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I am expecting a final delivery plan by March. I doubt there will be any substance to it though. During the consultation process there was no recognition of any need for any change in approach to care.

Two or three studies have been through peer review at the grant stage and at least one has recently been approved. That is about all I am allowed to say. I like the idea of doing proteomics on specific pathways. I have been a bit sceptical about proteomics as a fishing exercise but I can see...

There seems to be no plan for a physician led service. It refers to Admitting Consultant (will depend on reason for admission/ward identified for potential admission) The assumption seems to be that admissions will not be related to ME/CFS itself or require a physician with special...

Yes.

Can anyone help me grasp exactly what points Chris Snell is trying to make? Is the suggestion that we should invent a 'disease' even if we don't know what it is, in order to satisfy the injustice of insurance based health care systems? I don't know about 'knowing the history' but judging by...

So FND is quite uncommon at about one person in 1000, which is fairly credible for movement disorders without a structural explanation. It tends to suggest that claims of flooding of neurology clinics are inflated.

It doesn't seem say any more than the NICE Guideline - try and reduce noise etc. There is no mention of how to manage nutritional failure as far as I can see.

When I read the ECT literature in detail at the time my wife received it, it was full of analysis of negative effects as well as benefits. ECT is not without problems but all this other stuff seems tome irrelevant. ECT is a physical treatment to the brain for physical disease, just as...

Yes, that was my point. Having experience of severe ME/CFS maybe isn't really what Lucibee was looking for in that tweet. What is needed is insight into the reality. How they see things in UCL paediatrics now should be part of discussion when I present a Divisional Seminar in January.

Off label prescribing on the NHS is fairly common for less common illnesses, especially for 'secondary problems'. Thus patients with systemic lupus are often treated with drugs that do not have a specific license for use in lupus. But I think it must be quite unusual for NICE to endorse usage...

Just as important, yes.

The argument was dependent on a whole lot of other things I had written which do to as far as I can see apply to that list!

But it was the women who rated the pain lower?

But all those are emotive arguments based on the assumption that ECT would be used under section and that somehow it is a 'psychiatric' treatment. All disease is physical. ECT is a physical treatment, just like brain surgery for incurable epilepsy, which can restore people to normal lives. My...

In almost all situations where we devise successful therapies there are major unknowns. When I studied B cell depletion in rheumatoid there were many things I could not access. But the risk seemed justifiable and hundreds of thousands of people have benefited. I don't see ECT as any different...

If ME/CFS is indeed neurological disorder, which lots of people claim, and we cannot find any structural or biochemical abnormalities then faulty central nervous system plasticity comes to mind as a possible site the problem. That is pretty much what we think occurs in psychosis too, even if the...

Which, from my experience, often used to do the job! Or at least for ailing transistor radios. Some psychiatric science is bad but pretty much all the biomedical science around ME/CFS is bad too. When people are dying it is important not to tar everything with the same brush.

But ECT is no longer used in these situations because there was never any reliable evidence. The evidence for benefit in psychosis is clear. If people with ME/CFS are dying for reasons we do not understand then I do not see any good reason not to consider the possibility that ECT might help. We...

There is none, but for all we know it might work. If there was anecdotal evidence of benefit I see no reason not to consider a formal trial in very severe cases. Why is everyone shocked by ECT more than other things? It is a life saving treatment in the right setting.

Aren't these the modules headed up by David Strain that we have discussed?