User:Pgubert/sandbox

Assignment #1 Submission

Overall, the information presented in this article was relevant to the topic of African Tick Bite Fever. However, information was repeated multiple times, even as early as within the introduction (i.e., symptoms being resolved in a few weeks). Additionally, information was not always presented logically (i.e., antibiotic treatment was mentioned in the “diagnoses” section before the various tests were presented and explained). A further example of illogical presentation of information is that the subheading “Vectors” was placed under the heading “Causes”. This being problematic is two-fold: (1) the wording of this subheading “Vectors” is not directed at the general population  (it would more accurately be named “Transmission”) and (2) it contains information that does not belong under the heading “Causes” (i.e., prevalence of infectious tick species in different locations). This illogical presentation of information and the use of short, direct sentences limited the overall flow of the article, which would likely distract the average reader.

Another distracting finding was that the article contained multiple instances in which it contradicted itself. For example, upon stating that the fever is asymptomatic, it then also stated that symptoms would resolve within a few weeks – or that diagnosis would be made based on symptoms, which usually resolve in a few weeks, but then it goes on to list clinical signs for diagnoses (i.e., PRC, culture, etc.). Finally, the article listed Josamysin as one antibiotic to be  used for pregnant women who have an infection, but said antibiotic was then visibly missing the overall list of antibiotics.

It is important for sources of medical information – Wikipedia or otherwise – to inform and educate, but not to influence or persuade. Overall, this article did a good job of remaining impartial. It was written in a neutral tone that was not biased toward a particular position. Based on a review of the article, there are certain views that are over-represented. A significant portion of the article comes from case studies done on travellers who have contracted the fever. The article references these cases and presents the protocols used by individual physicians as the standard of care for treatment. If a case report is to be used, it is important to emphasize that the protocols for diagnosis/treatment are only applicable to certain cases/circumstances. As many of the case reports focused on travellers, there is inherent under-representation of individuals who are endemic to the African regions where tick bite fever is prevalent. It is important that all relevant demographics be included in the article so that a comprehensive picture of the disease can be portrayed.

To determine whether the links to the sources worked and whether the information within the sources effectively supported the claims made in the Wikipedia article, we investigated the first four links. Although the link to the first source cited (a textbook) worked, we were not able to locate any information in the relevant section of the book to support the claim made in the article. The link to the second source (a review article) also worked, and did accurately support the claim made in the article. The third citation did not include a link to the referenced textbook. The absence of a link to an online version of this textbook limited our ability to examine its alignment with the cited text in the article. The fourth source was a case study published in The Journal of Emergency Medicine, and it was found that the link did work and material in the introduction of the article supported the cited portions of the Wikipedia page. In summary, we have come to the conclusion that some sections of this article are currently cited properly, while others may need to be reexamined.

This article cited different types of resources. Specifically, it cited textbook chapters (1,3,12), review articles (2,5-7,11,18), case reports (4,9-10,13-15), and CDC webpages (8,16-17). However, over 40 percent of the references of the article in question were older than 5 years, including sources 5, 6, 7, 9 (from 1998), 13, 14 (1997), 15 (1996), and 18 (2007). Specifically with respect to treatment, there was only a modicum of information and about 50% of it was derived from older sources. The same is true of the bacteriology and vectors sections which use citations from the mid 1990’s. Moreover, sources from the 1990’s are also used to provide insight into the Diagnosis section. That being said, information regarding blood tests and microbiological tests was sourced from more recent studies. Interestingly, the described epidemiology of the disease uses exclusively old sources. Much of the information has been obtained from a review in Lancet, a reputable journal, but the specific review was published in 2006. Updating information to provide a more pertinent evaluation of the disease would be ideal. Albeit outdated, it doesn’t appear that there is bias with the references. However, as many of the references are case reports, an individual lab or group may make a strong statement based on their clinical findings. If this is taken to be fact, then the wikipedia articles becomes biased, as there hasn’t been a systematic review thoroughly evaluating these findings.

There were two students from UCSF who edited the references: they removed some unreliable references and edited the corresponding sections accordingly. They also expanded the page using both primary and secondary sources (although Wikipedia has been known for not using primary sources). There were two other students from UCSF who provided their classmates with peer feedback, though they didn’t add or change anything in the article itself. This was all done in December 2016, since then there has been no discussion in the talk page.

To increase the quality of this article, we plan to find and incorporate more up-to-date information from higher-quality sources. First, we believe that this can be done by eliminating low-quality sources such as those of case reports. We will also look into sources that discuss the experiences of individuals living in areas endemic for this disease, as opposed to those that rely on travelers who are merely transient in these areas. Additionally, we believe that by improving the overall flow and writing style of the article, and by adding pictures or images relevant to various subsections of the article, we could decrease distractions and confusion and support Wikipedia’s aim of disseminating objective, well-documented information to as many interested readers as possible.

