Blumenthal

Senator & Former CT Attorney General Richard Blumenthal

26 May 2010

Richard Blumenthal’s Lyme Deception

A nice review of the Blumenthal mess.

Connecticut Attorney General Richard Blumenthal has a problem and it is just not his military record that he is exaggerating about. He has also exaggerated in promoting his medical/scientific agenda. Mr. Blumenthal believes that all relationships with industry constitute a conflict of interest.In doing so he forced a medical society to spend almost a million dollars defending themselves against trumped up anti-trust charges for issuing clinical guidelines and the state resources on the hopeless investigation.

Read the whole article here.

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Labels: Blumenthal, Politics

18 May 2010

Blum’s War Record

May 18, 2010. msnbc.com news services5/18/2010WASHINGTON - Richard Blumenthal, the early favorite to win retiring fellow Democrat Christopher Dodd's Senate seat from Connecticut, never served in the military in Vietnam despite his public comments indicating he had done so, the New York Times reported on Monday.If these revelations harm Blumenthal's campaign, they could help Republicans pick up a Senate seat now in Democratic hands as they try to gain control of Congress in November elections.Blumenthal, Connecticut's state attorney general, received at least five military deferments [same as Cheney?] from 1965 to 1970, the newspaper said, citing his military records. It said in April 1970, Blumenthal landed a spot in the Marine Corps Reserve but never actually was sent to serve in Vietnam during the war. [Maybe he was guarding the Greenwich Country Club entrance.]

Given his penchant for practicing medicine, he should have considered the Yellow Beretsas an alternative to the draft. The only fighting he would have seen then would have been over dinner reservations and parking meters in Bethesda.

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Labels: Blumenthal

23 April 2010

Forbes on Lyme and Blum

Alternative Lyme Disease Doctors Are Still Wrong.

The Infectious Diseases Society of America yesterday released the results of its year-longassessment of its 2006 Lyme disease treatment guidelines. The specialty society was forced, under very unusual circumstances, by Connecticut Attorney General Richard Blumenthal, to hire an outside group of doctors to review its guidelines for possible inaccuracies, bias or conflicts of interest. The verdict: the guidelines, which advise Lyme patients to take short courses of oral antibiotics, are fine the way they are.

Activists and self-anointed Lyme doctors had complained that the IDSA's guidelines were keeping insurance companies from paying for costly long-term courses of infused antibiotics to treat patients suffering from so-called "chronic Lyme disease."

The IDSA, comprised of doctors with advanced training in the treatment of infectious diseases like Lyme, pointed out that such infusions can kill or seriously hurt patients while creating drug-resistant bacteria that threaten the rest of us. One example from the New England Journal of Medicine: a study of infused antibiotics was cut short after Lyme sufferers with persistent symptoms did not respond to a course of antibiotics any better than they did to a placebo. One patient getting antibiotics had a pulmonary embolism; another had gastrointestinal bleeding.

Blumenthal pandered to a vocal group of Connecticut activists, by taking the unprecedented step of "investigating" a group of doctors' treatment guidelines--and forcing the settlement. It was as if a prosecutor threatened to sue the American Academy of Pediatrics over its vaccine schedule to the cheers of Jenny McCarthy-led autism activists. Many IDSA doctor-members were disappointed that the group didn't stand up for science in the courtroom and instead agreed to the review.

Alternative Lyme groups that have and always will promote expensive, potentially dangerous courses of long-term antibiotics are predictably upset and--much like the vaccines = autism crowd after the latest debunking--in complete denial.

Blumenthal, who is currently running a much-maligned campaign for U.S. Senate, put out a petulant press release saying his office would review the IDSA's review. (Yesterday's release had none of the flair of the one announcing the results of his investigation back in 2008.)

We wrote about doctors profiting from dubious Lyme treatments back in 2007.

Posted by Relative Risk at 17:20 0 comments Links to this post

Labels: Blumenthal, IDSA

Blum Bombs

From the New London Day (Ct.)

April 23, 2010

IDSA vindicated after unfair Blumenthal attack

Connecticut Attorney General Richard Blumenthal demonized the Infectious Disease Society of America after the release of its 2006 Lyme disease guidelines that rejected the long-term use of antibiotics because they were ineffective and dangerous. A comprehensive evaluation of those guidelines has now concluded the IDSA was right, the attorney general wrong.

"Based on its review of all the evidence and information provided, the Review Panel determined that no changes or revisions to the 2006 Lyme Guidelines are necessary at this time," the special panel announced Thursday. The vote was 8-0.

The attorney general needlessly politicized the issue by trying to make whipping boys of the IDSA. He raised tenuous allegations of conflicts of interest and blamed the group because insurance companies were refusing to pay for long-term antibiotic treatment. It was political grandstanding.

Among Mr. Blumenthal's claims was this: "The IDSA's guideline panel improperly ignored or minimized consideration of alternative medical opinion and evidence regarding chronic Lyme disease."

In other words, the attorney general suggested the association cooked the results. That's a serious charge and one that the review panel found was baseless.

It determined the guidelines "were based on the highest-quality medical/scientific evidence available" and that it "did not find that the authors of the 2006 Lyme Guidelines had failed to consider or cite relevant data and references that would have altered the published recommendations."

The special review panel was formed after Mr. Blumenthal threatened to take antitrust action against IDSA. Society President Dr. Richard Whitley said Thursday the legal attack on medical guidelines by an attorney general was unprecedented.

Mr. Blumenthal and IDSA agreed to let Dr. Howard Brody, a medical ethicist at the University of Texas Medical Branch, screen all panelists for any conflicts of interest. The panel spent a year exhaustively reviewing the guidelines, conducted a public hearing and took evidence from more than 150 individuals or organizations before issuing its 66-page report with 1,025 citations.

It determined what the IDSA and other groups, such as the American Academy of Neurology, have been saying for several years - clinical trials have showed little benefit from prolonged antibiotic therapy. Such treatments, using intravenous catheters, can cause life-threatening infections and other medical problems.

