Chronic Pain Syndromes and Their Laryngeal Manifestations, 2020, Piersiala et al

Paywall, https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2764772
Sci hub, https://sci-hub.tw/10.0000/jamanetwork.com/jamaotolaryngology/article-abstract/2764772

Editorial: The Puzzle of Medically Unexplained Symptoms—A Holistic View of the Patient With Laryngeal Symptoms

Paywall, https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2764770
Not available via Sci hub at time of posting.

 

35 years of reading the literature and I have never heard of this

 

That's because it's bollocks.

 

As a Speech & Language Therapist I am fairly confident that I do not have any specific voice or laryngeal issues that could not be explained by breath support issues. Nor am I aware of any higher incidence of such problems in other people with ME. Certainly it is not something I have come across in patient forums.

 

Wow, another example of publish or perish...rubbish.

 

Me too - to both statements!

 

What a bizarre start this paper has, they authors can't get over their own words to try to paint diagnosing sick people as a burden to the system. Oh except, sorry, we just said physicians don't diagnose them and patients are reluctant to use the medical system. But isn't it a shame we have to waste testing on those that do?

As an aside this concept that seeking medical testing or treatments that don't produce results burdens the rest of the medical system, it makes no sense at all to me. Yes there are some supply limits but rarely does that apply to chronic illness testing. The chronically ill bear their own cost, but they can't go around saying I have dysphagia I can't test for it. Doctors and technicians have to do their job, and chronic illness creates more jobs and so on. It's seems a very bias way to phrase the whole thing.

 

This citation to this is a 32 year old paper by Lipowski. A strange citation give that, as far as I can see, provides no evidence for the sentence it is supposed to support.

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.469.4798&rep=rep1&type=pdf

 

So we are both reluctant to use the medical system whilst simultaneously desperately seeking expensive medical assessments to prove we have a biomedical condition. Does anyone ever get the impression that such researchers make up whatever premise happens to suit them at that point in time, without any concern about logically consistency within and between articles?

 

Yes, but what is shocking here is they are unable to see their own inconsistency within 3 sentences! Did they write each one of them a few days apart and then have a stranger put it back together?

 

On page 5, figure 2, it looks breaks down by type of pain syndrome (ibs, fm, cfs). CFS looks to have pretty close to normal odds except in one category, higher than normal swallowing problems and higher than normal functional problems.

One important info missing is number of investigations to reach diagnosis. It would be interesting to see if someone with fibro, for example, recieved less studies than someone without and thereby maybe missing a non-functional diagnosis.

It also raises the spectre of GERD, gastropareisis, etc often seen in me/cfs, causing swallowing problems but also manifesting as "functional" problems. How many of these patients had an endoscopy, or tests for stomach emptying? I couldn't find out.