Talk:Ear pain

Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Pygmysloth, JennDS, JH982, Yaya.wu. Peer reviewers: Chglucas, Pasta296, Solomon.lee, Af987.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 19:58, 16 January 2022 (UTC)

this
this page needs cleaning, i really wish i new how to scrawl citation needed all over it! migraines are often caused by ear infections and can therefore be treated with antibiotics? what? oh ok, ill go tell millions of patients world wide!!


 * Information.svg Thank you for your suggestion. When you believe an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the  link at the top. The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes—they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills.  New contributors are always welcome. You don't even need to log in (although there are many reasons why you might want to).
 * Your changes need not be limited to adding tags; you can correct or remove errors or descriptions that are confusing.  WhatamIdoing (talk) 22:45, 6 September 2011 (UTC)

WikiMedicine Project Spring 2018
Hello, we are four people that are part of the WikiMedicine Project at UCSF. This project aims to add broader and more accurate information to the medically-related pages in Wikipedia. We will be editing this page in the coming weeks to expand both the content and references. Below is the current division of labor and we’ll continue to update as our plan solidifies. Over the coming weeks, our work will undergo a peer review process, and we will receive feedback on the readability of our article through an Acrolinx report. As we are students and still developing our medical knowledge we welcome any feedback from the larger Wikipedia community to help improve this article.

Our goals include:


 * Modifying the format of the page in accordance with the WikiProject Medicine’s Manual of Style for “signs and symptoms”
 * Expanding the content of the page, including more information about the various causes, diagnostic approach, and management of ear pain
 * Embedding links to other relevant Wikipedia pages as appropriate
 * Verifying existing references and expanding references

Timeline

Week 1 Week 2 Week 4 Division of Labor by Section
 * Getting references
 * Basic outline/layout of article
 * Assess references already in article
 * Live edits
 * Week 3
 * Peer Reviews
 * Revisions
 * Revisions

These sections are determined by the manual of style of the WikiMedicine project.

128.218.42.96 (talk) 20:18, 8 March 2018 (UTC)
 * Lead (We will edit as a group when all other sections are finished)
 * Signs and symptoms (Yaya.Wu)
 * Causes (JennDS)
 * Pathophysiology (Yaya.wu)
 * Diagnostic approach (pygmysloth)
 * Treatment (JH982)
 * Epidemiology (Yaya.wu)
 * History (Yaya.Wu)
 * Society and culture (Yaya.Wu)


 * Welcome. Have adjusted the layout some. I guess one question is how to best present this topic? It is a symptoms with many potential causes rather than a disease in and of itself.
 * Per MEDMOS we use the heading "Differential diagnoses" and "Diagnostic approach". Doc James  (talk · contribs · email) 20:31, 15 March 2018 (UTC)

Gone awry
User:Doc James this page has gone awry; I understand you often work with the UCSF students - would you please review and talk to them about getting back on-mission? Thanks. Jytdog (talk) 19:51, 15 March 2018 (UTC)
 * We are still in the process of editing this page, but would appreciate any more specific feedback you may have about how this page could be improved. We are formatting it according to the manual of style for "signs and symptoms," and are hoping to make the article more comprehensive, similar to other well-done symptom articles. Thanks, JennDS (talk) 22:52, 15 March 2018 (UTC)
 * You have added a bunch of unsourced content. You have added a bunch of content that is too technical per WP:TECHNICAL (what does "Hx of URI" mean?). You have added content that is way too close to being an instruction manual for diagnosis in violation of WP:NOTHOWTO. In general you don't seem to be writing for general readers but rather (it seems) for doctors.
 * It is also not clear to me that an article about a symptom should go into this level of detail.
 * I am not at all sure that you are checking to see that the very specific content you are adding here about specific conditions matches what our articles on those conditions say... but when people get very specific on high level articles like this one, Wikipedia often falls out of sync with itself.  For example our article on GERD mentions that "research suggests that ear pain might be a symptom"  of that condition but has a very poor and old ref for that.  Very different from the definitive listing you have in the "referred causes" table (which, to repeat myself, is very technical - do you think an average person even understands what you mean by "referred causes"? )
 * Gone awry... Jytdog (talk) 23:13, 15 March 2018 (UTC)
 * Thank you for giving more detailed feedback. We felt that having a simplified lead would be sufficient for readers who wanted a quick overview. However, medical professionals do use wikipedia and more interested readers might be looking for further information. We used Low Back Pain GA-level and Headache B-level, both of which are wiki pages on symptoms, as models. In both, they followed the same format. We have continued to clean up the citations and also appreciate your efforts. Yaya.wu (talk) 17:05, 30 March 2018 (UTC)

WikiMedicine Project Spring 2018 Peer Review
Hello, fellow Wikipedians!

