My challenge to Dr MacDonald is that he wrote "some have advocated for magnetic resonance venography as a noninvasive modality to diagnose CCSVI, whereas others believe that catheter venography with or without the use of intravascular ultrasound may represent the gold standard for diagnosis" rather than saying invasive catheter venography with intravascular ultrasound is the gold standard for diagnosis of CCSVI syndrome in Spring 2012.
A challenge to you, MarkW, is to stop being, as you yourself called it, pedantic, about MRI, Doppler, and wordings like 'with or without', 'may represent' or 'is'. You might discourage acceptance of some of the science. At its worst, advice by the unqualified about surgical procedures can result in destabilization or worse. I think IRs would agree with neurologists on that.
I am wary also about 'expert patients', or patients who believe having a disease gives them not only an interest, but a degree or specialization. There again, I would rather believe the initials, but track records
give a doctor's degrees much more weight. They are my "Gold Standard". BTW, is gold a standard in the UK? The US was taken off it in the nineteen thirties, I think.
In engineering, bug-hunting after the problem is fixed is discouraged. So is fixing what isn't broken. I imagine there are cut-and-dried cases where IVUS, or some other tool, is not required
. I will leave it to experts like Dr. MacDonald to write the papers, and to decide on tools and standards.
This in no way implies I have any illusions that a degree confers infallibility to doctors, who are as human as I am. I would be one of the last to believe that about an MD. Some specialists, surgeons, and even GPs I have met and read about, were actually dangerous. I have to admit, before I came to this site I had never heard of an IR, but the wrong person could get those initials, too.
Here, the doctors who usually decide what specialist to first send us to, when we require one, are GPs. That's why they are being targeted in magazines they usually have in their waiting rooms. BTW my new GP uses a computer for a lot of things, and doesn't have paper for sick people to share, in his waiting room. I think virulent diseases are also often spread by stethoscopes. Slowly, the guard is changing.