridian Studies" has an impact factor of zero.[5]

Therefore I removed it User:Prokaryotes.[6] Doc James (talk · contribs · email) 09:05, 26 January 2016 (UTC)

Two points, Elsevier states, "The Journal of Acupuncture and Meridian Studies is a bimonthly, peer-reviewed, open access journal featuring high-quality studies", and impact factor is a controversial measure.prokaryotes (talk) 09:10, 26 January 2016 (UTC)
Besides this you link above to a Research Gate impact factor with 0, while Elsevier has much more, see http://journalinsights.elsevier.com/journals/2005-2901/snip (Or via SJR ranking http://www.scimagojr.com/journalsearch.php?q=12400154726&tip=sid ) Please be more careful when judging what appears to be reliable science. prokaryotes (talk) 09:21, 26 January 2016 (UTC)
An impact factor of 0.927 is fairly low. Doc James (talk · contribs · email) 10:01, 26 January 2016 (UTC)
What do you consider an acceptable impact factor? And is this a requirement for inclusion? Besides the actual study is a systematic review with meta-analysis, i thought that resembles something like the gold standard for medical sourcing. prokaryotes (talk) 10:39, 26 January 2016 (UTC)
It is potentially good methodology yes. But per WP:MEDRS we also want it to be from a reputable medical journal which I am not sure this is. Doc James (talk · contribs · email) 10:46, 26 January 2016 (UTC)
Since meridians don't actually exist, this journal has always puzzled me. It is potentially useful in discussing the beliefs of acupuncture in that article, but is clearly not appropriate for any reality-based topic. As with most SCAM-specific journals, it is uncritical of the concepts and claims of SCAM. Guy (Help!) 10:42, 26 January 2016 (UTC)
Can you cite a source for your claim that it is a SCAM journal? According to what appears to be an expert the review is sound, http://edzardernst.com/2015/02/acupuncture-new-meta-analysis-suggests-it-is-effective-beyond-placebo/ prokaryotes (talk) 10:52, 26 January 2016 (UTC)
while it follows MEDRS, it should be from a reputable medical journal...IMO--Ozzie10aaaa (talk) 11:13, 26 January 2016 (UTC)
The journal publishes in the area of supplements, complementary and alternative medicine (SCAM). It is a SCAM-specific journal, and the problem of uncritical coverage of SCAM claims in such journals is well documented. The "filing drawer effect" and other biases are rife in SCAM-specific journals and indicate caution when "balancing" negative findings in reality-based journals. Guy (Help!) 11:07, 26 January 2016 (UTC)
(edit conflict) Ok given that this journal is not reputable, the review is sound according to an expert, and acupuncture lists various things which seem to work. Also the part about that a. is controversial is from 2007, while reviews with positive results (i.e. cancer related treatment) are from earlier. So its not correct to state that a. is not reality based. prokaryotes (talk) 11:18, 26 January 2016 (UTC)
It's a fringe journal. That's all we need to know for this article. In terms of acupuncture more generally, there is no evidence that qi or meridians exist, the acupoints are inconsistent between traditions and studies fail to support any specificity of acupoints, so it doesn't seem to matter where you put the needles, it also doesn't seem to matter whether you actually insert them or not. This study has not changed any of those things. Guy (Help!) 11:23, 26 January 2016 (UTC)
The point of the review is that it claims that a goes beyond placebo.prokaryotes (talk) 11:35, 26 January 2016 (UTC)
And how likely do you think it is that a fringe journal like this would publish a paper saying that the entire field the journal purports to cover, is in fact bollocks? Fringe journals are not used on Wikipedia to "balance" mainstream ones. See WP:FRINGE. Guy (Help!) 14:47, 26 January 2016 (UTC)
Articles should rely on secondary sources whenever possible, the review-meta analysis apparently is a secondary source. Cite why we should not use this journal publication. Also these studies are not really fringe views, considering their exposure in the asian scholarship field. It is natural for asian/foreign science to be under represented in other parts and languages of the world. The journal is published by Elsevier which is as far as fringe as it can get. The acu. article includes many of the studies referred to. The review offers an assessment of existing published works in reputable journals. prokaryotes (talk) 15:00, 26 January 2016 (UTC)
Also you wrote in your revert summary, "contradicts reality-based journals." Then why is the lede stating "possibly chronic joint disorders"? Does this study paper also counts as fringe to balance the mainstream? prokaryotes (talk) 15:12, 26 January 2016 (UTC)
  • that is a low quality source. we use high quality sources. Jytdog (talk) 16:54, 26 January 2016 (UTC)
  • Impact factors are controversial because they amount to popularity contests. The impact factor of "0.0" is probably wrong in this case, as the journal appears to be fairly new, and it takes a while to start citing things. (I didn't see any papers from before late 2014; perhaps my search was incomplete?) Also, niche journals normally have a lower impact factor than general ones, so even if it's exactly median for its field, it will be relatively low.
    I disagree with JzG's claim that "publishes in the area of SCAM" automatically means that it's a "FRINGE journal". NPOV actually requires describing the POV of proponents in a way that those proponents will recognize. "This useless scam, which doesn't work, doesn't do anything and is a complete scam" does not meet that requirement. "According to this paper, proponents believe that this provides some benefit" can meet that requirements. WhatamIdoing (talk) 01:26, 27 January 2016 (UTC)

effectiveness

This 2010 meta-analysis indicates that LLLT is effective (contrary to the article). http://www.ncbi.nlm.nih.gov/pubmed/20842007 -- (David B) 58.96.149.251 (talk) 02:31, 17 April 2016 (UTC)

I completely agree that this article has serious problems with NPOV regarding effectiveness of LLLT. I cannot understand why majority of the content (with references) supporting effectiveness of LLLT was removed (although NPOV means representing "all of the significant views that have been published by reliable sources on a topic"). DavisNT (talk) 22:35, 1 May 2016 (UTC)

Add back History section

I suggest adding back History section that was removed here. I see that it was removed due to the fact that it was based on primary source, however the text itself is really easy to understand for general public and removing it violates NPOV. There are topics where different significant views (in this case - each evidence based) exist and neutral point of view is about knowledge and facts on the topic, so removing facts/knowledge from Wikipedia (esp. in cases when removed facts represent a view that is not well represented in the article) in undesirable. DavisNT (talk) 22:32, 1 May 2016 (UTC)

Your discussion of NPOV is not accurate. The problem has to do with sourcing (WP:V and WP:RS) not NPOV. Jytdog (talk) 22:51, 1 May 2016 (UTC)

Let's try to address your concerns

Hello Jytdog, you took exception to something in my recent edit. Hard to say which part, because you flipped the entire thing instead of just contesting whatever you thought wasn't right. :Please don't simply assume that my edit is "pushing woo." Most of my changes were fixing copyediting problems (and there were plenty). Originally I landed on this page because I came across a review study that might be helpful, but it turns out this article is already full of review study citations, surprisingly. Some show some benefit for some uses, and others don't, but it seems that this modality has been investigated enough that it's not "woo," it's just effective or ineffective for various purposes (and unknown effectiveness for other uses).
So what is your issue with my edit? Is it that I changed the order of the reviews listed for Hair Loss? I believe it makes sense to put more recent reviews first, as these should include studies that the older ones don't. If you have any problem with the wording or whatever for this, just state your preference, or make the edit yourself to bring it to improved wording. This can be a constructive process where multiple editors tweaking the wording can result in a much better final product. However if you just revert without making a suggestion, that process is thwarted. (Also, please assume good faith - I do.)
Or did you object to the sentence that I added regarding heat delivery? This is a point that needs to be added; otherwise readers might get confused and think that these lasers deliver heat. They don't (or very little anyway) - they deliver light. Hence the nickname "cold laser," though they aren't cold either, just neutral temp. I am open to discussing the wording of this sentence. Do you have a suggestion? --Karinpower (talk) 21:22, 28 August 2016 (UTC)
Almost all your edits summarizing the reviews played down the negative and played up the positive; the change in perspective was not even a little bit subtle. Please see your talk page. Jytdog (talk) 21:26, 28 August 2016 (UTC)
Ok, so the problem is with the reviews?
"LLLT might be useful for..." - I removed a strange bullet point list that only had 2 items, and changed it into a sentence. No problem there, right? Just formatting.
For Hair Loss, I put this sentence first: "No laser is FDA approved for this use." That seems like a useful caveat against any implied benefits from the studies. Are we ok there?
Just after that, a slight wording change "This type of laser does appear to be safe for this use." instead of "They however appear to be safe." I think my wording is more specific. OK?
As we get into the reviews, I would be fine with an initial sentence that says that the results are mixed, with some methodological problems (as noted in one of the 2014 reviews). Would that solve any reservation you may have about launching off with the most recent reviews (2 out of 3 of which happen to be more positive than the 2 older reviews)? I don't have a strong preference here but generally I think newer reviews should be given more priority/listed first since they are hopefully more inclusive (unless there's a reason that the older ones are more noteworthy; if that's a factor here please say so and explain why). I look forward to your detailed response please; even though I've been editing for a few years I do often learn from other editors' perspectives.--Karinpower (talk) 21:44, 28 August 2016 (UTC)
You wrote the following on my Talk page. I'm copying it here. "You dramatically changed the summaries of the recent reviews to make the evidence-base appear much stronger than it is." "the change from "2008 and 2012 reviews found little evidence to support the use of lasers to treat hair loss" to "No laser is FDA approved for this use" is completely out of line. It moves from discussing the evidence to something that has nothing to do with evidence."
OK, thank you for being more specific. I have no problem with the observation that you are making. Note that I only changed the order, not the content. I thought that the FDA approval was helpful to put upfront, however it could just as easily go at the very end. What do you think about the reviews being ordered with the newest first, possibly with an intro sentence summarizing all of the reviews as "mixed"? I really did not think that these changes would be controversial, so I apologize for causing such a reaction.
And this addition: "However, this comment contradicts the fact that this type of laser does not deliver heat, hence the term "cold laser." is 100% WP:OR (specifically WP:SYN). OK, I see your point. This was actually the only part of my edit that I expected might be controversial - and only because it provides some criticism to the accuracy of a Skeptic source. Do you have a suggestion for how to deal with the contradiction? It does seem that that author made an error; these devices do not deliver heat.--Karinpower (talk) 23:40, 28 August 2016 (UTC)
Editing is not rocket science if you accurately represent the sources. Jytdog (talk) 01:49, 29 August 2016 (UTC)
That remark is condescending. Back to the topic.... upon a closer read of Barrett (the source that mentions heat delivery), he actually states at the start of the same article that "Low-level lasers do not produce heat." Perhaps the best way to handle this is to simply state that additional piece of information and allow readers to try to make sense of the contradiction. Again, do you have a preference for how this is handled? I am attempting to do the right thing by addressing this in Talk before making additional edits on this point. Please humor me by either suggesting some language for the edit or making it yourself. --Karinpower (talk) 02:48, 29 August 2016 (UTC)
There is nothing in any policy or guideline that permits WP editors to peer review publications; in fact MEDRS teaches specifically against this. What you are confused about - what you missed in the Gorski article - is that the Anodyne device is cleared for marketing by the FDA as an infrared heat lamp. Jytdog (talk) 02:58, 29 August 2016 (UTC)
Ah, now we are getting somewhere! Thank you! This is a useful observation. Are low-level infrared lamps considered a type of LLLT? I did not think so, but I could be wrong. This WP article does not mention infrared. The quote from Barrett's article (not Gorski fyi) specifies "LLLT devices" on the heat delivery comment, but uses this term at the top: "Low-level lasers do not produce heat." Now I'm questioning which terms include which devices. --Karinpower (talk) 03:06, 29 August 2016 (UTC)

Proposed merge with Laser vacuum therapy

This is a sub-topic of the target article with marginal notability as a separate article. See Wikipedia talk:WikiProject Medicine#Draft at AFC contains medical claims Roger (Dodger67) (talk) 20:27, 27 September 2016 (UTC)

  • Support These are basically the same topic. (If nobody objects, and nobody feels like doing the grunt work to merge this, then someone can ping me, and I'll do the merge.) WhatamIdoing (talk) 20:38, 27 September 2016 (UTC)
  • I have redirected it here. The references that I looked at in the article in question are not of sufficient quality to merge any of it here. Left a note on the users talk page. Doc James (talk · contribs · email) 03:51, 28 September 2016 (UTC)

Changes?

User:Valerius Tygart in this series of diffs, it is unclear why you are changing the article so it doesn't follow WP:MEDMOS, and why you are separating the evidence from claimed uses - we keep that together in articles about proposed treatments. You also added WP:OR and unsourced content like the following:

Mester's publications on the bio-stimulatory effects of the low intensity laser commenced in 1967.[1] He performed early science experiments on the biological effects of laser irradiation. While applying lasers to the backs of shaven mice, Mester noticed that the shaved hair grew back more quickly on the treated group than the untreated group. Mester is believed to be only the fourth physician publishing in the area of laser medicine and surgery.

In 1971, Mester began treating patients with non-healing skin ulcers, while using Low Intensity Laser Irradiation.

References

  1. ^ Mester, E.; Szende, B.; Tota, J.G. (1967). "Effect of laser on hair growth of mice". Kiserl Orvostud. 19: 628–631.

