The one thing this review cannot become is a political compromise.
This is all about methodology, nothing else. Get that right and the rest will follow. Get it wrong, and we stay stuck in this cesspit.
Yep. Medicine seems to have not learned that if you want to find out where the flaws are in...
GET should be tailored to the individual and guided by professionals who are expert in the delivery of graded exercise therapy with the aim of empowering the individual to take control of their own exercise plan and recovery.
There is that whole patients are deluded morons who need to be guided...
And the effing CDC. Again.
So we currently have to simultaneously respond to reviews from Cochrane, NICE, and the CDC. All of them critical, much of it repetitive.
Grrr. :mad:
If the research shows anything it is that ME does not respond to any activity, exercise, or rehabilitation in the normal restorative way, but in fact does the opposite, with patients becoming sicker. It is, indeed, the most distinctive and defining feature of the condition, and nobody knows why...
In particular, Robert Courtney and @Tom Kindlon submitted influential major detailed comments that Cochrane published, but did not adequately respond to.
Thank you for that long overdue and thoroughly deserved acknowledgement.
Nobody is saying that actimetry is the gold standard, or the only measure to use, just that it gives an important part of the picture. The key point about it is that the data it does collect is objective. How to interpret that data is a different question.
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