User:Oheid25/sandbox

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

 * This is a place to practice clicking the "edit" button and practice adding references (via the citation button).

Task:

Group 9-Mycosis Fungoides


 * 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.

My Contribution

 * 1) Proposed Change:*move after “scaling” and expand*  Itching (Pruritus) is the most commonly reported symptom of people experiencing Mycosis Fungoides with up to 88% of people reporting varying intensities of pruritus that typically  worsens as the disease progresses. Those that experience intense pruritus commonly indicate that it negatively affects their quality of life emotionally, functionally and physically.
 * 2) Rationale: In the current article the statistic about patient’s experiencing prurirtus is not reflective of more current literature. Additionally, there is no reference provided in the current article. Content about quality of life was added as this is something that would be directly person relevant and emphasizes how symptoms can interfere with a person's day to day function. The new information has come from a textbook chapter, systematic review and is supported by evidence from point a point of care resource (ex. DynaMed).
 * 3) Critique of sources: The textbook by Rangoonwala & Cascella, has been recently updated as of August 11, 2021 to give the most up to date information of the condition. The author’s state no conflict of interest in publication and provide a comprehensive overview of differences between different peripheral T-Cell Lymphoma. Since textbooks take longer to publish some of the sources used in this article are a little older, however due to the primary publication of this textbook being online, this allows the author’s to regularly monitor and update information and change citations as they are made available. The review article by Ottevanger et al., provides a comprehensive look into patient important symptoms of Mycosis fungoides, helping to quantify the effects of pruritus on quality of life at beginning of symptoms, middle and end of disease progression. Despite the thoroughness and recent publication of this article there are bias concerns as study author’s are on the data safety monitoring boards of two large pharmaceutical companies, with one author receiving remuneration for manuscript writing. Additionally an unrestricted grant for this review was provided by a pharmaceutical company. However, in this study there is no analysis of treatment efficacy or mention of any drug trial. I chose to still include this source despite the stated conflicts of interest as this systematic review analyzes in depth, validated methods for measuring pruritus in patients with Mycosis Fungoides and Sézary Syndrome and explores highly relevant clinical and patient important factors that are not explored to this level of detail in any other secondary source.

Proposed Change 1

 * 1) Addition: add sentence after “buttocks”* These lesions can start as insignificant patches and may remain undiagnosed for up to a decade. Hypopigmented (when the skin is lighter than normal) lesions are less common but can be found in children, adolescents and/or dark-skinned individuals.
 * 2) Rationale: An expansion was needed on the clinical relevance of lesions. Additionally, it is beneficial to include how lesions are presented in different populations, making the article more representative and accessible for varying audiences.
 * 3) Critique of Sources: The textbook includes the most up to date information in a 2022 version with all its recent updates. The database has also been last updated in The textbook also discloses conflict of interest in each section, helping us mitigate bias in its clinical guidelines. One potential area of critique is noting that the research may be focused on a very niche population (i.e., WEIRD samples) thus limiting the generalizability of the guideline. However, I chose to include this source as it provides good clinical relevance of lesions and may still be applicable to the majority of those diagnosed with MF. The DynaMed guideline was last updated in 2018 and is therefore considered a valid source as it is within 5 years of its publication. Additionally, the DynaMed guideline is regularly reviewed and verified using a GRADE scale.

Proposed Change 2

 * 1) Addition:*move after “scaling” and expand*  Itching (Pruritus) is the most commonly reported symptom of people experiencing Mycosis Fungoides with up to 88% of people reporting varying intensities of pruritus that typically  worsens as the disease progresses. Those that experience intense pruritus commonly indicate that it negatively affects their quality of life emotionally, functionally and physically.
 * 2) Rationale: In the current article the statistic about patient’s experiencing pruritus is not reflective of more current literature. Additionally, there is no reference provided in the current article. Content about quality of life was added as this is something that would be directly person relevant and emphasizes how symptoms can interfere with a person's day to day function. The new information has come from a textbook chapter, systematic review and is supported by evidence from point a point of care resource (ex. DynaMed).
 * 3) Critique of sources: The textbook by Rangoonwala & Cascella, has been recently updated as of August 11, 2021 to give the most up to date information of the condition. The author’s state no conflict of interest in publication and provide a comprehensive overview of differences between different peripheral T-Cell Lymphoma. Since textbooks take longer to publish some of the sources used in this article are a little older, however due to the primary publication of this textbook being online, this allows the author’s to regularly monitor and update information and change citations as they are made available. The review article by Ottevanger et al., provides a comprehensive look into patient important symptoms of Mycosis fungoides, helping to quantify the effects of pruritus on quality of life at beginning of symptoms, middle and end of disease progression. Despite the thoroughness and recent publication of this article there are bias concerns as study author’s are on the data safety monitoring boards of two large pharmaceutical companies, with one author receiving remuneration for manuscript writing. Additionally an unrestricted grant for this review was provided by a pharmaceutical company. However, in this study there is no analysis of treatment efficacy or mention of any drug trial. I chose to still include this source despite the stated conflicts of interest as this systematic review analyzes in depth, validated methods for measuring pruritus in patients with Mycosis Fungoides and Sézary Syndrome and explores highly relevant clinical and patient important factors that are not explored to this level of detail in any other secondary source.

Proposed Change 3:

 * 1) Addition:*Insert in the beginning of “The key difference between Sézary syndrome…*  People with mycosis fungoides can also develop Sézary syndrome (SS). SS is a rare leukemic variant where cancerous lymphocytes found in mycosis fungoides are also found in the blood (leukemic disease). It is referred to as leukemic mycosis fungoides, Sézary syndrome preceded by mycosis fungoides, or secondary mycosis fungoides. However, not all forms of Sézary syndrome are an advanced form of mycosis fungoides.
 * 2) Rationale: In the current article, they mention Sezary syndrome and mycosis fungoides, but do not explicitly introduce the relation of the two initially, which can be confusing for the reader. The relationship between the conditions is also unclear so we included more sentences describing it.
 * 3) Critique of resources: I used the website by the National Cancer Institute (NCI), ​​ the U.S. government’s principal agency for cancer research. Medical experts, cancer researchers, and editors review the content before it is published to the website to ensure the material is evidence based and relevant to new literature. It was also last updated on August 27, 2021. The website also has a page dedicated to disclaimers, where they describe their lack of affiliation with any organization, commercial products, processes, or services, etc so they describe any conflicts of interests (none).

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