User:Cmoonqueens/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

CAFFEINE

ASSIGNMENT 2:
Assignment: Literature Search

1.    Search strategy: Search for [Caffeine] Meshterm and “Pregnancy” (with limit on dates in last five years) in Cochrane Reviews website

2.    Potential sources identified and considered:

a.    Health Canada website on pregnancy and caffeine; this was already cited in the Wikipedia article.

3.    This source was chosen because it was not already cited in the Wikipedia article. In addition, it is the only Cochrane review on the topic of effects of caffeine on a pregnancy.

4.    This review meets Wikipedia’s reliable medical sources (MEDRS) criteria.

a.    It is not a primary source, but a secondary source of amalgamated primary sources. It is a source of accepted knowledge, even though that knowledge is inconclusive.

b.    This review article is not an opinion piece but a gathering of information from different primary sources, making it more reliably unbiased.

c.    Cochrane reviews, including this one, is an independent source, not tied to industry ( such as the caffeine industry).

5.    Using this source, I will highlight the inconclusiveness of current evidence on affects of caffeine on pregnancy. The Wikipedia article currently lists several studies that suggest effects of caffeine on pregnancy. For example, one study cited posits that caffeine use in pregnancy may result in pregnancy loss, but this is a single study (primary source) and not a secondary source.

Thus I will use this article to add to the secondary sources available which may provide better evidence.

ASSIGNMENT 3:
 Sections to Change :

Introduction :

Evidence of a risk during pregnancy is equivocal; some authorities recommend that pregnant women limit consumption to the equivalent of two cups of coffee per day or less [18],[19].

Pregnancy and Breastfeeding

The UK Food Standards Agency has recommended that pregnant women should limit their caffeine intake, out of prudence, to less than 200 mg of caffeine a day – the equivalent of two cups of instant coffee, or one and a half to two cups of fresh coffee. The American Congress of Obstetricians and Gynecologists (ACOG) concluded in 2010 that caffeine consumption is safe up to 200 mg per day in pregnant women. For women who breastfeed, are pregnant, or may become pregnant, Health Canada recommends a maximum daily caffeine intake of no more than 300 mg, or a little over two 8 oz (237 mL) cups of coffee.

There are conflicting reports in the scientific literature about caffeine use during pregnancy. A 2011 review found that caffeine during pregnancy does not appear to increase the risk of congenital malformations, miscarriage or growth retardation even when consumed in moderate to high amounts. Other reviews, however, concluded that there is some evidence that higher caffeine intake by pregnant women may be associated with a higher risk of giving birth to a low birth weight baby, and may be associated with a higher risk of pregnancy loss. A systematic review, analyzing the results of observational studies, suggests that women who consume large amounts of caffeine (greater than 300 mg/day) prior to becoming pregnant may have a higher risk of experiencing pregnancy loss.

 Proposed Changes: 

Introduction :

Replace the two primary sources with one secondary source.

Pregnancy and Breastfeeding:

I will begin the section by adding the following sentences.

"Current evidence regarding the effects of caffeine on pregnancy are inconclusive . There is limited primary and secondary evidence for, or against, caffeine use during pregnancy and its effects on the fetus or newborn."

Rationale for Proposed Changes

Introduction

The introduction reference to pregnancy and caffeine use, uses two primary sources. I will replace it with one secondary source as this better complies with the MEDRS criteria for Wikipedia.

There may be push-back from others editing the page. For instance one of the two references is from the Mayo Clinic, a widely regarded clinic in the USA. However, the first clause of the sentence states that the evidence on whether caffeine influences pregnancy is equivocal, whereas the two sources cited have recommendations for daily limits on caffeine intake. Thus I will replace these sources with the reviewed source in order to a) better comply with MEDRS criteria and b) better comply with the statement.

Pregnancy and Breastfeeding

The added sentences acknowledge the limited evidence available.

There may be controversy related to these changes because there is much evidence cited. However these are primary sources and do not comply with MEDRS criteria.

 Critique of Source 

This Cochrane Review article only cites two studies that matched their search criteria. This review is therefore only a small review with little evidence.

However I believe this reflects a lack of literature overall and indicates that more research (particularly that which can show correlation and causation, such as RCTs) needs to be done in this area.

It is also better than the existing references because they are primary sources and do not comply with the MEDRS criteria for Wikipedia citations.

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