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We are at cross-purpose. My point about the implausibility of 8 all showing the same effects (on mice) being attributed to autoantibodies is independent of any actual measuring of autoantibody activity in pooled sera. The pooling of sera is another thing that a competent immunologist just would...

Yes I realise these points but that is not really what bothered me. Peptide arrays are a bad way to look anyway so that is another minus Brownie point. Don't even bother. They are trying to persuade us that all8 people had autoantibodies that had the same sort of effect on nerves - hence all...

I don't think this will prove reproducible. There are a whole lot of things in the man script that make me sceptical I am afraid. The key problems that it is vanishingly unlikely that all 8 of a sample of 'fibromyalgia' patients would have autoantibodies that do the same thing. The diagnostic...

Yes, you can use GRADE to shift your decision in whatever direction you like- which is why it is so ridiculous. NICE decided to downgrade on the basis of selection criteria I think. You could think up a reason under almost any of the categories. But that needs people who want to do that. If...

Sorry, I had not read all the comments before responding initially.i agree with Hutan. Systematic reviews are supposed to have rules that make them comprehensive and consistent. That makes sense to everyone. But unfortunately the grADE system used since around 2010 also has rules about how you...

The problems that Cochrane is locked in to the GRADE system which has a set of rules that do not reflect the facts about reliability so is bogus. Not sure what point you are wanting to discuss if not this?

There is nothing the least bit 'radical' about this. it is a matter of known fact that such trials are unreliable so there inso problem discounting them. Every medical student is taught this. such trials are routinely discounted for drug treatments so why not for non-drug treatments?

drivel-o-babble again since when did psychosocial intervention reduce inflammation?

It all depends on what you are actually wanting to mean by the word. It is alto easy house words like inflammation or immunological without actually having any specific concept in your head! Just as people talk of economic growth without necessarily having a clear idea what the term means.

There are plenty of better words if you know what your words mean!

I had not appreciated that Daniels had been tweeting out of line. That looks like a pretty damning admission: 'strong proponent for #CBTworks in medical conditions'. Hardly what Ilora Finlay called interested but disinterested. Why on earth was she not down as having a competing interest right...

I am afraid I am not motivated to look more closely than the abstract since it tells us nothing other than that for some reason BPS people also like to believe in joint hypermobility as the B bit. From what I have read the evidence is against any association of joint hypermobility with anything...

Yup.

I had clearly misremembered which number went with the Canadian criteria.However, it is interesting to note the word 'minimum'. Talking to Luis Nacul my impression was that they thought 0.2% was probably a fair estimate of the true prevalence - presumably the expectation is that a significant...

This statement indicates the low level of analysis: Women have a higher lifetime risk of inflammatory immune conditions such as chronic pain, chronic fatigue and autoimmune disease. There is little or no evidence for chronic ('primary') pain being inflammatory. If it was it wouldn't be called...

It sounds like something anyone could pull out of the textbooks as a trendy idea, no more than that. It is also rather full of holes. Bacteria stimulate TLRs much better than viruses and ME does not occur after bacterial infection so much as viral. Covid does not show much cytokine storm. And so on.

I don't think it actually fits together. People feel they are in PEM after exertion at rest. They feel too ill to want to do anything. In a way a can't see how you can subject someone in that state to a second CPET at all. PEM is not just not be able quite to score as high on an exercise bike...

My memory is that the formal epidemiological study by Nacul, Phebe et al estimated 0.2% for narrow Canadian-type criteria, which would be about 130,000 for UK. Also judging from numbers that I have encountered and GP friends have encountered I think significant long term ME must be present in at...

And the Cochrane lady Dr Flottorp was so keen on this. It is clear who needs the therapy here. Just stand on your paper and tell doing LP to STOP.

I would echo Trish's caution. Essentially nothing is known about the pathophysiology. The CPET studies do suggest some difference in metabolism in the context of exercise but I am sceptical that they tell us anything about PEM. I certainly do not think any conclusions can be drawn in relation to...