Journal of IiME Volume 4 Issue 1 www.investinme.org An Effort to Influence Medical Textbook Writers (continued) illness as highly controversial. Results Descriptive Statistics Of the textbooks, 18.5% were classified as biopsychosocial, 6.7% were biological, and 7.6% were psychological, leaving the remaining 67.2% to fall into the exclusionary category. Editor Replies Only 12 editors replied of the 78 contacted, giving a total response rate of 15%. Of the twelve editors who replied to our letter, three were associated with biopsychosocial, two with psychological, one with a biological section, and six with the exclusion category. Five of the responding editors (42%) had positive remarks, stating that the information was helpful and would be included in new editions of texts. Of these five responses one was associated with a biopsychosocially oriented chapter and the remaining four were part of the exclusion category that did not contain enough material on CFS to categorize. Six editors (50%) were placed in the neutral category, stating that they appreciated the information but could not use it in their texts usually due to the nature of the text (e.g. neuroscience or physically manifested diseases.) Of these editors one had written a biopsychosocial chapter, one a biological chapter, two wrote psychological chapters and two did not contain enough material on CFS to categorize. Only one reply (8%) of the total responses was categorized as negative. The editor stated that CFS would not be included due to its controversial nature and unknown etiology. The negatively responding editor had previously omitted CFS from the text. Discussion While the majority of the responses from the editors were positive, it is of importance to note that only 12 editors replied of the 78 contacted, giving a total response rate of 15%. Of the twelve total editors who replied to the letter, three were associated with biopsychosocial chapters, two with psychological chapters, and one with a biological chapter. The remaining six editors who replied were associated with an exclusion chapter. Five of the responding editors (42%) had positive Invest in ME (Charity Nr. 1114035) remarks. The editor of Neuroscience wrote the following: “Thanks for this good suggestion and information. We will definitely include a section on CFS in the next edition of Neuroscience.” The editor of Harrison’s Textbook of Internal Medicine wrote: “As Harrison's Textbook of Internal Medicine is used by many, if not the majority of, medical schools throughout the U.S. during the students' internal medicine rotation, it would be very important to make sure that we get this textbook's CFS chapter right for its next edition…Harrison's will have a new author for the CFS chapter. I'll share your position paper with the new author as the chapter is prepared.” Further, the editor of Pathophysiology: the Biological Basis for Disease in Adults and Children wrote: “[We] decided to wait until more data was available. We are going to include CFS in the alterations of musculoskeletal chapter… We agree with you that CFS is a very important disease/disorder and thank you for including all of your information.” The editor of General and Systemic Pathology wrote: “Your comments will be helpful when we come to decide what to include in subsequent editions.” Another was concerned about textbook sales, and this editor of Essential Family Medicine: Fundamentals and Cases wrote: “If there is another edition of the textbook (sales of all books are down significantly), I will certainly include a case illustrating CFS. I agree that it needs to be addressed.” Six editors (50%) were positive but did not indicate they would use our material or other CFS sources in a revised text. The editor of Pathophysiology: Concepts of Altered Health States wrote: “I agree that the topic warrants coverage in texts used in the education of physicians. Hopefully, we will soon gain a better understanding of its pathogenesis and insights into more effective treatment methods.” The editor of The Handbook of Stress Medicine Page 15/56

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