I am a medical student who will be reviewing and providing feedback on this article as part of an elective. At the start of the elective, this page was rated as a start-class, high-importance article. The editors had the following goals:

·Modifying the format of the page in accordance with the WikiProject Medicine’s Manual of Style for “signs and symptoms”

·Expanding the content of the page, including more information about the various causes, diagnostic approach, and management of ear pain

·Embedding links to other relevant Wikipedia pages as appropriate

·Verifying existing references and expanding references

I will be providing user:JH982 with feedback on recent edits to the lead and management section.

Over all impression: I believe the current edits are in line with the editors initial four goals. The format of the page is in line with a "signs and symptoms" page. The content of the page has expanded over the past few weeks. There are multiple links to additional wikipedia pages and new references. I feel the main points to refine are consistent use of terminology throughout the article and continued improvement of readability and reduction/simplification of information presented. It's obvious you all have put in a lot of work improving this article and it shows!

Lead: When compared to previous versions of the page, the lead has expanded to include a brief description of workup and management. A suggestion I have is to stick to one term for secondary (referred) ear pain throughout the article to help with readability. Otherwise, the lead is succinct and clear. The only other question I have is whether medscape is considered an appropriate reference?

Management: When compared to previous versions of the page, the management section has expanded to include the three subsections of antibiotics, procedures, and other. Each subsection has additional bullet points referring to specific treatments for specific circumstances. I appreciate the breadth and depth of detail with regards to treatment, but I also agree with previous comments that this now reads as an instructive manual. In terms of writing for a general audience, I would suggest organizing based on category of diagnosis (ear infection, deep tissue infection, material buildup) rather than treatment as the treatment for a specific category can be generalized (antibiotics for infections vs surgical intervention for material buildup etc). Another option would be to add a treatment column to the tables in the differential diagnosis section which may help with organization and readability. The information itself is all well-sourced and important but I feel there is room to improve the delivery. Please let me know if I can help to clarify any of the above points. Great progress and keep up the hard work! Chglucas (talk) 21:49, 22 March 2018 (UTC)


 * Thank you for taking the time to review and write feedback! This feedback was very clear, constructive, and helpful. You brought up many useful points that I kept in mind as I edited the section. I agree that the management section could benefit in clarity by decreasing the level of detail to make it more approachable and readable. I liked your suggestions regarding trying to rearrange the information to improve flow. I discussed with others in my group about including a treatment column in the tables. However, after much discussion, we decided it could potentially be a little confusing since it would result in the removal of the management section.  The merging of the management section with the diagnostic approach section may not be intuitive to a first-time reader of the article. I also tried to rearrange the content according to more specific etiologies as you suggested, however I found that created a lot of categories. But I do think I may have found a happy medium regarding more specific etiologies: I grouped the antibiotic section such that it is broken down into two smaller paragraphs of information grouped according to general level of care. As you and others of have suggested, I went through and tried to summarize the information down by removing extra details.  Since this is a general article, I tried to link to the more specific articles where I could. I’m always impressed by the Wikipedia community and encourage people to continue to edit this section.  Thanks again for all the feedback, User:Chglucas!  I think the article has benefited from your suggestions. JH982 (talk) 00:23, 30 March 2018 (UTC)

WikiMed Peer Review
Greetings Wikipedians!

Another peer reviewer here providing feedback for user:Pygmysloth on the “diagnostic approach” section.

Overall impression: As a whole, this page is far improved from prior! So much new information has been added, and although the materials error on the side of being overly technical and targeted toward a medical audience, I think it is an excellent foundation from which other users can contribute and simplify. I’m especially a fan of the added visuals and decision making trees. It helps guide the user through an otherwise overwhelming about of information.

