Patholines:Editorial guidelines

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This page in a nutshell:

Create new article

How to edit

Editors of articles must be doctors of medicine, or have formal expertise in pathology by other means.

See Patholines:About#Participation on how to become an active article editor.

Generally, be bold, and make changes whenever you think it will improve the site.

One highly beneficial method for editing is to write while performing the task at hand for an actual case, in order to discern what content is most relevant in that situation.

"Edit" or "Edit source"

When clicking "Edit", you use an editor (VisualEditor) that is "What You See Is What You Get". When you click "Edit source", you edit in wikitext. It is preferable that you'll get used to using wikitext, such as by Wikipedia help:Wikitext. Use Patholines:Upload for file uploads rather than the Insert > Media in VisualEditor (the latter is not tailored to the project, but please leave a message at the discussion page if you have a solution).

Recommended approach

Just start editing, taking the style and content to appear similar to any relatively well developed article at Patholines. If you do not know the tool or wiki code for what you want to do, just do something that makes it look as similar as possible, such as:

  • Headers using UPPER CASE LETTERS
  • Reference numbering using brackets, such as [1] in the text, and simply drop the PMID, DOI or web address of the source at the bottom (accurate formatting can be fixed later).

User page

A user page is the presentation page of that person, and can be found (and then edited) by clicking the username at top right. Recommended (but not mandatory) content of a user page includes:

  • Real name
  • Education, experience in pathology as well as current position.
  • An upload of a portrait of the user.
  • An external link to another website presenting the user.

The user page is not a personal website, blog, or social networking medium. They should be used to better participate in the community, and not used to excess for unrelated purposes.

References

It is acceptable to write from experience if editing under one's real name rather than a username, although material should preferably still be supported by reliable external sources whenever it is likely that such exists for the topic of a sentence or section. Such external sources should, where available, be secondary ones such as textbooks and reviews rather than primary studies.

When editing under one's real name, it is also acceptable to use a hospital as a reference for local practices.

Use only in-line referencing,[notes 1] using the "Cite" tab in "Edit" mode, and <ref> and </ref> in "Edit source" mode (see Wikipedia:Footnotes for additional help). With a known doi code for the reference, the {T} DOI reference generator can quickly generate the full citation. Likewise, the Biomedical citation maker can be used to generate full citations from PMID or PMCID.

Geographic origin

Geographic origin should be specified in the text for guidelines or other information that are expected to vary, including positive and negative predictive values of investigations (which depend on prevalences and incidences in the population). On the other hand, any geographic origin does not need to be stated for more universal knowledge such as sensitivity and specificity of investigations (which are independent on prevalences and incidences), or visible findings. Geographic origin can be given in prose such as "a US practice is to...", or in the beginning of a reference, such as:

  • USA: Sbaraglia, Marta; Dei Tos, Angelo P. (2018). "The pathology of soft tissue sarcomas

". La radiologia medica 124 (4): 266–281. doi:10.1007/s11547-018-0882-7. ISSN 0033-8362. 

Coding

In wiki code, it is recommended to add references by within <ref> and </ref> tags, in addition to adding the {{Top}} and {{Bottom}} templates to their respective places. Such <ref> tags can be automatically generated from the doi codes at this site:

For example, entering the doi code "10.1007/s11547-018-0882-7" at the former page yields the following text:

  • <ref name="SbaragliaDei Tos2018">{{cite journal|last1=Sbaraglia|first1=Marta|last2=Dei Tos|first2=Angelo P.|title=The pathology of soft tissue sarcomas|journal=La radiologia medica|volume=124|issue=4|year=2018|pages=266–281|issn=0033-8362|doi=10.1007/s11547-018-0882-7}}</ref>

When inserted in an article, it gives the following at the bottom:

  • Sbaraglia, Marta; Dei Tos, Angelo P. (2018). "The pathology of soft tissue sarcomas

". La radiologia medica 124 (4): 266–281. doi:10.1007/s11547-018-0882-7. ISSN 0033-8362. 