3.1: Is everything in the article relevant to the article topic? Is there anything that distracted you?

Overall, the information presented in this article is relevant to the topic of African Tick Bite Fever. However, information was repeated multiple times, even within the introduction (i.e., symptoms resolve in a few weeks). Furthermore, information was not presented logically throughout the article (i.e., antibiotic treatment is mentioned in the “diagnoses” section before the different tests are presented and explained). This illogical presentation of information and the use of short, direct sentences, limits the overall flow of the article. Another example of illogical presentation of information is the subheading called “Vectors” under the heading “Causes”. This is problematic two-fold: (1) the wording of this subheading is out of place as it is not descriptive of the information contained within (it would more accurately be named “Transmission” and (2) it  contains information which does not belong under the heading “Cause” (i.e., prevalence of infectious tick species in different location).

Another distracting finding was that the article readily contains information that contradicts itself. It states that the fever is asymptomatic, but then also states that symptoms resolve in a few weeks. It also states that diagnosis is based on symptoms, then goes on to list clinical signs they look for to diagnose (i.e., PRC, culture, etc.), not symptoms. Finally, Josamysin is one antibiotic briefly mentioned that is used for pregnant women who have an infection, but it not included in the overall list of antibiotics.

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

It is important for medical Wikipedia pages to inform their readers but not to lean readers towards one opinion on the topic or another. This article does a good job of staying impartial. It is written in a neutral tone that does not bias toward a particular position.

3.3 Are there viewpoints that are overrepresented, or underrepresented? Person: Lilly

Based on a review of the article, there are certain views that are over-represented. A significant portion of the article comes from case studies done on travellers who have contracted the fever. The article references these cases and presents the protocols used by individual physicians as the standard of care for treatment. If a case report is to be used, it is important to emphasize that the protocols for diagnosis or treatment have been used in some cases. As many of the cases were travellers, there is also an under-representation of individuals who are endemic to the African regions where the tick bite fever is prevalent. It is important that all demographics studied be included in the article so that a comprehensive picture of the disease can be portrayed. 3.4: Check a few citations. Do the links work? Does the source support the claims in the article?

To complete this task, we decided to explore the first four citations made in the article. We then examined the information provided in the source and its pertinence to the cited statement in the article.

The first link does work, and the resource is a textbook. However, we were not able to find the relevant text in the linked online copy of the book to support the claim made in the article. The second source (a review article) was also appropriate, and did accurately support the claim made in the article. The third citation did not provide a link to the cited work, however it appeared to be a textbook. Our inability to view this book inhibited our ability to adequately assess the validity of the source, however this alone does not necessarily indicate that the source is inappropriate or cited improperly. The fourth source was a case study published in The Journal of Emergency Medicine. Upon inspection, information in the introduction of the case study does align with the cited material, however this does not excuse the fact that the inclusion of this article as a citation was inappropriate in the first place.

Overall, upon examination of the citations for this Wikipedia, we have come to the conclusion that come articles may be appropriate, while others may need to be removed or reexamined in an effort to improve the quality of this page.

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? (Mohammed)

- Below are a short list of facts that are not referenced with an appropriate source (or at all) - Symptoms generally resolve within 3 weeks. - African tick bite fever is a type of spotted fever. The diagnosis is typically based on symptoms - Symptoms tend to be mild and often resolve on their own. - Some of the symptoms are referenced, while others aren’t - unclear if they are all coming from the same source or different - In Sub-Saharan Africa, the most common vectors of R. africae are two species of hard ticks, Amblyomma variegatum and Amblyomma hebraeum. - Unlike other hard tick species, which passively seek hosts, the Amblyomma hard ticks actively seek out hosts. However, a case of locally transmitted African tick bite fever in the French West Indies led to the discovery of R. africae within Amblyomma variegatum ticks on Guadelupe Island. - The body then releases chemicals that cause inflammation, resulting in the characteristic symptoms like headache and fever.

Diagnosis of ATBF is mostly based on symptoms, as many laboratory tests are not specific for ATBF Here is a summary of the types of resources used, numbered according to how they appear in the actual references page. Textbook Chapter (1,3,12), Review article (2,5-7,11,18), Case Report (4,9-10,13-15) and CDC Webpage (8,16-17). Most of the references listed are quite old, some dating back 20+ years. Although this is not a heavily researched area, there should be more recent literature in the form of review articles that consolidates individual findings and evaluates them critically. It doesn’t appear that there is bias in the references. However, as many of the references are case reports, an individual lab or group may make a strong statement based on their clinical findings. If this is taken to be fact, then the wikipedia articles becomes biased, as there hasn’t been a systematic review thoroughly evaluating these findings.