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What Peter White is teaching Medical Students on CFS via a chapter in a medical textbook

Bob

Senior Member
Messages
16,455
Location
England (south coast)
What do you make of the following (in bold):
Doctors have historically tended to diagnose ‘stress’ or ‘psychosomatic disorders’ in people with symptoms that they cannot explain. History is full of such disorders being reclassified as research clarifies the pathology. An example is writer’s cramp (p. 1122) which most neurologists now agree is a dystonia rather than a neurosis.

The likelihood is that these functional disorders will be reclassified as their causes and pathophysiology are revealed. Functional brain scans suggest enhancement of brain activity during interoception in more than one syndrome. Interoception is the perception of internal (visceral) phenomena, such as a rapid heartbeat.
When I read that (fairly reasonable) section of the text i was pleasantly surprised, which softened me up so that I wasn't expecting the onslaught that came after it. The quoted section seems incongruous with, and contradictory to, the section about CFS so I reckon they were written by different authors or co-authors. (i.e. I reckon that Pete White did not write the intro re functional disorders in general, but only wrote the CFS section.) (I'm just guessing though.)
 
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Bob

Senior Member
Messages
16,455
Location
England (south coast)
@biophile. Great post. If you've got energy/time/inclination, I think you should consider taking up @Firestormm's suggestion of writing an article based on your post. (We can help you edit it, if you like.) (Just a suggestion - please don't feel any pressure about it.)
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
I am disillusioned and disheartened by it all.
Occasionally I have a temporary crisis of 'faith' whereby I lose my sense of optimism about our direction of travel.
This textbook section re CFS, along with some of the comments below this article (see comments by Mitchell Lawlor, under the article), have led to me to having such a reaction this week.

I was thinking of starting a thread asking people to remind me of all the positive things going on at the moment for ME/CFS, in order to renew my optimism for 2014.
Edit: I've started a thread, here:
http://forums.phoenixrising.me/inde...ve-things-happening-in-2014-for-me-cfs.27527/
 
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user9876

Senior Member
Messages
4,556
When I read that (fairly reasonable) section of the text i was pleasantly surprised, which softened me up so that I wasn't expecting the onslaught that came after it. The quoted section seems incongruous with, and contradictory to, the section about CFS so I reckon they were written by different authors or co-authors. (i.e. I reckon that Pete White did not write the intro re functional disorders in general, but only wrote the CFS section.) (I'm just guessing though.)

Maybe editors or reviewers put it in. It seems strange to say that as causes are known something will be reclassified and then to write about treatment on the basis of the classification that it will loose.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
Or complaints to any universities using these books.

If the rest of the medical book is good (which it is likely to be), they probably wouldnt worry and at the most just avoid teaching the ME/CFS part (if they were at all in the first place) if there had been too many complaints. Of cause that would mean that future medical people reading that book would still likely to see and probably read the ME/CFS chapter anyway.

I really think its at the republishing level.. it needs to be stopped. Medical books get updated all the time.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
Occasionally I have a temporary crisis of 'faith' whereby I lose my sense of optimism about our direction of travel.
This textbook section re CFS, along with some of the comments below this article (see comments by Mitchell Lawlor, under the article), have led to me to having such a reaction this week.

I was thinking of starting a thread asking people to remind me of all the positive things going on at the moment for ME/CFS, in order to renew my optimism for 2014.
Edit: I've started a thread, here:
http://forums.phoenixrising.me/inde...ve-things-happening-in-2014-for-me-cfs.27527/

Dont loose hope, get ANGRY instead. If anything can help us start getting more involved in trying to change what we see and even if we are pushing ourselves over the edge to do it, its the drive of anger.

That is what finally made me do two petitions in the past week.

I too think the worst the issues are which are showing.. maybe the more easier it would be to prove...... if we went some strong routes to put a stop to it.
 

Dolphin

Senior Member
Messages
17,567
There's a thread on Peter White and some of his views and writings on CFS here: http://forums.phoenixrising.me/inde...ice-guidelines-insight-into-their-views.1239/ . However, I thought I'd give this its own thread

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One can read what trainee doctors are learning about Chronic Fatigue Syndrome in the 8th edition of the Kumar & Clark textbook, "Clinical Medicine", here: https://www.inkling.com/read/kumar-...ne-8th/chapter-23/functional-or-psychosomatic

Peter D. White was responsible for this chapter.

Sample extract:

----------------
"Prognosis

Prognosis is poor without treatment, with less than 10% of hospital attenders recovered after 1 year. Outcomes are worse with greater severity, increasing age, co-morbid mood disorders, and the conviction that the illness is entirely physical. A large trial showed that about 60% improve with active rehabilitative treatments, such as graded exercise therapy and cognitive behaviour therapy when added to specialist medical care."


Comment: This doesn't mention that of those that got specialist medical care alone, due to the broad post hoc definition of improvement used in the PACE Trial, 45% improved. Peter White is well aware of what this study (the PACE Trial) found as he was the chief Principal Investigator.

And a little bit of (largely subjective) improvement shouldn't necessarily be covered under "prognosis".

From:
Forward ME Group | Minutes of meeting held on 21 October 2014

Minutes of the Meeting held in the Television Interview Room
House of Lords
Tuesday 21 October 2014, 2pm

8. Any other business

8.1 The Chairman asked Dr Shepherd what was happening about the confusing information discovered in Kumar and Clarke’s “Clinical Medicine”. Charles said he was not aware of it until Dr Nigel Speight had contacted him the previous week. The two of them were keen to write to the editors. The Chairman asked them to frame a letter and let us see the draft.
 

