Wikipedia:Peer review/Bronchitis/archive1

Bronchitis

This peer review discussion has been closed.
I've listed Bronchitis for peer review because I would like some feedback on how to continue to better the article. It's currently at C class and I've been adding secondary and tertiary sources for references but would like more ideas on other things the article could use.

Thanks, TylerDurden8823 (talk) 02:17, 1 January 2013 (UTC)

Some comments from lesion

I think more experienced editors will be able to give more extensive advice than I. Initial impression is well referenced article and the info here is thoughtfully worded. Issues are not so much with content but layout to conform with MOS (This page should generally follow the MOS for diseases/disorders). If you are looking to get to GA status, this is also good reading Wikipedia:What the Good article criteria are not. As per the above, we are missing a few recommended sections...whilst they are not mandatory, I think this article could easily fit this better. E.g. move sections acute, chronic and protracted bacterial into a classification section. Note also these sections contain info that might be more appropriate in other sections. This will likely make some new sections which are too short, and these might need slight expansion to counter this.

• Classification
• Signs and symptoms or Characteristics
• Causes
• Pathophysiology/Mechanism
• Diagnosis
• Prevention
• Treatment
• Prognosis
• Epidemiology
• History
• Society and culture
• Research directions
• Special populations
• Other animals

•  Done

• The hatline "not to be confused with bronchiolitis" I have not seen before...usually they read, for the disorder of inflammation in the bronchioles, see bronchiolitis" or similar.

Don't know how to fix this, that was there before I got to the article. If you know how to fix that, please let me know and I will try.TylerDurden8823 (talk) 04:38, 6 January 2013 (UTC)

Much medical terminology that might not be understood.

• Differential diagnosis could do with parenthesized lay term or wikilink in lead
• Acute and chronic could do with parenthesized lay term or wikilink
• Epithelium could do with parenthesized lay term or wikilink
• Symptomatic treatment "
• Secondary infections "
• Productive cough
• fibrotic
• lumenal
• wet cough
• would be nice to have some explanation of how the Pulmonary function tests are performed and what the volumes are?

Hope this is useful.lesion (talk) 01:32, 6 January 2013 (UTC)

Epithelium already had a wikilink, differential diagnosis is gone, secondary infections...I can't really find a good wikilink. The infection page description for secondary infections is terrible. Luminal, fibrotic, productive cough are taken care of. Thinking about the other ones.

Apologies re epithelium, missed that. Feel free to use what ever terminology you want, as long as there is a way for people to understand if they haven't heard it before, either with bracketed lay term or wikilink. Re secondary infection agree poor section, but maybe one day that page is better? (or maybe try Superinfection? ... possibly something slightly different) Should still wikilink a term regardless of quality of other page imo. Just a thought, enjoy developing this page. lesion (talk) 15:14, 6 January 2013 (UTC)

Comments from Zad68

Round 1

TylerDurden8823 tore this up.

