Maps, Directions, and Place Reviews
Autism
Colin, I just came across this in a (frustrating) autism literature search: PMID 25072037 SandyGeorgia (Talk) 16:58, 6 April 2015 (UTC)
Bipolar removed for discussion
This text (copyedited a bit) was added by an IP:
- Please note that this Featured article uses list-defined references; per WP:CITEVAR, please attempt to respect the citation style.
- See the prominent edit notice that pops up whenever editing this article.
- This text discusses two case studies and uses a citation from 2001 for which no article title or PMID is given.
Including this text is likely WP:UNDUE, but a correct citation would be helpful. SandyGeorgia (Talk) 18:58, 30 April 2015 (UTC)
As great as this article is.....
Many of its sources are outdated. How to proceed? You want a page header template? Each outdated reference identified with an in-line template?
Bfpage, I see you went ahead with tagging without responding here first. Sometimes an old source may be the best source, or the only source. Unless you have indications that these are bad sources, tagging the articles isn't the best.[1] Do you have sources indicating this information is no longer good? SandyGeorgia (Talk) 19:50, 5 May 2015 (UTC)
This source is over my head:
- Paoli A, Bosco G, Camporesi EM, Mangar D. Ketosis, ketogenic diet and food intake control: a complex relationship. Front Psychol. 2015 Feb 2;6:27. doi:10.3389/fpsyg.2015.00027. PMID 25698989.
SandyGeorgia (Talk) 20:23, 5 May 2015 (UTC)
Hi folks. It is good to question if an FA is up-to-date, particularly one promoted Dec 2009. My, how time flies. Bfpage, there's no need to link to MEDRS since I created that guideline back in 2006 and this page is watched by a number of editors who helped shape it. I'm quite sure your edits are good-faith. The "needs update?" tag doesn't seem that intrusive or "defacing" as some tags, but an initial talk page request is probably the most polite way of making initial enquiries about sources. There will, for sure, be quite a number of featured/good articles for which the main authors have long-since departed, and perhaps a reader of the article who is qualified to help may feel inspired to improve/update the sources. I did research some new sources a few years ago but was disappointed that there wasn't really anything new to say. There seemed little point in replacing one review for another simply because the latter had a more recent date on it. I don't think the Neal randomised trial, for example, is likely to be updated with a newer RCT. It did its job wrt providing RCT evidence for insurance and government bodies who make decisions about efficacious medical treatments they wish to fund. The basic process of ketosis has been understood for nearly a century and more modern sources add nothing new. We still really don't understand why such a diet helps with epilepsy, though. I guess that's rather frustrating for Western science, but epilepsy is a problem with the brain, not individual neurons or chemical reactions, and we don't really understand the brain either. At least it has some plausible explanations and doesn't break the laws of physics like homoeopathy :-).
Looking at the areas that were tagged. I think the lead paragraph is basic stuff that hasn't changed since the 1920s. The lead sentence and sections that deal with research and possible other disease treatments is most likely to become outdated. I'm not aware of any medical uses for the KD that have reached mainstream other than for epilepsy. Just about any brain disorder from cancer to Alzheimer's to Tourette syndrome has been considered, as well as usage for dieting and diabetes control. I don't think epilepsy's rank after stroke in terms of serious neurological disorders has changed, or may ever change. The history of the diet and its conclusion with it becoming a standard (albeit not primary) therapy once again, is unchanged.
In terms of source-aging we have to consider any article is dealing with lots of different facts. If the best history of a disease/therapy was written 10 year ago, then that's still the best source even if there are some modern sources that copy/paste/tweak it. Has anyone improved on Temkin's "The Falling Sickness: A History of Epilepsy" book, for example? Some areas of our knowledge of the body are changing faster than others. Some diseases and therapies get more research than others. I dare say that cancer therapy, particularly common cancers, is a fast moving subject. This one less so. So I wouldn't hold the "five years old" guideline as anything other than a very crude measure. My point I suppose isn't really the age of the sources, but whether, when reading new sources, one realises that the facts are now considered to be wrong or are out of date. And for that, one really needs to do a literature search, rather than just look at the references list. I guess it is time I did another search .... :-) -- Colin°Talk 21:30, 5 May 2015 (UTC)
Asking for a review of FA status of this article
I am initiating the process of reviewing the FA status of this article by posting this message on the talk page. My main concerns are with older references which really weren't addressed adequately for me. I will take a closer look at the article to highlight more of the concerns that I see that may need improvement.
