Talk:Parkinson's disease/Archive 8

Social impact
@Hortur0 what percentage of Parkinson’s patients does that refer to? I ask because it certainly doesn’t apply to me but the way you word it makes it look as though it should. Doug Weller talk 19:43, 17 November 2023 (UTC)


 * Sorted by having it say "as it progresses". Doug Weller  talk 11:42, 28 November 2023 (UTC)

Social interaction
I have added a working link to the source. I'm not sure "Symptoms such as shaking, hallucinating, slurring speech, and being off balance can make the public feel awkward. Some people are unaware of Parkinson's and they don't know how to interact when it comes to communicating with a Parkinson's patient" reflects the article sufficiently or is worded as well as it could be. Doug Weller talk 11:41, 28 November 2023 (UTC)


 * I have corrected the citation per WP:CITEVAR; also note that when a PMC is provided, it automatically populates the URL field so a duplicate URL is not needed. Sandy Georgia (Talk)  15:53, 28 November 2023 (UTC)
 * @SandyGeorgia I didn't know that, always learning something new here. Thanks also for greatly improving the wording of that section. I knew it needed more work but lacked the energy to try. Plus I'm missing a finger which has decided to lock up. Doug Weller  talk 17:26, 28 November 2023 (UTC)
 * The best way to get a clean citation for this article is to just plug the PMID in to this citation filler tool. Sandy Georgia (Talk)  17:39, 28 November 2023 (UTC)

Life expectancy
Sandy Georgia (Talk)  18:26, 28 November 2023 (UTC)
 * https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840238/
 * https://www.sciencedirect.com/science/article/pii/S1353802020301954
 * https://www.sciencedirect.com/science/article/pii/S1353802020301954

Nee study shows Tai Chi good for Parkinson’s
. No way do I have time for this! Doug Weller talk 19:40, 29 November 2023 (UTC)


 * I think most exercise would help; but yes it takes time. -- Dustfreeworld (talk) 23:48, 29 November 2023 (UTC)
 * A primary study on one intervention won't be very helpful for this article, but I know there are plenty of secondary reviews in this territory, as I came across them when I was writing Dementia with Lewy bodies. Sandy Georgia (Talk)  02:17, 30 November 2023 (UTC)

Images
... are getting wacky in here. File:Тремор.gif is not a tremor at rest, and based on the sourcing on the image file, we can't even be certain this is PD. Also, captions are supposed to be succinct. Sandy Georgia (Talk)  18:37, 28 November 2023 (UTC)


 * Why is the article being filled with distracting and purely decorative images ??? Sandy Georgia (Talk)  14:42, 29 November 2023 (UTC)

The two images here are purely decorative and add nothing to reader understanding ... jarring because two images so different in style are placed side-by-side, and overloading an article with decorative images simply detracts from the content. Sandy Georgia (Talk)  15:01, 29 November 2023 (UTC)


 * IMHO the images serve to draw more attention to the less well-known potential causes of PD. I do agree that placing two images that are so different in style side-by-side is strange. Maybe the carbon disulfide one is better put together with another image that shows the spraying of pesticides like paraquat? -- Dustfreeworld (talk) 13:06, 30 November 2023 (UTC)

