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IOM's response to patients' concerns about panel selection

Nielk

Senior Member
Messages
6,970
To have an idea of how IOM chooses their panel members for a study in defining diseases, one can look at the current panel for defining CMI (used to be GWI).
http://www8.nationalacademies.org/cp/CommitteeView.aspx?key=49546

How many members of that panel have actually seen, treated or done research on Gulf War Illness patient?
For example, Drs. Fred Friedberg and Suzanne Vernon are on that panel.
A few are current members of the IOM. Psychiatrists/psychologists make up more than a third of the panel. I can only find three members with any experience with GWI. Some have previously worked for the NIH and/or CDC.
 

leela

Senior Member
Messages
3,290
The contract needs to be cancelled, the CCC adopted (preferably ICC), and everything needs to move along now.
It is entirely inappropriate for this shenanigans to be happening now.
Spending one sixth of the pathetic "CFS" "budget" on a definition that has already been publicly accepted by 50 (pretty much all) of the top experts in the field is insulting and wasteful of time, money, and professional resources.

The real experts have defined the illness and they need to get back to helping patients, and guiding those who don't know anything about it.
 

justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
To have an idea of how IOM chooses their panel members for a study in defining diseases, one can look at the current panel for defining CMI (used to be GWI).
http://www8.nationalacademies.org/cp/CommitteeView.aspx?key=49546

How many members of that panel have actually seen, treated or done research on Gulf War Illness patient?
For example, Drs. Fred Friedberg and Suzanne Vernon are on that panel.
A few are current members of the IOM. Psychiatrists/psychologists make up more than a third of the panel. I can only find three members with any experience with GWI. Some have previously worked for the NIH and/or CDC.

I don't know if you included Dr. Vernon in those with GWI experience. Her bio said:
"She currently serves on the Congressionally Directed Medical Research Program Gulf War Illness Research Program integration panel."

That's a mouthful.

I bet the main reason they picked Vernon, is they liked her work as a co-author of the fake CDC Reeves Criteria for CFS.

So, Three out of Sixteen panel members have done any prior work on GWI: 19% of the panel, less than the number of psychiatrists and psychologists. That's insane. And as others have said about other aspects of IoM GWI reports, what makes us think they will treat us any better? SInce the vets have more clout in Congress, I can only see us being treated the same or worse.

"Some have previously worked for the NIH and/or CDC."

For all their talk of independence from the sponsoring institution, they find a way to insure the HHS perspective is included in the panel.
 

Snowdrop

Rebel without a biscuit
Messages
2,933
To have an idea of how IOM chooses their panel members for a study in defining diseases, one can look at the current panel for defining CMI (used to be GWI).
http://www8.nationalacademies.org/cp/CommitteeView.aspx?key=49546

How many members of that panel have actually seen, treated or done research on Gulf War Illness patient?
For example, Drs. Fred Friedberg and Suzanne Vernon are on that panel.
A few are current members of the IOM. Psychiatrists/psychologists make up more than a third of the panel. I can only find three members with any experience with GWI. Some have previously worked for the NIH and/or CDC.

Chilling and quite scary.

Maybe we as a community should start thinking in terms of how we are going to respond to the inevitable. That is, get out ahead of this. We are so ill it's hard to respond to things immediately but maybe we should have contingencies in place for when the IOM comes out with the report that we can't help but expect from them.

We should be pre-mobilized.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Chilling and quite scary.

Maybe we as a community should start thinking in terms of how we are going to respond to the inevitable. That is, get out ahead of this. We are so ill it's hard to respond to things immediately but maybe we should have contingencies in place for when the IOM comes out with the report that we can't help but expect from them.

We should be pre-mobilized.

The first action along these lines is to scrutinize proposed panel members, due out next month I think. We can and should respond, but our time window is likely to be very short.
 

jspotila

Senior Member
Messages
1,099
It will be 20 days.

I've started assembling bio information on people who MIGHT be appointed. My goal is to get that info out on my blog within 36-48 hours of the announcement. That will give everyone a head start on responding in the 20 day window.
 

justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
That is quite actually insulting towards our experienced clinicians/physicians. It implies that they believe our experts couldnt do a diagnostic criteria good enough for non experts to use.

I personally think that those wanting OMI to do this, think the canadian definition is too complex and they are wanting something way easy eg to ignore most of the symptoms we have with this illness. There seems to be a reluctance to accept how complex our illness is.


I think some thought needs to be put into that too. Why would it be good for the USA to have "their own" definition of ME/CFS?. It is already the case of too many definitions out there.. just imagine if every country wanted their own definition!!! (that certainly dont help science).

What is really needed is one to be accepted worldwide, right now the CCC is the closest one to achieving that I think and if it could be adopted in America it will be getting much closer to achieving a world wide one (the CCC is already partly adopted in Australia, my state recognises it and opted to keep it.. along with the Australian definition one when that one was done).

Whatever definition US HHS adopts or endorses or 'distributes' instantly becomes the default standard all over the globe- look at Fukuda for example. This is why the IoM MUST be stopped and CCC adopted. I am never giving up on this.

I don't think it will cause the decades-long destruction that Fukuda and Oxford have, simply because our advocacy efforts are slowly growing, so this will shorten the time an IoM definition dominates the landscape. But if the IoM study is completed, I still think it will take years of hard advocacy to dislodge it from a dominant position. We need to stop this freight-train before it gains momentum.

This is our big opportunity to really make a difference! Lets hang in there and keep up our momentum (health-permitting), we are gaining.
 
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justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
Alex, here is an article of various critiques of EBM I found interesting. As you have mentioned before, (at least at the date of the article in 2004), there was no evidence (at least as defined by EBM) for EBM itself. It said that EBM supporters have admitted that, but some have responded that RCTs that would support EBM would all be either impossible or unethical.

So, EBM itself says there are very significant instances when it cannot and/or should not be applied, that it would even be unethical to apply it. This is one of those instances.

From this article, it looks like many (most?) EBM supporters don't insist anymore that it is the be-all, end-all method for medicine, but that it is an important tool to be integrated with clinical experience. It looks like they won't admit though that the EBM model itself should change at all, at least in the rankings of types of evidence. I guess they want their model itself unchanged, but are willing to concede that the EBM model should not trump or exclude clinical judgment and other sources of knowledge.

The wikipedia article, at least, fwiw, states that the methodological validity of the individual studies does need to be considered.

http://skynet.ohsu.edu/~hersh/ijmi-04-ebm.pdf
 

Izola

Senior Member
Messages
495
@leela, don't apologize. You are right on every point. Its so irrational its not just borderline stupid, it is stupid. Welcome to politics, and we are the political football.

Its a lot like the physics joke about entropy at the moment. Entropy is like a rigged game. You can't win, you can't break even, but you can't get out of the game.
Is entropy like I'm feeling like now? I don't know whether I'm living or dying or have been removed from the game. I stand by Leela's comments millions of per cents. And there's a hole in the part of my brain that used to understand what entropy is. Like your explanations though. They have kick-- dumb pun intended. Izola on sleep deprivation
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Has everyone given up on STOPPING this? It needs to not happen in the first place. We have two perfectly fine definitions
formulated by experts.

I don't think most of us have given up on stopping the IOM. I think we need to prepare additional fronts of battle, as it were. First, if the IOM proceeds to further stages we can start fighting each stage. Second, if we make sure they know we are going to fight them every single step, that sends a message.

The odds of stopping the IOM are weak. However there is another issue. Many are looking at modifying the process, making it more friendly to us. While possible I don't think we will get far. Instead the next tactic is to make sure they demonstrably had every opportunity to get it right, and then we can show they failed.

This is not a battle, its a war. We are going to lose some battles, but the war goes on. Unless the IOM somehow gets things right, something I think it very unlikely, then we need to make everyone aware the outcome is irrational, controversial, biased, and unacceptable to patients and our leading researchers.

They need to be aware that if the IOM definition goes through, and it gets disseminated, we will be fighting them for as long as it takes, on several fronts. Those fronts are public relations, political, and scientific. In the end a definitive biomarker or a successful treatment/cure may be what breaks the back of bad definitions and hypotheses.
 
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Snowdrop

Rebel without a biscuit
Messages
2,933
I agree with the above assessment.

We need to be fighting public perception as it is informed through mass media. Whenever an incorrect statement appears we need to as a group respond with calm and dignity but also with determination. If the large news outlets BBC, ABC, CBC, PBS etc put out info that supports a wrong view of ME it should be challenged by all of us.
 

justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
Is entropy like I'm feeling like now? I don't know whether I'm living or dying or have been removed from the game. I stand by Leela's comments millions of per cents. And there's a hole in the part of my brain that used to understand what entropy is. Like your explanations though. They have kick-- dumb pun intended. Izola on sleep deprivation

Yes, you have all the symptoms of entropy. ME is basically entropy on a stick, imo.
 

Gemini

Senior Member
Messages
1,176
Location
East Coast USA
I tried to do google searches but i couldn't turn up anything about how diagnostic criteria or case definitions are normally formulated.

JR, you might be interested in formulation of the MS diagnostic criteria. Good model, excellent documentation:

Series of published MS Diagnostic Criteria each new one incorporating new MS research developments over time:

Schumacher Criteria 1965
Poser Criteria 1983
McDonald Criteria 2001
Revised McDonald 2005
Revised revised McDonald 2010

http://www.nationalmssociety.org/se...=diagnostic+criteria&start=0&num=20&x=19&y=14

This might interest you: composition of the 2001 McDonald Criteria International Committee of 16 members:

15 of the 16 panel members (94% of the total committee) were MD neurologists, clinicians & researchers, who specialized in MS; and

1 of the 16 panel members (6% of the total committee) was a PhD neuroscientist specializing in MS, VP of Research Programs at the National MS Society.

All were MS experts.

Medical specialty societies are frequently involved in the development of guidelines & criteria.

Aside, one MD neurologist worked at NIH, NINDS, on MS research.
 
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leela

Senior Member
Messages
3,290
Multiple like button needed!
Please someone send this to that Kate Meck asap. There is no more time or space for the kind of drivel disseminated in her
response.
 

Seven7

Seven
Messages
3,444
Location
USA
Ok the way to do it is now find the weakness (if they are republicans, find support from democrats, and the opposite if truth) Play the game. Visibility. Press of every move BEFORE is over.

We need to have it in DEEP scrutiny so any miss-step is not as easy to buried. PRESS PRESS and more pRESS, find allies. We have to come from on top with everything we got.