Revision as of 03:37, 29 December 2009

Gulf War syndrome is currently a Biology and medicine good article nominee. Nominated by WVBluefield (talk) at 16:42, 30 November 2009 (UTC) An editor has indicated a willingness to review the article in accordance with the good article criteria and will decide whether or not to list it as a good article. Comments are welcome from any editor who has not nominated or contributed significantly to this article. This review will be closed by the first reviewer. To add comments to this review, click discuss review and edit the page.

Medicine: Genetics B‑class Mid‑importance

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This article has been mentioned by a media organization: N/A (March 3, 2009). "What was happening in the world the last time the market was this low". Foreign Policy.

Archives: Archive 1, Archive 2

Article Rewrite

I am currently re-writing this article to bring it up to a more appropriate standard for the nature and significance of the topic. Much of the previous version was duplicate material, information not relevant to the topic, rampant speculation, or worse, garbage from the junk science industry. Considering the number of high quality sources for this topic they are just not acceptable sources.

Please discuss changes or issues with the new version here. If you think anything is missing from my new and improved version, dont worry, I will be adding lots more in the weeks to come. WVBluefield (talk) 19:47, 25 November 2009 (UTC)

I saw your note at WP:MEDA. You may wish to request a peer review or to nominate it for Good Article status.

What you have looks pretty good, but it feels a bit incomplete -- or perhaps it only looks that way because of the organization. I suggest reading WP:LEAD about not introducing details into the introduction that aren't repeated and expanded on later. You might consider WP:MEDMOS#Sections for ideas about other topics to include.

In terms of FA, the capitalization of headings doesn't conform to WP:MSH, and the citation formats must be absolutely uniform to reach FA. It's not necessary for them to use "this" or "that" style -- you're allowed to make up your own style -- but the style you use must be consistently implemented in every single citation. Also, FA will require at least one citation per paragraph.

Also, the {{linkfarm}} needs to be weeded, and the article probably needs a section about the political/social aspects. WhatamIdoing (talk) 00:22, 26 November 2009 (UTC)

Thanks for the tips. I will work on this over the next few days and resubmit. WVBluefield (talk) 14:56, 30 November 2009 (UTC)

Why did you remove these three paragraphs?:

A 2001 study of 15,000 February 1991 U.S. Gulf War combat veterans and 15,000 control veterans found that the Gulf War veterans were 1.8 (fathers) to 2.8 (mothers) times more likely to have children with birth defects. After examination of children's medical records two years later, the birth defect rate increased by more than 20%:

"Dr. Kang found that male Gulf War veterans reported having infants with likely birth defects at twice the rate of non-veterans. Furthermore, female Gulf War veterans were almost three times more likely to report children with birth defects than their non-Gulf counterparts. The numbers changed somewhat with medical records verification. However, Dr. Kang and his colleagues concluded that the risk of birth defects in children of deployed male veterans still was about 2.2 times that of non-deployed veterans."

In a study of U.K. troops, "Overall, the risk of any malformation among pregnancies reported by men was 50% higher in Gulf War Veterans (GWV) compared with Non-GWVs."

1. Kang, H.; et al. (2001). "Pregnancy Outcomes Among U.S. Gulf War Veterans: A Population-Based Survey of 30,000 Veterans". Annals of Epidemiology. 11 (7): 504–511. doi:10.1016/S1047-2797(01)00245-9. PMID 11557183. {{cite journal}}: Explicit use of et al. in: |author= (help)
2. Department of Veterans Affairs (2003) "Q's & A's - New Information Regarding Birth Defects," Gulf War Review 12(1), p. 10.
3. Doyle, P., et al. (2004) "Miscarriage, stillbirth and congenital malformation in the offspring of UK veterans of the first Gulf war," International Journal of Epidemiology, 33(1), pp. 74-86; PMID 15075150.

Isn't that a pretty significant finding from the military's chief epidemiologists? 99.27.200.154 (talk) 18:09, 21 December 2009 (UTC)

The Nov 2008 report found that while there was an increase in birth defects, the increase was statistically insignificant and I cant really square away some of the more specific %’s with the material cited. Could you elaborate? WVBluefield (talk) 16:26, 22 December 2009 (UTC)

The claim that birth defects have been statistically insignificant refers to the specific sub-categories of birth defects, where the sample size was too small to make a statistically significant claim. Birth defects in general, such as are produced by a general mutagen like uranyl, were reported at significant rates both in troops and civilians. Have any mutagens or teratogens other than uranium even been considered as potentially responsible? Here are some excerpts from the Nov. 2008 report:

Although Gulf War illness is the most prominent condition affecting Gulf War veterans, it is just one health issue to be addressed in the larger context of the health of Gulf War veterans. Other Gulf War-related health issues of importance include rates of diagnosable medical conditions and post-war mortality among Gulf War veterans, and questions related to the risk of birth defects and other health problems in veterans’ family members. (p. 24; PDF p. 34)

The three studies most representative of Gulf War era veterans in the U.S. and U.K. have all indicated significant, but modest, excess rates of birth defects in children of Gulf War veterans. (p. 50)

News articles have reported that rates of cancer and birth defects in Iraq increased dramatically during the 1990s, specifically in regions where the greatest quantity of DU was used in the Gulf War. Conference reports describing an increased incidence of congenital anomalies in Basrah and increased numbers of cancer cases, both in Iraqi military personnel who served in the war and in four Iraqi hospitals, lend some support to these contentions. (p. 88)

Which of the percentages do you think are hard to square with the epidemiologists' reports? 99.60.1.71 (talk) 18:35, 22 December 2009 (UTC)

Statistically insignificant was a poor word choice as it has a defined meaning, the text says that the rates are still within the normal range.

