ME debate in Danish Parliament March 12 (2019)

 
Inara said:
This is so incredible that I can't stop not believing it. :jawdrop:

Wow.

I want that in Germany, too. Is there more info somewhere how this was achieved?
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I believe the Danish MEA partnered with one of the political parties/representatives to prepare this and bring it forward. Similar to the partnership with CM in the UK, maybe. I think a lot of work has been done over a long period of time to get there, but I don’t know any of the specifics.
 
Let's not forget the general, community push:
  • Unrest brought to light Karina's case to a wide audience
  • Protests of Per Fink
  • Karina's family, relentlessly promoting ME awareness in Denmark
  • MillionsMissing
And lots, lots of local advocates banging down doors.

I would also like to remind everyone that the fight isn't over until the vote this Thursday.

Please if you are in Denmark or you know someone who is -- tell them to directly thank their MP between now and then, and emphasize that science is on their side.

It will matter.

The highest levels of Denmark's health administrators must be getting quite nervous -- they've been pushing these therapies some time. I expect they will say just about anything right now, and that the idea of a "loud minority" of "mad patients" are pushing "false narratives" will feature prominently.

Logic & compassion will win the day, but I think some pointed thank-yous would not go amiss!
 
Rumors say the Danish Health Authority will be launching a counter offensive tomorrow.

I expect things to get pretty ugly. Don't think anyone was actually expecting this much progress to be made, and now the entire functional disorder approach is in danger. After all what's the point in having Fibro / IBS be a functional disorder when ME/CFS no longer is?

Fink and some of his colleagues have worked on this their entire life. Also the director of the Danish Health Authority went out of his way to vouch for the functional disorder approach very publicly last year. It will be a bitter fight, and I expect them to tell politicians to stay out of ''science''.
 
Kalliope said:
Propatienter is a Danish news site for patients and their families.
They have an article about today's debate where among others psychiatrist Per Fink is interviewed...

..."I don't care how we name the illness. But if you look at international research, you can see that when the patients are treated on the basis of a holistic model, where you look at both physical, psychological, social and other factors, they can get better. Some recover, ”says Per Fink.

Liselott Blixt and the ME Association believe that the health service must listen to a research review of over 9,000 studies, made by the recognized American Institute of Medicine. Here, the authors conclude that ME is a physical illness.

"The authors behind the report start by writing that they will look at the research that indicates that ME is a physical disorder. Then it is clear that this is what they find. In short, the report is poorly made, ”says Per Fink and continues:

“Exercise and therapy as treatment works on this patient group. A large Cochrane review (a research review by a recognized research institute, ed.) has recently established that. But there is still much we do not know, so it is important that we continue to research both causes and treatment. "
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Fink in a Rumpelstiltskin hissy fit over the IOM Report, in:

Syndromes of bodily distress or functional somatic syndromes - Where are we heading. Lecture on the occasion of receiving the Alison Creed award 2017. Per Fink. Journal of Psychosomatic Research 97 (2017) 127–130

https://www.jpsychores.com/article/S0022-3999(17)30445-2/fulltext

"An additional challenge is the small but very active patient groups that aggressively spread misinformation on the social media. In some cases, they also try to undermine doctors and researchers with whom they disagree. Unfortunately, it seems to have some impact on research. The Institute of Medicine in the US report on CFS/ME avoids including any studies on psychological factors or treatment by stating that this is a medical condition and not a psychiatric one [7,8].
This can only be counteracted by authorities, layman information on the internet, in books etc., and doctors must be aware of the scientific basis of medicine."​


I'd love to know his reaction to the WHO/CSAC/MSAC November 2018 decision that following an evidence review, the ICD-10 G93.3 categories are to be retained in their legacy chapter for ICD-11; and that the SNOMED CT Danish Edition has incorporated the SNOMED CT International Edition change of parent for CFS and its Synonyms terms, placing SCTID: 52702003 | kronisk træthedssyndrom under parents:

Sygdom i organsystem
> Sygdom i nervesystemet

https://browser.ihtsdotools.org/?pe...ols.org/api/snomed&langRefset=554461000005103


danishedition20180930-2png.png
 
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Dx Revision Watch said:
I'd love to know his reaction to the WHO/CSAC/MSAC November 2018 decision that following an evidence review, the ICD-10 G93.3 categories are to be retained in their legacy chapter for ICD-11; and that the SNOMED CT Danish Edition has incorporated the SNOMED CT International Edition change of parent for CFS and its Synonyms terms, placing SCTID: 52702003 | kronisk træthedssyndrom under parents:

Sygdom i organsystem
> Sygdom i nervesystemet
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First, good to see you.

