Objective cognitive performance and subjective complaints in patients with chronic Q fever or Q fever fatigue syndrome: Reukers et al June 2020

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05118-z

 

It would seem to me that this ‘phenomenon’, though it is not quite clear what the authors have observed, could in itself represent a cognitive impairment.

Given high levels of variation between individuals within the normal population surely you would need considerably larger groups sizes to make meaningful comparisons between the groups, it would be wonderful indeed if the 30 patients and 35 controls just happened to equally reflect the same bit of the entire populations normal distribution. The fact that they found no differences between their groups Is for me worrying, and raises the question are their tests sensitive enough.

I would have thought that either you need studies comparing pre and post morbid performance, which is generally impossible or much larger sample sizes.

 

This is frankly supposed to be easy stuff, I don't know how someone can screw it up but, BPS I guess, it's the sticker that tells you something is useless. Researchers with no personal insight into brain fog will never select the appropriate tests. And even then you need to go through a systemic process.

This makes me think of a common problem in software engineering: testing. Programmers can only test for problems they can think of, the ones they considered enough to code for. That's why there is an entirely separate discipline of quality assurance, which goes through all the imaginable and unimaginable tests possible, including random dumb stuff that no one would think about but where most of the bugs are actually found. QA is skipped entirely in some places. With disastrous consequences. BPS is just like that, coding without thought to begin with and no QA to verify anything.

If you don't know what you are actually testing you will not do the appropriate tests. Supply-side medicine strikes again, physicians thinking about physician things among physicians, validated by physicians and for physician needs. You can't keep on just searching where the light shines. If you are doing research you are expected to go where it's dark.

Really obvious that the entirety of the BPS model serves no purpose whatsoever because the people involved in it can't do the basic things they need to do while believing they are totally nailing it, like some drunk blaring out at the microphone while the crowd boos and asks them to leave but they're too drunk to even be aware of a crowd of booing angry people.

 

This smells like garbage.

There is no chance my cognitive problems are due to lack of effort and I highly doubt it's any different with other patients and similar illnesses.

 

Awful. I don't know why I clicked on this thread. Lets just disbelieve the patients rather than try and understand why the tests are not capturing the cognitive decline patients are complaining about.

That's pretty clear. Huge age difference between groups to start with but sample sizes too small for your correction formulas to be of use

Ummmmm, why aren't you focusing on this key finding instead of chucking 38% of patients out of this group so you can get a null result.

Duh.

Uhhhhh nope. Seems more like fiddling with the results to me.

 

I am bothered by this term and need to know more:

From another source because those tests are always proprietary and hidden from public view, but somehow many sources describe it as a malingering test and I have no idea how that even works:

How does poor performance on that test invalidate other tests to the point of warranting exclusion from analysis? It's not an especially good test but there is no possible reason to do that arbitrary exclusion. Unlike things about mood and beliefs it's a test that has some relevance, it actually tests performance, which is the point.

What a complete mess. As usual the deeper you look the worse it gets.

Also:

How is that valid?

If it's valid to posit that the test can be influenced by unrelated factors than by definition it is either a poor test, was incorrectly used or it's simply a BS excuse for disappointing results.

I see that excuse is now being re-used. This is absolutely laughable, not for the authors but for the journal. BMJ, where requirements are optional, peer review is a rubber stamp and substance does not matter as long as you label it BPS.

 

Only patients with significantly above average cognitive ability are usually willing to participate in studies like this in the first place. The study didn't prospectively study these participants from before they became ill, hence the study is only of "suggestive" quality evidence.