Talk:Serotonin syndrome/GA1

GA Review

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I'll be reviewing this interesting article. Give me a few days to let me sink my teeth into it. Sasata (talk) 16:32, 10 February 2009 (UTC)

GA review (see here for criteria)

1. It is reasonably well written.

   a (prose): b (MoS):

   I added some commas, and fixed a few obvious typos. See comments for some suggestions.

   All suggestions have been fixed. Sasata (talk) 15:21, 14 February 2009 (UTC)

2. It is factually accurate and verifiable.

   a (references): b (citations to reliable sources): c (OR):

   I checked a few of the online references, and they say what the article says they say.

3. It is broad in its coverage.

   a (major aspects): b (focused):

4. It follows the neutral point of view policy.

   Fair representation without bias:

   Per Xasodfuih's comments, there seems to be some disagreement among academics about the serotonin syndrome, i.e. whether it is really a syndrome, and what kind of patient management is required (based on reading the letters to the editor regarding PMID 15784664). I think it would benefit the article to at least mention these opposing viewpoints. The use of the more recent review articles mentioned below might help clarify the issue.

   These areas have now been addressed. Sasata (talk) 15:21, 14 February 2009 (UTC)

5. It is stable.

   No edit wars etc.:

6. It is illustrated by images, where possible and appropriate.

   a (images are tagged and non-free images have fair use rationales): b (appropriate use with suitable captions):

7. Overall:

   Pass/Fail:

Pending revisions. Article now meets GA criteria. Pass. Sasata (talk) 15:21, 14 February 2009 (UTC)

Sasata's comments

• This is a well-studied area of research – a Pubmed search of "serotonin syndrome" pulls up 757 articles, 160 of which are review articles. So I would expect the majority of sources to be secondary, because there's lot's available (and Wiki policy prefers secondary sources). Some recent (2007–8) review articles that could be used: PMID 18957623, PMID 18471139, PMID 17874986, PMID 1720914.
  • I agree there are a number of sources but I have tended to pick just the best general reviews: PMID 18957623 is a fairly specific reviw not a broad outline of the subject, PMID 18471139 is a veterinary journal, dealing with animal experiments, and does not really focus on Serotonin syndrome, just serotonin in general, PMID 17874986 is a good review, used some of the info in it, PMID 1720914 (I think this link is a mistake) :) Mr Bungle | talk 00:30, 14 February 2009 (UTC)
• In the Pathophysiology section, define or wikilink agonism.

• "It was originally suspected that agonism of 5-HT1A receptors in central grey nuclei and the medulla was responsible for the development of the syndrome." needs citation

• Wikilink pharmacodynamic

• I don't like how all the references are clumped together in the Drugs which may contribute section. If I want to look up a specific reference for one of the drugs, I have to check all the refs. Please put the citations after each drug listed. Also, should phenelzine and fluvoxamine (ref#25) not be on the list?
  • I knew someone would pull me up on this :), I didn't ref each one as I couldn't face the wikitext of this table along with refs; will give it a go! Phenelzine is a MAOI so covered by the broader category, while fluvoxamine is an SSRI so again covered by the broader category (The table would expand quite significantly if every SSRI, MAOI, TCA was listed so only the class of drug is listed).

• Risk and severity "It is usually only when drugs ..." sounds like a poor sentence construction, please rephrase.
  • Rearranged, slightly better (I think)

• Diagnosis "... and has symptoms of: ...Hypertonic" Maybe change to hypertonism?

• Management This section needs to be better cited, especially paragraph 2. Even if all the information is from reference #3, please give the multiple citations in the same paragraph.

• "Regardless of its severity..." Severity of what? Clarify.
  • Removed that bit (was not really necessary)

• "...may miss the syndrome due to its protean manifestations." Might you use a word I don't have to look up to understand? :)

• Clarify or define proserotonergic.

• Notable cases The Zion case was recently removed from the lead. Also, the statement "The case had a profound impact on graduate medical education and residency work hours." sounds POV, so you need to cite someone else, and/or take out "profound".
  • I don't know why it was removed from the lead, I thought that the lead should be an overvierw of the entire page, I put it back with refs.

• the references could use a light copyedit to make the citation styles consistent. Eg., when using the citation template, it doesn't give full journal names (which is preferred), and it gives the month of the publication (I don't think is necessary).
  • I use Wikipedia template filling [1] for all my referencing, it uses the pubmed title abbreviation when it does its thing, I have made them all consistent now.

Xasodfuih's comments

• Please adhere more strictly to WP:MEDRS to begin with. User:Ken Gillman's website, the first source cited, is not peer-reviewed. He does have peer-reviewed publications on this topic, e.g. PMID 18377389, or PMID 16460699 (which is slightly older but appears in a more prestigious journal, and you may have easier access to). You should use one of his published reviews instead. Xasodfuih (talk) 15:03, 13 February 2009 (UTC)
  • There were two references to Gillman, (Dr Gilmlan edited this page a while back, I think he put them in the article, possible COI, removed the ref to his website)

• Also, you should be aware the NEJM review PMID 15784664, which (n.b.) is the most cited one in this wiki page, has resulted in quite a few letters to the editor; one of them from Gillman. Have you read them? Xasodfuih (talk) 15:26, 13 February 2009 (UTC)
  • Yeah I read them, one suggests a tweak of the clinical diagnosis criteria. Gillman repeats his spectrum concept of serotonin toxicity. One describes a case treated with propofol and rocuronium, and one mentions some other opiates that can cause the syndrome. All the letters were not challenging the paper in any way just suggestions on minor points left out of the main review.Mr Bungle | talk 22:48, 13 February 2009 (UTC)