User:Kaiserbun/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.

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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

= Alpha-Thalassemia. =

Assignment #2:
Kwiatkowski J.L. (2019). Alpha-thalassaemia. In BMJ Best Practice. Retrieved from https://bestpractice.bmj.com/en-gb/250

1)      How did I search for the source?

Initially, I searched BMJ Best practice using the term “alpha-thalassemia”. As well, I searched PubMed using MeSH terms including “alpha-thalassemia” and “clinical characteristics”. I limited this search so that it only included reviews. The search details included:

("alpha thalassaemia"[All Fields] OR "alpha-thalassemia"[MeSH Terms] OR "alpha-thalassemia"[All Fields] OR ("alpha"[All Fields] AND "thalassemia"[All Fields]) OR "alpha thalassemia"[All Fields]) AND (clinical[All Fields] AND characteristics[All Fields]) AND Review[ptyp]

2)      Which other sources were considered?

Origa, R., & Moi, P. (1993). Alpha-Thalassemia. In M. P. Adam, H. H. Ardinger, R. A. Pagon, S. E. Wallace, L. J. Bean, K. Stephens, & A. Amemiya (Eds.), GeneReviews®. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK1435/

Harteveld, C. L., & Higgs, D. R. (2010). α-thalassaemia. Orphanet Journal of Rare Diseases, 5(1). doi: 10.1186/1750-1172-5-13

3)      Why was the source chosen?

This source was chosen because it provided a comprehensive list of clinical characteristics, diagnosis, and treatments that are found in patients with alpha-thalassemia. Compared to other sources, this source is a clinical practice guideline shared by BMJ Best practice compared to only reviews; it is more recent; it was not previously used in the current Wikipedia page as a source.

4)      List at least three reasons why the source that was selected meets Wikipedia’s reliable medical sources (MEDRS) criteria?

a)       MEDRS criteria recommends using “up-to-date evidence” and the source selected was updated within the last 5 years (2019).

b)      MEDRS criteria recognizes “statements and clinical practice guidelines shared by major medical/scientific authorities” as reputable sources to use, which includes BMJ Best Practice.

c)       MEDRS recommends using sources that have low bias. BMJ Best Practice guidelines limits its biases because they are reviewed by multiple experts in the field using rigorous and continuous evidence-based editorial processes.

5)      How do I plan on using this source for improving the article?

I plan on using this source to improve the Wikipedia article by providing more signs and symptoms of the disease (ex. splenomegaly, growth retardation). As well, the prevalence of each symptom will be added (common vs. noncommon) and whether it is a clinical characteristic in one type of alpha-thalassemia (ex. Hb H disease), or all types.

Assignment #3:
Proposed Changes:

Under the signs and symptoms for alpha-thalassemia, we propose adding:

COMMON

Anemia: People with alpha-thalassemia can experience both a decrease in the production of red blood cells (RBC) and an increase in the destruction of RBCs which can result in other symptoms such as fatigue and dizziness.

Enlarged spleen

Gallstones

Delayed growth

UNCOMMON

Jaundice

Pronounced forehead

Extramedullary hematopoiesis (blood formation outside of the bone marrow)

Hypertension (in pregnancy)

'''LW Comment: Excellent additions to the article. Avoided use of jargon and appropriately used wiki-links.'''

Rationale for Changes:

The reasoning for choosing these edits was to provide more overall signs and symptoms for alpha-thalassemia as they were original lacking. For all these symptoms we chose to use BMJ Best Practice as the source. This change provides almost double the signs and symptoms while also providing a distinction between which ones may be more common compared to others in individuals with alpha-thalassemia.

As well, anemia was provided a definition since it is not a common medical word that many people may know but is still important to understand in the context of alpha-thalassemia. The source for the definition was also BMJ Best Practice.

Controversy may arise from separating the symptoms into common and uncommon. These symptoms are based only on BMJ Best Practice and may vary somewhat depending on which other sources of literature are used. Overall, separating common and uncommon symptoms are important so that the readers understand that individuals with alpha-thalassemia can experience a range different clinical manifestations of the disease.

'''LW Comment: Good rationale. This is an important change to the article, to flesh out the signs and symptoms of the disease.'''

'''Interesting take on the controversy segment. I don't think that ultimately this would be too controversial, but it's a good thought.'''

Critique of Source:

The sources used for the proposed changes to this section both come from BMJ Best Practice. This form of evidence is referred to as clinical practice guidelines and falls at the very top of the hierarchy of research designs and level of scientific evidence. Generally, this has very low biases because they are reviewed by multiple experts in the field using rigorous and continuous evidence-based editorial processes. However, some biases that arise from using BMJ Best practice could include financial and conflicts of interest. Many of these reviewers have other academic positions and work with other companies which could indirectly affect their contributions to the clinical practice guidelines. Other biases could include positive publication bias, in which majority of the information is based on publications that only have positive findings, rather than incorporating studies that have negative results as well. Finally, while BMJ Best Practice is continually being edited with evidence bases processes (edited as of 2019), many of the studies that they use from 10-20 years ago may not be relevant to today.

'''LW Comments: Excellent! Very good point about the positive publication biases, and noting the use of older studies to form the best practice guidelines.'''