Re: More on Klempner's deceptiveness
- From: "a_weisman@xxxxxxxxx" <a_weisman@xxxxxxxxx>
- Date: 13 Apr 2005 09:50:36 -0700
derdrittemann2...@xxxxxxxxx wrote:
> GregGerber wrote:
>
> > "Derdritteman, you are wrong. The case definition was for
> surveillance,
> > but the serological standard voted on at Dearborn was for both
> > surveillance (from CDC) and also diagnosis. It was enfranchised as
> the
> > new serological standard to be used with diagnosis --and with that
> > status, almost all commercial labs stopped reporting OspsA and B.
If
> > the bands are not counted in any commercial lab for any doctor
doing
> > diagnosis, how can you insist that the standard is just for
> > surveillance. Most peer review on diagnosis also defers to the two
> tier
> > and the banding pattern voted in at dearborn. IN FACT, the dearborn
> > standard was approved as the serology standard for the vaccine
trials
> > EVEN BEFORE the Dearborn meeting. Derdritteman, you are seriously
> > misinformed.
> >
> > Look, the serostandard was enfranchised for surveillance at the
> > Dearborn meeting BUT it was also approved for diagnosis in the
> vaccine
> > trials before that and was elevated to the diagnostic standard for
> > patients by scientists writing in the peer review.
> >
> > It is currently part of the case definition for surveillance AND
the
> > recommended standard for serology in almost all diagnostic
guidelines
> > except the ones put out by ilads". gg
>
> My understanding...you can tell me where I have gone wrong...is that
> there is NO "CDC diagnostic" standard per se.
That much is correct. I have provided the CDC surveillance case
defintions above.
> There is the CDC case definition which, as it has stressed multiple
> times is NOT suitable for diagnostic purposes.
That is correct also.
HOWEVER, that definition is NOT a serodiagnostic standard--it includes
criteria for laboratory confirmation, which would be according to the
Dearborn criteria for serodiagnosis.
> The standard is also used for the qualification of research
> subjects...to qualify those participants under a uniform standard.
No that is wrong.
Each study employs their own entrance criteria, there is no uniform
standard for accepting patients into a study. Patient populations
differ vastly from study to study.
One of the most important and totally valid critiques of the Klempner
study is that the entrance criteria served to limit the study to a
group of patients that were very ATYPICAL for the "heartland" of
chronic Lyme patients. These standards led to great difficulty
recruiting for the study, which, ultimately, was halted BEFORE the
study was fully recruited for.
Fallon had difficulty recruiting too.
Thus, the importance of examining study design when parsing study
results.
What Klempner found--ASSUMING his data is accurately reported (some
doubt has been cast upon that by people here without evidence) can only
fairly be applied to patients in the study or those identical to those
patients.
Other studies have their own entrance criteria. Typically a positive WB
might be required and that would typically be using the Dearborn
(rather than Igenex) criteria.
> The CDC criteria for surveillance are used as Steere puts it
"usually"
> as a diagnostic tool...by analysing the Western Blot according to the
> surveillance standard.
It is NOT a surveillance standard. It is a seroDIAGNOSTIC standard.
.
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