NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby seeva » Thu Jan 22, 2015 3:06 pm

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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby cheerleader » Fri Jan 23, 2015 11:11 am

Seeva has posted the link to my breakdown of the blinded CCSVI study lead by Dr. Tromba in Rome. p value was less than .0001 for specificity of the difference between normals and those with MS. They did not find CCSVI in normals...at all. The difference? Following Dr. Zamboni's protocol and using M mode (motion mode) doppler, which picked up faulty valves, webs and intraluminal problems with flow.
http://ccsviinms.blogspot.com/2015/01/n ... ccsvi.html

This study flies in the face of the UBC Traboulsee study, which found CCSVI in everyone by using a new way to measure stenosis, never seen before in any published research. There was very low specificity in that study. And people are calling upon ethics boards to look into scientific misconduct. p value was .98 and higher.
http://ccsviinms.blogspot.com/2014/12/s ... nduct.html

Specificity and protocol matter!
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby Rogan » Fri Jan 23, 2015 1:52 pm

Cheerleader,

Sorry to bother you. But could explain p value again to us. I know it's statistical summary but of what? Lower means more accuracy correct?
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby cheerleader » Fri Jan 23, 2015 5:42 pm

Rogan wrote:Cheerleader,

Sorry to bother you. But could explain p value again to us. I know it's statistical summary but of what? Lower means more accuracy correct?


No worries! I'll try my best, but statistics and math are not my strong suit.

Basically, the p value is a way of expressing the statistical probability of an hypothesis actually happening in reality, compared to if it's happening by chance or coincidental. So, in the CCSVI study from Tromba, et al, the p value of the result that normals did not have CCSVI, but people with MS did was represented by p<0.0001. Yes, you're right, the smaller the number, the more significant the result. How do scientists come to find the p value...that takes a lot of considerations.

(in research) the statistical probability of the occurrence of a given finding by chance alone in comparison with the known distribution of possible findings, considering the kinds of data, the technique of analysis, and the number of observations. The P value may be noted as a decimal. The lower the P value, the less likely the finding would occur by chance alone.


Any researcher begins the research with null hypothesis and alternative hypothesis. Null will be for supporting the old fact and alternative will be for the new fact invented/ doubted by the researcher/ scientist. Next step is to select one of this scientifically by using the science of statistics. For that the researcher should calculate the likelihood or probability that the difference observed in the study, however big or small, could have arisen purely by chance. This probability is known as p-value and it is sufficiently small, you can conclude that you have obtained a statistically significant difference. Confidence intervals and p-values take as their starting point the results observed in a study.

https://www.webmedcentral.com/article_view/3338

The Tromba study had enough participants, enough different means of measuring blood flow, enough blinded data generated to come up with that lower p value. The difference between normals and pwMS was not by chance. Compared to the UBC study which had fewer participants, less rigourous testing, less results and had a p value of .98. UBC says pwMS and normals have CCSVI at about the same rates, but their research doesn't back up that claim as rigorously. The terrible thing is that the UBC study is held up as the death of CCSVI investigation, while truly rigorous and blinded studies by vascular specialists are ignored by neurology.

Hope that explains it in a general way. Statisticians would do a much better job, but that's not me :)
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby 1eye » Sun Jan 25, 2015 6:37 pm

cheerleader wrote:Hope that explains it in a general way. Statisticians would do a much better job, but that's not me :)
cheer


That's not me either, and I don't know how they got the .0001, but as I understand it, it's like this: chance being so chancy, there is always going to be a finite chance that your result, whatever it is, happened by chance. Purely a coincidence, in spite of randomization, control groups and everything, there is always the possibility your result had nothing to do with your hypothesis at all, but was just the luck of the draw.

So the p number is the chance of that happening. In this result it's 0.0001, or one chance in 10,000. So if you ran the entire experiment, start to finish, 10,000 times, you would likely get that result no more than once. I guess the moral of that story is never say never, but some people are short on legs to stand on these days.
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby 1eye » Tue Jan 27, 2015 2:23 pm

I feel like I'm beating a horse that is no more, but why is any credence given at all to a study which used an entirely new, untested, and therefore unquestionably unproven, yet key measurement? This is a very unscientific, dubious practice, which throws the entire paper into suspicion. It directly insults the intelligence and generous good will of the people who donated good money to the MS Society, to see them waste it so frivolously. For researchers also to ignore an offer of assistance from a world-renowned practitioner, university professor and scientist, is very suspicious. How can anybody think this study is definitive of anything except gall?
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby cheerleader » Wed Jan 28, 2015 9:58 am

As my father used to say, "Do you think they knew it was dark during the Dark Ages?"
We live in very strange times, 1eye. Scientific research is funded and initiated at the behest of corporations.
Corporations fund "patient advocacy" groups.
He with the biggest checking account gets the most clout.

