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Yes, but I wonder who is involved. Who is providing 'training sessions' I wonder?

Our understanding is that GAM is finding a baseline of activities that doesn't make our symptoms worse and then gradually increase it. In other words, it's pacing instead of GET. However, let's wait for the publication of the new Guidelines to confirm this. That isn't pacing as I understand it...

Nobody even dared to raise the 'we know it works from clinical experience' hare. Paul Chrisp and Peter Barry had made it clear that NICE works with proper evidence. I think that shut them up.

I think Leng and maybe Chrisp do actually take that seriously. That was what the round table was for. I think GPs are going to know about this because it is newsworthy if nothing else.

It might require the full Sisyphus protocol.

I don't think it is as simple as that. The rehabilitationists have a significant interest of their own in this. They may not have been very aware of the ME debate until this year but they got interested in the spring after seeing the draft guidelines. My impression is that they realise that...

I very much agree with this sentiment. I think there is a major problem and indicate that in my testimony. I think the answer is yes, proponents of CBT can hide behind not so much a monolith as a putty ball that can be squashed into whatever shape desired. The answer is always that CBT is...

GRADE says that recommendations do not follow directly from evidence quality. The implication is that you have to use common sense to make the step. Which of course you do. The only value of GRADE is as a recipe for trawling studies by people who do not understand the detailed context and as a...

I am not sure there even is a drug. Judging by the description it could fall under foodstuffs and supplements laws. It seems to be a cocktail.

Inspiritol is comprised of both endogenously produced and naturally occurring, well tolerated biochemicals That would be urine mixed with parsnip juice?

EBM’s other problem is quality. A lot of the time the data in a paper simply do not match the conclusions yet the conclusions are what get cited. Not sure that is a problem for EBM though. NICE cited the data quality and ignored the conclusions. A bit like saying the problem with using rulers...

If no therapy could be offered without moderate to high certainty evidence, clinical practice would largely grind to a halt. Low and very low certainty evidence is still evidence, and can be used to make weak recommendations - in favor or against - a therapeutic option. This statement from...

Could well be. Ironically, the evidence based medicine at NICE systematically devalued randomised sort-of-controlled trials and took seriously the other kind of evidence - patients' lived experience. It seems that she is proclaiming loud and clear that she doesn't get it. She doesn't get the...

This statement is frankly mendacious: While some patients have been harmed by exercise programmes that were neither graded nor therapeutic, ten scientific trials of GET show it is effective and safe when properly prescribed and delivered. This statement is unsubstantiated. This statement is...

Charles Shepherd sent this for interest! Mail on Sunday – letters page October 24 Fatigue treatment is safe and effective Ethan Ennals asked last week in Health whether doctors or patients are right about the lack of effectiveness and safety of graded exercise therapy (GET) for chronic...

I would stop fretting about the guideline publication. There is no reason to think it won't come out next week.

At the moment, slim. And so do, I. Brian Hughes puts it very clearly. There is a long way to go. But trying to engage those who are intelligent enough to see what the guideline says, and why it says that, seems to me worthwhile

No it is down to health professionals. I was simply illustrating the fact that varying views on CBT cut across all groups of people involved. My point was. 1. Best not to mention CBT. 2. It seems that the health professionals on the committee could not bring themselves to do this - maybe it was...

Yes, I made it clear that I thought the continued use of CBT was unethical in my expert witness testimony to the NICE committee.

I am not aware of any suggestion that sympathetic activation normally induces cytokine release. And there isn't any cytokine release in ME as far as I know. So it doesn't seem to have much going for it.