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Wikipedia Article Summary
The Wikipedia article on hypothyroidism starts with a definition and then goes on to give a thorough breakdown of signs and symptoms of the condition, from earlier to later symptoms, as well as uncommon ones. The article continues with a section on the various causes of hypothyroidism, including iodine deficiency, exposure to radioactive iodine, use of certain medications/drugs, and post-partum thyroiditis. Next it has sections on pathophysiology, diagnosis and treatment. Included under the diagnosis heading is a classification chart of the different types of hypothyroidism. The treatment section includes an area covering treatment controversies. The article ends with a blurb on epidemiology. The Wikipedia article has numerous contributors, but there is no one reliable statement of responsibility.

Encyclopaedia Britannica Article Summary
The Encyclopaedia Britannica article on hypothyroidism, also found online, lists Robert D. Utiger, M.D. as the primary contributor. He was a clinical professor of medicine at Harvard Medical School. This article is much more succinct, yet gives good information, from an obviously more scientific perspective. The article begins with a definition of hypothyroidism and then goes on to explain the various types and causes of the condition, but gives a different breakdown than the Wikipedia article. This is followed by a section on clinical manifestations, including symptoms in children. This is expanded upon with a paragraph on cretinism and an explanation of congenital hypothyroidism and screening in infants. The last section deals with diagnosis and treatment, including treatment of infants.

Comparing Main Contents
When comparing the main contents of the two articles, it is obvious that while they discuss the same health topic, they are very different. The Wikipedia article on hypothyroidism starts with a detailed description of symptoms of hypothyroidism, including uncommon ones. This is useful information as hypothyroidism is a condition that is sometimes quite difficult to diagnose. The section on Causes only briefly mentions congenital hypothyroidism (which should be included as a primary type of hypothyroidism), as that information seems to be part of another Wikipedia article, which is attached by hyperlink. The Encyclopaedia Britannica article  includes a whole section on cretinism, which is the result of undiagnosed congenital hypothyroidism in infants and “has led to routine screening in newborns”, an important item of note. A paragraph on postpartum thyroiditis is included in the Wikipedia article as well, but is only mentioned via link in the EB article, possibly because it is considered a form of transient hypothyroidism. In the Wikipedia article, there is a section on Stress and Hypothyroidism under the Causes heading, which will be further covered under Assessment, which is a topic not even touched upon in the EB article. The EB article offers a different breakdown of causes of primary and secondary hypothyroidism, and lists hypothyroidism caused by problems with either the pituitary gland or hypothalamus as “central hypothyroidism” while the Wikipedia article includes a classification chart listing primary, secondary and tertiary types of the condition, and lists the last two as being caused by problems with the pituitary gland or hypothalamus. It does not use the correct classification and does not even mention congenital hypothyroidism as a primary type. In terms of diagnosis and treatment, the Encyclopaedia Britannica article discusses standard protocol for diagnostic methods and treatment, while the Wikipedia article goes on to focus on Treatment Controversies. The EB article also includes links via sidebars to extra information from authoritative sources, such as "The Mayo Clinic" and "The Merck Manuals". Both articles include hyperlinks to other articles in their respective databases. While the Wikipedia article is longer and seems to provide more information, that information is not necessary all useful, or correct.

References, Further Reading and Contributors
The list of references in the Wikipedia article is very extensive at 66 footnotes. In general, most references are from reliable sources, such as the "American Association of Clinical Endocrinologists" (see footnotes 5, 59), the "American Thyroid Association" (7), the "Royal College of Physicians" (46) and numerous reputable medical journals such as "European Journal of Endocrinology" (27), "New England Journal of Medicine" (51) and "Medical Science Monitor" (22). However, there are also references to dubious sources such as "www.stopthethyroidmadness.com" (58) and references to studies that were done on rats (see 6, 25, 28). The Encyclopaedia Britannica article has no footnotes at all, presumably because it is an encyclopedia article. The Encyclopaedia Britannica article offers links to “Related Articles, EBooks & More” as well as “Web links” for further education on the topic at hand. This information would of course be current and relevant, as it is from regularly updated sources. In terms of suggested further reading, the Wikipedia article lists “Hypothyroidism Booklet”, put out by the American Thyroid Association, as well as a Lancet article entitled “The Importance of Selenium to Human Health” and another article on hypothyroidism management linked to Temple University.

The Wikipedia article is, as per the standard, written by numerous contributors coming from various backgrounds. They are often not authoritative sources of information, but students, self-proclaimed experts, or anyone with a voice that wants to be heard, as one can easily see when reading the Talk pages. The Encyclopaedia Britannica article lists its primary contributor as Robert D. Utiger, M.D. He was a Clinical Professor of Medicine at Harvard Medical School and an expert in his field. Other contributors include “The Editors of Encyclopedia Britannica”, which is an extensive list of professional editors. Upon checking the history of the article, one can see that the editing that was done was completed in 2009 by Kara Rogers, Senior Editor of Biomedical Science at Encyclopaedia Britannica, Inc., with a PhD in pharmacology and toxicology.

