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  1. Jonathan Edwards

    Guardian Article on NICE pause

    I have emailed Grover with the relevant points. I think I had made them when we had a long telephone call about a week ago, but I realise it takes time for things to sink in and I cannot expect to be treated as Moses with the tablets.
  2. Jonathan Edwards

    Guardian Article on NICE pause

    I agree that the attempt at 'balance' betrays a lack of insight. However, I think it is quite good to see Sharpe quoted saying something that all doctors will know is just silly - that you believe the patients when they say they are better (but not when they say they are worse). The irony will...
  3. Jonathan Edwards

    Guardian Article on NICE pause

    https://www.theguardian.com/society/2021/aug/30/withdrawal-planned-guidance-me-leaves-patients-distraught Natalie Grover seems to be getting nearer to understanding the problem, even if still a little way away. Some reasonable quotes from me. Some from Sharpe and Chalder as well.
  4. Jonathan Edwards

    What we're not being told about ME - UnHerd (Tom Chivers)

    Tom Chivers seems contrite and OK, he was relaying the other side he had heard. But the way it was relayed was a bit slap dash I think. The quotes from me are about general principles of trial design and clearly opinion. There wasn't an issue about whether or not I was manipulating historical...
  5. Jonathan Edwards

    What we're not being told about ME - UnHerd (Tom Chivers)

    For some reason Chivers seems to think that NICE should be the target of his criticism. Yes, NICE have made life difficult this week but in the longer term they are the only people who seem to have reached a sensible viewpoint. Exactly the same thing happened with the O'Neill piece where the...
  6. Jonathan Edwards

    What we're not being told about ME - UnHerd (Tom Chivers)

    I think Tom Chivers is learning what it is like to be used by journalists. The boot is on the other foot. Most times I talk to journalists I know they will mess up and use arguments upside down without checking and focus entirely on their agenda. Tom is now seeing what it is like to be...
  7. Jonathan Edwards

    Who Agrees That GRADE is (a) unjustified in theory and (b) wrong in practice?

    But what would this 'systematic' be other than to systematically apply every relevant piece of reliable evidence we have about trials and make a rational inference? If there is a paper from 1987 showing, surprisingly, that what looks like a good method for measuring something is useless then...
  8. Jonathan Edwards

    Who Agrees That GRADE is (a) unjustified in theory and (b) wrong in practice?

    But GRADE does not address the bias of the assessors. The permitted reasons for downgrading are applicable to just about anything if you want to. And it constrains downgrading, as Trish and Adrian say, so it is worse than useless in a sense. The only strictly systematic approach is to use the...
  9. Jonathan Edwards

    Who Agrees That GRADE is (a) unjustified in theory and (b) wrong in practice?

    Yet GRADE specifically says it is not this. It says it is subjective, not objective - it needs interpretation. So when it comes to the bias bit it opts out!! So I don't think it is. GRADE does not even attempt to deal with bias in interpretation. And the pseudo arithmetic is not slightly, it...
  10. Jonathan Edwards

    Who Agrees That GRADE is (a) unjustified in theory and (b) wrong in practice?

    At least NICE seemed to concede that they didn't get the competing interest issue right in 2007. They didn't seem to get it quite right this time but the final committee complement may have turned out to be politically advantageous. Conset to the guidelines was obtained even from those with...
  11. Jonathan Edwards

    Who Agrees That GRADE is (a) unjustified in theory and (b) wrong in practice?

    But that is not the alternative. The alternative is to do things as carefully as practical. GRADE has two components. One is a set of rules about all the things that need to be taken in to account. That bit is fine and likely to be very useful as an aide memoire for competent people trawling...
  12. Jonathan Edwards

    Who Agrees That GRADE is (a) unjustified in theory and (b) wrong in practice?

    There may be some of the underlying dislike of high tech medicine behind the EBM programme that is so prevalent in Cochrane. But the more basic relation may be the attraction for woolly minded 'scientists' to apply numbers to psychosocial issues where they do not belong. GRADE is based on very...
  13. Jonathan Edwards

    What we're not being told about ME - UnHerd (Tom Chivers)

    Standing back it may be important to realise just how easy it may be not to realise how muddled and self-serving the thinking of medical practitioners can be - even experts, maybe especially experts. The WHO has recently decreed that traditional Chinese medicine should be give the same respect...
  14. Jonathan Edwards

    Who Agrees That GRADE is (a) unjustified in theory and (b) wrong in practice?

    This post has been copied and following posts moved from What we're not being told about ME - UnHerd (Tom Chivers) Standing back it may be important to realise just how easy it may be not to realise how muddled and self-serving the thinking of medical practitioners can be - even experts...
  15. Jonathan Edwards

    Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management, 2021, Bateman et al

    A lot of this is good. Some of the pharmacological recommendations are bad and unevidenced though. It would have been nice to hold this up as support for the NICE guideline but being full of pharmacological stuff that is uncritical does not help sell the sensible bits on non-pharmacological care.
  16. Jonathan Edwards

    Raynaud's Syndrome in Fibromyalgia and ME/CFS

    Quite common - much more in women if not associated with specific autoimmunity.
  17. Jonathan Edwards

    What we're not being told about ME - UnHerd (Tom Chivers)

    This is a quote from Lynne Turner-Stokes. Which emphasises just how muddled everything, and Tom, is. GRADE is crap, just as Lynne says, but for quite different reasons - as I explained in my Rapid Response to her BMJ editorial (I think). So nothing arrogant here, just manipulative. We know...
  18. Jonathan Edwards

    What we're not being told about ME - UnHerd (Tom Chivers)

    But George M:)nbiot doesn't work that way.
  19. Jonathan Edwards

    Sense about Science (UK) and subjective outome measures

    But is it. I thought Chalder was doing this sort of thing thirty years ago.
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