User:Митчелл/sandbox

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 * Note: Please use your sandbox to submit assignment # 3 by pasting it below. When uploading your improvements to the article talk page please share your exact proposed edit (not the full assignment 3).


 * Talk Page Template: CARL Medical Editing Initiative/Fall 2019/Talk Page Template

Hereditary nonpolyposis colorectal cancer
Practice citation

Assignment #2:
Wikipedia Assignment 2: Literature Search

1) How you searched for a source (search strategy – where you went to find it).

·       Group discussion with our faculty tutor identified “Lynch syndrome” as a more correct name than “Hereditary nonpolyposis colorectal cancer” (HNCC) for our Wikipedia article given that Lynch syndrome is a condition associated with high risk of a variety of cancers, with HNCC being one of them. This change in naming is in line with recent naming suggestions from the World Health Organization: WHO Classification of Tumours Editorial Board. Digestive system tumours. Lyon (France): International Agency for Research on Cancer; 2019. (WHO classification of tumours series, 5th ed.;vol.1)

·       Group divided search focuses – my search focus revolved around the epidemiology of cancers associated with Lynch syndrome. I searched using several resources:

·       PubMed. Searched “lynch syndrome epidemiology cancer association”.

·       Subheading: epidemiology

·       MeSH Terms: epidemiology; colorectal neoplasms, hereditary nonpolyposis; neoplasms; carcinoma; neurofibroma; cysts; association; neurofibromatoses

·       Filters: Review articles, Past 5 years, Humans, English

·       BMJ – Best Practice. Searched “lynch syndrome”.

·       DynaMed. Searched “lynch syndrome”

2) What potential sources were identified and considered (give examples of 1 or 2).

·       Biller, L. H., Syngal, S., & Yurgelun, M. B.(2019). Recent advances in Lynch syndrome. Familial cancer, 18(2), 211-219.

·       DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 -. Record No. T115317, Lynch Syndrome; [updated 2019 Feb 22, cited 2019 Nov 6]. Available

from https://www-dynamed-com.proxy.queensu.ca/topics/dmp~AN~ T115317. Registration and login required.

3) Why the source was chosen (what made it better than other choices).

·       I would select the DynaMed article on Lynch syndrome. As per information found on the Queen’s University Library page on Point of Care Tools https://guides.library.queensu.ca/ family-medicine/point-of-care-tools), DynaMed is regarded as a good source for obtaining frequently updated and evidence-based information on a wide array of topics. Of the sources examined, this article best summarizes data on the prevalence of Lynch syndrome as well as incidence of Lynch syndrome associated cancer in an organized, clear, and concise manner.

4) List at least three reasons why the source that was selected meets Wikipedia’s reliable medical sources (MEDRS) criteria.

·       Recent and Up to Date: Last updated February 22, 2019, allows user to see recent updates made to the document.

·       Third-Party Unbiased Secondary Source: DynaMed synthesizes information from other sources and guidelines. Additionally, editors are required to disclose all Conflicts of Interest.

·       Good Quality Evidence: According to the DynaMed site, clinical evidence is continuously systematically monitored, and the most valid evidence is synthesized.

5) How do you plan to use the source for improving the article?

·       Our Wikipedia article’s section on ‘Tumoral predisposition’ and ‘Risk of cancer’ is unorganized, contains information that is outdated, includes data from primary sources, and provides information that is uncited. Data from this DynaMed source can help develop a more structured, robust, accurate, and evidence informed addition/revision to this section. Perhaps, information from this source can expand on summary chart on risks of associated cancers within the section.

Assignment #3:
Proposed Changes

Deletion of ‘Tumoral predisposition’ subsection within ‘Signs and symptoms’ as well as deletion of:

·        First sentence of first ‘Risk of cancer’ section paragraph. Second line of ‘Risk of cancer’ edited to specify ‘colon cancers’, since first line deleted.

·        Fourth sentence of first ‘Risk of cancer’ section paragraph.

·        Last sentence of first ‘Risk of cancer’ section paragraph.