Diagnostic approach: Specifically regarding the diagnostic approach section, you’ve created a comprehensive resource particularly with your visual frameworks and tables to guide readers to their most likely diagnosis. I think the opening paragraphs for the section are also well-written and appropriate. Regarding constructive feedback:

- Redundancy: I love how comprehensive and well-organized your diagnosis and features tables are. Perhaps as a by-product of having multiple people working on the page simultaneously, however, the information is highly redundant with that found in the “differential diagnosis” section. I actually prefer your tables to the way the information is presented in the “differential diagnosis” section, so I think the page would benefit if your tables replaced parts of the “differential diagnosis” section and the information was consolidated. Those tables could then be referenced by other sections when relevant instead of rewriting the same information.

- Red flags: The second and third paragraphs reference “red flags” without elaborating at all on what they are. I know red flags are expanded upon in the “signs and symptoms” section and also marked with an * in the tables below, but I did not see those until I had finished reading much more of the page. Given how important red flags are, a quick note in that second paragraph which says, please see ___ for more information on red flags with a referral to within the page would be great.

- Framework citations: Your frameworks are awesome! I think their legitimacy can be added to though with a list of resources from which your framework was built. I know it is your creation, but having no citations is not encouraging for a medical page.

You’ve done a great job and looking forward to seeing this page continue to improve!

Best Solomon.lee (talk) 23:38, 23 March 2018 (UTC)


 * Hi Solomon.lee! Thank you so much for your feedback, I appreciate how thoughtful you were with your comments.
 * Re: Redundancy - I think you’re right about it being a byproduct of multiple people working on one article, especially at the same time. With respect to Pasta296‘s suggestion to put the tables in the sidebar, I had debated this too but decided to stick with tables directly in the article so that future users can modify my work more easily. With a jpeg or pdf someone would probably have to recreate the table from scratch. All four group members will be meeting later in the week to work on consolidating the article and making it a more efficient read.
 * Re: Red Flags - I had the same concern as you and actually had a couple of sentences in my initial version that went into more depth about this, but it looks like it was deleted by another user.
 * Re: Framework citations - I had thought about this as well but couldn’t figure out a good spot to place them from a design perspective. I spoke with one of our facilitators and he's looking into a way for me to put in an elegant caption. :)
 * Thanks again! Pygmysloth (talk) 19:55, 26 March 2018 (UTC)

WikiMed Peer Review
Hi, I am another peer reviewer for this page. I will be providing peer review to user:JennDS re: additions to the lead and causes of ear pain.

This page was classified as a start page and as high importance, before edits began. Since then, the page has significantly expanded in scope and content, and in my opinion has been improved beyond recognition. The page has transformed from a brief, incomplete article on ear pain, with few citations, into a comprehensive article which would be a valuable resource to medical students or any other user interested in learning about ear pain in depth. In fact, this reviewer learned a whole bunch of new stuff just from peer reviewing this page, so thanks for the hard work.

Here are some suggestions: 1) In the infectious causes table, the abbreviation w/i may be unclear to some readers. It may be more accessible to write within, if space allows. 2) Regarding the peer review above, I do agree there is some redundancy in material. I like the way the material is presented in the differential diagnosis section, i.e neatly organized in terms of anatomy. I would suggest that the large tables in the diagnostic approach section could maybe become images similar to the flowcharts, which users more interested in delving into the various features of different types of ear pain could click on and find a larger table as an image. This may result in a cleaner transition to the "management" section.

3) Regarding the section "Differential Diagnosis", I'd actually suggest naming this section "Causes", as that header may be clearer to non-medical readers who may not be familiar with the term "differential diagnosis". Prior to med school I don't think I had a clear notion of what "differential diagnosis" meant.

4) I would suggest "Risk factors" could be it's own section, as it doesn't necessarily fit in "Causes". The risk factors mentioned could also be elaborated on a tiny bit. While I surmise that alcohol and smoking increases the risk of serious ear pain causes because of increased risk for malignancy, I'm not sure if that's what's being said in this section, and the average reader won't have time to look at the source listed. A quick elaboration could save the reader that effort. Similarly, I'm guessing diabetes increases the risk of serious infection or malignant otitis externae, but I'm not sure that's what's being said because there's no elaboration.