It is difficult to draw firm conclusions related to birth defects and pregnancy outcomes in Gulf War veterans, due to the diversity and limitations of study results reported to date. The three studies most representative of Gulf War era veterans in the U.S. and U.K. have all indicated significant, but modest, excess rates of birth defects in children of Gulf War veterans. Information on specific types of birth defects has been inconsistent, however, and overall rates are still within the normal range found in the general population.

Considering the shape the article was in previously, I am hesitant to read too much into the sources that isnt explicitly stated. The Basra information you cited has no formal studies and since is not specifically about GWS. WVBluefield (talk) 19:26, 22 December 2009 (UTC)

Which Basrah information are you referring to -- the conference report cited on page 88? I am also curious to know whether you have ever read about the excess birth defects being attributed to anything other than uranium. Frankly, you removed more than half of the original text, and re-wrote much of the remainder. This is not the only example of statements from peer reviewed sources that you removed. I think the previous version before your re-write was better, and I also wonder -- In what ways you think your version is better? 99.60.1.84 (talk) 00:48, 23 December 2009 (UTC)

The material on page 88 you cited referred to references news articles and they aren’t the highest quality sources for an article like this. The report also goes on to speak about the inherently unreliable nature of the self reported studies as well as the low level of birth defects in absolute terms. As such, I didn’t think it merited a lengthy portion in the article, although the material might be worth a sentence or two.

At any rate, the article looked like a sophomoric attempt to write a term paper and was filled with junk science, statements from unreliable sources and conclusions not directly supported by their citations. My rewrite deals only with GWS and uses the most recent studies available. I am sorry if you contributed to the old version, but hey, that’s Misplaced Pages. WVBluefield (talk) 02:10, 23 December 2009 (UTC)

How do you feel about a merge between this version and the longer version of 25 November? I'm interested most in your thoughts about restoring, "The November 2008 report implicated exposure to toxic chemicals as the cause of the illness," and the section on depleted uranium. 99.38.151.240 (talk) 04:58, 23 December 2009 (UTC)

The current article fairly and accurately summarizes the 2008 report and given the lack of evidence for depleted uranium's role in GWS, gives due wp:WEIGHT to the section on depleted uranium. WVBluefield (talk) 14:38, 23 December 2009 (UTC)

The current section on depleted uranium cites two studies showing negligible effects which weren't even peer reviewed. Per WP:SECONDARY, articles on science and medicine are supposed to cite literature reviews when available. Here is an example of the conclusions from a secondary report on the subject. Here is another. How do you feel about replacing the unreviewed sources with those two secondary peer reviewed sources? 99.55.162.157 (talk) 18:21, 23 December 2009 (UTC)

Attempt at reaching agreement on a version merge

I hope you like the merge proposal. 99.34.78.67 (talk) 16:49, 24 December 2009 (UTC)

The material you added and the references above have nothing to do with veteran medical complaints and seem to be more of a screed against uranium weapons. This isn't the article for it an is all wp:coatrack. WVBluefield (talk) 20:08, 24 December 2009 (UTC)

Why do you say that the birth defect rate, for example, has nothing to do with veteran medical complaints? 99.34.78.67 (talk) 20:30, 24 December 2009 (UTC)

I didn't say that, but your sources don't link them to uranium munitions and the 2008 report said that theu are within norms for the general polulation. If you want to add a paragraph or two on birth defects that's fine, but none of the garbage that's pupulated prior versions of this article.~~ —Preceding unsigned comment added by WVBluefield (talk • contribs) 20:40, 24 December 2009 (UTC)

The November, 2008 report (a government secondary source) links the two, as do three of the peer reviewed secondary sources you removed. Why did you remove those -- replacing them with sources from RAND and Sandia which only present one point of view and which have not been peer reviewed -- instead of working to achieve a compromise merge proposal? Most of the material you deleted in your re-write was not in the compromise proposal. And why did you delete the dispute tags while the article was still in dispute? 99.34.78.67 (talk) 20:50, 24 December 2009 (UTC)

The report did address it and discounted it, as evident by the table sumarising the known studies. Your text is not supportes by your sources, and that's why I removed the tags. WVBluefield (talk) 20:57, 24 December 2009 (UTC)

