User:Wikieditor M23/sandbox

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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.

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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

Assignment # 2
Information to add: The effects of cannabis use during pregnancy.

1. Search strategy and source identified:

I completed a PubMed advanced search using: (pregnancy[MeSH Terms]) AND cannabis abuse[MeSH Terms]. I then selected the Article Types filter “Review” and the Publication Dates filter “5 years”. This search generated 10 articles. I chose to review the following article based on its relevant title:

Conner, S. N., Bedell, V. , Lipsey, K. , Macones, G. A. , Cahill, A. G. & Tuuli, M. G. (2016). Maternal marijuana use and adverse neonatal outcomes. Obstetrics & Gynecology, 128(4), 713–723. doi: 10.1097/AOG.0000000000001649.

This source was chosen because:

This article is a recent review of the data surrounding cannabis use during pregnancy and its neonatal adverse effects. This article did a good job of considering the confounding factors of tobacco use and other substance use during pregnancy. The authors selected articles that stratified both the cannabis users and control group participants by the use of tobacco. They also selected studies that excluded other substance users. Their search strategy was well defined and reproducible.

This article meets the Wikipedia MEDRS criteria because:

It is a recent article that was published in October 2016.

It is a secondary source since it is a systematic review and meta-analysis of 31 publications selected from a search using 6 databases, including PubMed, Embase, Scopus, Cochrane reviews, ClinicalTrials.gov, and Cumulative Index to Nursing and Allied Health.

The authors have not reported any financial conflicts of interest.

What I plan to do with this source:

This article addresses the effects of cannabis use during pregnancy on the primary outcomes of low birth weight and pre-term birth. Interestingly, they did not find that cannabis is an independent risk factor but these adverse events may be attributable to concomitant tobacco use and other confounding substance use. I plan to add this information to the Wikipedia page to inform the public about the risks of poly-substance use that is often associated with cannabis use during pregnancy.

2. Search strategy and source identified:

I completed an advanced PubMed search using: (pregnancy[MeSH Terms]) AND cannabis/adverse effects[MeSH Terms]. I then selected the Article Types filter “Review” and the Publication Dates filter “5 years”. This search generated 12 articles. I chose to review the following article based on its relevant title:

Gunn, J. K., Rosales, C. B., Center, K. E., Nuñez, A., Gibson, S. J., Christ, C., & Ehiri, J. E. (2016). Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis. BMJ open, 6(4), e009986. doi:10.1136/bmjopen-2015-009986

This source was chosen because:

This article is a recent systematic review of data regarding the health outcomes related to cannabis use in pregnancy. They used a well-defined, reproducible search strategy. The articles chosen indicated high study quality. This article found that there are negative consequences associated with cannabis use during pregnancy, but was limited by the fact that the majority of the selected studies did not exclude participants with poly-substance use.

This article meets the MEDRS criteria because:

This article is recent as it was published in 2016.

It is a secondary source as it is a systematic review of 24 articles selected from a search of 7 electronic databases including PubMed/MEDLINE, Ovid/MEDLINE, CINAHL/EBSCO, PsychInfo/EBSCO, Web of Science, Sociological Abstracts and EMBASE.

The authors did not declare any conflicts of interest.

What I plan to do with this source:

I do not plan to use this source. I found this systematic review to be weaker than the first source, since they were unable to isolate cannabis use as an independent risk factor during pregnancy. However, since the field of research on this topic is still relatively new, this article’s findings that cannabis use during pregnancy effects both fetal and maternal health, including increased rates of maternal anaemia, decreased birth weight and an increased need for placement in the NICU/ICU, should be further investigated.

Assignment # 3
Proposed change:

Original: None, there is currently no information on the effects of cannabis during pregnancy. This proposed change will be added to a new section under the subheading "high risk groups" in a separate section about pregnancy.

New: There is an association between smoking cannabis during pregnancy and low birth weight. Smoking cannabis during pregnancy can lower the amount of oxygen delivered to the developing fetus, which can restrict fetal growth.

Rationale for proposed change:

This change is important because there is currently no information on this “Cannabis use disorder” Wikipedia page related to the effects of cannabis use during pregnancy. Currently there is an independent Wikipedia page called “Cannabis in pregnancy”, which is linked to this “Cannabis use disorder” page in the external links section. However, these proposed changes provide more up to date information than what is available on the "Cannabis in pregnancy" page. It is important that individuals who have a cannabis use disorder are informed about the effects cannabis can have during pregnancy, so it is beneficial to have this information directly available on the "Cannabis use disorder" page.

This information was initially retrieved from the National Academies of Sciences, Engineering, and Medicine. 2017. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Washington, DC: The National Academies Press. doi: 10.17226/24625. This report outlined the findings from the following systematic review and meta-analysis: Gunn, J. K. L., C. B. Rosales, K. E. Center, A. Nunez, S. J. Gibson, C. Christ, and J. E. Ehiri. 2016. Prenatal exposure to cannabis and maternal and child health outcomes: A systematic review and meta-analysis. BMJ Open 6(4):e009986.

Critique of source:

The systematic review is recent, as it was published in 2016. The authors completed a thorough search, as they searched the following databases: PubMed/MEDLINE, Ovid/MEDLINE, CINAHL/EBSCO, PsychInfo/EBSCO, Web of Science, Sociological Abstracts and EMBASE. The studies selected for the systematic review were all high-quality studies. Two authors independently assessed the quality of the selected studies using predetermined quality assessment criteria. The selected studies were all case-control, cross-sectional or cohort studies. The studies included had participants who used cannabis during pregnancy but did not concurrently use illicit drugs which helps reduce confounding bias. However, this review may be susceptible to publication bias, as only studies published in English were included. While this review excluded studies with participants who used illicit drugs during pregnancy, it may still be susceptible to confounding bias because they did not exclude studies that report outcomes of cannabis use during pregnancy in the presence of alcohol and tobacco use. Additionally, there was no mention about the socioeconomic status of the research participants in the selected studies, which could be a confounding factor for fetal birth weight.