It is WP:OR to write "Mester's publications on the bio-stimulatory effects of the low intensity laser commenced in 1967." and then cite a 1967 paper to support that claim - you need some indpendent source that actually says his publications started in 67; and the rest is unsourced altogether. Jytdog (talk) 18:07, 13 October 2016 (UTC)

I don't agree. I think a 1967 source is OK for something that happened in 1967. Also, no OR here. Valerius Tygart (talk) 18:17, 13 October 2016 (UTC)
Please respond to everything above. Please note dif #1 , dif #2; dif #3, dif #4. Per BRD please do actually respond to the points above. If you revert again before finishing discussion, you will be taken to EWN and you will be blocked; you have not discussed at all - the comment above is just dismissive. Jytdog (talk) 18:24, 13 October 2016 (UTC)
OK, Diff #1: I changed "mildly" to "modestly". So what? Valerius Tygart (talk) 18:27, 13 October 2016 (UTC)
Diff #2: I added sourced sections on "Names" & "History". So what? Valerius Tygart (talk) 18:28, 13 October 2016 (UTC)
Diff #3: I undid your revert. Yes? Valerius Tygart (talk) 18:29, 13 October 2016 (UTC)
Diff #4: I asked you to not revert a third time and, again, discuss on talk page. Explanation needed? Valerius Tygart (talk) 18:30, 13 October 2016 (UTC)
All my edits were for article improvement & well sourced. No OR. What is bothering you? Valerius Tygart (talk) 18:32, 13 October 2016 (UTC)
Why are you really objecting to my edits? It's not that they violate policy or quality standards. They do not. You must object to something about the drift of the content changes. Come clean! Valerius Tygart (talk) 18:37, 13 October 2016 (UTC)
You are still not responding to the objections which I clearly described above and now you have questioned my motives.. Hm. Please respond to the issues about MEDMOS, your separating evidence from claims, as well as actually addressing the issues of unsourced content and OR. Thanks. Jytdog (talk) 18:39, 13 October 2016 (UTC)

Please elaborate on how I have "separated evidence from claims". What do you mean? Valerius Tygart (talk) 18:41, 13 October 2016 (UTC)

Also, there's a lot under Wikipedia:Manual of Style/Medicine-related articles. What sin, exactly, have I committed? Valerius Tygart (talk) 18:42, 13 October 2016 (UTC)

yes exactly, there is a lot under MEDMOS; thanks for acknowledging that you are not aware of it. Please see this part for ordering of sections for devices like this. Please also note that we don't have an "Assessment" section like this is about a movie or book; evidence goes with the claims, not separated from them. Separating evidence from claims is PROMO and fails NPOV. Jytdog (talk) 18:51, 13 October 2016 (UTC)
I acknowledged no such thing. It may be that my added sections to not align exactly with the "suggested headings" in MEDMOS, but I think they are good ones. If you don't like the word "assessment" you can suggest another. The section is intended to present past published evaluations of LLLT & some sort of consensus of its effectiveness as determined by experts. I don't think there's any requirement that I break this down separately for each & every condition/disease that LLLT has been used or proposed for. Valerius Tygart (talk) 19:03, 13 October 2016 (UTC)

Unsourced? By my count, I added seven reliable references to the article that were not there before. In addition, other changes relied on sources that were already there. Please elaborate on how my changes were "unsourced". Valerius Tygart (talk) 18:48, 13 October 2016 (UTC)

as a for example, what is the source for each of the following sentences " He performed early science experiments on the biological effects of laser irradiation. While applying lasers to the backs of shaven mice, Mester noticed that the shaved hair grew back more quickly on the treated group than the untreated group. Mester is believed to be only the fourth physician publishing in the area of laser medicine and surgery. In 1971, Mester began treating patients with non-healing skin ulcers, while using Low Intensity Laser Irradiation." Jytdog (talk) 18:53, 13 October 2016 (UTC)
The ref is the one that was there from the start, the same one you copied above, namely: Mester, E.; Szende, B.; Tota, J.G. (1967). "Effect of laser on hair growth of mice". Kiserl Orvostud. 19: 628–631.
How can a ref from 1967 possibly be the source for "In 1971, Mester began treating patients with non-healing skin ulcers, while using Low Intensity Laser Irradiation." ? And it doesn't say ""Mester is believed to be only the fourth physician publishing in the area of laser medicine and surgery" Jytdog (talk) 19:00, 13 October 2016 (UTC)

No, the article addresses only the first 3 sentences that you copied. Not the fourth one. Feel free to move the citation up one sentence. Mester reviews the previous three pubs in his own article. Valerius Tygart (talk) 19:18, 13 October 2016 (UTC)

I'm primarily concerned with the WP:OR and unsourced content here. I'm a little hesitant to call the first sentence "that his first publication was in 1967" OR, however it would be less problematic if a secondary source were used. Carl Fredrik 💌 📧 18:45, 13 October 2016 (UTC)

If the main issue is whether the first publication was in 1967 or before, that could be removed & simply leave the statement that his research started in 1965 with the first pub cited being 1967. It seems rather inconsequential & I'm surprised anyone cares. The statement is taken directly from the Endre Mester article where it is referenced with the said article. Valerius Tygart (talk) 18:54, 13 October 2016 (UTC)
No, that is a side issue, but good, then we can use that source. Carl Fredrik 💌 📧 19:09, 13 October 2016 (UTC)
There are several issues, as laid out in my initial post. Ignoring MEDMOS, separating evidence from claims, and unsourced/OR. Jytdog (talk) 19:01, 13 October 2016 (UTC)
My comment was to Carl Fredrik. I know you, Jytdog, have a cornucopia of problems. Valerius Tygart (talk) 19:07, 13 October 2016 (UTC)
The main issue is promotional claims referenced to primary sources that do not properly support them. Guy (Help!) 19:06, 13 October 2016 (UTC)
Which are the promotional claims/sources? I don't think any that I introduced are that. Valerius Tygart (talk) 19:10, 13 October 2016 (UTC)

(edit conflict)This is a pretty substantial addition, I think it would be good to listen to Jytdog — he is being very reasonable. Evidence and claims really ought to stick together — if a section only covers potential or suggested effects, but does not actually tell us what the evidence says: you're bordering on alt-med techniques to make the science seem inconsequential. Carl Fredrik 💌 📧 19:09, 13 October 2016 (UTC)

@Carl Fredrik: I'm struggling to understand what you mean. You said: "if a section only covers potential or suggested effects, but does not actually tell us what the evidence says: you're bordering on alt-med techniques to make the science seem inconsequential". The sources I introduced (published policy statements from insurance companies, a statement of policy from a gov't agency, etc) relay the "assessment" as to what the experts believe can be said about LLLT for the referenced conditions. Their assessment is that the evidence is weak or non-existent. I have not cited articles to the effect that LLLT does or does not work. Mostly, they do not exist. How is this "bordering on alt-med techniques" or "mak[ing] the science seem inconsequential"? Valerius Tygart (talk) 19:27, 13 October 2016 (UTC)

refs added

Here are refs added, and what they are used for (note, I have formatted them, adding URLs, pmids, etc):

- Jytdog (talk) 19:33, 13 October 2016 (UTC)

(edit conflict)Right, that comment was simply to explain why we need to keep stuff together, and why WP:MEDMOS exists. Some of your additions were quite good, but there were a few issues: we do not use popular press for medical claims (abcnews), nor do we mention the policies of individual insurance providers, and the stuff that is completely unsourced needs to go.
The major issue here is that it was a large addition that was performed somewhat too quickly. A good idea is to keep additions smaller and to always try to keep them within the bound of WP:MEDMOS & WP:MEDRS.
Edit conflict comment: pretty much what Jytdog said.
Carl Fredrik 💌 📧 19:37, 13 October 2016 (UTC)
I think I mostly disagree. I don't think there's a prohibition on using "popular press" for quoting "medical claims" made by experts to journalists. A professional journal would be better, if available, but "popular press" could be acceptable. "We [never] mention the policies of individual insurance providers"? Really? Where is that prohibition laid out? "The stuff that is completely unsourced needs to go"? I wonder, but you'll need to be more specific. "A good idea is to keep additions smaller"? I often introduce substantial & voluminous additions to articles. I see no reason why I shouldn't, if they're good ones. Valerius Tygart (talk) 20:09, 13 October 2016 (UTC)
P.S. There is no reason to believe this won't result in quite a substantial portion of the edits being accepted, but they need to adhere to various policies. Edit-warring is never the solution, and I hope the page protection can help us crystallise what we want to keep before adding it again. Carl Fredrik 💌 📧 19:39, 13 October 2016 (UTC)
Sorry CFCF.... Valerius - There is some good stuff in what you added. Much of it can be kept -- addition of Medicare assessment, Aetna assessment, and additional Cigna ref were fine. Adding a history section is fine (I was actually restoring that with better sourcing and no OR when you reverted en masse). The re-arrangement to separate evidence from claims was completely unacceptable. The change away from MEDMOS structuring was not OK; as with any style guideline we don't depart from it without some thoughtful reason. There is a way to incorporate much of the content you wanted; not the restructuring. Can you live with that Valerius? If so we can ask the admin to un-protect and implement. Jytdog (talk) 19:37, 13 October 2016 (UTC)
agree w/ both CF and Jyt (on MEDMOS and some issues w/ MEDRS)--Ozzie10aaaa (talk) 19:45, 13 October 2016 (UTC)

Part of your argument I don't understand; part I disagree with. I don't understand how I "re-arranged to separate evidence from claims". I introduced a section "assessing" the technique of LLLT. It is a thing after all. The topic of the article. There is no prohibition in policy about assessing such a topic. (It is not "completely unacceptable".) I did not "restructure" the article "away from MEDMOS". I introduced a new section ("Assessment"), partly with material from an old one. I introduced a second section ("History"). And I moved a third one ("Names") higher up. What here is in violation of MEDMOS? BTW, the structure in MEDMOS is a "suggested" one. And my edits ARE thoughtful. (Unlike your blanket reverts.) Valerius Tygart (talk) 19:54, 13 October 2016 (UTC)

Yes it is clear that you don't edit health content often, and don't understand. As already mentioned, we don't separate evidence {assessment) from claims; there is no separate "assessment" section in MEDMOS. Your edits are against long-standing consensus expressed in the style guide. We, as a community of editors, don't depart from style guides or other guidelines on the whim of an individual editor, and you have provided no rationale for even doing so; you are not even engaging with MEDMOS. If you are going to insist on your idiosyncratic structure we can continue to wait and others will weigh in with time - so far not anyone has agreed with your proposed structure - not me, not Guy, not CFCF, and not Ozzie. We can continue to wait, as you wish. Jytdog (talk) 20:40, 13 October 2016 (UTC)
As I noted above, I agree that this History section should be there, and as I said I was in the process of restoring it with better sourcing when you reverted. The blanket revert was necessary due to the restructuring you did. Jytdog (talk) 20:44, 13 October 2016 (UTC)

(edit conflict) @Valerius Tygart: When you introduced a section titled "Assessment", you separated the article's discussion of LLLT's effectiveness from the claims that they related to. For example in your most recent edit, you removed Quackwatch's conclusion ("no reason to believe that they will influence the course of any ailment") from the "Musculoskeletal" section, leaving that section to give the false impression that LLLT might help wound healing if only the appropriate parameters were identified: "Though it has been suggested that LLLT may be useful in speeding wound healing, the appropriate parameters ... have not been identified". That's a deliberate distortion of facts to give the impression that there's benefit where none exists; that's "completely unacceptable", despite your protestations otherwise. The guidance of WP:MEDMOS is intended to help avoid problems such as you caused. Those "suggestions" enjoy community consensus and you don't have the right to ignore them on a whim. Whether or not "assessment" is a "thing" isn't relevant in this context, because content in a Wikipedia article is subject to WP:DUE - just because something exists doesn't mean it deserves to be in our article. You now have four editors telling you that many of the changes you've been edit-warring into the article have no consensus here and are moreover in contradiction to our policies and guidelines. So you have a simple choice: either get the message and start looking for what other editors and yourself can agree on; or stick to your mistaken view on what is acceptable here and find yourself losing your editing privileges. You've been around long enough to understand that Wikipedia is a collaborative project and what consensus involves. --RexxS (talk) 20:48, 13 October 2016 (UTC)
Support following MEDMOS. Having a usually layout makes it easier for both editors and readers. Doc James (talk · contribs · email) 01:51, 14 October 2016 (UTC)
Threatening to make me "lose my editing privileges" is not a helpful insertion into this discussion. And ultimatums as to what my "simple choice" is are also unconstructive. Additionally, the generally scolding & condescending tone taken by Jytdog, from the beginning, is going to complicate & prolong matters unnecessarily. But let's focus on specific issues: (1) "The blanket revert was necessary due to the restructuring you did." I disagree. It's what triggered the "edit war" in the first place. Only after the dust settled (and, possibly, someone actually read in detail what I had edited) did Jytdog & an admin observe that "Oh, a lot of this can stay. Oh, a lot of this is good. It's actually only a 'restructuring problem' & maybe one 'unsourced' issue." Now I ask, wouldn't it have been better to engage with me on the basis of "good faith", about some minor changes, rather than to abruptly & without warning place THREE new threatening headings on my user talk page as an opening bid, before I was even aware that any other editor was tracking my edits? Don't you think there's a better way of approaching this? (2) Regarding my introducing a section titled "Assessment" & thereby allegedly separating "the article's discussion of LLLT's effectiveness from the claims that they related to": the claim is that I did this in the one instance of taking the Quackwatch sentence (& ref) from "Medical uses#Other" & incorporating it into my new section. No, RexxS, this sentence was NOT originally in the "Musculoskeletal" subsection, it was in "Other". Furthermore, that sentence does not address "wound healing", as you imply, at all; rather it mentions that LLLT might provide "temporary pain relief", then states quite generically that it probably doesn't "influence the course of any ailment". The sentence above it, mentioning "wound healing", was never touched & remained in place throughout. (Please try & keep up!) The point of the Quackwatch sentence, in a subsection entitled "Other", was not to discredit any one "claim", but rather was a GENERIC statement that no evidence supports that LLLT effectively treats "any ailment". Therefore, "removing" it by elevating it to it's own section hardly creates a "false impression" or "deliberate distortion of facts". (RexxS, really, go back & look at the errors you've introduced into the discussion. You're so focused on beating me with a stick that you've overlooked your own mistakes. I assume, so far, that they are honest mistakes.) (3) Regarding the overall issue of whether I nefariously "restructured" the article in ways contrary to MEDMOS, I am not impressed. I have hardly introduced an "idiosyncratic structure" by introducing sections on "Names", "History" & "Assessment". These may not be in the MEDMOS "suggested structure" (and it is just a "suggestion"), but they are coherent, accurate, and similar to that found in standard, traditional medical texts. They were not introduced "on a whim", but quite thoughtfully & deliberately. If I may depart from NPOV for a moment — I think this is the place to do it — the long term drift of the LLLT article will likely be that there is no solid evidence that it does anything to effectively treat medical problems beyond, possibly, "temporary pain relief" from it's heat effect. Therefore, the editorial practice of matching a specific medical "claim" to specific cited "evidence", which is ordinarily laudable, my not apply so much here as in other drug/vaccine/device articles & therefore, IMHO, an "Assessment" (or pick your word) section is not out of order, since it can (and should) address the effectiveness of the technique overall. (4) Finally, a word to Jytdog on your propensity for taking personal swipes at me when you see an opportunity ("Yes it is clear that you don't edit health content often, and don't understand."): Please stop doing this. As you can see from my User page, I have indeed created/edited medical articles for many years. Sniping comments do not reflect flatteringly on you or help you build your case. Valerius Tygart (talk) 15:05, 14 October 2016 (UTC)
Jytdog is just explaining what normally happens to people who act as you are acting here. Feel free to ignore this, but do be aware that things are unlikely to go well for you if you do. We have most of us been here before enough times to know how it plays out. Guy (Help!) 15:40, 14 October 2016 (UTC)
RexxS was actually the one making the threat. And yes, I've been editing for over 10 years myself, with plenty of scars. Anything constructive to say, Guy? Valerius Tygart (talk) 15:48, 14 October 2016 (UTC)
Nobody cares even slightly about what you think is "unconstructive". And I'm not making a threat; I'm making a promise. Even if you can't read this diff, [7], everybody else can. It's clear in that diff how you separated the rebuttal from that fanciful claim of wound healing and it's clear you're pushing a POV. It's equally clear you've edit-warred to push that POV. If you continue in that vein, you'll find yourself at ANI, and with those diffs and your attitude towards other editors on this talk page, you'll find yourself with a few more scars. Optionally, you could try to suggest edits that would gain consensus from the other editors here. --RexxS (talk) 16:28, 14 October 2016 (UTC)

