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Etiology: graphic representations

Discussion in 'General Advocacy Discussions' started by Simone, May 20, 2020.

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  1. Simone

    Simone Senior Member (Voting Rights)

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    Hi brains trust!

    I’m looking for a graphic that presents a possible biomedical model of ME/CFS for a project I’m working on. I’ve got this one, from a Maes & Twisk article in 2010, but ideally I’d like something more recent and which isn’t framed as biopsychosocial.

    Any thoughts?

    Source for this image: https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-35
     

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    Simone, May 20, 2020
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  2. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    I don't think we have a clear enough picture to want to build a diagram of that sort. Diagrams like that in biomedical science are mostly very dubious and misleading. They are popular because they look as if they mean something but generally don't. People like to draw lots of circuits and loops but most of the time the mathematical basis is unsound. Diagrams really only start to hold water once you know in detail what is going on.
     
    Jonathan Edwards, May 20, 2020
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  3. Trish

    Trish Moderator Staff Member

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    That Maes and Twisk one seems to suggest symptoms are perpetuated by psychological stress. The biological bits look speculative. We don't know if they are accurate. So I agree, it's BPS and not useful.
    I dont like these sort of diagrams - we see them all over the BPS publications full of nonsense dressed up to look complicated and scientific when they are prejudiced nonsense.
    As Jonathan Edwards says, we dont yet know the biological basis of ME, so what would you put in the diagram?
     
    Trish, May 20, 2020
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  4. Hoopoe

    Hoopoe Senior Member (Voting Rights)

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    If the goal is to show an audience that there is a biological basis to the illness, then the epidemiology and selected findings like the responses to a 2-day CPET could be good.
     
    Hoopoe, May 20, 2020
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  5. sebaaa

    sebaaa Established Member (Voting Rights)

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    Here's a review article from 2019 by Warren Tate that should give you an overview of the current scientific literature. It doesn't have a diagram so I guess you could make your own and add bits from this review article to it. Of course, it's a bit difficult to have anything conclusive since, like others said, we don't have a clear picture of the disease.
     
    sebaaa, May 20, 2020
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  6. ME/CFS Skeptic

    ME/CFS Skeptic Senior Member (Voting Rights)

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    Graphic representation of ME/CFS

    [​IMG]
     
    ME/CFS Skeptic, May 20, 2020
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  7. Hutan

    Hutan Moderator Staff Member

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    Yes.
    About all we know is
    1. Infections(viral, bacterial, amoebic) (or other triggers) sometimes lead to ME/CFS (but some particular infections don't seem to be a trigger)
    2. Personality traits (as measured in the Dubbo study) including hypochondria have no meaningful impact on the risk of developing ME/CFS (e.g. the Cvejic 2019 paper)
    3. CBT to correct 'faulty thinking' and GET to correct approaches to activity have no meaningful impact on ME/CFS, suggesting that neither faulty thinking, a phobia about activity or deconditioning are causes

    Although, some would question whether 'other triggers' really do cause ME/CFS. And many would debate the name. And some still cling to beliefs about personality and behavioural problems. So, Michiel's graphic seems about right.
     
    Hutan, May 20, 2020
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  8. Trish

    Trish Moderator Staff Member

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    And even that is unclear, simply because the research hasn't been done.
     
    Trish, May 20, 2020
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  9. Barry

    Barry Senior Member (Voting Rights)

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    Yes, the good thing about that diagram is it clearly shows why it is wrong. The "Psychological stress" feedback loop, apparently able to provoke the same physical characteristics that are shown as perpetuating ME/CFS.

    When we know enough about what ME/CFS really is then such diagrams will be very helpful.
     
    Barry, May 20, 2020
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  10. Simone

    Simone Senior Member (Voting Rights)

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    I agree. I don’t think we do either, which is partly why I wanted to replace this one (which is currently proposed for this project). The people I’m working with want a nice picture, but I’m leaning towards us just providing a couple of sentences on some of the current hypotheses, to show that nothing is set is stone, but that there are biomedical hypotheses around.
     
    Simone, May 21, 2020
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  11. Simone

    Simone Senior Member (Voting Rights)

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    ha! ;)
     
    Simone, May 21, 2020
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  12. Simone

    Simone Senior Member (Voting Rights)

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    Yep, I’ve got those.
     
    Simone, May 21, 2020
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  13. Simone

    Simone Senior Member (Voting Rights)

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    Thanks for your responses, everyone. You’ve confirmed my instinct to push for having the diagram I posted removed from the project entirely.
     
    Simone, May 21, 2020
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