User:Paradise376/sandbox

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 * 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

= Noonan Syndrome =

ASSIGNMENT #2
Pardis Balari

Roberts, A. E., Allanson, J. E., Tartaglia, M., & Gelb, B. D. (2013). Noonan syndrome. The Lancet, 381(9863), 333–342. doi: 10.1016/s0140-6736(12)61023-x

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

I found my source on PubMed by using the search term “Noonan Syndrome”. My search strategy included implementing filters on the article types (Review only) and publications dates (from 2013 to present) and then sorting results by Best Match.

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

106 results were presented when the aforementioned search strategy was used. An example of another source that was considered is:

Yart, A., & Edouard, T. (2018). Noonan syndrome: an update on growth and development. Current Opinion in Endocrinology & Diabetes and Obesity, 25(1), 67–73. doi: 10.1097/med.0000000000000380

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

The source was found on PubMed, which is a reliable database. Furthermore, the Lancet, the journal that published the source, is a prestigious peer reviewed journal, which further guarantees the quality of this source. Lastly, the chosen source is detailed enough to include necessary and fundamental information on the diagnosis of the syndrome (my area of focus), compared to some other sources considered, which mainly focused on just one aspect of the syndrome.

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

1) The source is from within the past 7 years (and thus reflects current knowledge) 2) The source was published in a high-quality journal (The Lancet) 3) The source is not a primary source (ie, clinical trial) but rather a secondary source

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

I hope to use the sources’ information on prenatal features, diagnosis, and screening of Noonan Syndrome to add onto the “Diagnosis” section of the Wikipedia article, as it lacks comprehensive information on prenatal screening, which, for example, could be helpful for an expecting mother who is worried about her baby having Noonan Syndrome.

ASSIGNMENT #3
The content under "Ultrasound" in the "Diagnosis" section currently reads as:

"First-trimester ultrasound of Noonan syndrome may reveal nuchal edema or cystic hygroma similar to Turner syndrome. Follow-up scans may show clinical features as described above. A study shows this disease is also associated with hepatosplenomegaly and with kidney anomalies including malrotation and a solitary kidney. A rare case of choledochal cysts is also reported."

Proposed Changes

"Diagnosis" Section

Change #1: Change "Ultrasound" subsection to "Prenatal Diagnosis"

Change #2: Edit and expand on the current first sentence of this subsection (see Change #3), while removing the rest of the subsection

Change #3: Add the following two sentences to expand on this subsection:

"Prenatal diagnosis of Noonan Syndrome is guided by features including cystic hygroma, increased nuchal translucency, pleural effusion, and edema. More specifically, Noonan Syndrome diagnosis happens in 1-3% of cases of first trimester nuchal edema, and <10% of cases of second trimester cystic hygroma. "

Rationale for Proposed Change

Change #1: The diagnosis section of the Noonan Syndrome article currently has minimal information regarding prenatal diagnosis and features of the syndrome, which could potentially provide valuable information for a pregnant individual who has just been told their unborn baby might have Noonan Syndrome. The subheading of "Ultrasound" currently seems too vague and unrelated to the "Diagnosis" section. Renaming it to "Prenatal Diagnosis" and populating it with information regarding prenatal diagnosis would be a more relevant and informative use of this section.

Change #2: The current first two sentences under the "Ultrasound" subsection seem to be referring to fetal ultrasounds, whereas the following sentences are referring to abdominal ultrasound performed on people with Noonan Syndrome to identify any abdominal anomalies. The current second half of this section seems to be nonsensical and unrelated to the diagnosis section. Furthermore, the reference for this part is one primary study published in the Pediatric Radiology journal in 1993. I propose removing this second half of the section (from "Follow-up scans may show..." to the end of the paragraph) as it is unrelated to the section and also because the reference for it does not meet the Wikipedia guidelines of being a secondary source from the past seven years.

Change #3: I will be expanding on the first two sentences of this section by using information from a review in the Lancet published in 2013. I wanted to include updated, trustworthy, and more thorough information regarding the prenatal features that are used to diagnose Noonan Syndrome in a fetus. I also thought that including some relevant statistics would help better solidify the information for the reader. I believe the information I have added could be useful for a pregnant person concerned about their unborn baby having Noonan Syndrome and would assist them in having a more informed conversation with their physician.

I do not believe that any information I plan to add is particularly controversial, considering that it is mostly just a list of features that could point to Noonan Syndrome in a fetus, and that I have not come across any conflicting information regarding prenatal diagnosis during my research on this topic. The only potentially controversial change I would be making would be removing the second half of the current "Ultrasound" subsection, as it could be argued that it contains useful information about diagnosis. However, my rationale for removing it is that it is solely based on one outdated primary study (with only 44 participants) and so breaks several sections of Wikipedia's guidelines regarding references.

Critique of Source

The review used as the source is published in a highly reputable journal (The Lancet) which is comforting to know when assessing its credibility. However, it is always good practice to assess the article as rigorously as any other even if it is published in a reputable journal. The review was published in January 2013, which is still within the past 7 years and so reflects current knowledge according to Wikipedia guidelines. However, having a slightly more updated source would arguably have been better. Two of the four authors of the review declared conflicts of interest as they received royalties for genetic testing from various organizations and companies, however, I don't believe this bias could have affected the parts of the review that I took information from (most notably prenatal diagnosis). While the search terms used for reviewing articles seemed thorough (for example including the names of genes of interest), only PubMed was used for the search. Perhaps having searched on more databases would've resulted in finding a greater range of articles. Only articles published in English were reviewed, which introduces an English-language bias. The selection process was carried out based on novelty and importance of studies, as determined by the first author and confirmed by other authors. This selection process seems somewhat subjective and not reproducible, which raises questions about the quality of the review.

Overall, however, I still believe that the review was a good choice of source for my purposes and the information that I was focusing on in the "Diagnosis"' section. Ultimately, I don't believe any of the critiques mentioned above could have substantially affected the section I am proposing to change.