This unequivocal conclusion raises serious questions about the appropriateness of a 2009 Connecticut law that protects doctors prescribing long-term antibiotics for Lyme disease from sanctions by state health regulators.

A short course of oral antibiotics remains the standard treatment for patients with Lyme disease, the most common tick-borne illness. For most people, that quickly clears up the problem.

This report will not satisfy many of those who suffer from what they consider "chronic Lyme disease" or "post-Lyme disease syndrome," the joint soreness, fatigue, headaches and other lingering pain that continues long after the initial infection. The evidence is growing, however, that these symptoms result from a subsequent inflammatory condition rather than persistent infection with Lyme disease bacterium, making continuing antibiotic treatment useless.

Adding to the frustration of these patients and their physicians is the fact that other illnesses mimic the symptoms cited by long-term Lyme sufferers, adding to the challenge of diagnosis and treatment.

Mr. Blumenthal issued a brief statement that his office is reviewing the panel's report to assure it met the requirements set out before the panel began its work. What he should be offering is an apology. His attack on the work of the IDSA was needlessly over the top. The association did its job. It followed the science.

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Labels: Blumenthal

22 April 2010

The End

Today, the Infectious Diseases Society of America (IDSA) will be hosting a media teleconference to discuss the results of a voluntary, one-time review of its 2006 Lyme disease treatment guidelines.

How exciting. I can't wait to see if Blumenthal and his band of out-of-state co-conspirators have managed to overthrow evidence-based medicine and peer-reviewed science. If so, popes, fundamentalists and Republicans may want to take note.

Posted by Relative Risk at 11:55 0 comments Links to this post

Labels: Blumenthal, Lyme disease

16 April 2010

Vote Republican (But just this once)

NYT. April 14, 2010

Rough Start for Big Name in Conn. Senate Race

By DAVID M. HALBFINGER

HARTFORD — Richard Blumenthal’s campaign for the Senate was supposed to be a glide. Nothing and no one could stop him.

As the Connecticut attorney general, Mr. Blumenthal, a Democrat, had been sticking up for consumers and middle-class families for 20 years, with widely embraced crusades against easily demonized foes: pedophiles, used-car dealers, utility companies and, even here in the insurance capital of the world, insurers.

No politician in the state had anything close to Mr. Blumenthal’s popularity. So when he jumped into the race to succeed Senator Christopher J. Dodd, Democrats in Washington immediately crossed the seat off their list of ones to worry about.

But signs of trouble have quickly emerged.

Mr. Blumenthal flopped in his first televised debate against an obscure primary opponent, and he is ruling out any possibility of a rematch.

He appears almost incapable of offering concise answers to even the most predictable questions, like why he is running for the Senate.

And his reliance on prosecutorial parlance and legal arcana has raised unflattering comparisons to another attorney general in a Senate race who seemed a sure winner only to lose in spectacular fashion. Some Democrats are calling him “Martha Coakley in pants,” referring to the candidate who lost the Massachusetts Senate election in January.

[snip]

But the Democrats admit to some nervousness, in part because of the Republican he is most likely to confront next fall: the professional-wrestling impresario Linda McMahon. She promises a campaign much like her brand of entertainment, with blunt, in-your-face, emotional appeals and attacks.

And Ms. McMahon has vowed to spend as much as $50 million, about five times what Mr. Blumenthal can muster.

Mr. Blumenthal’s combat readiness has been questioned before. In 2005, Gov. M. Jodi Rell’s advisers let it be known that she would relish a challenge from the attorney general, who they said had a “glass jaw.”

Still, his halting style as he pursues the Senate seat is striking.

In an interview last week, Mr. Blumenthal took nearly 10 minutes to answer a question about why, aside from personal ambition, he wanted to be a senator, using much of that time to say why the job of attorney general had been a “perfect fit” for his skill set and passions. He eventually got across that he hoped to advance in the Senate the causes he has pursued as attorney general by changing federal law.

“But this is kind of a long-winded answer and not a terribly cogent one,” he acknowledged, unprompted.

His biggest blunder at the debate, on March 1, occurred when his opponent for the Democratic nomination, Merrick Alpert, rhetorically asked Mr. Blumenthal how many jobs his office’s lawsuits had created. Mr. Blumenthal took the bait. “Our lawsuits, our legal actions, actually create jobs,” he said, smiling earnestly. “Because businesses actually welcome competition and a level playing field.”

Jobs are the biggest issue in Connecticut, as nearly everywhere else this election cycle. But Connecticut is one of only two states — the other is Michigan — where employment has fallen in the decades since Mr. Blumenthal took office. His critics argue that his attacks on corporations have helped cement the state’s image as unfriendly to business.

And in January, a jury bolstered that argument, handing an $18 million verdict to a woman who said Mr. Blumenthal had unfairly destroyed her business through false accusations. (His office is seeking to have the verdict overturned.)

[snip]

Mr. Blumenthal could be forgiven for having been impressed with himself back then. After Harvard, he worked for Daniel Patrick Moynihan at the White House under President Richard M. Nixon. At 24, he made the front page of The New York Times when he rejected Nixon’s offer to have him lead Vista, the domestic version of the Peace Corps, because he opposed Nixon’s policies. Yale Law, a Supreme Court clerkship and a job with Senator Abraham A. Ribicoff followed, before the senator recommended him for United States attorney in 1977. He was all of 31.

The race for attorney general in 1990, when Mr. Blumenthal was a state senator, was indeed a close contest, in which he edged out a popular colleague, Jay B. Levin.

But that was Mr. Blumenthal’s last serious challenge, and nowadays there is a bit of Rip Van Winkle to his return to the fray. “When I started this job, the Internet didn’t exist,” he said at one point in the interview last Thursday. Later, he joked that his teenage daughter once asked him if he would be the “eternal general.”

The most noticeable aspect of Mr. Blumenthal’s campaigning is his caution. The man who twice shrank from running for governor hedges, fences and revises when queried on all manner of federal issues.