So, the Traboulsee study, which used fallacious measurements, ignored protocol and had lousy p value gets the prestige and press.
While our sorry vascular researchers, who toil in relative obscurity (well, until the internet) find answers, but are denigrated.
Because industry cannot benefit from their discoveries.

That's why I keep saying, "If rocket scientists at NASA will work with Dr. Zamboni, why won't neurologists?"

we all have to look after each other,
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby MrSuccess » Thu Jan 29, 2015 5:09 pm

maybe the best response to this pre-determined study ..... is to just smile from ear to ear ..... much like the person who wrote this comedy ..... is in a habit of doing.

It is both an annoying and condescending mannerism. F#@k him , and the horse he rode in on. :lol:

MrSuccess predicted that this person had already came to his own conclusions on CCSVI ...... but was more than willing to take on the task of proving or disproving CCSVI.

For money ..... I guess.

Same old story ..... a relative nobody trying to gain their 15 mins. of fame ..... by trying to attach themselves to the coattails of someone actually doing wonderful research and trying to solve some serious mankind problems.

It's the easiest thing in the world to say ...... it won't work. Small minds often take this route. The great ones .... just carry their work forward . History records their eventual triumphs over their fierce critics.


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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby Robnl » Fri Jan 30, 2015 4:23 am

Yup, everyody knows the name Traboulsee by now....
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby AMcG » Tue Feb 03, 2015 8:40 pm

Traboulsee really is a clown and his research is shameful but what worries me more is that he is now proposing to do venoplasty on unsuspecting pwMS without having any means to either detect or measure stenosis nevermind intra-luminal or valvular defects. This is utterly without any ethical basis. He is treating a disease he doesn't think exists addressing symptoms he believes he has proved are just normal variation using a treatment he has no experience of and he believes can be fatal. Why an ethics board would ever consider approving this research is completely beyond me. There is also the fact that his subjects are likely to suffer at least painful disappointment and perhaps serious damage due to his ignorance and stupidity. If the existing research was misconduct then this is infinitely worse.
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby 1eye » Thu Feb 05, 2015 8:51 am

While our Canadian fraudsters are allowed to do procedures they have no belief will work, on pwMS who they don't think have the problem they are treating, the evidence accumulates that those pwMS actually do have CCSVI, and may benefit. Of course there is less of a chance for them, since 400+ procedures are necessary before proficiency is attained, and they are not using IVUS.

They should probably have to explain this before the College of Physicians and Surgeons.

Prevalence of chronic cerebrospinal venous insufficiency in multiple sclerosis: a blinded sonographic evaluation

L Tromba1⇑
S Blasi1
A Vestri2
D Kiltzanidi1
F Tartaglia1
A Redler1

1Department of Surgical Sciences, Umberto I Hospital, Sapienza University, Rome, Italy
2Department of Public health and infectious diseases, Sapienza University, Rome, Italy

Luciana Tromba, viale Regina Elena 324, 00161 Rome, Italy. Email: luciana.tromba@uniroma1.it

Abstract

Objectives: To verify the prevalence of chronic cerebrospinal venous insufficiency in patients affected by different clinical forms of multiple sclerosis and in healthy subjects using the Zamboni ultrasound protocol combined with M-mode ultrasound examination.

Materials and methods: We enrolled 112 patients with multiple sclerosis and 67 healthy subjects from 20 to 67 years of age. All the patients underwent Duplex and color-Doppler sonography of the neck vessels, transcranial colour duplex sonography, M-mode study of the valve system and of venous abnormalities. Subjects were positive for chronic cerebrospinal venous insufficiency when at least two of five hemodynamic criteria of the Zamboni protocol were fulfilled. Chronic cerebrospinal venous insufficiency condition was further analyzed by a multivariate analysis including age, sex, disease duration, subtypes of multiple sclerosis and expanded disability status scale score as independent variables.