The proposed additions would be placed at the start of the ‘Risk of cancer’ subsection:

_____________________________

Lifetime risk and mean age at diagnosis for Lynch syndrome associated cancers  In addition to the types of cancer found in the chart above, it is understood that Lynch syndrome also contributes to an increased risk of small bowel cancer, pancreatic cancer, ureter/renal pelvis cancer, biliary tract cancer, brain cancer, and sebaceous neoplasms. Increased risk of prostate cancer and breast cancer has also been associated with Lynch syndrome, although this relationship is not entirely understood.

_______________________________

- I like the chart that you propose as it displays the information in a clear and concise manner. - I agree with deleting the tumoral predisposition section as it is incomplete and repetitive. - I agree that your more up to date reference can be used to replace ones currently in the article that are over 5 years old.

Rationale for proposed change

Regarding the removal of the ‘Tumoral predisposition’ subsection, the section lists forms of cancer associated with Lynch syndrome with out citing most of them; in fact, only one form of cancer whose risk is increased by Lynch syndrome (pyloric gland adenoma) is cited. This citation is also inappropriate since it is from a primary source and was published over 5 years ago.

The first sentence of the first paragraph of the ‘Risk of cancer’ subsection contains information on colon cancer lifetime risk which is from a source that is published over 5 years ago and not as up-to-date as the source which bears similar information in the  new summary chart pertaining to “Lifetime risk and mean age at diagnosis for Lynch syndrome associated cancers”. With this first sentence deleted, the second sentence of the paragraph can no longer use the wording “these cancers” but must then specify “colon cancers”.

The fourth sentence of the first paragraph contains information on ovarian cancer mean age of diagnosis which is the same as that which is found in my source. It also adds additional information about this (stating that 30% of cases are diagnosed before the age of 40 years) but does not provide any citations or evidence to support this claim. Given the redundancy of evidence from the first portion of the sentence and the lack of support, it would be recommended to delete this sentence.

The last sentence of the first paragraph contains information on other Lynch syndrome associated cancers which is very similar to that which is found in the new summary chart; however, only one section of the sentence is cited (that “urinary tract cancers are transitional carcinoma of the ureter”) with a 10 year old case-report. Given the generally redundant and uncited information in this sentence, it is recommended to be deleted.

The content of these removed sentences is to be replaced by the content of the proposed new chart and sentence with information sourced from the DynaMed page on Lynch syndrome. This provides a more concise and organized way to present information in a clearer and more robust format – an expanded list of evidence-supported Lynch syndrome associated cancers which also notes limitations of existing evidence. For example, the last sentence of my proposed change points out that some areas pertaining to the topic remain somewhat controversial and incompletely flushed-out.

Critique of source

The secondary source I used as evidence for the edits is the DynaMed article on Lynch syndrome.A

Strengths:

·        The source is up to date, having last been updated earlier this year and allows visitors to the source to see a history of new updates.A

·        DynaMed’s methodology for creating and updating pages involves systematically monitoring research/guidelines and having information objectively appraised by a team of professionals (physicians and methodologists).B

Weaknesses:

·        While it is stated that the editorial process is systematic, that 250 journals and 200 guidelines are reviewed, and that more than 50 specialists screen researchB – the exact methodology of this process remains rather vaguely described. There seems to be room for transparency to look deeper into just how rigorous and objective this process is. Perhaps, this relative lack of methodological transparency gives room for bias in the selection of literature (e.g. there may be room to make the method more rigorous and solid).

·        One of the topic editors (Yoo-Joung Ko MD, MMS, MSc) has disclosed financial relationships with three pharmaceutical companies (i.e. Taiho, Shire, and Eisai).A It is not clear whether this translates to any bias in this article; however, Wikipedia’s MEDRS guidelines caution situations with conflicts of interest and Wikipedia’s Conflict of Interest (COI) guidelines note that COIs can cause people to intentionally or unintentionally add/omit data due to this bias (e.g. differentially favoring the inclusion of sources which support their own positions or that of their financial affiliates).C,D

Citations

A.      DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 -. Record No. T115317, Lynch Syndrome; [updated 2019 Feb 22, cited 2019 Nov 18]. Available from https://www.dynamed.com/condition/lynch-syndrome. Registration and login required.

2.      DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 -. Editorial Processes; [cited 2019 Nov 18]. Available from https://www.dynamed.com/condition/lynch-syndrome. Registration and login required.

C.       https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)

D.       https://en.wikipedia.org/wiki/Wikipedia:Conflict_of_interest