So, Fallon is an infectious disease specialist?
High false positives? Determined how? Also, at the time this study was being done, the U.S. was suffering from about 250.000 Lyme cases each year. This study worked with a cohort of, what, 37? 37. Plus 40 healthy (as in no KNOWN Lyme history) controls. See any potential hurdles statistically speaking?
Yep - we are all in our own information bubbles and becoming more and more polarised all the time.
it could be that all of these serologic based tests are simply fallible - with both high false negative and high false positive rates.
for instance - its well documented in the scientific literature - but not well publicised - that things like EBV - which 95% of the adult population has had - and will still have virus in them for the rest of their lives - causes cross reactive antibodies with lyme disease - so do a number of other viruses and bacteria
and on the other side - lyme disrupts the immune systems ability to produce the expected antibodies to the Lyme spirochete - and this is one of the reasons for false negatives ( generally its poor science to test for something with a technology that is undermined by the very organism you are trying to detect).
so it may not be that lab X is poor or corrupt - and lab Y is good and honest
more it may simply be that the accuracy of the test technology being used is poor.
when that is the case you can move the slider over and have less false positives - but that will inevitably cause more false negatives - or visa versa - you cant have few of both with poor test technology - and serology is demonstrably poor for lyme.
but until quite recently we have had no other better options - and so i think everyone has more been just having to make do with what we have and do their best with the tricky interpretation piece.
the other issue is prevalence - its is assumed that the presence of Lyme disease causing spirochetes in humans is rare - and if a human is infected with these spirochetes then they will be ill with Lyme disease - nice and simple and clear cut.
however, if you spend any time looking into the epidemiology of lyme and its vectors and hosts - you will find it inhabits a huge range of animals in the wild from rodents to lizards and birds including seabirds and migrating garden birds that respect no national boundaries - as well as every tiny rodent - biting flies and spiders - basically if it bleeds something that can carry lyme will bite it - including us humans. and we can be exposed by simply sitting in our gardens or on the beach - no need to go off into the wilds.
think also about how we humans used to live only a few generations ago - in huts and shacks in the countryside surrounded with our animals, livestock, dogs and wildlife - often sleeping next to them.
Given that the lyme disease spirochete is not a new disease ( has been found in Egyptian mummies, iceman from the Italian alps etc from thousands of years ago)
so why were they not all dropping like flies from lyme? and why are the numbers of people getting ill from lyme growing exponentially in the last few decades?
it seems likely that our underlying paradigms about this disease are some way off the mark - it may be much more prevalent than we have so far recognised - but only makes some people actually ill - most likely when other factors kick in
with the advent of newer methods like qPCR of tissue - and even newer phage based test approaches - its being found in a high percentage of so called "healthy controls"
so could this be the explanation for why serologic testing for lyme is so contentious?
its well known how problematic serologic testing is for things that are very prevalent
you are basically reduced to trying to pick how positive is a "positive" - when everyone is positive to some degree - eg with EBV serology
throw in the fact that lyme messes with the immune system of those affected and you can see what a mess serologic testing is likely to be
food for thought...