Search results for free med journal review articles published in the past five years
Weak source and bold statements
"Extraordinary claims require extraordinary evidence".
The claim made in this edit that "The treatment results of the [diet] are better than most of the new antiepileptic medications." is an extremely bold claim. The source used (PMID 25221391) does confirm this but then doesn't actually present any evidence to back it up. Firstly, one must ask "in what kind of patients" and secondly one must ask "in what trials". Today, the KD is only used after many medications have failed and mostly in children. So we don't really have any modern experience of the KD as a first-line treatment (except perhaps in some rare metabolic disorders, or for trials in infantile spasms) nor do we have good contemporary evidence of its use in adults. Secondly, to state that it is better, one really requires a trial comparing it against "new anti-epileptic medications". And this hasn't been done. The closest is a randomised trial where the control group got "continuing treatment (on their existing AEDs) for three months" versus "adding the KD (on top of any existing AEDs) for three months". Advocates of the diet reckon that after you've tried several drugs, and for children especially, the diet is probably more likely to be successful than trying yet another drug. But that's their expert opinion rather than fully evidence-based results. So the issue is complicated and is mostly covered by the existing article text.
The addition of the above source as a reference in this edit is problematic. This paragraph, and that sentence is history. There's no better source for that that the current source which is an entire chapter in a professional textbook on the history. Every single article, just about, on the KD has a short "Introduction" section that covers the history in a sentence or two. The source given here is no different and adds nothing. I could pick a hundred other sources that do the same. I've already mentioned how history does not need up-to-the-minute sources. The state of epilepsy treatment in the 1920s is well documented already. But further, the source does not actually support any of the sentence. It doesn't say it was widely used or studied and doesn't mention bromides or phenobarbital. It merely says it was "initially devised in the 1920" and puts the decline down to "phenytoin and sodium valproate" (the latter drug is from late 20th century). Even if it did support the text, the source is so shallow that any reader following the link would learn nothing new about the history.
The citations in this featured article, support all the text preceding them in the paragraph up to the previous citation. So if a paragraph has one citation at the end of it, then the whole paragraph is sourced to that source. One cannot just add further citations against random sentences and phrases within the paragraph, without ideally also having access to and reading the original citation for the paragraph as a whole. Otherwise, the link between article text and sources begins to rot and soon nobody is sure what is backed up by what.
Lastly, a featured article is not written by finding random papers on PubMed (or by just reading the free ones) and inserting random facts or adding citations here and there. That approach might work for start-class articles but not when we're trying to write at this level. It will taken some time. -- Colin°Talk 21:54, 11 May 2015 (UTC)
Freeman's most recent book
Freeman's most recent book came out in 2011 and contains the same information as the 2007 text. It is not a medical textbook, but it is more recent. Is that a helpful source? Dr. James W. Wheless's newest medical textbook on epilepsy is from 2012. Why wouldn't this be a better source than his old one?
Clarification?
I've only read the lede, so perhaps it's explained in the body of the article, but I don't understand this addition from last July bolded below:
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories to maintain the correct weight for age and height. This classic ketogenic diet contains a 4:1 ratio (although a 3:1 ratio has also been used) by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains and sugar, while increasing the consumption of foods high in fat such as nuts, cream and butter. Thus, an individual's diet is composed of 90% and 86% of calories coming from fat, respectively.
