User:Gracelin97/sandbox

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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

Assignment #2:
Goal: Transmission and Management of Measles Outbreaks

Search Strategy:


 * 1) Pubmed: Searched using “Measles AND Transmission” or “Measles AND Epidemiology”
 * 2) CINAHL: Searched using “MH "Measles/EP/PC/RF/TD/TM" (Subheadings of epidemiology, prevention and control, risk factors, trends, transmission)

Potential Sources Identified and Considered:


 * 1) Stinchfield, P. A. (2019). Measles: A clinician's guide to a reemerging disease. The Nurse Practitioner, 44(11), 37-41.
 * 2) Strebel P.M., Orenstein W.A., (2019). Measles. The New England Journal of Medicine, 381(4):349-357.
 * 3) Brown, K. E., Rota, P. A., Goodson, J. L., Williams, D., Abernathy, E., Takeda, M., & Mulders, M. N. (2019). Genetic characterization of measles and rubella viruses detected through global measles and rubella elimination surveillance, 2016–2018. Morbidity and Mortality Weekly Report, 68(26), 587.

Selected Source and Rationale:

Source chosen: #3


 * This source provides a good, recent overview of measles in the epidemiological context, with a lot of statistics and numbers reflective of the global impact of measles.

Reliable Medical Source –Evidence:


 * 1) It is published by a major medical/scientific authority - the CDC
 * 2) It is a secondary resource that compiles evidence from multiple international organizations, such as the WHO.
 * 3) It reflects up-to-date data (2016-2018)

Implementation plan:

Since the wikipedia article contains minimal information on the transmission of measles, especially in

the global context, this article can help to supplement this information.

Assignment #3:
Proposed Changes

In 2000, the WHO established the Global Measles and Rubella Laboratory Network (GMRLN) to provide laboratory surveillance for measles, rubella, and congenital rubella syndrome. Data from 2016-2018 show that the most frequently detected measles virus genotypes are decreasing, suggesting that increasing global population immunity has decreased the number of chains of transmission.

ET-The proposal is written clearly and the medical terminology is liked appropriately.

Rationale for Proposed Change

This change is necessary because it gives additional information on how measles epidemiology has changed in recent years, linked to the changes in immunization patterns. The information comes from CDC's Morbidity and Mortality Weekly Report focused on genetic characterization of measles and rubella viruses. These changes will be added under the beginning paragraph of the "Epidemiology" section of the Measles article to supplement the information given on declining measles mortality. While declining rates of mortality are addressed, linked to increased global immunization, no information is currently provided in the article on how the measles virus strains were affected by the increased immunization. By providing the information that measles virus genotypes are decreasing, these proposed changes help explain why immunization could lead to the eradication of the measles virus.

ET-Well justified addition to the provided information.

Critique of Source The article used to discuss the proposed changes is a report of genetic characterization done by the GMRLN for 2016-2018. Although a report, there is still evidence that bias exists in this report. The authors mention that many countries reporting laboratory confirmed measles cases did not collect specimens for genetic characterization, especially during outbreaks, leading to possible selection bias. The effect of this bias is evident in that the geographical distribution of sequences reported does not align with the distribution of reported measles and rubella cases. A second case of selection bias is that sequences representing chains of transmission in countries with inadequate virologic surveillance were not represented in the global databases. These limitations could to over-estimating the conclusion that measles virus genotypes are declining, since the initial sample was not comprehensive enough to make this conclusion. However, there is reason to believe that the conclusions are still valid because of the relatively large sample size. The report states that 317,445 serum specimens were collected in 2018 alone for patients with suspected cases of measles or rubella. In terms of validity, the presence of selection bias threatens the internal validity of the report but does not affect its external validity. Due to the global nature of the data in this report, these results appear to hold high external validity. Although the report is not without biases, it is still valuable because it presents a very large, global dataset and draws conclusions on an amalgamation of the global data.

ET-In depth review of the source of this data. I would caution that threats to internal validity do affect externality validity (the strength of the apparent association will impact the ability to apply it to other settings) but it is totally fair to evaluate that even with limitations to internal validity that the findings are still strong and have external validity.