mrhodes40 wrote:It is actually a specious point though in a way because you can't operate on a vein that has no stenosis. Therefore by definition 100% of the liberation treated people had stenosis. 100% of the people Dr Dake operated on had stenosis.
You lost me on that one Marie. I thought we were talking about a situation in which (very nearly?) 100% of people with MS have proved to have venous stenosis, but instead you are saying that 100% of the people treated for stenosis have stenosis?
what I meant was that if you want treatment, you have to have a stenosis so in a way it does not matter to you and your treatment decision whether 100% or 2% have this anomaly, if you have it 100% of you has it! But from a purely academic and "criticism of the work" stand point I think it is an odd thing to pick on, even though it is unusual.
We've been trained to think of MS as this highly complex multiple factor possibly heterogeneous disease because the findings to date have always been heterogeneous--several lesion "types' many genetic associations etc etc.
But if MS is a CCSVI then all people with classic MS will have the stenosis.
Just like all people with ischemic heart disease have blockages in their cardiac arteries. 100% of them.
If MS is CCSVI then as long as you take care to only test classic MS you should find it in everyone because it is pathognomic; exclusive to this disease.
Obviously Dr Dake is taking all comers with no attempt to screen people out at all. He should come across people who are not testing positive.
But from a "can I turst this work" standpoint which is what you are really asking, how would it happen that they somehow managed in blinded studies to come up with a finding of 100% if it was not pathognomic for classic CDMS? how could they do that?
Let's review the facts.
they did 2 large doppler studies looking for reflux, roughly 175 msers and 270 controls total, blinded, and all the MSers had 2 or more abnormal findings on doppler, suggesting stenosis.
they did a third blinded study in which the MSers could undergo venogram IF they again had the reflux. Again 100% so all 65 MSers had venograms and all had stenosis. Venograms were done on others needing one for something else none had stenosis in the cerebral veins as did the MSers.
They could have cheated by asking the patients if they have MS before doing the doppler study and making sure they found 2 abnormalities on the MSers (unblinded themselves), but this would not work because the next step checking for stenosis would fail. It also would require pretending they did not have reflux in controls when it possibly existed there, but again this would be "outed" at the venogram stage. They would have had to carry out their plan for falsified research on nearly 850 people total and spend the last 3 years involved in this ruse
It would also require the entire team of 8 researchers to go along with this, a thing I find fantastically unlikely as any work they wanted to do in the future would be automatically suspect. Besides that, what would be the point? you can't pretend this is a pathognomic finding if it is not, it won't help people and MSers everywhere who go to be assessed will not have this.
also if the researchers were wishing it were so, and wanting it to be so, biased in other words, this still will not make blinded studies come out with that kind of concordance in THOSE numbers, maybe on 30 patients you could fool yourself in an honest way, but not in the hundreds
But Dr Dake and Dr Simka seem to be seeing this in patient after patient themselves as well, so it does appear pathognomic, this is the place where false research would have been outed. In fact Dr Simka commented in email that he considers that people without stenosis ought to be reevaluated with regards to other possible neuro diagnoses.
I believe this is going to prove to be pathognomic for MS not only because they documented it in these studies but also because the physiology of a stenosis being downstream of the MS lesions makes a really compelling hypothesis for MS causation.
I'm not offering medical advice, I am just a patient too! Talk to your doctor about what is best for you...
http://www.thisisms.com/ftopic-7318-0.html This is my regimen thread
http://www.ccsvibook.com Read my book published by McFarland Health topics