Talk:Chronic obstructive pulmonary disease

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Quotes to support[edit]

What quotes from the ref provided supports this:

"COPD is a disorder which combines components of various other conditions such as asthma, chronic bronchitis, emphysema or airway obstruction, with each of these conditions being important when considering the final process of COPD. These components determine the presentation, treatment and management of the disease as a result.[1]"

Also why are we using a review from 2002. http://www.ncbi.nlm.nih.gov/pubmed/12010839

There are newer sources. Doc James (talk · contribs · email) 19:18, 11 April 2016 (UTC)

Quote[edit]

Added a quote to support from 2013 review.

Moved this here "Smoking tobacco out of a water pipe does not reduce risk of developing COPD compared to smoking cigarettes [2]. The risk of developing COPD from marijuana smoke is less clear. A study of 878 adults in Vancouver found that smoking only marijuana was not associated with an increased risk of COPD [3]. In an analysis of multiple studies evaluating pulmonary obstruction [4], there was no consistent association found between long term marijuana use and obstruction measures. There was an association found between long-term marijuana use and respiratory symptoms (e.g. cough, phlegm). Though it is important to note that the selected studies were "variable in their overall quality (e.g. controlling for confounders, including tobacco smoking).""

Doc James (talk · contribs · email) 00:04, 22 July 2016 (UTC)

As the original author of this quoted edit, I feel compelled to respond to the subsequent changes here. The Vestbo et al. journal article[5] that was cited at the time and which is now again the main citation does indeed state "Other types of tobacco (e.g., pipe, cigar, water pipe (14)) and marijuana (15) are also risk factors for COPD (16, 17)."
But, this implies either that non-cigarette tobacco smoking and marijuana smoking confer the same risk (i.e. "other types of tobacco and marijuana are also risk factors"), or that the risks of non-cigarette tobacco smoking and marijuana smoking are undefined (i.e. "a risk" without quantification).
However, the articles cited in the original source to support this statement do not support either implication:
(14) The Raad, et al. study on water-pipe smoking[6] does not discuss marijuana smoking, and finds no statistically significant difference in the risk factors compared to cigarette smoking (i.e. smoking tobacco from a water pipe is just as dangerous as smoking cigarettes, not an undefined or unspecified risk).
(15) The Tan, et al. study on marijuana smoking[7] only found an increased risk in those who smoked marijuana and tobacco concurrently, whereas it found no increase in COPD risk among those study participants who reported smoking only marijuana.
(16) The WHO study[8] focuses exclusively on smoking tobacco out of water-pipes and reaches the same conclusions as the Raad, et al. study mentioned above.
(17) The Tetrault, et al. citation[9] is a review of multiple studies on the effects of marijuana smoking on pulmonary function and as such draws on a larger pool of marijuana users than the Tan, et al. study mentioned above. However, even though the 14 studies on long-term marijuana use all noted an association between long-term marijuana use and "respiratory symptoms", the authors also note that the studies under review varied in quality, specifically mentioning a failure to control for the confounding effects of concurrent tobacco smoke. This result would be entirely in-line with the speculation in the Tan, et al. study that the bronchodilation caused by marijuana smoking exacerbates the harmful effects of tobacco smoke.
In light of this information, I am at a loss to understand why the original quote and citation from Vestbo et al. was restored. I feel that, at the very least, my language indicating water-pipe tobacco smokers and cigarette smokers have statistically the same risk of developing COPD is more accurate than the Vestbo et al. quote which implies a vague and unspecified risk. Furthermore, in view of Tan, et al. and Tetrault, et al., I feel that my language stating that "the risk of developing COPD from marijuana smoking is less clear" is a more accurate representation of the findings cited by the Vestbo, et al. article.
216.254.255.219 (talk) 23:13, 29 July 2016 (UTC)
edited to conform to formatting guidelines 216.254.255.219 (talk) 00:13, 30 July 2016 (UTC)
That the review article cited supports it is sufficient. We do not typically try to figure out if the review article is correct or not.
It appears cannabis smoke and cigs is worse than cigs alone (so cannabis increases the risk).
And there is tentative evidence that "Long-term marijuana smoking is associated with increased respiratory symptoms suggestive of obstructive lung disease." Doc James (talk · contribs · email) 07:07, 30 July 2016 (UTC)
Have added "Problems from marijuana smoke may only be with heavy use.[10]" Thoughts? Doc James (talk · contribs · email) 08:37, 30 July 2016 (UTC)
I realize that calling foul on the citations of a citation is unusual; I never would have looked into the review article's citations if I had not been trying to quantify "are also risk factors" for my personal edification. It appears that the best way to describe the current understanding of the COPD risk of cannabis smoke is that it has a catalytic effect upon the COPD risk posed by tobacco smoke, rather than increasing the risk per se. Still, "may only be with heavy use" seems like a concise and accurate representation, though I lack the institutional and personal resources to view the full text of Joshi, et al.
I'm still concerned that the language quoted from the abstract of Vestbo, et al. implies that "other types of tobacco smoke" and "marijuana smoke" are both undefined risks. The Vestbo, et al. citation of Raad, et al. at "other types of tobacco smoke" in fact only addresses water-pipe tobacco smoking of the three types of tobacco smoking mentioned, and Raad, et al. quite clearly finds that water-pipe tobacco smoke is just as dangerous as cigarette tobacco smoke. And since the studies and reviews of marijuana smoke use language like "tentative" and "suggestive" and "did not control for tobacco smoke", it doesn't seem accurate to structure the sentence that way.
I would advocate something like the following, "Other methods of smoking tobacco (e.g. water-pipe) are no safer than cigarettes.[11] Those smoking both marijuana and tobacco have an increased COPD risk relative to those who smoke tobacco alone. The COPD risk posed by smoking marijuana alone appears to be less than tobacco alone, but it is not as well-studied as the risk posed by tobacco.[12][13] Habitual marijuana smoking is not harmless, however, and avoiding regular heavy use is wise.[14]" Reasonable?
216.254.255.219 (talk) 11:00, 30 July 2016 (UTC)
Have added "Water pipe smoke appears to be as harmful as smoking cigarettes."
Wording like "avoiding regular heavy use is wise" is a little to POV IMO.
Am inclined to stick with just the secondary sources. Doc James (talk · contribs · email) 11:10, 30 July 2016 (UTC)
Agree that my draft language is suggestive of POV. Was attempting to paraphrase the Joshi, et al. abstract. These most recent edits resolve all of my concerns. Thanks for your leadership here, and for being accommodating to this neophyte.
216.254.255.219 (talk) 22:29, 30 July 2016 (UTC)
Happy to have you here :-) Doc James (talk · contribs · email) 07:00, 31 July 2016 (UTC)

