GERWYN: You seem as unclear regarding Dr. Jason's qualifications and research as you are Dr. Wessely's. I agree with Tom K, who has been analyzing ME/CFS research for years, you are getting rather far afield with your statements. The forums are a great place for contributing one's two cents, but you seem to be beating a dead horse here.
Well, whether you not rate him, other people may be interested in the fact that in a published study he reported that 3/23 of those who satisfied the Canadian criteria did not satisfy the Fukuda criteria.
There is a term for this, criterion variance (?), where different people can interpret criteria in different ways.
I'm not so interested in the issue of how many might have the Canadian criteria who don't satisfy the Fukuda criteria. (I'm more interested in the claim that most people who satisfy the Fukuda criteria don't have PEM - the vast majority of research in the field has been published using the Fukuda criteria at least since it was published).
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3 out of 23 does not mean anything.If 3out 23 did not have the mandatory criteria associated with a diagnosis of ME,cfs then they did not have ME,cfs in the first place.
I think that Jason does some good work.
Retrospective subjective diagnoses accompanied by meaningless percentage figures is unfortunately is not an example of such.
If 67% of the people given a diagnosis did not "endorse" PEM then there are a number of potential reasons for that.
I know exactly what Dr Wesselly,s CV states you are unclear about the meaning of such qualifications.I also Know what Jasons qualifications are that is why I know that he is not qualified to make a diagnosis anymore than any other psychologist is.That includes me.
They might well have not understood the term in the first place,they may have been exhibiting demand characteristics or most likely they had been misdiagnosed in the first place.Jason should have raised those issues in the paper rather than quote meaningless figures.
The prevalence of PEM in a population with fatigue is many orders of magnitude smaller than the prevalence of the other symptoms.
This means that people presenting and given a diagnosis of Fukuda with PEM is much less likely than those ascribed a definition under the other possible symptom combinations.
That does not mean that the diagnosis is in anyway accurate merely that it is given.
According to Jason himself the Majority of patients given a diagnosis under FuKUDA don,t in any objective sense have ME/cfs at all.Adding subjectivity to the diagnostic criteria of the CCC merely compound the felony.
you cant make a diagnoses in different ways.if you do you end up with different cohorts which are totally useless for research purposes.The terms we are discussing are objectively defined.The canadian criteria are diagnostic criteria.Jason is not a qualified diagnostician
This is an example of Simon Wesselly,s "epidemiology"
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The Lancet, Volume 367, Issue 9524, Pages 1742 - 1746, 27 May 2006
<Previous Article|Next Article>
doi:10.1016/S0140-6736(06)68661-3Cite or Link Using DOI
Is there an Iraq war syndrome? Comparison of the health of UK service personnel after the Gulf and Iraq wars
Original Text
Oded Horn MSc a, Lisa Hull MSc a, Margaret Jones BA a, Dominic Murphy MA a, Tess Browne BSc a, Nicola T Fear DPhil a, Prof Matthew Hotopf PhD a, Prof Roberto J Rona FFPH a, Dr, Prof Simon Wessely FMedSci a Corresponding AuthorEmail Address
Summary
Background
UK armed forces personnel who took part in the 1991 Gulf war experienced an increase in symptomatic ill health, colloquially known as Gulf war syndrome. Speculation about an Iraq war syndrome has already started.
Methods
We compared the health of male regular UK armed forces personnel deployed to Iraq during the 2003 war (n=3642) with that of their colleagues who were not deployed (n=4295), and compared these findings with those from our previous survey after the 1991 war. Data were obtained by questionnaire.
Findings
Graphs comparing frequencies of 50 non-specific symptoms in the past month in deployed and non-deployed groups did not show an increase in prevalence of symptoms equivalent to that observed after the Gulf war. For the Iraq war survey, odds ratios (ORs) for self-reported symptoms ranged from 08 to 13. Five symptoms were significantly increased, and two decreased, in deployed individuals, whereas prevalence greatly increased for all symptoms in the Gulf war study (ORs 19—39). Fatigue was not increased after the 2003 Iraq war (OR 108; 95% CI 098—119) but was greatly increased after the 1991 Gulf war (339; 300—383). Personnel deployed to the Gulf war were more likely (200, 170—235) than those not deployed to report their health as fair or poor; no such effect was found for the Iraq war (094, 082—109).
Interpretation
Increases in common symptoms in the 2003 Iraq war group were slight, and no pattern suggestive of a new syndrome was present. We consider several explanations for these differences.
!00% variation in confidence intervals.Fixed choice questionaire.Drugs given in gulf war not given in Iraq War totally missed the connection which would have accounted for increased prevelance of all symptoms in gulf war by accident or design.Just for good measure confused correlation and causation. If there is something which is the opposite of an epidemiological study this is it.
It should have been presented as "there was a global significant increase in symptoms in the Gulf warsoldiers which was not apparent in the soldiers in the Iraq war.What are the reasons for this?Aha the drugs given in the Gulf war which were not given in the Iraq war.Our simon is very gifted but an epidemiologist he is not.It is not the number of studies that he publishes but their quality.The members of the Wesselly school are notorious for peer reviewing each others papers.The message is dont take things at face value in this game.