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Failure to Detect XMRV = Failure to Use Good Science

Posted by APring on 10 Jan 2010 at 02:32 GMT

The study is the first since the groundbreaking news publicised by scientists at the Whittemore Peterson Institute, the National Cancer Institute and Cleveland Clinic of the incidence of a retrovirus known as XMRV in 67% of their CFS patient sample. The results were published in the prestigious journal Science in October 9th 2009 to worldwide critical acclaim.

The new study conducted by British psychiatrist, Simon Wessely, published on Jan. 6 2010 in the open access online journal PLos ONE (where scientists have to pay for for editorial review and publication but aren't properly peer-reviewed at all, having an editor simply look the paper over for a day or two), tested 186 patients - all referrals to the CFS clinic at King’s College Hospital, London - who had undergone minimal medical screening to exclude them from other illnesses. The patients were also given the Chalder Fatigue Questionnaire; a woolly and subjective means of gauging the patient's disability level.

According to the study, “The patient set studied is a well-characterised and representative sample of CFS patients who have been described previously (therefore well-selected to fit the criteria Wessely et al. needed to disprove that XMRV is found in his cohort - which he very unscientifically concludes reflects the entire CFS patient set in the UK): all were routine clinic attendees, referred within the UK National Health Service, who had taken part in prior studies of neuroendocrine functioning and/or of cognitive behaviour therapy.”

Although the study did use positive and negative controls it did not follow the lead of the initial Lombardi et al. study and test the blood of healthy individuals as a clinical control. Other pertinent differences include the use of different blood sample volumes and processing, patient selection criteria, number and type of tests completed and the use of disparate primer sequences that amplified unequivalent regions of the XMRV proviral DNA.

The ‘tick-sheet’ style Chalder Fatigue Questionnaire used to garner samples to meet the ‘international consensus criteria for CFS’ consisted of questions such as Do you have problems with tiredness? Do you feel sleepy or drowsy? Do you have problems starting things? This type of tiredness has no relevance to the true disabling nature of ME/CFS but is likely to relate to those who suffer from depression-related tiredness or those with undetected thyroid and adrenal issues which often elude the minimal testing given to UK patients. The structure of the questionnaire undoubtedly allowed the inclusion of individuals suffering with clinical depression. Severely ill patients (25% of all patients) are not factored in due to their severity and lack of physical mobility making it difficult to reach one of the NHS Specialist ME/CFS centres. This inclusion of patients with mood disorders and drepression and exclusion of the very ill will skew the results.

Those involved in the Lombardi et al. study had previously called for restraint and the need for tightly regulated studies that replicate the work of the initial study with exactness in order to ensure accuracy.

The way in which the Wessely study was executed would indicate that it did not seek to replicate the Lombardi et al. study in line with other studies currently being conducted, but would seem to have been done simply to confound the results and attempt to deflect positive public opinion and funding.

Wessely's livelihood and career relies on the fact that no proof of biological cause is found in ME/CFS.

A statement from the Whittemore Peterson Institute sums up the Wessely study by saying “The WPI study was published after six months of rigorous review and three independent lab confirmations, proving that contamination had not taken place and that infectious XMRV was present in 67 percent of CFS patients diagnosed according to the Canadian and Fukuda criteria. In contrast, this latest study was published online after only three days of review. Significant and critical questions remain as to the status of patient samples used in the UK study as those samples may have been confused with fatigued psychiatric patients, since the UK has relegated
“CFS” patients to psychiatric care and not traditional medical practices.”

The initial findings by those of the Whittemore Peterson Institute and collaborators are likely to have a profound effect on the understanding of the nature of this illness and bring hope to millions worldwide. The psychiatric health procedures used in the UK to ‘cure’ sufferers of their abnormal illness beliefs will doubtless to be seen as outdated and unscientific in comparison to the work currently being conducted in the US and Europe. The direct comparisons may well help highlight the need to bring an end to two decades of corrupt and harmful medical care in the UK. Psychiatrists who have consistently denied the illness and lived off the suffering of patients for over twenty years may face a bleak future both professionally and economically.

Citations:

Erlwein O, Kaye S, McClure MO, Weber J, Willis G, Collier D, Wessely S, Cleare A. (2010) Failure to detect the novel retrovirus XMRV in chronic fatigue syndrome. PLoS ONE 5(1):e8519. doi:10.1371/ journal.pone. 0008519

http://www.plosone.org/ar...

Lombardi VC, Ruscetti FW, Gupta JD, Pfost MA, Hagen KS, Peterson DL, Ruscetti SK, Bagni RK, Petrow-Sadowski C, Gold B, Dean M, Silverman RH, Mikovits JA. Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome. Science 8 October 2009. 1179052.

http://www.wpinstitute.or...

Vernon, SD. PhD, CFIDS Association of America
XMRV Negative Results Emphasize - Need for Robust Replication Study
CFIDS Association of America, January 5 2010

http://www.cfids.org/cfid...

Vigil F, Whittemore Peterson Institute
Official Statement from the Whittemore Peterson Institute
Regarding UK Study
Whittemore Peterson Institute, January 5 2010

http://www.wpinstitute.or...

 




No competing interests declared.