Evaluating Commonalities Across Medically Unexplained Symptoms (2019) - Guo et al

Sly Saint

Senior Member (Voting Rights)
Dan Guo 1, Maria Kleinstäuber 2, Malcolm Henry Johnson 3 and Frederick Sundram
Abstract:
This commentary presents commonalities in medically unexplained symptoms (MUS) across multiple organ systems, including symptoms, aetiological mechanisms, comorbidity with mental health disorders, symptom burden and impact on quality of life. Further, treatment outcomes and barriers in the clinician–patient relationship, and cross-cultural experiences are highlighted. This discussion is necessary in aiding an improved understanding and management of MUS due to the interconnectedness underlying MUS presentations across the spectrum of medical specialties.

This research was funded by a grant from the University of Auckland.

https://www.mdpi.com/1660-4601/16/5/818/htm

As far as I can make out they prefer all MUS (ie CFS,IBS,FM) to be viewed as one syndrome and 'treated' as such. Also discusses Central Sensitisation.
(only skimmed it; not recommended reading)
 
Dan Guo School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia

Maria Kleinstäuber Department of Psychological Medicine, Dunedin Medical School, University of Otago, New Zealand

Malcolm Henry Johnson, Frederick Sundram, Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, New Zealand

Way too close to home for my comfort. I could have picked just about every paragraph to quote as an example of nasty, shallow and ill-informed thinking. CFS is definitely lumped in with the others.

Somatosensory amplification [19], for example, a hypervigilance towards physical changes in the body and a disposition to think and feel about bodily changes in a negative, catastrophising way, could be explained in the context of this new model by Van den Bergh and colleagues

I don't know how influential these people are or if there is anything to be done directly to mitigate their influence. We seem to be having some success in updating clinical pathways for ME/CFS in New Zealand and Australia, or at least moving towards that, to eliminate treatments based on MUS concepts. This, and doctor education based on the revised clinical guidance may be our best protection until we have a good biomarker.
 
Have just scanned through the references. The authors appear to have swallowed an overdose of Fink.

Also had a closer look at ref #38 because it's another NZ study.
(Petrie, K.J.; Faasse, K.; Crichton, F.; Grey, A. How common are symptoms? Evidence from a New Zealand national telephone survey. BMJ Open 2014, 4, e005374.)
This population-based study found that symptoms are more commonly experienced in the general population than previously estimated and are strongly associated with healthcare visits. Appreciation of the high prevalence of symptoms may help normalise the experience of symptom reports among the general population.
[...]
Bearing in mind these limitations, our findings suggest that symptoms in the general population are more common than previously believed and may be strong drivers for the use of healthcare. Previous studies have also found that high symptom reporting was associated with an increased number of reported bodily pain sites,21 as well as greater use of healthcare and increased mortality, even after controlling for relevant confounders.22 Interestingly, a recent study in general practice patients also found that as symptom reports increased, so did the patients’ belief that they were suffering from an unexplained condition such as amalgam poisoning, electromagnetic sensitivity or chronic fatigue syndrome.23

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4067867/


Bolding mine. No need to comment any further I don't think... :arghh:
 
Two of the authors have written about MUPS before. This study was published online in 2016.

The resource utilisation of medically unexplained physical symptoms.

Kimberley Lee, Malcolm H Johnson, [...], and Frederick Sundram

"Excessively pursuing the possibility of a physical diagnosis serves not only to unnecessarily increase healthcare costs but also reinforces patients’ illness beliefs and acts as a barrier to potentially more effective treatment options.

Furthermore, patients with MUPS report quality of life scores to be among the lowest of any patient group despite the considerable usage of healthcare resources.

In the United Kingdom, the Improving Access to Psychological Therapies (IAPT) programme interfaces with multidisciplinary teams at all levels of healthcare by facilitating effective and appropriate delivery of psychological therapies.

A similar change in healthcare pathways at a population level is required in Australasia and internationally to proactively enhance the long-term management of patients with MUPS and decrease maladaptive healthcare practices."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011389/#__ffn_sectitle
 
Have just scanned through the references. The authors appear to have swallowed an overdose of Fink.

Also had a closer look at ref #38 because it's another NZ study.
(Petrie, K.J.; Faasse, K.; Crichton, F.; Grey, A. How common are symptoms? Evidence from a New Zealand national telephone survey. BMJ Open 2014, 4, e005374.)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4067867/


Bolding mine. No need to comment any further I don't think... :arghh:
Hmmm...
This population-based study found that symptoms are more commonly experienced in the general population than previously estimated and are strongly associated with healthcare visits.
Let's rephrase that:
This population-based study found that hunger is more commonly experienced in the general population than previously estimated and is strongly associated with restaurant visits.
This entire field of research is literally based on mixing up the flow of causality and coming up with complex alternative explanations to justify how the outcome creates its own cause.
 
Furthermore, patients with MUPS report quality of life scores to be among the lowest of any patient group despite the considerable usage of healthcare resources.

Turned that around on us neatly, didn't they? And I thought we showed here that we don't actually use up "healthcare resources". Do they actually cite that, or is that within the realm of "it is known"?

tumblr_m3vxqkE22x1r8yaog.gif
 
Back
Top Bottom