Association for Research Against Cancer (ARTAC), 57/59 rue de la Convention, 75015 Paris, France.
European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium.
Int J Mol Sci. 2021 Jul 7;22(14):7321. doi: 10.3390/ijms22147321.
Clinical research aiming at objectively identifying and characterizing diseases via clinical observations and biological and radiological findings is a critical initial research step when establishing objective diagnostic criteria and treatments. Failure to first define such diagnostic criteria may lead research on pathogenesis and etiology to serious confounding biases and erroneous medical interpretations. This is particularly the case for electrohypersensitivity (EHS) and more particularly for the so-called "provocation tests", which do not investigate the causal origin of EHS but rather the EHS-associated particular environmental intolerance state with hypersensitivity to man-made electromagnetic fields (EMF). However, because those tests depend on multiple EMF-associated physical and biological parameters and have been conducted in patients without having first defined EHS objectively and/or endpoints adequately, they cannot presently be considered to be valid pathogenesis research methodologies. Consequently, the negative results obtained by these tests do not preclude a role of EMF exposure as a symptomatic trigger in EHS patients. Moreover, there is no proof that EHS symptoms or EHS itself are caused by psychosomatic or nocebo effects. This international consensus report pleads for the acknowledgement of EHS as a distinct neuropathological disorder and for its inclusion in the WHO International Classification of Diseases.
临床研究旨在通过临床观察和生物及影像学发现客观地识别和描述疾病,这是建立客观诊断标准和治疗方法的关键初始研究步骤。如果未能首先定义这些诊断标准,可能会导致对发病机制和病因的研究产生严重的混淆性偏倚和错误的医学解释。这在电过敏(EHS)中尤其如此,对于所谓的“激发试验”更是如此,这些试验并没有研究 EHS 的因果起源,而是研究与 EHS 相关的特定环境不耐受状态,即对人为电磁场(EMF)过敏。然而,由于这些测试依赖于多个与 EMF 相关的物理和生物学参数,并且是在没有首先充分客观地定义 EHS 和/或终点的情况下在患者中进行的,因此目前不能将它们视为有效的发病机制研究方法。因此,这些测试得出的阴性结果并不能排除 EMF 暴露作为 EHS 患者症状触发因素的作用。此外,没有证据表明 EHS 症状或 EHS 本身是由身心或反安慰剂效应引起的。本国际共识报告呼吁承认 EHS 是一种独特的神经病理学疾病,并将其纳入世界卫生组织国际疾病分类。