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Craig P. Cleveland, MD
Cincinnati, OH

JAMA. 1993;270(22):2682-2683.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—I was dismayed to read that Steere et al¹ ignored many of the basic principles of the practice of medicine as well as of good research. First, they ignored the accepted guidelines as published by the National Institutes of Health² that Lyme disease is a clinical diagnosis. Their insistence on eliminating cases that had not resulted in positive Lyme disease tests ignores this fact. Second, Luger and Krauss³ showed that the interlaboratory variation seen in their studies reinforced the concept that the diagnosis of Lyme disease must be made on a clinical basis. The inconsistencies were again shown by Bakken et al⁴ when they reviewed 45 laboratories. Why do Steere et al believe that their tests are better than any others? Is it in order to promote their own hypotheses?

Third, since there does not exist a test to demonstrate a "cure" in . . . [Full Text PDF of this Article]

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