Where's the excitement?

[1eye]

See http://www.thisisms.com/forum/chronic-c ... 25432.html...

[DrGeoff]

And just why should there be any excitement over a badly presented bit of research?

just read the abstract:

The MS group showed lower normalized internal jugular vein (IJV) blood flow (tIJV/tA) than the HC group (P < .001).

is followed by:

In the MS group, 72 (52%) were classified as ST while 66 (48%) were NST. In the HC group, 11 (23%) were ST while 37 (77%) were NST. The ST-MS group had lower IJV flow than both HC and NST-MS groups.

So we have two MS groups and two Healthy Control groups.
Now ask: Why, with a 2x2 contingency table, there was no Chi-square test reported?

One result that is highly significant is reported, but a very basic test is not. Make me wonder if the Chi-square was done and failed to be significant. From my point of view, this is a non starter in the research stakes.

Geoff

[1eye]

And just why should there be any excitement over a badly presented bit of research?

just read the abstract:

The MS group showed lower normalized internal jugular vein (IJV) blood flow (tIJV/tA) than the HC group (P < .001).

is followed by:

In the MS group, 72 (52%) were classified as ST while 66 (48%) were NST. In the HC group, 11 (23%) were ST while 37 (77%) were NST. The ST-MS group had lower IJV flow than both HC and NST-MS groups.

So we have two MS groups and two Healthy Control groups.
Now ask: Why, with a 2x2 contingency table, there was no Chi-square test reported?

One result that is highly significant is reported, but a very basic test is not. Make me wonder if the Chi-square was done and failed to be significant. From my point of view, this is a non starter in the research stakes.

Geoff

This was not badly presented. The purpose, as stated, was not to determine whether "MS" patients or HC were or were not ST. If that were the purpose, a Chi-squared test might have thrown some light.

The purpose was

To determine if extracranial venous structural and flow abnormalities exist in patients with multiple sclerosis (MS).

This was correctly determined. The ST-non-ST status was not the question. The stenotic status of the subjects was determined, as stated, by MRA assessment. I'm sure the researchers will provide you with those MRIs if you need them.

These measurements are not as clearly subjective as the Doppler tests commonly used in trying to disprove CCSVI's existence.

On the contrary this paper used MR images, which I am sure will be provided to anyone claiming to need them. It establishes not just CCSVI's existence, but the existence of venous structural and flow abnormalities in "MS" patients. It does more than that. I am sure you will be enlightened if you read the whole paper, and not just the abstract.

The measurements of this paper were objective, preserved in computer files, repeatedly observable, and quite repeatable by any MRI radiologist.

[brocktoon]

So we have two MS groups and two Healthy Control groups.
Now ask: Why, with a 2x2 contingency table, there was no Chi-square test reported?

It's in the paper, "More than half the MS group 72/138 (52%) classified as ST compared to 11/48 (23%) HC participants (χ2 = 12.01; P < .001)."

Did you happen to read it, or just make your inference from reading the abstract?

Most critical is the finding that a subgroup of the MS group has significantly reduced IJV flow compared to Healthy Controls. The statistics model is robust and clearly laid out. I welcome thoughtful critique, but at least read the paper first.

[DrGeoff]

It's in the paper, "More than half the MS group 72/138 (52%) classified as ST compared to 11/48 (23%) HC participants (χ2 = 12.01; P < .001)."
Did you happen to read it, or just make your inference from reading the abstract?

Thank you for making my point again.
If there was a highly significant Chi-square - why not mention it in the abstract. This would have improved the presentation of the work quite a lot.
I expect to see results mentioned in an abstract, not raw data.
I also rely on an abstract to tell me if it is worth the effort of reading the whole paper.

Geoff

[brocktoon]

I thank you for the interest in the work, and I will consider such criticsm in the next work that I do. But it is not the most critical finding that I was trying to convey. No raw data or processed data lies in the abstract, so I am not sure what you mean by that.

[1eye]

And thank you, for making my point for me. The Chi-squared test was very significant as it was used, and did verify something they "only" knew from having analyzed the MRI data. This had nothing to do with the objective of the study. They were just being thorough. You should thank them for that, rather than disparage. But I forgot, you hadn't read the paper itself, just the abstract. You won't thank them for just the abstract. But they hope to give you free access in the future, if you can wait that long. Meantime you can pay $35, and read the whole thing. Or if you were a doctor or teacher or researcher you would probably get access free.

Just because you expect to see extraneous matter in an abstract, does not mean everyone else does. It may mean you are unduly impressed by statistical tests. Personally, I expect to see mathematical tests such as this in the body or a footnote. Not the abstract. Abstracts should be a clear and concise summary of the main features of an experiment.

But then, as brocktoon tells me, you can't please everyone.

Another "point": people are not always what they claim to be on the Inert-net. Put another way, "on the Internet, nobody knows you're a Chihuahua."

BTW, "χ2 = 12.01; P < .001" is significant. It means most "MS" patients had stenosis, healthy controls did not. But as I said, that was not the main point. The main point was that when normalized to arterial blood flow, jugular flow in "MS" patients was low. Not just that they were stenotic, but that the stenosis was by and large in their jugulars.