Rising above your nastiness, I will address your error: The Quackwatch (Stephen Barrett) sentence is separate & unrelated to the wound healing sentence, which has its own reference, above it. The two are completely unrelated except that they were both in a subsection (separate paragraphs) called "Other". The Quackwatch statement doesn't address wound healing at all. Removing (moving) the Quackwatch line does not affect (remove any rebuttal to) the line about wound healing. As to my "pushing a POV", which I gather you think is to support the validity of LLLT: sorry, guy, you've read me all wrong. If I WERE to push a POV it would be an anti-LLLT viewpoint, as I don't think it has any efficacy. But I don't think I've pushed any particular viewpoint except that of wanting accuracy. Sorry, RexxS, ya screwed up on this one... Valerius Tygart (talk) 17:05, 14 October 2016 (UTC)

There is a proposal on the table Valerius about content; please respond to it or make one of your own so we can move forward on content. Thanks.Jytdog (talk) 16:52, 14 October 2016 (UTC)
Fair enough. I am still of the opinion that my edits, basically all of them, improved the article substantially. I'm not perfect. It can be improved further. Maybe the article would be even better if some of my edits were modified. If the consensus is that the Quackwatch line, which I moved, be returned to it's original place, while being kept in my "Assessment" section too, that could be done. If someone doubts that the citation about Mester being the fourth laser researcher is unlikely, put a [citation needed] tag by it. Or remove that line. MY PROPOSAL: Return the article to the status quo ante Jytdog's first revert, in other words my last edit. Then proceed from there on the basis that everything is up for possible modification (which it always is anyway). Make small changes only, over time, with discussion, and with no one attempting to dominate the process. Returning the article to the status quo ante will be taken as an olive branch of peace by yours truly. Valerius Tygart (talk) 17:23, 14 October 2016 (UTC)
Everyone here has rejected an "assessment" section and explained why; please propose something that may be accepted. Thanks. Jytdog (talk) 17:48, 14 October 2016 (UTC)
I don't concede that an "Assessment" section, or something equivalent, cannot ever go into the article. I think one is needed & I don't think it is reasonable to arbitrarily rule one out. (I'm not sure that "everyone has rejected", either. I don't remember a vote.) Anyway, its name or its placement or its exact content will be among the many items up for modification, if my proposal is accepted. Valerius Tygart (talk) 17:54, 14 October 2016 (UTC)
Sorry to do this, guys, but I am traveling over the weekend & will not be able to look at this again until Monday morning. (Probably good anyway to let the toxicity clear from the air after some of the statements made....) Meanwhile, try this: How about changing "Assessment" to "Reimbursibility"? That's what 3 of the 4 items there are -- minus the Quackwatch one, which can go somewhere else. I think the Quackwatch item should be more prominent rather than tucked away in an "Other" subsection the way it was, but whatever... Signing out for now... Valerius Tygart (talk) 19:08, 14 October 2016 (UTC)
I am not persuaded that anything needs to change. I understand that you want to reinforce the impression of legitimacy, but this appears to be motivated by something other than the best available sources. Guy (Help!) 21:58, 14 October 2016 (UTC)
Guy says “I understand that you want to reinforce the impression of legitimacy…” What? WHAT?!? I get the distinct impression that you didn’t even bother to read my edits! ALL my changes were either skeptical (anti-LLLT) or neutral. Nothing I added was even slightly “promotional” or “legitimizing”. On the contrary. Go back and look again (or for the first time).
Here is a brief summary of my changes: (1) a new “Names” section to present the 10 or more alternate names that LLLT goes by; (2) a “History” section to present how Endre Mester invented the “field”; (3) Change the section title “Medical uses” to “Proposed medical uses” since nothing in LLLT has really ever been validated to conventional medicine standards; (4) Addition of a sentence or two to the “Mechanisms” section relaying what a reliable news source reports as a veterinarian advocate’s proposed mechanism -- followed by the line “There is, however, little evidence supporting these explanations”; (5) Change the small “Other animals” section title to “In veterinary medicine”; and (6) by far the biggest change: a new “Assessment” section to present the best information available as to whether LLLT might actually work or not. Not counting the Quackwatch quote, which I moved here (and which essentially states that there’s no evidence the technique does much of anything beneficial) this new section consists of three formal statements from three major insurance reimbursers (Medicare/Medicaid, Cigna, Aetna) and sources, including external links, to back them up. (They all say the same thing, BTW: “We ain’t payin’ for this shit, ‘cause it don’t seem to do nothin’ ”.)
Guy says “I am not persuaded that anything needs to change.” Really? I don’t get you, Guy. Are you just being a contrarian? Are you generally incurious? Or are you just lazy? Of course it needs to change.
Finally, if you think I haven’t used “the best available sources”, by all means give us better ones. Valerius Tygart (talk) 14:36, 17 October 2016 (UTC)
The key issue here is your desire to restructure the article to create an "assessment" section, which no one commenting thus far agrees to. You can yield on that and we can request that the protection be lifted, or not. If you try to add it after protection expires, you will be reverted. We are just waiting on you, on this point. Jytdog (talk) 18:18, 17 October 2016 (UTC)

I am not aware that any such consensus has been arrived at. On this point, I hear the repeated voice of one person. PROPOSAL: Editors vote on the following proposition: "An 'Assessment' (or equivalent: 'Evaluation', 'Validity', 'Efficacy', 'Reimbursibility', etc) section, containing information on the overall expert opinion regarding whether LLLT is clinically efficacious or medically useful, may NOT be inserted into the article as it is not part of the MEDMOS "suggested structure" for healthcare articles." I take it that an affirmative outcome on this proposition will exclude all of the material that I included under "Assessment" (other than the transplanted Quackwatch line). I am not married to the word "Assessment", although I think it is probably the best one. Also, a significant number of editor votes should be represented, not just a few. Valerius Tygart (talk) 18:51, 17 October 2016 (UTC)

Everyone commenting here opposes your restructuring proposal. Jytdog (talk) 19:29, 17 October 2016 (UTC)
I don't consider it "restructuring". I have added a section. Also, it is not for you to speak for others. Valerius Tygart (talk) 20:00, 17 October 2016 (UTC)
Again, the only issue here is if you will yield to consensus. I will take that as a no, so we will just wait for pp to be lifted. So that's all I will say for now. Jytdog (talk) 21:27, 17 October 2016 (UTC)
I was asked to "suggest edits that would gain consensus from the other editors". I did so, with a formal proposal, but was ignored. It was then asserted, by Jytdog, that "consensus" has already been achieved & that there was nothing for me to do but surrender. I responded that, no, all I hear, above the noise, is one person insisting repeatedly that an "Assessment" section is out of the question because it violates MEDMOS's "suggested structure". That makes no sense to me, so I made a second formal proposal: that several editors vote on that very proposition. This too, apparently, is being ignored. At this particular moment, it appears to me that I am the only editor here dialoging in good faith. Lift the protection if you like, but consensus has NOT been achieved. Indeed, substantial & serious discussion of my edits has not even happened. "That's all I will say for now". Valerius Tygart (talk) 13:06, 18 October 2016 (UTC)

History section

Valerius, you have continued to add back the history section here and here, and it continues to have content that is either completely unsourced, or that continues to make the claims about history based on a primary source.

For example "In 1971, Mester began treating patients with non-healing skin ulcers, while using Low Intensity Laser Irradiation.[1]

References

  1. ^ Mester E, Spiry T, Szende B, et al. “Effect of laser rays on wound healing”. Am J Surg. 1971;122:532–535.

PMID 5098661 is not a source for him beginning to treat people in 1971; it is a source that he published work in 1971. Likewise the sentence is "Mester's publications on the bio-stimulatory effects of the low intensity laser commenced in 1967. " is unsourced and is your WP:OR. Please stop adding unsourced content to this article. We summarize accepted knowledge here in WP - we don't publish new historical research. Thanks. Jytdog (talk) 16:11, 21 October 2016 (UTC)

EdJohnson asserts (on my user talk page) that I have "made no effort at getting a talk page consensus". Well, I made two formal attempts (above) & I am still here. Valerius Tygart (talk) 16:26, 24 October 2016 (UTC)
Yes, you are here, but you are functioning in broadcast-only mode, whihc does not constitute a meaningful attempt to gain consensus. Neither does editing while logged out. That will get you blocked, so don't do it again. Guy (Help!) 23:00, 28 October 2016 (UTC)
“Functioning in broadcast-only mode”? You are very mistaken, Guy. I made concrete proposals twice, on 14 Oct and on 17 Oct, but they were ignored by “other editors” pretending to be engaging in good-faith dialogue. I even labeled them “PROPOSAL” so that those, like yourself, who are not paying very close attention could not miss the fact. I even bolded the second one. There were no arguments put forward as to why they were bad ideas, nor even an acknowledgement that they had been floated. So, no, I’m not in “broadcast-only mode”.
As to editing while logged out, there is no prohibition of this, so long as one does not sockpuppet. I routinely edit while logged out, and will continue to do so. I even have this posted on my user page:
AnonA majority of this user's edits have been (& continue to be) anonymous.



So, as regards your repeated provocations (“don't do it again”), you can go bark up another tree. Valerius Tygart (talk) 14:14, 31 October 2016 (UTC)

proposed history section

In this dif modified by these tweaks, then later re-proposed with additional refs in this dif, Valerius has proposed the following. Thoughts?

History

Hungarian physician and surgeon Endre Mester (1903-1984) started research with laser therapy in 1965. In 1974 he founded the Laser Research Center at the Semmelweis Medical University in Budapest, and continued working there for the remainder of his life. He is credited with the discovery of the biological effects of low power lasers.[1]

Mester's publications on the bio-stimulatory effects of the low intensity laser commenced in 1967.[2][3] He performed early science experiments on the biological effects of laser irradiation. While applying lasers to the backs of shaven mice, Mester noticed that the shaved hair grew back more quickly on the treated group than the untreated group. Mester is believed to be only the fourth physician publishing in the area of laser medicine and surgery.[4]

In 1971, Mester began treating patients with non-healing skin ulcers, while using Low Intensity Laser Irradiation.[5][6][7]

References

  1. ^ Judith Perera, "The 'healing laser' comes into the limelight", New Scientist, 19 March 1987.
  2. ^ Mester, E.; Szende, B.; Tota, J.G. (1967). "Effect of laser on hair growth of mice". "Kiserl Orvostud". 19: 628–631.
  3. ^ Hamblin, Michael R. (2016), ”Photobiomodulation (PBM) as it is known today …was accidentally discovered in 1967, when Endre Mester from Hungary attempted to repeat an experiment recently published by McGuff in Boston, USA.”; “Shining light on the head: Photobiomodulation for brain disorders”, BBA Clinical Vol. 6, December issue, pp 113–124.
  4. ^ Mester (1967), Op. cit.
  5. ^ Mester E, Spiry T, Szende B, et al. “Effect of laser rays on wound healing”. Am J Surg. 1971;122:532–535.
  6. ^ ”The effects of LILT on wound healing have been investigated for over three decades, with Mester’s early research conducted at a cellular level. (Mester, 1971)”, Ashford R, Brown N, Lagan K, Howell C, Nolan C, Brady D, Walsh M (1999) “Low intensity laser therapy for chronic venous leg ulcers.”, Nursing Standard. 14, 3, 66-72.
  7. ^ Young, SR and M Dyson (1993), “Work on the effect of light tissue repair was initiated by Mester in 1971…” The Effect of Light on Tissue Repair", Acupuncture in Medicine, May issue, Vol. 11, No. 1, pp 17-19.

