You are here

Responses

Article menu

Download PDFPDF

XML
Qualitative research
Research
Obstacles to diagnosis and treatment of Lyme disease in the USA: a qualitative study
Compose a Response to This Article
Compose Response

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

PLEASE NOTE:

  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • Published on: 6 July 2018
    Response to Peter Kemp

    Thank you for your letter and sharing the results of your work. We agree on the importance of accurate testing for Lyme disease. In our study, we required that participants have a positive IgG Western blot, a lab result only present at least six to eight weeks after infection, as we were interested in studying patients diagnosed in the later stages of disease. However, as we note in our paper, we recognize that this requirement excluded patients with false-negative laboratory results. Thank you for your comment.

    Conflict of Interest:
    None declared.
  • Published on: 25 June 2018
    Report of VIRAS Survey on Lyme Disease Testing Delay

    In the UK and other countries, a major obstacle to the treatment of Lyme Borreliosis is the requirement for positive serology tests. This requirement was incorporated in the recent NICE Guidelines for Lyme Disease (National Institute for Clinical and Care Excellence, NG95 for England and Wales: https://www.nice.org.uk/guidance/ng95).

    Although the authors of the guideline claim otherwise, the only concessions which the guideline makes to doctors who wish to treat without positive serology in the absence of a physician diagnosed Erythema Migrans rash, is that they may 'start treatment' whilst awaiting lab results, based on a "high clinical suspicion" - although what form this might take they omit to explain. Neither do they explain what to do when the awaited lab results come back.

    Therefore, with up to 75% of cases requiring positive serology to support a diagnosis and treatment, test accuracy is a critical factor in determining who gets treated and who does not, for a potentially injurious infection which all authorities agree, requires prompt diagnosis and treatment.

    In January 2018, VIRAS conducted a survey to investigate the reasons and extent of delays before people are tested for Lyme disease. The survey was publicised in Facebook support and campaign groups for Lyme patients and collected 330 responses.

    Key points from the survey:

    • 78% of respondents indicate...

    Show More
    Conflict of Interest:
    None declared.