User:Mishka 337/sandbox

ARTICLE EVALUATION

Q. Is everything in the article relevant to the article topic? Is there anything that distracted you?

The article provides a brief overview of the signs and symptoms of encephalitis, causes, diagnosis, treatment, prevention and epidemiology. Text and images within these sections are relevant to the article topic and the section topic. For example, the section on causes of encephalitis includes a detailed image of rabies, which is a viral cause of encephalitis. The only distracting element is a video of dendritic cells being trafficked during taxoplasmosis, as it is not immediately obvious how dendritic cells are related to the topic.

Q. Is the article neutral? Are there any claims, or frames, that appear heavily biased toward a particular position?

Yes. The article presents a wide range of information about encephalitis (although no section is particularly comprehensive) that does not bias towards or against any individual, issue, position, or perspective related to the disease or its causes. However, this neutrality may just be a by-product of the general lack of detailed information in the article, so there is not enough information presented to detect any bias. There may be a possible slant in the article towards portraying the disease as highly significant and serious (similar to the tone of a grant application where the clinical relevance of the proposed subject is often emphasized) although encephalitis is indeed a significant and serious disease. More importantly, having this slant does not misinform the reader or convey false information, so the impact on clarity and truthfulness is minimal.

Q. Are there viewpoints that are overrepresented, or underrepresented?

From a search of the available literature, causes, presentation, diagnosis and treatment of encephalitis seem to be well established and agreed upon by the medical community. Although brief, the current page provides a comprehensive overview of the disease in these respects. It presents different types of encephalitis and directs readers to the appropriate sources for more detailed information. However, the page does lack information in certain areas. Classification of primary versus secondary encephalitis is not mentioned on the current page. Risk factors and complications from the disease are not included. Self management (e.g. practicing good hygiene, using mosquito repellent) in prevention is underrepresented.

Q. Check a few citations. Do the links work? Does the source support the claims in the article?

We randomly selected 5 citations from the 24 references to cross the arbitrary criteria of 20% reference check. All 5 of the references were active, i.e. their links worked and redirected the user straight to the resource. The cited sections generally seem to take accurate information from the corresponding resources and overall, there is no information on the Wikipedia page that conflicts with information provided in any of the checked references. However, for one of the references (#7), there was mention of "irritability, poor appetite and fever" in younger children or infants, but there was no mention of this in the cited resource (or in any of the other randomly checked resources). We are not certain where this information came from and suspect that this might be a case of incorrectly referencing the source. To a larger extent, we think this page suffers through omission as the information presented is not extensive and some thorough and well-researched resources are used simply for one-line statements. Reference numbers 1, 4, 7, 10, 13 were used for the random check.

Q. Is each fact referenced with an appropriate, reliable reference? Where does the information come from? Are they secondary sources? Are these neutral sources? If biased, is that bias noted? “Post-infectious encephalomyelitis complicating smallpox vaccination is avoidable, for all intents and purposes, as smallpox is nearly eradicated.[21] “ in the prevention is not an appropriate as the reference from a media statement from the center for disease control contains content that is unrelated to the statement. Reference number 3 is used to define what Encephalitus is but the reference is not highly reliable as it is a online free dictionary. A number of times popular health websites are referenced, for example the NHS is referenced in citations 17 and 7. When you follow the links, the NHS does not cite any of their information regarding the symptoms and treatment of Encephalitus so the accuracy and validity of this information is unclear. All of the sources are secondary, and a variety of resources are used, for example they include websites for the World Health Organization and the Center of Disease Control. Much of the factual information is not referenced, for example, “Encephalitis lethargica is identified by high fever, headache, delayed physical response, and lethargy. Individuals can exhibit upper body weakness, muscular pains, and tremors, though the cause of encephalitis lethargica is not currently known.”. Overall I was unable to find any sources that appeared biased.

a) Other possible viral causes are arbovirus (St. Louis encephalitis, West Nile encephalitis virus), bunyavirus (La Crosse strain), arenavirus (lymphocytic choriomeningitis virus) and reovirus (Colorado tick virus).[10] - source is from 2004: Kennedy, P. G. E. (2004-03-01). "Viral Encephalitis: Causes, Differential Diagnosis, and Management". Journal of Neurology, Neurosurgery & Psychiatry. 75 (Suppl 1): i10–5. PMC 1765650 Freely accessible. . doi:10.1136/jnnp.2003.034280.

b) "may be a complication of a current infectious disease syphilis (secondary encephalitis).[12]" - source from 2008: Hama, Kiwa; Ishiguchi, Hiroshi; Tuji, Tomikimi; Miwa, Hideto; Kondo, Tomoyoshi (2008-01-01). "Neurosyphilis with Mesiotemporal Magnetic Resonance Imaging Abnormalities". Internal Medicine. 47 (20): 1813–7. . doi:10.2169/internalmedicine.47.0983.

c) "The number of new cases a year of acute encephalitis in Western countries is 7.4 cases per 100,000 population per year. In tropical countries, the incidence is 6.34 per 100,000 per year" - Jmor F, Emsley HC, et al. (October 2008). "The incidence of acute encephalitis syndrome in Western industrialised and tropical countries". Virology Journal. 5 (134): 134. PMC 2583971 Freely accessible. . doi:10.1186/1743-422X-5-134.

