Editorial & Review Policy

Our editorial process is informed by internationally recognized standards for health content quality. While we are a small nonprofit and do not claim formal certification under all frameworks listed, we commit to aligning our practices with these standards as closely as possible:

We classify evidence using the GRADE methodology, the international standard adopted by over 100 health organizations including the World Health Organization. Each clinical claim on the site carries an evidence certainty rating:

GRADE considers five factors that may lower certainty (risk of bias, inconsistency, indirectness, imprecision, publication bias) and three that may raise it for observational studies (large effect, dose-response gradient, plausible opposing bias). When evidence is limited, we clearly state the level of uncertainty so readers can make informed decisions with their healthcare providers.

We classify content into tiers based on clinical impact and the level of review required, following the tiered approach recommended by the National Academy of Medicine:

Content passes through a multi-stage review before publication, modeled on processes used by Mayo Clinic (6-stage editorial pipeline) and Healthline (5-layer review with medical integrity monitoring):

Following the evidence hierarchy approach used by Mayo Clinic (which categorizes sources by strength) and consistent with WHO Handbook for Guideline Development methodology, we prioritize sources in the following order:

1. Systematic reviews and meta-analyses (Cochrane reviews, PRISMA-compliant reviews)
2. Randomized controlled trials (CONSORT-compliant where available)
3. Regulatory documents (FDA clearances, 510(k) summaries, product codes)
4. Government and international health agencies (WHO, NIH, CDC, FDA)
5. Prospective cohort and case-control studies (STROBE-compliant)
6. Clinical practice guidelines from recognized medical organizations
7. Case series and case reports (labeled as limited evidence)
8. Expert consensus and textbook references (labeled as expert opinion)

When lower-tier evidence is the only available source, we explicitly note the limitation. We avoid citing content farms, non-peer-reviewed sources, or obviously biased commercial materials.

We maintain content through a structured review schedule. Mayo Clinic reviews fast-evolving topics at least every two years; UpToDate monitors 450+ journals continuously. Our cadence reflects our organizational scale:

When new evidence emerges that materially changes clinical recommendations or safety guidance, affected pages are updated within 30 days of publication, regardless of the scheduled review cycle—consistent with the approach recommended by NICE surveillance methodology.

We are committed to correcting errors promptly and transparently. Mayo Clinic publicly lists factual corrections for 30 days; the BMJ maintains open Rapid Responses for ongoing post-publication scrutiny. Our approach:

• Minor corrections Minor corrections (typos, formatting, broken links) are fixed without annotation.
• Factual corrections Factual corrections (data errors, citation updates, changed evidence ratings) are noted with a correction statement at the top of the affected page, including the date of correction and nature of the change.
• Substantive revisions Substantive revisions (changed clinical recommendations, retracted source studies, safety updates) include a visible revision notice with the date, nature of the change, and rationale. Previous versions of the recommendation are preserved for transparency.

If a source study cited on our site is retracted, we update the affected content within 14 days and reassess the evidence rating accordingly—following the approach being developed by Cochrane for handling retracted publications in systematic reviews.

To report an error or suggest a correction, contact us at adokukin@leechmedicine.com with the page URL, the specific claim in question, and any supporting references.

Following ICMJE recommendations and UpToDate’s conflict of interest framework, all content contributors and reviewers are required to disclose financial relationships, consulting arrangements, equity holdings, and other potential conflicts of interest that could influence editorial decisions.

The founders (Dr. Andrei Dokukin and Dmytro Ronsal) are the sole operators of the Society. ASH receives no external funding, advertising revenue, or commercial sponsorship. Neither founder holds equity in pharmaceutical companies, medical device manufacturers, or leech suppliers other than the Society’s own proposed infrastructure project.

This disclosure will be updated as the organization grows. As recommended by NAM Standard 2, chairs and primary reviewers should ideally have no conflicts of interest, and any disclosed conflicts should be discussed openly within the editorial team.

Transparency about AI use in medical content is increasingly required. The BMJ mandates disclosure of all AI involvement; UpToDate prohibits external contributors from using generative AI; Mayo Clinic uses AI for plain-language optimization but states it "does not replace editorial judgment."

Our policy: Some content on this site is drafted or refined with AI-assisted writing tools. In all cases:

• AI-generated drafts undergo the same multi-stage review process described above.
• All clinical and scientific claims are verified against primary peer-reviewed sources by human reviewers.
• AI tools are never the sole source for factual claims, evidence ratings, or clinical recommendations.
• The Clinical Director retains final editorial authority over all published content.
• AI cannot be listed as an author, consistent with ICMJE authorship criteria.

We align our practices with the 8 principles of the HONcode (Health On the Net Foundation Code of Conduct), the oldest and most widely recognized ethical code for health websites:

1. Authority: Medical content is reviewed by qualified practitioners. Reviewer credentials are stated.
2. Complementarity: Information supports, never replaces, the patient–provider relationship.
3. Confidentiality: We respect visitor privacy and comply with applicable data protection standards. See our Privacy Policy.
4. Attribution: Claims are supported by references. Last-modified dates are displayed on all clinical pages.
5. Justifiability: Treatment claims are backed by balanced, referenced evidence with explicit certainty ratings.
6. Transparency of Authorship: Contact information is publicly available. See Contact & Transparency.
7. Financial Disclosure: Funding sources and organizational structure are disclosed on our About.
8. Advertising Honesty: This site carries no advertising. If this changes, advertising will be clearly distinguished from editorial content.

As a health website publishing YMYL (Your Money or Your Life) content, we design our site to meet Google’s E-E-A-T requirements (Experience, Expertise, Authoritativeness, Trustworthiness)—the highest standard applied to medical content in search quality evaluation:

• Experience: Content is created and reviewed by practitioners with direct clinical experience in hirudotherapy and related specialties.
• Expertise: Medical reviewer credentials (MD, specialty training) are stated on each reviewed page. Editor qualifications are documented.
• Authoritativeness: We cite peer-reviewed research, FDA regulatory documents, and established medical references. Our content is built on a foundation of 129 pages with over 200 unique citations.
• Trustworthiness: HTTPS encryption, transparent privacy policy, published editorial standards (this page), named reviewers, visible update dates, and regulatory disclaimers on every clinical page.