User:IAgg6/sandbox

Welcome to your sandbox!
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
'''Wikipedia Assignment # 2: Literature Search

'''1. How you searched for a source (search strategy – where you went to find it). I was seeking a citation that would enable me to improve the “Prevention” section of the Wikipedia article on “Concussion.” To find an appropriate source, I searched Concussion AND Prevention in PubMed and filtered by Article Types (Review), Publication Dates (5 Years), and Species (Human). I obtained 112 results. '''2. What potential sources were identified and considered (give examples of 1 or 2). Potential sources included:
 * Emery, C.A. (2018). Injury prevention in kids’ adventure and extreme sports: Future directions. Res Sports Med, 26:199-211. doi: 10.1080/15438627.2018.1452239.
 * Master, C.L., Mayer, A.R., Quinn, D., et al. (2018). Concussion. Ann Intern Med. 169:ITC1–ITC16. doi: 10.7326/AITC201807030.
 * Schneider, D.K., Grandhi, R.K., Bansal, P., et al. (2017). Current state of concussion prevention strategies: A systematic review and meta-analysis of prospective, controlled studies. Br J Sports Med, 51:1473-1482. doi: 10.1136/bjsports-2015-095645.

'''3. Why the source was chosen (what made it better than other choices). I chose Schneider et al. (2017) over Emery (2018) and Master et al. (2018). Although all three sources are current (<5 years old), reliable, and discuss concussion prevention, I found Schneider et al. (2017) to be most systematic, comprehensive, and relevant. Specifically, Schneider et al. (2017) examined many different concussion prevention strategies (e.g. equipment, educational programs, training, etc.) in diverse populations (e.g. wide age range, both genders, various sports, etc.), answering all of my questions. Contrastingly, Emery (2018) only explored concussion prevention in a narrow subpopulation (i.e. children) and Master et al. (2018) provided a brief and limited overview of primary and secondary prevention, reducing generalizability and applicability of their findings. Furthermore, while full texts of Schneider et al. (2017) and Master et al. (2018) were available, I could not access full text of Emery (2018), failing to meet Wikipedia’s MEDRS criteria.

'''4. List at least three reasons why the source that was selected meets Wikipedia’s reliable medical sources (MEDRS) criteria.
 * The article by Schneider et al. (2017) is a systematic review and meta-analysis, making it a high-quality secondary source.
 * The article by Schneider et al. (2017) is recent (<5 years old) and up-to-date, better ensuring reliability of information.
 * No conflicts of interest were disclosed, reducing risk of bias.

'''5. How do you plan to use the source for improving the article? I plan to use this source to improve the “Prevention” section of the Wikipedia article on “Concussion.” The “Prevention” section focuses almost exclusively on protective equipment (e.g. helmets, airbags and seatbelts, and hard shoes) as useful tools for preventing concussion. Hence, I hope to add evidence showing educational and training programs are effective concussion prevention strategies as well.

Assignment # 3
Wikipedia Assignment # 3: Individual Improvement Plan

PROPOSED CHANGES

My proposed changes pertain to the “Prevention” section of the Wikipedia article on “Concussion.” Currently, the “Prevention” section focuses almost exclusively on protective equipment (e.g. helmets, airbags and seatbelts, and hard shoes) as useful tools for preventing concussion. I propose highlighting educational interventions as possible prevention strategies as well.

My proposed changes are bolded:


 * Prevention of mTBI involves general measures such as wearing seat belts, using airbags in cars, and protective equipment such as helmets for high-risk sports. Older people are encouraged to reduce fall risk by keeping floors free of clutter and wearing thin, flat, shoes with hard soles that do not interfere with balance. Protective equipment such as headgear has been found to reduce the number of concussions in athletes and improvements in the design of helmets may decrease the number and severity further. New "Head Impact Telemetry System" technology is being placed in helmets to study injury mechanisms and may generate knowledge that will potentially help reduce the risk of concussions among American Football players.


 * It has been shown that educational interventions, such as handouts, videos, workshops, and lectures, can improve concussion knowledge of diverse groups, particularly youth athletes and coaches [1]. Some studies have found that strong concussion knowledge is associated with greater recognition of concussion symptoms, higher rates of concussion reporting behaviors, and reduced body checking-related penalties and injuries, thereby lowering risk of mTBI [1].


