Talk:Croup/GA1

GA Review

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Reviewer: WhatamIdoing (talk) 04:10, 30 July 2010 (UTC)[reply]

1. Well written?:

The grammar is fine, and I've fixed a couple of things that might have been unclear.

The classification system isn't very well explained. I don't think that a typical reader will understand that the unlabeled numbers at the top are points assigned, and that you add them up to get the score. It looks more like "moderate" is "stage 2", and then you have all of the symptoms in the "2" column. I don't (unfortunately) have a particularly good suggestion for how to fix it. I'm open to any suggestions.

I don't think that the average reader will understand what it means for a patient to 'appear toxic'. I couldn't find an appropriate wikilink (which I think would be sufficient). Perhaps a very brief description could be substituted for this jargon?

Optionally, it seems to me that the ==Classification section== should be placed lower on the page (because a staging system used only for research isn't very important).

Optionally, when discussing the success of vaccination in reducing respiratory diseases, and therefore croup, it might be appropriate to re-point the wikilinks away from the diseases (e.g., influenza) in favor of the vaccinations (e.g., flu jab).

Optionally, editors here may want to consider consistent compliance with MOS:DASH (e.g., using en dashes for ranges of numbers). (This is not required by the WP:Good article criteria.)

2. Factually accurate?:

Overall, this article has a density of inline citations that goes well beyond the actual requirements of the WP:Good article criteria. I am particularly pleased to see the reliance on high-quality secondary sources: This is a good instance of quality over quantity.

I'm not convinced that croup is an acute viral infection (which is what the lead says): I think it is a medical condition that is (now) (among vaccinated persons) most frequently triggered by acute viral infections. It is not actually possible for croup to be (a) an acute viral infection and (b) occasionally caused by diphtheria. Consequently, the lead will need to be re-written to be more accurate in the definition.

I don't have access to the two sources that are most frequently cited, but the claims they support are consistent with what other sources say, and thus I have no concerns about unverifiable claims or original research.

3. Broad in coverage?: ✓ Pass

This article addresses all of the major points that are represented in the sources. It doesn't go into much detail about some of them, but detail is not actually required by the WP:Good article criteria.

4. Neutral point of view?: ✓ Pass

Neutrality isn't particularly difficult to achieve on a basic medical topic like this, and this article has done well on this point.

It does tend to lean a bit towards the emergency department/hospital perspective, and since many cases of (mild and moderate) croup are seen in a regular office/non-emergency situation, this may not always be appropriate. However, I couldn't identify any specific instance that was inappropriate, and so I've concluded that I worried needlessly about this.

5. Article stability? ✓ Pass

The article is stable; very few changes have been made during the last month.

6. Images?: ✓ Pass

The image is relevant and has an appropriate license.

Other comments

IMO this article is exactly the sort of shorter article that the WP:Good article criteria is intended to accept. It is concise but basically complete. If you have an interest in advancing it to WP:Featured article status, it will probably require a significant expansion.

I've marked the three problems that need to be resolved with a yellow "warning" icon. If we can get those resolved in the next few days, then I'll happily pass this article. WhatamIdoing (talk) 05:30, 30 July 2010 (UTC)[reply]

Many thanks for the review. I have changed "toxic appearance" to "very sick appearance". Have clarified how one uses the table in the text. Agree that yes technically croup is trigger usually by an acute viral infection. In the medical literature the definition of croup varies between sources. Would be happy to provide the sources if you wish. I have never understood the different uses of dashes and have trouble finding that long one on my keyboard. Would appreciate if someone with experience in these things could make sure this article is compliant. Have linked immunization in the text. Doc James (talk · contribs · email) 07:13, 30 July 2010 (UTC)[reply]

Are diphtheria and bacterial tracheitis really still referred to as "croup"? I was under the impression (viral) ALTB had been distinguished from bacterial illnesses for decades. I don't have access to the NEJM review, but I'd be very surprised if it actually refers to "bacterial croup" and defined croup as a complex or constellation of illnesses (including diphtheria) rather than a viral infection. Fvasconcellos (t·c) 14:00, 30 July 2010 (UTC)[reply]

