User:EBM McEBMFace/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

EDIT #1 (adding name of wiki article) and EDIT #2 (adding citation)
Cannabis Use Disorder

EDIT #3: Adding Assignment #2 with Citations
Article: Cannabis Use Disorder Information to add: Currently the article lists four scales used to measure cannabis use as a diagnostic tool, referencing a review article from 2008. Since then, there has been more research on different instruments and diagnostic methods to evaluate cannabis use, included a revised scale from the reported ones in the article. The proposed change is then:

Add more recent reference to scales used to subjectively measure cannabis use Comment on the limitations of current scales (e.g. excludes edibles, subjective, no consensus of scales) Add recent developments of diagnostic tools to measure cannabis use

Search Strategy and Article Selection Rationale:

PubMed Search

Marijuana Abuse [Mesh] AND Review[ptyp] AND (diagnos* OR test* OR scale*)

López-Pelayo, H., Batalla, A., Balcells, M. M., Colom, J., & Gual, A. (2015). Assessment of cannabis use disorders: a systematic review of screening and diagnostic instruments. Psychological medicine, 45(6), 1121-1133.

Chosen because: Article is more recent than one referenced in wikipedia Article is a review article and secondary source Article is from high impact (IF ~ 5.6) international journal and is reputable Content is relevant, provides information on screening and diagnostic tools not mentioned in the original wikipedia article No conflict of interest declared Article has reviewed 30+ other journals (research in cannabis use disorder is fairly recent) and includes consideration of existing articles in wikipedia

Google Scholar Search

cannabis use disorder diagnosis “review” (nothing of note appeared from search)

cannabis use disorder ("scales" OR "scale") “review”

Casajuana, C., López-Pelayo, H., Balcells, M. M., Miquel, L., Colom, J., & Gual, A. (2016). Definitions of risky and problematic cannabis use: a systematic review. Substance use & misuse, 51(13), 1760-1770. Diagnosis

Chosen because: Article is more recent than the one on scales references in wikipedia Article is a review article and not a primary source Article is published in a journal with a reputable impact factor (1.13), which although it isn’t prestigious, it is not a predatory journal Article has citations to all the scales mentioned in original wikipedia article with more modern scales Article also comments on the difficulty in evaluating the different scales and how to produce an accurate measure of cannabis misuse, which is an important disclaimer we propose to add to the wikipedia article Authors have disclosed travel grants received from pharmaceutical companies of antidepressants but otherwise no other conflicts of interest to disclose

Assignment # 3
Proposed Change #1:

Original: "As a time and cost saving alternative to extensive diagnostic interviews, several short scales for the screening for cannabis-related problems have been developed. Among the most frequently used screeners are the Cannabis Use Disorders Identification Test (CUDIT), Severity of Dependence Scale (SDS), Cannabis Abuse Screening Test (CAST) and Problematic Use of Marijuana (PUM)."

New: To screen for cannabis-related problems, several methods are used. Scales specific to cannabis, which provides the benefit of being cost efficient compared to extensive diagnostic interviews, include the Cannabis Abuse Screening Test (CAST), Cannabis Use Identification Test (CUDIT), and Cannabis Use Problems Identification Test (CUPIT). Scales for general drug use disorders are also used, including the Severity Dependence Scale (SDS), Drug Use Disorder Identification Test (DUDIT), and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). However, there are no gold standard and both older and newer scales are still in use. To quantify cannabis use, methods such as Timeline Follow-Back (TLFB) and Cannabis Use Daily (CUD) are used. However, the methods measure general consumption and not grams of psychoactive substance as the concentration of THC may vary among drug users.

Rationale: The original Wikipedia article contained some subjective language in labeling the scales as "time and cost-saving alternatives" to diagnostic interviews. Although the scales are generally time and cost-saving, they were also developed to be specific to cannabis use disorder and it is not clear is solely motivation is to be cost-efficient or cannabis-specific. Hence, the wording has been changed to maintain the information that the scales are cost-efficient without insinuation that of the motivation for developing the scales. Secondly, the SDS screen is for general drug use and not specific to cannabis as labelled in the original article. The proposed addition introduces more scales cited by a more recent review article and also quantification instruments, with the mentioned caveat that the quantification is still general due to varying THC concentrations.

Critique of Source: The sources are all review articles that are 7+ years more recent than the original cited article in reputable international journals. A potential weakness in the sources is that they are from European research groups and make references to European cannabis use when discussing the motivation of the study. Both journals reference sources from other countries (e.g. referencing DSM-5 and the American Psychiatric Association and many scales are used in non-European regions), though they are more European references for logistics and health authorities than American ones. However, the citations for existing work include American and European sources. Another potential weakness is that due to the recency of cannabis use disorder (i.e. new definitions, active research), the articles from 2015 may be missing the newest scales and diagnostic methods. However, the newer scales (e.g. CUDIT-R) are mainly from primary sources. This section is susceptible to selection bias, as not every single scale and diagnostic instrument is mentioned by the proposed edit. The goal of the edit is to avoid insinuating that one scale is better than the other, hence the sources were chosen to be exhaustive review articles that fully cover the scales and instruments mentioned by the original Wikipedia article.

Proposed Change #2:

Original: (None, this proposed change is a new addition do the Diagnosis section)

New: "Cannabis use disorder is also recognized in the 11th revision of the International Classification of Diseases (ICD-11), adding more subdivisions including time intervals of pattern of use (episodic, continuous, or unspecified) and dependence (current, early full remission, sustained partial remission, sustained full remission, or unspecified) compared to the 10th revision. "

Rationale: The wikipedia article cites DSM-5 to define cannabis use disorder, but not ICD-11 nor ICD-10, which has been released in 2019 and is used extensively in non-American guidelines. We propose for completeness that a reference to ICD-11 and ICD-10 to be made which includes how the categorization of cannabis use disorder has changed as the original Wikipedia article also notes how DSM-5 has changed from past revisions.

Critique of Source: The sources are the direct ICD-11 and ICD-10 documents. Although it is not explicitly a review article, the information is not from a randomized control trial or any primary source for experiment and the existing Wikipedia article (and the ICD-10 page) links directly to the WHO ICD documents as well so we would argue that the official ICD-11 and ICD-10 documents are an appropriate source.