-- Jytdog (talk) 20:20, 31 October 2016 (UTC)

I would support this content, changed as follows
History
Hungarian physician and surgeon Endre Mester (1903-1984) is credited with the discovery of the biological effects of low power lasers,[1] which occurred a few years after the 1960 invention of the ruby laser and the 1961 invention of the helium–neon (HeNe) laser.[2] Mester accidentally discovered that low-level ruby laser light could regrow hair during an attempt to replicate an experiment that showed that such lasers could reduce tumors in mice. The laser he was using was faulty and wasn't as powerful as he thought; it failed to affect the tumors but he noticed that in the places where he had shaved the mice in order to do the experiments, the hair grew back faster on mice he treated compared with the placebos.[3] He published those results in 1967.[2] He went on to show that low level HeNe light could accelerate wound healing in mice.[2] By the 1970s he was applying low level laser light to treat people with skin ulcers.[2] In 1974 he founded the Laser Research Center at the Semmelweis Medical University in Budapest, and continued working there for the remainder of his life.[4] His sons carried on his work and brought it to the United States.[1]
By 1987 companies selling lasers were claiming that they could treat pain, accelerate healing of sports injuries, and treat arthritis, but there was little evidence for this at that time.[1] By 2016 they had been marketed for wound healing, smoking cessation, tuberculosis, and musculoskeletal conditions such as temporomandibular joint disorders carpal tunnel syndrome, fibromyalgia, osteoarthritis, and rheumatoid arthritis, and there was still little evidence for these uses, other than a possible use in temporarily treating muscle or joint pain.[5]
Mester originally called this approach "laser biostimulation'", but it soon became known as “low level laser therapy" and with the adaptation of light emitting diodes by those studying this approach, it became known as "low level light therapy", and to resolve confusion around the exact meaning of "low level", the term "photobiomodulation" arose.[3]

References

  1. ^ a b c Perera, Judith (19 March 1987). "The 'healing laser' comes into the limelight'". New Scientist.
  2. ^ a b c d Chung, H; et al. (February 2012). "The nuts and bolts of low-level laser (light) therapy". Annals of biomedical engineering. 40 (2): 516–33. PMC 3288797. PMID 22045511. {{cite journal}}: Explicit use of et al. in: |first1= (help)
  3. ^ a b Hamblin, MR (1 October 2016). "Shining light on the head: Photobiomodulation for brain disorders". BBA clinical. 6: 113–124. PMC 5066074. PMID 27752476.
  4. ^ "Celebrating the 100th birthday of Professor Endre Mester". Laser World. Swedish Laser-Medical Society. April 18, 2004. Archived from the original on March 3, 2016.
  5. ^ Barrett, S (July 29, 2016). "A Skeptical Look at Low Level Laser Therapy". Quackwatch.
Everything here is derived from and sourced to reliable secondary sources. Jytdog (talk) 18:13, 2 November 2016 (UTC)
comments? Jytdog (talk) 21:13, 9 November 2016 (UTC)

Research

Hello, I would like to edit this page under the other animals and research sections. I have found research within the past five years about LLLT's use in veterinary medicine and would like to contribute my findings. I understand there have been some difference in opinions to the changes made on this page and do not want to necessarily get involved, but would love to make additions to this article. — Preceding unsigned comment added by TeddyGillie (talk • contribs) 15:17, 9 November 2016 (UTC)

Hi, thanks for your note! The key thing is the sources you bring; for research please see WP:SCIRS; we prefer literature reviews. You may want to propose content here first but of course feel free to be bold and make the edit; if it is not OK and it is initially rejected we can discuss it to see if there is something useable. Jytdog (talk) 21:13, 9 November 2016 (UTC)
@TeddyGillie: I would also add my encouragement & hope you do add to the “Other animals” section (or whatever it ends up being called). My own interest in LLLT was first piqued when I took my old arthritic dog to the vet and found that he was all over promoting this lucrative approach and later learned just how widespread it is in vet clinics across the country. BTW, WP:SCIRS says “Ideal sources for these articles include comprehensive reviews in independent, reliable published sources, such as reputable scientific journals, statements and reports….” But note the word “ideal”; they are the “best”, but not the “only”. This guidance page also says that “The popular press is readily accessible and can contain valuable supplemental information of a social, biographical, current-affairs, or historical nature.” In cases where news articles or similar are available, but are reporting on findings or events already published in the technical or scientific literature, then the latter are preferred, for obvious reasons: they’re more “independent” and “reliable”. And they are the primary source. I say all this because the field of “alternative medicine”, of which LLLT is an example, is notorious for biased, feeble or non-existent supporting "literature". A reliable, peer-reviewed journal article may be hard to come by. In such a case, there is nothing wrong with using a reliable, accurate and judiciously selected “popular press” source. Literature reviews in a professional journal are often superb, but when a Wikipedia editor says something like “we prefer literature reviews”, he is of course speaking for himself.
Hope to see some good stuff from you soon! Valerius Tygart (talk) 14:28, 15 November 2016 (UTC)

Proposed addition to "medical uses" section

Valerius proposed here and again here to add the following to the "medical uses" section. Thoughts?

Various LLLT devices have been advocated and sold for use in treatment of several musculoskeletal conditions including carpal tunnel syndrome (CTS), fibromyalgia, osteoarthritis, and rheumatoid arthritis. They have also been promoted for temporomandibular joint (TMJ) disorders, wound healing, smoking cessation, and tuberculosis. No standard or uniform recommended dosage, number of treatments, or length of treatment have been developed across the variety of devices. [1]

The US Food and Drug Administration (FDA) classifies most LLLT devices not as “laser application” devices, but as Class II [2] devices formally designated “lamp, non-heating, for adjunctive use in pain therapy” (FDA produce code NHN). Between 2002 and 2009, some 43 such devices received 510(k) clearance for marketing for temporary pain relief. Major health insurance companies, as well as Medicare/Medicaid, generally do not reimburse for treatments using LLLT devices due to insufficient evidence of efficacy:

  • In 2006, the Centers for Medicare and Medicaid Services (CMS) determined that "there is sufficient evidence to conclude that the use of infrared devices is not reasonable and necessary for treatment of Medicare beneficiaries for diabetic and non-diabetic peripheral sensory neuropathy, wounds and ulcers, and similar related conditions, including symptoms such as pain arising from these conditions.... The use of infrared and/or near-infrared light and/or heat, including monochromatic infrared energy (MIRE), is not covered for the treatment, including symptoms such as pain arising from these conditions, of diabetic and/or non-diabetic peripheral sensory neuropathy, wounds and/or ulcers of skin and/or subcutaneous tissues in Medicare beneficiaries.[3]
  • In 2010, the insurance company Cigna reviewed the evidence for LLLT and concluded that it is still considered an experimental treatment. Therefore, Cigna determined not provide coverage for it.[4] In 2016, Cigna concluded that "LLLT ... has been proposed for a wide variety of uses, including wound healing, tuberculosis, and musculoskeletal conditions such as osteoarthritis, rheumatoid arthritis, fibromyalgia and carpal tunnel syndrome. There is insufficient evidence in the published, peer-reviewed scientific literature to demonstrate that LLLT is effective for these conditions or other medical conditions. Large, well-designed clinical trials are needed to demonstrate the effectiveness of LLLT for the proposed conditions."[5]
  • In 2014, insurance company Aetna determined that it would consider "treatment with low-level infrared light (infrared therapy, Anodyne Therapy System) experimental and investigational for the treatment of acne, back (lumbar and thoracic) pain, Bell's palsy, central nervous system injuries, chronic non-healing wounds, diabetic peripheral neuropathy, ischemic stroke, lymphedema, neck pain, osteoarthritis, Parkinson's disease, retinal degeneration, and stroke ... because of a lack of adequate evidence in the peer-reviewed published medical literature regarding the effectiveness of infrared therapy for these indications".[6]

References

  1. ^ Barrett, S (2009-07-17). "A Skeptical Look at Low Level Laser Therapy". Quackwatch. Retrieved 2010-07-23. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
  2. ^ FDA Class II devices are higher risk devices than Class I and require greater regulatory controls to provide reasonable assurance of the device’s safety and effectiveness. For example, condoms are classified as Class II devices.
  3. ^ "Decision memo for infrared therapy devices" (CAG00291N). Center for Medicare & Medicaid Services, Oct 24, 2006.
  4. ^ "Cigna Medical Coverage Policy - Subject: Low Level Laser Therapy" (pdf). Cigna. 2010-07-15. Retrieved 2010-08-06.
  5. ^ "CIGNA medical coverage policy: Low-level laser therapy". Revised, July 15, 2016.
  6. ^ "Infrared therapy". Aetna clinical policy bulletin 0604, reviewed Oct 23, 2014. Aetna has additional information in its "Clinical Policy Bulletin on Cold Laser and High-Power Laser Therapies".

-- Jytdog (talk) 20:23, 31 October 2016 (UTC)

Thank you Jytdog. What, pray tell, is your own opinion of this material? Valerius Tygart (talk) 13:18, 1 November 2016 (UTC)
Not "medical uses". More society and culture stuff as it is regulatory approval and insurance coverage. Doc James (talk · contribs · email) 13:40, 1 November 2016 (UTC)
I had earlier proposed a "Reimbursibility" section. Just a thought. Valerius Tygart (talk) 14:27, 1 November 2016 (UTC)
Let me make a pitch, however, for keeping it as I originally edited it. It seems to me that the bottom line with LLLT — what a casual wikipedia reader will want to know, after "what is it?" — will be "how accepted is it; how effective is it; does it work?". The answer, as best I can tell, is that the FDA has approved several devices for sale, but only because the "laser" that is applied also includes infrared radiation (heat). The FDA has not endorsed any laser-specific medical effect. The device category they approve does not even use the term "laser". The laser involved is used (apparently) as a marketing gimmick, and the FDA (again apparently) allows this. This is my interpretation. But what I edited into the article is strictly the facts involved. Those facts, it seems to me, ought not to be relegated to a "Society" or "Culture" section, way down below. They are central to what someone looks up the article for. Accordingly, they ought to be fairly prominent. Maybe where I put them most recently, or in a dedicated (high up) section, or maybe even in the intro. Valerius Tygart (talk) 12:55, 2 November 2016 (UTC)
The content is a mix of stuff. The value of the insurance company refs is to support content about efficacy/safety or lack thereof, and that content belongs in this section. The content about whether insurance companies cover it belongs in a society and culture section, as does regulatory status. Jytdog (talk) 15:49, 2 November 2016 (UTC)
"Insurance company refs" vs "insurance company coverage"? Don't you mean FDA vs insurance companies? I agree that the material is in two parts, divided just before the line beginning "Major health insurance companies.." Valerius Tygart (talk) 17:47, 2 November 2016 (UTC)
the refs from cigna, aetna, and medicare are valuable in the "medical uses" section only to support content about efficacy. content about whether or not these agencies provide coverage (in other words, whether they will pay for the procedure) belongs in the "society and culture" section, supported by the refs used again there. Content about how the FDA classifies the device (regulatory status) belongs in the "society and culture" section. Please do read WP:MEDMOS and how content is sectioned there. Jytdog (talk) 18:14, 2 November 2016 (UTC)

Yes, I have read WP:MEDMOS and, again, the headings there are suggestions only. I don't care for a rigid, cookie cutter approach. I gather that you believe "efficacy" should go into the "Medical uses" section. That sounds right. (Interestingly, WP:MEDMOS does not include any instance of the words "efficacy" or "effective". (!) If I had been writing it, I would have made "Efficacy" a suggested heading for drugs/vaccines/medical devices articles. Maybe the editors responsible for WP:MEDMOS don't know much about medicine. Overall, it's written as if they think drugs/vaccines/medical devices always work as advertised, which of course is not true.) I agree that the refs are useful & appropriate to support statements about efficacy. And I agree that efficacy is very important in this article, even central to it. My bias is that LLLT doesn't have any efficacy, beyond that of mere heat. Anyway, you have a problem with the FDA status if you say that efficacy goes into "Medical uses" while the FDA status goes into the "Society and culture" section. This is because the FDA makes ALL of its approval decisions on the basis of "safety and efficacy". For this type of product, the FDA status and statements are likely to be the most compelling and authoritative sources available, since the FDA not only reviews the available literature, it judges the quality of the published clinical trials at a very sophisticated level, dispensing with the ones that are junk science. Moreover, the insurance companies' reviews and decisions are likely based on the same studies that the FDA reviewed in it's decision making, perhaps they even base their judgments directly on the FDA status and supporting statements. My point is that the two domains that you are so keen to keep separate (efficacy vs regulatory status/reimbursibility) are inextricably intertwined. Here is a case where the WP:MEDMOS suggested categories rather break down, in my view. Valerius Tygart (talk) 14:52, 3 November 2016 (UTC)

