Rigorous New Approach to Constructing a Gold Standard for Validating New Diagnostic Criteria, as Exemplified by the Eosinophilia-Myalgia Syndrome

Hertzman, Phillip A.; Clauw, Daniel J.; Duffy, Joseph R.; Medsger, Thomas A.; Feinstein, Alvan R.

doi:10.1001/archinte.161.19.2301

Cited by 12 publications

(32 citation statements)

References 34 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was identified following an outbreak of the syndrome that was associated with the consumption of a certain brand of nutritional supplement containing tryptophan in the late 1980s. Hertzman et al (2001Hertzman et al ( , p. 2302 report that EMS has proved difficult to diagnose in epidemiological studies of the disease, and that suggested diagnostic criteria had not been validated. They sought to produce and validate a set of diagnostic criteria by measuring their diagnostic accuracy.…”

Section: Eosinophilia-myalgia Syndromementioning

confidence: 99%

“…3 These patterns together functioned as criteria for the diagnosis of EMS, as the authors recommended that "EMS can be diagnosed if either pattern 1 or 2 is satisfied", so long as other potential causes of illness were first ruled out. "EMS should not be diagnosed in the presence of trichinosis, vasculitis, or any other documented infectious, allergic, neoplastic, connective tissue or other type of disease that could adequately explain the clinical manifestations" (Hertzman et al 2001(Hertzman et al , p. 2303.…”

Section: Eosinophilia-myalgia Syndromementioning

confidence: 99%

“…So Hertzman et al (2001) produced a set of criteria for the diagnosis of EMS that they believed should be accurate. But how did they check that this was actually the case?…”

Section: Eosinophilia-myalgia Syndromementioning

confidence: 99%

“…2, is drawn from the medical literature on the diagnosis of eosinophilia-myalgia syndrome (EMS) (Hertzman et al 2001). These researchers inspected a group of patients with the syndrome to see whether or not a set of diagnostic criteria they suggested was able to correctly distinguish diseased patients from not-diseased patients.…”

Section: Introductionmentioning

confidence: 99%

“…3, which is drawn from the medical literature on fibromyalgia (Wolfe et al 1990). These researchers attempt to establish a set of diagnostic criteria as the most accurate available by direct inspection, using similar methods to those recommended by Hertzman et al (2001). These researchers are, in effect, trying to discover the criteria that can be used to define the groups of patients with and without a certain target condition by correlating diagnostic tests results and disease status.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Meno’s paradox and medicine

Binney

2017

Synthese

View full text Add to dashboard Cite

The measurement of diagnostic accuracy is an important aspect of the evaluation of diagnostic tests. Sometimes, medical researchers try to discover the set of observations that are most accurate of all by directly inspecting diseased and not-diseased patients. This method is perhaps intuitively appealing, as it seems a straightforward empirical way of discovering how to identify diseased patients, which amounts to trying to correlate the results of diagnostic tests with disease status. I present three examples of researchers who try to produce definitive diagnostic criteria by directly inspecting diseased and not diseased patients. Despite this method's intuitive appeal, I will argue that it is impossible to carry out. Before researchers can inspect these patients to discover definitive diagnostic criteria, they must be able to distinguish diseased and not-diseased patients; and they do not know how to do this, because this is what they are trying to discover. I suspect the intuitive appeal of directly inspecting patients makes this difficult to appreciate. To counter this difficulty, I present this problem as a manifestation of 'Meno's paradox', which was described in classical antiquity, and of 'the problem of nomic measurement', described more recently. Considering these philosophical problems may help researchers address the methodological issues they face when evaluating diagnostic tests.Keywords Diagnostic accuracy · Meno's paradox · The problem of nomic measurement · Medical epistemology B Nicholas Binney

show abstract

Section: Eosinophilia-myalgia Syndromementioning

confidence: 99%

Section: Eosinophilia-myalgia Syndromementioning

confidence: 99%

“…So Hertzman et al (2001) produced a set of criteria for the diagnosis of EMS that they believed should be accurate. But how did they check that this was actually the case?…”