Assessment
When comparing the two articles, first and foremost one must consider the source. The Encyclopaedia Britannica article was written and edited by an authoritative source. Robert D. Utiger, deceased, was former Deputy Editor of the New England Journal of Medicine and former editor of Clinical Thyroidology, “a quarterly review journal of the recent throid-related literature sponsored by the American Thyroid Association”. The History page of the Wikipedia article, however, shows various editing done by unknown contributors, some even without a username. One has only to look at the Wikipedia Talk page to see that some contributors are being accused of vandalism while others get into heated arguments over controversial topics, such as whether or not to include controversial information on fluoride theories. Upon reading through the Wikipedia article’s Talk page, I discovered several issues with the article’s authors’ contributions. Firstly, segments of articles tend to be deleted and reinstated by other contributors, sometimes several times, based on the current writer's views. There tends to be a lot of disagreement about what should or should not be included in articles. For example, the conversation with regards to the fluoride controversy mentioned above. One contributor noted that it had no place in a scientific article since it was an unproven, fringe theory that overexposure to fluoride is a cause of hypothyroidism. This was argued back and forth by another contributor, who was for including it and had his own agenda, and did not feel that only mainstream articles from PubMed should be included in a Wikipedia article. Though the current version of the article has no mention of it, my point is that the extent of varying viewpoints leads to a messy article where contradictions and misinformation abound.

Another problem is the addition of contradictory information such as optimum TSH levels. This is stated several times in the Wikipedia article as being 0.5-4.5 (or 5.5) mIU/L, but it is later mentioned under the Subclinical Hypothyroidism heading that “Consensus American and British opinion since 2008, has been that in general patients with TSH under 10mIU/L do not require treatment”. This is very confusing to the reader.

Perhaps the main problem with the Wikipedia article, which is obvious to all as it is listed as a notice at the head of the article, is that it is missing citations: “This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed”. The areas of Pathophysiology, Treatment Controversies and Pregnancy and Fertility seem to be the worst offenders, as they are full of “citation needed” comments One simply cannot add information that can’t be proven or backed up. Parts of the article read as a matter of opinion, not fact. For example, the comment “Even mild or subclinical hypothyroidism is known to adversely affect fertility” has no citation and begs the question, “is known to whom?” The Encyclopaedia Britannica article is based on scientific fact and is written by an authoritative source, and therefore these types of comments or personal opinion statements are not included.

Another example of the unscientific nature of the Wikipedia article in comparison to the Encyclopaedia Britannica article is the section on Stress and Hypothyroidism. This section lists stress as a known “significant contributor to thyroid dysfunction” and is lacking citations. Several of the citations that are included in this section refer to scientific research studies that were conducted on rats, not humans. While I am not disagreeing that severe, chronic stress, such as that experienced by the refugees in one of the studies can have an impact on body functions, there is no proof that stress actually causes hypothyroidism in humans.

In conclusion, the Wikipedia article on hypothyroidism has too many problems with content and layout and not enough authority for me to consider it a good article. There is some good information included, but for someone reading it who knows nothing about the subject it can be misinformative as it is incomplete and even contradictory at times. The Encyclopaedia Britannica article is clear, concise and authoritative. As well, the links provided lead the reader to further exploration on the topic from other reliable sources.

Additional Resources
Ain, Kenneth B. and Rosenthal, M. Sara. The Complete Thyroid Book. New York: McGraw-Hill, 2011. Print.

Fettes, Ivy. Thyroid Problems: a Guide for Patients. Toronto: Prospero Books, 2001. Print.

Garber, JR, Cobin, RH, Gharib, H, et al. “Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association”. Thyroid. 22;12: 1200-1235. Pubmed. Web. 7 Nov. 2013.

Hamburger, Joel I. M.D. The Thyroid Gland: A Book for Patients. W. Bloomfield, MI: Michael M. Kaplan, 1997. Print.

Lindsay, Robert S., and Anthony D. Toft. "Hypothyroidism." Lancet 349.9049 (1997): 413. Business Source Complete. Web. 7 Nov. 2013.

Olivieri, Antonella. “Epidemiology of Congenital Hypothyroidism: What Can Be Deduced from the Italian Registry of Infants with Congenital Hypothyroidism.” The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies, The International Society of Perinatal Obstetricians 25. Suppl 5 (2012): 7-9. MEDLINE. Web. 7 Nov. 2013.

Prousky, Jonathan E. “Treating Hypothyroidism.” Journal of Orthomolecular Medicine 28.2 (2013): 51-54. Canadian Reference Centre. Web. 7 Nov. 2013.

Rosenthal, M. Sara. The Thyroid Sourcebook for Women. Los Angeles, CA: Lowell House, 1999. E-Book Collection (EBSCOhost). Web. 7 Nov. 2013.

Rosenthal, M. Sara. The Thyroid Sourcebook. New York: McGraw-Hill, 2000. Print.

Skugor, Mario. The Cleveland Clinic Guide to Thyroid Disorders. New York: Kaplan Pub., 2009. Print.

Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, Franklyn JA, Hershman JM, Burman KD, Denke MA et al: Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 2004, 291(2):228-238. American Thyroid Association. Web. 7 Nov. 2013.