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I think the general wording of the scale is of interest in that all the questions are really psychological questions - what you feel, what you need, what your problems are. The assumption is that 'fatigue' is a self-value judgment rather than a symptom as such. For arthritis we do not ask 'Do...

The content is not bad but I wonder who it is intended for? I am afraid that to me it has the air of the 'proclamation by clinical experts' that belongs to the 1970s. The statements about diagnosis do not seem to have any particular justification and I am not sure they could. The list of...

But in engineering do you have paradoxes? As for instance in the question: Where will you be after you have moved from there? Trial design tends to throw up just this sort of paradox.

I can see both sides of the argument here. But I tend to come down on the idea that there is no such thing as a perfect trial most of the time. Let us say we have an unblindable treatment. And our key outcome is subjective. How can there ever be a perfect trial of how well the treatment...

Another problem I see with this detailed specification of what is and what is not considered high risk of bias is that immediately researchers will be checking the list before they send off their manuscripts to make sure they are worded in exactly the right way to avoid the obstacles. We are...

Indeed

So, as Michiel points out, subjective bias comes under domain 4. But the examples given are very weird: When there are strong levels of belief in either beneficial or harmfuleffects of the intervention, it is more likely that the outcome was influenced by knowledge of the intervention received...

I find it very opaque but as far as I can see there is no reference to the issue of whether or not outcome measures are subjective? Bias in unblinded studies is not about deviation from anything but about a weighting to one of two options at any stage. A subjective outcome is one where there are...

It makes one wonder whether the people involved have ever done an experiment wanting to know the right answer (rather than the answer they wanted).

I also think it would be very easy superficially to confuse the two situations. If you have active vestibular problems it is exhausting trying to do anything and you feel dreadful for a while after - but only for a while until things have settled. It also makes sense to 'pace' just in the simple...

I think the person writing it may be confusing vestibular problems with ME. As we have discussed on various threads there are a number of health care professionals around who may be well intentioned but often provide patients with very garbled accounts of how different conditions are related...

That document looks pretty confused to me. I have suffered from vestibular problems. I had a protracted period of vertigo and now I have virtually no vestibular function so I just have to be careful I do not fall over. There is no vestibular function there to give me vertigo any more. I don't...

Remember that David won. And Adam does a quite good David impression.

It really is absurd that they should be saying this is allowed or so and so is allowed as if they were in a position to lay down rules when what matters is simply whether or not bias might have been slipped in. Changes to an analysis plan are only changes if the study has started and if a study...

I suspect this example has been dreamt up as a case where there would not be bias because the breakdown of a machine is not something you organise deliberately in order to stop collecting data. The problem is that it illustrates very clearly the naivety of anyone thinking this is bias free. If...

Maybe he had been listening to Dr W.

Neurasthenia had disappeared entirely from the UK medical vocabulary by 1970 judging by my training period.

Er, yes. Maybe it was the other way around?

So someone has pointed out that the corresponding author for this - presumably the head honcho - is an author on the SMILE trial. You could not make it up.

Just a small point on this. If I remember rightly from school biology salivary amylase works at alkaline pH (most pH) and takes about an hour to generate reasonable amounts of glucose from starch (when the iodine went purple). Food is normally in the mouth for about ten seconds and then hits a...