I guess it depends on how they view evidence. If one is creating a criteria for an illness that has no biomakers, then the evidence for symptoms would be whether the pattern differentiates the patient group from other other groups. One does not need evidence for the cause of the symptoms, because that is not yet known. Most illnesses are classified this way before the underlying mechanisms are known. OTOH, I have so little faith in medical professionals these days that I doubt that many will be focused enough to remember this.
This is very interesting. Do you have any stuff to read on this (or to cite to). I think this will be an important point to emphasize.
Someone has told me, not sure if they made this public on the forums that he has drafted an article on how diagnostic criteria USUALLY get drafted in other diseases, but is shopping it around. I am encouraging him to get it out there sooner rather than later bc its useful info.
In any event, we need info on this subject- how they usually get drafted. Couldn't find anything with google search. This person used pubmed. someone else posted info on MS criteria that was useful. I am going to start a new thread on this topic to have this info in a new place.
We want to keep these people, should this go down, focused on the proper way to draft a case definition, and not sidetracked with nonsense about fake treatments, fake criteria and untenable supposed requirements for criteria.
As to that last point, an article of criticisms on EBM, mentioned there were EBM standards for forming diagnostic criteria. There was no cite for this as far as i could tell. I will attach the link here. good article.
As I think i understand it from Alex, though I have seen different understandings on this point in the very limited amount of reading i have done on EBM, EBM presents a ranking of broad types of data based on the general supposed reliability of the method used to obtain that data. And in situations in which the only evidence is that of a low rank, such as clinical observation, c. expertise and c. opinion, this evidence is NOT ruled out. THat is, in this conception of EBM, EBM does not set a threshold for evidence that may be considered, it simply ranks the type of evidence. So in a situation where the only evidence is clinical expertise, that may form the entire basis of a report (perhaps with an asterisk that this type of evidence is of low reliability according to EBM standards).
http://skynet.ohsu.edu/~hersh/ijmi-04-ebm.pdf