Causes cited to 2004
Why is text cited to a 2004 primary study being added? It's 2023; if this information can't be found in a recent secondary review (which it probably can), it's UNDUE. Sandy Georgia (Talk)  15:20, 29 November 2023 (UTC)
 * Statistically significant geographical clusters of Parkinson's cases have been reported, suggesting a common environmental cause that is either chemical or infectious.
 * That was my bad. I haven't contributed significantly to any science articles yet. So the gold standard is recent review articles? Ar individual research studies to be avoided altogether? Thanks, ~ HAL  333  18:38, 30 November 2023 (UTC)
 * Thx, ; there are some good/valid uses of older or primary studies, but in a condition as well researched as PD, it would be rare for that to happen here. The way to rewrite this article is to get hold of the most recent secondary reviews and do a top-to-bottom rewrite.  To familiarize yourself with the standards, I can recommend looking over the very similar dementia with Lewy bodies (written by moi :)  Bst, Sandy Georgia  (Talk)  18:58, 30 November 2023 (UTC)
 * Or have a look at the 2011 featured version of this article; although now dates in some parts, it does give a very good idea of what this article should end up looking like. Sandy Georgia (Talk)  19:27, 30 November 2023 (UTC)
 * Some parts of the 2011 version are better than the current one. Seems that some of the good information has been removed since then. -- Dustfreeworld (talk) 21:45, 30 November 2023 (UTC)
 * Yes ... some of the wording could be restored with citations to newer sources ... Sandy Georgia (Talk)  00:11, 1 December 2023 (UTC)
 * Noted, thanks. I plan on completely re-writing and updating the "Research" section soon, and will stick to review papers. ~ HAL  333  02:34, 1 December 2023 (UTC)
 * Awesome ... some info:
 * Wikipedia Signpost/2008-06-30/Dispatches, somewhat old but still useful, how to find sources for biology and medicine
 * The citation filler tool, just plug in a PMID (seeing a cite journal without a PMID is like fingernails on a chalkboard for me, and when I see primary or very old sources going in, I eventually just give up and unwatch)
 * And because I never understood any point in writing a medical article if it's not going to be done to FA standards, here's User:SandyGeorgia/Achieving excellence through featured content (focused on medical content)
 * I know you know how it's done :) By the way, the new thinking at WP:FAC is that page numbers or section headings should be given also on journal sources.  You can see the latest medical FAs at Buruli ulcer, [complete blood count]], dementia with Lewy bodies (a close match for this topic), lung cancer, menstrual cycle, and Ajpolino is now at work on prostate cancer.  If you hew closely to the latest and highest quality secondary sources, you're on the winning track. Bst, Sandy Georgia  (Talk)  02:57, 1 December 2023 (UTC)
 * this should be useful for rewriting research (I am noticing that part of what destroyed this once fine FA is editors knocking in their own favorite bits, without taking note of the most recent and highest quality MEDRS-compliant sources, and assigning DUE WEIGHT accordingly):
 * Sandy Georgia (Talk)  17:05, 1 December 2023 (UTC)
 * Fantastic, thanks. I have finals over the next week, but immediately after I'll start chugging away. My goal is to see the whole article overhauled by maybe February. ~ HAL  333  22:35, 1 December 2023 (UTC)
 * Fantastic, thanks. I have finals over the next week, but immediately after I'll start chugging away. My goal is to see the whole article overhauled by maybe February. ~ HAL  333  22:35, 1 December 2023 (UTC)

Advocacy section
The advocacy orgs are self-cited; unless secondary sources mention their relevance, the content is UNDUE. (Secondary sources mentioning them should be sought, so they can be placed in context.) Sandy Georgia (Talk)  13:13, 30 November 2023 (UTC)

