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My breakdown of the percentages reported...

Posted: Thu Feb 18, 2010 3:47 pm
by Johnnymac
OK, perhaps I’m off base but this is how I read the data as it was presented in the press release:

500 subjects in three groups:
280 CDMS
161 Health Controls
59 OND/CIS

The wording of the press release talked about those with MS and Healthy Controls, so I don’t think that the 59 OND/CIS patients are included in the reported percentages (could be wrong).
The below math is based on the assumption that the OND/CIS patients are NOT included in the percentages reported in the press release

The percentages reported:
56.4% with MS showed 2 or more indicators CCSVI (apx 158 with CCSVI, 122 without CCSVI)
22.4% of healthy controls showed 2 or more indicators of CCSVI (apx 36 with CCSVI, 125 without CCSVI)
10.2% of subjects were borderline, some from both the CDMS and HC groups. (about 45 people)
The article states that if the 10.2% were added to the CCSVI category it would increase the CDMS % to 62.5%, or in flat number the positives would rise from 158 to about 175 in that group. That tells me that of the estimated 45 patients who fell within the borderline category, 17 were from the MS group and 28 were from the Health Controls group.

I don’t know if my math is wrong, but if its fairly accurate then I think what we’re going to learn something like:
1) CCSVI is a whole different disorder from MS that could be more common in MS patients.
2) CCSVI is the trigger of MS, but the testing/diagnostics to date are not what it needs to be in order to properly diagnose.
3) MS will be found out to be an umbrella disease that has been used as a catch-all to put those with ‘ms’ like symptoms into the same bucket because they didn’t know where else to put them, and that a number of MS patients may really just have vein disorders, while others truly have ‘MS’ and CCSVI isn’t present.
4) This list could go on for a while…..
I believe CCSVI truly is the cause of a lot of MSers pain/progression/symptoms, but I’m starting to wonder if this discovery isn’t just going to fraction the MS community into those with MS (or something else) and those with CCSVI.
These next couple of months are going to be very interesting…..

Posted: Thu Feb 18, 2010 3:53 pm
by marcstck
JohnnyMac, I agree entirely. Very good analysis.

Posted: Thu Feb 18, 2010 4:03 pm
by ozarkcanoer
JohnnyMac,

As for CCSVI being a wholly new disorder and strongly associated with MS, I'll tell you what my neuroradiologist and professor of medicine at a major medical school told me. This is a guy who spends all day operating on people. He and two partners have applied for an NMSS grant to study CCSVI. I talked to him on Feb 8 (for free by the way !!). He told me that he has often seen venous abnormalities like the ones described for CCSVI when he operates on people. So venous abnormalities of the extracranial veins are not something new. Everyone is speculating here to their heart's content. And I think that is a good thing !!! :D :D On the other hand, we will only know more when researchers tell us. It is too bad the news has come out in dribbles so we have to gnaw it to death, LOL. As for myself, I just keep looking forward to the next milestone, for better or for worse. The next milestone right now seems to be : what will Dr Zivadninov say in April ?

ozarkcanoer

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Posted: Thu Feb 18, 2010 4:06 pm
by Lyon
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Other View

Posted: Sat Feb 20, 2010 6:38 am
by Squeakycat
Until the actual data are published, everything is speculative, but there is the additional information from Fiddler about the Canadian Press medical reporter interview with Dr. Zivadinov in which he is reported to have said that 80% of the CDMS group were found to have CCSVI while only 38% of the CIS group were CCSVI positive.

Since roughly 40% of the CIS group had CCSVI and half of people with CIS can be expected to progress to full blown MS, that, assuming it is the people with CCSVI who progress to full blown MS, means that 80% of those with CIS who go on to full MS have CCSVI. That's pure assumption because we don't know yet who among the CIS group has CCSVI nor who will develop full MS, but it seems like a valid working hypothesis that should be tested in further research.

When you then correct the above numbers for (1) possible error in the diagnosis of MS as well as (2) the use of close relatives who have an extremely high chance of developing MS in the control group, I think you end up with something very close to what Dr. Zamboni has reported where he says that with 100% sensitivity and specificity as well as predictability, you can identify people with MS by whether they have CCSVI.

That points to a single explanation for MS, though there are probably both environmental and genetic factors that may further complicate the damage done by CCSVI, the rate at which it progresses and so on.

In other words, the 22% of controls shown to have CCSVI may well be undiagnosed, early cases of MS given that close relatives have such a high probability of developing MS. So rather than undermining the link between CCSVI and MS, it may well support it and provide a path to early diagnosis of MS.

Just to put all the data in one place, here's some additional information on the study from Dr. Zivadinov's presentation at Hamilton:

50 CIS
50 Pediatric MS
50 RIS (Radiologically Isolated Syndrome)
900 CDMS
300 "Adult Healthy and Familial Controls"
50 "Pediatric Healthy and Familial Controls"
150 CNS Autoimmune Disorders (SLE, PLAP, Vascular)
50 CNS Other Neurodegenerative Disorders (AD, PD, Epilepsy)

None of this speaks to any of our questions about the break down of the first 500 patients, although it does seem to make clear that the "Healthy Controls" are in fact familial which I think adds a twist to the findings as far as the controls since we know the probability of family members developing MS is very high.

Posted: Sat Feb 20, 2010 7:04 am
by Sotiris
I posted it in another thread but I think it should be also here.
After taking into account the significant digits of the percentages in the buffalo press release and with some assumptions, the raw data should be as follows:
Image

Posted: Sat Feb 20, 2010 7:19 am
by Algis
What means excl. ?? Excluding??

Yes

Posted: Sat Feb 20, 2010 7:23 am
by fiddler
Excl. means excluding.
...Ted

Re: Yes

Posted: Sat Feb 20, 2010 7:28 am
by Sotiris
fiddler wrote:Excl. means excluding.
...Ted
Exactly, i.e. 62,5%=158/(280-27).