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The P2P Draft Systematic Review Is Up

WillowJ

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Location
WA, USA
Then if I look at PACE specifically, 35% of patients had any depressive disorder and 47% of patients had any psychiatric illness, at least according to the P2P review. I recognize that some percent of the 35% could have secondary psychiatric illness versus primary but the point is that Oxford's loosened exclusionary criteria would allow primary psychiatric illness.

So if a subpopulation of PACE or any other Oxford study has primary psychiatric illness - or deconditioning or any other causes of chronic fatigue - then we can expect that their response to CBT and GET would be different than a population selected by CCC in which PEM is at play.

If the above is true, then patient selection issues in a general sense are an issue in addition to the study conduct issues that you outlined.

What am I missing?

I would be very careful with these points. It's already been pointed out that CBT/GET generally are unable to show an important benefit regardless of the crumminess of the inclusion criteria, so I won't spend any more time on that.

Rate of diagnosis of patients with any chronic disease with a psychiatric condition is about 30-40% (more if incorrect inclusion are used). So this is really not out of line for a chronically ill population (something that is probably worth mentioning--one useful citation, and where I got those figures particularly, is Elinor Stein's "Assessment and Treatment of Patients with ME/CFS: Clinical Guidelines for Psychiatrists").

While it is true that a multitude of diseases can be diagnosed incorrectly as "CFS" when a crummy criteria is used or any criteria is used sloppily, it's not important which diseases are getting misdiagnosed, but that misdiagnosis happens and is not only a trial confounder (bad for everyone collectively) but is bad for individual patients (the misdiagnosed ones particularly). The studies we have mostly show that actually medical-classified conditions are more common misdiagnoses in "CFS"-diagnosed populations, but it doesn't actually matter (on a collective level) because of course all diseases are important and everyone deserves a correct diagnosis, the best available treatment for the condition they actually have, choices in treatments, and ongoing research which sensibly researches that condition and follows interesting leads.

About 12%, IIRC, could not be diagnosed either with ME/CFS under our current guidelines or with anything else the examining doctors knew how to diagnose. Whether this means the guidelines for ME/CFS are inadequate or whether it means doctors are not good enough at diagnosing, or that there are unknown diseases, is anyone's guess. But it will not be fixed under the current situation.


By the bye, I would rather not see CPET used as diagnostic, as some patients cannot do this without harm. Also I do agree the science is not ready yet to announce it as diagnostic.

However, it should be offered, as should any other test that seems useful. In other diseases, tests do not have to diagnose the entire population of a given disease label, in order to be used to help characterize a given patient with that disease label. A variety of tests are used in Lupus, for example, many of which are necessarily diagnostic by themselves, and depending on the circumstances of the patient, some of them are not even meant to help with diagnosis but just to check on disease processes that are not expected to be the same from patient to patient.
 
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WillowJ

คภภเє ɠรค๓թєl
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Location
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That's interesting, to read about the distinction between the two. Thanks Dolphin.

Even so, Reeves 2003 has generally been lumped together with Reeves 2005 in people's minds, and neither Reeves criteria (2003 or 2005) are in general use. So perhaps the argument that they are not widely used, and are widely considered redundant, can be used for both?

I have always wondered why the PACE trial references Reeves 2003 and not 2005.

This is the 2003 paper:
Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution
William C Reeves1*, Andrew Lloyd2, Suzanne D Vernon1, Nancy Klimas3, Leonard A Jason4, Gijs Bleijenberg5, Birgitta Evengard6, Peter D White7, Rosane Nisenbaum1, Elizabeth R Unger1 and the International Chronic Fatigue Syndrome Study Group

BMC Health Services Research 2003, 3:25 doi:10.1186/1472-6963-3-25

The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1472-6963/3/25
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
The review claims CBT results in better employment outcomes, on page 5. Evidence to the contrary is ignored as you said.

Another weakness of the review is lumping different definitions together. We already know that the Oxford definition applies to a different group of patients than the ICCC. I see no justification for assuming that conclusions based on one definition apply to another. Speaking of ME/CFS as single illness is hopeless.