Notes

Notes are added by adding group= to the ref tag, such as:

  • <ref name="pitch" group="notes">Alternatively, the sample can be trimmed by radial slices in all four directions.</ref>

Contentious matters

Dubious or insufficiently referenced texts should be corrected, removed, or marked with inline cleanup tags, such as:
[Dubious ] - in source code editing, this is added by the addition of {{Dubious}}.
[Citation needed] - by {{Citation needed}}.
Template:Better source - by {{Better source}}.

When sources have conflicting information, the alternatives are:

  • Mention the differences. This is generally recommended when guidelines come from different countries.
  • Choose one that is from a more reliable source, or seems more reasonable. In such cases, a note may be made about alternatives.

Authorship

To be mentioned among the authors of an article, a user must:

  • Use his/her real name in the author list (regardless of username used for editing).
  • Have made a significant contribution to the article. There is no strict cutoff to what is significant, so in case of uncertainty it is recommended to make an entry at the Discussion page of the article on the matter. If there is no response after 4 days, it is acceptable to add oneself in the author list after contributing to the article.

Being listed as an author implies a shared responsibility for the content of the article.

The preferable wiki coding for stating authorship of an article is to add the {{Top}} template, such as in the text below, followed by a {{Bottom}} at the bottom of the article.

{{Top
|author1=[[User:Mikael Häggström|Mikael Häggström]]
|author2=
}}

When at least one author is listed, and edits have been made by additional users (regardless of fulfilling the criteria above), et al. should be added to the author list, linking to the "View history" page of the article, in order to denote that the listed author(s) is not the only contributor(s).

When a substantial amount of content (with no strict threshold but often corresponding to about a section) is copied or closely paraphrased from a source with a Creative Commons license that includes attribution (such as CC-BY), the authors of that article should be mentioned at top, such as "Authors of integrated Creative Commons article" followed by a reference to that article. If only minor portions of such article is integrated, it is enough to mention the authors by a reference at the integrated material.

Content

Target audience: The text should be written to be understood by a recent medical school graduate with corresponding pathology knowledge. It should be concise, so that a pathologist (or graduate training to become a pathologist) at work can quickly find the information of interest. For example, do not state what the reader most definitely already knows. Also, limit the content to what should be done at each step, and limit the underlying theory thereof to the most essential, such as an overview chart of etiologies and their incidences in Dark skin focalities.[notes 2]

Content must be relevant to a pathology practitioner. Every entry must directly tell the reader what to do in a certain situation, or contain the most relevant information that is needed for a such entry.

The organization of articles, as well as gross and microscopic examinations within articles, must be finding-based rather than diagnosis-based (as in form example Kidney autopsy#Microscopic evaluation), since it is oriented towards readers who presumably have a case at hand where they don't yet know the diagnosis. It should also be assumed that the readers do not know the names for the pathologic findings at hand, nor which conditions are causing them when needing to use Patholines in the situation at hand. Thus, findings should be given by images, followed by how to integrate their absence or presence to point toward the most likely diagnosis or differential diagnoses.

Text should be written in imperative format whenever possible, such as "Look at..." or "Avoid...", rather than stating facts.

The ambition should be what is acceptable for a general pathologist without sub-specialization to perform. More detailed evaluations or procedures should be noted (such as "Optionally" or by distinguishing "An acceptable approach..." from "A more comprehensive approach". Such material can also be linked to separate articles, whose title can contain "Beyond the acceptable". Similarly, reports can be of various comprehensiveness (see for example Autopsy).

