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I think things are much closer than they once were. As I see it the Cochrane exercise review can no longer be presented to the NICE committee as meaningful opinion. Whatever the technical status the editor in chief made it clear that he did not think it was of a standard consistent with...

Closer to home, however, it’s clear that however positive the latest headlines about IAPT may be, all is far from well. Levels of attrition among clients remain high, levels of staff burnout and low morale are at epidemic levels, and services seem to be haemorrhaging staff. I am tempted to say...

I don't buy those. I have been in this situation myself and I got on and did the research without the dollars, risking my reputation in the process. To base a service on unsubstantiated tests is laziness and is unethical. As simple as that.

Well you would be taking exactly the road I would take. I agree with all that post. I am not sure what more extreme road anyone is taking.

Interesting points, but thinking about it I am pretty sure the paternalistic approach is pervasive in 'biomedical medicine' too. My rheumatological colleagues would not tell patients much about drugs maybe not working or not actually producing recovery. Being positive is pervasive in medicine...

I sympathise with what you are saying. There probably are ways of doing research that will prove causal links, although they require a lot of work on developing methods. But the solution is in front of our noses. If it just accepted that the evidence base for exercise therapy is no good - and...

So why have the people doing this test not published some useful research so that we can include it in an evidence-based guideline. What we are left with is an anecdote and that is no use to anyone. The onus is on the people doing these tests to show they tell us something useful. Otherwise they...

The confusing thing is, @Sean, that your account is probably closer to the BPS account than the account of biomedical scientists and physicians (of a non-BPS type). There are 3 supposed views. 1. The BPS view that there are psychological or mental causes and these are different from biological...

I don't think that can be considered relevant. Treatment of rheumatoid arthritis or cancer frequently involves 3 months of time effort and money with no results. The difference is that adequate trials have shown that the chances of benefit are good enough to make that a reasonable risk.

I think it is important not to see all this is black and white (or White and Black maybe!). I have no doubt all sorts of people made suggestions last time but the decision was made by the committee. White was not in a position to 'get things changed'. I don't remember what it says about...

But the justification for the symptoms in the BPS model is that they arise from deconditioning secondary to the beliefs. If that were not so then there would be no need to do GET. A better approach would be a three day course of getting psyched up and standing on bits of paper - showing that...

A tilt table test does not prove orthostatic intolerance. Orthostatic intolerance is a symptom - it means 'not feeling well on standing up', nothing more than that. Postural orthostatic tachycardia is, in contrast a physiological response, but not necessarily one that causes OI. Some normal...

I am sorry that you feel aggrieved, Amy. However, the words above indicate clearly that you do not understand the basic requirements of valid biomedical science. None of the treatments you mention are of any value to anyone as far as we know from the evidence. This forum was set up to take a...

I will have to read the blog if I can summon the energy. But the second sentence is a non-sequitur. Dr Bateman stated that a third of ME/CFS patients are hypothyroid because their tests showed it. I presume this relates to a paper or at least a study that we saw about two years ago. Where...

It would be entirely a matter of whether or not those treating had been diligent enough in establishing that the treatment worked. You could ask was the treatment of rheumatoid arthritis with gold on the basis that it was an aberrant form of tuberculosis ethical. It was eventually, because a...

This is very true. However: If the evidence for the efficacy of GET is shown to be no good on general principles of method then it will be very difficult to replace GET with another treatment using the same known-to-be-flawed methods.

No, as JTJ says, this is the clever twist to BPS. There is no 'cause'. And that is a valid analysis; there is rarely a single 'cause' of anything. But they get away with the double speak that yes trauma is relevant but no it is not the whole story so CFS is not caused by emotion. This is why...

I don't think you can ever build an ethical argument on numbers like that. It is a matter of reasonable diligence in making the right diagnosis. It seems to me a red herring. What matters is whether GET is the wrong treatment for PWME. That revolves around harm to PWME. I am now pretty convinced...

It depends on what you mean by authoritative I think. If it just means 'eminent' then as you say, it is just an argument from authority which cuts no ice. If it means better informed and more cogent in interpreting the available evidence I am not very sure either. The IOM report as I remember...

I agree there are complexities to interpreting blood counts like this but I do not see what this has to do with a guideline on ME. People with established ME may develop vitamin and mineral problems but I don't think that is what the guideline is relating to - it is under the diagnostic section...