NOTE: these particular fact may have changes significantly since 2008!

Overall, it seems that each of the categories, especially diagnosis, treatment, prevention, epidemiology.

Q. Check out the Talk page of the article. What kinds of conversations, if any, are going on behind the scenes about how to represent this topic? Outline the article as it stands. What do you plan to contribute?

- We can improve the image captions so readers can clearly understand the relationship between the images/videos and the article topic

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Assignment 2:

Articles:  Assignment #2 - Emily W

1) how they searched for their source (search strategy – where you went to find it)

- Searched Pub Med with MeSH term “encephalitis” - selected first “encephalitis” then checked epidemiology add to search builder  selected systematic reviews  resulted in 23 articles

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

Sources:

Venkatesan A. Epidemiology and outcomes of acute encephalitis. Curr Opin Neurol. 2015;28(3):277–82.

Stahl J-P, Mailles A. What is new about epidemiology of acute infectious encephalitis? Current Opinion in Neurology. 2014;27:337–341.

Khandaker, G., Jung, J., Britton, P. N., King, C., Yin, J. K. and Jones, C. A. (2016), Long-term outcomes of infective encephalitis in children: a systematic review and meta-analysis. Dev Med Child Neurol, 58: 1108–1115.

3) why the source was chosen

Venkatesan A. Epidemiology and outcomes of acute encephalitis. Curr Opin Neurol. 2015;28(3):277–82.

I chose this source firstly because it is a recent (2015) systematic review. This review includes specific mortality rates for different subcategories or strains of encephalitis, which would add much needed perspective to the Wikipedia page. It is the most up to date and relevant review for the purposes of my search for epidemiology of encephalitis.

4) list at least three reasons why the source that was selected met Wikipedia’s reliable medical sources criteria

-	The source was published within the last 5 years -	The source is a systematic review of multiple primary and secondary sources -	The source provides an overview of current understanding of the topic

5) how you plan to use the source for improving the article

This article provides information that will improve the wiki article’s epidemiology section. The article includes mortality rates of acute encephalitis, herpes simplex encephalitis, West Nile virus associated encephalitis, and other arboviral enciphalitides. Including these mortality rates will update the article and provide further perspective on the condition’s severity in different populations. Interestingly, the article also points out that changes in the epidemiology will be effected by climate change and vector patterns, which leaves me curious to consider further studies about climate change and patterns in encephalitis, and potentially include a subsection on this in the wiki article.

Daniel:

1) How they searched for their source (search strategy – where you went to find it)

I searched Pubmed’s MeSH database for the term ‘Encephalitis’ and the subheading ‘Drug Therapy’. Modified in the search box with ‘AND national guideline’, and limited to past 5 years.

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

1. Backman R. et al. The development of an intervention to promote adherence to national guidelines for suspected viral encephalitis. Implement Sci. 2015 Mar 20;10:37. This source was ultimately not used because it is actually a primary research article investigating an intervention to increase physicians’ adherence to national guidelines for the management of encephalitis.

2. Kelly C. et al. Suboptimal management of central nervous system infections in children: a multi-centre retrospective study. BMC Pediatr. 2012 Sep 7;12:145. This source was ultimately not used when compared with the eventual article because it did not focus specifically on encephalitis, and also was a primary research article.

3) Why the source was chosen

Final source: Kneen R. et a. Management of suspected viral encephalitis in children - Association of British Neurologists and British Paediatric Allergy, Immunology and Infection Group national guidelines. J Infect. 2012 May 64(5):449-77. This source was chosen because the type of publication (national guideline) is considered to have one of the highest levels of evidence quality. Moreover, the source was chosen for its broad focus, which allows us to maximize our use of this paper to both input new content into the Wikipedia article and also serve as a cross-reference for information derived from other sources. Finally, we considered the focus on viral encephalitis and children as the target population to be the most relevant for inclusion in our article because these represent the most common cause and target population of encephalitis

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

1. The source is a guideline jointly published by two relevant national organizations (the British Association of Neurologists and the British Infection Association) which suggests its content reflects the broad consensus of the clinical community in Britain.

