Hi John
I accept you would get the message across better had I read all the Ebringer papers you sent. When this thread is finished I intend to do so. But if my questions were satisfied by reading his documents the same would not be true of others observing this discussion.
I spoke to a member of the AS rehab group tonight. He has been diagnosed AS for many years. He has previously been on NSAIDs but has stopped taking them and now takes no medication. He exercises a lot. He has not tried NSD /LSD, eats with no restrictions and remains convinced his symptoms are completely unaffected by food. His pain occurs periodically, he said 6 months or so, and he sees no connection whatsoever between this pain and what he eats. He is not opposed to those who support the use of a reduced starch diet. He simply does not see the need in his case.
Of course this is not a scientific study and there is a ‘subjective component’, but it is the type of story which has me, and I gather a lot of other people, wondering.
My 'concerns about filtering' were simply an interpretation of what Bilko wrote which was never challenged by anyone. "Often it is extremely difficult for a clinician to diagnose with the usual criteria, and some of the people in the group who do not respond to diet will have the wrong diagnosis." So did Ebringer include ALL the patients with 'the wrong diagnosis' in his studies?
Surely your approach is to use the results of a carefully controlled study group and apply them to another group with unknown and probably very varied controls.
Consider the range of competence of rheumatologists diagnosing patients with AS. If Ebringer is at the expert end, what is the quality at the other end of the range? Would Ebringer accept all patients from those doctors if some had 'the wrong diagnosis'.
Isn’t it a bit like one of the those competitions where you don’t have to choose the most beautiful but the one everyone else thinks is the most beautiful. For Ebringer’s studies to cover the full range of those diagnosed with AS today he would have to include the worst cases of mis-diagnosis by the most incompetent rheumatologist. Can you be sure he did? Because if he didn’t, the ones he left out could be the ones who don’t respond to diet. Perhaps the patient I spoke to tonight is one of them.
Wally
