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It is understandable if we assume that these people have no real idea what being a doctor entails in terms of knowing about human relations. That may well be the case but I was asking genuinely interested to know what people thought rather than what was 'understandable'! I am not clear what is...

Yes, afraid so. And if you have to torture someone else's data with statistics to get drops of data out I cannot raise enthusiasm.

What is he referring to? The NICE draft does not synthesise qualitative evidence as far as I am aware? The guideline is based on an assessment of formal evidence. I thought it was Turner-Stokes wanted a different interpretation of the qualitative evidence - not the Garner/GRADE crowd. Why is...

Yes, I am quite pleased with having managed to be succinct. The GRADE people really do seem to have put their foot in it. If it is now official that GRADE would rate the evidence from PACE as good enough to based guidelines on then maybe NICE are entitled to say no thanks to GRADE in the...

Looking at the MEpedia page my impression is that we do not have any reliable evidence for enteroviruses being involved in ME. I suspect there was a pre-existing theory that they would be found and so a variety of studies published weak evidence to support that. The tissue staining studies do...

As I understand it the evidence review was conducted by the full time professional staff at NICE who make use of a standard in house procedure. A number of these staff were present at the prior scoping meeting which several of us attended. The initial assessment was presented to the committee...

Sent.

I wondered about adding a quickie comment something like: The contribution to this debate by Busse et al. is interesting. Turner-Stokes and Wade argued that GRADE is too strict. Busse et al. say no, and (re: assessment of evidence for therapist-delivered treatments for ME/CFS) 'An appropriate...

@dave30th Patrick Steptoe together with Robert Edwards pioneered in vitro fertilisation from his base as a clinical obstetrician in a peripheral hospital using a laparoscope. Winston, as professor at the Royal Postgraduate Medical School at Hammersmith tried very hard to prevent Steptoe's work...

I understand your exasperation but maybe we have to accept that reaching Mars is something we know how to do but treating ME and protracted illness after Covid is not. My response was to the suggestion that more will be done for 'Long Covid' than was ever done for ME. I was suggesting that it...

I only ever had an old fashioned 24hr halter monitor that stopped working before anything happened. A monitor based on modern technology sounds a good idea. Since my own tachycardia was not documented my cardiologist colleague assumed it was functional. Which of course had a significant impact...

NICE fail with implementing GRADE guideline methods for CFS/ME-this is in plain sight to any guideline methodologist; makes me wonder whether NICE followed standard guideline procedures to assure consensus Thus speaketh a man from Lilliput. Since when did assuring consensus constitute the...

At least now it is clear that the ME/CFS community always had to take on all of EBM. Isn't it better for that to be transparent? But the most likely sign that it is going to stop is surely the EBM people starting to complain about what might have seemed something trivial - an ME/CFS NICE review...

The other point @Michiel Tack is that what we are seeing now is enthusiasts for bad trials fighting amongst themselves. Turner-Stokes and Wade have upset Guyatt and Garner. Bring it on. The more these people argue with each other the more they will expose the idiocy of their analysis. Guyatt and...

I see it as great for people who would like to see unfounded opinions out in the open rather than hidden behind dissembling and obfuscation. And I would not be so concerned about getting Guyatt involved because there are several people clearly more intelligent than Guyatt on the committee who...

One issue is that far too frequently, we see that many of our colleagues have been vilified. Yes, well he would know, after that vilification he showered on Sir Patrick Steptoe, without whom I would be childless. Winston was not well acquainted with humility.

If you mean the unblinded continuation study following the blinded phase 2 ME study then I don't think it would get as far as being assessed by GRADE because it was not controlled. The controlled trial was blinded.

I think thesis great, because we have Gordon Guyatt, Mr GRADE himself, weighing in and saying his system would have rated PACE as reliable evidence. It would have been easy to see the ME/CFS kerfuffle as a backwater in the evidence-baed world but I think this makes it clear that the NICE...

As I said before I am not sure I have much more to add, but the situation is complicated. Steroids give people a high so the fact that trials show some symptomatic improvement in the short term does not tell us much. Steroids block all sorts of signals and as I said before I think it is...

Yes, since the eighties is the new way for me!