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A lot of people in this field, like Dr Scheibenbogen, have looked at adrenergic and muscarinic cholinergic antibodies in parallel. People coming from the POTS side may just do adrenergic. I went over Dr Scheibenbogen’s data with her before a prepublication presentation to IiME a while back. My...

The study I remember was from a group in Copenhagen. T4 levels and autoantodies reduced with rituximab. But the focus has been on ophthalmopathy because it does not respond to radioiodine or thyroid surgery. Thyroid surgery is far preferable to rituximab. It produces a lon term solution, the...

As far as I am concerned knowledge and expertise of clinicians that is not based on hard research evidence is worthless. It is as simple as that. Medicine has moved on from ‘clinical judgment’. Doctors who do not recognise this are stuck in the 1970s. Unfortunately there is popular political...

The abstract does not even say which cells the methylation was in. I doubt they checked brain cells.

Mental gymnastics might be regarded as Dualist?

A randomised double blind controlled trial would certainly be possible and you would not need objective end points if blinded. I just think that better evidence for a link to autoantibodies is needed before exposin* people to the risks. It is possible that there are different antibodies in ME...

The paper I have seen using that assay looks difficult to interpret. A bioassay of a human antibody using another species has a lot of potential problems. And that is particularly so for individual case findings. I think a standard binding assay is easier to interpret. I still don’t see why...

Dear @Badpack You make some valid points but there are a couple of things I would add. Pretty much all effective soluble antibody is made by plasma cells, none of which have CD20. I was aware of that when we introduced rituximab for autoimmune disease. The rationale for rituximab is actually...

I doubt it is worth speculating much about these antibodies. The differences in levels between controls and disease cohorts are not big enough to suggest a role in disease mechanism. When autoantibodies cause disease the differences are much more stark.

Precisely. It is non sequitur and deliberately so.

I am not sure the new tool is any clearer on general risk of bias. It is actually wrong where the original tool assumed people new how bias works. The general risk of bias is always worse than the worst specific risk. Any reasonably intelligent person knows that. If bad weather includes rain...

I doubt Gary’s post cancer fatigue would have ever got to Knoop or been considered for psychotherapy. Major thoracic surgery leaves people in catabolic state for months - as he says a purely physiological reaction to tissue trauma. The people Knoop treats appear to be in a different category...

Because there is a new breed of professionals only interested in personal and political gain rather than the right answer. And they are now in charge of quality control for Cochrane etc. it seems.

I think the Wikipedia account is valid. The paper gives what people who do pragmatic trials want to claim they can do - which simply indicates they donor understand what they are doing. The pragmatic people have got this meme that these trials are in contrast to explanatory trials. Wrong. An...

A pragmatic trial does not even tell you if it works - that is the definition of a pragmatic trial - it cannot tell you that. Goodness knows what use it is.

Excellent, more sense than I can!!

Yes, I think it is all politics. The BMJ is doing a jolly good job keeping people well by supporting the cost cutting agendas advocate by both parties (or all six) because it reduces taxes.

My impression is that post viral fatigue is quite well documented as a causal relation - bye things like the decay curve for fatigue in the Dubbo study. What I see as more problematic here is that if you have a specialist unit set up to take referrals for 'post-cancer fatigue' they will get...

So maybe they have ME? Or maybe they have prolonged fatigue of another sort that can be triggered by lots of things. The authors here treat the problem as 'post-cancer fatigue' because they think it is all about the psychological state of having had cancer. Is this a real category? Does anybody...

I had a look on PubMed and it seems that Lipkin and Hornig have not published their big viral screen. They presented the findings sometime around 20114 I think.