Cameron
Dr. Dan Cameron
12 June 2010
Dr. Cheryl Koopman's funded research focuses on people living with serious illness, including breast/gynecological cancer, Lyme disease, and HIV/AIDS. Also, Dr. Koopman is collaborating with experts in Lyme disease and biostatistics to investigate the diverse manifestations of Lyme disease in relation to symptoms, signs, and diagnostic tests.What at first sounds like interesting research and a promising follow-on to the work of Hassett et al. on psychological co-morbidity in Lyme disease patientsturns out to be a junk science project funded by:the Turn the Corner Foundation,the California Lyme Disease Association,and IGeneX, Inc.
Worse, the so-called Lyme experts are fellow ILADS clowns Daniel Cameron and Raphael Stricker, and CALDA advisor, Christine Green.
The same activist funders and the physicians once again are trying to create data to fit a preconceived notion about an infectious disease, and likely using a famous university’s name to legitimize those results and conclusions. Some of their earlier "research" has been discussed here, here, here, here, and here.
So here’s the plan. According to Koopman, “The overall goals of our research project are twofold: (1) To systematically characterize different patterns of manifestations of Lyme Disease: a) in a large sample of patients seen in clinical practice who have been diagnosed with Lyme Disease for who we have retrospective medical record data; and b) in an additional sample of 100 patients diagnosed with Lyme Disease who will be recruited for the prospective phase of this research; and (2) To evaluate and compare the sensitivity of various antibody and PCR assays against patients’ and comparison groups’ clinical diagnosis and symptom and illness patterns. This research is inspired by considerations of the critical need for further research that recognizes the diverse manifestations of Lyme disease.”
Sounds like some of this has already been done. Koopman, et al. have already submitted the below abstract for the November 2010 meeting of the American Public Health Association in Denver.
218837. Lyme Disease: A Complex Illness with Distinct Subgroups
Cheryl Koopman, PhD , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
Tyson Holmes, PhD , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
Raphael Stricker, MD , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
Daniel Cameron, MD/MPh , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
Christine Green, MD , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
Yvonne Lin, PA-C , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
Adelaida Castillo, MA , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
Alexandra Aylward, BA , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
Jill Whisnant, MA , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
Casey Brodhead, BA , Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
The diagnosis of Lyme disease merits further study because of the diversity of its manifestations, with infections found in the brain, joints/muscles, and/or heart. Its diagnosis is further complicated by the insensitivity of the two-tier CDC diagnostic criteria requiring positive results on both the ELISA and Western blot. Physicians may rely too heavily on such criteria because of the potentially overwhelming number of symptoms that can accompany Lyme. Therefore, our study aim was to assess if manifestations of Lyme disease could be empirically classified into a small to modest number of symptom constellations. We also sought to identify if medical and demographic characteristics differentiate these clusters. We analyzed medical records of 1059 adult Lyme disease patients from a medical practice specializing in tick-born illnesses. All patients self-reported on the presence or absence of 132 symptoms and provided additional medical and demographic information. Gap statistic analysis identified 10 separable clusters, which differed in symptom frequencies and quantities of patients (3-220). These symptom clusters differed significantly with respect to gender (p ≤ .0005), age (p ≤ .0001), length of time since symptom onset (overall p ≤ .05), and prior use of antibiotic therapy (p ≤ .002). Clusters did not differ significantly with respect to recall of tick bite or bulls-eye rash or to current use of antibiotic therapy. The results of this study may have significant implications for both understanding and treating the complex illness of Lyme disease. Distinct symptom clusters and/or stages of the illness may require different treatment approaches.
“…1059 adult Lyme disease patients from a medical practice specializing in tick-born illnesses.” Could that be Stricker’s local San Francisco practice? That’s a lot of patients with Lyme disease. Probably more than the average I.D. doc is going to see in a lifetime. Far more than the whole state of California reports each year.
