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Behavioral Decision Analysis and Pathogenicity: How Do We Decide What Makes Us Sick?

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Blastocystis: Pathogen or Passenger?

Part of the book series: Parasitology Research Monographs ((Parasitology Res. Monogr.,volume 4))

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Abstract

The previous chapter suggested ways to use statistics to understand conflicting study results and improve decision making, however, such approaches remain uncommon in the area of infectious diseases. This chapter examines the processes that are currently used to resolve controversies, and the criteria people use to judge pathogenicity. We examine methods by which a scientific controversy can be categorized and understood based on written statements by individuals involved. Existing published studies suggest that the idea of pathogenicity is strongly subjective, with significance variation from individual to individual. Considerations such as economic cost, perceived benefit, and conflict with religious and philosophical beliefs can influence researcher viewpoints. By understanding the particular interests and impacts such a decision makes on different interest groups, scientists can design studies and guide research efforts to avoid unproductive conflict with the medical community.

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Notes

  1. 1.

    Cultures axenicized by Dr. Zierdt are still available from the ATCC and were used to develop the first real-time PCR test, which was used in the first US study to demonstrate that patients with symptoms attributable to irritable bowel syndrome or Gulf War Illness were infected with Blastocystis, which had not been previously detected in those patients (Jones 2008, 2009).

  2. 2.

    The intention in filing the FOIA request was not to be disrespectful of the institution or its staff members. Rather, BRF noted that each US University-based research effort that we had worked to organized came to an end when it was determined that the NIH would not provide funding. At the same time, we saw groups emerging in Mexico, Europe, and Asia, many of which did receive national funding. Why was the NIH’s position different? What can we learn about the decision making process from the differences? We also felt that this was a legitimate public policy question, since this infection was present in 10–15 % of the US population, with about 70 % of mono-infections being symptomatic by some analyses (Amin 2002).

  3. 3.

    The logic was that physicians already recognized Blastocystis as a pathogen by their actions. The common practice, as communicated to me by interviews with multiple physicians and gastroenterologists, was to treat Blastocystis when it was found in symptomatic patients. That is, laboratories looked for the organism in stool samples, physicians diagnosed patients with blastocystosis, and treated the infection. We had detailed testimony from patients or their guardians who had been seen repeatedly by physicians associated with the major hospitals and clinics in the region, and had been diagnosed and treated for Blastocystis infection. All physicians and board certified gastroenterologists who we contacted in the area supported passage of the bill, and provided signed letters supporting it.

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  1. Blastocystis Research Foundation, 5060 SW Philomath Blvd, #202, Corvallis, OR, 97333, USA

    Kenneth Boorom

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  1. Department of Zoomorphology, Cell Biology and Parasitology,, Heinrich Heine University, Universitätsstr. 1, Düsseldorf, 40225, Germany

    Heinz Mehlhorn

  2. National University of Singapore, Singapore, Singapore

    Kevin S. W. Tan

  3. , Department of Biological Sciences, Nara Women's University, Kitauoya-Nishimachi, Kitauoya-Nishimachi, 630-8506, Nara, Japan

    Hisao Yoshikawa

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Boorom, K. (2012). Behavioral Decision Analysis and Pathogenicity: How Do We Decide What Makes Us Sick?. In: Mehlhorn, H., Tan, K., Yoshikawa, H. (eds) Blastocystis: Pathogen or Passenger?. Parasitology Research Monographs, vol 4. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32738-4_8

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