on the FDA thing, these devices get 510K waivers which are not based on safety and efficacy of the device itself, but rather showing similarity to an already-marketed device. 510K waivers are not "approvals". That is what it is and i made no complaint about it. We do treat regulatory status under society and culture as MEDMOS describes.
With regard to to other issues, as you can read above the other editors talking here wish to keep the MEDMOS structure; there is no consensus to depart from it. Thanks for pointing out that MEDMOS doesn't explicitly say that "medical uses" describes uses as well as efficacy. that is where we put it in practice across medical articles. I added it there to reflect consensus practice. Jytdog (talk) 18:19, 3 November 2016 (UTC)
"We do treat regulatory status under society and culture..."? Who you calling we, Ke-mo sah-bee? MEDMOS describes no such thing. FDA status could just as easily go under "Medical uses" (the agency approves something for "use") as under "Society and culture" (what couldn't go under that?). I must say that, in addition to fixating over-rigidly to wikipolicy guidance (suggestions, actually) you have a tendency to extend what is actually written in a wikipolicy into what you think ought to be written there by simply saying that it is there. But I have no desire to bicker. I have no objection to leaving the first "half" of my edit (as I defined it above) in place while moving the second half to a "Legal status" subsection under the "Society and culture" section.
Regarding your latter comments, I think it is wrong, even deceptive, to make this into a "keep the MEDMOS structure or not" issue or set of issues. I see you as framing it that way to try and gain advantage. It is not my view. And to be clear, I hear one other editor (you) stating views repeatedly & substantially. Others are drive-by snipers. Nothing against them, that's all they care to say, but they do not add up to a "consensus". (A reason you declined to go the suggested RfC route?) There are but two substantive dialoguers here. So far anyway. Valerius Tygart (talk) 19:33, 3 November 2016 (UTC)
Look at a bunch of articles about medicine; that is where you will find it. "we" = the editing community. guidance reflects consensus, and the guidance is used to remind people of what consensus is. that is how this place works per WP:PAG. they aren't "rules".
The stuff about efficacy in the 2nd half should stay in medical uses; the coverage and regulatory goes in society and culture. this is also what doc james said above.
regarding "snipers" i am indeed the only one responding to you substantially; i will stop doing that soon and respond briefly as others are. i am hopeful you will become open to following the consensus of the community, which is being reflected in all the responses you have received here. Jytdog (talk) 19:49, 3 November 2016 (UTC)
Look again at your first statement (“Look at a bunch… they aren't "rules".”). Now, look again at what I said: " ‘We do treat regulatory status under society and culture...’? … MEDMOS describes no such thing.”
The “consensus” represented by wikipolicies & wikiguidelines includes no statement that regulatory status must go into a “Society and culture” section and never into a “Medical uses” section. The fact that it has been done this way in some cases does not make this a “consensus of the community”. Those sections are themselves only “suggestions”. MEDMOS uses that very word (“suggestions”). (This is also consistent with Wikipedia Pillar #5: “Wikipedia has no firm rules: Wikipedia has policies and guidelines, but they are not carved in stone”. ) But what you are asserting about what can & cannot go into one section or another is not even in a policy or guideline as a suggestion. Not only is it not “carved in stone”, you cannot even find it articulated anywhere (except in your edits on a talk page). So no, that is not how this place works; in this instance you have made up your own rule.
Let’s try and move ahead. Do you concur with this modest edit? PROPOSAL #3 Valerius Tygart (talk) 13:45, 4 November 2016 (UTC)
Thoughts on PROPOSAL #3, Jytdog? Valerius Tygart (talk) 15:16, 5 November 2016 (UTC)
Waiting for the "snipers" to comment. Jytdog (talk) 20:10, 5 November 2016 (UTC)
Dare I trouble you again, Jytdog, to say whether my PROPOSAL #3 is acceptable to you or not? (It's the third time I've asked. God forbid you should agree with anything the "difficult character" proposes.) I intentionally picked an edit that should (I think) be uncontroversial. It's intended as a baby step, a confidence builder, kind of like the Israelis & Palestinians agreeing on what refreshments will be served during breaks in negotiations in Geneva. I am trying to follow Wikipedia Pillar #4 which includes: "Act in good faith, and assume good faith on the part of others." You make this difficult. If you continue to stonewall, you run the risk of revealing yourself as a nihilist, rather than as the good faith partner that I'm sure you would like to be seen as. Valerius Tygart (talk) 16:50, 8 November 2016 (UTC)

If there are no objections, I'm going to implement PROPOSAL #3 & then propose a #4. Valerius Tygart (talk) 18:31, 9 November 2016 (UTC)

the proposed content is in the section called "medical uses". The 1st sentence isn't about medical use, but marketing. The second sentence is about medical use; it is OK. Jytdog (talk) 20:25, 9 November 2016 (UTC)
I disagree. The first sentence starts "Various LLLT devices have been advocated and sold for use...." Note the word "use". Your objection that it is also about "marketing" elicits the question "so what?". It is nothing but a cavil. (Your responses have degenerated into mostly caviling, BTW.) If you cannot do better than that, I will implement PROPOSAL #3 & move on to #4. (I believe this would be upheld by a majority of good faith editors.) Valerius Tygart (talk) 21:21, 10 November 2016 (UTC)
I have implemented PROPOSAL #3; here is PROPOSAL #4. Let me know your objections, if any. Valerius Tygart (talk) 20:53, 12 November 2016 (UTC)
  • implemented the above, and the history section, per consensus of discussion so far. Jytdog (talk) 23:06, 12 November 2016 (UTC)
PROPOSAL #5 Valerius Tygart (talk) 20:00, 18 November 2016 (UTC)
That kind of content would not be OK for human medicine. but i have no objection to it in the vet med section. OK by me. Jytdog (talk) 01:20, 19 November 2016 (UTC)

Names

PROPOSAL #6 The rationale is that this section doesn't belong in a "Society and culture" subsection. It functions like an "X, Y & Z redirect here" header, but obviously there are too many variant names for that. When I first went looking for an article on LLLT, I was baffled by the many names (LLLT was certainly not the one I started with), so I can vouch for the need for this from personal experience. Valerius Tygart (talk) 15:57, 5 December 2016 (UTC)

Thanks for proposing. i am not opposed to that even tho it departs from MEDMOS - the rationale makes sense. Let's give this some time to see what others think. Jytdog (talk) 19:39, 5 December 2016 (UTC)
Thanks, I'm happy to wait. This gets back to our old argument about how dogmatic one must be about MEDMOS, etc....... Valerius Tygart (talk) 13:39, 7 December 2016 (UTC)
If there are no objections, I will implement PROPOSAL #6. Valerius Tygart (talk) 14:02, 13 December 2016 (UTC)
Done. Valerius Tygart (talk) 14:32, 14 December 2016 (UTC)

Proposal #7

I propose removing the line "The effects of LLLT appear to be limited to a specified set of wavelengths of laser,[1] and administering LLLT below the dose range does not appear to be effective.[2]" from the intro. This sentence, with its 2 refs, is exactly replicated in the "Mechanism" section. I also have a problem with the phrase "below the dose range does not appear to be effective", since it implies that "within the dose range" it is effective (a proposition disputed elsewhere in the article), but I will let that go for now. Valerius Tygart (talk) 15:45, 17 December 2016 (UTC)

Anyone care? I'll give it another couple days. Valerius Tygart (talk) 14:02, 19 December 2016 (UTC)
per WP:LEAD the "intro" summarizes the body and leads often do that by repeating key sentences from the body. The lead probably needs updating but it should summarize the mechanism no matter how we change it. Jytdog (talk) 10:57, 20 December 2016 (UTC)

Image

Demonstration of LLLT with intranasal irradiation

In general it is good to use an image that doesn't include branding. File:NoseApp2S.JPG shows a branded product and i pretty much agree with Guy that no image is better than a branded one. We also don't discuss any use of LLT that would involve a probe stuck up your nose, so this doesn't really make sense. Jytdog (talk) 19:35, 7 December 2016 (UTC)

  • At thumb I cannot make out the brand. I am okay with its use. Does show what the device is. Doc James (talk · contribs · email) 05:18, 8 December 2016 (UTC)
Searching Wikicommons, it seems to be the only applicable image there. Full disclosure of my own bias: the image looks silly, and I think LLLT is silly. Valerius Tygart (talk) 15:07, 9 December 2016 (UTC)
Yeah i seached google images for free-use-licensed images and found nothing. I will withdraw my objection to image. Jytdog (talk) 20:04, 9 December 2016 (UTC)
Done. Valerius Tygart (talk) 14:06, 13 December 2016 (UTC)

I propose to change the photo, I have a lot of pictures showing laser treatment procedures, e.g. https://commons.wikimedia.org/wiki/File:ILBI_procedure.jpg this shows how intravenous laser blood irradiation is carried out. I am the author of over 50 books on laser therapy, 15 of which have more than 300 pages in small print, I carry out laser therapy for more than 32 years, have a personal library of over 100 thousand publications. The Chinese making the pictured device, offered me to write instructions for this device, but I refused, because it is not just useless and ridiculous nonsense, but the impact of the recommended parameters can lead to infertility in women, as endonasal area is a VERY powerful neuroendocrine area. This was proved more than 30 years ago, the monograph with results of research was published. In China there is problem of overpopulation, and specially or foolishly - I do not know, they solve it in such a way, but in the civilized world it is a crime to make women infertile. --Sergey Moskvin (talk) 07:02, 23 December 2016 (UTC)

well, i guess is one (unsourced) explanation for this weird nasal device. if it is accurate, it is no wonder we have no MEDRS sources on it. but with the new proposed picture we have gone out of the frying pan and into the fire, as it were. oy Jytdog (talk) 07:14, 23 December 2016 (UTC)
I agree, there is skepticism, which does not mean refusal of laser therapy, as doubt is due to lack of knowledge. But the task of the encyclopedia is to provide this knowledge. About infertility data is absolutely correct, we can prepare an article on this subject on the basis of our research and many years of experience. But where is it better to publish? About UV blood irradiation: there are hundreds of independent publications, proving recovery of 90-94% of patients with sepsis in the 20-30s of the last century, when there were no antibiotics and without this treatment, almost all died. It is impossible to deny this fact. And now, in the era of antibiotic resistance, nonspecific treatment methods, such as laser therapy step forward. We have thousands of publications and studies on ILBI (intravenous laser blood irradiation), millions of cured people, there is no doubt in the effectiveness of this method. However, I can find a neutral photo with external laser irradiation. Sergey Moskvin (talk) 09:32, 23 December 2016 (UTC)
"... millions of cured people, there is no doubt in the effectiveness of this method." It therefore ought to be easy to find WP:MEDRS to support this statement. Roxy the dog. bark 10:32, 23 December 2016 (UTC)
I absolutely agree that every statement must be supported by official and reliable sources. There is no direct reference, as well as in relation to other treatments. These are emotions. I evaluated it by two ways: 1. In Russia, about 50 thousand clinical studies with positive results were held and published. In each of them 20 to 600 people were involved in laser therapy groups, in total at least 3 million. 2. In Russia, almost every medical center, public and private, carries out laser therapy. Laser therapy is included in the standard of medical care with insurance cover. It is easy to understand that these are millions of people, if 146 million people live in Russia. Sergey Moskvin (talk) 13:54, 23 December 2016 (UTC)
If there are no sources that comply with WP:MEDRS than we can't talk about any of this stuff. Jytdog (talk) 19:24, 23 December 2016 (UTC)
E.g. There are official guidelines "Laser therapy in the treatment and rehabilitation and prevention programs: clinical guidelines // Gerasimenko M.Yu., Geynits A.V., Moskvin S.V. et al. – M., 2015. – 80 p. ISBN 978-5-94789-703-6 [in Russian]" Isn't it "guidelines or position statements from national or international expert bodies" as it is stated in WP:MEDRS?Sergey Moskvin (talk) 09:04, 24 December 2016 (UTC)
based on the info you provide there that is not a statement by a major medical/scientfic body, nor is it a review published in high quality journal. Jytdog (talk) 10:35, 26 December 2016 (UTC)
These clinical guidelines are developed by the two largest leading Public Health Research Institutions in Russia, approved by the Society for the Rehabilitation of Russia, which includes more than 10 thousand people, and the Russian Ministry of Health. And speaking of changing the photo, I do not see that this image https://commons.wikimedia.org/wiki/File:NoseApp2S.JPG is supported by "a statement by a major medical/scientfic body", or "a review published in high quality journal" – it is an outright advertising. Sergey Moskvin (talk) 11:29, 26 December 2016 (UTC)

I completely agree with the two editors who insist on high quality technical journal articles, or other high quality sources, for presenting material on such a dicey topic. Such sources are those that would be acceptable to the USFDA or the European Medicines Agency, or secondary sources citing said primary sources. (Alternative medicine is rife in Russia and, although I would not characterize LLLT as "pseudoscience" exactly, those articles/studies most avidly promoted by its advocates all appear to qualify as low quality, or "junk", science. I wonder, though, in light of the popularity of LLLT in so many places around the world, if a section covering the prevalence (i.e., popularity) of LLLT in various countries (as opposed to its validity/effectiveness in general) wouldn't be acceptable. It would have to still be in the context of use in the face of a lack of consensus that LLLT works. And the problem, as ever, would be getting reliable journalistic sources on such. Valerius Tygart (talk) 17:43, 3 January 2017 (UTC)

LLLT lasers ARE used extensively for therapy.

Noninvasive cellular stimulation on a conscious animal is a great alternative to surgery on an unconscious animal. My chihuahua had a broken leg and damaged vertebra; without LLLT and later accupuncture, we would have had to put her down. For every veterinarian out there with a laser, there is an animal miracle cure story and some have told me they took it home to use their husbands wounds successfully . While veterinarians charge about $40 for a treatment here in Bend Oregon; I invested around $1000 total on my dog using (808 nm) lasers on a general area of the dog (leg and vertebra). If we chose surgery they wanted $1600 to do an MRI, and the animal would be unconscious (very dangerous to Chihuahuas with collapsible trachea). Then they would have to knock her out again for a dye test down her spine. Then there would be surgery on the dog (again unconscious) after they knew what to do, around $1500. I would had to drive the animal over to Salem or Portland for the MRI further stressing her. By knocking out a delicate animal 3 times, and performing around $4500 of tradition medicine, the dog would still have had to heal after surgery and my Vet would use an LLLT laser. To the AMA MD hospital community the invasive dangerous type treatment they insist on would have given them $3500 (4 times more profit) more money and thrice threatened the life of the dog. Profit is reason medical doctors do not want to recognize LLLT therapy. ref Mt Bachelor vet clinic Bend, Broken Top Vet Sisters, Oregon. ref 

James Shaw central Oregon resident and retired senior microwave engineer from TRW and I know more about light and resonance than any of you.72.0.186.248 (talk) 04:07, 6 January 2017 (UTC)
Sounds like you saved yourself a lot of money, and trouble, and kept your animal away from some dangerous surgery. There's only one problem: You wasted the smaller amount of money that you DID spend. There's no evidence LLLT works as anything other than heat or a placebo. Valerius Tygart (talk) 18:59, 6 January 2017 (UTC)

History section

My proposal for this section is below, ready to discuss the references.

