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What is it that makes people still hold on to this idea that there is some magical way to 'manage' this that will be effective but hasn't been found yet? It's like there is this cultural block against advising rest when really it's the only thing that may help. Well, OK, it's a financial block...

Mentions in 2 places but largely ignores the giant ME/CFS elephant in the room. So still a very superficial effort that puts too much emphasis on old events and mostly frames it as an issue during epidemics, ignoring that this happens all the time, just at a lower level. Or that COVID will...

Well, they didn't really identify anything useful, but it at least data showing that half recovered naturally without doing anything could spell the end of all the crap rehabilitation that would be great, but I might as well ask for the damn moon so whatever. Anyway this was always likely the...

This endless loop of identical useless trials doesn't even pass the plausibility test. It's not even plausible that this should work, it has no possible value and will not inform anything, but they get away with it because 'pragmatic', while claiming to target etiology, for which they have no...

One thing I'll say about this disaster: if you're not outraged, you're not getting it. Although people have different of expressing outrage, this is one instance where expressing it is definitely warranted. If anything it should be screamed louder, but in our situation it only makes things worse...

No, no social, no bio, only psycho. That's the biopsychosocial way, most letters are actually silent, need to be spoken with a dog whistle.

Worthless drivel. All these people show is that they understand nothing about illness, and that they lack the empathy and imagination to see how this is simply a consequence of being ill. But since they don't believe in the illness, they pursue the same worthless nonsense decade after decade...

Only once he's retired. That's what power is all about. It will only make the fall harder, but progress in medicine happens at the pace of funerals. Although one important thing here: the man did not promote himself to those positions, other people did, and his ideas have widespread support in...

They're trying to use the excuse where a treatment that is found to be too effective to withhold from controls, even though it obviously did not meet this. Then they have no means to compare and simply declare it anyway, even though the outcomes are trivial at best in an excessively biased...

That seems to be the fundamental problem with PROMs: they can't be calibrated. Instead they get 'validated' by some convoluted process involving acceptability, reproducibility and few other hoops, but none of those actually provide any reliability or accuracy. More often than not they're not...

This is probably a bit of an overestimate, but there definitely is an overrepresentation of physically active people. Makes all the nonsense about deconditioning look at that more foolish. But still 4 years into LC most MDs stick to it like it's damn mantra, most still advice to exercise. I...

Misdiagnosing autism as CFS has that "finding an octopus inside a computer because someone misinterpreted the problem and this was judged to be the appropriate solution to that problem" feel to it. It legitimately raises concerns over the validity of psychiatry. Not of psychiatric diagnoses or...

Well this sure is some jumble of random questions and correlations that don't support a common meme, but as is tradition: Their recommendation is literally that they want more money to do the same thing again. Good grief. There really is a money tree somewhere, it just dispenses funds in some...

I think I got to the point where PROMs aren't just useless, they're actively harmful. Not inherently, rather it's because they are misused, but since they are systematically misused, and it's basically how evidence-based medicine works, it's a distinction without a difference. There is a...

I hope to keep discussion strictly on the methodology aspect, but I noticed how many of the issues overlap with the general problem of evidence-based medicine, the arbitrary application of standards, seemingly based entirely on preferences, and how very low quality evidence can influence real...

Another problem that has long been solved in software development. In most library packaging systems (basically ways to use code written by someone else) there is a versioning system that will throw warnings or errors when using deprecated versions of a library, even sometimes email the authors...

Consensus without the participation of everyone isn't really consensus. Doesn't mean it will be bad but, well, it usually is. If you're not invited at the table, usually you're what's for lunch.

It would be great if we could submit something. Sadly I say this as someone who likely can't contribute much... It'd be great if we could go a bit above the usual issue of ME/CFS and chronic illness and focus on the fundamental shortcomings in evidence-based medicine and how it has been...

All I can think of here, that a few letters are supposed to make some difference here only heightens my extreme disappointment in our sad species. There's no real difference here, it's all about beliefs and the weirdest-ass politics that humans can muster. Dunno if this breaches rules for...

There is the public version. And there is the private version. If you read what's published about psychosomatic medicine, it all sounds and looks so benevolent and good. If you can read or hear what they privately think of the patients, it reveals why it's none of those things and will never...