Search results

But what would this 'systematic' be other than to systematically apply every relevant piece of reliable evidence we have about trials and make a rational inference? If there is a paper from 1987 showing, surprisingly, that what looks like a good method for measuring something is useless then...

But GRADE does not address the bias of the assessors. The permitted reasons for downgrading are applicable to just about anything if you want to. And it constrains downgrading, as Trish and Adrian say, so it is worse than useless in a sense. The only strictly systematic approach is to use the...

Yet GRADE specifically says it is not this. It says it is subjective, not objective - it needs interpretation. So when it comes to the bias bit it opts out!! So I don't think it is. GRADE does not even attempt to deal with bias in interpretation. And the pseudo arithmetic is not slightly, it...

At least NICE seemed to concede that they didn't get the competing interest issue right in 2007. They didn't seem to get it quite right this time but the final committee complement may have turned out to be politically advantageous. Conset to the guidelines was obtained even from those with...

But that is not the alternative. The alternative is to do things as carefully as practical. GRADE has two components. One is a set of rules about all the things that need to be taken in to account. That bit is fine and likely to be very useful as an aide memoire for competent people trawling...

There may be some of the underlying dislike of high tech medicine behind the EBM programme that is so prevalent in Cochrane. But the more basic relation may be the attraction for woolly minded 'scientists' to apply numbers to psychosocial issues where they do not belong. GRADE is based on very...

Standing back it may be important to realise just how easy it may be not to realise how muddled and self-serving the thinking of medical practitioners can be - even experts, maybe especially experts. The WHO has recently decreed that traditional Chinese medicine should be give the same respect...

This post has been copied and following posts moved from What we're not being told about ME - UnHerd (Tom Chivers) Standing back it may be important to realise just how easy it may be not to realise how muddled and self-serving the thinking of medical practitioners can be - even experts...

A lot of this is good. Some of the pharmacological recommendations are bad and unevidenced though. It would have been nice to hold this up as support for the NICE guideline but being full of pharmacological stuff that is uncritical does not help sell the sensible bits on non-pharmacological care.

Quite common - much more in women if not associated with specific autoimmunity.

I have told him about it.

This is a quote from Lynne Turner-Stokes. Which emphasises just how muddled everything, and Tom, is. GRADE is crap, just as Lynne says, but for quite different reasons - as I explained in my Rapid Response to her BMJ editorial (I think). So nothing arrogant here, just manipulative. We know...

But George M:)nbiot doesn't work that way.

But is it. I thought Chalder was doing this sort of thing thirty years ago.

He talked to several of us and we could have explained if he had asked. He even put this weird subtitle in suggesting that it was NICE that was responsible for the poor evidence. I don't think he really understands the big picture. Let's face it, if he was a serious investigative journalist he...

Tom Chivers seems to be remarkably naive. I could have explained to him all the stuff he complains about not knowing. I fear he likes to find a story and run it without actually getting to grips with the background.

My decorators always move the furniture. Usually they put it all in the middle of a room with dust sheets over. And that's two lots of decorators. I think you should be able to find someone who will although it might depend on where you are.

That would be Raynaud's then.

I read the overdiagnosis comment, together with the one about subjective measure as referring to the PACE trial having been marked down on these grounds - with the risk the this meant that a subgroup who really would benefit from CBT and GET might not get it because of the evidence rating.

But it is a myth, isn't it? We have been asking patients about pain and fatigue since trials began.