Saturday, March 17, 2018

Thing 15: Evaluating Information

For this Thing, I started by using the Citation Hunt tool. In short order I realized it could take a long time to find a comfortable combination of topic area and needed citation.

And then, as luck would have it, after a few more clicks, I finally encountered an item I could handle. The Wikipedia article Testosterone lists a “normal” plasma level for the hormone in men and women, but lacked a citation for the data. This falls comfortably in my wheelhouse as a nursing librarian. My mind raced through the possibilities. There are all sorts of handbooks on laboratory and diagnostic tests that present reference values for hormones, but those are not readily available outside of clinical settings, large public libraries with strong medical collections, or academic libraries supporting clinical programs. There are numerous websites presenting this information, but their source(s) of data would need verification in turn. What if my library didn’t own or have access to a particular source or sources listed? Of course, either of those paths could lead ultimately to a source inaccessible to many other users of Wikipedia as well, contrary to recommended guidelines.

I started with a simple Google search: standard lab values testosterone. Ta-da! Early in the list of results was a press release from the Endocrine Society about recently published research: Landmark Study Defines Normal Ranges for Testosterone Levels. Having worked as a medical librarian, I recognized the Endocrine Society as a reputable organization—meeting the authority criterion in the CRAAP test. As for the other criteria, the publication date of the featured article was 2017, it was a peer reviewed and (presumably) accurate work, and it was written specifically for a clinical audience, describing normal ranges for testosterone levels in men’s serum (article terminology) or plasma (terminology used in that section of the Wikipedia article).

(An aside: the article is important clinically because testosterone levels are measured when diagnosing hypogonadism. Setting the low end of “normal” at too high a level means many men could risk side effects from hormone supplementation, and also means somebody—patient or insurer—would waste money paying for unneeded treatment. Presenting reference values for men ranging in age from 18 to 99 and varying in health status, the table from this article is more broadly applicable than a single range derived from men belonging to the young and healthy segment of a study population. Of course, as the authors themselves note, it’s far from ideal. Reflecting long-standing biases in medical research, the populations used for the paper consisted primarily of white men residing in developed North American and European countries. Without further research, it’s not known if the observed values hold true for men from other ethnic populations.)

I realized that instead of simply adding a reference, I would also need to make an edit in the Wikipedia entry itself. There was nothing in the section text indicating that testosterone levels might vary with age or other factors. And to my chagrin, the section still needs a reference, because the article I relied upon didn’t provide data on female serum testosterone levels.

On reflection, I didn’t really put myself in the shoes of people I assist at the reference desk. Students generally don’t have the same opportunity to try one topic after another in a short time span. Also, disciplinary newcomers don’t know the reputable individuals or entities in a given field. Locally, many instructors handle this reality by directing students to a limited selection of sources (e.g., JAMA: The Journal of the American Medical Association, Nature, New England Journal of Medicine, and Science). Veering off-list in a reference encounter creates student distress. Thus I don’t intend to change my current approach, which is to recommend that students consult with their instructors when they find sources that meet CRAAP (or similar) criteria, but aren’t on the recommended list.

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