Where does he find them all? And how does he know all of those patients have Lyme disease? Apparently, despite the alleged insensitivity of diagnostic tests (excluding Igenex, of course) and the endless number of protean symptoms, Ralph and company have no problem identifying patients with Lyme disease. So why the need for research?
Anyway, 1059 patients and a self-reporting checklist of 132 symptoms (quick, name any other disease or infection with 132 symptoms) to slough through. What have they found to date?
“Gap statistic analysis identified 10 separable clusters, which differed in symptom frequencies and quantities of patients (3-220). These symptom clusters differed significantly with respect to gender (p ≤ .0005), age (p ≤ .0001), length of time since symptom onset (overall p ≤ .05), and prior use of antibiotic therapy (p ≤ .002).”
The abstract data is a bit skimpy, but I’m guessing they sorted through 1059 of Ralph’s patients and found 10 statistical groups of people with other illnesses, including perhaps: arthritis, fibromyalgia, chronic fatigue, various autoimmune disorders among female patients and possibly some ALS/MS cases. Maybe one of the smaller clusters actually represented cases of Lyme disease.
“Distinct symptom clusters and/or stages of the illness may require different treatment approaches.”
Yes, especially if those distinct symptom clusters represent diseases other than Lyme Borreliosis.
This sounds like a mess of a study, especially if it leads to further delays in patients receiving a proper diagnosis of illness and appropriate treatment for that illness. Unless Stanford is taking indirect costs for Koopman’s Lyme study, they should cut her lose and tell her this project is her private business and not to be associated with the university. I think they might do that anyway if they knew about Stricker’s past problems with falsifying data, past FDA warningsabout non-standard Lyme tests, and past federal efforts to close down Igenex.
Maybe it’s time to write to Stanford before this nonsense hurts someone.
For general information regarding questions, concerns, or complaints about research, research related injury, or the rights of research participants, please call (650) 723-5244 or toll-free 1-866-680-2906, or write to the Administrative Panel on Human Subjects in Medical Research, Administrative Panels Office, Stanford University, Stanford, CA 94305-5401.
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Posted by Relative Risk at 15:52 0 comments Links to this post
27 May 2010
Interdisciplinary Perspectives on Infectious Diseases
Volume 2010, Article ID 876450, 4 pages
Proof That Chronic Lyme Disease Exists
Daniel J. Cameron
Wow, proof at last. It’s too bad this amazing news could only be broadcast through the pages of an open access journal published from the Nasr neighborhood of Cairo, Egypt. (Though it could have been worse; could have been from the Imbaba part of town.)
Anyway, this four-page “research article” contains no research, but plenty of shop-worn assertions from ILADS and the Lymee activists. (Cameron is the immediate past president of that online gang of private practitioners who dabble in quackery and wackery. Quackery being the medical use of worthless potions and procedures, and wackery being the belief in and dissemination of wacky ideas.)
Cameron provides no definition of what exactly “chronic Lyme disease” is, but it’s safe to assume he is referring to a persistent infection by B. burgdorferi. Why else would one want to prescribe long-term antibiotics? He writes in the paper, “there is no objective way to rule out an active infection.” So apparently, unable to proof a negative, he suggests we all just assume the persistence of complains (objective and subjective) is the work of a B. burgdorferi infection and not something completely different.
I don’t know what compelled him to write this silly proclamation, but I think it’s just further proof that he should not write anything at all. Even from Cairo.
Posted by Relative Risk at 23:12 0 comments Links to this post
Labels: Cameron, Lyme disease
17 December 2009
From a poster on the LymeNut Forum:
"I spent the better part of a day researching online and called the following doctors within 2 hours of NYC."
