User:IANOZORZ/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

== Measles ==

Group 13 Wikipedia Assignment Part 2: Literature Search
Viral presence through PCR analysis- Ian TESSIER

Goal: We have identified that the topic of the measles virus detection through PCR analysis should be added under the diagnosis section of the article.

Search Strategy:

PubMed and Cochrane Review databases were used to conduct the search. I used the meSH tool to search for “(measles/diagnosis OR measles/microbiology OR measles/virology)”. I then filtered the results to view review articles and 5 years publication date. only through PubMed.

Potential Sources Identified and Considered:


 * 1) Strebel PM, Orenstein WA. Measles. N Engl J Med. 2019 Jul 25;381(4):349-357. doi: 10.1056/NEJMcp1905181. Epub 2019 Jul 10. Review. PubMed PMID: 31184814
 * 2) Retrieved from pubmed. The article has information about the PCR process and some reasons why it would be used.


 * 1) Gadler T, Martinez N, Ogg-Gress J. Recognizing Measles, Mumps, and Rubella in the Emergency Department. Adv Emerg Nurs J. 2018 Apr/Jun;40(2):110-118. doi: 10.1097/TME.0000000000000190. Review. PubMed PMID: 29715253.
 * 2) Again, the similar information found in this one, though, I was more interested in one of their citations.


 * 1) Gastanaduy P. A., Redd S. B., Clemmons N. S., Lee A. D., Hickman C. J., Rota P. A., Patel M. (2017). Measles. In Roush S., Baldy L. (Eds.), Manual for the surveillance of vaccine preventable diseases (chap. 7). Retrieved from https://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html
 * 2) The article found as a citation in the second paper mentioned above. It contains more details in the laboratory testing section about the topic.

Selected Source and Rationale

   The source #3 has been selected as it contains better and broader details on the topic of PCR use for viral detection. It also talks about the benefit of using PCR for diagnosis in specific situations.

Reliable Medical source - Evidence

1- It is a secondary source article, that serves as a clinical practice guideline in a major medical authority (CDC)

2- A scientific consensus is presented, with citations from the Centre for Disease Control and Prevention (CDC) and the World Health Organization (WHO) that are included as evidence.

3- Since it has been published in 2017, the guideline uses relatively up-to-date evidence.

Implementation plan

The goal here is to explain the add more detail in the diagnosis section of the article. Indeed the PCR analysis for viral detection is not even mentioned even though it is routinely done in complementary of the confirmation by IgM and IgA testing. A quick explanation on what kind of specimen is required (urine, throat or naso-pharygial swab) and the purpose of doing this analysis for particular cases when serology results are inconclusive.

Salivary Testing - Gursharan SOHI

Goal: We have identified that the topic of salivary testing should be added to the Wikipedia article as a part of the diagnostic process for measles.

Search Strategy:

I used the PubMed and Cochrane Review databases to conduct my search. Within both databases, I searched “(measles) AND (saliva)”. I filtered results to view review articles only through PubMed. I separately conducted a search using the term “(measles) AND (IgA)” in both databases.

Potential Sources Identified and Considered:

'''1.     Dimech, W., Mulders, M.N. A review of testing used in seroprevalence studies on measles and rubella. Vaccine. 2016. 34:35 (4119-4122). Available from: doi 10.1016/j.vaccine.2016.06.006'''

a.     This source was retrieved from PubMed. At a cursory glance, it provides a thorough review of relevant literature (1998-2014) pertaining to serological tests used to diagnose measles.

'''2.     Simon, J.K. et al. Mucosal IgA responses in healthy adult volunteers following intranasal spray delivery of a live attenuated measles vaccine. Cochrane Central Register of Controlled Trials. 2011. 18: 3 (355-361). Available from: doi https://doi-org.proxy.queensu.ca/10.1128/CVI.00354-10 '''

a. This publication sought to determine the responses of adults to the measles vaccine. Oral fluid tests were used to determine of immunoglobin production.

Selected Source and Rationale:

Source #1 (above) was selected as it is a secondary source. The available literature specifically pertaining to salivary determination of a measles diagnosis is sparse, particularly where secondary sources of information are concerned. This review article effectively summarizes relevant information and is transparent with regards to the search and data extraction methodology. Furthermore, it assesses the various facets of seroprevalence testing in both a quantitative and qualitative manner, increasing the generalizability of results.

Reliable Medical Source – Evidence:

1.     The source is published in a legitimate medical journal (Vaccine), the impact factor (IF) of which is 3.269 (2018). This is acceptable, given the convention that IF >3 is respectable.

2.     The source uses relatively up-to-date evidence, having been published in 2016 and including information current up to 2014.

3.     The source effectively summarizes scientific consensus by citing WHO standardized guidelines (see “3.3 Reporting of Results”) against which to judge the studies included in the review.

