Wikipedia:Peer review/Rumination syndrome/archive1

Rumination syndrome

• A script has been used to generate a semi-automated review of the article for issues relating to grammar and house style; it can be found on the automated peer review page for July 2009.

This peer review discussion has been closed.
I've listed this article for peer review because I have turned it around from a... well... I'll let you compare the differences yourself and apply an appropriate term for what it was.

Having made this much new content, I'm sure I've tangled myself a web of grammar, spelling, and style nightmares that I'm not able to spot because of how much I've saturated my mind from reading and re-reading the whole article. The references list also seems really messy in comparison with featured/A/GA medicine articles. Style is primarily what I need input on, as I know it reads somewhat unprofessionally as it stands and I don't know what to keep and what to rewrite.

I'm hoping to eventually earn this a FA status if possible, so any comments and suggestions would be really appreciated! :)

(Also, if I need to remove the under construction tag for this to be eligible, it would not be a problem)

Thanks, ʄɭoʏɗiaɲ ^τ _¢ 03:27, 15 July 2009 (UTC)

Comment: The article still has an "Under-construction" banner, though it seems that little editing has taken place since the beginning of this month. The peer review should not take place until the reconstruction is complete; can you say whether this is so, and if it is, remove the banner? Brianboulton (talk) 15:57, 23 July 2009 (UTC)

The major reconstruction is done... I only had that there so that people wouldn't delete half of it saying that its unsourced or (insert reason here). I'm removing the banner now. - ʄɭoʏɗiaɲ ^τ _¢ 19:27, 23 July 2009 (UTC)

OK, I'll do the review in the next couple of days. Brianboulton (talk) 20:53, 23 July 2009 (UTC)

Brianboulton comments

I don't know anything of this subject, but I found it generally interesting to read. Some might find the proliferation of medical terms a bit daunting, but its hard to see what you can do about this, beyond careful linking. Because of my lack of knowledge, most of my review is about structure, grammar, MOS etc. I have made some corrections as I've gone through, but mostly I've left them to you.

The bigest weakness is the lack of inline citations in some sections of the article, with whole paragraphs left uncited. I have indicated the areas where this is most aparent. The article does not appear to lack good-quality sources, but it needs many more citations to them. Here are my detailed points.

• Lead
  • Is the long citation string in the first line necessary - do we really need seven citations for what seems to be a simple statement of fact?
  • Notes [8] and [9] are unsourced statements (personally, I don't think post-prandial needs explaining, but you could make a wiktionary link)
  • Overlinking: "aches" and "pains" are common words, don't need links
  • What does "cognitively healthy" mean?
  • The sentence beginning "Most of thos eafflicted..." is too long and winding. Suggest full stop after Bulimia Nervosa, then "These similarities include...
  • I think the gerundive form of "binge" is "bingeing", not "binging".
• Signs and symptoms
  • The section needs more inline citations
• Rumination should be linked on first mention (after the title) in the lead, not here. And it doesn't need a capital R here.
  • Another overlong sentence, beginning
  • "In some individuals..." Suggest full stop after "swallowed". Then: "In others,...". (I'm not going to keep pointing out all the sentences that need splitting, but I suggest you check through, and take action where necessary.)
  • "...anywhere from during the actual ingestion..." Awkward phrasing, suggest drop "during"
  • No-break spaces needed: 90 minutes, 30 seconds, and lots more cases throughout the article.
• Causes
  • The section needs more inline citations. For example, nothing in the first paragraph is cited.
  • Full stop, not comma, required after "cognitively impaired"
  • "over- and under-stimulation" - hyphens required
• Diagnosis
  • Almost complete absence of citations
  • Why the list format? The section should be presented in prose, unless you are quoting from an actual list, in which case the source should be cited.