 * Self-reported concussion rates among U-20 and elite rugby union players in Ireland are 45–48%. Half of these injuries go unreported. Changes to the rules or enforcing existing rules in sports, such as those against ‘head-down tackling’, or ‘spearing’, which is associated with a high injury rate, may also prevent concussions.

[1] Schneider, D.K., Grandhi, R.K., Bansal, P., et al. (2017). Current state of concussion prevention strategies: A systematic review and meta-analysis of prospective, controlled studies. Br J Sports Med, 51:1473-1482. doi: 10.1136/bjsports-2015-095645.

RATIONALE FOR PROPOSED CHANGE

The “Prevention” section of the Wikipedia article on “Concussion” is currently incomplete. It only discusses primary prevention strategies of concussion. Within primary prevention, a strong focus is placed on protective equipment. The section briefly mentions rules of play but does not discuss educational interventions or concussion legislation at all, both of which effectively reduce injury rates and concussion prevalence. Hence, for my edit, I highlighted educational interventions as promising prevention strategies of concussion. My first sentence showcases different types of educational interventions (i.e. handouts, videos, workshops, and lectures) and discusses populations most likely to be targeted and affected by awareness and educational programming (i.e. diverse groups, particularly youth athletes and coaches). My second sentence describes scientifically supported benefits of concussion education (i.e. greater recognition of concussion symptoms, higher rates of concussion reporting behaviors, reduced body checking-related penalties and injuries), succinctly emphasizing advantages of educational interventions. Future editors should consider discussing concussion legislation and secondary (e.g. screening programs, certain educational interventions, etc.) and tertiary (e.g. proper concussion management) prevention strategies of concussion.

For my edits, I used Schneider et al. (2017). My source is current (<5 years old) and was published in a highly credible journal (i.e. Br J Sports Med, Impact Factor of 11.645). It is a systematic review, representing highest quality of evidence, and examined over a dozen studies in diverse populations. Hence, I am confident my edits are based on reputable evidence.

There is some controversy surrounding my proposed changes. First, only a small number of studies have explored effectiveness of educational programs as concussion prevention modalities. Additionally, study findings have been mixed (i.e. some studies have reported significantly lower injury rates following concussion education whereas others have found no effect). Despite controversy, I believe it is important to discuss educational interventions under “Prevention.” Educational programs raise public awareness/build knowledge of common health concerns, foster positive attitudes/behaviors, help reduce disability and disease prevalence, and are relatively cost-effective and, hence, should be highlighted.

CRITIQUE OF SOURCE

My secondary source is a systematic review and meta-analysis of prospective, controlled studies.

Strengths include:
 * Provides a rigorous review of a focused clinical question (i.e. How effective are interventional protective equipment, education, and training programs in concussion prevention?).
 * Follows a scientific plan and lays out an explicit structure for identifying, reviewing, and evaluating studies (e.g. authors established inclusion/exclusion criteria a priori, experts were consulted and multiple databases were scoured using a specific search strategy, sources were collected and appraised by several reviewers, etc.), increasing transparency and replicability of review.
 * Findings were presented as a quantitative summary and statistical synthesis (i.e. meta-analysis).
 * Discussion explores cross-disciplinary themes (e.g. economic effects of concussion briefly discussed) and considers diverse populations, increasing external validity/generalizability of systematic review.

Limitations include:
 * All studies were American, reducing external validity/generalizability of systematic review.
 * Many studies were outdated (10-15 years old), reducing credibility of findings.
 * Few RCTs were included, increasing risk of selection bias and reducing internal validity of systematic review.
 * Participants, evaluators, and assessors in most studies were not blinded, potentially creating conflicts of interest, increasing risk of misclassification bias, and reducing internal validity of systematic review.
 * Risk of bias was assessed using PEDro scale. Mean PEDro score was 3.5, indicating low internal validity of included studies.
 * There was considerable heterogeneity among included studies.

Based on aforementioned strengths/limitations, my secondary source is of low/moderate quality. Hence, my claims may be untrue (e.g. educational interventions may not be effective concussion prevention strategies). However, a more comprehensive systematic review on concussion prevention strategies does not exist and thus, Schneider et al. (2017) offer best available explanation of our current knowledge base.