My sympathies to patients who will be affected by this review.

Its exactly what a lot of us was expecting and why we were against all this.
 

biophile

Places I'd rather be.
Messages
8,977
The systematic review excluded actual employment data from PACE and misinterpreted the WSAS data from PACE as employment outcomes (the WSAS is about functional impairment, not employment, and saying otherwise is misleading).

Maybe I'm naive but I'd be willing to view this as an oversight, as the actual employment and welfare outcomes were buried in a paper about cost-effectiveness, and the review covers so much that some details can be missed. However if the P2P maintain this position even after having it pointed out to them, then it's certainly rigged.
 
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taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
In correspondence, subsequent to publication, the authors of the study have said that the PACE trial studied 'CFS', and not 'ME', but the correspondence wasn't published in a peer-reviewed journal (as far as I recall) so it can't be used as evidence.

I may be wrong but I thought that was published. Wasnt it Tom Kindon???? who's comment got published and then the authors offically made that comment back? Im 80% sure it was published letter by one of the authors saying that (I may be wrong with my brain thou). It was AFTER publication the comment Im thinking of
 
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taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
Maybe I'm naive but I'd be willing to view this as an oversight, as the actual employment and welfare outcomes were buried in a paper about cost-effectiveness, and the review covers so much that some details can be missed. However if the P2P maintain this position even after having it pointed out to them, then it's certainly rigged.

It's always been rigged.. it was set up to be so from the start.
 

Ecoclimber

Senior Member
Messages
1,011
A message to ME/CFS advocates and to the ME/CFS Community
This is a follow up on my previous posting http://forums.phoenixrising.me/indee x.php?threads/international-experts-speak-out-against-the-iom-contract-to-determine-clinical-diagnostic-criteria.25448/page-4#post-391251 International experts speak out against the IOM contract to determine clinical diagnostic criteria

The ME/CFS community must abandon the failed strategy over the last decade if it is to succeed against the powerful forces that are aligned against it and other patient communities. Letter writing, emails, 3-4 person demonstrations, and patient testimony at various meetings over the last decade do not work! The CFSAC and similar boards incorporated in the political process by government agencies all the way from city to the federal level, is a administrative ploy and tactic employed by governmental agencies to quell protest against unpopular policy decisions. It is a sounding board to appear as though government is listening when in fact the opposite is true.

These are the hard, cold facts which I have enumerated a number of times on this forum last year during the IOM protest.

This is the reality that exists today. The insurance industry is spending hundreds of millions of dollars too pass legislation that is favorable to their industry and to fund Congressional and Presidential election campaigns to get the job done. They have multitude of paid lobbyists that meet with Congressional members each day throughout the year. There is no way that ME/CFS patient community can match the resources from the insurance industry.

The link below demonstrates the power behind political action committees and special interest groups. The same tatics are used within the insurance industry.
Actually please click on it and read it. Inform yourself.
http://www.prwatch.org/news/2011/07/10887/cmd-special-report-alecs-funding-and-spending


Below is a list of links demonstrating how Unum established a research center within the UK. Unum disability insurance company along with members of the Tory government, collaborated together to changed the criteria and to disassemble the entire disability benefits program within the UK.

Unum persuaded the UK government circa 2005 to move from biological determination of illnesses to biopsychosocial model.

Tom Hennessy, a marketing executive and former member of the ME/CFS community, stated in order for this community to succeed, you need CRITICAL MASS. He termed the word 'AMASS'. You don't have it in this community. The ME/CFS community is fragmented. There is no unifying and creative strategy in place to confront the strategy from the insurance industry.

This community does not have the resources to fight the insurance industry!

I do not see a favorable outcome for this community. However, I have several suggestions.

ME/CFS community must form an alliance among other stakeholder patient communities specifically: the Fibromyalgia, Lyme, GWI, HIV and other chronic illness and disease groups. We NEED their resources and help.