Inter-article structure

Articles in Patholines can be directly found by search engine, either by the internal search box at top, or external ones. In addition, each article subject should be connected with the main page through links in a series of pages, so that a pathologist can find their way to it by the appearance of that condition. For example, Colorectal adenocarcinoma should be found by clicking links in articles in the following sequence:

Level Main Location Presentation Diagnosis
Example Main Gastrointestinal canal Colorectal polyp or Intestine with tumor Colorectal adenocarcinoma

There may be variations in the level structure, such as additional levels between the ones above, or articles about diseases in specific locations or by a specific modality. However, Patholines should as much as possible be presentation-based, so that users can learn how to favor or disprove the differential diagnoses of the presentations they see.

By linking to further information in other articles, each article should be kept short enough to be read conveniently for a pathologist working with the subject at hand.

No orphans

The creator of a new article must link the article back through a likely sequence that a pathologist would find that condition when seeing it. Articles lacking an unbroken connection to the main page should be tagged with {{Orphan}}, and should be either connected to a sequence or deleted (if the author has been notified of this intention but hasn't made amendments in over two weeks).

Structuring into these levels require more extensive work for more systemic diseases. Adenocarcinoma, for example, must be included in articles of multiple locations. It is the responsibility of the creator of such a disease article to add it to all locations where it is well known to be relevant. It may therefore be more simple to start with for example Lung adenocarcinoma, which only needs linking from Lung tumor.

An author wanting to upload for example a case image must therefore make sure that there is at least a short article about the condition in general, for example a general article about Adenocarcinoma when wanting to upload images of an unusual presentation of it.

Forking

Forking means to make one or more sub-articles from contents of a longer article. This should be done when the resultant structure better conforms to the inter-article structure above, and also when an article exceeds 15-20 images. The parent article should link to the fork by the following note at the top of the section:

Main article: Fork title

This can be generated by the template {{Main|Fork title}}. The section of the parent article should also contain a short summary of the most relevant aspects of the topic.

No plain lists of causes

No disease or other condition should be mentioned without realistic clues for reaching it. Thus, when linking to a condition from the previous level in the sequence, it must not be done by including it in a plain list of causes. Rather, it must be integrated so that it is clear how it is different from other conditions. It is preferably done by a gallery (such as {{Squamous-cell like skin proliferations - differential diagnosis}} (in this case a Template (see below) that is used in multiple articles). It may also be done in prose and/or a table.

At least the most common causes should be mentioned in such differentials.

If there is no pathologic appearance that distinguishes the condition from one or more other conditions, then another type of distinctive feature needs to be mentioned, such as a specific clinical symptom, or epidemiology including incidence or prevalence. Images of the conditions are sufficient when the difference is visually obvious.[notes 3]

Exemptions to the rule of no lists of causes:

  • Presentation articles should include a gallery of the most important and/or common diagnoses.
  • If the article as a whole clearly conveys unique characteristics for each listed condition.
  • The list has a description that pathologists generally do not need to distinguish between the conditions, and why that is the case. Reasons include that the conditions are rare or insignificant so that pathologists generally do not need to screen for them unless specifically asked by the referring clinician.

Current focus

The main focus is currently to achieve a complete collection of the essential material that a newly certified pathologist is expected to know after the training years. The content should be enough to diagnose at least 70% of specimens, including the most common, dangerous or otherwise relevant differential diagnoses thereof. Patholines currently needs to establish articles for the most common locations, as well as the most important diseases and conditions. Cases should preferably be typical of the disease or condition at hand. The most important initial sections thereof are generally "Evaluation" or "Basic screening".

Addition of relatively rare conditions or cases with atypical presentations are acceptable already, but before doing so you must first establish at least one chain of inter-article structure linking back to the main page.

Also, there is a draft for making a textbook on Starting Pathology, using transcluded articles from Patholines.

For most needed articles, see Patholines:Contribute.

Patholines is made by humans

Do not import or generate content in large amounts by automatic applications. It is acceptable to copy-paste text from other sources with compatible licensing (see Patholines:Copyright), but it needs to be properly integrated into the context of existing Patholines material.

It is acceptable to perform automated maintenance tasks, such as making terminology or organization more consistent, but it should be done with care, because an unusual layout or wording may be better for certain conditions.