Second, I imagine there was a lot of red-faced jumping up and down.
 
Rick Sanchez said:
Fibro deserves focus / research just as much.
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At least they've got approved drugs (in the US -- true in Denmark?) However, I just read some really awful things re: when Lyrica was first approved about how FM was a "made up" illness and drug companies were peddling for no reason, just to make more money. They definitely go through a lot of the same flaming hoops we do.
 
Great the debate went so well! And that the misleading headline of the article below had no impact. Though with the actual vote still to come let's hope no MPs get swayed between now and then.

I'm guessing the debate was the reason Videnskab.dk decided to publish tody a translation of a month-old Norwegian article about that 4-day course discussed elsewhere on the forum (can't find the thread right now).

The headline just about made me choke on my morning coffee:

Kronisk trætte fik det bedre efter et 4-dages kursus. Hvad betyder resultatet for patienterne?

Translated: Chronically tired felt better after a 4-day course. What does the result mean for patients?

The article is a bit better, fortunately. It outlines many of the problems with the study quite well but still gives too much space to the study authors - in an attempt of journalistic impartiality, no doubt. The problem is a casual reader could well come away with the idea the headline is correct.

Today's Danish article: https://videnskab.dk/krop-sundhed/k...et-4-dages-kursus-hvad-betyder-resultatet-for

The Norwegian original: https://forskning.no/immunforsvaret...yr-resultatet-egentlig-for-de-me-syke/1293066

ETA:

Jyllands-Posten has now picked up on the 4-day course, too, with a shortened version of the Videnskab.dk article.

Slightly better headline, at least there is a 'maybe' in there.

Norsk studie: Kronisk trætte kan måske have gavn af intensivt kursus

Translated: Norwegian study: chronically fatigued can maybe benefit from intensive course

https://jyllands-posten.dk/nyviden/...tte-kan-maaske-have-gavn-af-intensivt-kursus/
 
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JaimeS said:
Let's not forget the general, community push:
  • Unrest brought to light Karina's case to a wide audience
  • Protests of Per Fink
  • Karina's family, relentlessly promoting ME awareness in Denmark
  • MillionsMissing
And lots, lots of local advocates banging down doors.

I would also like to remind everyone that the fight isn't over until the vote this Thursday.

Please if you are in Denmark or you know someone who is -- tell them to directly thank their MP between now and then, and emphasize that science is on their side.

It will matter.

The highest levels of Denmark's health administrators must be getting quite nervous -- they've been pushing these therapies some time. I expect they will say just about anything right now, and that the idea of a "loud minority" of "mad patients" are pushing "false narratives" will feature prominently.

Logic & compassion will win the day, but I think some pointed thank-yous would not go amiss!
Click to expand...

Thanks, @JaimeS :thumbup: I couldn’t remember it all and didn’t want to get it wrong, so I hoped someone would jump in with the rest:) This forum never disappoints!
 
Kalliope said:
If I've understood everything correct, all political parties agreed to this motion which will formally be voted for later in the week.

(hastily translated and my bolding)

Suggestion for motion:

