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Practice Editing Here (Nov 15th in-class Wiki session work)

 * Amyloidosis

Task:


 * 1) Find a peer-reviewed journal article on PubMed. Practice inserting your citation in the above space using the "cite" tool
 * 2) Choose one "B-level" medical article on Wikipedia from the following list: https://wp1.openzim.org/#/project/Medicine/articles?quality=B-Class&importance=High-Class
 * 3) Practice editing live on Wikipedia by finding a typo in the text or improving the clarity/readability of a sentence by adjusting a few words in a sentence.

Assignment # 3- please post an anonymous copy here!
Proposed Changes

Old - There are about 30 different types of amyloidosis, each due to a specific protein misfolding. Some are genetic while others are acquired. They are grouped into localized forms, and systemic ones.

New - There are about 36 different types of amyloidosis, each due to a specific protein misfolding. Within these 36 proteins, 19 are grouped into localized forms, 14 are grouped as systemic forms, and 3 proteins can identify as either. These proteins can become irregular due to genetic effects, as well as through acquired environmental factors.

Rationale for Proposed Change

The original section had included outdated information from an article published in 2014. The new article, published in 2020, had allowed me to update the information to include a more in-depth understanding towards the different types of amyloidosis. This had updated the total number of amyloidosis forms, and had allowed me to include additional reference information.

Although there has been a minor increase in the different types of amyloidosis, I believe that this change is important as it is updated in regard to the current literature to provide more relevant, critical information pertaining to the topic. This also provides information on how the 36 types can be broken down into subgroupings.

Critique of Sources

The source that I have retrieved information from is recent, comes from a credible journal, and declares no sources of conflict. I understand that there is some bias as I had used this single article to update the 3 sentences in my selected section; however, due to it’s reputable nature I believe that this source improves the credibility of the pathophysiology of amyloidosis.

Proposed Changes

Old - There are several types with varying symptoms; signs and symptoms may include diarrhea, weight loss, feeling tired, enlargement of the tongue, bleeding, numbness, swelling of the legs, or enlargement of the spleen.

New - There are several non-specific and vague signs and symptoms associated with amyloidosis. These include: fatigue, peripheral edema, weight loss, shortness of breath, palpitations, and feeling faint with standing. In AL amyloidosis, specific symptoms can include enlargement of the tongue and periorbital purpura. Additionally in wild-type ATTR amyloidosis, non-cardiac symptoms include: bilateral carpal tunnel syndrome, lumbar spinal stenosis, bicep tendon rupture, small fiber neuropathy and autonomic dysfunction.

Source: Gertz, M. A., & Dispenzieri, A. (2020). Systemic Amyloidosis Recognition, Prognosis, and Therapy: A Systematic Review. JAMA, 324(1), 79–89. https://doi.org/10.1001/jama.2020.5493

Rationale for Proposed Change

Looking at the original section, they included signs and symptoms of the 4 different types of amyloidosis all into one category. It is important to note that there are different symptoms for the different types of amyloidosis. Additionally there were some symptoms which were not included in recent literature such as diarrhea. Also, in the study by Gertz et al., they mention that in a survey of 459 patients with amyloidosis, only 26% of patients reported they were given a diagnosis within 1 year of onset of symptoms while 49% reported that they had to see 4 or more physicians prior to diagnosis. Therefore, it is important to note the symptoms for amyloidosis can be non-specific and vague. Lastly, I added more wiki links to the symptoms listed.

Critique of Sources

The systematic review by Gertz et al., is a secondary source that is trust-worthy. After appraising the paper, critically analyzing the methods and looking up the protocol, I was unable to find significant sources of biases. The paper is published in JAMA (impact factor 56.27), which is a reputable journal in the scientific community. After conducting a review of the literature, this systematic review seems to be the most recently published article on this topic.

Proposed Changes

Current Article Section

Diagnosis may be suspected when protein is found in the urine, organ enlargement is present, or problems are found with multiple peripheral nerves and it is unclear why. Diagnosis is confirmed by tissue biopsy. Due to the variable presentation, a diagnosis can often take some time to reach.

Proposed Edits (to sentence highlighted above)

Amyloidosis is typically diagnosed through tissue biopsyª, with the exception of cardiac transthyretin amyloidosis, which can be diagnosed using scintigraphic imaging* if stringent criteria are met (Wisniowski & Wechalekar, 2020).

ªWiki-link to biopsy wikipedia page, *Wiki-link to the scintigraphy wikipedia page

Source

Wisniowski, B., & Wechalekar, A. (2020). Confirming the Diagnosis of Amyloidosis. Acta haematologica, 143(4), 312–321. https://doi.org/10.1159/000508022

Rationale for Proposed Change

The current version of the Wikipedia article suggests that tissue biopsy is required to confirm the diagnosis of all amyloidosis subtypes. However, this statement is overgeneralized and does not take into consideration an important exception for cardiac transthyretin amyloidosis, as highlighted in the review article by Wisniowski and Wechalekar (2020). The proposed change will include the noninvasive diagnosis of cardiac transthyretin amyloidosis using scintigraphic imaging, which is an important consideration for patients and healthcare providers.

Critique of Source

The Wisniowski and Wechalekar (2020) review article is a high-quality secondary source that summarizes the most recent evidence on the diagnosis of amyloidosis. This article is also published in a reputable journal and the authors declare no conflict of interest. After critically appraising the article, there does not appear to be any potential sources of bias or validity issues. Since the article is now a year old, it is possible that other studies may have alternative evidence for the diagnosis of cardiac transthyretin amyloidosis, however, this article appears to be the most recent secondary source summarizing the available evidence.

What to post on the Wikipedia article talk page (part of assignment 3)

 * This will also be covered on Nov 15th in class. Your group should use the below template to share an outline of your proposed improvements (including your new wording and citations). Article talk pages are not places to share your assignment answers. The Wikipedia community will be more interested in viewing your exact article improvement suggestions including where you plan to improve the article (which section), what wording you suggest, and the exact citation (Note: all citations must meet WP:MEDRS)
 * You will not be able to paste citations directly from your sandbox to talk pages (unless you are interested in editing/learning Wiki-code in the "source editing" mode). We suggest re-adding your citations on the talk page manually (using the cite button and populating the citation by pasting in the DOI, website, or PMID). You will have to repeat this process yet again when you edit the actual article live.
 * Talk Page Template: CARL Medical Editing Initiative/Fall 2021/Talk Page Template