Implementation plan:

The current Wikipedia article does not cover the diagnosis of measles very thoroughly. The information retrieved will contribute to making this section of the article more robust. This piece of evidence concludes that diversity amongst seroprevalence testing methodologies renders it difficult to definitively recommend one method of diagnosing measles above all others. This is important to emphasize in the Wikipedia article, given the diversity of the population who will be accessing it. Integrating these results with other findings about diagnosing measles may help readers develop a more comprehensive understanding of appropriate diagnostic modalities and where they can look in the literature to find more specific information.

Vitamin A - Adelaide BURROWS

Goal: We have identified that the topic of Vitamin A under “treatment” needs to be expanded on in a more pertinent context.

Search Strategy: I used both the Cochrane Review and PubMed databases to conduct my literature search. I searched (“Measles”) AND (“Vitamin A”) AND (“Treatment.”) I filtered my results on PubMed to include the article types: Review, Guideline, Practical Guideline and Meta Analyses. Since the majority of research involving Vitamin A treatment on measles mortality was conducted within the last decade, I filtered my results to be within the last 10 years of publication dates and only in the English language. On Cochrane Review, I filtered my results to be within the last 7 years and only in the English language.

Potential Sources Identified and Considered:

1.    '''Sudfeld CR, Navar AM, Halsey NA. Effectiveness of measles vaccination and vitamin A treatment. Int J Epidemiol. 2010; 39(Suppl 1):i48–55. Available from: DOI 10.1093/ije/dyq021'''

a.    This source provides a comprehensive review of all published literature from 1960-2008 to determine the effect of Vitamin A treatment on measles mortality.

b.    Source retrieved from PubMed.

2.     '''Bester JC. Measles and measles vaccination: a review. JAMA Pediatr. 2016; 170(12): 1209-1215. Available from: DOI 10.1001/jamapediatrics.2016.1787.'''

a.    This source provides a comprehensive review of the efficacy of Vitamin A supplementation in children with measles.

b.    Source retrieved from PubMed.

3.    '''Bello S, Meremikwu MM, Ejemot-Nwadiaro RI, Oduwole O. Routine vitamin A supplementation for the prevention of blindness due to measles infection in children. Cochrane Database of Syst. Rev. 2016; CD007719. Available from: DOI 10.1002/14651858.CD007719.pub4.'''

a.    This source provides an overview of measles and vaccination for healthcare professionals.

b.    Source retrieved from Cochrane Review database.

Selected Source and Rationale:

·      I chose Source #2 for the following reasons:

o  It is a secondary source, so analysis has already taken place externally which improves reliability.

o  It is recently published (2016) as compared to Source #1 which was published in 2010.

o  Source #3 made no significant conclusions as they did not include any trials assessing whether the supplementation of Vitamin A on children with measles prevents blindness. Source #2 makes significant clinical conclusions about Vitamin A effectiveness in the treatment of measles.

Reliable Medical Source – Evidence:

1.    The source is published by a reliable and legitimate source (JAMA Pediatrics) which is published by the American Medical Association. The journal currently has an impact factor of 12.004.

2.    The data reflected in the source is up-to-date and recently published as of 2016, which falls within the past 3 years. As this source conducted a review based on systematic reviews, meta-analyses, narrative reviews, epidemiologic reports, and research studies focusing on review content, the quality of the evidence is high.

3.   A scientific consensus is presented, with databases and online repositories of the Centre for Disease Control and Prevention (CDC) and the World Health Organization (WHO) being utilized and cited amongst the evidence presented.

Implementation plan:

This source concludes that 2 doses of Vitamin A (200 000 IU) lower mortality for measles in children younger than 2 years, as well as mortality from measles-associated pneumonia. The source also states that the World Health Organization and American Academy of Pediatrics recommends the use of oral Vitamin A for children diagnosed with measles at a dose of 200 000 IU for 2 consecutive days for children 1 year or older; 100 000 IU for 2 consecutive days for children 6 months to 1 year; and 50 000 IU for 2 consecutive days for children younger than 6 months.

Vitamin A may be indicated in pediatric patients with diet deficiencies - indications

Effect of Vitamin A

Treatment, only indicated in certain people, source

The Wikipedia article is currently vague and unspecific in its presentation of Vitamin A as an effective treatment for measles. Using the evidence presented in this source, we plan to substantiate the existing content on Vitamin A under the “treatment” portion by providing a more reliable and high-quality source of information. We also plan on providing more information related to the use of Vitamin A as a treatment in the pediatric population, as opposed to the false and unsupported information currently included in the Wikipedia article that presents Vitamin A as a widespread treatment for anyone infected with measles.

Transmission and Management - Grace LIN

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.