The article is still in dispute, and it will be until you can explain why you replaced three peer reviewed secondary sources with non-peer reviewed sources. The table of known studies you are referring to is not from a peer reviewed source. Can you work together to reach compromise text? 99.34.78.67 (talk) 21:19, 24 December 2009 (UTC)

When I tried to fill out the Diagnosis and Management sections, I learned a lot, and ended up making dozens of high-level changes. 99.191.74.146 (talk) 11:55, 26 December 2009 (UTC)

I appreciate some of the work you have done hear, but after a review of your (and associated IP’s) edits and this article’s history it’s pretty clear that you are Nrcprm2026 and you shouldn’t be editing this, or any article on Misplaced Pages. I am going to rework some of what you contributed and ask that you let it go. WVBluefield (talk) 19:15, 28 December 2009 (UTC)

Thank you. I had hoped that you could refrain from making accusations or massive reverts deleting both the vast majority of peer reviewed secondary sources in the article along with the dispute tags. However, that you have not strongly suggests that you are banned User:Hempbilly, who as User:TDC also claimed to be a chemical process engineer from Chicago. I am reverting to the version with the dispute tag and the peer reviewed secondary sources. I urge you to try cooperation instead of confrontation. I hope you will act as though two experienced medical doctor Misplaced Pages editors are editing along with us, because I believe they are. I hope so! 99.27.201.92 (talk) 03:37, 29 December 2009 (UTC)

Comment

Isn't this just a type of PTSD? Doc James (talk · contribs · email) 01:09, 8 December 2009 (UTC)

Some cases might be, but many have nothing to do with PTSD. WVBluefield (talk) 20:02, 8 December 2009 (UTC)

"Similar syndromes have been seen as an after effect of other conflicts — for example, 'shell shock' after World War I, and post-traumatic stress disorder (PTSD) after the Vietnam War." These are all different names for PTSD.Doc James (talk · contribs · email) 00:48, 9 December 2009 (UTC)

That’s part of the controversy surrounding it. Some of it is undoubtedly PTSD or anxiety driven however a link between some of the physical non-psychosomatic ailments and exposure to nerve gas and other chemical agents has been established. WVBluefield (talk) 15:41, 18 December 2009 (UTC)

No; I replaced a summary sentence to that effect and re-structured the ruled-out causes. 99.191.74.146 (talk) 12:30, 26 December 2009 (UTC)

Added a few sections

The classification section is were you are going to want to discuss how this condition is categories. Who it is recognized by ( WHO, DSM4, etc ). And how it relates to other conditions. Doc James (talk · contribs · email) 00:53, 9 December 2009 (UTC)

Before a GA review will be able to continue classification needs to be fleshed out.Doc James (talk · contribs · email) 18:52, 21 December 2009 (UTC)

The only classification code I could find was MeSH's. I tried all the databases in the {{infobox disease}}. Thanks for adding those two sections, by the way. 99.191.74.146 (talk) 11:57, 26 December 2009 (UTC)

medically unexplained symptoms

The opening sentence, "Gulf War syndrome (GWS) or Gulf War illness (GWI) is an illness reported by combat veterans of the 1991 Persian Gulf War typified by a range of medically unexplained symptoms.", may need to be reviewed.

Medically unexplained symptoms is term that can have a physiological connotation and is favored by specific psychological researchers. While MUPS may be valid wording for subsections discussing these points, having it in the lead without discussion in a subsection is irregular.

From the medically unexplained symptoms article:

"MUPS may be synonymous with somatization disorder PMID 10489969 or psychosomatic illness, where the cause or perception of symptoms is mental in origin, or may overlap these terms or be a "lower threshold variant" of them.PMID 18040099 Because several definitions of both somatization and MUPS exist, and the usage of both terms is inconsistent in medical literature and practice, MUPS is sometimes used interchangeably with somatization and functional somatic symptoms.PMID 16025867" Ward20 (talk) 19:15, 22 December 2009 (UTC)

I removed the term, since it no longer applies. Both the peer reviewed and non-peer reviewed secondary sources have stopped using terms like "unexplained" and say outright that toxic chemicals are the cause, as the intro says now. 99.191.74.146 (talk) 10:18, 26 December 2009 (UTC)

GA Review

This review is transcluded from Talk:Gulf War syndrome/GA1. The edit link for this section can be used to add comments to the review.

The issue of classification needs to be addressed before a full review can take place ( how is it diagnosed, who recognizes it, etc. ) Google scholar pulls up lots of hits so it should not be hard to address. Reviewer: Doc James (talk · contribs · email) 19:33, 22 December 2009 (UTC)

I will get on this tonite. WVBluefield (talk) 19:40, 22 December 2009 (UTC)

Sadly, I believe we are failing GA criteria 1(b), 2(b), 3(a), 4 and 5 (stability) at present. 99.27.134.160 (talk) 03:31, 31 December 2009 (UTC)

Looks like the nominating editor is having some difficulties. Will leave open till I arrive home.Doc James (talk · contribs · email) 06:51, 2 January 2010 (UTC)

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