[snip]

Still, judging from a couple of days on the trail, Mr. Blumenthal retains a reservoir of support that is less about star power than the accumulation of favors banked and names remembered. The onetime varsity swimmer and Marine reservist now has thinning hair and, at 5-foot-11 and a gaunt 155 pounds, wears his dark suits like a wire hanger. When he enters a room, he does not turn heads, but instead silently seeks out familiar faces, invariably finding many.

[snip]

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Labels: Blumenthal

16 February 2010

Is the Wonk Wacked?

Boy, this Lorraine character is a real wackjob. She can’t seem to get anything straight. She may be the Sarah Palin of LymeLand. Here’s the latest from her blog of Lyme disease wonkery…..

“One of the problems with the IDSA reviewing its own guidelines is that it is not an independent process. The IDSA selected the panel, paid the ethicist, and sets the ground rules.”

Well, for those of you who were asleep last July during the guidelines review, the IDSA is not reviewing its own guidelines, the independent review panel is. Otherwise, what would be the point of a re-review? Secondly, the panel was selected by the IDSA and thatsleazeball lawyer in Ct. now trying to become a sleazeball senator. Thirdly, I don’t know if the medical ethicist* running the review is being paid, but both he and the ground rules for the re-review were jointly approved by the IDSA and the narcissistic Blumenthal. (By the way, why wasn't she complaining about all this back in July before any reviewing and voting took place?)

She continues (unfortunately)….

“And, now we have the IDSA manipulating the voting process to achieve a goal—protection of the IDSA’s professional reputation—that conflicts with the goal of providing quality patient care. Think about it.”

Yes, let’s think about it. Lorraine seems to be upset that the IDSA is allegedly in control of the re-review, and she also seems to be upset that they allegedly are not following their own review rules. Huh? Kind of like being upset about being mugged and the mugger not taking your money.

This blog diatribe then swerves off to an alleged vote about lab test requirements for diagnosis. As far as I know, the votes aren’t in and no reports have been released. I don’t know where Lorraine is getting her information (could it be Blumenthal?), but without independent confirmation, it’s just a lot of smoke and mirrors probably intended to confuse and upset people.

Again, here’s the Blumenthal-IDSA Action Plan for voting on any proposed changes to the guidelines.

Voting

a. The Review Panel shall strive to achieve consensus.

b. It is the responsibility of the Review Panel Chairperson to manage any vote on any key finding or recommendation and report such vote to the Ombudsman. The name and vote of each Review Panel member must be maintained for the record, but will not be made public, though the overall vote of the Review Panel on the final recommendation(s) shall be made public.

c. Panel determinations/recommendations shall require a supermajority vote of 75% or more of the total voting members.

5. Recommendation

a. Based on its weighing of evidence, the Review Panel shall recommend one of the following three options:

i. That no changes to the 2006 Lyme disease guidelines are necessary.

ii. That there is a need for sectional revision of the 2006 Lyme disease guideline. In this instance the Review Panel shall make proposals for those revisions, which shall be considered and implemented by the SPGC [Standards and Practice Guidelines Committee].

iii. That a complete rewriting of the 2006 Lyme disease guideline is required. If the Review Panel determines that such a rewriting of the Lyme disease guideline is warranted, the IDSA shall convene a guideline panel consistent with the terms of this Action Plan and the and the IDSA's Handbook on Clinical Practice Guideline Development.

6. The recommendation(s) of the Review Panel shall be binding upon the IDSA.

Too bad the recommendations won’t be binding on LLMDs and the denizens of LymeLand.

* As agreed by all parties, all review panel members, including the chairperson, were screened for potential conflicts of interest and were deemed eligible by ombudsman and medical ethicist Howard Brody, MD, PhD, author of “Hooked: Ethics, the Medical Profession, and the Pharmaceutical Industry.” Dr. Brody was jointly selected by IDSA and the Office of the Attorney General.

-

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Labels: Blumenthal, IDSA

05 February 2010

Wonking and Whining

More online discussion about the recent whining of A.G. Blumenthal, the Lyme obsessed pol from Connecticut, and the self-styled wonkette and frequent pamphleteer, Lorraine Johnson can be found at LymeNet Europe.

All of this whining, angst, and conniving public antics over a set of voluntary, best practices guidelines for treating a fairly common bacterial infection!? Someone needs a little therapy here, and maybe some adult supervision within the halls of the A.G.'s offices.

-

Posted by Relative Risk at 07:23 0 comments Links to this post

Labels: Blumenthal, IDSA

04 February 2010

Don’t like the results, question the process.

Supreme Court Justice A. Scalia once opined that it was perfectly constitutional to execute an innocent man as long as he had been run through the legal process in a proper manner. For lawyers, process is everything.

And that’s what Blumenthal seems to be arguing about in a Feb. 1, 2010 letter to the IDSA. Just before the review committee gets ready to release their report on the IDSA treatment guidelines, Blum jumps in to question the review process, which he helped set up. I guess he’s worried about the outcome and he’s hoping to undermine it (again) by questioning the process by which it was achieved (again).

Lyme activist and occasional lawyer, Lorraine Johnson, has already posted Blum’s letter online, urging agitation among the denizens of LymeLand. According to Johnson, "The four-page Attorney General letter was released in response to a Freedom of Information Request made on behalf of patient groups for information regarding the IDSA’s compliance with the Settlement Agreement." If that’s true, it must have been the fastest request-and-release in the history of the FOIA. 24 hours?! I'm guessing Blum's office passed them a copy, hoping they would post it and start making calls and accusations.

I don’t know if the reviewers followed the review and voting procedures to the letter. Frankly, I don’t care. What I do care about is Blum continuing to harass the IDSA and attempting to undermine science. If he’s really concerned about the review process he should write to the Chair of the review committee, Carol Baker. She’s in charge, not the IDSA. Here’s the list of reviewers:

Carol J. Baker, MD, Chair Baylor College of Medicine

William A. Charini, MD, Peabody, MA

Paul H. Duray, MD (retired) Resigned October 7, 2009, due to a family illness.

