Wikipedia talk:WikiProject Clinical medicine/Template for medical conditions

Comments
Here are some comments on the proposed template for medical conditions as of 5th April 2006.


 * I assume these are guidelines for those writing new articles or where a substantial edit is already required. In other words, that we are not proposing that existing non-stub articles are transformed to this format merely to fit the template. To what extent do you wish this to become "policy"? It would be very helpful to give some examples of articles that follow this template. Surely this template has to be shown to be useful in forming some good quality articles before anyone can give a justified opinion of whether it should be policy (or even a recommendation). In other words, we need some practical evidence rather than guesswork.
 * Use of the word patient. Please don't. Unless you are writing about the doctor-patient relationship or the health service, then this word is not appropriate and indicates the editor's point-of-view. Wikipedia is not a medical encyclopaedia for doctors and some articles clearly read as though they were written by doctors for doctors.
 * Saying headers are mandatory. This sounds too much like a rule. Better to say "There are some basic headings that are essential to any medical condition article – these are indicated with a *". I think most folk here would regard References as essential.
 * The template advises not using other top-level headings or a different order. I don't think we can or should be so restrictive. Encouraging folk to write content is more important than worrying about these things. This template can be a useful framework to help an editor, but shouldn't be a straightjacket.
 * Can you expand on the Disease associations heading?
 * Pathophysiology. What does that word mean to the lay person? This is not a section I've seen in many articles and might be covered adequately within other sections. Can someone suggest a different word or section to cover this topic?
 * Treatment. The word "follow-up" implies a point-of-view.
 * Management. This section might be more appropriate than Treatment as a top-level section for a chronic or non-curable condition. It might include Treatment as a sub heading but would also include many other things (e.g. scans, tests, equipment, palliative care).
 * Cause. (i.e. Etiology). This section is missing.
 * Social Impact. Need a section like this, though obviously not for all articles. Not sure if those are the best words – suggestions?. Many conditions have a section discussing the impact on the person in society, legal issues, stigma, public heath concerns, etc. IMO, the Epidemiology section has a more limited remit than currently indicated.
 * Prevention. It would almost certainly be a bad idea to include this section heading in a genetic or congenital disease (regardless of your own personal view on this issue) unless there was an antenatal treatment or preventative measure (e.g. folic acid) that didn't involve termination. Consider a different heading (e.g. Prenatal screening) and be careful how you word it.

Colin°Talk 15:53, 5 April 2006 (UTC)

Should there be a section for "Differential diagnoses" or "Related conditions"? -AED 21:23, 6 April 2006 (UTC)

I largely in agreement with the above points - are they going to be implemented? I have just editted the Huntingtons Chorea article to the current format and it didn't feel quite right, maybe alternative headings according to the type of entry e.g Treatment/Management. Leevanjackson 17:49, 24 April 2006 (UTC)


 * I'm also largely in agreement with the above points, and I've edited the project page to attempt to reflect the feedback. However, I'd recommend to future editors that as you have feedback, that you directly edit the project page to reflect your priorities, so things don't get lost in translation. --Arcadian 18:45, 24 April 2006 (UTC)

Disease associations
I've removed this section and the text:
 * List the self-help or official organisations relevant, include external links where possible.

I don't think that was what was originally meant – I think it was associated diseases. Perhaps I'm wrong. I've updated the External links section with guidance on this area. Discuss here. Colin°Talk 12:39, 25 April 2006 (UTC)

Now you've put it into that context I do believe you're right Leevanjackson 14:30, 25 April 2006 (UTC)

Organization of Template for medical conditions
I recently made some changes to the organization of the Cystic fibrosis article. There had been some discussion that the article needed improvement and, besides the rewriting of the introduction, a major change I made was to reorganize the article in a manner that I believe is more logical and addresses the complexity of a multi-organ problem that is based on a genetic disorder. I was (gently) admonished that I did not to adhere to the template. So I will explain.

The current template has this order, - after Classification and before References:
 * Symptoms and signs - Cause/Etiology - Diagnosis - Pathophysiology - Treatment/Management – Prognosis - Prevention/Screening - Epidemiology - History - Social Impact - Notable cases-

I submit that this order is less than ideal: The order in the current template leads to jarred reading, jumping back and forth in the development of the explanation process, and invites duplication within the article. We are not working on a self-help book for medical problems (there I would accept signs and symptoms to list at the top) but an encyclopedia.
 * 1) Signs and symptoms are consequence of the disease process, -bringing it to the top makes it hard to understand why the body reacts this way.
 * 2) Why would pathophysiology follow diagnosis?  If you know the pathophysiology, you will understand the diagnostic process.
 * 3) Why would epidemiology follow Prevention & screening? Understanding epidemiology allows for P&s, not the other way around.

I propose that a medical template in an encyclopedia should follow a logical sequence, that is first comes the cause, then the effect on the body, and then its response. It is the task of the introduction to hook the reader and provide a connection to the cause.

Perhaps this is a way - bracketed by Classification and References: Ekem 13:36, 1 June 2006 (UTC)
 * Cause - Pathophysiology - Signs and symptoms - Diagnosis - Treatm/Prog – Epidem. - Prevent/screening - Social impact - History - Notable cases.


 * If there are no major objections here in the next few days, I'd recommend that you edit the template to reflect those priorities. I largely agree with your suggestions, with one possible exception. I agree that Signs and Symptoms more naturally derive from the disease process; however, on most pages the signs and symptoms section should be much shorter than those on cause and pathophysiology. If the first two sectiosn are very long and technical, it could discourage some readers from getting drawn into the article. Also, it is more likely that lay readers would understand the terminology behind signs and symptoms, because the presenting symptom is usually what would drive the patient to the health care provider in the first place. So I would recommend the following: "Signs and symptoms - Cause - Pathophysiology - - Diagnosis - Treatm/Prog – Epidem. - Prevent/screening - Social impact - History - Notable cases." But I see the other point of view, and I wouldn't object if signs and symptoms appeared later in the article. --Arcadian 14:01, 1 June 2006 (UTC)


 * I agree that there is the danger that if the Cause - Pathophysiology section at the beginning becomes too technical, people may be turned off, although we should never underestimate the reader. In that case I would suggest to split a more detailed article off into a linked separate article. For example, in the Cystic fibrosis article the discussion about the molecular basis of CFTR could very well be made into a new article in its own right.Ekem 14:57, 1 June 2006 (UTC)


 * Just like to add my support – if the author feels he/she can develop a story where ideas are explained in a logical order, then why be forced to conform to different order? However, many medical articles are not nearly so comprehensive as the cystic fibrosis one, with each section containing contributions from various authors over time, and no progression apparent. In that case, there is an argument for putting the popular/easy-to-read sections first, and the scary molecular biology later on. Regardless, the use of sections helps the reader know what to skim past if it gets too much. If a section is very technical, then it should have an introductory sentence that the lay reader can understand.


 * If we do change to a "progressive-order" rather than a "popularity-order" then it would be good to explain the rationale in the main page. Perhaps also add a note to say that deviations from the order are quite acceptable if a justification is given on the article talk page. Colin°Talk 19:07, 1 June 2006 (UTC)

Article merged
This article was a forerunner to Manual of Style (medicine-related articles), and it's content is included in that style document. The article is now redirected to the 'live' article. L&there4;V 10:25, 12 June 2009 (UTC)