Contact the mainstream investigative journalists that exposed the situation with the Gulf War Veterans concerning GWI and the IOM. Contact national news organizations and writers that are sympathetic to the issues of the ME/CFS

The best defense is an offense. Put the NIH on the defensive by having to defend their actions. Expose them. Use attention gathering words such as genocide, death panels. There is a saying within the news media that if it 'bleeds, it leads'. In other words, from the aspect of the news media, attention gathering conflict raises the importance of the issue and the likelihood that it will be reported!

The only thing that Washington considers concerning policy directives is money and votes.

Since the 2014 and 2016 elections are around the corner, use this fact to create a strategy.

President Obama made a campaign promise that he will address the issues concerning ME/CFS community. He also made a campaign promise of complete transparency. "My Administration is committed to creating an unprecedented level of openness in Government. We will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government."
http://www.whitehouse.gov/the_press_office/TransparencyandOpenGovernment


He appointed a White House liaison to investigate ME/CFS and report back to him. Initiate an email campaign address to the President, the Vice President and members of his staff. Make this a focal point to the President and his staff, that he and his administration has failed on both accounts within not only the ME/CFS patient communities but with other patient communities mentioned above. We are fed up and disenchanted with the actions of the NIH and the CDC.

Remind the President and his staff that with close elections just around the corner that could determine a GOP control of both Houses and a GOP president, he can ill afford to lose the votes of patients from these communities. The last thing the President needs is bad press.

Get the message out concerning the insurance industry attack on our patient communities. Since the majority of the patients don't have the funds and most medical benefits do not cover psychological treatments for this illness, the solution by the NIH is no solution at all. Drive these facts. Attack the NIH, the Insurance industry and the psychobabble community, that their record for treatment and 'cures' is a record hidden behind smoke and mirrors fueled by unscientific research.

Is this the type of care that awaits patient communities after patient doors are busted in, patients are hauled out and placed in psychiatric hospitals at the behest of the insurance industry.

http://www.thedailybeast.com/articl...yhound-therapy-for-mentally-ill-patients.html
-
Sophia

-
http://lymedisease.org/news/lyme_di...-lyme-recognition-in-australia-rip-theda.html

These are just a few of the links that will shock you concerning the strategy within the Insurance Industry to influence governments of both the U.K. and the U.S. Advocates need to inform themselves on the history of the relationship between the insurance industry and government!!

This shocking expose by others should be used within social media to present our case. It has affected tens of millions of people concerning benefits. An effective strategy needs to be implemented to get this message out. There is a lot of ammunition in these links:

http://blacktrianglecampaign.org/20...ational-medicine-royal-college-of-physicians/
http://www.lawyersandsettlements.co...num-insurance-disability-claims-11-16462.html
http://www.ekklesia.co.uk/node/17021
http://www.meassociation.org.uk/201...and-income-protection-cover-11-november-2011/
http://dpac.uk.net/2012/04/a-tale-o...rnment-and-disability-charities-debbie-jolly/
http://www.sophiaandme.org.uk/collusion.html
http://meagenda.wordpress.com/2008/12/26/dr-chris-bass-pulse-somatoform-disorders-article-and-unum/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480686/
http://www.livingfoods.co.uk/pages/articles/cbt-and-m.e.-by-margaret.php
http://biomedicalmecfs.blogspot.com...ordpress.com/2008/12/cmoreport2007_up1431.pdf
http://www.advocacyforpatients.org/
http://influenceexplorer.com/organization/unum-group/7cfdd5707de84c4c8bd3e08638c1c313

https://www.whatdotheyknow.com/request/101018/response/248774/attach/html/2/FoI 236 27.01.12.pdf.html
http://www.uqur.com/unum.html
http://www.uqur.com/unum-claims/
https://meagenda.files.wordpress.com/2008/12/cmoreport2007_up1431.pdf
http://caselaw.findlaw.com/us-9th-circuit/1128258.html


Research non-profit organizations that have file legal action against the U.S. government such as the ACLU, Common Cause. Contact them and explain the dire situation concerning the policy directives by the NIH and ask them if they can help our patient community! Initiate legal action.

