• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of, and finding treatments for, complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia, long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

Gathering Misdeeds of the IoM.

Ecoclimber

Senior Member
Messages
1,011
I believe we should put together a file for a Press Release, all of misdeeds of the IOM over the years starting with the current contract listing all of the irregularities, federal violations of law, statute and procedure, inconsistiencies in HHS statements, their actions, harassment,the entire CFSAC fiasco, conflicts of interests, bias, connections to big money, all of this should be documented and listed

Then proceed with the GVW panel and continue down the line, every misdeed, every lawsuit, every negative outcome. We are buidling a case against them so the world can see the results of their actions.
http://www.news9.com/story/5545019/...d-panel-examining-mercury-risks-say-advocates
http://www.news9.com/story/5545019/...d-panel-examining-mercury-risks-say-advocates

Does anyone want to take this project on? Thoughts?

Eco
 

justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
I'll note tangentially that I was curious to see where all of this money was going from the contracts and donations to IoM. I mean, if the National Academies of Science, which includes IoM does 400 or 600 studies a year, I believe, at say $1M per; and all of the panelists not only volunteer, but members pay hefty dues, for which I don't think they receive any benefit other than the prestige of belonging to the NAS; and they have a $400M endowment which would produce unearned income of $32M in an average year; and they get $Millions in donations every year, where is all this cash going?

I have only a passing familiarity with accounting, so it would take more work to really look into things, which I'm not sure I want to do or not. I don't think I saw any really smoking guns, but there were things that seemed might be bad business judgment and one thing that was substantially misleading as far as I could tell on a very important matter.

I found documents for the National Academies of Science, which includes IoM. In 2011, the latest year for which IRS filings are available, NAS booked an approximate $30M loss despite receiving $6M in donations and holding an investment portfolio worth about $400M which should produce about $32M in unearned income in an average year of 8% income/appreciation.

This loss was mostly due to a decline in worth of investments since, according to their own accounting, they had inordinately large positions in highly risky investments such as hedge funds, private equity funds and derivatives. I don't have the figures in front of me, I will come back to edit when I do, but the loss was something like $30M.

In NAS' annual report this staggering loss was very briefly explained away as the product of a bad year for investments generally, implying strongly that they were hit no worse than comparable institutions. According to my brief research on the topic, this is false.

The Dow gained about 5%, the S&P500, which is a better measure, was flat. More relevantly, Non-profits, such as NAS, which account by calendar year experienced no change to their endowments on average. Educational institutions, which NAS projects itself as using the .edu domain names, experienced staggering gains to their endowments, on average, not losses. For example, of the 500 largest educational endowments, only 26 experienced less than double-digit gains in 2011 and none lost money. None out of 500.

There a few other things that raised my eyebrow, but I haven't looked into further. These include $3M in loans outstanding to officers and directors (this is a frowned on practice, according to my understanding); the average salary of the three top paid employees was $850K (which Im not sure is excessive or not); the average salary for employees at IoM was $100K plus apparently $19K per employee for travel (there are 1,320 employees) for a total of $27M in employee travel. Another $30M was listed for travel for non-employees. (Two non-employees were given "tuition" of $150K each; perhaps this is for four years of schooling which they book as an expense all at once, I don't know)

There were several vague itemizations termed "misc.", "other" and the like, each for $Ms or $10Ms, some of which were required by law to actually be itemized, but at least on the IRS' website, these schedules did not appear (though others did).

Im not going to go into this further in the foreseeable future. Im not sure if it will help us. But if someone who has accounting knowledge thinks it is worth looking into now or later, Pls let me know. Again, most of these figures are exact, but a few are very approximate. I will come back and edit when I fish out the figures.
 
Last edited:

Izola

Senior Member
Messages
495
I believe we should put together a file for a Press Release, all of misdeeds of the IOM over the years starting with the current contract listing all of the irregularities, federal violations of law, statute and procedure, inconsistiencies in HHS statements, their actions, harassment,the entire CFSAC fiasco, conflicts of interests, bias, connections to big money, all of this should be documented and listed

Then proceed with the GVW panel and continue down the line, every misdeed, every lawsuit, every negative outcome. We are buidling a case against them so the world can see the results of their actions.
http://www.news9.com/story/5545019/...d-panel-examining-mercury-risks-say-advocates

Does anyone want to take this project on? Thoughts?

Eco

It would take a group.
 

Ecoclimber

Senior Member
Messages
1,011
Yea,"All that is necessary for evil to triumph is for good men to do nothing."
I was thinking adverse news media articles, court cases, etc. Shouldn't be too difficult.
 

Ren

.
Messages
385
I believe someone somewhere recently made reference to the following info, but I'm sorry to not recall who or where now. Regardless, I found the following two-page document, with a Google search of "criticism institute of medicine":

"Are the Institute of Medicine’s Trustworthiness Guidelines Trustworthy?" (2013)

Benjamin K. Young, MS; Paul B. Greenberg, MD

Rhode Island Medical Society; Rhode Island Medical Journal



ABSTRACT (emphasis and breaks-in-text added):

The Institute of Medicine (IOM) has published a set of eight standards[*] for guideline development groups (GDGs) to derive trustworthy clinical practice guidelines (CPGs). We investigated the adherence of these IOM guidelines to its own standards.