Over and under wikilinking: Common terms like "cigarette somking" and "air pollution" probably don't need to be wikilinked, all the terms in "coal mining, grain handling, textile manufacturing, livestock farming" probably don't need wikilinking. Can you find a wikilink target for some of the nonlinked technical terms like "fibrotic", "differential diagnosis"? I kept the cigarette smoking but changed it to the health effects of cigarette smoking page instead of just cigarettes, etc. More of the technical terms are now wikilinked. * Done From what I was told: You put the wikilinks into the lead and body as 2 separate entities. For example, "bronchi" is wikilinked in the lead but not body, but should be in both places. You also have a nice explainer note in the lead about what "bronchi" are (fundamental to the understanding of the topic), but that explainer is not in the body. The lead is considered its own stand-alone item. Nearly every term in " About 90% of cases of acute bronchitis are caused by viruses, including rhinoviruses, coronaviruses, adenoviruses, metapneumovirus, parainfluenza virus, respiratory syncytial virus, and influenza.[4] Bacteria, including Mycoplasma pneumoniae,[4] Chlamydophila pneumoniae,[4] Bordetella pertussis,[4] Streptococcus pneumoniae, and Haemophilus influenzae, account for about 10% of cases.[5]" is wikilinked. Do you need all these terms? This part seems important since these are the direct viral/bacterial causes of acute bronchitis and readers may want to click on a wikilink to find out more about these pathogens. I'm not really clear on why these should not be wikilinked. I'm working on readjusting the wikilinks discussed earlier in your comments though.TylerDurden8823 (talk) 04:24, 6 January 2013 (UTC) You don't need a {{Main}} containing the phrase of mentioned term that has its own article. Like in section Chronic bronchitis, you have "Main article: Chronic bronchitis" and then the first words of the section are "Chronic bronchitis, a type of...". Just wikilink Chronic bronchitis and get rid of the {{Main}}, that's what a wikilinki is for.  Done The list of five refs after "and metal molding may also be a risk factor for the development of chronic bronchitis" is ugly. Look into using a note to bundle the refs, or see the recommendations in WP:CITECLUTTER and WP:CITEMERGE. Down from five to three now. * Done You shouldn't have a one-sentence paragraph, like at the end of section Chronic bronchitis.  Done Per WP:MEDMOS don't use "should" (as in "antibiotics should not generally be used") because that appears to be giving medical advice (try "antibiotics generally are not recommended"). Same thing with patient ("Using antibiotics in patients without bacterial infections..."). Avoid "patient."  Done Treatment: There is far too little content about treatment. There's one very general sentence about treatment, only for acute. Once more coverage of treatment is there, update the lead. The lead is missing any mention of treatment and really needs it. Needs more prevalence too. I see just one sentence in Chronic, attached to a paragraph about causes. The items in External links really are not worthy of external links. They are links to two other encyclopedia-type treatments for the layperson. This Wikipedia article should cover everything those two articles in External links covers, and should cover it better and more completely than they do, so that those two items would not be in the External links section. Agreed.TylerDurden8823 (talk) 04:57, 6 January 2013 (UTC) In the lead, I'd change "Bronchitis can be divided into two categories, acute and chronic, each of which has its own distinct etiology, pathology, and therapeutic approach." tp "Bronchitis can be divided into two categories: acute and chronic." The end of that sentence doesn't really add any information. The wording in the lead needs to be very efficient and information-dense.  Done Consider removing this whole sentence from the lead: " In addition to acute bronchitis, the differential diagnosis for an acute cough may include: allergic rhinitis, asthma, common cold, exacerbation of congestive heart failure, exacerbation of chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease, cancer, pneumonia, postinfectious cough, postnasal drip, sinusitis, and viral syndrome.[4]" It's very long and doesn't really add information fundamental to the understanding of bronchitis. I thought this sentence would be important (though I agree it was long) because the question of what else it could be is an important one but, for the moment * Done Maybe pick the three most common differential diagnoses, or can you describe the diff diags categorically? I'm sure that can be arranged but I'll get to that later once I've restructured the article.TylerDurden8823 (talk) 04:48, 6 January 2013 (UTC) As pointed out above, the article should be restructured according to Wikipedia:Medmos#Diseases_or_disorders_or_syndromes.  Done I would like more background and explanation of the mechanism, and some context about the system bronchitis affects. "However" is used twice in Chronic, both times inappropriately. Same thing in Diagnosis.  Done There are three different kinds of bronchitis listed now, I'd like to see the relative prevalences of each. Diagnosis: This sentence appears to be missing a verb: "Due to the nonspecific signs and symptoms exhibited by bronchitis patients, diagnostic tests such as a chest x-ray to rule out pneumonia or other explanations for the observed cough, sputum culture to rule out whooping cough or other bacterial respiratory infections, or a pulmonary function test to rule out asthma or emphysema"  Done I see several different ways "explainer" phrases are done: After a comma: Bronchitis is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs After a dash: Unlike other common obstructive disorders such as asthma or emphysema, bronchitis rarely causes a high residual volume-the volume of air remaining in the lungs after a maximal exhalation effort. In parentheses: Wheezing and shortness of breath can be treated by reducing bronchospasm (reversible narrowing of smaller bronchi due to constriction of the smooth muscle) ... Pick one and make it consistent. My preference is for parentheses.  Done Sourcing: I see you're using websites for sourcing medical info. You've picked good ones, like Mayo Clinic and American Lung Assn, and they'll probably be good enough for GA, but my understanding is that they won't pass muster for FA. Unfortunately, limited resources that I'm dealing with. I've done PubMed searches for acute, chronic, etc. bronchitis and put in what I have access to or what looked relevant. The tertiary sources what I was able to find online. No idea what other sources to use if these are not sufficient though my thinking is I'd like to get it up to GA first and then worry about FA status when it's nearing GA. If you have ideas for better sources/additional sources, I am open to suggestion.TylerDurden8823 (talk) 05:01, 6 January 2013 (UTC) Have you tried Wikipedia's resource exchange? Or ask Doc James, he's gotten me several sources. You can also get at least pieces of textbooks from Google Books and Amazon. Zad68 05:06, 6 January 2013 (UTC) I have tried the resource exchange with some success lately. However, in this case I don't think it's going to help much since I combed through the literature (at least on PubMed) fairly thoroughly. It's definitely possible I missed some good ones I guess. That's a good idea asking Doc James, he has been helpful in the past. I was under the impression that textbooks would be considered tertiary sources, is that not right? Biosthmors told me that tertiary sources are okay but that the emphasis should definitely be placed on secondary sources.TylerDurden8823 (talk) 05:09, 6 January 2013 (UTC) Source PMID = 9071245 is an old primary study and does not pass WP:MEDRS. The way it is being used is unacceptable, it is not nearly a strong enough source for "Most cases of bronchitis are caused by a self-limiting viral infection and resolve themselves in a few weeks." This is a serious WP:V problem and must be fixed ASAP. Source PMID = 21857781 and source PMID = 22161409 are awesome and those are the kinds of sources (if you can get them) you should be using for everything. I'm guessing this is the old 1997 paper. I agree, that was also there before I got to the article and I'll be sure to replace it with something much more recent. There was a lot more wrong with this article than right when I got started though admittedly I made a few missteps here and there. Probably tired while editing.TylerDurden8823 (talk) 04:59, 6 January 2013 (UTC) There's something sourced to "Chronic Bronchitis", Times Essentials. It really should be sourced to the underlying A.D.A.M. reference work. Enough for now... I'll check in later. Zad68 04:56, 6 January 2013 (UTC) Nice work... Zad68 03:58, 6 January 2013 (UTC)