History

Even during the time of the Nobel Prize winner in 1903 Niels Ryberg Finsen it has been proven that the narrower the spectrum of light, the greater the therapeutic effect. Therefore, it is not surprising that with the appearance of lasers that have a minimal light spectrum width, (a single wavelength) the methods of light therapy became much more advanced, and hence became known as laser therapy. Furthermore, laser diodes (diode- emitting lasers) - which are currently being used in all modern therapeutic laser devices – allow the user to not only have better control of the parameters of laser illumination, but also to widely vary the methods of use of laser therapy. Looking at laser therapy from a historical aspect, it is clear that lasers are the next step in the development of light therapy. This conclusion can be drawn from the evident evolutionary timeline: Heliotherapy → light therapy → laser therapy . [1][2][3]
Initial studies in this area have been associated with the study of the influence of laser light on blood and red blood cells. For example, it is shown that light exposure of the KTP-laser (potassium titanyl phosphate, green spectrum, wavelength 532nm, power 1mW) to red blood cells promotes the binding of haemoglobin with oxygen, therefore providing true oxygenation, while a ruby laser (red spectrum, 694nm) does not cause the same effect. [4] [5]The structure and composition of the lipoprotein membranes of red blood cells and the mitochondria of other cells does not change, indicating the absence of a destroying or de-structuring effect, and showing and safety of low power laser light [6]. That is to say, the first experimental data showed the importance of the choice of wavelength of the laser light for maximum bioefficacy. However, in the known method of intravenous laser blood irradiation (ILBI) - proposed by Russian scientists [7] – much less effective lasers were used (helium-neon lasers –HeNe lasers, with a wavelength of 633nm, in the red spectrum).
Until the early 1980’s - in Russia and abroad - both in the research of biological effects caused by LLLT, as well as in clinical practice, HeNe lasers were predominantly used [8] [9] [10][11][12][13][14] [15] [16] [17] [18]]. Only a few experimental and clinical trials were carried out using low-energy lasers with different wavelengths: argon (488nm and 514nm) [19] [20] [21] [22], ruby (694nm) [20], Nd-YAG (1064nm) [23], carbon dioxide (CO2 10600nm) [24] and etc.

Since the mid-1980’s, clinicians around the world began to show an interest in infrared (IR) pulsing diode lasers [25]. At present, it is crucial to further develop laser therapy and optimise the techniques and methods to expand the range of wavelengths used [26] [27]. There are no competitors against diode lasers. They are compact and lightweight, and require very little energy (2.5-10V). They have the advantage of being available in a wide range of different wavelengths, from the ultraviolet (36nm) to the infrared (3000nm) regions of the spectrum. Additionally, some diode lasers (with a wavelength of 904nm and 635nm) may operate in a pulsed mode, which is the key to their unique therapeutic effectiveness and versatility. [3] [28]
Laser therapy had been officially recognised in the Soviet Union in 1974 as an effective method of treatment, where it has developed the most. In Japan, the Institute of Laser therapy has been successfully working since the 1980’s [29],. Countries such as China [30], Canada [31], Vietnam[32], as well as countries in Latin America and Eastern Europe [33]have also been using this method for a long time, although not on the same large scale as in the USSR, and later Russia [34] [35]. The motivation for the promotion of one of the most promising areas of modern physiotherapy was the official recognition of this method in Europe in 2000, and in the USA in 2003, which then led to a real boom in its distribution throughout the world. [36]
Laser therapy received further motivation for development after the opening of the Institute of Laser Medicine in Moscow in 1986, which had been successfully led for 11 years by a member of the Academy of Medical Sciences – Professor O.K. Skobelkin. It was later renamed as the State Research Centre for Laser Medicine FMBA RF. This centre has actively studied the mechanisms of interaction of the biological tissues with LLLT, developed and tested new methods of laser therapy, organized refresher courses for doctors and has developed and published dozens of teaching aids, as well as regularly holding scientific conferences.

References

  1. ^ Finsen N.R. Phototherapy. – Spb., 1901. – 39 p. [in Russian]
  2. ^ Moskvin S.V. Laser therapy is the contemporary stage of heliotherapy (historical aspect) // Lazernaya meditsina. – 1997. – Vol.1, Issue.1. – p.44-49. [in Russian]
  3. ^ a b Moskvin S.V. The effectiveness of laser therapy. Series "Effective laser therapy". Vol. 2. – M.–Tver: Triada, 2014. – 896 p. ISBN 978-5-94789-636-7 [in Russian]
  4. ^ Johnson F.M. Olson R.S., Rounds D.E. Effects of high-power green laser radiation on cells in tissue culture // Nature. – 1965. – Vol. 205 (5). – P. 721–722. doi:10.1038/205721a0
  5. ^ Rounds D.E., Olson R.S., Johnson F.M. The laser as a potential tool for cell research // J Cell Biol. – 1965. – Vol. 27 (1). – P. 191–197. Doi: 10.1083/jcb.27.1.191
  6. ^ Rounds D.E., Chamberlain E.C., Okigaki I. Laser radiation of tissue cultures // Ann N Y Acad Sci. – 1965(1). – Vol. 28 (122). – P. 713–727. doi: 10.1111/j.1749-6632.1965.tb20253.x
  7. ^ Meshalkin Ye.N., Sergiyevskiy V.S. The use of direct laser irradiation in experimental and clinical cardiac surgery // Nauchnyye trudy. – Novosibirsk: Nauka, 1981. –p. 172. [in Russian]
  8. ^ Gamaleya N.F. Lasers in experiment and clinic. – M.: Meditsina, 1972. – 232 с. [in Russian]
  9. ^ Devyatkov N.D., Belyayev V.P. Some types of laser systems for research in the field of oncology, surgery and radiation therapy // All-Union Symposium "The physiological and anti-tumor effect of laser radiation." - Kiev-M., 1971. – pp. 9–11. [in Russian]
  10. ^ Inyushin V.M. On the question of the biological activity of the red radiation. - Almaty, 1965. – 22 с. [in Russian]
  11. ^ Inyushin V.M. The biological effect of monochromatic red light on the body of animals and humans // Abstracts of Rep. Symposium "Biological effects of lasers." - Kiev: Naukova Dumka, 1969. - P. 32-33. [in Russian]
  12. ^ Inyushin V.M. The study of bone marrow production of red blood cells by the action of monochromatic red light // The use of solar energy technology, agriculture and medicine. - Alma-Ata, 1969 (1). - p. 86-88. [in Russian]
  13. ^ Inyushin V.M. Laser light and a living organism. – Almaty, 1970. – 46 p. [in Russian]
  14. ^ Inyushin V.M. Г Histophysiological study of action of monochromatic red light optical quantum generators (OQG) and other light apparatus on animals: Author. Thetis ... Doctor. biol. Sciences. - Lviv, 1972. – 30 с. [in Russian]
  15. ^ Kavetskiy R.E., Chudakov V.G., Sidorik E.P. et al. Lasers in biology and medicine. - Kiev: Zdorov’ya, 1969. – 259 p. [in Russian]
  16. ^ Korytnyy D.L., Zazulevskaya L.Ya. Application of laser light in the complex treatment of periodontitis // Light of HeNe lasers in biology and medicine. - Almaty, 1970. – p. 51–52. [in Russian]
  17. ^ Piruzyan L.A., Yevseyenko L.S., Gleyzer V.M. et al. The use of optical quantum generators in experimental biology and medicine // Experimental Surgery and Anesthesiology. – 1967. – № 12 (6). –p. 10–14. [in Russian]
  18. ^ Mester E. Szende B., Tota J.G. Effect of laser on hair Growth of mice (in Hungarian). – Kiserl Orvostud. – 1967. – Vol. 19 (7). – P. 628–631.
  19. ^ Jongsma F.H.M., Bogaard A.E.J.M.v.D., Van Gemert M.J.C., Henning J.P.H. Is closure of open skin wounds in rats accelerated by argon laser exposure? // Lasers in Surgery and Medicine. – 1983. – Vol. 3 (1). – P. 75–80. doi: 10.1097/00006534-198501000-00094
  20. ^ a b Mester E., Mester A.F., Mester A. The biomedical effects of laser application // Lasers in Surgery and Medicine. – 1985. – Vol. 5 (1). – P. 31–39. doi: 10.1002/lsm.1900050105
  21. ^ McCaughan Jr. J.S., Bethel B.H., Johnston T., Janssen W. Effect of low-dose argon irradiation on rate of wound closure // Lasers in Surgery and Medicine. – 1985. – Vol. 5 (6). – P. 607–614. doi: 10.1002/lsm.1900050609
  22. ^ Nagasawa A., Kato K., Negishi A. Bone regeneration effect of low level lasers including argon laser // Laser Therapy. – 1991. – Vol. 3 (2). – P. 59–62. doi: 10.5978/islsm.91-or-07
  23. ^ Abergel R.P., Meeker C.A., Dwyer R.M. et al. Nonthermal effects of Nd:YAG laser on biological functions of human skin fibroblasts in culture // Lasers in Surgery and Medicine. – 1984. – Vol. 3 (4). – P. 279–284. doi: 10.1002/lsm.1900030403
  24. ^ Robinson J.K., Garden J.M., Taute P.M. et al. Wound healing in porcine skin following low-output carbon dioxide laser irradiation of the incision // Ann Plast Surg. – 1987. – Vol. 18 (6). – P. 499–505. doi: 10.1097/00000637-198706000-00006
  25. ^ King P.R. Low level laser therapy: a review // Lasers in Medical Science. – 1989. – Vol. 4 (2). – P. 141–150.
  26. ^ Carroll J.D. Irradiation parameters, dose response, and devices // Handbook of Photomedicine / Edited by M.R. Hamblin, Y.-Y. Huang. – Boca Raton – London – New York: CRC Press, 2016. – P. 563-567. doi: 10.1201/b15582-54
  27. ^ Huang Y.-Y., Chen A.C.-H., Carroll J. D., Hamblin M.M. Biphasic dose response in low level light therapy. – University of Massachusetts, 2009. – 18 p. doi: 10.2203/dose-response.11-009.Hamblin
  28. ^ Hashmi J.T., Huang Y.-Y., Sharma S.K. et al. Effect of pulsing in low-level light therapy // Lasers in Surgery and Medicine. – 2010, 42(6): 450–466. doi: 10.1002/lsm.20950
  29. ^ Ohshiro Т. Light and life: a review of low reactive-level laser therapy, following 13 year’s experience in over 12000 patients // Laser Therapy. – 1993. – Vol. 5 (1). – P. 5–22.
  30. ^ Zhou Y.C. LLLT in the People’s Republic Of China // Laser Therapy. – 1991. – Vol. 3 (1). – P. 5–9. doi: 10.5978/islsm.91-re-01
  31. ^ McKibbin L.S., Downie R. LLLT in Canada // Laser Therapy. – 1991. – Vol. 3 (1). – P. 45–47. doi: 10.5978/islsm.91-nu-01
  32. ^ Lap V.C., Duet T.C., Cuong D.K. Low-level laser therapy: The experience in Vietnam // Laser Therapy. – 1994. – Vol. 6 (1). – P. 62.
  33. ^ Ailioaie C., Chiran D.A., Ailioaie L.M. Laser blood irradiation in juvenile idiopathic arthritis – case study // Conference WALT. Abstracts. – Lemesos, Cyprus, 2006. – P. 181.
  34. ^ Korepanov V.I. State of the art of laser therapy in Russia: a brief overview // Laser Therapy. – 1997. – Vol. 9 (1). – P. 41–42. doi: 10.5978/islsm.9.41
  35. ^ Skobelkin O. Achievements low level laser therapy in Russia // Laser Therapy. – 1994. – Vol. 6 (1). – P. 12.
  36. ^ Plavskiy V.YU., Mostovnikov V.A., Ryabtsev A.B. et al. Equipment for low-level laser therapy: current status and development trends // Opticheskiy zhurnal. - 2007. - V. 74. - № 4. - p. 27-41. [in Russian]

-- Vasyatka12345 (talk) 10:45, 26 December 2016 (UTC)

I am unwilling to consider a section built almost entirely of sources in Russian and that includes extremely low quality primary sources (conference abstracts, for pete's sake) Jytdog (talk) 11:30, 26 December 2016 (UTC)
Do you know that in Russia there is 1,000 times more research on the topic of laser therapy than in the rest of the world, and the quality of research is 1000 times higher than those published in English in the "reliable and respectable" magazines? Articles in English on laser therapy are of so poor quality, that it is a very difficult task to choose one. You just do not understand the matter, incompetent, so consider the opinion of the Ministry of Health of Russia non-serious. Maybe you want to say that there is no science and medicine in Russia, and only wild and uneducated people live there. Right? Sergey Moskvin (talk) 11:08, 29 December 2016 (UTC)
Russian science has produced some titans (think Mendeleev, Metchnikoff, Sakharov, etc). Also, in literature, music, cinema, etc, Russia is one of the great world civilizations and can hold its own against any other. No, the problem there is the government…which spills over into all other areas. This situation has produced some world class atrocities over the years, including in the realm of science. One word, Lysenkoism, says it all. Remember, these are the scientific leaders who insisted for decades that the Sverdlovsk anthrax leak was a natural occurrence, until Yeltsin finally fessed up. Do you think this situation has changed in 2016? No, things are going backwards, if anything. Putin has repudiated Yeltsin’s confession & said it was all totally innocent. Valid science requires an open society in which practitioners are free to critique each other vigorously without the fear of retaliation or intimidation. I agree with User:Jytdog that Vasyatka12345’s proposal (including references) is a non-starter. It may be true that “Laser therapy had been officially recognised in the Soviet Union in 1974 as an effective method of treatment”, but LLLT is not known to be an effective method of treatment for anything, except an expensive way to deliver heat. LLLT is not “one of the most promising areas of modern physiotherapy”. There is no good scientific evidence that it works. The supposed “official recognition of this method” by the USFDA in 2002 was as a “lamp, non-heating, for adjunctive use in pain therapy”… No mention of lasers. It is apparently true that advocacy of LLLT has “led to a real boom in its distribution throughout the world”. This fact could be recognized in the article, perhaps with some of the references cited, but not without the proviso that such distribution has happened without any sound scientific basis or consensus. The history section proposed by Vasyatka12345 is a history of junk science and is entirely unacceptable in content and tone. This is the case notwithstanding the junk science LLLT “Centers” and “Institutes” in various countries around the world. Saying this is no insult to the various countries involved. The best scientists and physicians in all those countries know LLLT for the junk science that it is. Valerius Tygart (talk) 16:40, 3 January 2017 (UTC)
"The best scientists and physicians in all those countries know LLLT for the junk science that it is." Can you provide data on who are these "best scientists", who gave them this title, from which countries are they, where are their studies, proving their opinion about "junk science"? In 2016 there were 222 articles devoted to this "pseudoscience" in only 4 main specialized journals (Journal of Photochemistry and Photobiology B Biology, Lasers in Medical Science, Lasers in Surgery and Medicine, Photomedicine and Laser Surgery), about 800 articles in English were published in a hundred thematic magazines. In total more than 1000 articles. Is this also Putin's propaganda, are the authors of articles agents of the Kremlin, are the magazines marginalized and articles paid personally by Putin? I will mention only two of many monographs, that you can read: Handbook of Photomedicine / Edited by M.R. Hamblin, Y.-Y. Huang. - Boca Raton - London - New York: CRC Press, 2016. - 854 p. & Karu T. Ten lectures on basic science of laser phototherapy. - Grängeberg, Sweden: Prima Books AB, 2007. - 414 p. Propaganda (advocacy) is when, instead of the truth (e.g. that LLLT is extremely effective, and that's why it is so popular and its popularity is growing rapidly) someone puts forward unsupported lie. Sergey Moskvin (talk) 11:12, 10 January 2017 (UTC)
Laser devices and laser therapy are approved by USFDA, there are 510(k) clearances e.g. for Thor lasers, Acculaser etc. Yes, "lamp" is stated in the Classification Name/ Product Code, but it is according to FDA terminology, for them - sun, lamp, laser - is the source of light. Well, it is like bicycle, car and spaceship – is a vehicle. In addition, there are dozens of different clinical guidelines by professional societies in USA, Canada, Australia etc. Sergey Moskvin (talk) 14:18, 10 January 2017 (UTC)
Ioannidis (2005) "Why Most Published Research Findings Are False".

