User:Leesclash/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

= Alpha-thalassemia =

Assignment #2
1) How you searched for a source (search strategy – where you went to find it).

While the focus of the Wikipedia article was on the effects of alpha-thalassemia in early life, there was no information on how alpha-thalassemia impacts life in adulthood, specifically in women looking to have children. Thus, my objective for this assignment was to address the question: “What additional measures are needed to ensure optimal pregnancy in a patient with alpha-thalassemia?” I searched the MeSH database and found the MeSH Heading of alpha-Thalassemia listed entry terms as A-Thalassemia, Alpha Thalassemia, Hemoglobin H Disease, and Thalassemia-alpha. As such, I inputted the following search details into PubMed:

((("alpha-thalassemia"[MeSH Terms]) OR ("α-thalassemia") OR ("alpha" AND "thalassemia") OR ("A-Thalassemia") OR ("Hemoglobin H Disease") OR (Thalassemia-alpha)) AND Review[ptyp] AND "last 5 years"[PDat]) AND pregn*

2) What potential sources were identified and considered (give examples of 1 or 2).

Lao, T. T. (2017). Obstetric care for women with thalassemia. Best Practice & Research Clinical Obstetrics & Gynaecology, 39, 89–100. doi: 10.1016/j.bpobgyn.2016.09.002

Origa R. & Comitini F. (2019). Pregnancy in Thalassemia. Mediterr J Hematol Infect Dis, 11, 1. doi: 10.4084/MJHID.2019.019

3) Why the source was chosen (what made it better than other choices).

Both articles were secondary sources as review papers, and discussed cases of care management in patients with thalassemia. However, I chose the first paper as it gave more detailed information on the management of cases with obstetric care in alpha thalassemia patients, while the second paper provided more general information for all cases of thalassemia. Furthermore, the journal of the first paper, Best Practice & Research: Clinical Obstetrics & Gynaecology, was more relevant and focused on the question of interest than the second, and also had a higher impact factor. Thus, despite the second paper being more recent, the first paper provided more relevant information to better address the question of interest.

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


 * 1) This source was published within the last five years [Use up-to-date evidence]
 * 2) This was a review article [Respect secondary sources]
 * 3) This source was published within the journal “Best Practice & Research: Clinical Obstetrics & Gynaecology”, which provides a comprehensive review of current    clinical practice and guidelines in obstetrics and gynaecology. [Summarize scientific consensus]

5) How do you plan to use the source for improving the article?

I plan to use this source to enhance the treatment section of the alpha-thalassemia Wikipedia article. While the current treatment section focuses only on treatment at birth and early life, this source would provide information on treatment for later adult stages of life, with an added focus on treatments needed for pregnancy as a later life decision.

Assignment #3
* Completed with Brett Rothery

Proposed Changes:
Replace second sentence in introduction:

“Alpha-thalassemia is due to impaired production of alpha chains from 1, 2, 3, or all 4 of the alpha globin genes, leading to a relative excess of beta globin chains.”

With:

"Thalassemias are a group of inherited blood conditions which result in the impaired production of hemoglobin, which is the molecule that carries oxygen in the blood. Normal hemoglobin consists of two alpha chains and two beta chains; in alpha-thalassemia, there is a quantitative decrease in the amount of alpha chains, resulting in fewer normal hemoglobin molecules. Furthermore, alpha-thalassemia also leads to the production of unstable beta globin molecules which result in red blood cell destruction."

'''LW Comment: Nicely done! This is very clear and concise, you have avoided using jargon and used wiki-links appropriately. I might just change the last sentence to "Furthermore, alpha-thalassemia leads to the production of unstable beta globin molecules which cause increased red blood cell destruction."'''