The IOM document passed two of its own standards ("GDG-Systematic Review Team Interaction" and "GDG Composition"), only partially passed two others ("Articulation of Recommendation" and "External Review") and failed to pass four ("Establishing Transparency," "Management of Conflict of Interest," "Establishing Evidence Foundations" and "Updating").

The IOM standards for the development of CPGs do not meet their own criteria of trustworthiness. Further study is needed to determine the best methodology to evaluate CPGs.

[* "Standards for Developing Trustworthy Clinical Practice Guidelines" - March 2011]



Also from the article:

"...the editorial also criticized the IOM standards on the grounds of setting standards too high and also as inflexible, since a guideline needs to meet all eight standards to be considered "trustworthy."

The only study to examine guidelines with respect to the IOM standards found 0/130 CPGs met all standards.3 In light of this controversy, we thought it would be instructive to determine if the IOM standards would be considered trustworthy by their own criteria."

http://www.rimed.org/rimedicaljournal/2013-08/2013-08-13-iom.pdf




As noted in the occupycfs.com bio on proposed IOM ME/CFS panelist Dr. Cynthia Mulrow, Mulrow served on the committee of the IOM text noted above ("Standards for Developing Trustworthy Clinical Practice Guidelines" 2011). http://www.occupycfs.com/?s=guidelines - And OccupyCFS also links to this (the IOM) text, fyi.

And as an aside, the IOM info page on Mulrow *seems* to be out-of-date: http://www.iom.edu/Global/Directory/Detail.aspx?id=0003012650


- which is kind of ironic since the Rhode Island Medical Journal article said the IOM report failed the category of "Updating". :/
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
http://www.iom.edu/Reports/2011/Clinical-Practice-guidelines-We-Can-Trust/Standards.aspx

STANDARD 5
Establishing evidence foundations for and rating strength of recommendations
5.1

For each recommendation, the following should be provided:

An explanation of the reasoning underlying the recommendation, including:

A clear description of potential benefits and harms.

A summary of relevant available evidence(and evidentiary gaps), description of the quality (including applicability), quantity (including completeness), and consistency of the aggregate available evidence.

An explanation of the part played by values, opinion, theory, and clinical experience in deriving the recommendation.

A rating of the level of confidence in (certainty regarding) the evidence underpinning the recommendation.

A rating of the strength of the recommendation in light of the preceding bullets.

A description and explanation of any differences of opinion regarding the recommendation.

This gives us something to aim for in our own criticisms of papers. I am looking into this further.
 

justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
Ren, I had found that article, and using the same search terms a you. As you said, there is a sizable list of institutions and people who have criticized IoM.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
http://archinte.jamanetwork.com/article.aspx?articleid=1384245#METHODS

Failure of Clinical Practice Guidelines to Meet Institute of Medicine StandardsTwo More Decades of Little, If Any, Progress
Justin Kung, MD; Ram R. Miller, MD; Philip A. Mackowiak, MD
Arch Intern Med. 2012;172(21):1628-1633. doi:10.1001/2013.jamainternmed.56.

Background In March 2011, the Institute of Medicine (IOM) issued a new set of standards for clinical practice guidelines intended to enhance the quality of guidelines being produced. To our knowledge, no systematic review of adherence to such standards has been undertaken since one published over a decade ago.

Methods Two reviewers independently screened 130 guidelines selected at random from the National Guideline Clearinghouse (NGC) website for compliance with 18 of 25 IOM standards.

Results The overall median number (percentage) of IOM standards satisfied (out of 18) was 8 (44.4%), with an interquartile range of 6.5 (36.1%) to 9.5 (52.8%). Fewer than half of the guidelines surveyed met more than 50% of the IOM standards. Barely a third of the guidelines produced by subspecialty societies satisfied more than 50% of the IOM standards surveyed. Information on conflicts of interest (COIs) was given in fewer than half of the guidelines surveyed. Of those guidelines including such information, COIs were present in over two-thirds of committee chairpersons (71.4%) and 90.5% of co-chairpersons. Except for US government agency–produced guidelines, criteria used to select committee members and the selection process were rarely described. Committees developing guidelines rarely included an information scientist or a patient or patient representative. Non-English literature, unpublished data, and/or abstracts were rarely considered in developing guidelines; differences of opinion among committee members generally were not aired in guidelines; and benefits of recommendations were enumerated more often than potential harms. Guidelines published from 2006 through 2011 varied little with regard to average number of IOM standards satisfied.

Conclusion Analysis of a random sample of clinical practice guidelines archived on the NGC website as of June 2011 demonstrated poor compliance with IOM standards, with little if any improvement over the past 2 decades.
 
Last edited: