Invest in ME Conference 12: First Class in Every Way
OverTheHills wraps up our series of articles on this year's 12th Invest in ME International Conference (IIMEC12) in London with some reflections on her experience as a patient attending the conference for the first time.
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MUS or DEN? Letter in British Journal of General Practice. Good one.

Discussion in 'General ME/CFS News' started by trishrhymes, Apr 4, 2017.

  1. trishrhymes

    trishrhymes Senior Member

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    Spotted this on Twitter - Editors choice in BJGP.

    MUS means Medically Unexplained Symptoms, and is used by the biopsychosocial crowd as a catch all for ME/CFS, FM, IBS and assorted other conditions they say wrongly are psychological.

    DEN means Doctors education needed.

    ‘MUS’ or ‘DEN’?
    Emma J Reinhold
    Br J Gen Pract 2017; 67 (657): 156. DOI: https://doi.org/10.3399/bjgp17X690077

    ''I have long despaired at the focus on the ‘consultation’ and the psychological approach to patients whose symptoms have not yet acquired a diagnostic label.1 Since learning the latest about the linked conditions of mast cell activation syndrome, postural orthostatic tachycardia syndrome, dysautonomia, and the hypermobility syndromes (including Ehlers–Danlos), I have yet to find anyone with ‘MUS’. I just find patients who have been failed by a lack of medical knowledge among their caring clinicians. Stop feeling that heartsink and stop giving patients the message that it’s all in their head. Instead, educate yourself about the manifold presentations of these newly recognised conditions and give your patients the validation they deserve.''

    © British Journal of General Practice 2017

    http://bjgp.org/content/67/657/156.1
     
  2. AndyPR

    AndyPR Senior Member

    Ah, she is Primary Care Adviser to EDS-UK, which would explain her different view.
     
  3. Dx Revision Watch

    Dx Revision Watch Owner of Dx Revision Watch

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    Two additional letters were published alongside Dr Reinholds' letter and all three can be read in full on the BJGP site:

    http://bjgp.org/content/67/657/156.2

    MUS: continuing challenges for primary care
    Janet P Watters

    Br J Gen Pract 2017; 67 (657): 156. DOI: https://doi.org/10.3399/bjgp17X690089

    (Same old, same old MUS as psychological pain that cannot otherwise be acknowledged and/or expressed.)
    --------------------------

    http://bjgp.org/content/67/657/159.1

    Letters
    Medically unexplained symptoms
    Vernon H Needham

    Br J Gen Pract 2017; 67 (657): 159. DOI: https://doi.org/10.3399/bjgp17X690185

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

    They were written in response to this BJGP editorial (most of which is behind a sub):

    Editorial:

    Medically unexplained symptoms: continuing challenges for primary care

    Carolyn A Chew-Graham, Simon Heyland, Tom Kingstone, Tom Shepherd, Marta Buszewicz, Heather Burroughs and Athula Sumathipala

    Br J Gen Pract 2017; 67 (656): 106-107. DOI: https://doi.org/10.3399/bjgp17X689473

    First couple or paras available on site.

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

    One of the authors, Athula Sumathipala, is a member of the ICD-11 Somatic Distress and Dissociative Disorders (S3DWG) working group that has been revising, among other categories, the various ICD-10 somatoform disorders, now proposed to be replaced with ICD-11's "Bodily distress disorder."


    Yesterday, I alerted Dr Reinhold that patients with yet to be diagnosed multisystem diseases like EDS, Behçet disease, ME and CFS, are also at risk of misdiagnosis with, or misapplication of, an additional diagnosis of "Bodily distress disorder" and gave her a copy of the proposal Mary Dimmock and I submitted to ICD-11 Beta on March 27, with the sections on BDD and BDS highlighted.
     
  4. lilpink

    lilpink Senior Member

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  5. lilpink

    lilpink Senior Member

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    Now cancer sufferers affected too it would seem -

    http://www.dailymail.co.uk/health/a...failing-estimated-32-000-cancer-patients.html

    NB - more likely for women and young people to be misdiagnosed by their GP


    compare this with the Guidance for Commissioners of Services for People with Medically Unexplained Symptoms - http://www.jcpmh.info/resource/guid...rvices-people-medically-unexplained-symptoms/

    which says - "The risks or associated factors for MUS include being female, younger in age, and currently employed"
     
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  6. slysaint

    slysaint Senior Member

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    Does this mean you don't really fall ill if you're working, you only think you're ill?

    edit: I re -read that whole risks line again and it makes no sense...........you are more at risk of having something that doesn't exist if x,y,z, also as a lot of people with ME don't work...(?):confused:
     
    Last edited: Apr 25, 2017
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  7. lilpink

    lilpink Senior Member

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    I think you're over reaching if you expect MUS to make any 'sense' :bang-head::bang-head::bang-head::bang-head::bang-head::bang-head::bang-head:
     
  8. suseq

    suseq

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    On p.5 of the MUS guidance document @lilpink links to, under the subheading 'How will this guide help you?' It states:

    This guide has been written by a group of highly experienced MUS service experts (see page 18 for list of members involved). Evidence-based practice has been summarised where it exists. While robust evidence is lacking in many areas, ideas deemed to be best practice by expert consensus have been included. This guidance encourages services to develop alongside emerging evidence, with a focus on innovation.

    This illustrates that these 'experts' know they have little evidence to support their hypotheses. They clearly state that robust evidence is lacking and is merely based on ideas! They know all their studies are subjective and fail to prove their claims. It also confirms their aim to use a powerful lobby of vested political and commercial interests to 'encourage' and 'educate' doctors and health services to buy into their unsubstantiated theories and thereby 'prove' their beliefs, and that their ideas work to save time and money.

    A complete spin on the truth.
     
    SamanthaJ, ukxmrv, lilpink and 8 others like this.
  9. Sean

    Sean Senior Member

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    expert consensus

    ...has the lowest ranking in evidence based medicine.

    Translation: We got no effing idea what we are talking about, but don't have the integrity and courage to admit it. So we are just gonna make shit up as we go along, muddy the waters as best we can, and hope nobody important notices before we reach retirement.

    :meh:
     
    Last edited: Apr 25, 2017
    MEMum, trishrhymes, SamanthaJ and 7 others like this.
  10. slysaint

    slysaint Senior Member

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    It must be the perfectionist Achiever in me:nerd:
     
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  11. suseq

    suseq

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    @Sean love your translation which is The Truth!
     
    MEMum and Sean like this.
  12. lilpink

    lilpink Senior Member

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    Doesn't need saying ;) :bang-head::ninja:
     
    MEMum likes this.
  13. Luther Blissett

    Luther Blissett Senior Member

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    The BPS crowd has long had it's sights set on supposedly subjective work related injuries and or injuries that affect workers.

    Lower Back Pain, Repetitive Strain Injuries, Whiplash after car accidents, etc.

    If you think of it from an insurance company perspective, it's helpful to throw doubt on work related injuries, especially those to do with manual work, as the workers are the most vulnerable class in the hierachy (lack of ability to challenge 'expert' opinions). It's helpful to the administrators of Social Security too for the same reasons of limiting claims.

    Most of us would think that in say a factory environment, with repetitive movements being a high proportion of activity, that these kind of injury would be a risk, but no, these places became incubators of a sudden onset of 'Malingering and Illness Deception'.
     
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