Section: Eosinophilia-myalgia Syndromementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Meno’s paradox and medicine

Binney

2017

Synthese

View full text Add to dashboard Cite

show abstract

The Pediatric Rheumatology European Society/American College of Rheumatology/European League against Rheumatism provisional classification criteria for juvenile systemic sclerosis

Zulian

Woo

Athreya

et al. 2007

Arthritis & Rheumatism

179

View full text Add to dashboard Cite

This criteria set has been approved by the American College of Rheumatology (ACR) Board of Directors as Provisional. This signifies that the criteria set has been quantitatively validated using patient data, but it has not undergone validation based on an external data set. All ACR-approved criteria sets are expected to undergo intermittent updates.Objective. To develop criteria for the classification of systemic sclerosis (SSc) in children (juvenile SSc). Methods. The study consisted of 3 phases: 1) collection of data on the signs and symptoms of actual patients with juvenile SSc that are useful for defining involvement of a particular organ; 2) selection of the parameters essential for the classification of juvenile SSc and preparation of a set of provisional classification criteria (PCC) using 2 Delphi surveys; 3) consensus conference consisting of 2 steps: discussion and rating of clinical profiles of 160 patients with definite juvenile SSc, possible juvenile SSc, or other fibrosing diseases as "having or not having juvenile SSc," using nominal group technique, and defining those PCC with the best statistical performance and highest face validity by using the clinical profiles of patients with definite juvenile SSc as the gold standard. Results. In phase 1, 55 centers submitted clinical data on 153 patients with juvenile SSc. A total of 48 signs and symptoms were derived from these patient data and were used to define 9 organ system categories (cutaneous, vascular, gastrointestinal, respiratory, renal, cardiac, neurologic, musculoskeletal, and serologic). During phase 2, these were reduced to 21 criteria (3 major criteria [Raynaud's phenomenon, proximal skin sclerosis/induration of the skin, and sclerodactyly] and 18 minor criteria) and combined to generate 86 different PCC. At the consensus conference, these 86 definitions were tested on the case profiles of 127 patients with juvenile SSc. The PCC with the highest ranking were proximal sclerosis/ induration and at least 2 minor criteria. Conclusion. These provisional classification criteria for juvenile SSc will help standardize the conduct of clinical research, epidemiologic and outcome studies, and therapeutic trials.

show abstract

Post‐epidemic eosinophilia–myalgia syndrome associated with L‐tryptophan

Allen¹,

Peterson²,

Sufit³

et al. 2011

Arthritis & Rheumatism

View full text Add to dashboard Cite

Eosinophilia–myalgia syndrome (EMS) is characterized by subacute onset of myalgias and peripheral eosinophilia, followed by chronic neuropathy and skin induration. An epidemic of EMS in 1989 was linked to L-tryptophan consumption originating from a single source. Following the Food and Drug Administration (FDA) ban on the sale of L-tryptophan, the incidence of EMS declined rapidly. Moreover, no new cases have been published since the FDA ban was lifted in 2005. We report the clinical, histopathological and immunogenetic features of a new case of L-tryptophan-associated EMS along with evidence of activated transforming growth factor-ß and interleukin-4 signaling in the lesional skin.

show abstract

Rigorous New Approach to Constructing a Gold Standard for Validating New Diagnostic Criteria, as Exemplified by the Eosinophilia-Myalgia Syndrome

Cited by 12 publications

References 34 publications

Meno’s paradox and medicine

Meno’s paradox and medicine

The Pediatric Rheumatology European Society/American College of Rheumatology/European League against Rheumatism provisional classification criteria for juvenile systemic sclerosis

Post‐epidemic eosinophilia–myalgia syndrome associated with L‐tryptophan

Contact Info

Product

Resources

About