User:Amanda0054/sandbox

Welcome to your sandbox!
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

=  Concussion  =

Assignment 2:
1) How you searched for a source (search strategy – where you went to find it).

-       First checked Cochrane database searching “concussion” and didn’t find any articles

-       Next searched PubMed with keywords “concussion duration,” “concussion AND duration,” and “concussion AND recovery” and applied the filters: review, last 5 years, human

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


 * 1) McCrory P, Meeuwisse W, Dvorak J, et al Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016 British Journal of Sports Medicine 2017;51:838-847. ( https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097699.full.pdf )
 * 2) Concussion: pathophysiology and clinical translation.

Giza C, Greco T, Prins ML.

Handb Clin Neurol. 2018;158:51-61. doi: 10.1016/B978-0-444-63954-7.00006-9. Review.

PMID: 30482375 [PubMed - indexed for MEDLINE]

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

-       This article (McCrory et al) is the result of a conference of professionals who reviewed over 60 000 publications and have compiled expert data over 4 previous conferences. Formal systematic reviews were done for each consensus question and are referenced.

-       This article provides up-to-date, consensus-driven information

-       I had access to the full text to article 1 but not article 2 (which would not meet Wikipedia’s reliable medical source criteria)

-    The article is specifically about SRCs but states that the definition for concussion is vague and varies between papers

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

-       It is a consensus statement done by an international body of experts (Concussion in Sport Group)

-       The information in the article is based on multiple systematic reviews

-       The statement is from the 5th and most recent conference proceedings (most up-to-date consensus)

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

-       I plan to use the consensus statement definitions of normal clinical recovery times for adults and children to improve the introduction section of the Wikipedia article. The Wikipedia article gives a blanket statement that “it is not unusual for symptoms to last four weeks.” I would like to clarify that this is the maximum normal clinical recovery time for pediatrics, but for adults a normal recovery time is actually half that.

Proposed Change
I propose the following change to the following sentence in the introductory paragraph of the article:

Any of these symptoms may begin immediately, or appear days after the injury, and it is not unusual for symptoms to last four weeks. The severity of the initial symptoms is the strongest predictor of slower recovery time and it is not unusual for symptoms to last 10-14 days for adults and 4 weeks for children .

Rationale for Proposed Change
-      I found this sentence misleading because there is a difference in adult and paediatric recovery times that was not stated. The timeframe given, and its corresponding reference, are for paediatric concussions and is actually higher than normal adult recovery time. I also thought adding in that the severity of the initial symptoms predict recovery time would help give the reader a bit more understanding of the potential variation in recovery times.

-      The Berlin consensus statement provides these ranges in order to quantify what would be considered “persistent symptoms.”  Because there is no standard definition for recovery time it is possible there may be disagreement with the Berlin consensus values.

-      This data is also for sports-related concussions (and therefore athlete-related concussions) but the article states that “lessons derived from non-sporting mTBI research informs the understanding of SRC (and vice versa), and this arbitrary separation of sporting versus non-sporting TBI should not be viewed as a dichotomous or exclusive view of TBI.”

-      There may be an issue with the generalization of “children” because there are ranges of 5-12 for children and 13-18 for adolescents. The Berlin consensus states that these age groups are not adequately referenced in the literature and used the term children in the 4-week recovery estimate. I felt it was important to emphasize the large difference in estimated recovery times between children and adults.

Critique of Source
-      There are no competing interests declared in the article and author affiliates from many different countries and research backgrounds have contributed. The consensus addresses potential biases in the studies being referred to and attempts to extrapolate the data while accounting for these biases. I don’t see any obvious concerns or potential sources of bias with this consensus statement beyond the issues listed.

-      A previous consensus statement by the same body is currently used as a reference in the Wikipedia article.