Patholines can sort articles into Categories for scrolling among less common diseases. However, the use of categories is not a replacement for articles that describe, summarize and distinguish related topics by prose.

Images

Use Patholines:Upload to upload new files.

Image description.

Images can be added in articles by clicking the "Edit" tab at top and then "Insert" and "Media". In source code, images are added to the right in the text by the following code for an example file "File:Histopathology of ovarian serous borderline tumor.jpg":
[[File:Histopathology of ovarian serous borderline tumor.jpg|thumb|350px|Image description.]]

Images should be large enough in articles to clearly show their relevant findings, even without clicking on them to see larger versions. Findings are preferably labeled within images as shown, since the purpose is to teach them to people who don't know them yet, so they may not even know what part of the image to look at. For better flow, avoid repeating such findings in the image caption or in the article prose. If possible, do not use (Fig. 1) in the text and a separate figure elsewhere, but rather have it as a gallery directly following the related text (see the "Help:Gallery tag" page in Wikipedia for formatting), such as this segment of Brain autopsy:

Infarction
Attempt to estimate the age of any infarct. Also look at blood vessels for thrombus or stenosis.

Similarly, preferably avoid sequencing of images into "a, b, c, etc". If a caption needs to say more than "upper right" or similar, then make it a separate image and give it a separate caption.

The image description should mention the purpose or relevance of each mentioned finding (such as "Typical features of the condition are as follows:").

For more rendering alternatives, see Mediawiki:Help:Images

Links

Internal

Add internal links for words that are notable enough in pathology to have their own article, whether or not that article exists yet or not. In source code editing, internal links are created by adding [[ and ]] around the word or words. The text can be made different than the linked article title by [[title|text]]. For example, [[Reporting|General notes on reporting]] shows as General notes on reporting but links to the article Reporting.

External

External links, when not used as references, should be kept in a separate section at the end of an article. They should only include open access pages. External links are not a replacement for writing content in Patholines with the same topic.
In source code, external links are added by [URL title]. For example, with the following code:
*[https://www.cap.org/ College of American Pathologists]
The following link is generated:

Sections

Suggested headers for different types of articles are given in their sections below. Still, it is not necessary for the creator of an article to start multiple sections right away, but can let it grow with time by collaborative editing.

The top may include the scope of the article if not sufficiently specified by the article title alone. Example: Dermatitis

Sections to generally avoid:

  • Anatomy or histology sections should generally not be used, because any relevant anatomy should be integrated into its context in other sections. For example, normal hair follicles are mentioned among the differential diagnoses of basal-cell carcinoma. Rare exceptions are specimen types where normal histology should generally be reported, such as cervical biopsies and endometrial curettages.
  • Indications for biopsy or Treatment, unless generally performed by pathologists themselves. Otherwise, information about treatment is only relevant if being written together with how it affects the way to plan, evaluate or report on the imaging.[notes 2]
  • Section headers without content, where section content should be added right away, or the header be removed.

Titles can be either singular or plural.

Location articles

Example: Skin, Liver

Recommended sections:

This section may contain a subsection titled Most common direct requests, which can include diagnoses, such as Skin mentioning Melanoma of the skin.
  • Gross processing
  • Triage, when the specimen type often comes fresh. This describes procedures done until the specimen is put in formalin for later grossing.
  • Basic gross examination, basic evaluation assuming that no pathology is present, leaving procedures for specific presentations or diseases to be described in their individual articles instead.
  • Tissue selection, generally including necessary slices or other samples that are sent for further processing, in order to make a basic screening. This section may also include guidelines for additional cuts and trimming that are often useful, and can then be titled Tissue selection and trimming.
  • Gross report for gross examination findings (or absence thereof), and descriptions of tissue selections if applicable.
  • Basic microscopic screening, describing a minimal evaluation of the sample(s) in order to report that no pathology is found.
  • Common findings, which may also include harmless incidental findings.

