User:8je11/sandbox

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Cardiac Arrest
Project Homepage and Resources

Practice Editing Here (Nov 15th in-class Wiki session work)

 * This is a place to practice clicking the "edit" button and practice adding references (via the citation button).

Task:


 * 1) Find a peer-reviewed journal article on PubMed. Practice inserting your citation in the above space using the "cite" tool
 * 2) Choose one "B-level" medical article on Wikipedia from the following list: https://wp1.openzim.org/#/project/Medicine/articles?quality=B-Class&importance=High-Class
 * 3) Practice editing live on Wikipedia by finding a typo in the text or improving the clarity/readability of a sentence by adjusting a few words in a sentence.

Assignment # 3- please post an anonymous copy here!
Proposed changes: Adding a sentence addressing risk factors that have been shown to predict sudden cardiac death in children, which include previous adverse cardiac events, non-sustained ventricular tachycardia (NSVT), syncope and left ventricular hypertrophy (LVT).

Reference used: Norrish, G., Cantarutti, N., Pissaridou, E., Ridout, D. A., Limongelli, G., Elliott, P. M., & Kaski, J. P. (2017). Risk factors for sudden cardiac death in childhood hypertrophic cardiomyopathy: A systematic review and meta-analysis. European journal of preventive cardiology, 24(11), 1220–1230. https://doi.org/10.1177/2047487317702519

Rationale for proposed change: These risk factors which pertain specifically to children are lacking in the current Wikipedia article. The current article instead focuses on risk factors and causes more relevant to adults, which may not be generalizable to children and has the potential to mislead readers to believe that there is no difference between younger and older populations. Possible controversy may arise in the fact that this article is not particularly recent (although still published within five years of our current year) and therefore may not necessarily be reflective of current knowledge. However, childhood hypertrophic cardiomyopathy is a rare disease, and outcomes in children can be highly variable depending on their underlying aetiology. This necessitates long follow-up periods in order to identify prognostic risk factors, which contributes to the gap in knowledge about cardiac arrest in children and the fact that there are very few recent studies on this subject. The conclusions from this meta-analysis are therefore still helpful to include in the Wikipedia article, because the information remains currently relevant given that there are few other studies to suggest otherwise.

Critique of sources: The number of studies included in this meta-analysis is small, and nearly all of these were retrospective cohort studies. Its conclusions are therefore limited by the intrinsic problems of retrospective studies, including missing and incomplete information. Many of the studies included in this meta-analysis also included fewer than 150 participants, which influences the generalizability of the conclusions. Moreover, the patient populations were heterogeneous, making comparisons less reliable. Many of the included studies had low event counts, which likely reduced their power to detect differences between groups. Since the patients in the included studies were often recruited from a small number of highly specialised tertiary services, which care for highly symptomatic individuals, it is also possible that this patient group may have more severe disease and that duplication of patient data may have occurred in different studies. Despite these limitations, since there are so few studies that address the topic of cardiac arrest in children, I still believe that listing the risk factors as part of my proposed changes is justified and is helpful information that contributes to the comprehensiveness of the Wikipedia article.

PROPOSED CHANGE #2

Proposed changes: Adding a final sentence to the Children Subheading in Causes in Mechanisms which will say “Common causes of sudden unexplained cardiac arrest in children include hypertropic cardiomyopathy, coronary artery abnormalities, and arrhythmia”.

Reference used: Topjian AA, Raymond TT, Atkins D, Chan M, Duff JP, Joyner BL, Lasa JJ, Lavonas EJ, Levy A, Mahgoub M, Meckler GD, Roberts KE, Sutton RM, Schexnayder SM; Pediatric Basic and Advanced Life Support Collaborators. Part 4: Pediatric Basic and Advanced Life Support 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics. 2021 Jan;147(Suppl 1):e2020038505D. doi: 10.1542/peds.2020-038505D. Epub 2020 Oct 21. PMID: 33087552.

Rationale for proposed change: Rationale for the proposed change include that these additional causes are not present in the current Wiki, and the causes (other than shock and respiratory failure) in the wikipedia article focus largely on drug interactions. Given that the cause of cardiac arrest is different in pediatric population, but there is very little dedicated information on this in the Wikipedia, it warrants that other etiologies are included. The source used for causes in pediatric populations in the Wikipedia page is from 2017 and would benefit from an update. Possible controversy includes this information was newly updated in the 2020 guidelines, however this information appears to be supported by a large panel of pediatric specialists (intensivists, cardiac intensivists, cardiologists, emergency medicine physicians, medical toxicologists and nurses as well as volunteers) who underwent a very comprehensive review of the evidence (systematic reviews, scoping reviews and evidence updates).

Critique of Sources: The article states in their critique that often in pediatric medicine, recommendations are taken from adult data which is the case for the Basic Life Support components of this report. They state that further research is required with respect to pediatric cardiac arrest because the causes of pediatric cardiac arrest are different than adults. In addition infants, children and adolescents are distinctively different populations. Therefore, the information that I will be updating may not have a large body of evidence to support it as there is little research presently in this area. In addition, those in the writing group appear to be largely from North America (and one individual from Norway) and thus the data collected is from English sources and North American focused. This data may not be representative of the global audience that reads the Wikipedia page. I still feel that the updates are important, especially given the very limited information that is afforded to pediatric cardiac arrest in the current Wikipedia.

What to post on the Wikipedia article talk page (part of assignment 3)

 * This will also be covered on Nov 15th in class. Your group should use the below template to share an outline of your proposed improvements (including your new wording and citations). Article talk pages are not places to share your assignment answers. The Wikipedia community will be more interested in viewing your exact article improvement suggestions including where you plan to improve the article (which section), what wording you suggest, and the exact citation (Note: all citations must meet WP:MEDRS)
 * You will not be able to paste citations directly from your sandbox to talk pages (unless you are interested in editing/learning Wiki-code in the "source editing" mode). We suggest re-adding your citations on the talk page manually (using the cite button and populating the citation by pasting in the DOI, website, or PMID). You will have to repeat this process yet again when you edit the actual article live.
 * Talk Page Template: CARL Medical Editing Initiative/Fall 2021/Talk Page Template