Search results

Thought this is a good example of why what Jason Busse propose is problematic. How Covid-sceptics were duped by the “wonder drug” ivermectin (newstatesman.com) COVID-skeptics promote the drug ivermectin and claim that all studies have reported positive effects. The author of the article (Stuart...

GRADE rates each outcome separately. I think there is even an example of an unblinded trial where the subjective outcome was downgraded but the objective one (mortality) isn't.

It's interesting to get an overview of the different European countries: The situation in the Netherlands isn't adequately described - there is a decent 2018 report by the Health Council but an old guideline promoting GET and CBT is still in place. There has been an announcement that it will...

Some quotes from the paper: 2) “Serious concerns were expressed about GPs’ knowledge and understanding of ME/CFS, and, it was felt, about 60% of patients with ME/CFS went undiagnosed as a result.” 3) “Disbelief, and misleading illness attributions, were perceived to be widespread, and the...

Well said. This seems to be one of the main issues: that GRADE does not believe in a fatal flaw that makes 'evidence' totally unreliable. The only way to rate something as very low quality is if a trial suffers from several different flaws. I haven't seen any arguments why this would be the...

It's great news but Busse and colleagues have focused on the review on GET and haven't brought up CBT yet.

The Cochrane review on GET seems to be one of the main reasons why people think GET is effective. And it mustn't be flawed because Cohrane hasn't withdrawn it...

Someone referred me to this, suggesting it might be useful for ME/CFS. Don't know much more about it. Here's the link: https://covidgraph.org/

There isn't that much arithmetic involved, simply rating different levels of evidence from very low to strong. Could you give an example of something that is not simply wrong but badly wrong/abhorrence? in the GRADE handbook

GRADE has a lot of issues but I don't think it's the main problem here. It's the authors. Most of what is in the handbook seem reasonable, nothing as absurd or counterintuitive as what Busse et al. are proposing. GRADE doesn't say that committees should make recommendations for a treatment...

I think GRADE simply gives guidance to committees and panels in cases where they would like or are forced to make recommendations. But it doesn't suggest that recommendations should be made. That seems like the only reasonable explanation. Does NICE have to make a recommendation for or against...

Very low quality is the lowest the GRADE system goes. That's the level of case reports etc. See for example: So if very low quality evidence should lead to a recommendation, then NICE would have to recommend everything (carnitine, LDN, Ampligen) that has scientific studies in support, no matter...

No I think this is simply a precaution to not make strong recommendations when things are unclear. The full section reads (my bolding) so it seems that the 'more cautious' refers to more cautious than making a strong recommendation. If the evidence was unclear or unconvincing the cautious...

Thanks. I had to shorten it a bit because it was originally too long.

Only read the abstract, but this looks like a good example of the inappropriate use of questionnaires. I could make a diabetes questionnaire with nonspecific symptoms that occur in patients with diabetes such as thirst, fatigue etc. I then offer the diabetes questionnaire to a group of CFS...

Yes the evidence isn't overwhelming (because there isn't much data that compared case definitions) but it does suggest that oxford results in much higher prevalences and thus risk overdiagnosing patients with ME/CFS. Made a Twitter thread about it in response to Alan Car.

Thanks very much, change it. Aha! Good to know!

Yes thanks Andy - updated it asap.

I've written a blog (with the help of Evelien) where I analyse the rapid response by Guyatt and colleagues. https://mecfsskeptic.com/the-nice-guideline-committee-and-grade-methodology/