• • "bile" has been linked previously
• Differential diagnosis
  • Again, the section is presented effectively as a two-item list, and should be adjusted so that it is in normal prose.
  • Bolding should not be used in text (per WP:MOS).
  • Bulima nervosa has already been linked
  • "misdiagnosis" is a word, it doesn't need parentheses around the "mis"
  • The sentence should stop at "misdiagnosis" - the rest reads too informally. The comment does, however, require a citation.
• Pathophysiology
  • Lack of citations (none in first or third paragraphs)
  • Bolding should not be used in text
  • Third paragraph should not be in bullet-point format.
• Treatment
  • "weened" → "weaned"?
  • Strange clustering of citations at the section end; several earlier staements appear uncited.
• Prognosis: far too short to be a section on its own. Either expand, or merge into another section
• Epidemiology
  • No citations in the first paragraph
  • Number ranges, e.g "6–10%" need ndashes, not hyphens
  • Formats such as "12.9 ± 0.4" are unintelligible to the general reader. You must explain in words what is meant. After the fitst instance you can add, after your explanation, "...(represented by 12.9 ± 0.4)" and then use the numeric form thereafter
• History: this should be the first section, not the last section of the article.
• General points
  • Reference [13] needs formatting
  • External links should be more than web addresses. A minimal description should indicate the nature of the link.

I hope you find these comments helpful. As I can't watch all the peer reviews I do, please leave a message on my talkpage if you don't understand something I've said. Brianboulton (talk) 20:54, 24 July 2009 (UTC)

Awesome, and again thank you so much! I'm going to try and fix everything you've pointed out (Unfortunately I cannot find a study which defines congnitively disabled patients with rumination... Every study has one sentence which reads: It is found in 6–10% of mentally retarded patients.), starting with the lead right now. I'm copying this list to the talk page to check things off as I go. - ʄɭoʏɗiaɲ ^τ _¢ 18:57, 29 July 2009 (UTC)

Comments from colin (talk · contribs)

This is a pretty good article that still needs a fair bit of work before it is ready for FAC. Here are some of the issues I found.

• The fact that it is "under-diagnosed" is not a defining characteristic of rumination syndrome. Suggest this fact be tagged on the end of (as a consequence of) the "lack of awareness" sentence at the end of the paragraph.

Actually its one of the most defining characteristics of the disorder is the total ignorance of its existence by most doctors. - ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

• Avoid "recently". See WP:DATED. How recent is recent? The last year, last few years, last decade, ...? Similarly for the benign aspect. The Levine(1983) source is not sufficient to say "Past studies of rumination syndrome have described it as benign." as that paper could be a one-off. Your Sidhu(2009) source provides the contrast between past/present so that source covers both sentences. Suggest you drop Levine(1983) and Tamburrino(1994). The Sidhu(2009) paper shows how to handle the shifts from old->new. You can say things like "first believed to " "historically treated as", "Originally, ..." and then contrast that with "now". Rather than have the reader wonder "how recent is recent" we just let them know a shift has occurred and here's the current state of play.

The paper is a one off that unfortunately continues to be cited to this day (They can't make money off the cure, so its benign). Have adjusted this over to Sidhu 2009 though. - ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

• Always a concern when citations only appear in the lead -- the lead should be a summary of the body so this indicates the lead is probably covering something that the body doesn't cover (or covers differently). I see that the History section doesn't really include anything much about the last century. That section should cover the above shift in thinking.

Its a small tidbit that the previous reviewer felt belonged there as it didn't fit in any sections. ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

• Avoid language like "suffering from" and "afflicted". Just say "an affected adult with normal intelligence...", "most adults with the disorder..."
• Avoid language like "bulimics" -- best not to define people solely by their medical condition. How about "bingeing and purgine seen in bulimia".

Done - ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

• "private about their illness" I can't find this in the first two sources. Do you have a source for this?

• "few are correctly diagnosed" this is stronger than "often misdiagnosed" allows for. Do you have a source that confirms that correct diagnosis is very rare?

will change to often misdiagnosed. There would never be such a source as its impossible to say "Heres a bunch of people that haven't been diagnosed with Rumination syndrome" because in finding that they would diagnose them. - ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

• The lead says the reason for this is the similarity with bulimia nervosa. However, Papadopoulos(2007) says "This is due to insufficient awareness of the clinical features and also due to the broad spectrum of clinical symptoms that blur diagnosis." It then goes on to say it is frequently confused with "bulimia nervosa, gastroesophageal reflux disease and upper gastrointestinal motility disorders, including gastroparesis and chronic intestinal pseudo-obstruction." The Chial(2003) source uses almost identical language. So the first two aspects are the reason, the confusion with is the consequence. The source doesn't single-out bulimia.
• The figures for treatment success are more exact than we should quote. We can't really say treatment has an 85% improvement based on one study in one hospital. That primary research paper doesn't give us the evidence that the same treatment is widely used and with similar results. Nor is that study the kind that can actually prove the treatment caused the improvement (many of the patience could have spontaneously improved, for example). The figures of 30% resolved, 56% improved are for those patients they managed to follow up at 10-months. The total number of patients was 147 so those 56 might have been the patients who responded well. See ascertainment bias.

