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I have been banned for a week there, because some of my answers there violated rules that nowhere else on Stack Exchange are imposed.

The problem is the demand that everything be backed up by peer reviewed articles, even though this site's policy allows answers based on personal experience. Of course, you don't want people to give an answer that is incompatible with what has been scientifically established, but what I've stumbled on has nothing to do with such a problem. Also, it should be clear that no medical advice should be given, questions of that sort will be closed. But you can still answer such questions by addressing some relevant aspects appropriately.

We don't have this demand from hard core scientific topics like physics where I'v made the most contributions, so I wonder how on Earth you could have such a policy for a topic like health where the peer reviewed literature does not cover a lot of what many people want to know or what would be helpful in an adequate way.

E.g. this answer by me addressed a relevant issue with someone experiencing back pain. It was also a request for medical advice, so the question had to be closed by the Mods until that time the OP can reword the question. However, the answer by me that the OP accepted turned out to be very relevant, as the OP wrote in the comments that he wasn't doing any core exercises. My original answer did not mention other aspects relevant to weight lifting, as JohnP wrote in the comments, but I corrected my answer to also include a suggestion about that.

But then the notice

Some of the information contained in this post requires additional references. Please edit to add citations to reliable sources that support the assertions made here. Unsourced material may be disputed or deleted.

is just ridiculous. First, Stack Exchange site policy allows for answers based on personal experience, you don't always need to back up each and every detail using references. Also, it's not really helpful to tag answers without specifically discussing what should be referenced and why.

A big problem with a subject like health is that the peer reviewed literature does not adequately cover the entire subject, many people will ask questions where the peer reviewed literature does not have good answers on. E.g. in case of back pain, if you would base things on secondary review articles you can't recommend core exercises specifically, as no difference is seen between that and general fitness exercises in studies that have examined the results published in primary research articles. But for weight lifting the situation is not clear, if one only looks in the peer reviewed literature.

However, there is of course a great deal of experience in the field and most people who do serious weight lifting also do core exercises. This knowledge then counts for nothing just because the medical professionals have yet to do rigorous studies. The question one should then ask is why, against this site's policy, one cannot give that information here when it is not contested. Obviously, if people were to disagree and say that actually core exercises are bad for your back, on can have a discussion about that.

This is a more serious problem. The OP should obviously have gone to the doctor a long time ago, the question was closed as it should have been. But my answer which was accepted by the OP, simply addresses how to prepare for the appointment with the doctor considering that the problems have been festering for too long. I'm not familiar with any appropriate articles one could cite here, nor do I think it's necessary to give such references in this case. Now the Mod who tagged this and other answer also downvoted all the tagged answers. So, I don't think we're dealing with objective moderating here.

Final example. Here we can see quite well that sticking to what the Mods calls "good references" leads to problems. Two answers are given, one very strictly based on peer reviewed sources, the other one by me based more on the personal experiences that many in the general public will have. The first answer, while technically correct is not all that useful in practice, if you actually take your time to read the articles to find out how big the effect of e.g. frequent hand washing is in practice, you'll find that it has a marginal effect. While significant and one of the few rigorously proven ways to prevent the common cold it isn't actually going to help the OP deal with his problem.

My answer, while inferior from a rigorous scientific point of view (and I do mention in my answer that "although the rigorous proof that it does anything at all is still lacking...") received 5 downvotes and the tag for more references. The discussion shows that the Mod will only be satisfied with a ref that contains the rigorous proof. Another problem with my answer mentioned by another commenter was corrected later by me.

