Wikipedia:Peer review/Fecal incontinence/archive1

Fecal incontinence

This peer review discussion has been closed.
I've listed this article for peer review because…

previously stub, recently undergone large expansion by only one editor with limited experience of wp style etc. I am particularly unsure about the level of medical terminology used... is it understandable without some medical knowledge? Hoping to move this article to GA status eventually.

Thanks, lesion (talk) 04:13, 19 November 2012 (UTC)

I could do this review. Could the nominator reply and confirm they are still interested having a review? --Noleander (talk) 10:37, 6 December 2012 (UTC)

I am willing to action the suggested improvements, thanks.lesion (talk) 19:00, 6 December 2012 (UTC)

Comments from Noleander

• No numbered paragrs in Lead - The lead should not have any bullet points or numbered paragra. All pargrs in lead should be straight prose. Max 4 paragrs.

changed numbered para to prose

• wording in lead: " the perceived devastating impact of FI for patients." - word "devastating" is too subjective; too argumentative. Need a more objective wording. E.g. "significant" or "severe".

Reworded to make clear that word devastating was taken from sources, rather than the personal POV of wikipedia editors:

"Some suggest that physicians may fail to recognize the impact of FI for patients, describing it as devastating."

• Too conversational: "To understand FI, it is helpful to study the normal continence mechanism.." - Too informal & conversational. WP articles should be very detached & objective. Very aloof wording. That whole sentence could probably be deleted.

Removed

• Wording: "The rectum is believed to act as a reservoir to .." - "believed" is wrong here: For facts that are 99.9% certain to scientists, just asser them. Uncertain words like "believe" should only be used when there is great uncertainty (e.g. is there extraterrestrial life? etc).

Reworded "The rectum acts as a reservoir..."

• CIte needed: for the following: "In continent individuals, defecation can be temporarily delayed until it is socially acceptable. The rectum is able to expand to a degree to accommodate this function (rectal compliance). Distension of the rectal walls creates the awareness of needing to defecate."

Re-used suitable named ref which defines compliance, also changed wording awareness -> urge.

• Section ordering: The Mechanism section ends with "Problems affecting any of these mechanisms and factors may be involved in the etiology of FI." I think the Etiology section should immediately follow this, for flow & continuity.

unsure of best order, but if we are treating this page as a "symptom or sign" page, Wikipedia:Manual of Style/Medicine-related articles#Symptoms or signs sort of agrees with you, so reordered. Also changed titles, replaced etiology with pathophysiology, "Prevalence & risk factors" with epidemeology, "symptoms" with "Signs & symptoms" and "diagnosis" with "diagnostic approach" as per above manual.

• No main link: "Main article: encopresis" There is no need for that. The plain link on the word encopresis in the prior paragr is sufficient. A "main" link usually only appears at the top of a section (after sec title, before any prose).

Removed main link

• key fact missing in Lead: "FI is a sign or a symptom, not a diagnosis" - that needs to be in 1st paragr of Lead section.

Added above to lead, with wikilinks

• Citations & footnotes: I must say, the citations look outstanding. Good job. Per WP:SAYWHEREYOUGOTIT, I presume that you personally read those sources, true?

All refs I added I read, (the textbooks i read only the relavent chapters) however there were existing references before I started on this page, which I have not read. I retained all existing refs into the current page, suggest trust previous editors in this.

• Roman numerals NG: Readers cannot be presumed to know roman numbering, so " i) intra-anal, ii) intra-vagina iii) cutaneous ..." must be changed; maybe just eliminate the numbers altogether.

removed roman numerals, changed to prose without numbering. Also added non jargon explanation of these phrases in parentheses

• Capital: "... retrograde colonic irrigation, This is were a vo" - lowercase "This"

Typo, corrected

• Picture vs. Text? - There is an illustration near top with caption: "Stylized diagram showing action of the puborectalis sling, ..". (1) I dont' see where this sling is mentioned in the article itself; (2) Is this correlated with the procedure mentioned in "Dynamic graciloplasty" section? If so, that picture should be moved down to that section.

worked term "puborectalis sling" into section "physiologic continence mechanism", with explanation. Also slight edit of picture caption for clarity. Article might benefit from some simple diagrams to accompany some of the treatment options to help with this?

• Uniform terminology: Subsections under Surgical treatment section: the top bullet outline uses term "Fecal diversion (colostomy)" but then the section name is "Fecal diversion (stoma creation)" ... need to be uniform.

Both outline and section name now "fecal diversion (stoma creation)"

• Wording: "FL is a related topic to rectal discharge, .." - change to "FL is related to ..."

done

• Comprehensive: Section "Types": is this supposed to contain a comprehensive list of FI types? I see only 2 subections: AI, and FL. Do those two types make up all the various kinds of FI that there are?

This is difficult, Fecal leakage was to be its own page, but I merged it in the end with this main page...Still not sure if "types" just needs to be cannibalised into relevant main sections. FI is supposed to have 4 main types, gas, liquid and/or mucus and solid.

• Clarify: "It has been suggested that male FL patients respond to non surgical treatment, as compared to those with more severe forms of FI who usually require surgical intervention." - Not sure what this is saying. Males but not females? "Compared to ..." I would expect to see a population group named there not a "form of FI". Re-word whole sentence.

Re-read source, this whole sentence was supposed to refer to males with FL and males with FI. Reworded: "Research carried out on male patients with FL suggested that there was improvement with non surgical treatment. This was contrasted with male patients with more severe forms of FI, who usually require surgical intervention"

• avoid acronyms: "quality of life (QOL)" - since QOL is only used once after this, just eliminate the acronym: they should be avoided.

done

• Citation: Citation needed for 2nd half of the QOL paragraph.

whole para is adapted from same source, moved citation to end of para to reflect this.

• Contradiction? - article says "Diagnosis of FI usually begins with a thorough medical history ..." but also says "FI is a sign or a symptom, not a diagnosis". I'm not a medical person, but that seems to be inconsistent. I take it that FI is a symptom, and there may be several underlying causes/diseases/issues. If so, should the "Diagnosis" section be renamed or ???

Changed "diagnosis" section to "diagnostic approach" as per manual above. Reworded contradictory phrase to "Identification of the exact cause(s) of FI usually begins with..."

• That is all for now. Why don't you address the items above, and when you are done, if you want more, post a note on my Talk page, and I can go thru the article again. Regards, --Noleander (talk) 21:57, 6 December 2012 (UTC)

End Noleander comments. --Noleander (talk) 21:32, 6 December 2012 (UTC)

my comments italicized lesion (talk) 01:38, 7 December 2012 (UTC)