That study was performed at, as far as I've found, the only place in the world that currently treats this condition. - ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

• The distribution of age at diagnosis chart has a mistake in the last column (14 rather than 16).

Will fix. - ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

• I don't think the first paragraph of Epidemiology needs eight footnotes. That's the sort of statement that should be sourced to one good review.

There's only one or two reviews. Whatever Papadopolis doesn't have often must be sourced by several primary sources. - ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

• The age-of-onset figures are too accurate. Those are figures that are the result of one study of 147 patients aged 5 to 20 diagnosed at one clinic between 1975 and 2000. I see Eubulides (talk · contribs) has already found this issue. You say this paper is cited by lots of others. Do any of those generalise it? We can't generalise those figures or state them as a worldwide fact. Saying the mean age of diagnosis was 12.9 might simply be an artefact of the sample set containing people aged between 5 and 20. The issue isn't so much that there's only one study, it is that the limitations of that study prevent us from widening its results.

We should include what we do know right now, even if it may be statistically flawed. I don't forsee any wider studies if they have 150 patients over 25 years. A few studies in the last couple years have included the results of Chial (Which is rather recent, being from 2007), often quote for quote. It is by far the most accurate source statistically. - ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

• I suspect I'll continue to find issues similar to those Eubulides found at FAC. This sort of investigation is very time-consuming, difficult without access to all the sources, and without a fair amount of reading up on the subject. I suggest you go through the article sentence by sentence challenging every fact. Does the source say that or does it say something much more limited? A typical flaw would be our text generalising from a single study, which is why reviews are such useful sources. Have you got a partner or friend who could play devil's advocate? You could sit together, working through the article, with one having to convince the other, ticking off or crossing out as you go along.

Well, I do have my significant other who had this for the past 5 years. I suppose this is what I'll need to do (I in many cases only have abstracts to work with. I refuse to pay $75 to look at a sheet of paper (but only for 24 hours)). - ʄɭoʏɗiaɲ ^τ _¢ 15:41, 16 October 2009 (UTC)

Colin°^Talk 17:31, 14 October 2009 (UTC)

• WP:MEDMOS recommends that when the article has the full text freely available online, it should be linked to (e.g., via the URL parameter in cite journal). This is in addition to the DOI, even if they end up at the same place. This is so that readers without journal access can tell if they can read the source or if they are going to be charged a ridiculous fee for two sheets of A4 paper. Colin°^Talk 17:35, 14 October 2009 (UTC)

A few replies.

• Wrt defining features. You may regard "under-diagnosed" as an important feature, and one you want to stress, but it isn't defining. If this condition achieves wider awareness and starts becoming more frequently diagnosed, would it cease to exist? Be careful your advocacy doesn't colour the article.
• Wrt "Heres a bunch of people that haven't been diagnosed with Rumination syndrome" not being in a paper. Actually that kind of study does occur. For example, you could take a bunch of people diagnosed with bulimia or a bunch of people attending an eating-disorder-clinic and put them through the tests for rumination syndrome to see if you can pick up undiagnosed cases. It is the proper scientific way of saying "we are failing to pick up cases of this disease", rather than relying on a hunch.
• Wrt treatment. If there is only one centre treating this condition, we should say so and say those success figures apply to them. This raises the question: what happens to people elsewhere? Are they not diagnosed or are they told there is no treatment?
• Having only abstracts will significantly weaken your chances a FAC. It is like claiming to read a book having only read the blurb on the back. The purpose of a citation to a journal article is to say "this is what the article says, and I know because I've read it". I know we tend to supply convenience links to the abstract on PubMed through the PMID but that doesn't mean we are claiming that our source the abstract. It might be useful to highlight which sources come only from you reading the abstract. Then try to enlist help from someone with access to the sources. Is there any way you can get to a big library with access? FAC requires "a thorough and representative survey of the relevant literature on the topic", which for a small topic like this might reasonably expect the editors to have read most of the available journal articles.
• I know you are limited by the studies done and reviews available. This means the text has to be much less confident and more specific in its claims.

Colin°^Talk 16:06, 16 October 2009 (UTC)