Trichloroethylene
Best I can tell, is the only review to mention the substance, and it's an article about the substance. Normally, per WP:UNDUE, I'd not place content in the lead unless it's mentioned in broad secondary reviews about the condition (PD) generally. How is this due in the lead if there's only one paper, and it's described as a hypothesis? Sandy Georgia (Talk)  21:09, 28 November 2023 (UTC)
 * To the contrary, I think it's very much due. TCE is one of the (if not the) most notable chemical risk factors for Parkinson's. We also have, , ,  etc. ~  HAL  333  23:11, 28 November 2023 (UTC)
 * I think the keywords in her post are “broad secondary reviews about the condition”.
 * The health effects of TCE are gaining more and more attention though.  . -- Dustfreeworld  (talk) 00:34, 29 November 2023 (UTC)
 * works for me then ... it's a recent, broad secondary review .. although I'm wondering how it escaped my search ... Sandy Georgia  (Talk)  02:53, 29 November 2023 (UTC)
 * So just a passing mention of TCE (in the source) is OK? I thought it needs to be longer to warrant inclusion in the lead. Look like I was wrong ( again :p ) -- Dustfreeworld (talk) 03:07, 29 November 2023 (UTC)
 * I think the error was mine :) I can't understand why no other secondary reviews turned up in my search, so ... given that we do have broad reviews that do mention it, it can go in the lead (due weight) and content can be expanded ... tomorrow's a new day (I was out at a fascinating presentation by someone who had deep brain stimulation). Sandy Georgia  (Talk)  03:17, 29 November 2023 (UTC)
 * Sounds cool, enjoy! So how fascinating was it? Tell us more. -- Dustfreeworld (talk) 03:21, 29 November 2023 (UTC);00:59, 30 November 2023 (UTC)
 * Not on a technical level ... just one person telling his story of how it changed his life and gave him back his profession ... which caused me to feel shame that I haven't updated deep brain stimulation in about ... a decade ... I edited DBS mostly back when the benefits didn't outweigh the risks. And now DBS is so common ... Sandy Georgia (Talk)  02:14, 30 November 2023 (UTC)
 * I don’t know much about DBS. It’s not common here. It sounds like a good treatment though. Perhaps I should take some time to read our article. Must be expensive right? -- Dustfreeworld (talk) 05:14, 30 November 2023 (UTC)
 * Just have a quick glance at the article. Nothing about the cost, but the images look a bit scary to me. -- Dustfreeworld (talk) 05:18, 30 November 2023 (UTC)
 * Publication databases can be very annoying sometimes. ( From my experience, literature reviews have two stages: 1) accumulating everything that the databases yield and 2) finding the dozens of cited articles therein that the database algorithms don't yield for whatever reason...) ~ HAL  333  04:05, 29 November 2023 (UTC)
 * It's more likely that one of my settings was wrong, as I was trying to get out the door for the evening presentation ... Sandy Georgia (Talk)  14:42, 29 November 2023 (UTC)
 * Dustfreeworld, I don't think I completely answered your question last night. When I searched on TCL reviews, my (faulty) search came up with only that one secondary review.  It was strong enough to warrant one sentence in the article, but not the lead.  Since many more sources are available, and since a broad secondary review also mentions it, I can't object to it being also in the lead.  If we were looking at this article ever being restored to FA-level, then we might look even more closely at what belongs in the lead, but for now, no problem. Sandy Georgia  (Talk)  14:45, 29 November 2023 (UTC)
 * Sandy, I understand now. Thanks so much for the detail explanation! -- Dustfreeworld (talk) 23:45, 29 November 2023 (UTC)

Sourcing to governmental bodies

 * I have another question … I know that for disease like COPD, the GOLD report is used as source. Do we have something similar for PD? And, can sources like this be used as well? :) -- Dustfreeworld (talk) 01:16, 2 December 2023 (UTC)
 * I'm not familiar at all with COPD or the GOLD report (it smells like advocacy, but I really don't know). Sources like those can be used, but I prefer going to the underlying sources whenever possible, because I don't see why add something to an article if not adding it to the best sources, particularly in a case like this when so many are available. The article needs years of special interest damage repaired, and that is best done by going to the most recent high-quality journals (we have the Lancet for example), and starting over. I don't find working on marginal content an enjoyable hobby ... but that's just my own preference. Sandy Georgia  (Talk)  02:20, 2 December 2023 (UTC)
 * I do agree sources like the Lancet is great; but it’s not freely available ...
 * Yes there are many sources available ... the problem is too many ... and IMHO we probably only need a few that summarise the condition well ...


 * BTW in WP:MEDRS it says,


 * “Summarize scientific consensus


 * ... Wikipedia policies on the neutral point of view and not publishing original research demand that we present prevailing medical or scientific consensus, which can be found in recent, authoritative review articles, in statements and practice guidelines issued by major professional medical or scientific societies (for example, the European Society of Cardiology or the Infectious Disease Society of America) and widely respected governmental and quasi-governmental health authorities (for example, AHRQ, USPSTF, NICE, and WHO), in textbooks, or in scholarly monographs. Although significant-minority views are welcome in Wikipedia, such views must be presented in the context of their acceptance by experts in the field. Additionally, the views of tiny minorities need not be reported.”


