Re: Fibromyalgia, RCTs, and the selection of journal articles

In the May issue of the BCMJ (2004;46[4]:164) you have defended your decision to publish the article on acupuncture (“Treatment of fibromyalgia with acupuncture and counseling,” 2004;46[1]:21-23) in response to a letter to the editor from Dr Oppel (2004;46[4]:169,171).

As part of your defence, you point out that some medical conditions defy pathological categorization while still achieving recognition as disease processes with widely accepted diagnostic criteria. You further say that it is virtually impossible to study this disease without relying on subjectivity. What you have pointed out about fibromyalgia is true of many disorders that are studied using valid scientific methodology and is not unique to fibromyalgia. This is, for example, true of depression, anxiety, schizophrenia, pain, insomnia, eating disorders, and many more disorders in all areas of medicine. Not only is it possible to conduct randomized controlled trials on fibromyalgia, but there are in fact randomized controlled trials on various medications for fibromyalgia going on right now. It is quite possible to conduct scientific research on disorders without defined pathology.

You may still argue that your decision to publish an article has many components, as you have done, but please don’t defend it on the basis that randomized controlled trials are impossible.

—Paul R. Latimer, MD
Okanagan Clinical Trials

Paul R. Latimer, MD. Re: Fibromyalgia, RCTs, and the selection of journal articles. BCMJ, Vol. 46, No. 6, July, August, 2004, Page(s) 275 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

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