When Lipkin could not find any unique virus, bacterial and fungi pathogen from the CFI, the government immediately contracted to the IOM and denied Lipkin’s request for funding for the Microbiome Project. He was turned down twice. Why?

Yet, the NIH initiated the Microbiome Project and disbursed over $665 million dollars among various leading research institutes to conduct studies and investigations on the relationship between pathogens, illnesses and the microbiome.

Why didn't the NIH peal off a a scant $1 million dollars from the $665 million dollars for Lipkin's research?
http://hmpdacc.org/
https://www.bcm.edu/research/centers/metagenomics-and-microbiome-research
http://www.sciencemag.org/content/336/6086/1245.short
https://www.bcm.edu/news/molecular-virology-and-microbiology/human-microbiome-project-at-bcm


If this illness is turned into biopsychosocial model, then medical care including medical prescriptions other than for psychotropic medicine will be nonexistent.

If this goes through, medical doctors will cease treating the medical symptoms and will instead refer patients to psychiatrists for treatment. Everyone within the ME/CFS community has a stake in fighting the NIH policy concerning ME/CFS. We need the help from advocacy organizations, groups and members of those organizations from both sides of the pond on this issue. We need a well coordinated and timely strategy or strategies and action plans.

I know there is an aversion to clicking on links but please do and then reply with your comments and suggestions so we as a community can brainstorm an effective strategy.

Does this community have the will to engage and fight the NIH, this is the ultimate question?
 
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Gingergrrl

Senior Member
Messages
16,171
@Ecoclimber I can get easily overwhelmed by all the info but really want to participate in advocacy.

For those of us in the US, if we were to start with the single most important thing to advocate, what would that be?

Would it be sending an e-mail to President Obama or something else? I feel like if I am given a really clear guideline, I know I can do it and I WANT to do it.

I just don't know where to start or what to say!!! Thanks for any guidance on this.
 

Ecoclimber

Senior Member
Messages
1,011
@Ecoclimber I can get easily overwhelmed by all the info but really want to participate in advocacy.

For those of us in the US, if we were to start with the single most important thing to advocate, what would that be?

Would it be sending an e-mail to President Obama or something else? I feel like if I am given a really clear guideline, I know I can do it and I WANT to do it.

I just don't know where to start or what to say!!! Thanks for any guidance on this.

Thanks for your help. Whatever you can do within your own sphere is sufficient. Sending emails to the White House and their staff would be great start :)

What is needed is a coalition of advocates, a workforce, that can assimlate ideas from the community, discuss those ideas, create an effective strategy and communicate that strategy through an action plan to the members of the ME/CFS community. There can more then one strategy and action plan but somone has to step up to the plate and take on this project. Timimg is critical. We need the help from members of advocacy groups and organizations from both sides of the pond!!
 

*GG*

senior member
Messages
6,389
Location
Concord, NH
@Ecoclimber

You might want to alter your signature:

http://blog.ap.org/2014/09/19/8-ways-the-obama-administration-is-blocking-information/

This is probably news to you, right? So much the media doesn't broadcast from the highest towers/ with big megaphones, they cannot do to much to damage the party the majority of them align with. We need another great 8 years of economic growth and "hope and change" so Hillary can take her rightful place. LOL

I woke up after 9/11, I always watched the news,, and somehow this struck me out of the blue and the info I would get from the radio.

Glad I am no longer in the workforce and having the gov't take half of my earnings and having prices still escalate but no my wages in keeping pace!

I am not holding my breath on anything from Obama and his cronies!

going to preserve my precious energy for more fruitful endeavors :)

GG
 

Ecoclimber

Senior Member
Messages
1,011
@Ecoclimber

You might want to alter your signature:

http://blog.ap.org/2014/09/19/8-ways-the-obama-administration-is-blocking-information/

This is probably news to you, right? So much the media doesn't broadcast from the highest towers/ with big megaphones, they cannot do to much to damage the party the majority of them align with. We need another great 8 years of economic growth and "hope and change" so Hillary can take her rightful place. LOL

I woke up after 9/11, I always watched the news,, and somehow this struck me out of the blue and the info I would get from the radio.

