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My spellchecker screwed up on csf pressure.

Lactate is not a sign of inflammation. It is a sign of altered respiration. I think Younger has conceded that calling this inflammation may not be very helpful.

I think it is a fair point that there is a problem with EBM in capitals, not with evidence based medicine. There is certainly a problem that people who make a living out of extolling EBM, like Paul Glazsiou, are not helpful to a reliable evidence base - quite the opposite.

Hilda Bastian’s blog makes a lot of important points but, in her own words, it does not go nearly far enough. Presumably there is some value in being polite to the new editor but somewhere it needs to be stated that the flaws in the analysis are far deeper than she addresses. When I refereed...

I am fairly that brain tissue itself does not generate pain as a result of injury or inflammation to brain itself. Pain is usually ascribed to meningeal irritation. Brain inflammation is one of the causes of raised coffee pressure, which produces headache worse in the morning but I don’t think...

Probably is certainly way less than would normally be considered adequate evidence for efficacy of a treatment. I think we would in medicine generally expect to be 90% sure, preferably 95%. But probably at least has a standard meaning to medics. If we say someone probably has measles it is...

I think to be scientific a word just needs to have an adequately defined meaning. Probably has a very precise meaning in ordinary English: a more than 50% chance. So it is fine - if based on adequate evidence.

I get that probably is what moderate quality is supposed to mean but you cannot use the same probabilistic statement twice in a sentence. It is a bit like a double negative, it should combine to produce something else. I think there is a Freudian slip at work here. They wanted to say there was...

I do not see how an editor could have approved ‘moderate certainty evidence that probably...’ This is meaningless. Moderate certainty cannot then be qualified by probably. The text appears to be an appalling case of confused English. I had thought that Cochrane’s GRADE system gauged evidence of...

I am supposed to be properly educated about this, as a professor of medicine and immunology who worked on the role of mutation in immune disease. The radiation theory looks to be a non-starter to me. All the suggestive connections fall apart on inspection of detail. For a start the epidemiology...

‘Evidence-based medicine’ has got a bad name for being recipe-based and that is a potential problem but the ideal is simple and sound. What I think people are beginning to realise is that meta-analysis is a pretty unreliable process. I have always preferred to look for a single cast iron study...

I think this is well worded. There are potential confusions around ‘evidence-based’ and ‘science - based’ but I think the intention is clear enough. Science is generally about explanatory hypotheses. The hypothesis that a treatment will work is not explanatory so we tend to think of a test of...

It has to be a filter because there is no mechanism for shining a searchlight on your own neural activations, or looking to see what shows up either. The searchlight idea was never a going concern back to my student days as far as I am aware. Maybe at least these researchers have cottoned on to...

A lot of people in this field, like Dr Scheibenbogen, have looked at adrenergic and muscarinic cholinergic antibodies in parallel. People coming from the POTS side may just do adrenergic. I went over Dr Scheibenbogen’s data with her before a prepublication presentation to IiME a while back. My...

The study I remember was from a group in Copenhagen. T4 levels and autoantodies reduced with rituximab. But the focus has been on ophthalmopathy because it does not respond to radioiodine or thyroid surgery. Thyroid surgery is far preferable to rituximab. It produces a lon term solution, the...

As far as I am concerned knowledge and expertise of clinicians that is not based on hard research evidence is worthless. It is as simple as that. Medicine has moved on from ‘clinical judgment’. Doctors who do not recognise this are stuck in the 1970s. Unfortunately there is popular political...

The abstract does not even say which cells the methylation was in. I doubt they checked brain cells.

Mental gymnastics might be regarded as Dualist?

A randomised double blind controlled trial would certainly be possible and you would not need objective end points if blinded. I just think that better evidence for a link to autoantibodies is needed before exposin* people to the risks. It is possible that there are different antibodies in ME...

The paper I have seen using that assay looks difficult to interpret. A bioassay of a human antibody using another species has a lot of potential problems. And that is particularly so for individual case findings. I think a standard binding assay is easier to interpret. I still don’t see why...