User:14hgl1/sandbox

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This is place to practice clicking the "edit" button and practice adding references (via the citation button). Please see Help:My_sandbox or contact User_talk:JenOttawa with any questions.

Link: Project Homepage and Resources


 * 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

Citation:
Tobalem S, Schutz JS, Chronopoulos A. Central retinal artery occlusion – rethinking retinal survival time. BMC Ophthalmol. 2018;18(1):101. doi:10.1186/s12886-018-0768-4

1. How you searched for a source (search strategy – where you went to find it).
I searched for this source by searching “Central retinal artery occlusion” with “epidemiology” or “risk factors” on PubMed and selecting “published the last five years” and “review articles”. Please find my search strategy below.

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

Limaye K, Wall M, Uwaydat S, et al. Is Management of Central Retinal Artery Occlusion the

Next Frontier in Cerebrovascular Diseases? J Stroke Cerebrovasc Dis. 2018;27(10):2781-2791. doi:10.1016/j.jstrokecerebrovasdis.2018.06.006

Woo, S. C., Lip, G. Y., & Lip, P. L. (2016). Associations of retinal artery occlusion and retinal

vein occlusion to mortality, stroke, and myocardial infarction: a systematic review. Eye (London, England), 30(8), 1031–1038. doi:10.1038/eye.2016.111

The above citations were also considered, due to the first article’s recency and the second article’s recent publication date and connection to CRAO as a risk factor for strokes and other diseases informing a patient’s prognosis. However, the first article was not used because of its focus on management of CRAO in treating CVD and the second article was not used because it did not expand upon risk factors for developing CRAO.

3. Why the source was chosen (what made it better than other choices).
The article chosen was the best choice because it is recent (published in 2018), from a peer-reviewed journal, it is a secondary source (systematic review), and it is relevant to the prognosis of retinal artery occlusion. Specifically, it provides an updated prognosis of retinal infarction following CRAO from 90 minutes, which is currently cited on the Wikipedia page, to 12-15 minutes (Tobalem et al. 2018).

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

1. This article is a secondary source. Systematic reviews/meta-analyses are found at the top of the hierarchy of critically appraised evidence, as indicated on the MEDRS criteria page.

2. This article is in an open-access, peer reviewed journal.

3. The information in this article is up-to-date, given its recent publication in 2018.

5. How do you plan to use the source for improving the article?
I plan to use this source to contribute to and improve the “Prognosis” section of the Wikipedia page on central retinal artery occlusion. I will first critically appraise the article, ensuring the studies included in the review do not contribute to any heterogeneity in findings. Next, I will extract the relevant information and add it to the sections of the Wikipedia page in a digestible manner, using non-scientific terminology where appropriate. Using the information in this article, I plan to correct the current prognosis included on the Wikipedia page to the updated values presented in this systematic review.

Change 1:
'''The incidence of CRAO is approximately 1 in 100,000 people in the general population. '''

Change 2:
"Irreversible damage to neural tissue occurs after only 90 minutes" --> change to --> "Irreversible damage to neural tissue can occur after approximately 15 minutes of complete blockage to the central retinal artery, but this time may vary between individuals. "

Change 3:
"Risk factors for CRAO include the following: being between 60 and 65 years of age, being over the age of 40, male gender, hypertension, caucasian, smoking and diabetes mellitus." --> change to --> "Risk factors for CRAO include the following: being over 50 years of age, male gender, smoking, hypertension, diabetes mellitus, dyslipidemia, angina, valvular disease, transient hemiparesis, cancer, hypercoagulable blood conditions, or a family history of cerebrovascular or cardiovascular issues. "

Change 1:
This change was made to provide readers with an estimate of the disease incidence in the general population. This statistic may be helpful for readers aiming to understand their general risk of CRAO, assuming no other risk factors. The incidence for CRAO was not previously included on the Wikipedia page. The reference used for this statistic is a book written on central retinal artery occlusion that was last updated in 2019.

Change 2:
This change was made because the statistic for time taken to achieve irreversible neural tissue damage following CRAO that is currently on the Wikipedia page is higher than current literature suggests. As stated by a review conducted by Tobalem, Schutz, & Chronopoulos (2018), irreversible retinal infarction can occur just 12-15 minutes following a complete occlusion of the central retinal artery. This is far lower than the 90 minutes currently cited on the Wikipedia page. It is important to update this statistic in the article to correct misinformation about the disease and to prompt individuals to seek medical care more urgently if they are concerned they may have CRAO.

Change 3:
This change was made to update the contradictory statistic about age as a risk factor for CRAO that is currently on the Wikipedia page. Currently, the page dictates two age ranges that represent risk factors for developing CRAO. According to current literature, the updated age that represents a higher risk for disease is over 50 years old. This updated statistic (being over 50 years old as a risk factor for CRAO) was cited from a review published in 2018 in the Journal of Stroke and Cerebrovascular Diseases.

There remains ambiguity in current literature regarding different risk factors for CRAO depending on age. I was unable to find conclusive evidence regarding modifications of risk factors for younger versus older populations from a secondary source. As a result, I decided not to include a sentence about how risk factors may differ for younger populations. Instead, I included the evidence-based risk factors for CRAO in individuals of the general population.

References:

Farris, William; Waymack, James R. (2019), "Central Retinal Artery Occlusion", StatPearls, StatPearls Publishing, PMID 29262124, retrieved 2019-11-16

Tobalem S, Schutz JS, Chronopoulos A. Central retinal artery occlusion – rethinking retinal survival time. BMC Ophthalmol. 2018;18(1):101. doi:10.1186/s12886-018-0768-4

Limaye, Kaustubh; Wall, Michael; Uwaydat, Sami; Ali, Sheharayar; Shaban, Amir; Kasab, Sami Al; Adams, Harold (2018-10-01). "Is Management of Central Retinal Artery Occlusion the Next Frontier in Cerebrovascular Diseases?". Journal of Stroke and Cerebrovascular Diseases. 27 (10): 2781–2791. doi:10.1016/j.jstrokecerebrovasdis.2018.06.006.

Source 1:
Although this source was published in 2019, some of the articles referenced by the book were published over seven years ago. As a result, some of the information may be outdated, potentially contributing to bias.

Source 2:
This source completed a systematic review on central retinal artery occlusion. In this review, they searched for articles in Medline and on the internet. This search strategy may have missed relevant articles not included in Medline or retrieved through their additional search. This concern would contribute to evidence selection bias of the review.

Source 3:
This source completed a literature review in both PubMed and Cochrane, which reflects a wide search strategy. While this represents a strength, the researchers only included articles published in English. This would contribute to evidence selection bias of the review, as articles published in other languages may have been missed. Additionally, language bias states that studies publishing positive results may be more likely to be published in English. As a result, if a review is only considering studies published in English, the data included in the subsequent review may be positively skewed.