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    Doesn't Skeptics require references, too? – jimsug Sep 30 '15 at 0:09
  • @jimsug I think there you need references to be able to debunk or support certain claims. If references are essential, and the nature of the topic implies that this is always going to be the case, then obviously you can make a policy demanding this. But health is such a huge topic, you really can't approach all aspect of it from only the peer reviewed medical sources. Not all questions are about technical medical issues, there are plenty of questions about issues relating to e.g. exercise that the peer reviewed literature won't be clear on when the known facts are actually quite clear. – Count Iblis Sep 30 '15 at 0:16
  • Questions relating to exercise will most likely be migrated to Fitness.SE, where you won't have the requirement for references. However, even on fitness, we expect answers to be backed up, not just "broscience" common knowledge. – JohnP Sep 30 '15 at 3:09
  • @JohnP Common knowledge isn't all that bad when presented as such. Now, you don't want someone's common knowledge to overrule well established scientific facts. But without common knowledge we wouldn't be here, e.g. how would your ancestors 200,000 years ago have known that vegetables are healthy without that basing on "common knowledge"? And as a recent BMJ article points out, the US dietary guidelines are not as rigorous as they should be, so even today we're not where we should be. But that won't stop someone from asking questions on nutrition. – Count Iblis Sep 30 '15 at 3:50
  • Maybe, maybe not. However, it was established at the outset of the health site, and defined and codified in subsequent meta posts (Several of them) that references are needed. You refused to comply with that. That is why you were suspended for a period of time. You are welcome to come back and contribute, so long as you comply with the rules of the site. If you want to take your ball and go home, or try a "softer" health site on Area 51, that is also your right. – JohnP Sep 30 '15 at 3:59
  • @JohnP I don't stubbornly refuse to comply with any rules, it's just that giving a reasonable answer for which there are references for, like that exercise may help to prevent colds gets 5 downvotes and a request for references because the ref I did include says "may" and gives the ways by which it may work, which is exactly how I put it. But then that "may" is not "will" and therefore the Mod says that one cannot claim that exercise has a role to play in preventing colds. – Count Iblis Sep 30 '15 at 5:03
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    If someone is going to be citing health-related advice, it has an incredible potential to cause harm. Having a requirement to cite scientific proof is an incredibly good thing to have. It may not be perfect, but it will minimize the amount of crackpot and harmful advice provided. – fbueckert Sep 30 '15 at 21:29
  • @fbueckert The point you raise is irrelevant as I explained in detail. Obviously we don't want medical advice to be given but that problem is being dealt with adequately, this is not the point of contention. The main issue is that health is a far larger topic than only medicine and that a lot of well known facts are not covered adequately in peer reviewed articles. You may find some articles, but there is far more knowledge in society that yet has to get the "peer reviewed stamp of approval". – Count Iblis Sep 30 '15 at 21:39
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    Yes, there is more knowledge than what's in peer reviewed journals. And you know what? That's what doctors are for. They have the training and expertise to not kill their patients. Crackpot and unproven remedies are not something I want SE supporting, and apparently, Health.SE sees the danger, and has restricted it. Not going to see support from me for relaxing this. – fbueckert Sep 30 '15 at 21:43
  • E.g. I did cite an article about exercise to prevent colds, saying as the article itself said that the rigorous proof was lacking. But I believe that I did adequately address the issue raised by the OP. But the demand for refs by the Mod was merely to disagree with the idea that you cannot mention exercise if it isn't rigorously proven. This attitude is wrong, most of what we do to stay healthy has never been rigorously tested to such a degree. Getting enough sleep, exercise eating healthy, what is healthy food etc. if you take the Mod's attitude, you can throw most of that out the window. – Count Iblis Sep 30 '15 at 21:43
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    And? The site can make what rules it wants to. You disagreeing with them is your perogative. As is mine to support them. If they want to narrow their scope, they can do so. If you want to widen it, gather community support to do so. You've already attempted it, and been shot down. At the end of the day, the community has the right to dictate their rules, within the framework of SE. You don't have to agree, but you do have to abide by them. – fbueckert Sep 30 '15 at 21:46
  • @fbueckert They don't narrow the scope by keeping questions open and then downvoting and tagging reasonable answers that lack references that reasonably cannot be given, see this answer. My answer is supported by a reference, and I do say that the rigorous evidence is lacking as the source says it is. But the source also goes on to explain why it may work and that's also what my answer is about. But the rigorous evidence that fit people get less colds than couch potatoes is not yet given. The Mod uses that fact to argue why this answer is wrong. – Count Iblis Sep 30 '15 at 22:04
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    So, you link to an article that says there is no evidence, but you still state that it's correct? Seems like the policy is working as intended. Answers need to be based in fact, not hunches or gut feelings. If you lack references, the reasonable option here seems to be not posting, not arguing that there is no evidence and using that as an excuse to flaunt the rules. – fbueckert Sep 30 '15 at 22:09
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    Again, the reasonable option, lacking rigourous evidence, is to not post. Your answers aren't meeting the standards the site has imposed. It's irrelevant whether you agree with the rules or not; you have to abide by them. – fbueckert Sep 30 '15 at 22:20
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    Again, your opinion is rather biased. The point is, it was sourced. To the satisfaction of the requirements. Anything after that is up to the judgement of the community. – fbueckert Oct 1 '15 at 20:43
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I'm not familiar with Health's specific policy, so I won't weigh in on that. However, I will comment on a few things from a broad, network-wide perspective:


