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Multiple sclerosis article. This is not a forum for general discussion of the article's subject. |
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Multiple sclerosis is a former featured article. Please see the links under Article milestones below for its original nomination page (for older articles, check the nomination archive) and why it was removed. | ||||||||||||||||
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Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Multiple sclerosis.
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doi:10.1056/NEJMra1401483 JFW | T@lk 15:53, 11 January 2018 (UTC)
Although the article on multiple sclerosis is eloquent and generally informative, many of its attributions are rather obsolete and possibly misleading (or even erroneous). For instance, the sentence in the prognosis section - "Almost 40% of people with MS reach the seventh decade of life" - is derived from an article published in May 1987, yet there have been significant advances in longevity since then, so it is likely that this claim is, in fact, false. (In fact, the 2019 Merck Manual article claims that "Life span is shortened only in very severe cases" [cf. https://www.merckmanuals.com/professional/neurologic-disorders/demyelinating-disorders/multiple-sclerosis-ms].) In addition, the article does not consider the possible efficacy of acetyl-L-carnitine, which may potentially have some benefit in mitigating fatigue among MS patients with low levels of L-carnitine (cf. https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/expert-answers/acetyl-l-carnitine/faq-20057801). Finally, the article discounts the clinical efficacy of oral cannabinoid extracts, even though another Mayo Clinic article suggests that certain medical cannabinoid extracts may alleviate spasticity and pain among some MS patients (cf. https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/expert-answers/cannabis-for-ms-can-it-help-treat-symptoms/faq-20112500). Because the article exerts significant influence as a gold-star recipient, it would be great if it could be updated to reflect recent advances in MS treatment and diagnosis.
2600:1700:F5A1:2460:2103:FE62:D17A:4EA7 ( talk) 18:00, 21 July 2020 (UTC)
Under Other: "Vaccinations were studied as causal factors; however, most studies show no association." This statement is without citation and misleading. The citations used do not support this statement. There is a snippet in the citation used that suspects Hepatitis B vaccination may cause MS but finds no correlation. This alone does not support the complete statement that "most studies show no association to all vaccinations"
Furthermore: "some shots may trigger an infection that causes you to relapse. If you get a live vaccine (which contains tiny, weakened amounts of a live virus), this is more likely to happen." citation: https://www.webmd.com/multiple-sclerosis/multiple-sclerosis-and-vaccines
"Multiple sclerosis presenting as late functional deterioration after poliomyelitis." citation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2397915/
"Certain striking similarities to the epidemiological patterns found in paralytic poliomyelitis have been noted" and "Multiple sclerosis has been shown to be rare between the equator and latitudes 30-35 degrees...In poliomyelitis a similar variation with latitud occurs" citation: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0404.1966.tb02007.x
These statements contraindicate the misleading statement from the main article and postulate a link of MS and Poliomyelitis (or Post-polio syndrome). Considering the polio vaccine is a live attenuated virus that leads to vaccine derived polio outbreaks. — Preceding unsigned comment added by 2605:A601:A0C6:1200:EDC2:D071:347A:4EFE ( talk) 08:05, 14 October 2021 (UTC)
In conclusion: "virus bad unless injected into you for profit to prevent you from contracting the virus..then virus good. Hurr durr derp da derp. derp da derp a doo." — Preceding unsigned comment added by 2605:A601:A0C6:1200:EDC2:D071:347A:4EFE ( talk) 08:10, 14 October 2021 (UTC)
Both the top para and later sections of this article assume inflammatory activity is the core of MS.
However this is now being questioned. See e.g. Smouldering multiple sclerosis: the ‘real MS’. Gavin Giovannoni, Veronica Popescu, Jens Wuerfel, ... First Published January 25, 2022 Review Article Find in PubMed https://doi.org/10.1177/17562864211066751 — Preceding unsigned comment added by JCJC777 ( talk • contribs) 05:59, May 22, 2022 (UTC)
The treatments section is a complete mess. Do we want to include exact clinical trial data in the article (e.g. X was reduced the annual relapse rate by n% compared to Y) or we want to stick with the moderate, mild, ... terminology? Now there are numerical data for some treatments but not for all.
The issue is that there is not head-to-head trials for all pairs of drugs. I propose including the numerical data of the pivotal clinical trials that have led to FDA/EMA/... approvals + the year of the approval.