Dr Raxlen in NYC (a friend of ours went to him and did not have a positive experience though she did not elaborate)
- $900 initial fee + labs
- No insurance accepted
- No appts before Feb
Dr Leigner in Armonk, NY
- No insurance accepted
- Only nurse practitioners are seeing new patients
- $1065 for an initial 3 hr appt
- 2nd week of Jan availability
Dr Fein in West Caldwell, NJ
- Have not been able to speak to anyone
Dr Cameron in Mt Kisco, NY
- Accepts her insurance (HealthNet)
- Available appointment for next Monday.
Dr Streit in Howell, NJ
- do not take HealthNet (may take other insurance)
- Appts avail 2nd week of Jan
- $300 initial visit
Dr Horwitz in Hyde Park, NY
- No insurance accepted
- $975 for 2 hour initial consult
Dr Eiras in Jackson, NJ
- No insurance accepted, but they said testing is usually covered
- $300 new patient appt, followups $100-115
- No appts before Feb
The last time I saw a doctor it cost me $15.00.
Posted by Relative Risk at 13:52 0 comments Links to this post
Labels: Cameron, Lyme disease
14 September 2009
Below is a list of conference “faculty” for an upcoming meeting of the ILADS, a group of like-minded quacks preying on people who think they have a chronic, incurable bacteria infection otherwise know to the saner world as Lyme disease.
If the roof of the conference room was to fall in, it would put an end to a large amount of quackery in the U.S., save many people from financial ruin, and lessen the workload of numerous state medical licensing boards.
Quite a few of these so-called “Lyme Literate” doctors have been sued by former patients or dragged before state licensing boards for their unorthodox practices; and not because they’re treating Lyme disease, but because they’re just bad doctors. Some of them aren’t even doctors.
What’s particularly interesting about the below list is the large number of people with training in psychiatry or psychology. Now Lyme disease is a common bacterial infection, normally treated by internists, rheumatologists and infectious diseases specialists. That a number of head doctors are involved with chronic Lyme patients suggests they at least recognize the common psychiatric co-morbidity among people who think they have a chronic Lyme infection and are taking advantage of that professional recognition. Regrettably, they are probably taking financial advantage of the situation. (Note: the exception is Joseph J. Trunzo, PhD at Bryant University in Rhode Island who is trying to conduct a legitimate study of these unfortunate people. No doubt this will be his last ILADS meeting....unless he starts up a study of doctors who believe in chronic Lyme disease or make a living off of chronic Lyme disease patients.)
What’s surprising about these annual self-stroking sessions is that they have anything to talk about. They don’t do research. They don’t pay attention to actual infectious disease research or the professional literature because they despise the people who do that work. More to the point, they actually don’t believe in research in the modern sense or what most scientists recognize as evidence. So what do they talk about year after year? Bill padding? How to hide cash payments? Property values in the Caribbean? How to get your patients to pay your legal fees through Internet-solicited defense funds? I don’t know. It might be interesting to attend some of this conference, but I’m afraid my head would explode.
Finally, quite a few of these quacks seem to have gone though something called ILADS/TTCF training. I’m not sure what it involves, but it probably makes a bad doctor worse, or perhaps less aware of his or her inadequacies by masking them within a group of equally bad or unaware graduates of medical schools now masquerading as healthcare providers. Certainly, it doesn’t help patients. The Internet is choke-full of middle-aged, white women sitting online at home convinced they have an incurable infection that robs them of the ability to do anything but sit at home online complaining about their incurable infection and the vast conspiracy of insurance companies and academic researchers who are keeping them from appropriate treatment.
