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It is certainly nonsense in the sense that there has been no 'wider shift' to subjective measures. Subjective measures have been used all along and are critically important, but not enough. I was trying to find out who tweeted that. It shows a remarkable medical science illiteracy.

The article at the top is a commercial health site muddle. If you have blueness and coldness of more than hands and feet it is probably not Raynaud's. Raynaud's is a very specific problem relating to digital sympathetic nerves and is best identified by a yellowish-white phase, followed by...

I wonder what Michael Sharpe thinks the commentators have missed in the PACE paper? Maybe the truncated Y axis? Maybe the inappropriate comparator arms? Maybe the absence of any significant objective changes? Hard to say.

The subtitle to the article quoted by @Adam pwme was clearly an error, maybe by a subeditor. Tom said he would get it changed, although not seen that so far.

I guess Tom Chivers the journalist.

Well that seems to make clear what stakeholder really means, despite the woke gloss. It means money.

Well what about potato?

I don't understand this. If most of our food energy goes through the citric acid cycle I would guess that we make use of about 500 gram of oxaloacetate molecules a day. Yes, part of the molecule gets recycled but if there was a block to making oxaloacetate that needed topping up with...

It may be that Hammond realises that for people like him it is a better strategy to let the guideline be published and make use of all the loopholes to carry on the same rather than make a big hoo-hah that just brings all the issues to people's attention.

It just means that different people are shouting louder at RCP I think.

Was it sauté brain this time @Trish - you really should be careful of these moderators.

I think he was misunderstanding a response to his comment that the science was uncertain. He thought somebody was suggesting that the science of ME was sorted. What is sorted is the science of CBT and GET - they don't work. Edit: what hinterland said!

'with a huge range of causation' So Dr Hammond can now divine the cause of each patient's illness and base treatment on it? Goodness knows what the bit about diagnostic tests was about. He seemed to miss the point that there was certainty about treatments not having a useful effect.

Thanks for sending the whole Hammond piece. Yes, it is dreadful. Drivel dressed up as 'common sense'. This is just what is problematic - appearing to provide everything patients might want but in fact providing untested treatment that probably achieves nothing. At least he seems to agree that...

Is the rest problematic? It is if he wants a compromise to suit everyone. That is precisely what we need to avoid.

Yes, I agree. Having tried to look at the article it doesn't seem too bad except being wishy washy about let's all compromise if we have different views. I am banging on about the case by case thing because it looks like what might derail the whole business. Although, fortunately, it should have...

The science is quite certain Dr Hammond. PACE shows very clearly that CBT and GET either have no effect or such a small effect that they are not cost effective. Moreover, there is significant informal evidence of harm. But what I see of his piece otherwise looks OK -are there bad bits later?

Yes, but this case by case argument is becoming seriously pernicious. It allows clinicians to use whatever they like under the guise of 'choice'. Being sympathetic while at the same time making people worse for life is not what is needed. It is time that touchy-feely be-nice-to-patients...

Enough of those and you'd get a Norwegian guideline...

Therapists come under clinicians I think. Moreover, it would do no harm for BACME to include all clinicians. Therapist organisations are pretty much by definition professional self-help groups. What is needed is an organisation that is centred around learning rather than meal ticket. In...