The idea of putting all these things in a table might also work but I don't want to spend two hours building the table and someone removing it just because it is hard to maintain. So I think we should not go with the table idea now. BehMon ( talk) 22:09, 7 July 2022 (UTC)
I've moved a chunk of excess detail, per WP:SS to Talk:Management of multiple sclerosis, for incorporation there if not already included. A bot will come through in a bit to repair the missing citations here. [2] Those edits were sample only; more could be done, remembering to take care with the important attribution requirements of WP:CWW. BehMon, perhaps you'd be interested in working on that sub-article, as treatment seems to be of interest to you ? SandyGeorgia ( Talk) 00:29, 9 July 2022 (UTC)
Tristario please don't remove maintenance tags without resolving the problem. Readers are confronted with the following text:
Studies show that only 16% of people with relapsing MS needed a cane to walk after 20 years.[medical citation needed][87] For people with relapsing MS, approximately 50% who do not receive disease-modifying treatments will develop secondary progressive MS after 20 years, however newer treatment options may mean this rate will be significantly lower.[155] A more recent 2016 study found only 11.3% transitioned to secondary progressive MS during the ten-year follow-up period.[156][155][87]
This is gibberish; none of the timelines are explained, and then we suddenly get a "more recent". "More recent" than which part of the paragraph, which talks about what and when? Newer treatment options" relative to when? More recent than what ? I understand it's a 2021 review talking about 2016 data; that still doesn't clear up what this paragraph is trying to say about what based on when. That is, if we have something outdated in the article, we should remove it, along with the "more recent" qualifier. SandyGeorgia ( Talk) 02:33, 27 July 2022 (UTC)
I've made an attempt at rewriting the prognosis section, using newer sources. This probably isn't the final version, and some more information (eg. on life expectancy) needs to be added. Any adjustments or comments etc. are welcome -- Tristario ( talk) 03:34, 12 August 2022 (UTC)
Regarding these edits, [3] [4] I have removed this excess detail twice and explained why on the OP's talk. Anna Zelenska please respond to my concerns on your user talk page, and engage on this talk page to gain consensus for adding content. SandyGeorgia ( Talk) 13:51, 26 June 2023 (UTC)
https://tidsskriftet.no/en/2015/05/impact-environment-multiple-sclerosis I have never heard of this journal and so don't know if it's a quality journal. May or may not contain relevant information to the article. P.S. if my citation format breaks some local citation format consensus, let me know and I'll fix it. I used the default reference format so far. Chamaemelum ( talk) 05:45, 13 July 2023 (UTC)
The article is really large and full of information, but it is missing a lot of references. Also, if there is a reference in the paragraphs, it is old and needs to be updated, such as the " Epidemiology" paragraph. Also, there are many phrases or words that refer to other Wikipedia's pages, and this makes it difficult to read the article in addition to Difficult terminology, but on the positive side, the article is really full of information and requires Edits that do not take much time. However, I didn't find much editing! Mesan Hijazy ( talk) 16:15, 24 September 2023 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 November 2023 and 15 December 2023. Further details are available on the course page. Student editor(s): The-GOAT-of-GOATs ( article contribs).
— Assignment last updated by The-GOAT-of-GOATs ( talk) 18:58, 21 November 2023 (UTC)
Hello everyone, its a pleasure to be working with you all on this article. I've read through the talk page and have a general idea of what I want to start editing, but wanted to get some input on what you all think are the most important areas that need improvement and if anyone is currently working on a section of the article so that I can focus my time effectively and avoid stepping on anyone's toes. I will be adding my workplan for the next couple weeks based on your feedback soon.
Also, I'm a new wikipedian so any tips/tricks are appreciated, thanks! The-GOAT-of-GOATs ( talk) 18:45, 27 November 2023 (UTC)
Peer Review UTSW (12/10)
Good job with very detailed workplan
Good job addressing all of the edits on your work plan , I didn't find anything unaddressed
The article some left over medical jargon throughout, although good job on linking out some of the jargon to other wikipedia pages for more information that may not be relevant to this article topic
May be helpful to have a section on comorbidities as MS has quite a few, this could go under associated symptoms.