Round 2

Lead

• "Bronchitis is a general medical term signifying an inflammation..."--how about "Bronchitis is an inflammation..."
• "the larger and medium-sized airways that carry air from the trachea into the more distal parts of the lung parenchyma" -- simplify, how about "the larger and medium-sized airways that carry air from the trachea into the lung"?
• "those who are immunocompromised, appear to be at increased risk"--how about "those who are immunocompromised, are at increased risk"

•  Done

• Still needs treatment

Added to it :* Done

• Diff diag... I know you're coming back to this one simplified wording.

Sure, we can try that bronchitis is an inflammation, that was uploadvirus who wrote that and the second bullet point. Uploadvirus felt that these two things would help readability. Does it seem to hinder that cause rather than help it in your opinion? I'm not certain if it has been established if immunocompromised people are considered at "increased risk" or whether being immunocompromised is considered a risk factor since there is a subtle difference between the two but for now it's changed since appear doesn't seem to fit well. I'm going to have to scale my efforts back a bit for about a week and then I can do more with treatment, etc. I'm also not sure what you're talking about regarding differential diagnosis since it's not on there yet. We discussed trying to classify it by type or just putting the top three differentials on there.TylerDurden8823 (talk) 04:12, 8 January 2013 (UTC)

Classification

• "Acute bronchitis is a self-limited infection of the lower respiratory tract causing inflammation of the bronchi and is characterized by an acute illness with a duration of less than three weeks, cough as the main symptom, at least one other lower respiratory tract symptom such as wheezing, sputum production, or chest pain, and cannot be better explained by another diagnosis."--long run-on sentence, split up

I wanted to make sure everyone was clear that it was all one idea/definition but :* Done

Prevalence

• Can you find more content

I will soon. Been working on hunting down leads for the history section. Going to work on prevalence, pathophys, etc. soon.TylerDurden8823 (talk) 04:15, 8 January 2013 (UTC)

History

• Obviously. You don't need to go nuts, just like one paragraph is probably all you'd need, unless bronchitis has a long, storied, fascinating history.

