An anecdote of a missed diagnosis: Lyme Disease, Kris Kristofferson

Jackson, Brian brian.jackson at ARUPLAB.COM
Fri Jul 8 14:11:52 UTC 2016

Major problems with this story.

1.       Alternative medicine conspiracy theory theme:  "Mainstream" medicine doesn't know how to diagnose certain diseases, and they're too proud to see the light, but "holistic" practitioners have special knowledge and are better advocates for their patients.  Right.

2.       Misunderstanding of diagnostic accuracy theme:  it's true that available tests from major labs (including my own) have serious sensitivity and/or specificity limitations for diagnosing Lyme disease.  Which is why reputable mainstream medical groups such as Infectious Disease Society of North America and American College of Physicians have issued recommendations to be very cautious of such test results, and rely more heavily on history and symptoms.  The article actually refers to this.  But then the article goes on to become an advertisement for a certain non-mainstream lab that caters to the holistic practitioner community.  Such labs don't have any special science that's not available to mainstream labs; there's no "special sauce" in our industry.  Basically, labs like this either promote tests that happen to have high positivity rates combined with poor specificity, or engineer the cutoffs to increase the positivity rate at the expense of specificity.  (Note:  I'm not specifically referring to IGeneX, since I don't have any inside knowledge of their tests or practices.)  Sure, diagnosing all chronic fatigue patients with Lyme might pick up the occasional undiagnosed Lyme infection and get it treated.  It will also subject lots of patients who don't have Lyme to long courses of IV antibiotics that they don't need.

3.       Science still has a long way to go to satisfactorily diagnose and treat Lyme (or chronic fatigue, or fibromyalgia, or autism, or for that matter most metastatic cancers).  But the solution isn't to throw the scientific baby out with the bath water and go the "alternative" route.

Having said all that, I'm sincerely glad Mr. Kristofferson is doing much better after that strange journey.

--Brian Jackson

From: Hamm, Robert M. (HSC) [mailto:Robert-Hamm at OUHSC.EDU]
Sent: Thursday, July 07, 2016 9:38 PM
Subject: [IMPROVEDX] An anecdote of a missed diagnosis: Lyme Disease, Kris Kristofferson

Robert M. Hamm, PhD
Clinical Decision Making Program
Department of Family and Preventive Medicine
University of Oklahoma Health Sciences Center
900 NE 10th Street
Oklahoma City OK 73104
405 271 5362 ext 32306       Fax 405 271 2784
robert-hamm at<mailto:robert-hamm at>



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