Under diagnosis section, it would be helpful to delineate diagnostic criteria that are standard of care
Did a great job fixing links/citations and some of the medical jargon is linked to another wiki article which is helpful if a reader needs clarification
Some of the signs and symptoms are under the management section instead of the symptoms section, would move these over
— Preceding unsigned comment added by Yalayli ( talk • contribs) 03:18, 11 December 2023 (UTC)
I will be adding these sources for the ARR figures provided. Don't have the time just yet to do all the referencing but plan to do so in the next couple days! If someone feels like adding them already, thanks :)
Annualized relapse rates: -------------------------------------------------------------
Interferons 0.256 in every 2-week group, 0.288 in every 4-week https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326221/
Copaxone 0.3 ARR https://pubmed.ncbi.nlm.nih.gov/32329362/
Aubagio 0.35 ARR https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437319/
Plegridy 0.12 ARR https://pubmed.ncbi.nlm.nih.gov/35158459/
Tecfidera 0.15 ARR https://pubmed.ncbi.nlm.nih.gov/34465252/
Vumerity 0.11-0.15 ARR https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870078/
Gilenya 0.22 - 0.25 ARR https://pubmed.ncbi.nlm.nih.gov/30731303/
Zeposia 0.18 - 0.24 ARR https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768354/
Kesimpta 0.09 - 0.14 ARR https://www.ncbi.nlm.nih.gov/books/NBK572489/table/cl4.tab11/ https://multiplesclerosisnewstoday.com/news-posts/relapsing-ms-patients-better-after-switch-kesimpta/
Mavenclad 0.1 - 0.14 ARR https://www.sciencedirect.com/science/article/pii/S221103482200270X https://www.ncbi.nlm.nih.gov/books/NBK539998/
Lemtrada 0.08 ARR (RRMS) https://pubmed.ncbi.nlm.nih.gov/31762387/
Ocrevus 0.09 ARR https://multiplesclerosisnewstoday.com/news-posts/2021/08/25/ocrevus-reduces-ms-relapse-risk-but-linked-more-hospitalizations/#:~:text=In%20terms%20of%20efficacy%2C%20Ocrevus,clinical%20trials%2C%20the%20researchers%20said. Bob ( talk) 09:34, 5 December 2023 (UTC)
The term "autoimmune" is vastly overused to describe diseases with no known cause. True autoimmune diseases require the presence of autoantibodies. As per this article, it is NOT confirmed to be autoimmune. It COULD be, but labeling it as such is misleading https://link.springer.com/article/10.1007/s10787-010-0054-4 Cporosus1 ( talk) 10:15, 13 December 2023 (UTC)
This is the
talk page for discussing improvements to the
Multiple sclerosis article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
Archives: 1, 2, 3, 4, 5 |
Multiple sclerosis is a former featured article. Please see the links under Article milestones below for its original nomination page (for older articles, check the nomination archive) and why it was removed. | ||||||||||||||||
This article appeared on Wikipedia's Main Page as Today's featured article on November 18, 2005. | ||||||||||||||||
| ||||||||||||||||
Current status: Former featured article |
This
level-4 vital article is rated B-class on Wikipedia's
content assessment scale. It is of interest to multiple WikiProjects. | |||||||||||||||||||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Multiple sclerosis.
|
doi:10.1056/NEJMra1401483 JFW | T@lk 15:53, 11 January 2018 (UTC)
Although the article on multiple sclerosis is eloquent and generally informative, many of its attributions are rather obsolete and possibly misleading (or even erroneous). For instance, the sentence in the prognosis section - "Almost 40% of people with MS reach the seventh decade of life" - is derived from an article published in May 1987, yet there have been significant advances in longevity since then, so it is likely that this claim is, in fact, false. (In fact, the 2019 Merck Manual article claims that "Life span is shortened only in very severe cases" [cf. https://www.merckmanuals.com/professional/neurologic-disorders/demyelinating-disorders/multiple-sclerosis-ms].) In addition, the article does not consider the possible efficacy of acetyl-L-carnitine, which may potentially have some benefit in mitigating fatigue among MS patients with low levels of L-carnitine (cf. https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/expert-answers/acetyl-l-carnitine/faq-20057801). Finally, the article discounts the clinical efficacy of oral cannabinoid extracts, even though another Mayo Clinic article suggests that certain medical cannabinoid extracts may alleviate spasticity and pain among some MS patients (cf. https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/expert-answers/cannabis-for-ms-can-it-help-treat-symptoms/faq-20112500). Because the article exerts significant influence as a gold-star recipient, it would be great if it could be updated to reflect recent advances in MS treatment and diagnosis.
