http://www2.lymenet.org/domino/nl.nsf/0/b92eed8f70f4e839852565e2000aeab8?OpenDocument HEADLINE: STEERE TO INSURERS: USE CASE DEFINITION FOR DIAGNOSIS SOURCE: LymeNet News BYLINE: By Marc Gabriel In a recently published document written for insurance company medical directors, Dr. Allen Steere of Tufts University School of Medicine urges readers to use the CDC's Lyme disease National Surveillance Case Definition to diagnose patients. The CDC has repeatedly stated that this very restrictive definition should not be used for diagnosis. In a copy of the "Transactions of the American Academy of Insurance Medicine" (101st Annual Meeting) obtained exclusively for the LymeNet Newsletter by Contributing Editor Frank Demarest, Dr. Steere uses a table format to list the case definition criteria. The title of that table is: Lyme Disease National Surveillance Case Definitions Clinical Criteria for Diagnosis According to Kenneth Fordyce, Chairman of the New Jersey Governor's Lyme Disease Advisory Council, the CDC denies insurance companies misuse the case definition. He calls the CDC's attitude towards such abuses "non-benign neglect" and says he warned the CDC of such misuses in the past. The agency has apparently failed to take any action. In the article, Dr. Steere wastes no time to present his controversial assertions. In sentence number 4 of the 9 page document, he writes: "All stages of the infection may usually be treated successfully with 10- to 30- day course of oral or intravenous antibiotic therapy..." Dr. Steere apparently dismisses seronegativity, maintaining that positive serology is a requirement for diagnosis. He also spends a considerable amount of time discussing over-diagnosis, referring to his now thoroughly discredited over-diagnosis analysis. The 101st Annual Meeting of the American Academy of Insurance Medicine took place at the Westin Hotel at Copley Palace in Boston, MA, in September 1992. The "Transactions" were printed earlier this year by Klay Printing of Tampa, FL.