Recent outbreaks in under vaccinated populations in America - Miriam MAES

Goal: The information about how undervaccination causes outbreaks should be expanded to include information on recent outbreaks that have occurred in developed nations.

Search Strategy:

Searched terms: “Measles AND Outbreak AND CDC”, “Measles AND Outbreak AND WHO”

Sources

I searched PubMed using the search terms above. I decided not to filter for review articles and meta-analyses because I am looking to find resources that are not necessarily research based, for instance I would be open to reading articles that are case studies of measles outbreaks in various regions of America or other developed countries. I did, however, filter for articles created in the last 5 years.

Potential Sources Identified and Considered:


 * 1) Patel, M. et al. National Update on Measles Cases and Outbreaks — United States, January 1–October 1, 2019. MMWR. Morb. Mortal. Wkly. Rep. (2019). doi:10.15585/mmwr.mm6840e2
 * 2) Zipprich, J. et al. Measles outbreak — California, december 2014–february 2015. Morb. Mortal. Wkly. Rep. (2015). doi:10.1016/j.annemergmed.2015.04.002
 * 3) O’Connor, P. et al. Measles and rubella elimination in the WHO Region for Europe: progress and challenges. Clinical Microbiology and Infection (2017). doi:10.1016/j.cmi.2017.01.003

Selected Source and Rationale: Source #1

This source provides a detailed overview of the most recent cases of measles outbreaks in America and touches on how undervaccination has contributed to the growing number of outbreaks. Source #2 was very specific to a couple cases originating in California, and source #3 did not focus as much on the outbreaks themselves but more so on the legislation surrounding issues related to measles in Europe.

Reliable Medical Source – Evidence:


 * 1) This was published by the Center for Disease Control (CDC) which is a major scientific authority.
 * 2) This is not a primary research article, it gives a general consensus agreed upon by the scientific community and includes multiple citations by the CDC.
 * 3) This source is very up to date, as it only includes measles cases that have so far occurred in the 2019 calendar year.

Implementation plan:

Since the wikipedia article lacks information on the recent outbreaks in undervaccinated communities, information from this article would supplement the information already present in wikipedia’s measles page so that it is more thorough, relevant, and up to date.

Strain Identification - Arushi SACHDEV

Goal: We have identified that the topic of strain identification should be added to the Wikipedia article, as it is an integral component to molecular epidemiology and monitoring the transmission of the measles virus.

Search Strategy:

The databases PubMed and Cochrane Review were used, with the initial query being “(measles) AND ((strain) OR (molecular epidemiology))”. The search results were then filtered for review articles only.

Potential Sources Identified and Considered:


 * 1) Rota, Paul A., et al. "Global distribution of measles genotypes and measles molecular epidemiology." The Journal of infectious diseases 204.suppl_1 (2011): S514-S523.
 * 2) Santibanez, S., et al. "Molecular surveillance of measles and rubella in the WHO European Region: new challenges in the elimination phase." Clinical Microbiology and infection 23.8 (2017): 516-523.
 * 3) Rota, P. A., D. A. Featherstone, and W. J. Bellini. "Molecular epidemiology of measles virus." Measles. Springer, Berlin, Heidelberg, 2009. 129-150.

Selected Source and Rationale: Source #1

Source #1 was selected because it was the only review article that was published relatively recently and looked at the molecular epidemiology of only measles on a global scale. Source #2 restricted their findings to the European Region and considered rubella as well. Source #3 was published earlier than Source #1.

Reliable Medical Source – Evidence:

1.     The source is published in The Journal of Infectious Diseases, which has an impact factor of  5.045. Given that anything greater than three is considered “good” for an academic journal, we can conclude that this publication is likely to have a greater reach. This is confirmed by the number of times it has been cited in subsequent publications, which is 234 according to Google Scholar.

2.     The source uses reliable evidence, as it was provided by the World Health Organization’s Measles and Rubella Laboratory Network. The molecular epidemiology data included over 7000 genotype reports and over 4000 entries in the Measles Nucleotide Surveillance database.  

3.     The publication is a secondary source.

Implementation plan:

In the History section, the Wikipedia article mentions that there are various measles strains. However, they mention that there are 21 strains when there are in fact 23. Therefore, the first step is to rectify this mistake. The next step is to include the strain designations that the World Health Organization currently recognizes, which are the eight clades from A to H. Lastly, there will be a sentence or two describing how strains are differentiated, which is by sequencing the 450 nucleotides that encode the COOH– terminal amino acids of the nucleoprotein.

Differential Diagnosis - Raahulan RATHAGIRISHNAN

Goal:There is a need for a differential diagnosis of measles, specifically with external exanthems, that should be added to the Wikipedia page concerning measles.