Paul M. Lantos, MD, Duke University Medical Center

Gerald Medoff, MD, Washington University School of Medicine

Manuel H. Moro, DVM, MPH, PhD, National Institutes of Health

David M. Mushatt, MD, MPH & TM, Tulane University School of Medicine

Jeffrey Parsonnet, MD, Dartmouth‐Hitchcock Medical Center

Cmdr. John W. Sanders, MD, U.S. Naval Medical Research Center Detachment, Peru

Having lost a potential ally on the committee (Duray), Blum and the activists seem to have only one card left to play: questioning the process and accusing members of inappropriate actions.

Isn’t that how all this started back in 2006?

So Blum and the activists are back to threats: “Patient organizations call upon the IDSA to hold an individual vote on whether each of the guidelines’ recommendations is medically/scientifically justified in light of all the evidence as requested by the Attorney General. If IDSA fails to do so in good faith, patients continue to rely upon the Attorney General to continue to enforce the Settlement Agreement.”

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Labels: Blumenthal, IDSA

26 January 2010

The Conflict over Conflicts

January 26, 2010

NYT: Corporate Backing for Research? Get Over It

By JOHN TIERNEY

Below is part of a NYT article about the impact of alleged conflicts of interest among scientists. It’s a nice reality check about the merits of such accusations. Too bad Blumenthal--a hack lawyer and a hack politician--was not able to apply this level of common sense and sophistication to his recent dealings with the Infectious Diseases Society of America (IDSA).

He would have saved the CT taxpayers a lot of money. Instead, he used these all-too-common accusations of financial conflicts to harass and intimidate a medical society, accuse its members of conflicts, “investigate” medical guidelines, preen before the local news camera, and bask in the accolades of out-of-state Lyme disease activists who seem to think the IDSA has something to do with their lack of physical and mental well-being.

Having waited 20 years for one of CT’s senators to die (physically or politically), thepathologically cautious Blumenthal is out campaigning for a senate seat. Maybe now CT residents will get a chance to ask him how much state money he spent on his recent investigation of Lyme disease treatment guidelines, and how much Senate time he plans to devote to his very odd obsession with Lyme disease. There are other problems in the country beside entomophobia

and hypochondria among middle-age white women.

[snip]

But I do agree with his basic insight: Conflict-of-interest accusations have become the simplest strategy for avoiding a substantive debate. The growing obsession with following the money too often leads to nothing but cheap ad hominem attacks.

Sure, money matters to everyone; the more fears that Dr. Pachauri and Mr. Gore stoke about climate change, the more money is liable to flow to them and the companies and institutions they are affiliated with. Given all the accusations they have made about the financial motives of climate change “deniers,” there is a certain justice in having their own finances investigated.

But I don’t doubt that Mr. Gore and Dr. Pachauri would be preaching against fossil fuels even if there were no money in it for them, just as I don’t doubt that skeptics would be opposing them for no pay. Why are journalists and ethics boards so quick to assume that money, particularly corporate money, is the first factor to look at when evaluating someone’s work?

One reason is laziness.

It is simpler to note a corporate connection than to analyze all the other factors that can bias researchers’ work: their background and ideology, their yearnings for publicity and prestige and power, the politics of their profession, the agendas of the public agencies and foundations and grant committees that finance so much scientific work.

Another reason is a snobbery akin to the old British aristocracy’s disdain for people “in trade.”

Many scientists, journal editors and journalists see themselves as a sort of priestly class untainted by commerce, even when they work at institutions that regularly collect money from corporations in the form of research grants and advertising.

We trust our judgments to be uncorrupted by lucre — and we would be appalled if, say, a national commission to study the publishing industry were composed only of people who had never made any money in the business. (How dare those amateurs tell us how to run our profession!) But we insist that others avoid even “the appearance of impropriety.”

This snobbery was codified by The Journal of the American Medical Association in 2005, when it essentially required chaperones for any researchers receiving corporate money. Citing “concerns about misleading reporting of industry-sponsored research,” the journal refused to publish such work unless there was at least one author with no ties to the industry who would formally vouch for the data.

That policy was called “manifestly unfair” by BMJ (formerly The British Medical Journal), which criticized JAMA for creating a “hierarchy of purity among authors.” The hierarchy looked especially dubious after a team of academic researchers (not financed by industry) analyzed dozens of large-scale clinical trials in previous decades and reported that industry-sponsored ones met significantly higher standards than the nonindustry ones.

The new fetish for disclosing “conflicts” has led some of the best medical researchers to shun drug company money altogether — not because they think it leads to bad research, but because they are tired of that fact being highlighted every time they are identified in a news story, as if that were the most important thing to know about their work.

There are, of course, notorious cases of corporate money buying predetermined conclusions, like the reports once put out by the Tobacco Institute to rebut concerns about smoking and cancer. But there has also been dubious work promoted by government agencies and foundations eager to generate publicity and advance their own agendas.

It’s naïve to caricature scientific disputes as battles between “industry” and the “public interest,” as if bureaucrats and activists didn’t have their own selfish interests (and wealthy, powerful allies like trial lawyers). Too often, corporate conflict-of-interest accusations have been used as smear tactics to silence scientists who ended up being correct. (Go to nytimes.com/tierneylab for examples.)

Instead of stigmatizing certain kinds of research grants, perhaps we should consider the bigger picture. If scientists listed all their public and private donors on their Web pages, journalists could simply link to that page and let readers decide which ones are potentially corrupting. Instead of following rigid rules to report “conflicts,” journalists could use their judgment and report only the ones that seem relevant.

Sometimes you can’t understand a debate or a controversy without knowing who is paying whom.

But in general, I’m with Dr. Pachauri: follow the science, not the money.

Posted by Relative Risk at 12:33 0 comments Links to this post

Labels: Blumenthal, IDSA

07 January 2010

What the Senate needs: another timid bore

Blumenthal, At Long Last, Leaving His Comfort ZoneCourant.ComConnecticut Attorney General Richard Blumenthal could be viewed as one of the state's greatest cases of untapped political potential, held back by his own caution in a job that's become too comfortable — like the perennial minor-league MVP who never tried to crack the majors.It's not as if 19 years in the attorney general's office is the minor leagues. But for a politician with Blumenthal's resume and ability — Harvard magna cum laude, clerk to a U.S. Supreme Court justice, one of the youngest U.S. attorneys to head a federal prosecutor's office in any state — two decades seem too long to remain in what's often seen as a waiting room for the political heights such as governor or U.S. senator.Well, the waiting is over.

