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

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Since the “London criteria” have never been published, they have no authors as far as the real world is
concerned.
Notwithstanding, claims were made on the internet by one of the purported authors of the proposed
“London criteria” that they had been operationalised, and that five published studies had used them. Those
studies were alleged to be:
(i) Costa, Tannock and Brostoff (Q J Med 1995:88:767‐773), which makes no mention of the “London criteria”
but does cite as reference 14 “Criteria for a diagnosis of ME…based on the criteria suggested by WRC Weir in
Postviral Fatigue Syndrome by Jenkins and Mowbray, pp 248‐249”. The Jenkins and Mowbray textbook sets out
Dr William Weir’s own modification of the Holmes et al 1988 criteria and is virtually identical to the
subsequently proposed “London criteria” set out in the National Task Force Report
(ii) Raymond Perrin (an osteopath) claimed in a 1998 study for his PhD that he had used both the 1994 CDC
criteria and the “London criteria” (J Med Eng Technol 1998:22:1‐13). When contacted, he expressed surprise
because he had been led to believe that the “London criteria” had been published and validated. He
confirmed that he had accepted assurance from someone connected with Action for ME that the “London
criteria” had been published, an assertion that originated from the same person who made other claims for
the “London criteria”. Mr Perrin confirmed that he would have to amend his thesis
(iii) Paul L et al (European Journal of Neurology 1999:6:63‐69), which did not mention the “London criteria”;
the authors state: “The patients… fulfilled established criteria for CFS (Fukuda et al, 1994)”
(iv) Whiting et al (The York Systematic Review: JAMA 2001:286:11:1360‐1368), which did not mention the
“London criteria”
(v) McCue, Scholey and Wesnes (Proceedings of the British Psychological Society, 12 th January 1999); this
was a poster presentation at a BPS Conference, which does state that the 20 patient satisfied the “London
criteria”, although the criteria were not defined in the abstract. Poster presentations are not published
studies. Direct personal contact was made with Professor Andrew Scholey, who confirmed that his work on
ME had not been published.
The key point about the intended use of the “London criteria” by the PACE Trial Investigators is that
they are not on PubMed and are not available for scrutiny. How is it possible for the MRC to claim
scientific validity by using criteria that do not formally exist and which cannot be accessed for
comparison? Is this the “high standard of excellence” claimed by the MRC?
The PIs specifically predict in the Protocol that those who satisfy the “London criteria” will do less well,
but how is it possible to enter into a statistical model a covariate based on a case definition that has never
been published and does not formally exist?
This appears to amount to significant internal inconsistency.
Of importance is what the PIs state about their “London criteria for ME” on pages 188 ‐ 190 of the Full
Protocol (note that whilst some patients do experience tinnitus, it is not a cardinal symptom of ME):
“Criteria 1 to 4 must be met for a diagnosis of ME to be made.
1. Exercise‐induced fatigue precipitated by trivially small exertion (physical or mental)
2. Impairment of short‐term memory and loss of powers of concentration, usually coupled with other [neurological or
psychological] disturbances…[NB These symptoms should be asked for as symptoms…These symptoms in (a –
e) should be recorded, but are not necessary to make the diagnosis]: