User:Julia.dhk/sandbox

Comments for assignment 3

Well done. Some minor comments to consider:

Minor wording changes to your sentence: Actinic keratosis may progress to invasive squamous cell carcinoma (SCC) but both diseases can present similarly upon physical exam and can be difficult to distinguish clinically. Histological examination of the lesion from a biopsy or excision may be necessary to definitively distinguish AK from in situ or invasive SCC.  (source)

I agree with avoiding adjectives such as "simply" to improve the objectiveness of the sentence. Did you come across the reference source for that original sentence "many scientists argue ..." It would be interesting to find out how accurate is this statement. What is the opinion of Fitzpatrick on this?

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

Actinic keratosis

== Assignment 2 == Reference: Heppt MV, Schlager G, Berking C. Epithelial Precancerous Lesions. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, Orringer JS. Eds. Fitzpatrick’s Dermatology, 9e New York, NY: McGraw-Hill; http.accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectioned=210434201. Accessed November 06, 2019.

Search strategy
From our group discussion, we felt the need to improve the introductory paragraph in the diagnosis section of actinic keratosis and clearly introduce its significance with respect to squamous cell carcinoma. This required some clinical and histopathological context so I referred to UpToDate as a tertiary point-of-care source and AccessMedicine for foundational textbooks with focused topics on actinic keratosis. I searched for the terms “actinic keratosis” on UptoDate and “actinic keratosis carcinoma” to look for texts that detailed the relationship between actinic keratosis and relevant carcinomas.

Potential sources
Harbour P, Song DH. The Skin and Subcutaneous Tissue. In: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Kao LS, Hunter JG, Matthews JB, Pollock RE, eds. Schwartz’s Principles of Surgery, 11e New York, NY: McGraw-Hill; http: accessmedicine.mhmedical.com/content.aspx?bookid=2576&sectioned=216206374. Accessed November 06, 2019.

Padilla RS. Epidemiology, natural history, and diagnosis of actinic keratosis. Robinson JK, ed. UpToDate. Corona R: UpToDate Inc. https://www-uptodate-com.myaccess.library.utoronto.ca/contents/epidemiology-natural-history-and-diagnosis-of-actinic-keratosis?search=actinic%20keratosis&topicRef=5336&source=see_link (Accessed on November 06, 2019.)

Why the source was chosen
This specific source was chosen because the whole textbook is dedicated to dermatology and the book chapter on actinic keratosis covered various aspects of this disease in detail. This was in contrast to the first potential source, which focused on surgery and thus, only presented relevant details of actinic keratosis. Additionally, while UpToDate page on the diagnosis of actinic keratosis provided a wealth of information on diagnosis and its importance in differentiating between actinic keratosis and squamous cell carcinoma, the selected source provided more contextual information.

Three reasons why selected source meets MEDRS criteria
The selected source meets MEDRS criteria because:

1.     It is medical textbook published by academic publishers so it is reliable

2.     It provides neutral statements that have been established by the field.

3.     The textbook is in its ninth edition (2019) so it is recent and relevant.

Plan on using the source to improve the article
I plan to use this source to clearly present the diagnostic process and the underlying purpose of using additional tools in distinguishing between actinic keratosis and squamous cell carcinoma beyond clinical presentation.

Proposed changes
I propose a change to the following sentence in the diagnosis section “Actinic keratosis and squamous cell carcinoma (SCC) can present similarly on physical exam, and many scientists argue that they are in fact simply different changes of the same condition.” I would like to avoid non-concrete words such as “simply” and “changes” and clarify the relationship between AK and SCC.

This sentence can be changed to “Actinic keratosis may progress to invasive squamous cell carcinoma (SCC) but both diseases can present similarly upon physical exam and can be difficult to distinguish. A histological examination of a biopsy can be performed to exclude SCC with certainty in the differential diagnosis."

Rationale for proposed changes
The proposed sentence clarifies the vague wording and broad terms used, such as “changes” and “condition”, while also explaining the significance of biopsies to the diagnosis of actinic keratosis (AK). Additionally, the current sentence suggests that there is controversy surrounding the distinguishing characteristics of AK and squamous cell carcinoma (SCC). However, AK has been established to potentially precede SCC but how different grades of AK progress to SCC histologically is still debated. This specific topic is very narrow in scope and would require support from research findings and thus, not included in a Wikipedia article which acts as an encyclopedia.

Critique of source
The selected source is a medical textbook published by reliable academic publishers and remains recent and relevant in its edition. Textbooks are a secondary source and written and edited by experts within the field, allowing for bias based on their expertise and practice. The textbook claims diversity in its expertise and global practice but the majority of their editors are from US institutions and practice guidelines may differ in other countries where AK is a common condition (e.g. Australia). Additionally, textbooks may be prone to gender and racial bias where there is a lack of representation of darker tones, which may narrow the scope and applicability of the source. However, the limitations of the source used here is unlikely to negatively influence the quality of information that was specifically used for the proposed edit because it is established in the field.