The Parliament takes note of:
- that the effort for patients with ME-fatigue syndrome/CFS (G93.3) is inadequate. The patients experience stigmatisation and doesn't get relevant offers of assessment and treatment.
- that the existing treatment of ME-patients is far from enough, and that there will be taken initiative to the establishment for specialised treatments of ME. It should happen in an interdisciplinary setup with all relevant specialities and should be anchored organisationally in the somatic medicine.
- That the Danish Health Authority updates all relevant special guidelines across the whole course of the illness ME to secure that ME/CFS (G93.3) is described in all relevant guidelines.
- That the Danish Health Authority recognise and recommends the usage of WHO's diagnostic classification system ICD10 and ICD11, where ME (G 93,3, ICD10 and 8E49 in ICDII) is included.
- That the Danish Health Authority and the Danish Health Data Authority with the new code practice differ ME/CFS from the umbrella term "functional disorders".
- That knowledge from other countries is collected and to start treatments for ME/CFS
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V 82 For ME-fatigue syndrome.
By: Flemming Møller Mortensen (S), Liselott Blixt (DF), Jane Heitmann (V), Peder Hvelplund (EL), May-Britt Kattrup (LA), Pernille Schnoor (ALL), Lotte Rod (RV), Kirsten Normann Andersen (SF) and Mette Abildgaard (KF)
Collection: 2018-19
Status: Made

On the proposal for the adoption

Made:
12-03-2019

Proposals for adoption:
Parliament notes: - That the efforts for patients with ME-fatigue syndrome/CFS (G93.3) is deficient. Patients experience stigma and do not get appropriate offer of diagnostics and treatment. - That the existing treatment for ME patients is far from adequate, and to take the initiative for the creation of specialized treatment of ME. It should be done in an interdisciplinary setup with all the relevant specialities and should be organizationally anchored in the somatikken. - To the Danish medicines agency updates all of the relevant specialevejledninger across the whole of the ME-disease, to ensure that ME/CFS (G93.3) are described in all relevant guidelines. - That the board of Health recognizes and recommends the use of the WHO's diagnoseklassifikationssystem ICD10 and ICD11, in which the diagnosis of ME (G93.3, ICD10 and 8E49 in ICD11). - That the national board of Health and Sundhedsdatastyrelsen with the new kodepraksis distinguishes ME/CFS from the collective term "functional disorders". - To obtain knowledge from other countries and initiated the treatments of ME/CFS.

Submitted under: F 28 About the ME-fatigue syndrome
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spot on!
https://www.ft.dk/samling/20181/vedtagelse/v82/index.htm

eta: translation from Yandex
 
JaimeS said:
First, good to see you.

Second, I imagine there was a lot of red-faced jumping up and down.
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Thank you, JaimeS.

In that same Journal of Psychosomatic Research 97 (2017) 127–130 lecture write-up Fink also wrote:

"To include the BDS/BSD* diagnosis and all the relevant functional somatic syndromes in a separate chapter in the ICD-11 would have been optimal, but the WHO has rejected this option."​

Which he had also mentioned at the 2014 Danish Parliament presentations [1].

*Ed: By "BSD" - Fink means the BSS construct proposed for inclusion in the ICD-11 PHC, a 27 mental disorder only, non mandatory WHO publication that revises the ICD-10 PHC (1996). His Danish colleague, Marianne Rosendal, is a member of the ICD-11 PHC working group, known as the "PCCG" and chaired by Prof, Sir David Goldberg.

Marianne Rosendal is also a member of the update and revision committee for the primary care classification ICPC-2. Since around 2010, Rosendal has been pushing for a BDS-like construct to be included in the ICPC-3, which has been under development for a number of years. I haven't seen a draft of the most recent proposed content for ICPC-3, but I imagine Rosendal is likely still pushing hard for inclusion of a BDS term, or a BDS derivative.

It's like Whack-A-Mole. But this debate is good news and I will be watching the progress of the parliamentary motion with interest.


References:

1 Presentation, Professor Per Fink, March 19, 2014 Danish parliamentary hearing on Functional Disorders. Prof Fink stated that he and his colleagues had tried to get WHO to incorporate a section [in the core ICD-11] for a special group of disorders where BDS could be placed that was located neither in psychiatry nor in general medicine, but had not been successful.

2 Dr Marianne Rosendal (Department of Public Health, Aarhus University), who has published with Prof Per Fink, is the European representative on WONCA (World Organization of Family Doctors) International Classification Committee.

Dr Michael Klinkman is current convenor of WONCA’s International Classification Committee (WICC) that is responsible for the development of ICPC-2.

Dr Klinkman is also vice-chair of the ICD-11 PHC "PCCG" working group and represents WONCA.
 
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