Rationale for Proposed Change:
Rationale:

The proposed changes to this article surround the need to clarify the Introduction, in particular, making it more accessible to the layperson. In its current state, the Wikipedia article for Alpha-thalassemia has an Introduction that is inadequate in its ability to clearly and definitively explain to a non-medical reader what the particular pathophysiology of the disease is. The language used is fairly unapproachable and written at a level that requires a degree of knowledge that should not be expected of someone from the general public. In particular, we took issue with the lack of explanation of what a "thalassemia" actually is, the lack of explanation briefly of what the functionality of hemoglobin is, and the overall the expectation of readers to have a fairly sophisticated understanding of genetics in order to understand some of the nuance of the pathophysiology of the disease. Broadly, all of these changes are necessary in order to make the Wikipedia article more approachable and understandable to those in the general public, as Wikipedia is commonly used as a primary source of information for individuals who wish to access knowledge about a topic in a comprehensive and concise fashion.

The first sentence that we propose to change offers to solve the issues of not having a proper definition for "thalassemias" and describing the role of hemoglobin in the blood, which are key features missing from the original Introduction. Important related pages of Wikipedia have been referenced to support the understanding of our proposed change, but in general would not be critical as the new sentence makes the article more approachable to the layperson without taking away from the complexity and nuance that is necessary for somewhat complicated genetic disorders. The second sentence that we propose to change acts to address the issue in the original article of having a lack of explanation of what the pathophysiology of the disease is, in part due to broad and convoluted sentences about higher level genetics concepts. Instead, this has been changed to once again reflect the nuance of the disease at hand and not take away from its complexity, while still laying out clearly what the changes that are required to allow this disorder to appear in an individual, with associated links for more information. Lastly, our third proposed sentence takes on the issue in the original article of not explaining concisely how the genotype of the disease appears as a particular phenotype, and how this manifests physically.

'''LW Comment: Excellent rationale. You are right, the original introduction does not help matters much, and your additional sentences would be a big help.'''

The below listed reference was the source for all three sentences that are proposed to be added to the Wikipedia article for Alpha-thalassemia.

Reference Used:

Lanzkowsky's Manual of Pediatric Hematology and Oncology 6th Edition (2016)

LW Comment: Good choice of resource.

Controversy:

As mentioned before, the primary purpose of the Introduction of a Wikipedia article is to deliver a brief overview of key points. While changes to other sections of our article, such as Treatments, could create controversy if they appear to be biased towards one treatment, the Introduction serves as a non-biased short summary of our topic for both healthcare professionals and lay people. As such, I do not see any major controversy from the proposed addition of our 3 sentences.

Given that our changes completely replace a sentence written by another prior editor(s), it is possible that the original editor(s) will disagree with our changes. However, our proposed changes have a greater focus on explaining the context of Alpha-thalassemia as compared to the prior introduction, and while they lengthen the introduction by a couple sentences, we believe they greatly facilitate the comprehension of the article and allow for a better understanding of the other sections regardless of the reader's level of clinical knowledge. As such, our proposed changes render the article considerably more accessible and maintain a proper level of complexity and accuracy given the potential audience being the entire general public.

LW Comment: Good discussion of implications of changing the first few sentences of the article, but correctly identified that there is nothing controversial in the new sentences themselves.

Critique of Source:
The one source that we used for our changes to the introduction was a textbook, Lanzkowsky's Manual of Pediatric Hematology and Oncology, 6th Edition [2016]. This source is a highly respected secondary-source within the field of clinical genetics and has been directly referenced in journals dozens of times. In addition, while the textbook is 3 years old, it is the most recent edition of Lanzkowsky's Manual of Pediatric Hematology and Oncology. The editors of the textbook do not appear to have any financial relationships which might present any conflicts of interests, and given the nature of the source, being a textbook as compared to a systematic review of a new clinical treatment, there is little evidence of any direct bias. However, in terms of the hierarchy of evidence, there are some issues with using textbooks as they present weaker evidence as compared to other secondary-sources such as a systematic review or a meta-analysis. While textbooks are considered secondary-sources because of their gathering of findings from a number of inputs, they are often also integrated with the expert opinion of one or a few authors. As such, this source is more susceptible to bias than other secondary-sources. Nonetheless, the Introduction of any Wikipedia article requires a level of foundational knowledge that is most clearly disseminated through a source such as a textbook, and given that our source was cited to provide a definition, it was chosen, taking into the account the high level of credibility given the nature of the textbook.

'''LW Comment: Well said. Good critique and evaluation of the source.'''