This Is MS Multiple Sclerosis Knowledge & Support Community

fogdweller wrote:

concerned wrote:It seems one can only detect venous abnormalities properly if one has Zamboni's machine and course, which obviously come at a price. It seems odd that he's offering these things for sale before his theory has been tested and proven.

It sounds like a lot of vested interest to me.

I worry less about the vested interest, and more about the scientific issue, that if the only way to detect the stenoses is to use special techniques and special equipment and special protocol, what is really going on is "creating" an image that looks like a stenoses. Veins are pretty malable, and react to positioning in special ways.

Frankly, I believe in CCSVI and have my own arguments agains this objection, but I would really like to hear what others think about this.

Not being a doppler technician, I don't really know and therefor can't say anything about that, but I've read doctors making those objections and I haven't read any arguments against them yet. What are your arguments?

These wheelchairs are indeed dangerous. Mine sinks right to the bottom, every time.

1eye wrote:These wheelchairs are indeed dangerous. Mine sinks right to the bottom, every time.

Try to leave it on the shore, and "Just put your hat on" ;)

Hi I have posted a new topic, "transcranial ultrasound", in case you are interested. [/list][/quote]

concerned wrote:

fogdweller wrote:

concerned wrote:It seems one can only detect venous abnormalities properly if one has Zamboni's machine and course, which obviously come at a price. It seems odd that he's offering these things for sale before his theory has been tested and proven.

It sounds like a lot of vested interest to me.

I worry less about the vested interest, and more about the scientific issue, that if the only way to detect the stenoses is to use special techniques and special equipment and special protocol, what is really going on is "creating" an image that looks like a stenoses. Veins are pretty malable, and react to positioning in special ways.

Frankly, I believe in CCSVI and have my own arguments agains this objection, but I would really like to hear what others think about this.

Not being a doppler technician, I don't really know and therefor can't say anything about that, but I've read doctors making those objections and I haven't read any arguments against them yet. What are your arguments?

I answered this yesterday, but somehow my post got lost in cyberspace.

Four reasons (I only listed tdwo yesterday and now want to include all four)

1. One of the early Zamboni tirals and all the Buffalo trials had the professionals who were reading the diagnostic images blinded, and they found stenoses in the MS patients and not in the controls to an overwhealming degree. Since the same protocol was followed in both, if it was creating an image that appeared to be a stenoses where none existed, both would have shown the same thing;

2. There are very clear collaterals developed that shuttle blood around the stenosis, and these would not exist if there was no stenosis;

3. Not very strong, but the Interventional radiologists are very used to looking at the veins, and do not seem to have any doubt that what they are seeing is a stenoses. Even the nay sayers don't make a big deal about what is shown in Zamboni's images not really being stenoses. They just say they are not concentrated in MS patients. This is not a very strong argument, but basically I do put some trust in the IR's.;

4. Ballooning the stenoses results in dramatically increased flow through that area. A stent would hold open a vein that closed in the normal course of events and was created to look like a stenoses, but merely ballooning it would not.

Isn't it possible that the technicians doing the scans looked harder for stenosis in the pwms than the controls, in the process "creating" the image for one but not the other.

concerned wrote:Isn't it possible that the technicians doing the scans looked harder for stenosis in the pwms than the controls, in the process "creating" the image for one but not the other.

That is why it was persuasiv3e that the technicians (probably doctors, actually) were "blinded". They didn't know whether the images they were looking at came from a pwMS or a control. That is what blinded means.

fogdweller wrote:

concerned wrote:Isn't it possible that the technicians doing the scans looked harder for stenosis in the pwms than the controls, in the process "creating" the image for one but not the other.

That is why it was persuasive that the technicians (probably doctors, actually) were "blinded". They didn't know whether the images they were looking at came from a pwMS or a control. That is what blinded means.

And whodaf**k cares if their screening is no good? Do the x-ray venography (oh, yes, invasive, very invasive: NOT!) like you would in a scuse me heartbeat if there were an artery needing it. Screened by a portable ultrasound. Or like you would if you had a thrombosis induced by a port that you put in the patient's jugular to do a plasmapheresis, or chemotherapy, or infuse immunoglobulins, or do a dialysis.

Take a look. Do it "blinded" if you want.

But please don't tell me any more fairy stories about Doppler Ultrasound. I've never bought them and never will, and I among I'm sure *many* others, am tired of them. To the point of puke. It is a big red fish, that you can hunt for a long time and never catch. If you do, it turns out it tastes like... use your imagination.

fogdweller wrote:

concerned wrote:Isn't it possible that the technicians doing the scans looked harder for stenosis in the pwms than the controls, in the process "creating" the image for one but not the other.

That is why it was persuasiv3e that the technicians (probably doctors, actually) were "blinded". They didn't know whether the images they were looking at came from a pwMS or a control. That is what blinded means.

The technicians who actually performed the ultrasounds must have known, that's what I was trying to say. Not the ones who interpreted them.

concerned wrote:

fogdweller wrote:

concerned wrote:Isn't it possible that the technicians doing the scans looked harder for stenosis in the pwms than the controls, in the process "creating" the image for one but not the other.

That is why it was persuasiv3e that the technicians (probably doctors, actually) were "blinded". They didn't know whether the images they were looking at came from a pwMS or a control. That is what blinded means.

The technicians who actually performed the ultrasounds must have known, that's what I was trying to say. Not the ones who interpreted them.

That's true. and since dopplers provide immediate feedback, the technician could keep working and looking until he generates an image that shows reflux indicating a stenosis. They weren't "double blinded".

I am not sure what test these two "blinded" trials were using. I don't think it was doppler, though. I think they were using MRV or veinography or a whole battery, ion which case the operator would still know, but presumably they were a kind that didn't have immediate interpretation and continuing feedback like the doppler.

The other arguments I had supporting the CCSVI validity still apply. It is true, however, that no unequivocally double blind trials have yet been done. However, if you were to evaluate the evidence so far, it falls rather heavily on the "valid" side.