some of my answers there violated rules that nowhere else on StackExchange are imposed.

So? What does it matter that they're only imposed on one site? That site's community decided that it wanted those rules, and communities are largely free to make whatever rules they want.

We don't have this demand from hard core scientific topics like physics where I'v made the most contributions

Physics is also largely not life-or-death. It's a completely different kind of site.

But then the notice

Some of the information contained in this post requires additional references. Please edit to add citations to reliable sources that support the assertions made here. Unsourced material may be disputed or deleted.

is just ridiculous. First, StackExchange site policy allows for answers based on personal experience,

... except on Health, or on any site that decides it doesn't want answers based on personal experience. Sites are free to make that determination.

There is very, very little override "site policy" that applies equally to all sites. Individual sites, ultimately, can change almost anything they want. You have to respect the rules of the place you decide to participate in.

Just because two sandboxes both have sand in them doesn't mean the rules have to be the same.

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    "Just because two sandboxes both have sand in them doesn't mean the rules have to be the same." Oh, I am totally going to steal this line. – anongoodnurse Sep 30 '15 at 0:03
  • As I explained in detail, It is wrong, but not per se because of the uncommon aspect. – Count Iblis Sep 30 '15 at 0:08
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    @CountIblis It might not be the best thing for their site, sure. I haven't researched their policy in depth. But what I can tell you is that it isn't wrong at a network level. If you want Stack Exchange to repeal an individual site's policy... it's not going to happen. If you have a real concern that you can articulate in a not-ranting way, you're free to do so on Meta Health after your suspension period is over. – Undo - Reinstate Monica Sep 30 '15 at 0:11
  • I did raise the issue but that was a waisted effort. I think I'm going to create a fork of the Health topic on Area 51, explaining there why the existing Health topic does not cover the totality of the field of health. It's quite similar to why chemistry is not the same as physics. In principle it is, but in practice you can't compute from first principles the properties of anything more complex than the Helium atom. – Count Iblis Sep 30 '15 at 0:33
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    @anongoodnurse with citation of course right? – Anthony Pham Sep 30 '15 at 1:19
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    @PythonMaster - Absolutely. – anongoodnurse Sep 30 '15 at 1:59
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Health.SE is a controversial site, no doubt about it. In many ways, it doesn't fit the general SE model of upvotes and downvotes determining the best answer, because many people visiting the site are not health professionals who are 1) very familiar with prevailing medical opinion, or 2) know enough of the background to evaluate the medical literature.

As such, an answer is more apt to get upvotes based on whether it resonates with a user's biases than that it is medically/scientifically correct. Visitors familiar with the SE model might see an upvoted - but completely incorrect - answer as representing accepted medical practice.

Since one's health is possibly at stake, judging a good answer by the number of upvotes alone is not a desirable situation.

Because of that, it was decided early on that the best chance that Health.SE establishes itself as a helpful site (as opposed to popular) was that answers have reputable sources. We've tried to make that easy by listing such sources.

Our model is very similar in this respect to that of Skeptics.

Of course, you don't want people to give an answer that is incompatible with what has been scientifically established, but what I've stumbled on has nothing to do with such a problem.

The first part of that quote is very important; the second is not exactly true. You have received numerous comments asking you to back up your answers. Not only have you largely ignored these requests, but you have given medical advice without backing up your answers.

Most SE sites won't touch medical questions for precisely this reason.

A big problem with a subject like health is that the peer reviewed literature does not adequately cover the entire subject, many people will ask questions where the peer reviewed literature does not have good answers on.