Location-specific presentation articles

Examples: Dark skin focalities, Breast biopsy or excision, Intestine with tumor, Kidney autopsy

Recommended sections:

  • Tissue sampling, mainly for any relevant biopsy guidelines.
  • Fixation, such as the {{Fixation - standard}} template as in Location articles.
  • Gross processing
  • Gross examination
  • Tissue selection (and trimming), which likewise can use a template, followed by additional aspects and techniques.
  • Gross report, including at least the most essential aspects that need to be commented on.
  • Staining, including orders for further processing even before microscopy evaluation, including for example immunohistochemistry, if it should be different or complementary to H&E stain.
  • Microscopic evaluation (can also be called Histopathologic evaluation), which should minimally include a gallery of the most important and/or common diagnoses. Eventually, articles should include a systematic approach to the evaluation, including what areas and findings to look for, and how to interpret them, such as in Kidney autopsy.
  • Microscopy/Histopathology report

Use bulleted lists where possible.

Location-unspecific diagnosis or presentation articles

Example: Melanoma

Recommended sections:

  • Microscopic pattern, describing features that are common regardless of location.
  • Locations, such as Melanoma linking to Melanoma of the skin

Location-specific diagnosis articles

Example: Basal cell carcinoma

The title should include a location, unless the diagnosis or finding is already specific to a certain location, such as Basal-cell carcinoma being specific to the skin already.

  • One or more images or gallery (such as in Seborrheic keratosis) should be at the top of the article. These should have a short description, leaving more detailed descriptions to later sections.
  • Tissue sampling, mainly for any relevant biopsy guidelines.
  • Fixation, such as the {{Fixation - standard}} template as in Location articles.
  • Gross processing, as in Presentation articles
  • Gross examination
  • Tissue selection (and trimming), as in Presentation articles
  • Gross report, as in Presentation articles
  • Microscopic/Histopathologic evaluation, preferably including:
  • Characteristics/Microscopic characteristics such as diagnostic criteria. For features not seen in the vast majority of cases with the diagnosis of interest, note whether they are specific, or which conditions they help rule out (rather than just mentioning that the condition "sometimes displays" the feature).
  • Variants, in case the condition has notable different appearances.
  • Any mention of immunohistochemistry staining should include the conditions that stain helps to indicate. Example: Lobular carcinoma in situ
  • Main clinical clues, such as most common patient age, to help in evaluating the likelihood of the given diagnosis. This should be included after microscopic characteristics, because it becomes pathologically helpful only if microscopy does not give a definite diagnosis already.
  • Further workup once the diagnosis is established, which depending on the disease may include:
  • Staging
  • Degree of differentiation
  • Further subtyping if relevant. At least when being an addition to the Variants section, it should only include clinically relevant subtyping.
  • Microscopy report
  • Important items to mention
  • A modifiable template for a report
Including a template for a synoptic report if relevant. Example: Urothelial carcinoma#Microscopy report
  • Example report

Location-specific finding articles

Example: Proteinaceous material in Bowman's space

Questions

Preferably add one or more questions at the end of articles so that readers can test themselves on memorization-worthy content. Present a possible real life situation, as well as all pertinent information that you can readily look up before needing to answer the question, so to ensure that it tests you memorization-worthy knowledge (see Learning pathology).

Genetics

Do not add genetic test results such as mutations without describing in what situations you would order genetic tests in the first place.

Cases

Case descriptions should be written entirely in the description page of the uploaded image. The following data are preferable:

  • Consent note, for example "Verbal consent", or, if applicable:
  • Diagnostic certainty, from "Possible", "Probable", "Almost certain" to "Certain", or "Not applicable"
  • If patient consent: Age, sex and history and/or symptoms
  • Findings in the image

In cases with multiple images, it can be done by either:

  • Copying the descriptions to each image page.
  • Templating (recommended for 3 or more images), as described in the #Templates section below, allowing any updates to immediately show for all images. For this purpose, the steps include:
    • Giving the template a title, for example: 26 year old woman with ectopic pregnancy, description
    • Write the case description on the template page. On the template page, it is also recommended to list all images that belong to the case.
    • Press save, and implement the template in each related image.