Glad I am no longer in the workforce and having the gov't take half of my earnings and having prices still escalate but no my wages in keeping pace!

I am not holding my breath on anything from Obama and his cronies!

going to preserve my precious energy for more fruitful endeavors :)

GG

I want to focus on the immediate issue with the NIH and not make this political. This occurred under both administrations and is tied not to just one party. It highlights the influence from the Insurance industry on governmental policies through legislation regardless of who occupies the White House or 10 Downing Street.
 

Nielk

Senior Member
Messages
6,970
@Ecoclimber I can get easily overwhelmed by all the info but really want to participate in advocacy.

For those of us in the US, if we were to start with the single most important thing to advocate, what would that be?

Would it be sending an e-mail to President Obama or something else? I feel like if I am given a really clear guideline, I know I can do it and I WANT to do it.

I just don't know where to start or what to say!!! Thanks for any guidance on this.

Advocates Eileen Holderman and Jeannette Burmeister commented here on protesting the P2P.
From Eileen Holderman:


In October, 2012, CFSAC made a recommendation to convene a workshop of ME/CFS experts (researchers, clinicians, advocates, and patients) to reach a consensus on a research and clinical definition starting with the Canadian Consensus Criteria (CCC). Instead of implementing the recommendation, HHS told Committee Members in subcommittee teleconferences, they would pursue new definitions their way: NIH would address (in part) a research definition with a workshop (called the EbMW, then called the P2P), and HHS and its agencies would pursue a clinical definition (later identified as the IOM Study). When 3 Committee Members sought information and expressed concerns about the proposed initiatives to redefine ME/CFS, HHS shut down the conversations, then called those 3 Committee Members and threatened to evict them from the Committee.

HHS continued their secrecy about the IOM and P2P, despite efforts from advocates, patients, and other stakeholders to uncover information about their redefinition initiatives.

Mass opposition to both IOM and P2P from CFSAC members, ME/CFS experts, advocates, patients, and caregivers sent a clear message to HHS that the majority do not want more Government-sponsored definitions for ME/CFS. Like so many advocates, I agree with our experts that HHS should adopt the CCC in all their agencies and use the money instead for biomedical research.

Therefore, I will restate and reaffirm, in writing, my opposition to both the IOM and P2P, and will send my letter to HHS for the public record. I will list my reasons for my opposition, without making any suggestions, so HHS is clear that I am protesting, and so they cannot claim stakeholder "buy-in" because I sent a letter.

Please click on the link to my June, 2014 CFSAC Written/Public Comment which enumerates the reasons for my opposition to IOM and P2P:

http://forums.phoenixrising.me/inde...holderman-cfsac-written-public-comment.31078/

If you wish to join the multitudes of advocates, patients, and stakeholders protesting the IOM and P2P, please send your letters of opposition (not suggestions - only your reasons for opposition) to the Government officials at HHS:

Sylvia.Burwell@hhs.gov (Secretary of HHS)

Frances.Collins@nih.hhs.gov (Director of NIH)

Tomfrieden@cdc.gov (Director of CDC)



From Jeannette Burmeister:


P2P: Don’t Buy the Hype! Protest!
The reason why I will not cooperate with, or participate or engage in, the P2P process is very simple. HHS and NIH have shown time and time again that they do not have ME patients’ interest at heart. This disturbing and indisputable fact has been confirmed again very recently in my FOIA lawsuit regarding documents relating to the IOM contract (the diagnostic equivalent of P2P), in which I won my motion for summary judgment against HHS and NIH in early September with a ruling by the court that the government violated federal law. The government, in turn, lost their motion for a summary judgment against me. HHS’s and NIH’s conduct in this matter has been dilatory, obstructionist and unlawful.

