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Trial By Error: The Cost of MUS

Discussion in 'General ME/CFS news' started by Andy, Feb 25, 2019.

  1. Andy

    Andy Committee Member

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    Hampshire, UK
    http://www.virology.ws/2019/02/25/trial-by-error-the-cost-of-mus/
     
    Unable, Sean, MEMarge and 21 others like this.
  2. chrisb

    chrisb Senior Member (Voting Rights)

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    It is astonishing that a professor would not seek to address such criticism at the earliest opportunity either by acknowledging and correcting statements, or refuting the allegations.
     
  3. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    I think I now would be more shocked by a proffessor, advocating a BPS approach to ME/CFS and/or the catch all psychiatric pseudo non diagnosis of MUS, that did acknowledge a valid criticism and corrected their work. It definitely feels there is something rotten in this area of medicine/academia.
     
  4. ScottTriGuy

    ScottTriGuy Senior Member (Voting Rights)

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    Ditto.

    How sad is that?
     
  5. Alvin

    Alvin Senior Member (Voting Rights)

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    I posted a reply but its awaiting moderation.
    Is it because i added links?
     
    MEMarge likes this.
  6. dave30th

    dave30th Senior Member (Voting Rights)

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    It is a mystery to me why the system does what it does. I'll try to check.
     
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  7. Alvin

    Alvin Senior Member (Voting Rights)

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    Thanks :)
     
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  8. dave30th

    dave30th Senior Member (Voting Rights)

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    it was "unapproved" so I "approved" it. Who knows why the system had unapproved it? probably because of the length. but others that are long sometimes get through.
     
  9. Alvin

    Alvin Senior Member (Voting Rights)

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    Thanks
    No worries, i just didn't want it to be forgotten, on some websites they sit in purgatory indefinitely.
     
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  10. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    With the new system for comments with the Virology Blog, my experience is longer comments sometimes go into moderation but eventually reappear unlike the old DISQUS system where comments under moderation just seemed to disappear.
     
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  11. Barry

    Barry Senior Member (Voting Rights)

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    Just reading now, but with "The promise of this idea rests on two assumptions:", did you mean to say "premise" @dave30th?
     
  12. Alvin

    Alvin Senior Member (Voting Rights)

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    Cool.
    I don't often comment right on the articles but this time it seemed important, if someone reading the article reads the comments they need to know this is not a new thing nor can you sweep it under the rug
     
    Last edited: Feb 25, 2019
  13. Barry

    Barry Senior Member (Voting Rights)

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    Really worthwhile article, and excellent as always. Same pattern as ever: Make a serious mistake that has massive implications for patients (and major issues for NHS economics as it happens), but the damage could be limited if readily corrected when first spotted. To me the real crime is in not setting things to rights when the mistake becomes clear, because at that moment things are at a tipping point: the consequences of not doing the right thing are potentially horrendous, and if the chance to do the right thing is passed by, then the situation will rapidly get worse, and more entrenched. The difference in numbers is major, and the idea that NHS economic policy is being set based on such misinformation ... is just mind boggling.
     
  14. dave30th

    dave30th Senior Member (Voting Rights)

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    No, I meant the promise that this idea, if implemented, would produce savings. but it's obviously clunky phrasing. I actually myself kept thinking of premise was right. But then it would have had to be "this premise rests on..." I think rather than "the premise of this idea rests on..."
     
  15. Barry

    Barry Senior Member (Voting Rights)

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    That's OK, "promise" is growing on me :).
     
  16. Stewart

    Stewart Senior Member (Voting Rights)

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    @dave30th - I was going to post this on Virology Blog, but I couldn't work out how to add a link...

    The Department of Health's 2008 Departmental Report gave the NHS financial settlement for 2008/9 as being £97.1 billion (Page 148, Figure 9.5). So £2.89bn would be less than 3% (2.98% to be more precise) of the total NHS budget for that year. The 10% figure that Professor Chew-Graham is so fond of is more than a threefold exaggeration of the actual spending on MUS as a percentage of the total NHS budget for that year.

    (And of course, this is not to say that you should estimate current spending on MUS as being 2.98% of current NHS expenditure either - a lot could have changed in the decade since the Bermingham study...)
     
    Last edited: Feb 26, 2019
  17. dave30th

    dave30th Senior Member (Voting Rights)

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    Thanks, Stewart--someone else pointed that out. I can use that in follow-up posts. And then in some references it got changed to 11%. Not sure how that happened.
     
  18. Barry

    Barry Senior Member (Voting Rights)

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    What I find really interesting is this. This 10%/11% figure (more than 3x greater than the reality) has likely been used to influence major decisions on NHS spending, possibly even influence government thinking on its resource allocation to the NHS. So how different might those decisions have been if the correct figure had been used? Not necessarily just financial decisions either. More of a rhetorical question really, given how impossible it likely is to ascertain what might have been.
     
  19. Alvin

    Alvin Senior Member (Voting Rights)

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    That is probably the point.
    In my experience those who spout lies to support their lies are interested in ideologies and not the truth.
     
  20. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    The whole business about trying to make health care 100% efficient is worth some thought. We know that 100% bed occupancy in hospital sis dangerous but I suspect people do not realise just how essential 'inefficiency' is to good health care.

    The idea of a doctor is someone who is likely to know whether or not you are really ill when you, as a lay person may not. Recognising signs of disease is an art that takes 10 years training. So it is reasonable to assume that the lay person will be looking after their health properly if they go to the doctor three times as often as they have serious disease. So we want a system that is 75% 'inefficient' in terms of there being something seriously wrong every time someone goes to the doctor.

    Those 75% of times may often be for symptoms with no medical explanation of importance. So in a sense we are expecting 75% of resources at least in diagnostic terms to be 'wasted' if we want adequate health care. And of course that does not in any way imply that these unexplained symptoms then need to be dealt with by some mumbo-jumbo therapists. The person just needs to be told that nothing serious has been found.

    What I find most worrying is that the RCGP has bought in to this 'efficiency' approach wholesale.
     

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