Use of Reeves criteria, inter alia, renders this study patently invalid
Justin Reilly (03 July 2010) _
Quote from paper:
The 1994 International CFS case definition and the Canadian Consensus Criteria are different and do not necessarily identify similar groups of ill persons. Most notably, the Canadian Criteria include multiple abnormal physical findings such as spatial instability, ataxia, muscle weakness and fasciculation, restless leg syndrome, and tender lymphadenopathy. The physical findings in persons meeting the Canadian definition may signal the presence of a neurologic condition
considered exclusionary for CFS and thus the XMRV positive persons in the Lombardi et
al. study may represent a clinical subset of patients [11].
The Canadian Criteria are the only valid definition of ME/CFIDS. The authors attempt to reframe "CFS" as tired people by using Reeves definition exclusively and saying that neurologic disease and signs are inconsistent with "CFS". And they approve of the Oxford definition used in the dutch study; incorrectly stating that the Dutch and UK studies were well characterized and WPI was not! They are explicitly insisting Oxford and Reeves definitions are valid and Canadian Consensus Criteria are invalid!
Reeves and Oxford definitions are patently invalid. Oxford defines tired people and Reeves defines low functioning people.
Heneine was the person who contributed the most error to the failed the CDC DeFreitas 'replication attempt'.
This study is totally incredible on its face for the above reasons and the fact that if Reeves and Heneine published findings different from what they did they would be acting directly against their personal interests.
Conversely, the fact that NIH (and to a lesser extent FDA) would be acting against their interests by publishing positive data showing a connection between ME/AIDS-X and XMRV makes the NIH/FDA study even more credible than it otherwise would be.
The study, in summary, is facially invalid.
Competing interests
Patient
Yet another definition used
Kelly Latta (04 July 2010) medical writer
The CDC paper enters yet another definition for CFS patients into the XMRV race.
The "revised" 1994 CDC definition, may be colloquially referring to the rarely used empiric definition, which refers to the 2005 paper published by Dr. William Reeves.
Lombardi et al, which originally found XMRV in CFS patients, used the original 1994 Fukada definition.
A key element that may be missing is severity. One of the cardinal CFS symptoms is post exertional malaise unrelieved by rest, not the result of ongoing exertion and last more than 24-hours as required by the 2003 Canadian Consensus definition.
Severity is of course what differentiates vague symptoms commonly found in the general population from pathological symptoms.
It should also be noted that only three of the 51 cases were apparently of acute onset which would be the most likely patients to show signs of viral infection. Unfortunately, none of the papers published thus far tell us what if any other viruses were also found in the patient cohort.
The Switzer paper also states, "...The physical findings in persons meeting the Canadian definition may signal the presence of a neurologic condition considered exclusionary for CFS..."
This a very confusing statement since the WHO classifies CFS in the ICD-10, along with myalgic encephalomyelitis and post viral fatigue syndrome, exclusively as a brain (neurological) disease under G93.3. This can be verified by checking the alphabetical index in the 2006 edition of the ICD-10 found on the WHO website.
Are they referring to yet another neurological disease other than ME/CFS?
References
Switzer, W. M. et al. Retrovirology doi: 10.1186/1742-4690-7-57 (2010).
Lombardi, V. C. et al. Science 326, 585-589 (2009)
Reeves, W.C BMC Med. doi: 10.1186/1741-7015-3-19 (2005).
Competing interests
None
