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I think the problem is that these studies did not find low grade inflammation in ME. The second study sounds as if it did but it actually had no controls so tells us nothing about ME having low grade inflammation. It talks about correlations with symptoms but although it picks out the few...

There are a number of autoantibodies for which we see little if any fall in any patients with rituximab - antibodies to Sm, RNP, Ro (Sjogren's) for instance. Lupus has a mix of antibodies that fall nicely (anti-DNA) and once that don't like Sm. If ME were autoantibody driven it would presumably...

I agree with Hutan. In fact I would go much further. Anyone not fully conversant with the reasons why PACE is no good is not competent to do this review. You don't ask people who do not understand plumbing to service a central heating system. I could muster up ten people who are conversant...

Technically speaking I think the philosophy behind combined use of objective and subjective measures for arthritis is that the subjective measures of pain, stiffness, swelling and tenderness (subjective either to the patient or the assessor) are primary but need to be corroborated by objective...

Yes, I am rather hoping that Hilda realises she should never have raised that!

This is a valid argument Hilda raised some time ago. But the other side of it is this: There is no point in doing a systematic review of evidence of efficacy of a treatment unless you think you may find some reliable evidence of efficacy. If you don't find any there is no reason to suggest the...

This is worryingly muddled. That many treatments are used for back pain is a fact, not something to have an opinion ion about. That there is not one treatment proven to be more effective than another is a reasonable opinion - but in what way is it a rebuttal of the criticism? It isn't. That it...

It is an intriguing idea. But if you are testing whether or not an information package is valid then to assume it is 'education' and an alternative' sham education' begs a very big question. If the sham group had done better then presumably it would have been real education and the test sham. I...

I mean less. I diet that way and it always works with effort. I agree that surgery things and fatty things like crisps can be addictive but as long as you eat less of everything than before you can guarantee to get into negative balance. I have talked about weigh to countless patients and...

It looks to me as if the lead author for the new review will be a physiotherapist, Nicholas Henschke. That seems a bit crazy since the problems with the last review stem from having a physio as lead author. If you are a physio and you write a review of physio that says there is no evidence it...

Well I'll be darned. It shows how important it is to keep voicing concerns.

Trouble is, I cannot really make anything of these generalised cryptic responses. This is a real life situation and although professional colleagues may see me as breaking 'protocol' it seems to me that for the benefit of the patients we need to call a spade a spade. I cannot understand why...

I am not familiar with the work of the Centre beyond Faulkner's writings, which include probably the best account of the historical problems of PACE we have. This publication served me as a primer for PACE analysis some years back and it is always worth referring back to. It mentions the...

I don't understand that though. It points out that the medical profession have things roughly right - obesity is a major health hazard and the only way to deal with it is eat less. Doctors may seem unsympathetic but it is difficult to know what they can do if food availability and advertising...

I am not sure if you prefer not to read my posts @Hilda Bastian, or whether you just find them too close to home to respond, but sadly this looks to me more and more like the blind leading the blind. What is needed is clear thinking. Clear thinking is easily recognised, as is muddled thinking...

I think one could probably say 'Everything in this article is wrong'. Diets work fine, if they are stuck to - and that is all anyone ever claimed. Overweight and obesity are health problems at least as serious as cancer. The article is exactly the sort of irresponsible sabotage that it...

IgG therapy for ME seems a muddle. I cannot see any point in giving it to people with slightly low IgG levels or subclass levels - which are common enough findings and unlikely to have anything to do with immunodeficiency'. IgG has been given for autoimmune disease in the past but mostly that...

Not really. You cannot meaningfully compare a pretreatment with follow-up in an uncontrolled trial and treat a difference as 'statistically significant'. Statistical significance is based on a null hypothesis that populations are the same and a finding that they cannot be. But it is absurd to...

The lab story looks cast iron to me. I had always assumed it would be the lab since it is too much of a coincidence that a bat coronavirus epidemic should start in the one town in the world with a huge lab working on bat corona viruses. The DNA trail looks incontrovertible. Presumably un til now...

Yes, Hilda made the point that even bad trials can be worth reviewing if they show things like harms or in this case refute a theory. But maybe it is an indication of the toothless nature of Cochrane that as a rule it does not seem to venture into such negative territory. Are there many reviews...