Talk:Parkinson's disease/GA1

GA Review

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I'm delighted to have the chance to review such an important article. I'll add points here as I go through it part by part. On an initial scan, I see that there are a number of places where copy-editing is needed, so I'll do some of that as I go. I'll work in very small chunks to make it easier for you to review each change -- feel free to undo anything that you think is incorrect or misguided. Looie496 (talk) 15:58, 30 June 2009 (UTC)

Garrondo's points

I'm actually going to start with a copy&paste of the points that Garrondo raised, because I believe they are all valid:

Signs and symptoms

Mnemonics are discouraged (considered writing for professionals)

Fixed (eliminated).--Garrondo (talk) 07:36, 1 July 2009 (UTC)

Most symptoms do not have a citation, while the ones that have them are primary sources: a text book or seminal review could be used to give a reference for them; eliminating primary sources per WP:MEDRS

Since it is a GA nomination this is not as important, but the section would look much better if prosified instead of having a list format. Additionally maybe such an extensive list of symptoms maybe is not as important as a summary of the evolution-importance of the different groups of symptoms.

Causes

I believe this section is quite misleading and should be reviewed with secondary sources; probably there is a confusion between PD and parkinsonism.

Introduction: More importance should be given to idiopathic PD since it is the most common. Citations needed.

Toxins: Probably a combination of undue weight: Do secondary sources give so much importance to toxins? I doubt it. Second and third paragraph would be better moved to research directions as they do not truly talk about parkinson but about an induced parkinsonism with no evolution which is used as animal models (See for example Huntington's disease)

Created animal models subsection in research directions and moved second and third paragraphs.--Garrondo (talk) 07:36, 1 July 2009 (UTC)

Head Trauma: Too much importance to single primary sources.

Diagnosis

I believe that UPDRS is not used for diagnosis but for evolution following.

Are there any proposed diagnostic criteria? Which ones? (See Alzheimer's disease)

Regarding "diagnostic tools": In text only DatScan is commented while image talks about 18-F PET: What are their differences and similiarities? When is better used each one?

Treatment

It should be stated when each treatment is recommended.

L-Dopa

L-Dopa is the most common treatment, however its section is completely unreferenced.

I also feel that italics use per MOS for trademarks is uncorrect (I believe trade names should be italized)

Surgery

It should be much more explained: how is it work?, what kind of surgery is it? Same for deep brain stimultion, which only has a line.

Prognosis

Scales are unreferenced

Epidemiology

I am sure that something else than a line could be said

Research directions

it is probably too long: maybe it could be summarized and moved to a secondary article (See Alzheimer or Huntington diseases articles).

Complementary treatments: it probably has problems of undue weight. Secondary refs should be searched to achieve balance.

Notable sufferers:

Not a single ref is provided.

It is simply a list of sufferers with no reason for the inclusion of each one. Section has to be fully cleaned up.

Whole article

Please make sure to use "Parkinson's" rather than "Parkinson" everywhere. I fixed a couple of these but there are more. Looie496 (talk) 15:07, 4 July 2009 (UTC)

You are right, I fixed all the rest, thanks for the notice.  Done GiggsHammouri (talk) 10:36, 28 July 2009 (UTC)

Seconding one of Garrondo's points, the WP:MOS considers lists to be non-encyclopedic. It may be acceptable to have one list in an article like this, but the rest should be converted to prose. I'm aware that this actually makes them harder to understand, but it should be done anyway. Looie496 (talk) 15:11, 4 July 2009 (UTC)

Lead

I have just found myself doing a rather significant rewrite, partly copy-editing, but partly I felt that the relationship between PD and Parkinsonism needed to be clarified. Please check and revise as needed. Looie496 (talk) 16:55, 30 June 2009 (UTC)

References

I'm still working my way through at my usual slow pace, but in light of recent developments, I need to jump the gun and say that there is no way I will pass this unless it at least comes close to complying with WP:MEDRS, which means relying on review articles whenever possible and avoiding reliance on the primary research literature. My initial impression is that far too many primary publications are cited -- but if you feel this is wrong I won't push it, I haven't gone through in detail yet. Looie496 (talk) 00:55, 2 July 2009 (UTC)

What if we provide more than 1 citation for the statement, and I ll make sure that one of them is a review, can that work, or should we be very specific and add only 1 citation?? please check the signs and symptoms section to see what I am talking about, I worked on it yesterday MaenK.A._Talk 14:57, 2 July 2009 (UTC)

It's generally best not to use more citations than necessary, because it makes things harder for people who maintain the article in the future. If you're stating a specific fact and there is a particular paper that people in the field associate with that fact, then it's reasonable to cite it, but you definitely don't want to be citing multiple primary papers to establish a single statement that is covered in review papers. (This is written before looking at the section you pointed to; I'll look at it shortly.) Looie496 (talk) 15:03, 2 July 2009 (UTC)

I ll revert every thing and start all over again, thank you for the constructive comments :-) MaenK.A._Talk 23:12, 2 July 2009 (UTC)

Another question, can we use the references used by the reviews them selves?? MaenK.A._Talk 17:25, 3 July 2009 (UTC)

