Moderator note: Moved from this thread: Trial By Error: FOI Response from Bristol about LP Study; Correction in BJGP about MUS I have e-mailed the following letter to Professor Carolyn Chew-Graham of Keele University, who has repeatedly mis-quoted a key data point about the cost of so-called MUS to the NHS: Dear Professor Chew-Graham— As you undoubtedly know, the British Journal of General Practice has now taken the responsible step of correcting a false statement in a 2017 editorial written by you and several co-authors. That false statement involved the reported cost of so-called "medically unexplained symptoms" to the National Health Service. ...
First discussed here in February: Trial By Error: The Cost of MUS Here, in May: Trial By Error: My Letter about MUS to the British Journal of General Practice
ETA: It was first thought that Keele university had removed a blog post on MUS by prof. Carolyn Chew-Graham, but turns out the whole blog section is down.
Blog site seems to be partially archived. https://web.archive.org/web/20190731024005/http://primarycarekeele.blogspot.com/ ETA: The archived blog post: https://web.archive.org/web/2019010...eele.blogspot.com/2017/02/mus-guidelines.html There's a link to it at the bottom of the first link.
Chew-Graham has experience of working on NICE guidelines, and currently is a member of the NICE Clinical Guideline Development Group Depression (update) and is a Standing member of a NICE Quality Standards Advisory Group - work which directly impacts on commissioning decisions and patient care. This appears on the Keele University biography for Chew-Graham. One presumes it is current information. https://www.keele.ac.uk/pcsc/ourpeople/carolynchew-graham/ What does it say about NICE guidelines quality if members of its groups see no necessity to correct, or even acknowledge, mistakes? Mistakes can happen, but uncorrected mistakes should not.
All these threads made it a bit confusing where to post this, but I just saw that Alan Carson was claiming around 30% for 'what percentage of all medical visits (not just neurology appts) are due to functional disorders?' https://twitter.com/user/status/1331732233028136960 That seems high.
Carson - I'm not sure if he's being honest here or having a laugh. I love the way the word "definition" here sounds static and immutable instead of being the fluid and very slippery thing it becomes at the hands of BPSers.
It is pure delusion. Or perhaps an alternative fact. In rheumatology I would see maybe one or two people a year who did not seem likely to have structural problems. Is there any reason to think that Dr Carson's opinion is of any interest - other than that he was a trainee of Michael Sharpe I suppose.
Another influential figure helping train others and shape policy. Another sign that things are likely to get worse before they get better!
Pretty astonishing claim, for which there is no evidence. I have seen Stone et al mention the 30% figure in the context of new referrals to neurology clinics and how poor neurologists are swamped by these nonpatients. These sorts of people seem more interested in blame apportioning, stigmatising and labelling patients in such a way that would make it unlikely for them to be able to access good medical care in the future than getting to the bottom of what’s causing unexplained symptoms.
Alan Carson has been known to exaggerate the prevalence of MUS by often referring to a paper by Nimnuan, Wessely and Hotopf (2001), which found that an enormous number of referrals to secondary care were due to MUS, but he has also repeatedly downplayed the rate of MUS misdiagnosis. From the Opposing MEGA (OMEGA) group's blog post last year on the exaggeration of the prevalence of medically unexplained symptoms (bolding mine): Context (Nimnuan et al. 2001): Parts on Alan Carson (bolding mine):