What does the 90% and 86% refer to? The 3:1 and 4:1 ratios? Whatever, it could be clearer. --Anthonyhcole (talk · contribs · email) 06:09, 13 May 2015 (UTC)
Guideline update
Source NICE Guideline CG20:
- Stokes T, Shaw EJ, Juarez-Garcia A, Camosso-Stefinovic J, Baker R. The diagnosis and management of the epilepsies in adults and children in primary and secondary care. (PDF). London: Royal College of General Practitioners; 2004. ISBN 1-84257-808-1
has been superseded by
- The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care. (PDF). January 2012. National Institute for Health and Care Excellence.
The Evidence update notes the Modified Atkins diet may be effective for children with refractory epilepsy, but they do not regard this as a fact to update in the guidance. They cite Use of the modified Atkins diet for treatment of refractory childhood epilepsy: A randomized controlled trial as evidence. This definitely looks like a fact to include in our article. However, NICE have three problems with the trial. It is not blinded (but then that is essentially impossible for this therapy), 77% participants were male and 44% vegetarian, which may limit its applicability to the UK. These issues meant they didn't recommend it in their guidance, recommneding a European setting for future trials. -- Colin°Talk 15:20, 17 May 2015 (UTC)
British English?
The population of the United States is roughly 5 times that of the UK. In order to ensure that Wikipedia serves as wide an audience as possible, I propose changing the style of this article to U.S. English instead of British English. -- Preceding unsigned comment added by 139.78.252.149 (talk) 21:50, 10 June 2015 (UTC)
Cyclic ketogenic diet?
Dear ketogenic diet editors. I've just come across:
- Cyclic ketogenic diet (edit | talk | history | protect | delete | links | watch | logs | views)
- a rather poor article. Is this a viable distinct topic? And if so does it merit its own article, or at most a mention here? Alexbrn (talk) 05:30, 23 July 2015 (UTC)
-
- Various low-carbohydrate diets are used for slimming or body-building or as a lifestyle choice. Some are ketogenic and some are only ketogenic for a phase of the diet. Most are also high protein. Most are followed by adults rather than sick children. Etc, etc. There's an adjective in common with the medical therapy discussed here, but that's about all. -- Colin°Talk 15:54, 24 July 2015 (UTC)
Proceeding with review of FA status
To those who have contributed to the improvement to this article I need to let you know that I am proceeding with the request to have this featured article reviewed. Little to no progress has been made to update references that comply with WP:MEDRS. I completely understand that older references are not necessary better references but is likely not true for the whole article. Almost every reference cited is sourced to publications that are more than five years old. I might be missing something but it doesn't appear that any references include review articles, systematic review articles, meta-analyses, reliable and official webpages by the CDC or WHO or medical textbooks.
I am not criticizing the article; It's prose is excellent, it flows naturally point by point. Obviously, a lot of hard work has gone into it, but few if any significant edits have been added that provided good sources.
I am no way suggesting that this article is less than a good article and I know it was created and edited in good faith (except by vandals). Best Regards,
suggested update
In the Other Applications section, the third paragraph cites a 2013 review and says "the only evidence of benefit is anecdotal". This article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215472/ has a slightly stronger conclusion and cites clinical studies that I think can be described as preliminary rather than anecdotal. Since I've never edited a featured article, I'll leave that observation here for consideration. JonSidener (talk) 17:30, 15 May 2016 (UTC)
Review
doi:10.1136/practneurol-2015-001288 JFW | T@lk 11:40, 17 May 2016 (UTC)
Doesn't merit Featured Article status
This is essentially an article about the ketogenic diet as a treatment for epilepsy. If it were titled as such, it might merit the star. As a general treatment of the subject, it is too specific. It doesn't have much to say about the widespread use of the diet for weight-loss and treatment of diabetes. It doesn't say anything about how the diet actually works - the chemistry. -- Preceding unsigned comment added by 80.174.78.122 (talk) 09:33, 20 July 2016 (UTC)
Source of the article : Wikipedia
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