[snip]

The speed with which Blumenthal jumped to declare his Senate bid contrasted with past, protracted flirtations with a gubernatorial campaign, and also with following up on a Clinton administration feeler to install him as a 2nd Circuit U.S. Court of Appeals judge.

The answer was always "no," and then he went back to his televised life as the crusading people's lawyer.

So why, on Wednesday, was the answer suddenly "yes"?

He responded in his usual carefully chosen words....

Blumenthal has rarely reacted to an undercurrent of criticism that he has lacked the fortitude for electoral risks. But when asked about it Wednesday, he talked at length.

[snip]

Even on the phone, Blumenthal speaks with such deliberation that it's easy for a reporter to keep up with him, word-for-word, while taking notes on a computer keyboard. His thoughts always seems to come out in finished paragraphs.

Blumenthal has relentlessly crusaded on TV for citizens' causes against Big Tobacco or some other "special interest." His steady TV presence led former Gov. John G. Rowland to say "never get between a camera and Dick Blumenthal."

[snip]

Blumenthal has "a lot of advantages but he hasn't really been tested," said Howard Reiter, a political science professor at the University of Connecticut.

Republicans…began criticizing him as a worn Democratic shoe that will tread the path of excessive federal spending and control.

Christopher Healy, Republican state chairman, [said] "He's never had to explain a policy or position, never had to take a real stand, never had to face the questions of the media beyond the details of a lawsuit that may or may not ever pan out."

Healy said Blumenthal has spent nearly 20 years taking "an extreme adversarial role against some of the most dynamic industries" in the country, costing jobs and increasing the costs of doing business.

He said news stories critical of Blumenthal are likely to resurface — on issues such as the lucrative fees his former law associates made from his legal action against the tobacco industry.

"The curtain's going to be lifted on his 20 years of terror," Healy said.

[I’m looking forward to the show.]

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Labels: Blumenthal

30 September 2009

Propaganda still generates heat but no light.

Maybe that was the point.

Mon, Sep. 28, 2009

New documentary follows the heated medical debate over Lyme disease

Philadelphia Daily News

AS ANY Lyme disease sufferer can tell you, stress makes the symptoms worse. This is a problem, because a Lyme diagnosis will send you straight to the Internet for research, and there's nothing more stressful than reading about Lyme on the Net.

Online, you will find the kind of angry debate over disputed science that, in our combative age, dominates discourse among patient advocates and factions of the medical establishment. The most basic questions inspire the deepest disagreement.

Can your Lyme become a chronic disease? Might you need more than one course of antibiotics?

You seek out the big brains, but they are split. One Ivy League institution says no, another says yes. The International Lyme and Associated Disease Society says yes, the Infectious Disease Society of America says no. In fact, the IDSA says "Hell no," although it may completely change its mind later this year, as did the Mayo Clinic. What's a patient to do?

Really? And which Ivy League schools might those be? As for the Mayo, I just checked the website and they’re still providing evidence-based information. As for ILADS, it’s a bunch of quacks and crooks masquerading as a legit medical society. Most of ILADS officers have been in some kind of legal or professional trouble, none have any expertise in infectious diseases or clinical research, and their headquarters is a mail drop in Bethesda, Maryland.

[snip]

On the other hand, there are those who say there is no hard-to-treat form of Lyme. The IDSA says hard science - double-blinded, placebo-controlled studies in humans - does not support the idea that viable Lyme bacteria can beat a routine course of antibiotics. And it's the IDSA that publishes guidelines most physicians follow. Those who do not can be targeted by medical licensing boards, which is what happens to one physician featured in "Skin," allegedly for treating patients who did not have the disease.

A big bone of contention in the Lyme debate, as "Skin" shows, is the way groups like IDSA's Lyme panel are composed. Many of the expert panelists are expert because they hold patents on Lyme tests or treatments - creating, detractors say, obvious conflicts of interest.

No, they’re experts because they teach, do research, see patients, and publish. If you ask the PTO they’ll tell you the vast majority of filed patents never yield the patent holders a dime. Besides, it’s not the patent; it’s the clinical lab doing the tests that makes the money. Just ask the ILADS quacks why they all use the same California lab for their Lyme tests.

So thought Connecticut Attorney General Richard Blumenthal, who sued the IDSA, as noted in the film. "Under Our Skin" was completed before the settlement, one that disbanded the old IDSA Lyme board and directed it to re-form without doctors with financial ties to Lyme-related companies. The new board heard testimony from ILADS and others, to be considered before new guidelines are issued later this year. Patient advocates are hopeful the guidelines will be liberalized. But not optimistic.

That’s not going to happen. Politicians like Blumenthal have been trying for centuries to recreate the world in their own imaginations. They keep failing.

[snip]

Patient advocates say there is a great deal at stake, [yeah, income for ILADS’ private practice quacks] since Lyme specialists in the ILADS camp want the latitude to extend antibiotic treatment in ways they believe are essential to preventing later-stage problems, which can be severe [and to bill insurance companies for unnecessary, but expensive treatments].

The screening of "Under Our Skin" will be followed by a Q&A with panelists, including Chester County Lyme physician Anne Corson, who does not mince words when it comes to the current IDSA guidelines.

"The IDSA guidelines are useless," said Corson, a plainspoken woman who says she prefers to treat patients until they get better. "They've been the focus of a tremendous amount of criticism by the ILADS. We've presented reams of scientific proof of our viewpoint, supporting the guidelines we use in treating these ailments.