Thanks! Hope this is helpful. Great work! Pasta296 (talk) 06:51, 24 March 2018 (UTC)
 * Hey Pasta296, thanks for your helpful feedback! This week I have been working with User:Pygmysloth to reduce the redundancy in our two sections of the article. Because our two reviewers each preferred a different format of presenting the material (tables vs. anatomic organization) and we want each section of the article to be useful if a reader only wants to reference a specific part, we will keep both structures in the article. However, I will remove information about common presentations of the different causes of ear pain from my section, as this information is more appropriate in the diagnostic approach section.  We also renamed the "differential diagnosis" section as you suggested and moved the information about risk factors out of the "causes" section.  Thanks again! JennDS (talk) 18:11, 29 March 2018 (UTC)

Peer review for Causes section
I am a peer reviewer for WikiMed and am giving feedback on the causes section.

Overall impression: Great Job! I think this section does an overall effective job at classifying and providing features for the potential causes of ear pain. I think it is thorough and is helpful for readers. My suggestions are more for the organization and providing more clarification to certain areas.

Causes:


 * I thought having the statement in the lead about most causes being non-life threatening was good for reassurance to a non-medical reader. With the following sentences, it might read more easily to give examples with the primary and secondary ear pain because those terms might not be understood by those reading the lead. I think the lead would be most effective to be written for a non-medical audience and then give more details and medical terminology in the subsequent sections.
 * In the causes section: Under “primary ear pain” I think it would be useful to give a few examples or have a general statement describing what is meant by “primary”
 * For causes table: this was an effective way to display the information and it seems clear. Some suggestions
 * I liked the organization of the table into sections of infectious causes, referred causes, and other causes was a good way to classify them
 * I found the “features” a little hard to read because some were precipitating factors (ex. Q tip in ears) and some things were clinical findings (air-fluid levels), and some were symptoms. I am wondering if more columns to more easily read the table could be helpful.
 * Write out URI the first time used as the abbreviation is not defined
 * I would write out “history” instead of hx
 * I liked that the “red flags” causes were highlighted
 * I would consider adding a list of “red flag” features to the narrative since this is important in addition to highlighting the possible causes. It refers to worrisome features but does not list what the most concerning features are
 * I would consider adding a subheading of "causes" before ddx
 * Thank you so much for your feedback. For the lead, we decided to put examples in the next paragraph. In terms of structure, our idea is that the first paragraph is definitions while the second paragraph covers the most common causes. We did try to make the lead as non-medically as possible without losing accuracy and also following the diction of the next paragraph. As a result, our lead had to contain the same medical terms (we couldn't see a way to avoid it). Causes wasn't my section but the whole group went over all the reviews together and re-edited the article. We moved the section of red flags into the diagnostics section and explained why it was important in more detail. Also group members spelled out the first abbreviations. We are currently leaving the table/columns alone. Love your point on more columns for clarity, we were just worried that more columns would make the table look to busy and also squish the other text. Yaya.wu (talk) 16:54, 30 March 2018 (UTC)

Silver and other nanoparticles
See: Nanoparticles for the Treatment of Inner Ear Infections. Excerpt:
 * https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156593

4.1. Inorganic Nanoparticles

Metal-based NPs with inherent antimicrobial activity are one of the most extensively researched materials [83,86]. Silver nanoparticles (AgNPs) are of special interest against infections, exhibiting strong activities in antibacterial, antiviral, and antifungal studies [87,88,89,90,91]. AgNPs can physically interact with various bacterial cells’ surface, damage the cell membranes, and produce structural changes that render these pathogens more permeable [89]. Specifically, AgNPs can reach the inner ear in a dose-dependent manner after intratympanic administration and destroy pathogens either alone or in combination with various antibiotic formulations [89,92]. This is a highly advantageous ability against multi-drug resistant bacteria, such as P. aeruginosa, overcoming the drawbacks of free antibiotics and eliminating the microorganisms with high efficacy in the ear therapy [87]. --Timeshifter (talk) 08:50, 30 June 2024 (UTC)