2600:1700:F5A1:2460:2103:FE62:D17A:4EA7 ( talk) 18:00, 21 July 2020 (UTC)
Under Other: "Vaccinations were studied as causal factors; however, most studies show no association." This statement is without citation and misleading. The citations used do not support this statement. There is a snippet in the citation used that suspects Hepatitis B vaccination may cause MS but finds no correlation. This alone does not support the complete statement that "most studies show no association to all vaccinations"
Furthermore: "some shots may trigger an infection that causes you to relapse. If you get a live vaccine (which contains tiny, weakened amounts of a live virus), this is more likely to happen." citation: https://www.webmd.com/multiple-sclerosis/multiple-sclerosis-and-vaccines
"Multiple sclerosis presenting as late functional deterioration after poliomyelitis." citation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2397915/
"Certain striking similarities to the epidemiological patterns found in paralytic poliomyelitis have been noted" and "Multiple sclerosis has been shown to be rare between the equator and latitudes 30-35 degrees...In poliomyelitis a similar variation with latitud occurs" citation: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0404.1966.tb02007.x
These statements contraindicate the misleading statement from the main article and postulate a link of MS and Poliomyelitis (or Post-polio syndrome). Considering the polio vaccine is a live attenuated virus that leads to vaccine derived polio outbreaks. — Preceding unsigned comment added by 2605:A601:A0C6:1200:EDC2:D071:347A:4EFE ( talk) 08:05, 14 October 2021 (UTC)
In conclusion: "virus bad unless injected into you for profit to prevent you from contracting the virus..then virus good. Hurr durr derp da derp. derp da derp a doo." — Preceding unsigned comment added by 2605:A601:A0C6:1200:EDC2:D071:347A:4EFE ( talk) 08:10, 14 October 2021 (UTC)
Both the top para and later sections of this article assume inflammatory activity is the core of MS.
However this is now being questioned. See e.g. Smouldering multiple sclerosis: the ‘real MS’. Gavin Giovannoni, Veronica Popescu, Jens Wuerfel, ... First Published January 25, 2022 Review Article Find in PubMed https://doi.org/10.1177/17562864211066751 — Preceding unsigned comment added by JCJC777 ( talk • contribs) 05:59, May 22, 2022 (UTC)
The treatments section is a complete mess. Do we want to include exact clinical trial data in the article (e.g. X was reduced the annual relapse rate by n% compared to Y) or we want to stick with the moderate, mild, ... terminology? Now there are numerical data for some treatments but not for all.
The issue is that there is not head-to-head trials for all pairs of drugs. I propose including the numerical data of the pivotal clinical trials that have led to FDA/EMA/... approvals + the year of the approval.
The idea of putting all these things in a table might also work but I don't want to spend two hours building the table and someone removing it just because it is hard to maintain. So I think we should not go with the table idea now. BehMon ( talk) 22:09, 7 July 2022 (UTC)
I've moved a chunk of excess detail, per WP:SS to Talk:Management of multiple sclerosis, for incorporation there if not already included. A bot will come through in a bit to repair the missing citations here. [2] Those edits were sample only; more could be done, remembering to take care with the important attribution requirements of WP:CWW. BehMon, perhaps you'd be interested in working on that sub-article, as treatment seems to be of interest to you ? SandyGeorgia ( Talk) 00:29, 9 July 2022 (UTC)
Tristario please don't remove maintenance tags without resolving the problem. Readers are confronted with the following text:
Studies show that only 16% of people with relapsing MS needed a cane to walk after 20 years.[medical citation needed][87] For people with relapsing MS, approximately 50% who do not receive disease-modifying treatments will develop secondary progressive MS after 20 years, however newer treatment options may mean this rate will be significantly lower.[155] A more recent 2016 study found only 11.3% transitioned to secondary progressive MS during the ten-year follow-up period.[156][155][87]
This is gibberish; none of the timelines are explained, and then we suddenly get a "more recent". "More recent" than which part of the paragraph, which talks about what and when? Newer treatment options" relative to when? More recent than what ? I understand it's a 2021 review talking about 2016 data; that still doesn't clear up what this paragraph is trying to say about what based on when. That is, if we have something outdated in the article, we should remove it, along with the "more recent" qualifier. SandyGeorgia ( Talk) 02:33, 27 July 2022 (UTC)
I've made an attempt at rewriting the prognosis section, using newer sources. This probably isn't the final version, and some more information (eg. on life expectancy) needs to be added. Any adjustments or comments etc. are welcome -- Tristario ( talk) 03:34, 12 August 2022 (UTC)
Regarding these edits, [3] [4] I have removed this excess detail twice and explained why on the OP's talk. Anna Zelenska please respond to my concerns on your user talk page, and engage on this talk page to gain consensus for adding content. SandyGeorgia ( Talk) 13:51, 26 June 2023 (UTC)
https://tidsskriftet.no/en/2015/05/impact-environment-multiple-sclerosis I have never heard of this journal and so don't know if it's a quality journal. May or may not contain relevant information to the article. P.S. if my citation format breaks some local citation format consensus, let me know and I'll fix it. I used the default reference format so far. Chamaemelum ( talk) 05:45, 13 July 2023 (UTC)
The article is really large and full of information, but it is missing a lot of references. Also, if there is a reference in the paragraphs, it is old and needs to be updated, such as the " Epidemiology" paragraph. Also, there are many phrases or words that refer to other Wikipedia's pages, and this makes it difficult to read the article in addition to Difficult terminology, but on the positive side, the article is really full of information and requires Edits that do not take much time. However, I didn't find much editing! Mesan Hijazy ( talk) 16:15, 24 September 2023 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 November 2023 and 15 December 2023. Further details are available on the course page. Student editor(s): The-GOAT-of-GOATs ( article contribs).
