Trial By Error: My 2011 Exchange with White et al about Case Definition

http://www.virology.ws/2019/12/31/t...hange-with-white-et-al-about-case-definition/

 

The patients in this trial had a disabling chronic illness in which fatigue was their main symptom and for which no alternative had been found; that is the definition of the syndrome used in Britain.

I have no idea what Sharpe meant in that response to DT's article in the NYTimes. Does anyone? No alternative what?

 

I would assume it's missing the word explanation, as in

"..and for which no alternative [explanation] had been found.."

so therefore, in my opinion, idiopathic chronic fatigue.

 

I hadn't properly appreciated that distinction, but it makes perfect sense, and is crucial. In the clinical case you don't want to miss people even with marginal diagnoses who it might be possible to still help. In the other case you need to avoid ambiguous diagnoses, in order to avoid ambiguous trial findings.

 

That's right. That's how it originally appeared when they sent the letter in. I never noticed before that it was likely missing a word.

 

Exactly. So using a clinical case definition in research can be problematic.

 

I took it, given the context, to mean no alternative illness.

 

Coming from people who loudly self-proclaim themselves to be "top researchers" in this field, this is just pathetic. They simply have no integrity and even less diligence in their work beyond the appearance and language of science, with none of the substance.

However, much more fault lies in people who allow, approve, fund and defend this charade, even worse that identical garbage is still, to this day, richly funded and promoted as having any scientific value. You can fault the con man for fooling you once. Just the once. After that, responsibility lies in those who gave line-item budget to the con.

 

Using "alternative explanation" doesn't make sense unless some other explanation had been mentioned earlier in the letter. None was. I think it's probably a "typo" in which the word "alternative" was used instead of "explanation."

"The patients in this trial had a disabling chronic illness in which fatigue was their main symptom and for which no explanation had been found; that is the definition of the syndrome used in Britain.