Search Strategy:

The PubMed database and the point-of-care resource UpToDate were used in the search strategy. For PubMed, the search included the Medical Subject Headings (MeSH) terms measlesand diagnosis, differential. On UpToDate, a simple search strategy of measles AND differential diagnosis was used.

Search protocol for PubMed:

"Diagnosis, Differential"[Mesh] AND "Measles"[Mesh]

Potential Sources:

1.     Buonsenso, D., Macchiarulo, G., Supino, M. C., La Penna, F., Scateni, S., Marchesi, A., Reale, A., & Boccuzzi, E. (2018). LABORATORY BIOMARKERS TO FACILITATE DIFFERENTIAL DIAGNOSIS BETWEEN MEASLES AND KAWASAKI DISEASE IN A PEDIATRIC EMERGENCY ROOM: A RETROSPECTIVE STUDY. Mediterranean Journal of Hematology and Infectious Diseases, 10(1), e2018033. https://doi.org/10.4084/mjhid.2018.033

a.    At first glance, this paper offers an evaluation criterion using laboratory results in order to differentiate diagnosis between Kawasaki disease and measles.

2.    Gastanaduy, P., Redd, S., Clemmons N., Lee, A., Hickman, C., Rota, P., & Patel M. (2019). Manual for the surveillance of vaccine-preventable diseases, Chapter 7: Measles. Centers for Disease Control and Prevention

a.    This manual on the various vaccine-preventable diseases includes a chapter specific to measles. The chapter includes a differential diagnosis and the necessary additional tests to rule out other diseases that present similar to measles.

Selected Source and Rationale:

The third source, Manual for the Surveillance of Vaccine-Preventable Diseaseswas selected because it comes from a reliable source, a national health organization. It is a secondary source (whereas the first potential source was a retrospective study (primary source) and has been written and edited by multiple health experts and peer reviewed. The manual was first written in 1996, however it is constantly updated and reviewed. The last review of the measles chapter was May 13, 2019, highlighting the article’s recency. The review article gives a global view of measles, while also having specific information on differential diagnosis.

Reliable Medical Source – Evidence

1. The chapter from the manual is published by a national health organization(Centre of Disease Control and Prevention). The information is accessible and available in medical databases as well as directly through the CDC.

2. The chapter is a secondary source that references many primary sources and other health organization articles and all information disseminated is evidence-based and traceable to other sources.

3. Much of the investigations and queries on measles were done in previous decades, however the chapter is constantly being reviewed and updated, ensuring that the article has up-to-date evidence.

Implementation Plan

The diagnosis chapter in the measles Wikipedia page is brief and does not have any mention of differential diagnosis. To mitigate this problem area of the page, this source will have two purposes. It can be used to provide insight on the various diagnoses that need to be ruled out when. The secondary use of the article can be used to also highlight the necessary testing to confirm a measles diagnosis as well. It is important that the information is communicated in an accessible fashion due to the large and diverse population that will access the measles’ Wikipedia page.

Proposed changes
In the diagnosis section, instead of “Laboratory diagnosis of measles can be done with confirmation of positive measles IgM antibodies or isolation of measles virus RNA from respiratory specimens. ”, I’d add some details about the PCR viral detection with this:

“Laboratory diagnosis of measles can be done with confirmation of positive measles IgM antibodies or isolation of measles virus RNA from throat, nasal or urine specimen by using the polymerase chain reaction method (PCR). This method is particularly useful to confirm cases when the IgM antibodies results are inconclusives. ”

ET-Very clear.

Rationale for proposed changes
The diagnosis section lacks detail in general and so, I decided to add more information about PCR, which is one of the way that helps to diagnose measles and that was only slightly mentionned. Even though the main method is by confirmation of IgM antibodies presence, it is stated in almost all reviews and practice guideline as a pratice that is often done in conjuncture, thus why it had to be added. It has a specific purpose of detecting the actual virus and so will be very useful when IgM antibodies results are inconclusive. Also, the original article only stated that the isolation of measles virus RNA was from respiratory specimens whereas urine can also be used. Hance why, I decided to specify the 3 main specimen locations (throat, nasal or urine) with a more precise and less ambiguous approach than using "respiratory specimen".

Critique of sources
The source used for the added information is from the "surveillance manual of vaccine-preventable diseases" found on the cdc website. Following a critical approach, the primary concern that could be presented about this specific guideline is the fact that it is made for the US healthcare system and thus have a lot of recommandations and specific guidelines for them. Though, the information found in the  Virus isolation in cell culture and measles RNA detection (RT-PCR)  section would not differ based on the region so it is safe to use it for a more general and worldwide approach as what you would want to find on a wikipedia article.

ET- Important to consider the context of where guidelines are coming from. One could also look at who was at the table when these were being put together, specialists, primary care, patients, scientists, etc. It heavily influences the interpretation and trust in guidelines in other settings (perhaps less applicable in this case).