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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).
 * Name of Wiki Article: Chronic Lymphocytic Leukemia
 * Practise of citation

Task:


 * 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.

Assignment # 3- please post an anonymous copy here!
1. Proposed changes:

We are proposing three minor changes to the CLL webpage: two in paragraph four related to statistics and one in paragraph five to clarify CLL signs and symptoms.

a.              We suggest adding updated statistics about CLL prevalence that are available from the United States in 2021 to add additional context to the 2015 global statistics currently in the article. Proposed sentence: “In 2021, the estimated incidence of CLL in the United States is 21, 250 new cases and 4,320 deaths.”

b.              We suggest updating the age at which the disease most commonly occurs, and adding greater context about increased risk with age. Existing sentence: “The disease most commonly occurs in people over the age of 50.” Proposed sentence: “The disease most commonly occurs in people over the age of 65 due to the accumulation of genetic mutations that occurs over time. ”

'''c. ''' We suggest modifying this sentence: “Less commonly, CLL may present with enlarged lymph nodes. This is referred to as small lymphocytic lymphoma.” by either deleting it or changing the language to: “Less commonly, CLL may present with enlarged lymph nodes. [9] If enlarged lymph nodes are present and additionally, the peripheral blood concentration of B lymphocytes does not exceed 5.0x10^9 per L, a diagnosis of small lymphocytic lymphoma (SLL) is made rather than CLL.”

2. Rationale for proposed changes:

a.              These updated CLL statistics add information about the North American context and provide evidence that CLL is still a current and ongoing issue that needs to be addressed.

b.              The age at which CLL most commonly occurs should be updated from 50 to 65. According to the existing reference on the Wikipedia page, this statistic (age of 50) was retrieved from the National Cancer Institute’s page on CLL in 2017. However, upon consulting the source it states that CLL is most commonly diagnosed among people aged 65-74, with the median age of diagnosis being 70. This median age is significantly higher than 50. Secondly, this sentence should be expanded to provide some insight into why the risk of CLL increases with age (the accumulation of genetic mutations).

c.              The language used in the original sentence suggests that CLL with enlarged lymph nodes is automatically considered as SLL, however, there are other factors that need to be considered which we have included. The original sentence was also missing a reference to support their statement. The reference I have used to support my information is the following: PMID : 32735048

Kreuzberger N, Damen JA, Trivella M, et al. Prognostic models for newly-diagnosed chronic lymphocytic leukaemia in adults: a systematic review and meta-analysis. Cochrane Database Syst Rev. 2020;7(7):CD012022. Published 2020 Jul 31. doi:10.1002/14651858.CD012022.pub2

3. Potential controversy:

a.              The selection of a statistic from the North American region was chosen to create a point of reference different from the existing global statistical study that was done in London, England.

b.              It could potentially be argued that people over the age of 50 still face a higher risk of CLL than those under 50: according to the National Cancer Institute, 8.3% of new CLL cases are diagnosed between 45-54 and 22.6% of new cases are between 55-64, compared to less than 2% for all ages under 44. However, age groups between 65-74, 75-84, and >84 years face the greatest risk (30.8%, 23.7%, and 12.7%, respectively). Because the mean age of diagnosis is 70, referencing 65 years is more specific and accurate than over 50. No controversy is expected regarding the mention of the accumulation of mutations that occurs with age, because this is general knowledge and widely accepted in the field of cancer research.

c.              Possible controversy related to our third edit is that CLL and SLL are considered different branches of the same disease. This is most likely why the original author of this sentence felt that it was adequate to include a simplified description about SLL in the article. We decided to go forward with further differentiating SLL as, although it is in a similar branch to CLL, there is enough of a difference to be able to distinguish the two and readers should be aware of this.

4. Critiques of Sources:

a.              The 2021 study is an estimate of projected numbers for the rest of the year based on when the article was made. As we are in 2021, all the incidents of CLL have not yet occurred to verify these numbers. However, this is the most recent and reliable source available.

b.              The source that is already referenced on this page is the National Cancer Institute. This is a very reputable government agency in the United States, so we are not changing this source. The page specifies that it is using data across all races and both sexes, which should minimize bias. However, the data is from 2014-2018, so it may be outdated. The source that we would add is from the Canadian Cancer Society (specifically the Genes and Cancer webpage), which is another reputable organization that provides extensive education on cancer-related topics.

'''c. ''' A concern with the source used for this edit is that the article’s main focus is on CLL and prognostic models used in predicting the development of CLL in a patient. As such, the article’s interpretation of diagnosing SLL may be over-simplified as this is not the main focus of the article. As our Wikipedia article also mainly focuses on CLL, we have assumed that, even if the information from this source is simplified, it will suit the subject matter of our Wikipedia article as the main focus is also CLL.

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