 * And that’s why I’m asking ... -- Dustfreeworld (talk) 04:31, 2 December 2023 (UTC)
 * I refer you again to Dementia with Lewy bodies; what I tend to do (to be sure I'm using the best sources, even if they aren't all freely available) is a) get the governmental guidelines up front by using them in the infobox (so the reader will encounter them first or high up in the source list), and b) then cite to the underlying literature everywhere else that I can, but particularly in the body of the article, and c) if there is more than one high-quality source for use in the body of the article, and they are of equal quality, prefer the freely available one in the body. In other words, yes, use those kinds of sources, they are compliant with MEDRS ... but remember that if we only use them or only prefer them because of their readability and accessibility, then we end up with articles that are no more than a summary of what readers can find elsewhere (that is, from the governmental bodies), without directing them to the underlying literature upon which those pages are based. You can see from citations 2, 4 and 19 that I get the governmental bodies in first, and use them often ... but the bulk of the article is cited to the underlying literature.  You can see similar at Chagas disease and at Buruli ulcer; WHO is used first and frequently, but it's followed right away by a Lancet article.   Conversely, you can see at Tourette syndrome that I avoid to the extent possible citing to the NIH, because it has had errors for decades (which we discussed at length when writing the MEDRS guideline beginning back in 2007); over-relying on governmental bodies can be problematic if the top researchers in the area aren't represented by those bodies or if  a proponent is highly placed in the organization, eg PANDAS.  (Think in terms of the varying information from the CDC and NIH during the initial stages of COVID.) Regardless of source type used, they're all subject to consensus (the New England Journal of Medicine once printed an infamous error in the basic definition of Tourette syndrome, also well discussed when the guideline was being developed). Sandy Georgia  (Talk)  15:40, 2 December 2023 (UTC)
 * Remember also that you can usually get someone to send you sources by using WP:RX. Sandy Georgia (Talk)  16:06, 2 December 2023 (UTC)

PD without tremor
I have read that around 20-30% of people with PD don’t have tremor. Can we have that information in the article? -- Dustfreeworld (talk) 08:29, 29 November 2023 (UTC)


 * @Dustfreeworld Definitely. I have no tremor. But we need a source of course. Doug Weller  talk 11:40, 29 November 2023 (UTC)
 * In general, the article needs a rewrite and update, and that is best done by getting hold of the latest broadest and best secondary reviews and going top-to-bottom, rather than piecemeal. What are the recent secondary reviews that people are working from here ? I'm seeing a lot of emphasis on anecdote and images on the talk page and in the article, but the needed update should be based on first laying out what the best and newest sources are, and working from them. Sandy Georgia  (Talk)  14:55, 29 November 2023 (UTC)
 * Totally agree. -- Dustfreeworld (talk) 12:18, 2 December 2023 (UTC)
 * Totally agree. -- Dustfreeworld (talk) 12:18, 2 December 2023 (UTC)

Recent reviews for rewrite


That's just a very small start. With over 500 reviews in the last year alone, there is no reason for this article to be mentioning anything that isn't covered in a secondary review in the last five years, because there is such an abundance to indicate due weight. Over the years, from what was once a fine and succint broad overview using summary style with a series of sub-articles, has been degraded by a lack of attention to WP:DUE, and chunking in of pet theories and bits of text without using secondary reviews. If something isn't covered in a recent broad overview, it might have a place in a sub-article, but with the amount of research available, it's hard to see a reason for WP:NOTNEWS-style additions of primary sources here. A rewrite with the most recent secondary reviews to hand is indicated-- updating the still valid to newer sources, and removing the dated and primary studies and UNDUE content, either entirely, or to sub-articles. Sandy Georgia (Talk)  17:21, 1 December 2023 (UTC)


 * More:
 * 1)


 * 2a)
 * 2b)


 * 3a)
 * 3b)


 * 4a)
 * 4b)
 * 4c)


 * 5a)
 * 5b)


 * 6)
 * -- Dustfreeworld (talk) 15:20, 11 January 2024 (UTC)
 * 7)
 * Pinging ... Lancet seems to be doing some major updates. Hopefully more accurate diagnosis based on biomarkers (as well as new treatments and new definition of the disease) will be available in the near future. A few more papers (reviews) -- Dustfreeworld  (talk) 20:08, 27 January 2024 (UTC); 08:10, 28 January 2024 (UTC)