2. As a national guideline for encephalitis management, this source represents one of the highest quality types of evidence because the findings presented are the aggregate of many (themselves high quality) primary studies. Moreover, the authors actually discuss the quality of the primary studies they cite in their guideline.

3. The source is up-to-date. Wikipedia’s rule of thumb for review articles is 5 years, and this guideline was published in 2012. Moreover, no subsequent review has been published to replace this review, as the British Infection Association lists this as the most up-to-date guideline for encephalitis management in their database.

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

I plan to use this source to expand on the depth of the content of the article. Specifically, I plan to clarify the differences between adult and child presentations of encephalitis in the ‘signs and symptoms’ subheading. I plan to expand on the ‘diagnosis’ section by clarifying the challenges of differential diagnosis between viral encephalitis and other causes of encephalitis, and more fully explaining the different diagnostic tests/techniques involved (e.g. PCR, brain biopsy, MRI) Finally, I plan on expanding the ‘treatment’ section by providing examples of different antivirals (e.g. aciclovir) that can be used, and also adding a paragraph on contraindications and other precautions to take into consideration for treatment. I chose these sections because I believe they are especially relevant for the management of encephalitis in a clinical setting, which is important because of how Wikipedia is sometimes used as a source of medical advice.

 Natasha: 

Source:

Case Definitions, Diagnostic Algorithms, and Priorities in Encephalitis: Consensus Statement of the International Encephalitis Consortium, Clinical Infectious Diseases, Volume 57, Issue 8, 15 October 2013, Pages 1114–1128, https://doi.org/10.1093/cid/cit458

1) I started by searching BMJ for “encephalitis”. BMJ had an extensive references list highlighting the key resources used to write the overview, which I used to find a source.

2) I identified four systematic reviews or physician guidelines in BMJ’s “Key resources” list and evaluated them as potential sources. Examples include a guideline on the management of encephalitis written by the Infection Diseases Society of America and a guide to managing encephalitis in children, written by a British association of pediatricians and neurologists.

3) This source was chosen among the four systematic reviews/guidelines because it was published most recently (in 2013) and because it focused on how to diagnose and manage encephalitis. Most of the other resources in the “key resources” list focused only on the management aspect, and didn’t provide a lot of information on the causes and diagnostic procedures used to identify encephalitis.

4) One: The source is a medical guideline and position paper from an internationally recognized body: the International Encephalitis Consortium

Two: The source is recent as it was published <5 years ago in 2013

Three: The source is published independently of the research, and draws on many primary and secondary sources to make its conclusion.

5) The source can be used to add more detail to almost every section of the Wikipedia page. Since it focuses on diagnosing and managing encephalitis, we can use to greatly expand the diagnosis and treatment section of the page. The source also highlights new research priorities, such as host-genetics interactions for viral causes of encephalitis, which could be used to add a new section (ex. “future developments”) on the Wikipedia page or update an existing section (ex. "viral causes of encephalitis"). Finally, the source also discusses emerging infections, which can contribute to the epidemiology section of the Wikipedia page.

Vithusha

1. PubMed was searched using the following strategy: “autoimmune encephalitis”, “diagnosis” and “treatment”. Results were restricted to review articles only.

2. The selected article was “The diagnosis and treatment of autoimmune encephalitis”. Another review, “Autoimmune encephalitis: recent updates and emerging challenges” by Ramanathan et al. was identified in the same search. It was not considered because upon further review, the article explored recent findings in the field that have not been well investigated and were still under scrutiny.

3. The article by Lancaster et al. was selected because it provided an overview of the various subtypes and pathophysiologies of autoimmune encephalitis with diagnostic approaches and infectious causes of encephalitis. As there is already a more in-depth page on the topic of autoimmune encephalitis, information from this comprehensive overview is appropriate for a general page on encephalitis.

4. This paper was written by a neurologist, and published in a peer-reviewed journal. It is an example of a secondary source, it compiles and summarizes information that is well-established.

5. I plan to use this source to provide some more information and expand on the section on autoimmune encephalitis. The information on causes and diagnoses will provide unique characteristics of the condition and differentiate this section from other forms of encephalitis.

Sources: Lancaster E. The diagnosis and treatment of autoimmune encephalitis. J Clin Neurol 2016;12(1):1-13.

Ramanathan S, Mohammad SS, Brilot F, Dale RC. Autoimmune encephalitis: recent updates and emerging challenges. J Clin Neurosci 2014;21(5):722-30.