Monday, September 23, 2013

HHS Signs IOM Contract

The CFSAC Listserv sent out the following announcement this evening:

We are pleased to announce that the Institute of Medicine (IOM) will begin conducting a study on Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome this month.  This study grew out of the 2012 CFSAC recommendation to the Secretary to convene a workshop to “reach a consensus for a case definition useful for research, diagnosis and treatment of ME/CFS.”  Because the use of and audience for case definitions for research and clinical care are very different, HHS decided that separate processes were needed to develop them.  The NIH is convening an Evidence-based Methodology Workshop process that will consider case definitions appropriate for ME/CFS research and the IOM will address the clinical diagnostic portion of the recommendation.

The Office on Women’s Health/HHS is co-sponsoring the IOM study with several agencies that participate in CFSAC.  A group of voting and non-voting members of the committee participated in the development of the Statement of Work.

The IOM has agreed to perform the following tasks over the next 18 months:
·         Conduct a study to identify the evidence for various diagnostic clinical criteria of ME/CFS using a process with stakeholder input, including practicing clinicians and patients;
·         Develop evidence-based clinical diagnostic criteria for ME/CFS for use by clinicians, using a consensus-building methodology;
·         Recommend whether new terminology for ME/CFS should be adopted;
·         Develop an outreach strategy to disseminate the definition nationwide to health professionals.

To accomplish these tasks, the IOM has also agreed that:
·         the IOM committee will include approximately 15 members with expertise in the following areas: epidemiology; clinical medicine/primary care and other health care fields, particularly with expertise in ME/CFS, including neurology, rheumatology, immunology, pain, infectious disease, behavioral health, cardiology, endocrinology; and scientists and physicians with experience in developing clinical case definitions.  The IOM will ask interested parties, including expert clinicians, researchers and patient advocates, to make suggestions for nominees to the committee.
·         the IOM, in addition to the committee meetings, will sponsor open meetings to enlist the comments and concerns of patients, family members and other caretakers, health educators, health care professionals, and advocacy groups.  During these meetings, an open phone line and email address will be available to those who cannot attend in person.
·         as the committee reviews the literature, efforts that have already been completed on this topic area will be considered, including the 2003 ME/CFS Canadian Consensus Definition, the 2007 NICE Clinical Guidelines for CFS/ME, the 2010 Revised Canadian ME/CFS definition, the 2011 ME International Consensus Criteria, and data from the ongoing CDC multi-site clinical study of CFS. In an effort to minimize overlap and maximize synergy, the committee will seek input from the NIH Evidence-based Methodology Workshop for ME/CFS.
·         the committee will distinguish between disease subgroups, develop a plan for updating the new criteria, and make recommendations for its implementation. Any recommendations made by the committee will consider unique diagnostic issues facing people with ME/CFS, specifically related to: gender, across the lifespan, and specific subgroups with substantial disability.

HHS is proud to be making this investment in ME/CFS. We have heard the advocates’ concerns and trust that many have been addressed by the information provided in this email.  It is our hope that a widely accepted clinical definition and a clear distinction from case definitions for clinical trials and research will aid in advancing clinical care, drug development, and basic translational research for ME/CFS. 

The CFSAC Support Team

I wanted to get this distributed as soon as possible.  It will take us all some time to digest the news.  Please note that all those emails to HHS and Congress were not for nothing.  It appears, at first glance, that the ME community's concerns are reflected in part in this summary.  In addition, the emails to Congress have built awareness not only of ME but also of the problems our community is having with the lack of transparency from HHS.

1 comment:

  1. Any definition which fails to address low NK cell function is a conspicuous omission of the very "unspoken" evidence that caused the CDC to create "the chronic fatigue syndrome" in the first place.

    A transparent substitution which is obviously a disingenuous connivance to make sure this abnormality is never considered part of "CFS"

    North Lake Tahoe Bonanza

    Nov 16 1987

    "Incline Victims Show Cell Abnormalities"

    Tests Reveal New Clue in Fatiguing Illness

    by Chris Fotheringham
    NLTB Managing Editor

    Laboratory results published this week in a prestigious medical journal confirm that over 50% of Incline Village chronic fatigue patients tested have suffered "dramatic" abnormalities in their immune systems.

    Calling it the "most significant finding yet" in efforts to unravel the mystery of the widespread fatigue illness, Harvard researcher Dr. Anthony Komaroff said Monday the report published Sunday in the Journal of Immunology is the first scientific study that confirms "something is wrong with these people."

    "it is really dramatic." said Komaroff, who is chief of general medicine at a Harvard teaching hospital in Boston.

    The article, which underwent nearly 11 months of peer review before being published, was authored by Komaroff, Incline Village internist Dr.Daniel Peterson, and former Incline internist Dr Paul Cheney.
    Dr Michael Caligiuri, an immunologist with the Dana-Farber Cancer institute of the Harvard Medical Center, was the lead author for the article which was originally submitted for review in January.

    Komaroff says test results reveal an attack on the immune system's "natural killer cell" which is the body's primary means of killing virus-infected cells or cells that become cancerous.
    Komaroff said "There is a substantial reduction in the number of natural killer cells in patients tested." He said the study has determined that this "major defense against virus infection and cancer" is damaged in over half of the test cases involving Incline Village patients.

    Komaroff first broght his team of researchers to Incline Village in February of 1986 after Incline doctors Cheney and Peterson had documented an outbreak of approximately 200 cases of mononucleosis-type illnesses in the North Tahoe and Truckee area beginning in the fall of 1985.
    While the Incline Village cluster of fatigue cases has drawn primary attention in the national media, researchers have found widespread occurrence of the illness throughout the country.

    See TESTS on page 9.