“In science, the burden of proof falls upon the claimant; and the more extraordinary a claim, the heavier is the burden of proof demanded…. Since the true skeptic does not assert a claim, he has no burden to prove anything.” -- Marcello Truzzi (1987)

Valerius Tygart (talk) 18:53, 10 January 2017 (UTC)

The point is not science and objective proof, but who makes decisions, to allow or not. The one who has more rights is right. Dissidence is not allowed. It's a sample of totalitarian policy.Sergey Moskvin (talk) 12:32, 13 January 2017 (UTC)

Sergey, comments like that don't help you persuade anyone. Wikipedia is a clue-ocracy, btw. Jytdog (talk) 14:39, 13 January 2017 (UTC)

Remove the nose treatment image

Only tiny bit of weak evidence for up the nose treatment so image should be removed until a better one sourced. For example there are 27 randomised controlled clinical trials with several systematic reviews in world class journals and recommendation statement from MASCC for oral mucositis treatments. So an image of that treatment would be far better.

Agreed here by Doc James https://en.wikipedia.org/wiki/User_talk:Doc_James/Archive_108

Why remove the infobox answer Hi there,

I'm new and could not for the life of me find a way to replace that terrible photo, so I had to remove the whole infobox and add the better confirmed treatment photos which are also non-branded into content.

If you can replace the 'up the nose treatment' image with one of the other ones in the infobox, then please do.

That photo makes everyone in the community look like idiots if showing that as the main photo for low level laser therapy.

There is a tiny little bit of weak evidence for up the nose treatment whereas are there are 27 Randomised controlled clinical trials with a dozen several systematic reviews in world class journals and a recommendation statement from MASCC for oral mucositis treatments.

See here the medscape article: https://www.facebook.com/permalink.php?story_fbid=966129913418833&id=109931359038697

And several US insurance companies now declare Low Level Laser "medically necessary" for Oral Mucositis because the trial results finally can't be ignored any more and is becoming recognised and going mainstream to help thousands of patients.

Thanks for your time, kind regards, Ian — Preceding unsigned comment added by Ibrayshaw (talk • contribs) 03:37, 15 March 2017 (UTC)

Ah okay. User:Ibrayshaw done. Doc James (talk · contribs · email) 03:42, 15 March 2017 (UTC)

Ibrayshaw (talk) 22:47, 3 April 2017 (UTC)

Side-stepping a number of your statements, which I disagree with... On the image issue: I have long sought a good (acceptable to other editors) image to go in this article. (I was the one who first posted the reviled "nose picture", not because I like it but because it was literally the only one available at Wikicommons that looked marginally acceptable.) Therefore: By all means upload a good pic of LLLT to Wikicommons that passes muster there, editors will evaluate it here, and we will be off to the races!! (I would do this myself, but I don't work with LLLT or have access to good pictures of it, devoid of copyright problems.) Valerius Tygart (talk) 14:48, 6 April 2017 (UTC)
There is another picture on Wikimedia Commons here: [8] Zyxwv99 (talk) 15:54, 9 April 2017 (UTC)

Intro

I want to examine the phrase "Despite a lack of consensus over its scientific validity, specific test and protocols for LLLT suggest it may be modestly effective, but in most cases no better than placebo...." I don't disagree with the sentence, but the phrase "specific test and protocols for LLLT suggest..." is not just awkward: it is vague to the point of incoherence. What the hell is 'specific test' (singular)? And what about 'protocols'? That term has many meanings. One is as a study (investigational) document describing how a proposed experiment is to be carried out. (Clearly putting the cart before the horse.) Another is as a term for a treatment regimen. But again, the existence of such a regimen wouldn't suggest that something works; only a clinical trial could do that. I suggest that the sentence read: "Despite a lack of consensus over its scientific validity, some clinical studies have suggested that LLLT may be modestly effective, but in most cases no better than placebo....". Valerius Tygart (talk) 13:34, 18 April 2017 (UTC)

Sounds like a good change to me. thx Jytdog (talk) 01:58, 19 April 2017 (UTC)
Done. Valerius Tygart (talk) 19:34, 22 April 2017 (UTC)

N.B.

Note that there is a very large talk page archive (2013-2017) for this article. Not sure why the anomalous 2006 sections above were left up. Valerius Tygart (talk) 14:40, 8 July 2017 (UTC)

Alternative medicine or not?

The article states that LLLT is "alternative medicine" (no citation given), and that the therapy is "in most cases no better than placebo" (citations given, but they suggest that the therapy *is* better than placebo, but may be no better than exercise or conventional heat application). These charges aren't adequately supported by the article; this isn't helpful for a sceptical reader trying to understand the current state of evidence. This might be a better summary to adopt: "LLLT devices may bring about temporary relief of some types of pain, but there's no reason to believe that they will influence the course of any ailment or are more effective than standard forms of heat delivery"[1]. AndrewBolt (talk) 08:05, 7 November 2017 (UTC)

N.B.

Note that there is a very large talk page archive (2013-2017) for this article. Not sure why the anomalous 2006 sections above were left up. Valerius Tygart (talk) 14:40, 8 July 2017 (UTC)

Moved from Roxy's talk page

Changes made to LLLT page only included missing information. Regarding reimbursement, Blue Cross Blue Shield Association has changed their policy to indicate that LLLT is considered 'medically necessary'[2][3]. Plenty more can be cited if further evidence is required. The treatment of Oral Mucositis included citations from multiple papers[4][5][6], including a systematic review[7] and is further supported by the policy changes by Blue Cross Blue Shield Association. The Blue Cross Blue Shield of Western New York medical policy states this (emphasis mine):

"A recent systematic review of RCTs on LLLT for prevention of oral mucositis included 18 RCTs, generally considered at low risk of bias, and found statistically significantly better outcomes with LLLT than control conditions on primary and secondary outcomes. In addition, three double-blind, RCTs published in 2015 found significantly better outcomes in patients undergoing LLLT than undergoing sham treatment prior to or during cancer treatment. The evidence is sufficient to determine qualitatively that the technology results in a meaningful improvement in the net health outcome."[8]

Please review changes and tell me which content you feel is not supported by the citations and evidence.

edit: in case you are concerned about the use of static PDFs, you can search Blue Cross Blue Shield of Western New York's medical policy here, look for Low Level User therapy, you can do the same for Blue Cross Massachusetts and Blue Kansas City. 

Academia salad (talk) 11:43, 6 February 2018 (UTC)
  1. ^ https://www.devicewatch.org/reports/lllt.shtml
  2. ^ http://medicalpolicy.bluekc.com/MedPolicyLibrary/Medicine/Standard%20Medicine/06-17_2_Low_Level_Laser_Therapy.pdf
  3. ^ http://docplayer.net/docview/66/54500782/#file=/storage/66/54500782/54500782.pdf
  4. ^ https://www.ncbi.nlm.nih.gov/pubmed/?term=22884841
  5. ^ https://www.ncbi.nlm.nih.gov/pubmed/?term=23625880
  6. ^ https://www.ncbi.nlm.nih.gov/pubmed/?term=23224689
  7. ^ https://www.ncbi.nlm.nih.gov/pubmed/23001179
  8. ^ https://www.bcbswny.com/content/dam/COMMON/Provider/Protocols/L/prov_prot_20156.pdf

the above was posted at my talk page. -Roxy, the dog. barcus 14:26, 6 February 2018 (UTC)

Hm, there are some useful refs there, and some not useful ones. Will look more later. There are some things here to work with. Jytdog (talk) 15:49, 6 February 2018 (UTC)
I reverted the recent change to the article, as briefly hinted by my edsum, because of the clear WP:COI of the editor, and the fact that they are a WP:SPA editor. The edits appear designed to promote the business of the editor concerned. Furthermore, I fail to see the relevance of the reimbursements portions to an encyclopeadia article. The article is also a mish mash of apparent misinterpretation, contradictions and contraindications which only serve to confuse, and needs a good broom. Mr Salad, have you ever read WP:MEDRS? -Roxy, the dog. barcus 23:08, 6 February 2018 (UTC)
I agree that the page needs a good spring clean. I had not read WP:MEDRS, but a quick scan suggests that secondary sources are preferred over primary sources, which makes sense. I’ll read it more carefully when I get the time. In the meantime, here is a systematic review published in the peer reviewed Supportive Care in Cancer on oral mucositis, a systematic review published in the peer reviewed journal The Lancet about the management of neck pain, and a systematic review in the peer reviewed BMC on interventions in osteoarthritic knee pain. I didn’t add the reimbusement section, I just updated it. I understand concerns over COI, I'm happy to limit my activity to discussion on this Talk page. Academia salad (talk) 14:15, 7 February 2018 (UTC)
you got it on MEDRS. We summarize what high quality secondary sources say - reviews in good journals, statements by major medical/scientific bodies are best. We reach for things like insurance company evaluations when there are not other good secondary sources (we can count on the insurance folks to be critical and independent of manufacturers, at least). If you want to take a shot at proposing content based on the refs that fit the bill, to update the content, that would be amazing. Jytdog (talk) 03:55, 9 February 2018 (UTC)
I'd be happy to, but I could use some guidance. One of the problems with reporting from all the sources is that a lot of them don’t take dosage into account when reviewing evidence. Dosage is critical to the efficacy of LLLT/PBMT. This is well put in a systematic review in the Lancet, where they say "effectiveness depends on factors such as wavelength, site, duration, and dose of LLLT treatment. Adequate dose and appropriate procedural technique are rarely considered in systematic reviews",[1] but it is also addressed in "Meta-analysis of pain relief effects by laser irradiation on joint areas.",[2] "Low level laser treatment of tendinopathy: a systematic review with meta-analysis.",[3] and "A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders."[4] However I don't feel I should just cut out papers that do not account for dosage. Do you have any recommendations?
--Academia salad (talk) 15:51, 15 February 2018 (UTC)
Tricky. per MEDMOS we generally don't do discuss dosing in order to avoid becoming an instruction manual. But in this case where dosing is crucial (it is "low level LT" after all) something in the "medical use" section mentioning how dose plays into efficacy and safety, sourced to those MEDRS refs, would be fine. With regard to refs that omit dosing, are you are aware of discussion in the biomedical literature where people who don't take those things into account, justify not taking them into account?
In general it is true with all medical procedures that the skill of the physician (referring to "proper technique") is by far the biggest factor determining outcomes. This is not surprising and efficacy and safety should take into account how the procedure is done "in the wild", by experts and novices and middle-experienced people -- anybody who does it. Jytdog (talk) 16:32, 15 February 2018 (UTC)
I am not aware of any papers that justify not taking dosage into account, but there are papers and reviews that acknowledge that dose should have been taken into account. It is not difficult to find some of these papers as examples and I could provide some examples. A good example of the specific concern I have is the paper "Is low-level laser therapy in relieving neck pain effective? Systematic review and meta-analysis.”[5], which is currently cited on the Wikipedia page as evidence against the effectiveness of LLLT.
The paper by Kadhim-Saleh et al. was rebutted by the authors of the original paper "Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials",[1] in "Methodological shortcomings make conclusion highly sensitive to relevant changes in review protocol”,[6] citing specific problems with the paper, including that "Kadhim-Saleh et al. appeared to give no serious consideration to the appropriateness of LLLT technique including dosage a priori in selection criteria or analysis protocol." and "They cited meta-analyses published over 20 years ago to demonstrate the consistency of their claim with previous reviews that found no effect from LLLT despite 80–90 % of RCTs on LLLT being published after these citations." I would strongly recommend reading all three papers, but then paper by Kadhim-Saleh et al. is not a paper I would include on the wikipedia page.
I was wondering what the best practice is for cases like that? Academia salad (talk) 10:23, 20 February 2018 (UTC)

References

  1. ^ a b Chow, Roberta T.; Johnson, Mark I.; Lopes-Martins, Rodrigo A. B.; Bjordal, Jan M. (5 December 2009). "Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials". Lancet (London, England). 374 (9705): 1897–1908. doi:10.1016/S0140-6736(09)61522-1. ISSN 1474-547X.
  2. ^ Jang, Ho; Lee, Hyunju. "Meta-analysis of pain relief effects by laser irradiation on joint areas". Photomedicine and Laser Surgery. 30 (8): 405–417. doi:10.1089/pho.2012.3240. ISSN 1557-8550.
  3. ^ Tumilty, Steve; Munn, Joanne; McDonough, Suzanne; Hurley, Deirdre A.; Basford, Jeffrey R.; Baxter, G. David. "Low level laser treatment of tendinopathy: a systematic review with meta-analysis". Photomedicine and Laser Surgery. 28 (1): 3–16. doi:10.1089/pho.2008.2470. ISSN 1557-8550.
  4. ^ Bjordal, Jan M.; Couppé, Christian; Chow, Roberta T.; Tunér, Jan; Ljunggren, Elisabeth Anne (2003). "A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders". The Australian Journal of Physiotherapy. 49 (2): 107–116. ISSN 0004-9514.
  5. ^ Kadhim-Saleh, Amjed; Maganti, Harinad; Ghert, Michelle; Singh, Sheila; Farrokhyar, Forough. "Is low-level laser therapy in relieving neck pain effective? Systematic review and meta-analysis". Rheumatology International. 33 (10): 2493–2501. doi:10.1007/s00296-013-2742-z. ISSN 1437-160X.
  6. ^ Bjordal, JM; Chow, RT; Lopes-Martins, RA; Johnson, MI (August 2014). "Methodological shortcomings make conclusion highly sensitive to relevant changes in review protocol". Rheumatology international. 34 (8): 1181–3. doi:10.1007/s00296-013-2940-8. PMID 24402005.

