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I don't think that is right @Snow Leopard. In my phase I study of rituximab in RA the primary outcome I chose was C-reactive protein because I knew that for a small study that was open label and uncontrolled I was only going to get useful information from a highly objective measure. We have a...

This looks very problematic. To be robust the method has to make sure there is no way attitudes can influence. If bias is possible it will almost certainly occur, or at least one has to assume it may well have done.

A primary outcome measure has to reflect reliability as well as directness. If a direct measure is totally unreliable it is not suited to being a primary outcome. The whole point of distinguishing a primary outcome measure is to maximise the chances of getting a statistically significant...

From the abstract it looks as if the authors do not understand the process of choosing a primary outcome measure. The result looks pretty unhelpful for everyone.

It isn't clear from the abstract whether the initial MRI findings predicted fatigue improvement or that the change in MRI over 6 months correlated with fatigue improvement. I cannot be bothered to try to find out because the whole thing looks like gibberish. Surely asking the patient how they...

It is likely that a small proportion of people diagnosed with ME in fact have an autoimmune disease. But equally, people often get given diagnoses like Sjögren's syndrome on very dubious grounds by overenthusiastic rheumatologists. The main issue for a study like this for me is that...

Not particularly, the pattern of incidence with age is not similar to autoimmune disease in general. Some autoimmune diseases have odd age incidence profiles like lupus and MS but even there the pattern is different. The data for ME may be biased but that is taking it at face value.

I spoke to an academic haematologist with expertise in clotting today. They had not heard of any of the Pretorius work or the methods being used. The more I look at the pictures the less they mean to me.

Such things are a thing of the past, I fear. Everyone at the top has lost the plot since the introduction of the 'internal market'. Fortunately there are one or two people like Peter Barry and Ilora Finlay, who care, but beyond that it is mostly self-driving robots.

I think UC has symptoms that sound very like ME, but the key thing about the cycles of symptoms in ME is that they do not seem to relate to any identifiable inflammatory disease. Although feeling fatigued after sitting on a chair with UC might be post-exertional and a similar malaise to ME I...

This is a distraction, just as Trish says, but I think the metaphor was in use way before 2014. I wonder if it was hijacked by feminism. I have just been in a conversation with an eminent US physicist who said he trusted Google (tongue in cheek). A Welsh Nobel Prizewinning physicist replied...

To me the use of glass ceiling seems reasonable, if stretched. I think it means limits due to vested interests within an establishment blocking justified progress. My concerns about this stuff is not sommuch the confused language, although it is, as the ham-fisted seeming approach that does not...

If I were of the twittering kind, Which thank the Lord I'm notsir...

I would be surprised, actually. I think these signs are valid if done carefully. It is not a question of activating reflexes so much as simple laws of levers - something we can do nothing about. To move one leg we need to do all sorts of things with our spinal muscles and muscles around the...

This seems to be put out by a commercial organisation linked to Birmingham City Football Club and British Transport Police. Interesting.

Indeed. The standard teaching in medicine for the last forty odd years has been that the diastolic is the more important for hypertension. In hypotension the pulse rate is probably more important than either.

My mum has (remarkably) rheumatoid arthritis and my wife, her sister and I have all had two cancers each. Nobody has ME. These things are around so studies have to be very careful.

Yes, this does not look to me to use reliable enough methodology to want to put much weight on it. A decent population based study with very good checking of data is needed. There may be correlations and they may be important but we all have relatives with diseases. Ulcerative colitis is...

To be really honest those pictures look like a random selection of dirty slides. There does not seem to be much consistency in the bright objects. But those that are there have clear enough margins (remember that some may be blurred because of the depth of field) which suggests to me that this...

But the drug may block an effective response to vaccination for a month or more and also an effective antibody response to new variant.