Corson has no research background or training in infectious diseases. If there was any rational, demonstrable basis to the ILADS guidelines for treating “chronic” Lyme patients there won’t be any ‘chronic” Lyme patients and therefore there would not be a controversy. Yet, the controversy remains because quacks like Corson want to keep pumping antibiotics into people until they’re out of cash to pay for them, they develop a complication from the antibiotics, or the patient decides on his or her own that they’ve had enough attention and move on to some other phobia or aliment.

"For me, working in the trenches, taking care of sick people in Southeast Pennsylvania, which is the epicenter of this disease, [Did the epicenter shift; I thought it was Ct and NY?] I use the ILADS guidelines. The IDSA does not help people with the acute and chronic stage of the disease."

The IDSA argues there is still no ironclad study in human Lyme patients proving post-antibiotic viability of Lyme bacteria, and points out that any long-term antibiotic treatment can be dangerous.

ILADS counters that there are studies that show it persists in other mammals [right, let‘s model human therapy after that of lab work on rodents, lizards, and birds], and cites scientists on the frontier of microbiology are learning that the Lyme microbe is an unusually tough little bug.

[snip]

Yes, all successful pathogens are actually “tough little bugs.” Check out Strep pyogenes or Staph aureus sometime.

"Skin" documentarian Andy Abrahams Wilson has talked with Lyme physicians who believe that different symptoms in different areas of the country reflect different strains of infection.

Nice theory. Might even be true. But right now where’s the proof and what‘s the point? The bug is still susceptibility to common antibiotics.

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Posted by Relative Risk at 01:44 0 comments Links to this post

Labels: Blumenthal, Film, IDSA

10 August 2009

Alternative History

So Lorraine Johnson has published the secret history of the IDSA guidelines investigation. Unfortunately, it reads less like honest history and more like a self-serving pat on the back.

First off, she refers to the “historic” review of the guidelines. There’s nothing historic about this kind of action. Bush, Cheney and their underlings were suppressing and rewriting science throughout much of the 2001-2008 period. Just ask the Union for Concerned Scientists. The only thing new about this particular assault on evidence-based medicine and peer-reviewed science was that it was carried out by a Democratic state attorney general and some middle-aged ladies from California and New Jersey.

As for the history of the anti-trust efforts, well, lawyer Johnson may be a bad lawyer, but I doubt Richard Wolfram is. He must have known that had Lorraine and company filed an anti-trust suit on their own—and as far as I know any two-bit lawyer can—it would have been immediately tossed in the trash. Why? Because since 1996, the FTC and the Justice Department have concluded that treatment guidelines issued by medical societies don’t limit competition (F2d 397, 7th Cir 1989). That would have been the end of it. And a quiet end.

But if they could find some government official or attorney general to launch an “investigation,” well, that would create news, buzz, public confusion, media interest, etc. And they had one: Richard Blumenthal—not a guy with “vision and Intestinal fortitude” as Lorraine suggests, but rather a megalomaniac and TV-camera addict who already had an unhealthy obsession with Lyme disease. He already had spent public money on his obsession so what was a little more CT taxpayer money to “investigate” a VA-based medical society in support of the delusions of a few people from CA and NJ?

No, I don’t think the real purpose of the “suit” or “investigation” or whatever you want to call it was to bring the IDSA into court—that was clearly impossible. Rather it was to generate noise. Make a big public demonstration. Embarrass the IDSA. Maybe embarrass some of the authors of the guidelines. Keep “chronic” Lyme disease in the news. Keep the public and the press confused. Undermine the credibility of the IDSA while boosting the credibility of ILADS and the other activists groups. And maybe if they made enough noise some congressmen would hear and start writing legislation or holding hearings.

No, this was never a legal strategy. It was a PR strategy. And to some degree, I think it worked. Lorraine confesses as much when she writes, “…we have grown enormously as a community….”

They must have raked in a lot of money too. Lawyers—even bad ones—aren’t cheap, and Lorraine notes that the “legal costs were borne by CALDA, Time for Lyme and the national Lyme Disease Association.” I hope they’ll post on their websites how much donor money they spent on this one-ring circus.

Finally, Lorraine suggests the activists uncovered “previously suppressed information” about chronic Lyme disease. Well, it couldn’t have been too suppressed if they managed to find 1300 pages of peer-reviewed literature. How hard is it to go to the library or log onto PubMed? Much of this “suppressed” information has been regurgitated by ILADS and CALDA before, and much of it has nothing to do with human disease or treatment of human infections. I’m familiar with the Lyme and borreliosis literature too, and most of it has nothing to do with human beings. Lorraine, et al. could have dumped 13,000 pages in the panel’s laps and it would not have made any difference. Irrelevant is irrelevant, no matter how much of it there is.

There’s some irony here. Well, actually, a lot of irony. The activists like Lorraine regularly accuse IDSA of ignoring vast amounts of relevant literature, but then they do exactly the same thing. I’ve never once heard an activist acknowledge the likely role of psychiatric co-morbidity in many cases of chronic Lyme disease, or the all too common phenomenon of “medically unexplained syndromes” or the secondary pharmacological properties of many antibiotics or the large number of people who contract Lyme, get treated and go on about their lives, or the 10% of people who contract Lyme, never know it, and go on about their lives.

But this bias is not unique to Lyme activists. It’s fairly standard behavior among the anti-vaccine groups too. And the homeopaths, and other alternative medicine, and alternative science groups.

In the end, they’re all like the Pope Urban VIII who refused to look through Galileo’s telescope because he didn’t want belief threatened by reality. Instead, he tried a couple of legal maneuvers on Galileo. It didn’t work….but people are still talking about it.

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Posted by Relative Risk at 11:18 0 comments Links to this post

Labels: Blumenthal, IDSA, Lyme disease

06 August 2009

Lies ad infinitum

Lies told often enough often come to be believe--just ask any Republican--so it’s worth taking the time to knock them down. That said, here’s yet another refutation to Blumenthal’s oft-repeated lies about the IDSA treatment guidelines for Lyme disease.

Blumenthal Off Base Criticizing Lyme Guidelines

8/3/2009

The Day

By Anne Gershon

We could not disagree more with the inaccurate statements made by

Connecticut Attorney General Richard Blumenthal in his opinion piece

on our Lyme disease guidelines (”Conflicts of interest in treatment

guidelines,” July 19).

