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Sharpe: Somatic symptom count scores do not identify patients with symptoms unexplained by disease:

Discussion in 'Other Health News and Research' started by Esther12, Jan 10, 2015.

  1. Esther12

    Esther12 Senior Member

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    http://www.ncbi.nlm.nih.gov/pubmed/24935983

    Maybe a worthwhile reference for someone? I've not read the whole thing.

    The way some tried to argue that a high symptom count was good evidence of MUS/hysteria/functional symptoms/whatever always seemed silly to me.
     
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  2. Valentijn

    Valentijn Senior Member

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    Sharpe's listed dead last, so probably had very little involvement or control over the contents. But it's nice that his name is on it, as he shouldn't have an excuse to play stupid now.
     
  3. Sasha

    Sasha Fine, thank you

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    Weirdly, in medical papers, the first author listed is the main author and the next most important author is often listed last.
     
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  4. Esther12

    Esther12 Senior Member

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    Yeah - I thought that the last author was often the senior bod who supervised things.
     
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  5. Sasha

    Sasha Fine, thank you

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  6. Valentijn

    Valentijn Senior Member

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    Actually I think the last is usually an "expert" who gives info but otherwise doesn't do anything.
     
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  7. Bob

    Bob

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    I think the order of names can vary. I've occasionally seen senior researchers listed last, but more often I think I've seen minor players and external consultants listed last.
     
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  8. alex3619

    alex3619 Senior Member

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    That is because it IS silly, or to use the terminology I prefer, its irrational. At best its only suggestive.
     
  9. alex3619

    alex3619 Senior Member

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    In this context its about neurology patients ... and we do not yet understand the brain. The most likely explanation is the simple one: there is lots of stuff we still don't know, and so all that can be said about the symptoms is that the cause is unknown and is worthy of further study.

    From the abstract (I have not read the full paper) the conclusion appears fine taken in isolation:

     
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  10. Bob

    Bob

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    I've only read the abstract, but I wonder if my interpretation is correct that neurologists use the PHQ15 as a short-cut to assessing their patients to decide if they have medically unexplained symptoms (i.e. to decide whether to dismiss their patients as 'somatisers'), and now they've discovered that the PHQ15 is useless. If so, it all seems rather corrupt.
     
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  11. Min

    Min Guest

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    Must admit I had hoped that Sharpe, who called us " the undeserving sick of our society and our health service.” had retired.
     
  12. Bob

    Bob

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    It's been proposed that the ICC selects a higher rate of non-ME patients (i can't remember if it was suggested that it selects somatising patient or patients with other psychological disorders) because of its requirement for a higher number of symptoms. (Was it Lenny Jason who proposed this?) I've never understood that argument, or how he came to that conclusion. I wonder if the assertion is based on one of these somatic symptom questionnaires like the PHQ15? I'll make a point of looking out for that if I come across Jason's research again. (Caveat: my memory about this is so vague that I might have it all wrong.)
     
  13. worldbackwards

    worldbackwards A unique snowflake

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    He'll live forever. When the holocaust comes, it'll be him, Wessely and some cockroaches left standing.
     
  14. Esther12

    Esther12 Senior Member

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    He didn't say that we should be considered the undeserving sick, he was using that term to make another point. He is a dick, just not for that!
     
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  15. Valentijn

    Valentijn Senior Member

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    I'm pretty sure he said that the ICC selects for more patients who also fulfill criteria for somatization disorders or similar. My conclusion (not his) was that the problem is obviously with the diagnostic criteria for somatization disorders :p
     
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  16. Min

    Min Guest

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    Esther, Sharpe said this of ME/ CFS patients in 1999:


    How have these doctors, who harm us so badly, got away for all these years with ignoring the fact that our illness is classified as neurological? It is monstrous.
     
  17. Scarecrow

    Scarecrow Revolting Peasant

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    Re the Sharpe quotation, here's the horse's mouth, so to speak. To be fair to Sharpe, the very blunt sentence has to be read in context. He did NOT suggest that PWCFS are 'the undeserving sick'.

    Of course his basic stance is nonsense but if you're going to accuse him, accuse him for the right thing.

    p.s. The title of the lecture 'ME - What do we Know?' was pretty amusing. Not much, in his case.

     
    Last edited: Jan 11, 2015
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  18. Sean

    Sean Senior Member

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  19. Scarecrow

    Scarecrow Revolting Peasant

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    This is how I interpreted what he meant, again from his own words:

     
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  20. Simon

    Simon

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    They mean 'unexplained by known/identified disease' ie it should actually be a "we can't find a disease to account for the symptoms" diagnosis, not a "there is no disease" diagnosis. That's a pretty important distiction, one you'd hope the researchers would have been able to make for themselves.
     
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