— Assignment last updated by The-GOAT-of-GOATs ( talk) 18:58, 21 November 2023 (UTC)
Hello everyone, its a pleasure to be working with you all on this article. I've read through the talk page and have a general idea of what I want to start editing, but wanted to get some input on what you all think are the most important areas that need improvement and if anyone is currently working on a section of the article so that I can focus my time effectively and avoid stepping on anyone's toes. I will be adding my workplan for the next couple weeks based on your feedback soon.
Also, I'm a new wikipedian so any tips/tricks are appreciated, thanks! The-GOAT-of-GOATs ( talk) 18:45, 27 November 2023 (UTC)
Peer Review UTSW (12/10)
Good job with very detailed workplan
Good job addressing all of the edits on your work plan , I didn't find anything unaddressed
The article some left over medical jargon throughout, although good job on linking out some of the jargon to other wikipedia pages for more information that may not be relevant to this article topic
May be helpful to have a section on comorbidities as MS has quite a few, this could go under associated symptoms.
Under diagnosis section, it would be helpful to delineate diagnostic criteria that are standard of care
Did a great job fixing links/citations and some of the medical jargon is linked to another wiki article which is helpful if a reader needs clarification
Some of the signs and symptoms are under the management section instead of the symptoms section, would move these over
— Preceding unsigned comment added by Yalayli ( talk • contribs) 03:18, 11 December 2023 (UTC)
I will be adding these sources for the ARR figures provided. Don't have the time just yet to do all the referencing but plan to do so in the next couple days! If someone feels like adding them already, thanks :)
Annualized relapse rates: -------------------------------------------------------------
Interferons 0.256 in every 2-week group, 0.288 in every 4-week https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326221/
Copaxone 0.3 ARR https://pubmed.ncbi.nlm.nih.gov/32329362/
Aubagio 0.35 ARR https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437319/
Plegridy 0.12 ARR https://pubmed.ncbi.nlm.nih.gov/35158459/
Tecfidera 0.15 ARR https://pubmed.ncbi.nlm.nih.gov/34465252/
Vumerity 0.11-0.15 ARR https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870078/
Gilenya 0.22 - 0.25 ARR https://pubmed.ncbi.nlm.nih.gov/30731303/
Zeposia 0.18 - 0.24 ARR https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768354/
Kesimpta 0.09 - 0.14 ARR https://www.ncbi.nlm.nih.gov/books/NBK572489/table/cl4.tab11/ https://multiplesclerosisnewstoday.com/news-posts/relapsing-ms-patients-better-after-switch-kesimpta/
Mavenclad 0.1 - 0.14 ARR https://www.sciencedirect.com/science/article/pii/S221103482200270X https://www.ncbi.nlm.nih.gov/books/NBK539998/
Lemtrada 0.08 ARR (RRMS) https://pubmed.ncbi.nlm.nih.gov/31762387/
Ocrevus 0.09 ARR https://multiplesclerosisnewstoday.com/news-posts/2021/08/25/ocrevus-reduces-ms-relapse-risk-but-linked-more-hospitalizations/#:~:text=In%20terms%20of%20efficacy%2C%20Ocrevus,clinical%20trials%2C%20the%20researchers%20said. Bob ( talk) 09:34, 5 December 2023 (UTC)
The term "autoimmune" is vastly overused to describe diseases with no known cause. True autoimmune diseases require the presence of autoantibodies. As per this article, it is NOT confirmed to be autoimmune. It COULD be, but labeling it as such is misleading https://link.springer.com/article/10.1007/s10787-010-0054-4 Cporosus1 ( talk) 10:15, 13 December 2023 (UTC)