•  Done

• If possible some more dates in here, the only one is 1808. What year did bronchodialtors become available?

Sources

• (continuing from above convo.)--You have the secondary and tertiary idea right. Tertiary is great for well-accepted background or historical info. What the lung is and how it works is well-established by now, and tertiary sources are great. You need secondary sources esp. for things like up-to-date prevalence figures, latest theories about causation and treatment, etc.
• Don't forget about "There's something sourced to "Chronic Bronchitis", Times Essentials. It really should be sourced to the underlying A.D.A.M. reference work."

•  Done

Wow what a huge improvement. You're very, very close to GA. The first time I read through the article I didn't really get the concept behind what the article is talking about. On this read-through, it's so much more clear. I feel like I actually learned something on this read through, great job. Zad68 19:40, 7 January 2013 (UTC)

Don't worry, I haven't forgotten about the Times article. That may end up being a merged citation but I just haven't gotten around to it yet. Any suggestions for what to do about the secondary bacterial infection bit? I just linked it to the infection page which briefly discusses secondary infections but I feel like it is a bad page for those looking for a better explanation. Do you think superinfection might be better? Or is this just one of those just wikilink it moments? Thanks for the compliment, I'm trying to make it better so I'm glad to hear that it's going well. TylerDurden8823 (talk) 04:19, 8 January 2013 (UTC)

Round 3

• Lead--You'll have to come back after the rest of the article is done to make sure all the new content you added is reflected in the lead--again no treatment in there yet, and there should be just a mention of history now that you have a section for it
• "Typically, acute bronchitis is characterized by an acute illness with a duration of less than three weeks, cough as the main symptom, at least one other lower respiratory tract symptom such as wheezing, sputum production, or chest pain, and cannot be better explained by another diagnosis." -- very long sentence, can you break up? Or at least fix the grammar and tighten/copyedit, consider: "Acute bronchitis is an acute illness lasting less than three weeks with coughing as the main symptom, and accompanied by at least one other lower respiratory tract symptom such as wheezing, sputum production, or chest pain." -- do you really need ", and which cannot be better explained by another diagnosis."? It sounds tautological.

The "and which cannot be better explained" bit was part of the definition from the source but I can how that might come across as redundant:* Done

• "2" and "3" should be spelled out here, see WP:MOSNUM, this is required for GA

•  Done

• "Protracted bacterial bronchitis is defined as a chronic productive cough, with a positive bronchoalveolar lavage, that resolves with antibiotics." - probably get rid of the commas

•  Done

• "supplemental oxygen"--capitalize

•  Done

• "Oxygen supplementation can result in decreased respiratory drive, leading to increased blood levels of carbon dioxide and subsequent respiratory acidosis."--unsourced

•  Done

• "Most cases of bronchitis are caused by a self-limiting viral infection and resolve themselves in a few weeks.[citation needed]"--consider: "Most cases of bronchitis are caused by a self-limiting viral infection and resolve without intervention in a few weeks.[citation needed]"

•  Done

• History--you don't really need that same one ref repeated every sentence if it's the only ref used, just put one at the end of the paragraph. Generally history sections have large amounts of context pulled from only one or two sources, as opposed to the medical content sections which often have lots of refs. I understand, you build up the "ref every assertion" habit in the other parts of the articles and you do it to history too, but you don't need to.

•  Done

• History--looks great! You found a great ref and that one paragraph is probably all you need.
• Images-- can't you find some more? Something to break up the text.

