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Skewed statistic: Nearly 80% of cases occur in the developing world.
Quite prominently it's mentioned in the leading paragraphs of this article that 80% of cases occur in the developing world. I feel that without context, this suggests it's a disorder with a higher per-capita prevalence in developing countries. However, since roughly 80% of the worlds population itself is in developing countries, shouldn't this be removed/get less prominent attention/be added that 80% of the world lives in developing countries?
I was updating a Cochrane review version and I just wanted to get some feedback on the present wording in the article. The Epilepsy article presently says: "There are a number of medications available. Phenytoin, carbamazepine and valproate appear to be equally effective in both focal and generalized seizures.", ref 94 is the Cochrane review I updated.
The conclusions of the 2017 review version indicate that although a statistically significant difference has not been detected, they recommend caution when interpreting this result.
Cochrane review conclusions, pasted from pubmed:https://www.ncbi.nlm.nih.gov/pubmed/28240353 "AUTHORS' CONCLUSIONS: We have not found evidence for a statistically significant difference between carbamazepine and phenytoin for the efficacy outcomes examined in this review, but CIs are wide and we cannot exclude the possibility of important differences. There is no evidence in this review that phenytoin is more strongly associated with serious adverse events than carbamazepine. There is some evidence that people with generalised seizures may be less likely to withdraw early from phenytoin than from carbamazepine, but misclassification of seizure type may have impacted upon our results. We recommend caution when interpreting the results of this review, and do not recommend that our results alone should be used in choosing between carbamazepine and phenytoin. We recommend that future trials should be designed to the highest quality possible, with considerations of allocation concealment and masking, choice of population, choice of outcomes and analysis, and presentation of results."
Do you think that we should be expanding on this in the article and mention that the evidence suggesting that there is not a difference between carbamazepine and phenytoin is of weak quality?
Thanks for your assistance interpreting this edit.
@JenOttawa: That's very guarded language. I think it is reasonable to say that the evidence suggesting no difference is very weak indeed. In practical terms, long-term phenytoin use is becoming increasingly less common. JFW | T@lk 08:25, 21 August 2017 (UTC)
@Jfdwolff: Thanks for the feedback. I was away from my computer for a couple of days and am back to clean this edit up. Taking a look at the other Cochrane review that was used in this sentence, there is also only low to very low evidence to support that valproate and phenytoin have a similar efficacy on seizure outcomes. I can change to text to read:
"There are a number of medications available including phenytoin, carbamazepine and valproate. Very low-quality evidence suggests that phenytoin, carbmazepine, and valproate may be equally effective in both focal and generalized seizures."