The physicians and scientists who wrote the Infectious Disease Society

of America's (ISDA) guidelines thoroughly reviewed all the medical

evidence and took great care to address the claims made by the small

minority of physicians who advocate long-term antibiotic use. Their

conclusion, based on several peer-reviewed studies, was that long-term

antibiotics are unnecessary and potentially harmful.

The notion that the authors had financial conflicts of interest is

absurd to anyone who has read the guidelines, which recommend generic

tests and a short course of generic drugs. If the authors were seeking

to profit financially, it would have made more sense for them to

recommend a lengthy course of treatment and a broader definition of

the disease.

Ironically, Mr. Blumenthal and those who criticize IDSA guidelines

would increase profits for pharmaceutical companies and revenues for

physicians who treat Lyme disease. Mr. Blumenthal's investigation of

IDSA ended without filing any legal complaint, and the agreement (not

a settlement) that he signed stipulated that IDSA guidelines remain in

place. The agreement called for a special review, which is currently

under way.

IDSA's signing the agreement was not, as he alleges, an admission of

guilt, but an effort to end a fruitless investigation that was costing

our organization (and presumably Connecticut taxpayers) thousands of

dollars. We hope the review will put to rest the tired old allegations

and put the focus where it belongs: making sure that people with Lyme

disease get treatment that is safe, effective, and supported by sound

medical evidence.

Editor's note: The writer, a physician, is president of the Infectious

Diseases Society of America.

Posted by Relative Risk at 11:33 0 comments Links to this post

Labels: Blumenthal, Lyme disease, Politics

03 August 2009

Blumenthal is Pleased?

Blumenthal pleased? Well, that was the whole point: Blum's megalomanical need to appear in the news on an hourly basis, and his obsession with Lyme disease. It's clear from his comments below that he still doesn't understand that "fairness" and other points of view are simply irrelevant to science. The only thing that matters is what can be consistently and independently demonstrated.

Blumenthal pleased with D.C. Lyme hearing

By Lisa

Chamoff

Hartford Courant

Posted: 07/30/2009

Connecticut's attorney general said he felt a hearing in Washington, D.C., on Thursday on Lyme disease treatment guidelines that he helped bring about was "unprecedented" and set a standard for transparency and fairness in crafting medical recommendations.

"It certainly aired diametrically different and sometimes conflicting views and highlighted the stark divide between various sides in the debate," said Attorney General Richard Blumenthal in a phone interview Thursday evening.

[snip]

While Blumenthal didn't attend the invitation-only hearings -- which included testimony from 18 presenters representing varying viewpoints on Lyme disease diagnosis and treatment -- an attorney from his staff was present, and Blumenthal viewed the proceedings through a live Webcast.

"There undoubtedly are individuals or groups who feel either one viewpoint or presenter should have been given more emphasis or time, but that kind of criticism is also healthy no matter who the critics are, because it means that they're watching or scrutinizing the process," Blumenthal said.

But again, an opinionated process is irrelevant to peer-reviewed science and evidence-based medicine.

Lyme advocates hope the IDSA changes its guidelines to allow more liberal

treatment. Doctors who don't believe chronic Lyme disease exists say there simply is no scientific basis to allow it.

The new IDSA panel will now review whether the existing guidelines should be maintained, modified or entirely rewritten, and expects to complete its review by the end of the year.

"The panelists seemed to be listening very intently, asking probing and

perceptive questions, which augers well for the outcome," Blumenthal said.

[snip]

If by outcome Blumenthal means the guidelines are going to be changed by a politician and his fans, then he’s just as delusional as the chronic Lyme activists. I’m sure much of the strange, irrelevant, and anecdotal information submitted to the review panel by the public will only encourage them to retain the existing guidelines intact. Certainly, Carol Baker’s statement doesn’t suggest that anything the panel heard was going to warrant much attention.

Posted by Relative Risk at 09:34 0 comments Links to this post

Labels: Blumenthal, IDSA, LDA, Lyme disease

30 June 2009

The Light of Day

Some Connecticut Yankee sense published in the New London Day

Lyme Disease: Legislating Medical Treatment Is Seldom A Successful Approach

By Paul Choiniere

Published on 6/28/2009

Our June 17 editorial urging Gov. M. Jodi Rell not to sign a new law sanctioning the long-term use of antibiotics for the treatment of “chronic Lyme disease” generated an unusually large and critical response.

Perhaps it was the controversial topic, the provocative headline: “The Cure that Does Harm,” or the fact that those suffering from chronic Lyme disease have formed a tight Web-linked network, but for whatever reason the critical comments attached to the editorial and those flooding my e-mail and voice mail kept coming. A week after it ran, the editorial was the second most commented topic found on theday.com.

Last week Rell signed the bill into law.

Few times have politics and medicine clashed as in the case of so-called chronic Lyme. While in the vast majority of cases, prompt antibiotic treatment effectively treats Lyme disease, a small percentage of people report continuing pain - fatigue, sore joints, muscle aches and generalized discomfort.

Many of these sufferers insist that the long-term use of antibiotics eases their suffering. They were enraged when, in 2006, the Infectious Disease Society of America issued its guidelines for treating Lyme disease. The guidelines rejected long-term antibiotic treatment as not only useless, but dangerous.

”In more than 20 years there has not been one scientifically valid study published in the peer-reviewed medical literature that proves that the benefit of long-term antibiotic treatment outweighs the risk.

”Long-term antibiotic therapy for so-called chronic Lyme disease is not only unproven, it may in fact be dangerous. For instance, it may lead to complications related to delivery of the medicine, such as infections of the blood stream as a result of long-term intravenous administration of antibiotics. Also, use of certain antibiotics can lead to a potentially severe and sometimes deadly infection of the bowel caused by a type of bacteria called Clostridium difficile. Further, long-term antibiotic therapy may foster the development of drug-resistant superbugs that are difficult to treat,” states the medical society on its Web site.

