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December 8, 1993

The Overdiagnosis of Lyme Disease

Author Affiliations

East Hampton, NY

JAMA. 1993;270(22):2682. doi:10.1001/jama.1993.03510220038016

To the Editor.  —The article by Steere et al1 on the overdiagnosis of Lyme disease has caused a great deal of concern and anger among physicians and patients alike. Lyme disease is a clinical diagnosis,2 for it is the patients' histories and symptoms that are the criteria on which the diagnosis is made. This fact is discounted by the authors, as are the results of serologic tests done elsewhere. However, the authors obviously lend great weight to their own test, despite the well-documented awareness of the unreliability and variability of serologic test results.3 Indeed, there is no proof that their laboratory is any more accurate than the many others tested. Their own T-cell proliferative assay, used on some of their patients here, misses 55% of confirmed cases.4My experience in a practice that serves as a referral center for thousands of patients with chronic Lyme disease