-Chris Sullivan (1eye)

[cheerleader]

As to where's the excitement? I experienced it with you, Chris, at the preliminary presentation in Sherbrook last year (BTW, thanks for going public--but we always knew you were not a chihuahua

I also saw it in the room during the International Society for Neurovascular Disease http://www.isnvd.org conference presentation last February. The specialists in imaging, cerebral blood flow and the vasculature in attendance were appreciative of the hard data presented--which is all clearly detailed in the full paper.

As Brocktoon states---it's all in the paper

It's in the paper, "More than half the MS group 72/138 (52%) classified as ST compared to 11/48 (23%) HC participants (χ2 = 12.01; P < .001)."

Did you happen to read it, or just make your inference from reading the abstract?

Most critical is the finding that a subgroup of the MS group has significantly reduced IJV flow compared to Healthy Controls. The statistics model is robust and clearly laid out. I welcome thoughtful critique, but at least read the paper first.

Whether or not an abstract impresses anonymous posters (doctors or otherwise) on this board is of little consequence. All of the data is published in the Journal of Neuroimaging--the official journal of the American Society of Neuroimaging--and will continue to get notice. Let's make sure to link the full paper once it's free for all.
Onward!
cheer/Joan

[cervocuit]

[cheerleader]

Whether or not an abstract impresses anonymous posters (doctors or otherwise) on this board is of little consequence. All of the data is published in the Journal of Neuroimaging--the official journal of the American Society of Neuroimaging--and will continue to get notice. Let's make sure to link the full paper once it's free for all.
Here are other recent publications in vascular journals--
http://ccsviinms.blogspot.com/2014/09/r ... earch.html

[DrGeoff]

Whether or not an abstract impresses anonymous posters (doctors or otherwise) on this board is of little consequence.

Just because you expect to see extraneous matter in an abstract, does not mean everyone else does.

This sort of comment does betray a total lack of understanding as to how scientists work!

The whole point of an abstract is to tell the reader what is in the paper. If the abstract looks a tad dubious, then who is going to bother reading the complete paper (apart from those who believe that the author(s) will say something that they already believe, that is).
If you consider a serious conference/symposium that is running anywhere between four and sixteen parallel sessions, and is offering several hundreds of papers and posters, then it is the abstracts that advise which paper will get the attendance from any individual.
If I want papers on a particular theme in Neurology, I use the online indexing service of the American Association of Neurologists. It searches abstracts.
If I want papers in Psychology, I use the Psychology Abstracts (four large volumes each year) or PsychInfo online. These deal in abstracts.

Efforts to hype one particular paper just because it supports one particular viewpoint do not impress me. The paper that will be of interest to me is the one that finally settles the argument about whether MS is caused by CCSVI, or whether CCSVI is a symptom of MS.

Geoff

[brocktoon]

Efforts to hype one particular paper just because it supports one particular viewpoint do not impress me. The paper that will be of interest to me is the one that finally settles the argument about whether MS is caused by CCSVI, or whether CCSVI is a symptom of MS.

Geoff

I certainly would never hype a paper, and I personally abhor the idea of cherry picking papers to fit a belief. But I stand behind everything I have written and the group I am with. I am actually very surprised that none of the esteemed researchers, doctors, or peer-reviews did not point this out beforehand.

As far as the chicken/egg issue with MS and CCSVI, I would like to see that elusive paper you speak of as well, however, this paper does not offer that, but merely a piece of the complex puzzle with an alternative analysis.

[1eye]

The reason I might be said to be 'hyping' this paper have not got anything to do with personal beliefs, either. I don't have any beliefs that cannot be shaken by a good argument. My interest is personal, through no choice of my own. I am excited by the ideas presented in "Jugular Venous Flow Abnormalities in Multiple Sclerosis Patients Compared to Normal Controls". I think this abstract does not look at all dubious. That opinion was apparently shared by the publisher.

[DrGeoff]

I think this abstract does not look at all dubious. That opinion was apparently shared by the publisher.

Well, you might think that.
Over the years I have been an author, a reviewer, an editor (and a conference presenter).
The publisher may set policy, the editor may or may not decide what goes into a particular issue - and the page count may have as much influence as the reviewers' comments.
I once had a paper to review that was already typeset down to the page numbers. That made it quite clear that no major criticism would be considered.
Another journal that I am aware of uses a standard rating form (1-5 in five categories) for the reviewers to complete and any paper had to achieve a minimum score - and there was provision for a paper that was flawed but raised an important issue.

The existence of a connection between MS and venous haemodynamics has been known for more than a century The paper in question is hardly earth-shattering, it just moves the debate on a tiny bit. Perhaps you should also try reading Lee et al, (2010), where you will find this stetement:
"If there is a relationship between CCSVI and MS it is expected to be a complex one."
and then tell us what the Sethi et al paper has really contributed to our knowledge of this complex problem.

Geoff

[JeanDeEau]

To me, a statement like: "To me, you and Dr. Haacke deserve a Nobel prize for this." (taken from the thread in the CCSVI forum) sounds sort of like hype to me. So do a lot of other things you wrote on October 16.