Too much negativity

I tried to clean up a few things, but got reverted by Valerius Tygart here. I can understand calling this "a form of alternative medicine", but the linked article says "and where the scientific consensus is that the therapy does not, or cannot, work because the known laws of nature are violated by its basic claims". This is not the case here; far from a consensus that it does not or cannot work, there are a number of cited MEDRS secondary sources showing that it is sometimes effective, and that number of plausible mechanisms are being studied. Another effect of the revert was to restore "appear to be limited to a specified set of wavelengths" which is not at all what the cited source says; I had changed it to say "Beneficial effects of LLLT have been found at several wavelengths and not at others." And I had taken out "but in most cases no better than placebo", as I didn't see that the cited sources supported that. This feels like the reverting editor is just biased against "alternatives" to the usual medical practices, even when there's evidence that they do sometimes work. Dicklyon (talk) 04:09, 23 February 2018 (UTC)

There is some evidence for a few things such as this review in BMC cancer[9]
But not for other stuff[10] Doc James (talk · contribs · email) 13:45, 23 February 2018 (UTC)
Hi, @Doc James:, there is good quality evidence from secondary sources for LLLT being effective in the prevention of severe oral mucositis,[11][12], including a guideline by MASCC[13]. Alongside that, the Blue Cross Blue Shield Association[14][15] considers LLLT "medically necessary for the prevention of oral mucositis". Given that the alternative medicine page provides the description "practices claimed to have the healing effects of medicine but which are disproven, unproven, impossible to prove, or are excessively harmful in relation to their effect", I would argue that the use for OM alone should push it out of the category of alternative medicine as it is clearly proven to work.
In interest of disclosure, I have a COI as listed on my user page. I intend to open up a discussion on other uses of LLLT at a later date on this talk page to review evidence for other uses of LLLT.
As an aside, you don't seem to use full citations for the talk page, is that the preferred way for talk pages? I've used the method you used for this reply, but I can do whichever is better in the long run. Academia salad (talk) 15:17, 23 February 2018 (UTC)
Doc James, please also note that a lack of evidence of effectiveness is not remotely like "where the scientific consensus is that the therapy does not, or cannot, work because the known laws of nature are violated by its basic claims". If that's what alternative medicine is, this is not. An altnertive strategy would be to fix the alternative medicine article, as its definition seems overly negative, and is used to imply that all alternative medicines can't work. Dicklyon (talk) 00:48, 24 February 2018 (UTC)
Blue Cross Blue Shield Association is not a sufficient source. But the others are okay.
Yes the url to pubmed is sufficient for talk pages. Doc James (talk · contribs · email) 04:10, 24 February 2018 (UTC)

Suggestions for 'medical uses' section.

I'd like to propose some changes to the 'medical uses' section. As listed on my user page, I have COI.

Currently, the way this section is written, a single source is used to broadly dismisses LLLT as being no better than "other low tech ways of applying heat". But the source does not cite any specific papers/reviews to support that claim. I recommend changing the lead to not specify what LLLT has been promoted for. I recommend changing it to a non-specific 'many different treatments'. Hopefully this reduces the chance of people being misled to think LLLT is effective/not effective for anything not listed. I am also recommending areas which evidence shows LLLT is effective.

CHANGE: Various LLLT devices have been promoted for use in treatment of several musculoskeletal conditions including carpal tunnel syndrome (CTS), fibromyalgia, osteoarthritis, and rheumatoid arthritis. They have also been promoted for temporomandibular joint (TMJ) disorders, wound healing, smoking cessation, and tuberculosis. While these treatments may briefly help some people with pain management, evidence does not support claims that they change long term outcomes, or that they work better than other, low tech ways of applying heat.

TO: LLLT has been promoted for many different treatments, for which there are varying levels of evidence.

ADD: Evidence supports the use of LLLT for the treatment of various tendinopathies,[16][17], such as shoulder tendinopathy,[18]and tennis elbow. [19] A review found tentative evidence that LLLT may help frozen shoulder.[20]

ADD: LLLT appears to be effective for treating joint pain [21] and "can significantly improve the functional outcomes" for people suffering temporomandibular joint dysfunction [22], and can “provide symptom management” for people with osteoarthritis.[23] Reviews have found benefits for nonspecific chronic low-back pain.[24][25]

ADD: There is some evidence that LLLT is effective for breast cancer related lymphedema.[26]

Feedback is appreciated. Academia salad (talk) 17:33, 1 March 2018 (UTC)

Do any of your sources above comply with WP:MEDRS? -Roxy, the dog. barcus 17:49, 1 March 2018 (UTC)
Unless I've mis-copied or misread, they should all be secondary sources (systematic reviews), as per WP:MEDRS. Academia salad (talk) 18:00, 1 March 2018 (UTC)
I've looked at the first one of those, number [8] and found this in its conclusion - "Assuming the lack of themes and samples associated with the studies found in this review, and the fact that well-known databases were used, it is suggested that further research are made using low-intensity laser therapy in patients with this condition to best assess this therapy." - If the rest of your "WP:MEDRS sources" are as good, I'd say that we wont be changing the page at all. -Roxy, the dog. barcus 18:31, 1 March 2018 (UTC)
I would be very leery of allowing an editor with a self-acknowledged COI to drive numerous changes to this article. (Shouldn't that mean that he/she voluntarily refrains from editing the article?) LLLT has not been "clearly proven to work" in OM. The cited article merely asserts "increasing evidence". I also disagree that, even if it did, it would "push it out of the category of alternative medicine". AM is, simply put, medicine that has not been shown to work. If 99% of promoted uses of LLLT remain unvalidated, LLLT remains 99% alternative medicine. The overall picture of LLLT (which, presumably, the average Wikipedia reader wants when seeking out the article) has not really changed recently. Stephen Barrett (at Quackwatch, a reliable secondary source) updated his page on LLLT about 13 months ago. His conclusion that "there's no reason to believe that they [LLLT modalities] will influence the course of any ailment or are more effective than other forms of heat delivery" remained unchanged. BTW, here is the paragraph he updated in Feb 2017:

One FDA-cleared LLLT device—the QLaser—has been promoted with curative claims that resulted in civil and criminal prosecution. The primary marketer, Robert L. Lytle (better known as Dr. Larry Lytle), had begun manufacturing and distributing low-level laser devices in 1997, shortly before the South Dakota Board of Dentistry had revoked his dental license for fraud and substandard patient care. In 2014, a federal complaint charged that Lytle, doing business as QLasers PMA and 2035 PMA, had marketed a dozen devices with illegal claims that they could treat "over 200 different diseases and disorders," including cancer, cardiac arrest, deafness, diabetes, HIV/AIDS, macular degeneration, and venereal disease. However, court documents indicate that although the FDA obtained a permanent injunction [4], Lytle continued selling the devices to and through other distributors. In January 2017, he and three distributors were charged with conspiracy in connection with the sale of QLaser devices and one of the three pleaded guilty [5,6].

Dicklyon insists there's "too much negativity" in the LLLT article. Hmmmm. LLLT has "alternative medicine" written all over it. Even if it is ultimately shown to work in some limited contexts (something about which I am personally doubtful), it remains a scam, plain and simple, for the "over 200 different diseases and disorders" for which is has been (& is being) promoted. I am all for carefully introducing well sourced updates regarding positive (& negative) developments in LLLT as time goes by, while always maintaining the relevant context & avoiding promotion. But I think the article (as of a few days ago) strikes just the right tone. Valerius Tygart (talk) 14:36, 8 March 2018 (UTC)
I did not give my proposal the time it deserved, I had it on a to do list for ages and made the mistake of rushing it to get it off my to do list.
But:
  • This review for shoulder tendinopathy has good reviewing methodology, reporting and high quality testing of articles found — they use the PEDro scale, which is is robust and well regarded. The evidence here is a mix of high and moderate (13 RCTs of high quality and 4 of moderate quality) and has a positive conclusion in favour of LLLT - both alone and in combination with physiotherapy.
  • This is a well written review for lateral elbow tendinopathy, it finds the evidence is positive in favour of LLLT - both alone and as an adjunct therapy - for short term pain and reduced disability. Of particular interest and a credit here is their analysis and commentary on treatments and dose parameters (and how these vary between studies).
  • This review shows good evidence for reducing lymphedema and moderate evidence for reducing pain, it's a high quality systematic review with good methodology and is well written. It does report heterogeneity of studies in terms of treatment protocols, laser parameters and methods of applications.
How do you feel about those?
Valerius wrote "Shouldn't that mean that he/she voluntarily refrains from editing the article?". This is why I am not editing the article directly but instead communicating via this page as Jytdog recommended. I am more than willing to work within the framework Wikipedia provides for people with COI to contribute. If I make mistakes, please let me know and assume best intentions. Academia salad (talk) 18:46, 9 March 2018 (UTC)
@ Academia salad: Your #1 (Haslerud) is already cited in the article. No edit recommended. Your #2 (Bjordal) is also already there (cited 5 times). No edit recommended. Your #3 (Baxter) is new. It could be added to the two articles after the first sentence in the "Cancer" subsection. If so, I suggest quoting or paraphrasing the caution given in that article: "Due to the limited numbers of published trials available, there is a clear need for well-designed high-quality trials in this area." Such is MHO. Valerius Tygart (talk) 00:30, 12 March 2018 (UTC)

Medicine or Alternative Medicine?

I'm disappointed in the change Valerius made to the article, reverting a previous change made by Dicklyon. Valerius stated earlier that "[Alternative Medicine] is, simply put, medicine that has not been shown to work" and stated "LLLT has not been 'clearly proven to work' in OM. The cited article merely asserts 'increasing evidence'." The words "increasing evidence" were taken from the abstract of this systematic review published by the Multinational Association of Supportive Care in Cancer. The full quote states that the "increasing evidence allowed for the development of two new guidelines supporting this modality" and, in the discussion section, goes on to say:

Based on the current scientific information, the panel was able to reach the following decision: “The panel recommends that, for centers able to support the necessary technology and training, LLLT be used to prevent oral mucositis, in HSCT patients receiving high-dose chemotherapy with or without TBI. […] A systematic review with meta-analysis concluded that there is consistent evidence from small high-quality studies that red and infrared LLLT can partly prevent development of cancer therapy-induced OM. It indicated that LLLT significantly reduces pain, severity, and duration of symptoms in patients with OM."

A recommendation like that is not issued for medicine that has not been shown to work. Hopefully the evidence from this systematic review dispels the fallacy that "there's no reason to believe that they [LLLT modalities] will influence the course of any ailment or are more effective than other forms of heat delivery".

Valerius’ argument continues that "If 99% of promoted uses of LLLT remain unvalidated, LLLT remains 99% alternative medicine". I do not agree with that method of sorting treatments between medicine and alternative medicine. If aspirin was promoted for 200 pathologies that it has not been proven to be effective for, that would not make Aspirin alternative medicine.

I do not dispute that there are illegitimate claims made of LLLT, however if it is the intention of this page to reflect current thinking on LLLT the page should not lead with a phrase that lumps it in with reiki, faith healing and psychic surgery. LLLT, at minimum, has been proven to clinically effective for the treatment of mucositis and therefore does not meet Wikipedia's definition of alternative medicine. Academia salad (talk) 17:17, 15 March 2018 (UTC)

The comparison is not really to AMs like "reiki, faith healing and psychic surgery", but to AMs like acupuncture, chiropractic, and osteopathy, all of which have had ad hoc panels and committees make "recommendations" & formulate "guidelines" over the years, but for none of which has the scientific medical community at large been convinced of their efficacy. They remain "alternative medicines" on Wikipedia & elsewhere. I would suggest that — for purposes of Wikipedia articles — a controversial "medicine" moves from being an "AM" to "not-AM" when the relevant national or international specialty or sub-specialty College or Society (e.g., American Society of Clinical Oncology, International College of Surgeons, etc), or their subordinate working groups or panels, endorse it. At the very least, it should have received a solid positive evaluation from a non-biased, non-profit group such as the Cochrane Reviews. BTW, if aspirin were to be touted, without reliable evidence, as a treatment for schizophrenia & became a popular fad for that condition, then yes, it would be an "alternative medicine" for that indication. Valerius Tygart (talk) 22:24, 18 March 2018 (UTC)
An international non-profit non-biased association whose specialty is supportive care for cancer treatments, known as the Multinational Association for Supportive Care in Cancer (MASCC), endorses LLLT for the prevention of Oral Mucositis. Demonstration of a lack of bias of MASCC towards LLLT is illustrated in their recommendations on a number of different treatments, for and against, and found here.[27]. The MASSCC’s endorsement of LLLT for Prevention of OM is supported by their systematic review, previously referenced. Moreover, this endorsement does not stand alone, supported, for example, by a meta-analysis in Current Opinion in Oncology,[28] which concludes that "It is now imperative to include photomedicine using LLLT as a possible mode of prophylactic and therapeutic intervention in the management protocol of oral mucositis in cancer patients."
Whether or not the intention is to compare LLLT to psychic surgery or chiropractic, when the article contains "is a form of alternative medicine" within the first 10 words, it is comparing it to any and all fields which are described as alternative medicine. It is describing LLLT as "disproven, unproven, impossible to prove, or excessively harmful in relation to their effect". But as shown, at minimum LLLT has been proven to be clinically effective for the treatment of oral mucositis and therefore does not meet the definition of alternative medicine.Academia salad (talk) 09:47, 10 April 2018 (UTC)
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