Min

Guest
Messages
1,387
Location
UK
There is no specialist care for myalgic encephalomyelitis in the UK, only GET and CBT nonsense.
 

user9876

Senior Member
Messages
4,556
To persistently suggest that improvements seen in a trial control group are improvements due to therapeutic intervention - is that fraud? (It can't stupidity, because he designed the trial.)
Given the new commercial nature of the NHS it would be interesting to know what Barts is promising the clinical commissioning organizations in terms of results when touting for work. If a drug company were to mislead in this way what action would be taken?
 

Ren

.
Messages
385
Surface-level observations:

Kumar & Clark is published by Saunders Ltd (based in Philadelphia USA), an imprint of Elsevier. (1),(2) “Following the tradition of quality started by W B Saunders more than 120 years ago, each work is written by experts in the field, edited to reflect the latest research…” (3)


“Elsevier B.V. (Dutch pronunciation: [ˈɛlzəvir]) is an academic publishing company that publishes medical and scientific literature. It is a part of the Reed Elsevier group*. Based in Amsterdam, the company has operations in the United Kingdom, US, Mexico, Brazil, Spain and elsewhere.” (4)

“In December 2013, Elsevier announced a collaboration with University College, London, the UCL Big Data Institute…Elsevier's investment is "substantial" and thought to be more than £10 million.” (4) [General FYI: Per Fink co-author Anne Mette Skovgaard is affiliated with UCL.]

“In 2010, Elsevier reported a profit margin of 36% on revenues of US$3.2 billion…Elsevier's high profit margins and copyright practices have subjected it to much criticism.” See also criticisms related to weapons industry, shill review offer, and cost of knowledge protest.(4)(5)


* “Reed Elsevier is an Anglo-Dutch multinational publishing and information company co-headquartered in London, United Kingdom and Amsterdam, Netherlands…. Net income £1.110 billion (2013)… Erik Engstrom (CEO) (6).

“He [Engstrom/Engström] has a BSc from the Stockholm School of Economics [Sweden], an MSc from the Royal Institute of Technology in Stockholm [Sweden], and an MBA from Harvard Business School where he was a Fulbright scholar.” (7)


Elsevier’s neuroscience education endeavors:

“Morristown, NJ, 10 February 2005 - Elsevier’s International Medical News Group (IMNG) is pleased to announce an educational alliance between the Neuroscience Education Institute (NEI) and Clinical Psychiatry News to create and deliver high quality medical education for psychiatrists and allied health professionals.

NEI is an independent, Accreditation Council for Continuing Medical Education (ACCME)-accredited, provider of continuing medical education (CME) and a leader in psychopharmacologic education. NEI has been recognized for its innovative contributions to psychiatric education through such awards as the 2002 Lundbeck International Neuroscience Foundation (LINF) Prize…” (8) (See also Lundbeck (9)).


And more recently:
“It [Reed Elsevier] has strengthened its presence in digital media and, in April [2013], acquired Mendeley, a social network for academics.” (10) “David Dobbs, in The New Yorker, described Elsevier's reasons for buying Mendeley as two-fold: to acquire its user data, and to 'destroy or co-opt an open-science icon that threatens its business model.'” (11)


(1) http://store.elsevier.com/Kumar-and-Clarks-Clinical-Medicine/isbn-9780702044991/
(2) http://en.wikipedia.org/wiki/Saunders_(imprint)
(3) https://store.elsevier.com/Saunders/IMP_23/
(4) http://en.wikipedia.org/wiki/Elsevier
(5) http://en.wikipedia.org/wiki/The_Cost_of_Knowledge
(6) http://en.wikipedia.org/wiki/Reed_Elsevier
(7) http://en.wikipedia.org/wiki/Erik_Engstrom
(8) http://www.elsevier.com/about/press...nce-educational-alliance#sthash.2Faif5JA.dpuf
(9) http://forums.phoenixrising.me/inde...-from-rebecca-hansen.29011/page-2#post-508084
(10) http://www.euroinvestor.com/news/2013/09/25/reed-elsevier-cfo-resigns-update-2/12508391
(11) http://en.wikipedia.org/wiki/Mendeley


Perhaps someone (or a group of someones ) should write an open and of course respectful letter to Mr. Engström, explaining how Saunders/Elsevier's info does not reflect experts' "latest research" in the field and ask Mr. Engström to consider updating ME/CFS info according to, for example, the CCC and/or ICC and/or IACFS/ME Primer?


-------------------------


Edit: It appears that Malcolm Hooper tried to alert Engström to problems with Engström's ME/CFS publications (the Lancet with PACE?), but Hooper seems never to have heard from Engström or his office.

http://www.meactionuk.org.uk/Comments-on-PDW-letter-re-PACE.htm
 
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leela

Senior Member
Messages
3,290
“It [Reed Elsevier] has strengthened its presence in digital media and, in April [2013], acquired Mendeley, a social network for academics.” (10) “David Dobbs, in The New Yorker, described Elsevier's reasons for buying Mendeley as two-fold: to acquire its user data, and to 'destroy or co-opt an open-science icon that threatens its business model.'” (11)
[shudders]