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Practice Editing Here (Nov 23rd in-class Wiki session work)
Chronic Lymphocytic Leukemia
 * This is a place to practice clicking the "edit" button and practice adding references (via the citation button).

Assignment # 3
Assignment #3
 * Note: You will be emailing your assignment # 3 directly to your tutor, however, please paste a version here that excludes your personal information. This will allow us to support your efforts on Wikipedia prior to editing "live" in the article.

Proposed Changes:

In the Prognosis section, the first sentence says “Prognosis depends on the subtype”. I propose to replace this sentence with the following two sentences:

“Prognosis can be affected by the type of genetic mutation that the person with CLL has. Some examples of genetic mutations and their prognoses are: mutations in the IGHV region are associated with a median overall survival (OS) of more than 20-25 years, while no mutations in this region is associated with a median OS of 8-10 years; deletion of chromosome 13q is associated with a median OS of 17 years; and trisomy of chromosome 12, as well as deletion of chromosome 11q, is associated with a median OS of 9-11 years.

Rationale for Proposed Changes:

Presently, the Prognosis section starts with the sentence mentioned above: “Prognosis depends on the subtype”. The issue with this sentence is that different subtypes of chronic lymphocytic leukemia (CLL) are not mentioned anywhere else on the Wiki page. The fact that prognosis depends on subtype emerges out of nowhere and is provided with no context. On the other hand, in the causes section, it is mentioned that different genetic mutations could cause CLL. This information is mentioned here but then not touched on again. Thus, there is a huge discrepancy in the information presented on this page. That is why I propose to change the sentence completely from discussing different subtypes to discussing different genetic mutations. By doing so, the information on the page flows much more smoothly. As well, the reader can appreciate that prognosis could be affected by the different genetic mutations because it is mentioned earlier that different genetic mutations can cause CLL. I also propose to add the second sentence because it is important to provide some examples of the different mutations to the reader. It would be unhelpful to just mention that prognosis depends on different genetic mutations but not provide any other information about them, such as what types of mutations there are and how those mutations may affect a person’s prognosis. That is currently how this section is presented - it is mentioned that prognosis depends on the subtype, but that fact is not followed by any substantial or helpful information.

I used two references for my proposed changes. Both sources discuss how the different genetic mutations affect prognosis. The article by Bosch and Dalla-Favera provides a comprehensive review of the different mutations but does so with a lot of jargon. The website by the National Cancer Institute provides a good explanation as well, but does so in ways that are more understandable by the general public. Therefore, I thought it would be useful to use both of these sources together as they complement each other well.

I do not think that there is any real controversy or varied opinions about my proposed changes from subtypes to genetic mutations, except for the opinions I had myself when I began my search. I did an extensive search on the subtypes of CLL but I could not find any articles that spoke of the different subtypes. I managed to find some webpages that talked about how different leukemias, like hairy cell leukemia, is a subtype of CLL, but was unable to find that information verified in any resource that I could actually use.

1.     Bosch, F., & Dalla-Favera, R. (2019). Chronic lymphocytic leukaemia: from genetics to treatment. ''Nature reviews. Clinical oncology, 16''(11), 684–701. https://doi.org/10.1038/s41571-019-0239-8

2.     PDQ Chronic Lymphocytic Leukemia Treatment. National Cancer Institute. (2020). Retrieved 1 December 2020, from https://www.cancer.gov/types/leukemia/hp/cll-treatment-pdq?fbclid=IwAR2IsqOo5CXpdjE3WIou_N3HoUK3ObhdVApZSiD-dcPXLVWto6zgXktpZys#cit/section_1.44

Critique of Source

1. Bosch and Dalla-Favera Article

Weaknesses

The authors do not explain their methodology or their inclusion/exclusion criteria for the selection of their papers.

Strengths

In my opinion, the strengths of this article far outweigh the weaknesses. The authors discuss CLL and its genetic mutations and variations in an objective tone. The authors do not have any conflicts of interest. Lastly, the article was published in Nature Reviews, which has a very high impact factor (53.276). These strengths are why I wanted to include this article and its information on the Wikipedia page.

2. National Cancer Institute Source

Weaknesses

The website does not report the methodology of how they found the evidence (i.e. if a systematic search was conducted or not). They also do not discuss their inclusion/exclusion criteria.

Some of the information that is included is from articles that had very small sample sizes. I did not want to use that information because of that – however, that is why I decided to use a second source. The same information is reiterated in the review article which is why I felt confident in using it.

Strengths

The committee that reviews the research discussed on this page is independent from the National Cancer Institute (the publisher of the website). Thus, there is no conflict of interest for the reviewers. The information is represented in an objective tone.

What to post on the Wikipedia article talk page?

 * This will also be covered on Nov 23rd 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 2020/Talk Page Template