I initially filed my lawsuit pro se (meaning without engaging lawyers) because I was hoping that, when faced with a lawsuit, the government would finally comply with the law. I wanted to give them a chance to resolve the matter swiftly and without incurring any legal fees. Before filing my complaint, but sadly to no avail, I even gave them a warning that legal action was imminent, unless they complied. Even after filing my complaint, the government did not avail itself of the opportunity to moot the lawsuit (i.e., end it with a relatively small legal bill) by conducting a reasonable document search. Instead, the government filed a frivolous summary-judgment motion five months after I initiated litigation when they could have used all that time to remedy their prior FOIA violations. When faced with my opposition motion that clearly demonstrated that the government was in violation of federal law, they doubled down by filing another motion making frivolous and meritless legal arguments and misstating the law and the facts—the latter, under penalty of perjury. Even as late as in the oral-argument phase did they incorrectly cite the law, as noted by the court.

HHS and NIH have wasted the court’s time and energy and worse, they have directly caused my health to dramatically deteriorate as a result of their unreasonable conduct and stonewalling, as the case was factually extremely complex and required my close involvement in discussing strategy with my attorneys, reviewing documents, drafting and revising the motions, etc. This has predictably triggered an intense post-exertional crash, the hallmark symptom of ME. Ironically, HHS and NIH continue to boast of their commitment to our disease. It would follow that they knew about the post-exertional fall-out that their indefensible approach would have on my physical health and yet they passed on every opportunity to right their wrong. Instead, they have done everything to prolong this litigation and drive up my attorneys’ fees. Counsel for the government stated during oral arguments that he didn’t even understand the case until July of this year, six months into the litigation! Half a year! That is how seriously they take this patient population.

In short, HHS and NIH have acted like bullies vis-à-vis a disabled ME patient whose only “infraction” was to avail herself of her statutory rights. After all that litigating, the court ordered HHS and NIH to do what they should have done more than eight months ago, without a dime spent and without any additional damage to my health: to produce the requested documents. Does anybody honestly believe that the government is somehow—miraculously—going to conduct itself differently in this ludicrous and high-stakes jury-model P2P project when they don’t even take a very simple and straightforward FOIA request seriously and instead fight it tooth and nail contrary to explicit instructions by the US Attorney General for clear-cut cases like mine? Please see “P2P: ‘Patients to Purgatory’ or the Jury Model Stood on its Head” for an explanation of why the jury-model analogy of NIH is preposterous.

I urge patients and other stakeholders to voice their unambiguous opposition to the P2P in strong, but professional, terms. Opposing this effort means making our voices heard; quite obviously, it is the opposite of silence. Getting our opposition on the record is crucial because the government will try to claim that they had the support of the patient community for P2P when that is clearly not the case, as even most of those who suggest that patients should cooperate with the process are against the P2P in principle. Engaging the government allows them to claim that they took the community’s concerns into account when they have no intention of doing so. Their outreach to the patient community, the comment period, is a mirage.

The distinction between opposing/protesting and participating/cooperating/engaging is subtle, but very important. To clarify:
Do not participate or cooperate by making suggestions on how the P2P should be conducted or which areas it should focus on or by engaging regarding the seriousness of the disease, etc. Basically, do not make any substantive comments, in writing or in person at the workshop, because that will, without a doubt, be entirely ignored, as has been the case with the IOM and will allow the government to pretend that our concerns have been heard and will be reflected in the P2P outcome. Remember the changes that were made to the IOM panel in response to patients’ concerns about various suggested panel members’ conflict of interests? No? I don’t either. The make-up of the committee was not changed at all despite a few advocates researching the background of the proposed panel members and finding some troubling facts. The feedback of those advocates was entirely ignored. If the government wanted our input, they would have designed the whole process completely differently instead of merely having one token, hand-picked patient advocate at the P2P workshop purporting to speak for the entire community. Giving our input means legitimizing the farce. Don’t fall for it.

Opposing/protesting, on the other hand, is stating one’s unequivocal disapproval of this redundant, unscientific and ludicrous effort without making any substantive suggestions whatsoever. This effort is redundant because we already have a research definition that has been adopted by our experts, the Canadian Consensus Criteria. P2P is unscientific because it precludes anybody with ME/CFS expertise from being a member of the P2P panel. And it is ludicrous because the utilization of the jury-model approach in this context is, frankly, beyond comprehension. Therefore, I will send a letter protesting the entire effort in no uncertain terms, but without engaging substantively.