Results: No healthy subjects was positive for chronic cerebrospinal venous insufficiency, while in the sample of patients affected by multiple sclerosis the diagnosis was made in 59.8% of cases (p < 0.0001). The first criterion was the most frequent in patients affected by multiple sclerosis and chronic cerebrospinal venous insufficiency (respectively 54.4% and 76.1%, p < 0.001). The second, third and fourth criteria were never present in healthy subjects but were detected in patients with multiple sclerosis. The positivity of the second criterion was associated with diagnosis of chronic cerebrospinal venous insufficiency in 100% of cases. The third criterion had a prevalence of 52.2% in the subgroup of chronic cerebrospinal venous insufficiency patients. It was positive in 36 multiple sclerosis patients and was associated with chronic cerebrospinal venous insufficiency diagnosis in all cases except one.

The multivariate analysis showed that age, disease duration, sex, subtypes of multiple sclerosis and expanded disability status scale score were not considered predictors of this haemodynamic condition.

Conclusion: Chronic cerebrospinal venous insufficiency is a haemodynamic condition strongly associated with multiple sclerosis and is not found in normal controls. The addition of M-mode ultrasound to the diagnostic protocol allows improved observation of venous valve abnormalities.


Seems to be less success with the CCSVI procedure with "SPMS", which is what I am supposed to have, so instead of another procedure I would seek out some form of EBV treatment. If I had the money, which I don't. I really would like to play guitar again.

An example of my playing is available:
This is a recording Kathleen Johnson and I did, in December 1987 for a cassette Christmas present. It proves I could once sing and play the guitar, banjo, and kalimba. All rights to the songs belong to their authors, and to the performances belong to Kathleen and me.

The web link is http://sullivanweb.me/Kathleen%20and%20Chris%20Christmas%201987.mp3

There are some notes to it at http://sullivanweb.me/Chris%20and%20Kathleen%20Christmas%201987%20cassette.txt

You may be able to just click on it to play it. If you have trouble, you can download it, usually in Windows by right clicking on it.
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby AMcG » Tue Mar 03, 2015 5:24 pm

Having re-read this thread I thought I ought to give Rogan a reply about Traboulsee's P values.

The general idea of all statistical tests as 1eye says is to judge whether the results could have reasonably been due to chance or not. So it is like odds in horse-racing. If the odds of your results occurring are greater than 20:1 it is considered not to be a chance result. 20:1 written as a decimal is 0.05 so results with a P value of 0.05 are considered significant (the results have not occurred by chance and the researcher has proven what he set out to prove.) If an experiment's results achieve a 100:1 chance then they report it as P=0.001 which is said to be highly significant.

I hate to seem to support Traboulsee but the way he has reported his results does not follow the same rules. Some of the tests he used do not actually calculate P at all but another statistic. Others do calculate P but he has still has not reported those actual P values. I am not sure why he has done it the way he has but to cut a long story short he has reported values which are showing correlation not difference. He is trying to prove their is no difference between pWwMS and normals so what he wants to show is that the differences between them are NOT significant. He is looking for lack of significance not significance. So in his results a P value of 1.00 means no significant difference. So the P values he is quoting are showing how similar the two groups are not how different they are. The way he is doing it a value of 1.00 means the two groups are identical and values near to one like 0.98 mean more or less the same thing. So all the P values he quotes are much nearer 1 than 0.05. The way he is doing it that proves his hypothesis not disproves it. The way he does it P values of 0.05 or smaller would indicate the opposite of what he was trying to prove.

I don't think there is anything actually wrong with his statistics he has just reported them in a different way.

Having reread what I have just written it looks pretty confusing even to me and I used to teach stats. If you read this I apologize if all I have done is confuse you even more.
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby Rogan » Wed Mar 04, 2015 3:43 pm

Thank you for the further explanation. I don't know either if what he has done is incorrect but it did seem to me like he was using p in a way opposed to the definition provided above.
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Re: NEW BLINDED STUDY FINDS CCSVI ASSOCIATED WITH MS

Postby AMcG » Sat Mar 07, 2015 2:30 pm

You seem to have grasped what I was trying to say despite my poor explanation. I am glad. But I should say one other thing about Traboulsee's results. He had two sets of data from different sites: British Columbia and Saskatchewan. The two data sets looked quite different and Traboulsee just went ahead and aggregated them without trying to account for the difference. I believe he had no basis to do that. So the results he reported may well be masking a substantial trend towards a positive identification of CCSVI in the smaller Saskatchewan group. In any case the sample sizes here are very small compared with Zivadinov's study which found a clear correlation. To any impartial observer who knows the basics of experimental design and basic stats this study looks very shaky. The press releases about it when it was released were simply preposterous. Pure unsupported hyperbole.

So although I think he probably performed the statistical calculations correctly I still think his results are garbage. So does Zamboni (although he is much more polite about it.).
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