That assumption is incorrect. There is a huge body of reputable literature covering almost every aspect of human health. The Journal of Orthopaedic & Sports Physical Therapy covers many aspects of back pain, as does the Journal of Back and Musculoskeletal Rehabilitation and others too numerous to list. Some of the information is behind a paywall, but we allow answers based on abstracts alone.

Please note that you are still free to answer any question you please, as long as you have a source. If it's not a reputable source, or if the source material has been misinterpreted, it will be commented upon and may be down voted. With downvotes, it may be deleted by the community when enough members have sufficient rep. I have deleted less than a handful of posts as a moderator, preferring to vote/comment and let the community decide on the rest.

  • The examples of common cold in relation to exercise and that poster who had diarrhea for 8 mounts who just needs to see a doctor, show that there is more this. In the first case a source was given backing up my statement that there is no rigorous proof. But then you made an issue about there not being rigorous proof. You then end up in a situation where the lack of rigorous research in the area (no rigorous studies where people of different fitness levels are exposed to the cold virus) leads to a request for refs that can't be given. – Count Iblis Sep 30 '15 at 0:54
  • In the second case, just telling the OP that he/she should go to the doctor and how to prepare for the appointment, basically simple common sense, leads to a demand of refs. – Count Iblis Sep 30 '15 at 0:57
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    "just telling the OP that he/she should go to the doctor" isn't a helpful answer on a site like Health.SE. – anongoodnurse Sep 30 '15 at 0:59
  • But it seems the OP did find it helpful. Also, in this case the OP did need to be told to go to the doctor given the way he/she asked the question. Whether that could have been done in the closing statement or in an answer doesn't really matter, as you had an OP who should have visited a doctor, who instead was trying to evade doing that. – Count Iblis Sep 30 '15 at 1:05
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    You're using a question where you managed to sneak in an answer before it closed as proof? – JohnP Sep 30 '15 at 3:10
  • @JohnP that question was closed quite a few days later, but the request for refs and the downvote came in today, 4 hours ago. – Count Iblis Sep 30 '15 at 3:30
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    @CountIblis - Actually, the question has three upvotes and two downvotes. If the only answer that fits is "See a doctor", then that is expressly off topic as noted in the help section - "If your question is requesting personal medical advice, it is off-topic and instead should be directed to your personal physician.". New users on the site can up and downvote as they see fit, I have gotten several upvotes on weeks old topics recently. – JohnP Sep 30 '15 at 3:40
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I think you might have a bit of a misunderstanding about how Stack Exchange policy and site policy work.

You can think of Stack Exchange as providing some default policies or guidelines that will tend to be a good idea for most sites. However, sites are generally free to define their own policies if the community decides to do so. Thus, sites can establish their own policies that override, modify, or tweak the default policies. There is nothing inappropriate about Health.SE setting their own policies that impose extra requirements (e.g., requirements for references to back up certain statements). If you think about it, this makes sense: each community is different, and there needs to be some flexibility for individual communities to make things work well for their particular topic area.

So, yes, you will find that policies do vary somewhat from site to site. Some SE sites have special policies or rules that might deviate significantly from what you're used to on other SE sites. So, it's important to read the help center, listen to feedback you get from other members of the community, and check out the site's meta in case of doubt.

I realize this might not be entirely obvious, so it's understandable that you were taken by surprise by this -- but that's how things work on Stack Exchange. Now you know.

  • In general, adding additional requirements will have the effect of redefining the topic. That effect can be a small effect, but I think in this case by making certain questions de-facto unanswerable, it is a clearly a shift away from health in general, to a more limited medical topic. The question is then how one would deal with new topics being created on Area51 that would be a fork of an existing topic, but with different rules? The Mods would presumably move to the newly created topic and start some dispute. At least, on Wikipedia this used to be an issue that had to be fixed. – Count Iblis Sep 30 '15 at 0:28
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    @CountIblis, that's really a separate question. I am explaining to you how the site works. If you want to argue that's a bad thing, that's fine, but it belongs elsewhere -- in a separate question, or in chat. (But really: I don't think you are in a good position yet to make a persuasive case that the way things currently work is bad; before judging, I recommend that you educate yourself about how things actually do work, and why, and what the relevant history is. People did not set things up this way on a whim; they had reasons.) – D.W. Sep 30 '15 at 0:32

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