Targeted Lung Denervation therapy[edit]

Why is there no mention of this? [15]

It is a research technique that is under study and not yet avaliable. Doc James (talk · contribs · email) 18:40, 9 August 2016 (UTC)
Added here [1] Doc James (talk · contribs · email) 18:54, 9 August 2016 (UTC)

People appear to be receiving the treatment successfully in the UK already: http://www.watfordobserver.co.uk/news/14664556.Woman_first_in_the_country_to_have_new_treatment_for_lung_disease/

We wait for high quality sources. We do not use popular press for medical content. Doc James (talk · contribs · email) 20:59, 10 August 2016 (UTC)

External links modified[edit]

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References

Research[edit]

Submit an edit request

Template:Connected Contributor

My edit request is in reference to the paragraph below:

...Treatment with stem cells is under study.[160] While there is tentative data that it is safe and with promising animal data there is little human data as of 2014.[161][162][163] Some of the human data that is available has found poor results.[164]

After reviewing the cited articles within the paragraph above, the sentence, "Some of the human data that is available has found poor results"--albeit true--seems particularly pointed and unindicative of the full state of research within the field. After reviewing the same source articles listed in the paragraph above (although a few are now greater than 3 years old) I believe this paragraph below is a more balanced and accurate summary of the state of stem cell therapy research and it's efficacy for the treatment of lung disease.

Suggested Edit:

"In recent years, treatment using stem cells has undergone a gradual shift from animal to human studies. [160] Although animal studies have shown promising results--proving efficacy in repopulating airway and alveolar epithelial cell lineages during homeostasis and repair--more clinical testing in humans is necessary in order to better understand the reparative mechanisms currently exhibited in rats. [161][162][163] Though treatment effectiveness in humans can vary, stem cell therapy and its ability to reduce systemic inflammation and reprogram developmental pathways to induce lung regeneration may be proven a risky but promising pathway.[164]"

I believe this is a fairer and more accurate depiction of stem cell therapy using the original sources of the initial paragraph, while the suggested changes have originated directly from its listed sources. --Ckennerly (talk) 17:41, 18 January 2017 (UTC)

I think it is fine how it is. Thanks for disclosing your COI. Best Doc James (talk · contribs · email) 20:01, 18 January 2017 (UTC)
Can you tell me if my suggested edit is fair? We spoke about a year ago on this very subject and the ultimate edit was, in fact, a more negative revision to the original post. If I can be frank, I've used the exact sources (taken directly from the articles' concluding remarks) and presented a revision that accurately portrays the tone and messaging of the article's intent; a treatment with a promising, albeit weary potential. I've followed the regulations and rules present within Wikipedia's guidelines to the letter and am not adding any messaging that is not directly present in the articles that were originally referenced. What can I do to influence a more balanced revision? --Ckennerly (talk) 19:31, 19 January 2017 (UTC)