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Why do we see in this area a rush to produce clinical interventions based on pet theories, without any adequate investigation as to whether there is any evidence for that pet theory or if it is pure fantasy? Because something is a logical possibility does not mean it is a reasonably fancy.

This may illustrate floor/ceiling effects in the cognitive tests used in study conditions. For example I suspect I would score above average or average on a relatively time limited reading task, even though I have only managed to read one entire book in the last six years and that took me over...

Here, here!

My memory of research on treating phobias, albeit forty years out of date, was that the key thing was sufficient exposure to the object of the phobia, at least where there was a specific concrete object such as spiders. Dressing up that exposure in different ways did not make a lot of difference...

They have previously complained about medical professionals who collude with or reinforce false MUS beliefs by doing biomedical testing or making consultant referrals, so this is more of the same reasoning.

‘A common symptom’: I have not checked which clinical definition they are using, but surely PEM is a core symptom, and if they were looking at people who did not have this symptom, not all their sample had ME/CFS.

Luckily I have periods of relative remission in the thirty years of my ME enabling with planning and the right medication a trip to Tibet over twenty years ago, before a dose of flue triggered a major relapse, then to South America and Antarctica fifteen years ago and a trip to Japan under ten...

Such articles assert that ‘functional’ conditions have ‘high healthcare utilisation’ but I wonder if they have the evidence to back this up. Even if they form a significant proportion of medical consultations, if you look at it from the patient perspective do people with conditions so labelled...

Unfortunately too many people love ‘assertive, confident statements’ as illustrated by the people offering blind devotion to such as Dr Myhill.

Well said @rainy .

Somewhat surprised that apart from my thumbs I have no lunula (fingers and ties). I have no idea when they disappeared. Is this pretty universal? Do we need a poll on finger and tie nail changes?

I remember when I was training and then newly qualified as a Speech and Language Therapist lots of anecdotal evidence of harm from possibly/probably unnecessary tonsillectomies, particularly palatal incompetence, but more recently I am aware of several young adults having to research the...

Interesting to read the paragraph on sleep anxiety: This suggests that the ‘sleep police’ who see pushing for ‘normal sleeping patterns’ as self evidently (ie unevidenced) a desirable target in treating ME may not helpful, and certainly overall questions how useful such off the shelf sleep...

I echo the need to be able to read the survey through before starting. My reasoning is that given the historical problems that much ME research has been designed with a specific agenda I do not want to invest time and energy in a questionnaire that half way through leaves me feeling I can not...

Very interesting but again an association is a long way from indicating cause and effect in either direction. As @Andy points out both phenomena could be arising from a distinct common cause. Are there similar fluctuations in viral loads in other conditions?

Is there any evidence that the PACE researchers believed exercise intolerance exists, I had assumed they believed that patients were miss reporting the effects of unfitness or ‘deconditioning’, that all patients were on a single fatigue continuum with no qualitative distinction between those...

An excellent overview, many thanks for posting.

To which the nutritionalist who believes diet can cure all including cancer, would respond ‘in our society we are over fed but under nourished’. I agree people with ME would benefit from appropriate support in relation to their diet, but because of all the practical issues raised by @Invisible...

I suppose when talking about an adequate ‘control’ it is important to ensure the right things are being controlled for. You could argue that a ‘no treatment control’ or a ‘treatment as usual control’ is ‘controlling for the passage of time’, demonstrating that any change in the treatment group...