MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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Clearly, therefore, the Oxford criteria do not identify patients with ME, yet the Wessely School and the MRC
insist otherwise.
On 16 th June 2005, Sarah Perkins, Programme Manager, MRC Neurosciences and Mental Health Board,
confirmed: “The main entry criteria for the PACE Trial are the Oxford criteria…the exclusion criteria of ‘proven
organic brain disease’ will be used to exclude neurological conditions of established anatomical pathology such as
Parkinson’s disease and multiple sclerosis. It will not be used to exclude patients with a diagnosis of ME”.
Given that the Oxford criteria expressly exclude those with organic brain disease and that the WHO
classifies ME as a neurological organic disease under Disorders of Brain, Sarah Perkins was asked why the
MRC was adopting special pleading in relation to ME, and on what scientific evidence‐base the MRC was
relying to enable it to disregard the ICD‐10 classification that had been approved by the World Health
Assembly.
Furthermore, given that the Wessely School psychiatrists demand 100% proof of organic pathoaetiology for
ME before they will “allow” it to be accepted as a “real” organic disease as distinct from a mental disorder,
she was also asked why the MRC does not equally require a similar standard of proof from the Wessely
School that ME is indeed a mental disorder as they assert.
She did not reply.
Despite their insistence that they are studying people with “CFS/ME”, the Wessely School do not accept
that ME is a neurological disorder, so it is unlikely that an assessment which would identify the relevant
signs and markers of ME would be carried out on PACE Trial subjects.
Without such an assessment it is not possible to be confident that people with ME have been screened out,
so the possibility remains that some participants recruited to the PACE behavioural research trial actually
have ME, which may mean that at least some participants have a disorder that contra‐indicates the
interventions concerned.
If there is no strict adherence to the entry criteria, then the results will be flawed from the outset ‐‐ either
the criteria are adhered to, or the results will be flawed: there is no other scientifically credible
interpretation.
The CDC criteria
As noted above, one of the PACE Trial Principal Investigators (Michael Sharpe) was a co‐author of the 1994
CDC (Fukuda) criteria and, as a member of the International CFS Study Group who advised the authors,
Simon Wessely was also involved, and they successfully incorporated elements of the Wessely School’s
model of “CFS” into the CDC 1994 definition.
The 1994 CDC criteria do not stipulate the presence of the cardinal feature of ME, which is post‐exertional
malaise (it is optional) As a result, the 1994 CDC definition does not identify people with ME as distinct
from those with psychiatric fatigue because it includes people with psychiatric disorders; moreover, the
1994 CDC definition dropped all physical signs, but physical signs are always present in ME (see Section 2
above).
The “London” criteria
In apparent response to public disquiet about the use of the Oxford criteria for entry, it was confirmed by
the MRC that there was to be an additional “secondary analysis” of the data using the “London criteria”, but
there is no mention of any “secondary analysis” using the “London criteria” in the original Trial Identifier.