User:Anonymousgiraffe21/sandbox

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Practice Editing Here (Nov 23rd in-class Wiki session work)

 * This is a place to practice clicking the "edit" button and practice adding references (via the citation button).
 * My wikipedia article: Combined oral contraceptive pill

Assignment # 3
Wikipedia Assignment #3
 * Note: You will be emailing your assignment # 3 directly to your tutor, however, please paste a version here that excludes your personal information. This will allow us to support your efforts on Wikipedia prior to editing "live" in the article.

Combined Oral Contraceptive Pill (COCP)

Proposed changes:

In the “Contraindications” section: “Current formulations of COCP's do not contain doses high enough to increase the absolute risk of thrombotic events in otherwise healthy people, but people with any pre-existing medical condition that also increases their risk for blood clots makes using COCPs more dangerous. These conditions include but are not limited to high blood pressure, pre-existing cardiovascular disease (such as valvular heart disease or ischemic heart disease), history of thromboembolism or pulmonary embolism, cerebrovascular accident, migraine with aura, a familial tendency to form blood clots (such as familial factor V Leiden), and in smokers over age 35.”

I am planning to remove “migraine with aura” and “in smokers over age 35” from this list and add in the following:

"There are conditions that, when associated with COCP use, increase risk of adverse effects other than thrombosis. For example, people with a history of migraine with aura have an increased risk of stroke when using COCPs, and people who smoke over age 35 and use COCPs are at higher risk of myocardial infarction [reference]."

I have kept in the wiki-links for “migraine” and “smokers” and will add them in for “stroke” and “myocardial infarction”.

Rational for changes:

This change is necessary as the current format is misleading to readers by implying that migraine with aura and smoking over age 35 are contraindications due to increased risk of thrombosis. A person who reads this section should know all of the possible risks of COC use and also which conditions they may have that could increase risk. According to the WHO guidelines for medical use of COCPs, these conditions are associated with stroke and myocardial infarction rather than thrombosis. These risks need to be clearly communicated in the wiki article, rather than included in the current list which is vague and misleading.

Controversy:

There is little controversy over this topic as far as I am aware. The WHO guidelines use multiple primary sources to back up this association, and I also read some high quality reviews on these associations during my research for Assignment #2.

Critique of Source:

The WHO guidelines do have potential for bias, as they have a long list of authors, some of whom have financial associations. However, all potential conflicts of interest are listed within the report in and any authors with significant conflict of interest were asked not to participate in creating sections related to those conflicts.

Additionally, the WHO guidelines cover a wide range of topics, but do not have additional details about the mechanisms behind these contraindications and their associated risks. Therefore, I will not be expanding on any of these mechanisms, as these details are not provide in the source, and are also beyond the scope of a Wikipedia page. This source contains enough information to make a simple statement about the association that people may be interested in knowing about, as well as using a graded scale to quantify the risk associated with each contraindication.

Talk Page Submission:

Under Section:Contraindications we propose removing smokers over age 35 and migraine with aura from the list of contraindications that are associated with increased risk of thrombosis. The following sentence will be added: “There are conditions that, when associated with COCP use, increase risk of adverse effects other than thrombosis. For example, people with a history of migraine with aura have an increased risk of stroke when using COCPs, and people who smoke over age 35 and use COCPs are at higher risk of myocardial infarction.[9]”

Reference: World Health Organization (2015). Medical eligibility criteria for contraceptive use: Combined Hormonal Contraceptives (5th ed.). Geneva: World Health Organization. pp. 111–156.

What to post on the Wikipedia article talk page?

 * This will also be covered on Nov 23rd 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 2020/Talk Page Template