User:Sarennalalani/sandbox

Welcome to your sandbox!
This is place to practice clicking the "edit" button and practice adding references (via the citation button). Please see Help:My_sandbox or contact User_talk:JenOttawa with any questions.

Link: Project Homepage and Resources


 * 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

Wikipedia Assignment #2

 * 1) I considered searching multiple databases, but ended up selecting PubMed as my primary database.
 * 2) All relevant search results were considered and two potential sources were selected:
 * 3) https://www.ncbi.nlm.nih.gov/pubmed/27476137
 * 4) https://www.ncbi.nlm.nih.gov/pubmed/28570791
 * 5) These two sources were selected on the basis of:
 * 6) Including analysis on Bipolar I disorder specifically (it is important to note there is a difference between Bipolar I and Bipolar II disorders).
 * 7) Addressing the subjects (Bipolar I disorder and PTSD or substance use disorder) as co-occurring diseases or comorbidities rather than consecutive diseases (e.g. one causing the other).
 * 8) Both articles addressed prevalence of the two diseases rather than symptomology or treatment, which is the primary focus of my investigation.
 * 9) The articles meet the Wikipedia MEDRS Criteria as follows:
 * 10) Both sources are secondary sources. Neither article is a clinical trial or direct investigation, they are both reviews of collated data.
 * 11) Both sources are high quality evidence as they are a systematic and a “rapid” review.
 * 12) Both sources are up-to-date and were published in the last five years.
 * 13) The two sources will be used to add a section on comorbidities of Bipolar I disorder. Certain comorbidities are common to Bipolar I disorder and, at present, are not at all addressed by the Wikipedia article.

Proposed Changes
The sentences below are to be included in the 'Diagnosis' section of the Wikipedia page and should be inserted after the third sentence.

Bipolar I disorder (and bipolar II disorder) is often comorbid with other disorders including PTSD, substance use disorders and a variety of mood disorders. Up to 40% of people with bipolar disorder also present with PTSD, with higher rates occurring in women and individuals with bipolar I disorder.

'''I would probably just include the 'context' of where the change is going to occur, as I'm not sure just looking at this what the 'however' is responding to. I would maybe get rid of the 'However, it should be noted that' and just do 'Bipolar I disorder (and Bipolar II) is often comorbid...' (the ellipses representing the rest of your proposed change). -rreidcaf'''

 Final Feedback: 

- Simply written and clear.

- terms properly wiki-linked

- no issues with people-first language.

RREIDCAF



Rational for Proposed Change
Bipolar disorders often have clinical presentations that include other comorbid disorders. The current Wikipedia page does not touch upon this concept, as it only reports the need to rule out substance-induced and other mood disorders in order to arrive at the diagnosis of bipolar I disorder. This standalone report could falsely lead viewers to believe that bipolar and other mood and substance disorders cannot co-occur. Adding in the above two sentences, which are supported by high-quality evidence-based reviews found on PubMed, will clarify common presentations of bipolar I disorder and ensure that there is public knowledge of comorbid disorders.

Research shows bipolar I disorder to be comorbid with a multitude of other disorders and diseases. The focus on PTSD and substance use disorders could paint an incomplete picture, leading to controversy. Some studies demonstrate high comorbidity rates between bipolar I disorder and anxiety, impulse-control disorders and substance use disorders. The exclusion of the former two in my amendment could prove to be controversial. In addition to this, bipolar I comorbidities are inherently more controversial in adolescents and children, where the diagnostic boundaries between comorbid diseases are less clear. This could open a can of worms that could prove to be problematic as the details are hard to communicate on an online interface.

'''I think you've done a good job both addressing controversy, and also predicting what feedback you might get once you post to the talk pages. Anxiety and impulse-control disorders are also highly comorbid (infact it is difficult to differentitate between mild hypomania, GAD, impulse-control) but you're only slotted to change 1-2 sentences for this assignment! How's it feel to be limited? Perhaps after the assignment is done, you may want to go back and add 1-2 sentences to wikipedia, and become a lifelong editor on the platform... Dr. Dawson would be very happy. -rreidcaf'''

 FINAL FEEDBACK 

- nothing to add RREIDCAF

Critique of Source
The paper from the Journal of Clinical Psychiatry identified no potential conflicts of interest and indicated that the funding sponsor had no role in the study planning or conduction processes. The first author of this study is a PhD in the Discipline of Pyschiatry at the University of Sydney. The paper from the Journal of Affect Disorders identified that no external funding was provided and that there were no conflicts of interest. The first author of this study is an MD, MPH and an acting assistant professor in the Department of Psychiatry at University of Washington. The disclosures of financial and other conflicts of interest and the qualifications of each author positively influenced my assessment of each of the sources' validities as they are less likely to have bias towards a specific outcome.

As with any systematic review and/or meta-analyses, individual studies with poor internal validity can be hidden in the outcomes of the larger review. In addition, the database searching process and study selection is prone to biases, depending on the method of search and selection (e.g. only using one author to select). English-language bias can be problematic if internationally-published articles are not included. The Journal of Clinical Psychiatry paper identified that their study limitations were aligned with the limitations inherent to systematic reviews (see above). The Journal of Affect Disorders paper identified that there were few studies used in their meta-analysis, and that the studies had high levels of heterogeneity. This means that the statistical outcomes of the systematic review could misrepresent the true relationship between comorbidities and bipolar I disorder.

'''Very objective critique of the sources. Well done. -rreidcaf'''

 FINAL FEEDBACK 

You've done an excellent job of reviewing the review.

RREIDCAF