Wayne Anderson, ND, ILADS member, is a naturopathic doctor
Paul V. Beals, MD, is an integrative medicine specialist and ILADS member
Sandra Berenbaum, LCSW, is an ILADS member with a private practice
David Berg, MS, is lab director at Arizona Coagulation Consultants
Steven J. Bock, MD, ILADS member
Marilyn Boehm, MD, graduate ILADS/TTCF training program, private practice
Robert C. Bransfield, MD, President-Elect ILADS, private psychiatry practice
Joseph J. Burrascano, Jr., MD, Board member ILADEF
Daniel J. Cameron, MD, MPH, President ILADS, private practice
Sarah Chissell, MD, graduate ILADS/TTCF training program, OB-GYN
Ann Corson, MD, graduate ILADS/TTCF training program, now a training physician
Jonathan Forester, MD, MS, FAAOA, ILADS member, private practice
Andrea Gaito, MD, Past President ILADS, rheumatologist
Eric Gordon, MD, ILADS member, private practitioner in specializing in alternative medicine
Christine Green, MD, ILADS training physician; private practitioner
Steven Harris, MD, ILADS/TTCF training physician; private practitioner
Richard I. Horowitz, MD, President of ILADEF, ILADS/TTCF training physician; private practice
Joseph G. Jemsek, MD, ILADS Treasurer and ILADS/TTCF training physician. Private practice
Lorraine B. Johnson, JD, ILADS Secretary, Executive Director, California Lyme Disease Association
Charles Ray Jones, MD, ILADS member, ILADS/TTCF training physician
Ahmed Kilani, PhD, is lab director of Clongen Laboratories
Cheryl Koopman, PhD is associate research professor of psychiatry
Judith G. Leventhal, PhD is membership chair, ILADS and is in private psychological practice
Kenneth Liegner, MD, ILADS/TTCF training physician who is in private practice
Elizabeth Maloney, MD is a prolific advocate on behalf of Lyme patients. She is a member of ILADS.
David C. Martz, MD, is an ILADS Board member and advocate for Lyme patients
Maureen McShane, MD is a graduate of the ILADS/TTCF training program. She is in private practice
V. Anne Mears, BSN, is a member of ILADS and Lyme advocate
Shawn Naylor, DO, is a graduate of the ILADS/TTCF training program with a special interest in alternative medicine
Carsten Nicolaus, MD, PhD is a member of ILADS.
Steven E. Phillips, MD is past president of ILADS. He is in private practice
Bernard D. Raxlen, MD, is a ILADS/TTCF training physician in private psychiatry practice
Virginia Savely, RN, FNP-C, ILADS member and graduate of the ILADS/TTCF training program
Armin Schwartzbach, MD, PhD is an ILADS member. He is specialist in laboratory medicine
Leo J. Shea, III, PhD is a Board member of ILADS. He is in private clinical psychology practice
Virginia T. Sherr, MD is in private psychiatric practice. She is a former Board member of ILADS.
Samuel M. Shor, MD, is an ILADS member and internal medicine specialist
Sheila M. Statlender, PhD is an ILADS member in private clinical psychology practice
Raphael B. Stricker, MD, is past president of ILADS. He is in private practice
Aparna N. Taylor, ND is a graduate of the ILADS/TTCF training program and member of ILADS. She is in private practice
Keri B. Topouzian, DO, is a graduate of the ILADS/TTCF training program in practice
Joseph J. Trunzo, PhD is associate professor, Department of Applied Psychology at Bryant University.
Diane Wilcox, PhD is an ILADS member.
David S. Younger, MD is an ILADS member who has a private clinical practice
Leila H. Zackrison, MD is a former ILADS Board member and active in clinical practice
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Posted by Relative Risk at 11:44 0 comments Links to this post
02 August 2009
'Lyme Rage': Can Lyme Disease Affect Your Personality?
Roaming Ticks Can Carry Disease Linked to Physical Problems, Mental Madness
July 30, 2009 —
They're tiny insects that can cause big problems. A rise in the number of ticks this year has infectious disease experts focused on the best way to treat the Lyme disease that the little buggers can spread.
Some 20,000 Americans are infected and treated every year, but countless others go undiagnosed. The illness has symptoms that include fever, fatigue and headaches, but if left untreated, Lyme disease can be more serious.
While there are physical symptoms of the disease that can include severe headaches, severe joint pain and even numbness in the hands or feet, many experts believe Lyme disease can rewire the human brain and affect personality.