You can use any reputable journal publication or book if it is needed to substantiate the material in the article. There are basically two goals: first, to minimize the number of references because they take up a lot of space and impair readability; second, to use secondary references whenever possible. The aim in referencing a high-level article like this isn't to provide a guide to the literature, only to substantiate the statements in the article. Looie496 (talk) 14:26, 4 July 2009 (UTC)

Classification

I think this section is basically good. It needs more refs, though. Also the wording is too formal and technical in some places -- remember that these articles are written for a broad audience. Words like "ophthalmoparesis" and "apraxia" should be avoided, or at least defined. Also, "med-speak" such as "presents with" should be avoided as much as possible. Looie496 (talk) 15:05, 4 July 2009 (UTC)

In the paragraph "The usual anti-Parkinson's medications...", I'm not sure which disease is being referred to. CBD? In that case, the last sentence from the preceding paragraph should be moved down into this one. Looie496 (talk) 15:05, 4 July 2009 (UTC)

I'd like to use this section to discuss whether Parkinson plus syndrome should be merged into the Parkinson's disease article--Robert Treat (talk) 02:24, 10 September 2009 (UTC)

Images

The images require proper formatting.

The section on epidemiology also requires some more work.--Doc James (talk · contribs · email) 01:16, 6 July 2009 (UTC)

Jargon

Would you consider providing some help for the general reader who does not understand some or all of the following, please: idiopathic, cognitive dysfunction, DLBD, ophthalmoparesis, autonomic dysfunction, syncope, dysphasia, apraxias, neuroleptic, akinetic-rigid, decremental loss of amplitude, prefrontal hypometabolism, dopaminergic, dystonia, dysmotility, injuries associated with attempts at accommodation, hypokinetic, non-striatal pathways (there's more in Pathophysiology, but it may be that it's not possible to explain fully to someone without a background in anatomy), agonists, dyskinesias, antiemetic, hypertensive crisis, anti-apoptotic.

I see that idiopathic is both explained and wikilinked in Causes, but it is frustrating to see the word used twice before finding out what it means. 'Dopaminergic' is described as "dopamine-secreting" in Pathophysiology; did you intend that usage to apply in the section Neuropsychiatric in the phrase "dopaminergic medications"? Would a wikilink to dopaminergic be useful, or is a more specific meaning of "secreting" intended? --RexxS (talk) 22:32, 26 July 2009 (UTC)

I tried to clarify and wikilink every word or phrase you had mentioned. But as you already know, it is hard to explain every word in each article on wikipedia, so it is best to just wikilink it, and if the reader is still interested to understand the meaning of this particular word, simply the reader can follow the link. As for the word dopamenergic, it means anything related to dopamine, and since the aforementioned cells secrete dopamine, they are referred to as dopaminergic, just as it is explained in the dopaminergic article. I also wikilinked the word idiopathic. I hope that your request has been fulfilled, and if not, please comment and I'd be more than happy to help. Thank you for your contribution. GiggsHammouri (talk) 12:19, 28 July 2009 (UTC)

Many thanks, I think that's a big improvement for non-medics like me. I have a science background, so I can generally understand what is explained in the linked articles, and obviously find the convenience of a link on first occurrence very helpful. Sorry I didn't make myself clearer before: I first got the impression that dopaminergic meant "dopamine-secreting" (the definition used in "Pathophysiology"), which fitted with "dopamine-secreting neurons", then wondered what "dopamine-secreting medications" would be in "Signs and symptoms - Neuropsychiatric". Reading the dopaminergic article has cleared that up now I can mentally substitute "dopamine-related" for dopaminergic.

One small point left is that I'm still not sure what 'DLBD' means in the third paragraph of "Classification". Is it a typo for 'DLB' (which is explained in the previous paragraph)? or is it an alternative acronym for the same thing? or something different? You have written out in full all the other acronyms at first use. Cheers. --RexxS (talk) 14:36, 28 July 2009 (UTC)

I am glad that we have cleared up the dopaminergic misunderstanding. And for the DLBD, I'm sorry I didn't fix it up the first time, but actually, it is almost the same thing, as the extra D stands for Disease. I agree it is confusing for non-medical readers, but I fixed it now, and I hope there isn't anything else that could be misleading. I wish I was clear and sufficient, and haven't disappointed you to get a clear picture of the Parkinson's disease. Thank you for your intervention as it was nothing but an improvement to the article. I look forward to hear from you again, cheers.  Done GiggsHammouri (talk) 23:07, 28 July 2009 (UTC)

Thanks very much for your prompt response. I'm most certainly not disappointed and - although medical articles can be hard work for non-medics - I think you've made a fine job of painting that clear picture of PD. I look forward to commenting when it reaches FAC in the not-too-distant future. --RexxS (talk) 23:19, 28 July 2009 (UTC)

Fail for now

Although this article has seen some pretty substantial improvements since the GA nom, most of the points in the review have not been addressed. It really needs to be removed from the queue one way or another, so I am going to fail it for the present, although I hope it can reach renomination shape in the near future. Looie496 (talk) 20:27, 17 August 2009 (UTC)