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He talked to several of us and we could have explained if he had asked. He even put this weird subtitle in suggesting that it was NICE that was responsible for the poor evidence. I don't think he really understands the big picture. Let's face it, if he was a serious investigative journalist he...

Tom Chivers seems to be remarkably naive. I could have explained to him all the stuff he complains about not knowing. I fear he likes to find a story and run it without actually getting to grips with the background.

My decorators always move the furniture. Usually they put it all in the middle of a room with dust sheets over. And that's two lots of decorators. I think you should be able to find someone who will although it might depend on where you are.

That would be Raynaud's then.

I read the overdiagnosis comment, together with the one about subjective measure as referring to the PACE trial having been marked down on these grounds - with the risk the this meant that a subgroup who really would benefit from CBT and GET might not get it because of the evidence rating.

But it is a myth, isn't it? We have been asking patients about pain and fatigue since trials began.

It is certainly nonsense in the sense that there has been no 'wider shift' to subjective measures. Subjective measures have been used all along and are critically important, but not enough. I was trying to find out who tweeted that. It shows a remarkable medical science illiteracy.

The article at the top is a commercial health site muddle. If you have blueness and coldness of more than hands and feet it is probably not Raynaud's. Raynaud's is a very specific problem relating to digital sympathetic nerves and is best identified by a yellowish-white phase, followed by...

I wonder what Michael Sharpe thinks the commentators have missed in the PACE paper? Maybe the truncated Y axis? Maybe the inappropriate comparator arms? Maybe the absence of any significant objective changes? Hard to say.

The subtitle to the article quoted by @Adam pwme was clearly an error, maybe by a subeditor. Tom said he would get it changed, although not seen that so far.

I guess Tom Chivers the journalist.

Well that seems to make clear what stakeholder really means, despite the woke gloss. It means money.

Well what about potato?

I don't understand this. If most of our food energy goes through the citric acid cycle I would guess that we make use of about 500 gram of oxaloacetate molecules a day. Yes, part of the molecule gets recycled but if there was a block to making oxaloacetate that needed topping up with...

It may be that Hammond realises that for people like him it is a better strategy to let the guideline be published and make use of all the loopholes to carry on the same rather than make a big hoo-hah that just brings all the issues to people's attention.

It just means that different people are shouting louder at RCP I think.

Was it sauté brain this time @Trish - you really should be careful of these moderators.

I think he was misunderstanding a response to his comment that the science was uncertain. He thought somebody was suggesting that the science of ME was sorted. What is sorted is the science of CBT and GET - they don't work. Edit: what hinterland said!

'with a huge range of causation' So Dr Hammond can now divine the cause of each patient's illness and base treatment on it? Goodness knows what the bit about diagnostic tests was about. He seemed to miss the point that there was certainty about treatments not having a useful effect.

Thanks for sending the whole Hammond piece. Yes, it is dreadful. Drivel dressed up as 'common sense'. This is just what is problematic - appearing to provide everything patients might want but in fact providing untested treatment that probably achieves nothing. At least he seems to agree that...