• Overall--keep it up. Zad68 04:37, 17 January 2013 (UTC)
  • I'll get to work on these but I don't know how to upload images to wikipedia and I don't know how to add a picture to a wikipedia page. The last time I looked I couldn't find a free picture to use. I've been looking for a reliable source for the oxygen supplementation bit and so far have come up empty. I don't think it will be terribly difficult to find the self-limited viral infection bit and I know the epidemiology section needs to be more robust. I'll take a more detailed look at your third round in a little while and start.TylerDurden8823 (talk) 05:13, 17 January 2013 (UTC)
    • No excuses! Uploading images is easy, just use the image uploader tool, the one thing you need to be careful about is copyright and licensing issues, so ask about that. There's also a bunch of images already, look through what has already been uploaded. Also, look at these results: http://en.wikipedia.org/w/index.php?title=Special%3ASearch&profile=images&search=cough&fulltext=Search What would be REALLY great is if you were to look through the sound files that are named like "File:The-description-of-cough-sounds-by-healthcare-professionals..." and find the ones relevant to what a bronchitis cough sounds like. Zad68 15:37, 17 January 2013 (UTC)
      • That link didn't go anywhere and I haven't been able to find any public domain pictures on wikipedia that are of bronchitis related pathology. I realize a histopathology slide showing the pathological consequences of chronic or acute bronchitis would be a nice addition. Next up I think will be epidemiology stuff if I can find it. TylerDurden8823 (talk) 21:26, 17 January 2013 (UTC)
        • Weird if the link didn't work, I just tried it again and it works for me. I really want you to look through the File:The-description-of-cough-sounds-by-healthcare-professionals... files, there's something good in there I am sure. Zad68 17:18, 18 January 2013 (UTC)
          • It works now. I'll try again later with that.TylerDurden8823 (talk) 20:23, 18 January 2013 (UTC)
            • Okay, so, I looked through the cough search and most of the search was irrelevant. The only thing I found were some cough sounds from a paper that made the sounds public domain but the problem is that while there were two COPD coughs which had mucus and wheeze, it is unclear to me whether they have chronic bronchitis or emphysema or both. They often coexist from what I've read. If you think a COPD cough is sufficient, we can use that. I don't know how different the cough is between a COPD patient with chronic bronchitis and a COPD patient with emphysema. It may not be different at all. Let me know what you think.TylerDurden8823 (talk) 06:17, 20 January 2013 (UTC)
              • Thanks for looking... I was really hoping there would be something specific for this bronchitis. In my opinion it'd be worth it to try to track down some info on whether a general COPD cough sound would be useful for this article. If I were you I would ask at WT:MED. There are some actual physicians there who might be able to help. A physician might be able to tell you a COPD sound file would be useful.

Thanks

Thanks guys, that's plenty to work on and it'll take me a little while but I think I'll be able to incorporate your suggestions and fix the article up. There were definitely some things here that didn't come to mind right away and some policies of which I was unaware.TylerDurden8823 (talk) 04:35, 6 January 2013 (UTC)

Delighted you appreciate it! You're definitely moving the article forward and it's well on its way... Zad68 04:37, 6 January 2013 (UTC)

Okay, so, the article has changed dramatically now. I have restructured the entire article according to the guidelines set by Wikipedia: MOS of Diseases. Please have another look and continue with your feedback. I'll continue addressing the points you mentioned earlier and yes, some sections are smaller or not filled in yet as predicted earlier and I will try to address this as quickly as I can.TylerDurden8823 (talk) 18:56, 6 January 2013 (UTC)

It is dramatically improved. Sourcing is top-notch. Your prose style has definitely improved, I find very little to pick on. Flush out the rest of the content sections and fix the lead, and nominate it for GA. Zad68 04:36, 21 January 2013 (UTC)

Most of the prose wasn't mine haha. My prose is normally quite respectable. If I'm tired, perhaps it falters on occasion. Can you be more specific when you say flush out the rest of the content sections? I'm not sure what you're referring to exactly. Glad to hear it's basically ready for GA and just needs the lead to be fixed. Regrettably, I'm not sure I will have the time to see this to completion and I may need someone else to put the finishing touches on it since I'm getting rather busy. TylerDurden8823 (talk) 04:56, 21 January 2013 (UTC)