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Yea consequence or cause? If it's consequence then presumably you need to understand what's upstream. If it's cause then it's more interesting; Chris Armstrong (from memory) put forward the theory (webinar 2015?) that gut dysbiosis was maintaining the disease state - bi-stability if you like...

I barely remember reading it but my impression was that it was way out of order. NICE is an independent body and its role is to analyse the evidence, which it has done, and prepare the guideline. NHS England should not be making these comments at this stage of the process (in fact I've a feeling...

I've participated in an anxiety & depression GWAS study run by Ulster University (Northern Ireland). Obviously that's an attempt to understand underlying (genetic) predisposition ---- and genetic traits that may protect? So yea anxiety seems to be poorly understood ---- the whole...

@Arnie Pye posted me a link to this* North Bristol NHS Trust - CFS/ME Service posted this re Professor Jonathan Edwards: "“Some exercise studies show objective changes in indices of fitness but that does not necessarily imply a reduction in illness or disability”, domains which are typically...

Haven't read the posts here but I assume you've noticed the response from "NHS ENGLAND & NHS IMPROVEMENT" to NICE* *"Paul, I have read the new guideline. To me, it reads very much like the previous guideline with little change in emphasis and doesn’t really address the key criticisms...

If they had done then their comments may have been minuted and the response (probably setting out that the comments made no sense) would also have been in the minutes. Possibly an FOI would have led to the disclosure of those statements ---- so best to say nothing that makes you look stupid...

Stop bragging everyone will be trying to get blocked --- badge of honour!

Interesting* @Nightsong I haven't followed this closely but NICE reviewed the evidence for CBT & GET, re ME/CFS, and found it to be "low" or "very low" quality; logically there should be a review of "other conditions including chronic pain and fibromyalgia" i.e. which rely on these...

I think Paul Chrisp has made the classic mistake of management --- he hasn't been involved in the development of the guideline so he should shut up and let the people who were (and who impressed a challenging audience) speak. Maybe there's a case for the management class to do the dark arts of...

I guessed they'd get the guideline out quickly but no I hadn't heard that.

That looks like a very good strategy but is there any indication that it will be published in the second week of November? I wouldn't be surprised if NICEs strategy is to publish it as soon as possible - let's face, it this has caused NICE enough hassle already! On the plus side, NICE appears...

Yea I've no problem believing that Psychiatry diagnosis can be changed; lets face it, there really is no understanding of the underlying cause, so it's sticking labels on the presentation. I vaguely recall a post where @Jonathan Edwards set out his experience as a young medical student -...

Yea Northern Ireland has no specialist service to the best of my knowledge. @Keela Too However, I'm hoping that the changes for the better in the UK will e.g. be picked up elsewhere (European Union is one example) @Michiel Tack

I'm surprised that an NHS clinic would not stick to the guidelines - OK strictly speaking the new guidelines haven't been adopted yet. Perhaps a route to challenge this would be for a charity to contact the health trust and ask if this is within the new guidelines? You might find that the...

Regarding "I assume also it is up to commissioning groups/bodies to specify compliance with guidelines when they are contracting for services." I assume that following the current guidelines is the only defensible option so it may not be necessary to spell it out; also the contract will probably...

I assume the trusts, who are responsible for delivering care, are responsible for implementing the guidelines. NHS England [English National Authority] has responsibility - i.e. as the Authority which commissions care via the trusts - and the body which oversees the NHS system in England - so I...

It was a (failed) attempt at humour - I recall her reaction at the News Night feature re Paul Garner --- I don't recall it +ve myself.

I noticed this on MEpedia. Guess what he worked at Liverpool School of Tropical Medicine --- where, you've guessed it, Paul Garner works --- @Trish might provide the link to the News Night interview but I'd caution against watching it. I see Alistair was "Principal Medical Adviser from...

Precisely.

What's worrying is that there may well be customers for the unproven products they are selling e.g. a purchasing/commissioning officer who listens to their sales pitch and doesn't research further----.