Maybe, but then so can a good case of meningitis or encephalitis, or even a dose of West Nile or Borna virus.
"I'm convinced that Lyme in a chronic form can affect psychiatric issues, neurological issues and you can have neurological problems," New York epidemiologist Dr. Daniel Cameron said.
Unfortunately, he can’t convince anyone else that matters. See: Wormser, GP, et al. Analysis of a flawed double-blind, placebo-controlled clinical trial of patients claimed to have persistent Lyme disease following treatment. Minerva Med. 2009;100:171-2.
The Center for Disease Control and Prevention notes that up to 5 percent of patients "may develop chronic neurological complaints months to years after infection."
Lyme disease patient Kelly Kulesz told "Good Morning America" she saw herself change overnight because of her infection. "They put me on stage fright medications," Kulesz said. "Doctors thought it was obsessive compulsive disorder, but it's just not."
When Terry Jo Sedlacek went to trial for allegedly gunning down the Rev. Fred Winters in March, the defense cited his Lyme disease infection and it's contribution to what many call "lyme rage."
But not all experts believe Lyme disease causes such changes in personality.
"The example I like to cite is if I have Lyme disease and I get run over by a truck, the Lyme disease didn't cause my broken leg," said Dr. John Halperin, lead author on the new American Academy of Neurology Guideline on Lyme Disease Treatment.
ABC News medical contributor Dr. Marie Savard, who had lyme disease, said that the possibility of personality changes should at least be taken into consideration.
"It does affect the central nervous system. You can have behavior changes, personality changes," she said. "We have to listen and pay attention."
To whom? The patient with the alleged personality change or behavioral problems. Well, people have looked at this problem. And more often than not it’s the already disturbed personality that finds Lyme disease and latches onto it as the physical cause of that person’s emotional or psychological problems.
Arthritis Rheum. 2008 Dec 15;59(12):1742-9.
Role of psychiatric comorbidity in chronic Lyme disease.
Hassett AL, Radvanski DC, Buyske S, Savage SV, Gara M, Escobar JI, Sigal LH.
Psychiatric comorbidity and other psychological factors distinguished CLD patients from other patients commonly seen in Lyme disease referral centers, and were related to poor functional outcomes.
Environ. Hlth. Perspect. 2002;110(4):607-11.
Contributions of societal and geographical environments to "chronic Lyme disease": the psychopathogenesis and aporology of a new "medically unexplained symptoms" syndrome.
Sigal LH, Hassett AL.
Division of Rheumatology and Connective Tissue Research, Department of Medicine, Lyme Disease Center, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey
Lyme disease is a relatively well-described infectious disease with multisystem manifestations. Because of confusion over conflicting reports, anxiety related to vulnerability to disease, and sensationalized and inaccurate lay media coverage, a new syndrome, "chronic Lyme disease," has become established. Chronic Lyme disease is the most recent in a continuing series of "medically unexplained symptoms" syndromes. These syndromes, such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity, meet the need for a societally and morally acceptable explanation for ill-defined symptoms in the absence of objective physical and laboratory findings. We describe factors involved in the psychopathogenesis of chronic Lyme disease and focus on the confusion and insecurity these patients feel, which gives rise to an inability to adequately formulate and articulate their health concerns and to deal adequately with their medical needs, a state of disorganization termed aporia.
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Posted by Relative Risk at 10:34 0 comments Links to this post
30 July 2009
In some ways the IDSA re-review of its treatment guidelines for Lyme disease seems like an Internet version of the old Gong Show. You’ve got a lot of amateurs trying to impress a panel of expert judges with their ability to redefine science through emoting, arguing, and repeating 15-year-old tautologies.
First up is Tina Garcia, head of a Lyme support group in a state (AZ) where there is no endemic Lyme disease because there are no vectors.
