User talk:CaliforniaLyme

List of people who have died of Lyme disease

I've added the "{{prod}}" template to the article List of people who have died of Lyme disease, suggesting that it be deleted according to the proposed deletion process. All contributions are appreciated, but I don't believe it satisfies Wikipedia's criteria for inclusion, and I've explained why in the deletion notice (see also "What Wikipedia is not" and Wikipedia's deletion policy). Please either work to improve the article if the topic is worthy of inclusion in Wikipedia, or, if you disagree with the notice, discuss the issues at Talk:List of people who have died of Lyme disease. You may remove the deletion notice, and the article will not be deleted, but note that it may still be sent to Articles for Deletion, where it may be deleted if consensus to delete is reached, or if it matches any of the speedy deletion criteria. Kchase T 19:17, 15 December 2006 (UTC)[reply]

I can't find where you said why and I don't understand WHY!!!!!!!!!!!!!!!!!!!!!!!!!! How come you haven't deleted all those other lists of people? I don't understand!!!!!

TTP

In response to your email, I have explained my removal of your content on Talk:Thrombotic thrombocytopenic purpura. If this is not satisfactory, please leave a message on WP:CLINMED, and fellow medical editors will be able to comment on the dispute.

I'm sorry you've had so much trouble and I hope things are better now. Please do realise, however, that your experiences may not be typical, and that your edits on Lyme, babesiosis, ehrlichiosis etc should not overshadow the general content of pages. On the TTP page, material from 3 case reports was taking up about 10% of the article's total content. Also, you speculated that "thus it is entirely possible that a great deal of TTP may be due to underdiagnosis of [Ehrlichiosis]." This falls under original research.

This is in no way meant to downplay the significance of your condition or the diseases in question. For some general guidelines on health articles please have a look at the very high-quality pages asthma, multiple sclerosis, prostate cancer - all of which have been reviewed heavily and now have featured status. Hopefully this will give you an idea of the standard of medical article on Wikipedia.

Good luck, and let me know if you have further questions. JFW | T@lk 22:47, 18 December 2006 (UTC)[reply]

Dear JFDWOlff,

Sorry I emailed you- I thought that was what I was supposed to do!! I did not know about this page. I agree the speculation did not belong, I have to admit that even posting it I felt like I was overstepping, but I do have such fervent feelings about the matter it overcame my good judgment there. However, since TTP is *not* a large section and because it *is* fatal to so many people diagnosed with it, doesn't it make sense to offer not even a sentence then, fine, but just TWO words- "Ehrlichiosis tests"- in what a physician should do- so a patient may ask them for it- or a doctor who has never treated such a relatively rare condition might think to do it when probably they have never even heard of it?

That makes sense to me. If you think all the rest is too much, fine, but the article is NOT terribly long and if it could save lives, which it COULD, then just putting in to test for a condition which can cause the same thing makes sense to me!!!

Just two words? "Ehrlichiosis tests"?

Sincerely,

Sarah

I get your point, but I think very few haematologists would even entertain the diagnosis of Ehrlichiosis in a clear-cut case of TTP. You are suggesting that every patient with TTP should have these investigations. Given that only 3 cases have been reported in the literature, it would be impossible to estimate the pre-test probability (but it is likely to be low). Diagnostic science dictates that unless the pre-test probability is high, doing tests just causes trouble (I can give you several examples from daily medical practice). I agree with the removal (by Davidruben (talk · contribs)) of the two added words - because it suggested that every patient with TTP should have Ehrlichiosis investigations as part of the clinical workup.

Generally, if the relevant Emedicine article does not mention something[1], chances are it is not suitable for inclusion into Wikipedia. JFW | T@lk 04:08, 20 December 2006 (UTC)[reply]

The pretest probability IS HIGH. If you look at serosurveys they have come back in geographically disparate places as Wisconsin, New York and Sweden all over TEN PERCENT of the general population!!!! That is certainly high!! When you add in that 11 of 15 acute phase sera patients were seronegative then the possibility of infection is even higher. How could you GET any higher than that?

This makes the pretest probability even worse. What you will now get is a TTP patient with positive Ehrlichiosis serology - is that "background seroprevalence" or is it a MAHA secondary to active disease? I fully agree with the physician who declined to test your babysitter for Ehrlichiosis, because of the methodological issues I have mentioned. Modern medicine is as much about doing the right test as it is about making the correct diagnosis, because one needs to live with the uncertainty generated by an abnormal test. If your babysitter had tested negative for Ehlichiosis, would that have satisfied the clinical mind? After all, it has a poor positive predictive value (11/15 being negative)!

You appear to be misunderstanding some very crucial medical clinical and statistical concepts. You also appear to be misunderstanding WP:POINT and WP:FORK, given your creation of Ehrlichiosis Induced TTP Mimic. I have nominated this new page for deletion, not out of personal motives but because I think the issue is not suitable for a general encyclopedia. Please understand. JFW | T@lk 13:51, 24 December 2006 (UTC)[reply]

Tick borne disease and ALS

As the article Amyotrophic lateral sclerosis points out "In searching for the cause of ALS, researchers have also studied environmental factors such as exposure to toxic or infectious agents. Other research has examined the possible role of dietary deficiency or trauma. However, as of yet, there is insufficient evidence to implicate these factors as causes of ALS." This remains the establsihed medical view point.

Hence this duplicating entry on ALS disambiguation page for 'Amyotrophic lateral sclerosis' and stating as fact that this is "a progressive form of the tick-borne encephalitis virus" is POV pushing. The reseach might suggest that some cases of tick-borne encephalitis progress to an ALS-like picture, but to assert as if fact that ALS is invariably a presentation of the virus is inappropriate.

As for this addition to Tick-borne meningoencephalitis.

If "The disease is untreatable once manifest" then how can there be a treatment section? I think the former should be stating incurable as opposed to untreatable.
The large number of claims made need individual citations - 'Reference section' is for sources that act as background for the whole topic, whereas 'Footnote section' give details on sources for specific points.
Various footnote systems have been used at wikipedia, newest being the <ref>...</ref> <references/> cite.php system - see WP:FOOTNOTES.
Also PubMed links are automatically achieved using marked up of PMID abstract-number, the insertion of a colon after "PMID" prevents any hypertexting.
As it currently stands, the dumping of the unformated un-link references makes it almost impossible to workout what citation verifies which facts. This is going to need a lot of work to untangle. Please join discussion on Talk:Tick-borne meningoencephalitis. David Ruben ^Talk 00:56, 25 December 2006 (UTC)[reply]