How to create a new article

You need to create an account and become approved as Editor before being able to create articles. See Patholines:About#Participation. As an approved Editor, you can create an article as follows:

You also get the alternative to create an article by clicking red links (terms lacking an article), or by searching for such terms in the search box at top right.

Templates

A template has the ability to show the same material in multiple pages, and edits to it show up immediately in all those pages. This avoids contradictions and missed locations when the data needs to be updated.

Indications

Information that is identical for multiple topics. It thereby avoids contradictions and missed locations when the material needs to be updated.

For example, the template {{Basic gross evaluation of suspected malignant skin lesions}} shows these aspects in these articles:

Templates can also be used for data tables that are applicable to multiple articles.

Common templates include those with general information on a topic, which should be added at the end of each such section:

Hence, an article may be created with the following foundation:

{{Top
|author1=[[User:Mikael Häggström|Mikael Häggström]]
|author2=
}}
{{Fixation - standard}}
{{Fixation - general notes}}
==Gross processing==
{{Gross processing}}
==Microscopic evaluation==
===Microscopy/Histopathology report===
{{Reporting}}
{{Bottom}}

Creation

Implementation

Write the same title, surrounded by two curly brackets on each side, where the template is needed, such as:
{{26 year old woman with ectopic pregnancy, description}}

Edit

Alternatively, templates can be edited by searching for the template title in the search bar at top, preceded by Template: but without the curly brackets, such as:
Template:26 year old woman with ectopic pregnancy, description

When editing or viewing a template page, the pages where it is used are found at "What links here" in the left menu.

Technical description of templates in MediaWiki: MediaWiki: Help: Templates

Variations of English

Patholines articles may be written in American English (such as tumor) or British English (such as tumour). Keep a consistent format within each article; If an article is started in American English, make any additions in American English as well.

Bolded keywords

Preferably use bold for keywords, making it easier to scroll fast to relevant topics.

Talk pages

Talk pages of each article is found by clicking the "Discussion" tab above. Use the "Edit source" or "Add topic" to make additional entries. Add ~~~~ at the end, which will add your username and timestamp. The "Add a comment" functionality is reserved for readers who do not have Editor permission.

Introducing new editors

New editors can be welcomed by adding the following, or similar, on their talk pages (which can be found by entering "User talk:" followed by the username in the search bar):

In source code editing, the above may be added by copy-pasting the following text:

  • Welcome to Patholines! I have received your submitted form, and I have now added you as an editor of Patholines. You will find more information on how to contribute at [[Patholines:Contribute]]. I have also added you at [[Patholines:About#Editors]]. You are welcome to add more details about yourself there, as well as at your user page (see [[Patholines:Editorial guidelines#User_page]]). Feel free to ask me if you have any further questions. Again, welcome! ~~~~

Board questions

One or more questions and answers related to the article content may be added in section near the bottom of the article. Questions should preferably relate to information that may not conveniently and/or timely be looked up when needed in practice, such as by emergency (for example lung wedge resection and lobectomy which often appears as intraoperative consultation) or complexity. In practice, there is limited reason to memorize the rest of the field of pathology for a pathologist who has experience in where to find needed information in reliable sources.[notes 4]

See also

Notes

  1. Never just add a citation at the bottom of the article, even if it reflects all current content, since verification will be extremely difficult following future content additions
  2. 2.0 2.1 Patholines presumes that additional underlying theory can generally be readily found elsewhere.
  3. Without the rule of no lists of causes, such lists in similar wiki projects such as Radiopaedia tend to develop into excessively long lists, which are not useful at all.
  4. Examples of items that hence do not need memorization include chromosome numbers of genes and their proteins.


Main page

References


Image sources