Then there’s two more activists (Johnson and Cameron) hoping to promote their organizations as credible purveyors of modern medicine.
We’re back to reality for a few minutes with Phil Baker and Ben Luft, followed by another plunge into the medical Twilight Zone with another ILADS doc.
Then some serious discussion of diagnostics by Barbara Johnson and Dave Volkman followed by some old news about tetracyclines from Sam Donta.
Back to no-nonsense medicine with Gene Shapiro followed by Brian Fallon, a once respected expert on hypochondria who failed to detect said condition among his activist fans and whose very expensive NIH study of chronic Lyme patients found…..Nothing.
Then some more back and forth: Sood, followed by another ILADS guy running a quiet practice in Armonk, NY, followed by Allen Steere, followed by another ILADS guy who thought Detroit tap water might be a secret ingredient for growing borrelia, followed by Art Weinstein.
Then my personal favorite, Ralph “Need a bigger penis?” Stricker who can give his data-free spiel in his sleep.
Batting clean-up is Gary Wormser.
It’s a real seesaw of reality and imagination, of science and pseudoscience. It’s “bread and circuses” for the “chronic” Lyme patients. In other words, it’s cheap entertainment. Well, not cheap. It took time and money to arrange this stunt just to keep a PR-hungry politician from trying to redefine what science is and how it’s conducted.
I think even many of the activists realize this is just a stunt. Peer-reviewed science and the practice of evidence-based medicine are not going to be redefined by some hack attorney and some tearful patients. If the IDSA did rewrite their guidelines in response to “popular” pressure, it would be the end of the IDSA, the end of all clinical practice guidelines, and a return to pre-Enlightenment quackery.
That’s not going to happen. Blumenthal is not a medieval pope who can order the IDSA to its knees and recant like Galileo. Even on his knees, Galileo knew he was right and the Powers that be were deluded.
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Posted by Relative Risk at 01:56 0 comments Links to this post
Labels: Cameron, IDSA, Politics
07 June 2009
The Infectious Diseases Society of America has selected presenters to speak before its Lyme disease guidelines review panel on July 30. Here’s the list from the Lyme Disease Assoc. incorrecting identifying most of the speakers.
Tina Garcia (patient advocate )
Lorraine Johnson (patient advocate)
Daniel Cameron (physician-scientist)
Phillip Baker (physician-scientist)
Ben Luft (physician-scientist)
Allison Delong (scientist)
Barbara Johnson (physician-scientist)
David Volkman (physician-scientist)
Sam Donta (physician-scientist)
Eugene Shapiro (physician-scientist)
Brian Fallon (physician-scientist)
Sunil Sood (physician-scientist)
Ken Liegner (physician-scientist)
Allen Steere (physician-scientist)
Steven Phillips (physician-scientist)
Art Weinstein (physician-scientist)
Raphael Stricker (physician-scientist)
Gary Wormser (physician-scientist)
Well, this could certainly be entertaining. First off, three people who know nothing about science or medicine (Garcia, Johnson and Delong). Then the LLMD Cameron, whose MPH doesn’t qualify him as a physician-scientist. Baker and Barbara Johnson are not physicians, but they are Lyme experts. Volkman is long retired from NIH. Donta is no scientist. The same with Liegner and Phillips; they’re just two private practice LLMDs.Fallon runs the LDA-created Lyme center at Columbia and spent a lot of federal money trying to 1) find real Lyme patients, and 2) trying to prove chronic Lyme exists and requires long-term antibiotics. He failed in both cases. Rounding out the entertainment is Raphael—do you need a larger penis—Stricker, best known for being fired by UCSF and banned from NIH funding for data manipulation.
Yes, it should be entertaining: some serious infectious disease discussion interspersed with a little emoting and quackery. The only thing missing is popcorn and a few minutes of Blumenthal preening before the webcams.
Posted by Relative Risk at 09:12 0 comments Links to this post
Labels: Cameron, IDSA, Lyme disease