There is no doubt in my mind that P2P will harm patients greatly and I will have no part in that by being seduced into thinking that my engaging will result in any meaningful effect on the process.

Please see the three e-mails highlighted to send letters of protest to.

If anyone had any doubts as to where the HHS was heading with the implementation of the IOM and P2P processes, all they need to do is to read the draft systematic review. It is pretty clear where they are heading. They want ME/CFS to be considered a somatoform illness which necessitates CBT.
 

WillowJ

คภภเє ɠรค๓թєl
Messages
4,940
Location
WA, USA
"genocide" has a specific legal meaning which is not met by harming (or even passively killing off) disabled people of multiple races.

"Death panels" has already been tried as a strategy to warn against euthanasia/healthcare rationing for elderly (and other undesirable) people. It was originally meant to apply to IPAB (AMA, WaPo, NEJM), Medicare cuts, etc., but others successfully changed the meaning to apply to routine end-of-life counselling for Medicare patients, which people not surprisingly don't find all that threatening. The people using "death panels" were not able to stay on message and revert the topic to cuts and implicit rationing.

It might be smarter not to draw attention to the rationing. On what basis is it fair to ration health care? Is it fair to deny health care to people who have a condition which has never had serious research? ...pause... Yeah, I didn't think so either.
 
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Ecoclimber

Senior Member
Messages
1,011
PR strategy is to get news organization's attention which requires offbeat or something really sensational, a hook, that will drive readers to their site. Death Panel were very effective PR to counter the ACA and gardner a great deal of national exposure and debate in social media, TV, radio, newsprint etc. I was thinking of tying it somehow to the NIH/CDC/AMA Tuskegge syphilis experiment on a vulnerable patient population. After the study and its consequences became front-page news, it was ended in a day.

Lets see, we got NIH/CDC experimenting on a very vulnerable group, the elderly, teenagers, disabled, with some locked up in mental wards- their Constitutional Rights violated. There health deteriorating under their care. We saw that with Gulf War Veterans who were committing 22 suicides a day (CNN), more than combat deaths in Iraq during the entire war because of psychiatric treatment.

https://en.wikipedia.org/wiki/Tuskegee_syphilis_experiment

It's time to put the NIH/CDC/APA on the defensive. They violate their own Federal Laws, Rules and Procedures for which they should be held accountable. We don't serve the government, the government serves us: of the people, by the people and for the people.

This is not being driven by the NIH/CDC buy by the Medical(APA)/Health and Disability Insurance industry to move people to psychosomatic somatoform where health coverage is non-existence for such illnesses and treatment options are limited to bogus unscientific and skewed datasets and slight of hand cohort selection indicating inclusion of MDD patients under Holmes, Oxford, NICE, Reeves, Fuduka.
 
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Dolphin

Senior Member
Messages
17,567
I'm working my way through this. I think they have missed some employment data. The PACE Trial has been mentioned but I believe O'Dowd et al. had some too. It would be good if all such data was checked - not sure I'll get to do it myself.
 

catly

Senior Member
Messages
284
Location
outside of NYC
For those of you who want an easy way to protest the P2P, this was just posted on the ME Advocay webpage regarding how to use twitter.

http://www.meadvocacy.org/p2p_saturday_tweetstorm?recruiter_id=3896

The instructions might seem a little long but it's actually very easy to create a twitter account and to tweet.

Please join us, we can use more tweeters! The tweeterstorms happen on Saturdays around 7 pm EST, but you can tweet any time--just try to remember to use the #stopp2p4me.
 

WillowJ

คภภเє ɠรค๓թєl
Messages
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Location
WA, USA
sorry, typo. Might be a better strategy to draw attention to (implicit) rationing. Yes, vulnerable patients at risk, very newsworthy. Just need to be accurate, and find the right person to listen.