Further infuriating chronic Lyme suffers, IDSA concluded there really is no chronic Lyme disease and the benefits of antibiotics may be imagined.

”Although some people may feel better, it doesn't prove that the antibiotic cured or suppressed infection. Sometimes, the belief that a treatment is helping can be enough to make people feel better,” states the IDSA.

Supporters of such treatment call the guidelines' conclusions nonsense. For that perspective, read the adjacent commentary submitted by members of the Lyme Disease Association.

I don't know who is right, I'm not a doctor, but neither are most of the lawmakers in Hartford, nor the governor. This is a matter best settled by the medical community. The state should not be inserting itself into the matter by sanctioning a treatment that remains controversial.

Attorney General Richard Blumenthal also inserted himself into the issue when he launched an investigation two years ago into the IDSA, suggesting the experts who shaped its Lyme disease guidelines had “undisclosed financial interests” in insurance companies, diagnostic testing firms and drug corporations that could have influenced their conclusions. The association flatly denies the allegation.

In May 2008 the IDSA called the attorney general's bluff when it agreed to have its guidelines reviewed by an independent panel. The IDSA and the attorney general agreed that medical ethicist Dr. Howard Brody, author of “Hooked: Ethics, the Medical Profession, and the Pharmaceutical Industry,” would screen every potential panelist for potential conflicts of interest.

Dr. Carol J. Baker, an infectious disease specialist and pediatrician with Texas Children's Hospital in Houston, is chairing the nine-member panel. The panel has accepted arguments and documents from those on both sides of the controversy. On July 30 it will conduct a day-long public hearing in Washington. Eighteen experts, representing a wide variety of views, will give presentations.

The conclusions this independent panel reaches should be fascinating, and certainly far more medically informed than those reached by a bunch of politicians in Hartford. It makes no sense that the legislature and governor did not wait to see the review results before acting.

Will the panel's impartial assessment settle the debate about the treatment of “chronic Lyme?”

Probably not.

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Posted by Relative Risk at 18:03 0 comments Links to this post

Labels: Blumenthal, Lyme disease, Politics

18 June 2009

A 'Cure' That Does Harm

The New London Day An Editorial.

Published on 6/17/2009

Most people diagnosed with Lyme disease are completely cured after less than a couple weeks of antibiotics, but those who complain of lingering symptoms ranging from aches and fatigue to memory loss sometimes are prescribed a lengthier but controversial regimen to treat the tick-borne illness.

State legislation that would in effect allow physicians to administer long-term antibiotics to patients they've diagnosed with chronic Lyme disease was approved by the General Assembly in early June and now awaits Gov. M. Jodi Rell's signature.

While we sympathize with those who put their faith in such treatment, there not only is scant medical research to support its efficacy but there is ample evidence that overuse of antibiotics is a dangerous practice because it makes the drugs less effective against bacterial diseases and infections.

Therefore we urge Gov. Rell to veto or delay signing the measure, and encourage legislators and doctors to come up with a better strategy for dealing with an emotionally charged medical challenge.

In an attempt to reconcile sharp differences in the medical community about Lyme disease treatment, the bill did manage to gain the support of some warring factions. The measure does not actually suggest that long-term antibiotics should be used to treat chronic Lyme disease, but it would protect doctors who prescribed such a regimen from state sanctions. In our view such penalties should remain in place.

Before deciding whether to sign the bill the governor should at least wait until July 30, when the Infectious Disease Society of America holds hearings on the issue. The organization has in the past advised doctors against chronic Lyme disease diagnosis and treatment, suggesting that symptoms may be due in fact to other factors such as an autoimmune disorder. But now, under pressure, it is considering revising its guidelines.

Some of that pressure has come from Connecticut Attorney General Richard Blumenthal, who has challenged the society's findings and negotiated an agreement that calls for an outside arbiter to help draw up new guidelines. Mr. Blumenthal, who supports the state bill, contends that the guidelines unfairly limit doctors and favor insurance companies that restrict coverage for various Lyme disease treatments.

While we agree that doctors should be free to make diagnoses, they should not be authorized to administer unproven treatments that put their patients and the rest of society at risk.

At the same time, in this region that has the ill fortune to be considered the birthplace and epicenter of Lyme disease, we must recognize that many who contracted the affliction believe they suffer long-term consequences. More research is needed to provide them with better diagnoses and more effective treatment of their maladies.

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Posted by Relative Risk at 15:28 0 comments Links to this post

Labels: Blumenthal, Lyme disease, Politics

30 May 2009

Who's the Gov: Rell or Blumenthal?

Senate OKs long-term antibiotics for Lyme Disease

The Associated Press

Updated: 05/29/2009

HARTFORD--Licensed physicians, under a bill that has passed the Connecticut General Assembly, will be allowed to prescribe and administer long-term antibiotics to patients with Lyme Disease.

The bill also prohibits state health officials from taking disciplinary action against a physician that prescribes or administers the antibiotics.

Sen. Scott Frantz, a Republican from Greenwich, says he understands there is controversy within the medical community over the practice. But he says anyone who has been afflicted with the tick-borne disease, should have the ability to receive long-term antibiotic treatment.

Sen. Jonathan Harris, the co-chair of the Public Health Committee, says the bill provides "a safe harbor" to physicians who want to use the therapy.

It passed the Senate unanimously and now awaits Gov. M. Jodi Rell's signature.

Aside from encouraging some quacks to move to Connecticut, I'm not sure this bill is what Blumenthal and his activist friends are hoping for. Doctors certainly can still be disciplined for inappropriate medical practices or indicted for crimes. Patients are still going to have to pay out-of-pocket for invasive, expensive, and ultimately useless i.v. antibiotics. And a physician's diagnosis is still going to have to be one "recognized by the federal Centers for Disease Control and Prevention (CDC) as a cause of Lyme disease."

Of course, the governor may not sign the bill. She still wants to run in 2010.

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Posted by Relative Risk at 15:35 0 comments Links to this post

Labels: Blumenthal, Lyme disease, Politics

13 May 2009

Sound and Fury becomes the Fast and the Furious