The sources cited in the article tend to say things like "Croup is a common childhood upper airway disorder caused by a viral infection," rather than 'Croup is itself a viral infection' or 'Croup is always caused by a virus'. It seems that croup is the syndrome/constellation of signs and symptoms (whatever the cause), rather than a particular type of infectious disease. WhatamIdoing (talk) 01:06, 1 August 2010 (UTC)[reply]

(undent) Uptodate says:

INTRODUCTION — Croup is a respiratory illness characterized by inspiratory stridor, cough, and hoarseness. These symptoms result from inflammation in the larynx and subglottic airway. A barking cough is the hallmark of croup among infants and young children, whereas hoarseness predominates in older children and adults. Although croup usually is a mild and self-limited illness, significant upper airway obstruction, respiratory distress, and, rarely, death, can occur.
The clinical features, evaluation, and diagnosis of croup will be discussed here. The management of croup is discussed separately. (See "Approach to the management of croup" and "Pharmacologic and supportive interventions for croup".)
DEFINITIONS — The term croup has been used to describe a variety of upper respiratory conditions in children, including laryngitis, laryngotracheitis, laryngotracheobronchitis, bacterial tracheitis, or spasmodic croup [1]. These terms are defined below. In the past, the term croup also has been applied to laryngeal diphtheria (diphtheritic or membranous croup) which is discussed separately. (See "Epidemiology and clinical features of diphtheria" and "Diagnosis and treatment of diphtheria".)

Doc James (talk · contribs · email) 12:24, 1 August 2010 (UTC)[reply]

Thanks—I guess I was thrown off by the mention of diphtheria cited to a recent review.

Speaking of recent and historical, have you considered adding a "History" section to the article? :) It is by no means a requirement for GA status (and, hey, I'm not reviewing the article), but I'd love to see a couple of separate paragraphs. Maybe the current sources are enough to draw from? Fvasconcellos (t·c) 16:00, 1 August 2010 (UTC)[reply]

Will see what I can come up with. Doc James (talk · contribs · email) 22:20, 1 August 2010 (UTC)[reply]

Moving respiratory score section: Agree this should be moved further down the article or listed as a subheading under signs/symptoms. The score system is useful out side of research setting but would be more useful to health care provider than general public. General public that needs a quick understanding of disease process would need to be quickly led to signs/symptoms to better understand the disease. Oregonkc (talk) 00:53, 11 August 2010 (UTC)[reply]

I prefer keeping the standard lay out for disease articles as discussed here WP:MEDMOS. Thus people who use Wikipedia frequently will always know were to find what they are looking for.Doc James (talk · contribs · email) 04:43, 11 August 2010 (UTC)[reply]

The standard order says that it's appropriate to rearrange things on occasion; this might be one of the occasions. (Merging it into the symptoms section is another possibility.)

Have you decided whether you want to add a history section? WhatamIdoing (talk) 04:49, 11 August 2010 (UTC)[reply]

Yes one can rearrange things. I know a few other editors occasionally do. I however believe the importance of a consistent structure is more important than this small change in order. If others believe strongly that merging with signs and symptoms would be an improvement I do not have any real concerns. I have started work on a section dealing with history. Doc James (talk · contribs · email) 05:16, 11 August 2010 (UTC)[reply]

FWIW, I do feel either merging with signs and symptoms or moving down would be an improvement. Fvasconcellos (t·c) 06:42, 11 August 2010 (UTC)[reply]

Or maybe merging it into the end of ==Diagnosis==. WhatamIdoing (talk) 17:30, 11 August 2010 (UTC)[reply]

I've reviewed the new history section, and it passes on all points. Thanks for adding that: I think it provides interesting information. WhatamIdoing (talk) 17:43, 11 August 2010 (UTC)[reply]

I have merged to diagnosis as recommended as the score is used to determine the degree of severity.Doc James (talk · contribs · email) 17:56, 11 August 2010 (UTC)[reply]

I like the way it works in that section.

Any last complaints before I formally promote this? WhatamIdoing (talk) 18:10, 11 August 2010 (UTC)[reply]

Since all of my issues were addressed, and since no one raised any further issues, I have promoted the article. Congratulations and sincere thanks to all of the editors who helped write and improve this article. WhatamIdoing (talk) 21:44, 12 August 2010 (UTC)[reply]