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ME/CFS shares many of the same characteristics as other functional disorders (acute/subacute onset often after a physical or mental stressor, fluctuating symptoms often moment to moment or day to day, and disability level out of proportion to exam findings/pathology). Also, it is highly comorbid...

I use an $8 plastic dustpan brush. Get maybe 12 months out it. One of these:

Recovery depends on positive patient engagement with the process. If our pseudo-treatment doesn't work it is the patient's fault. Yep. It is the mother of all double-binds.

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I am at the point where merely getting the psycho-tyrants off my back for what remains of my life existence would be a major win, let alone getting a good treatment, or even a cure. Though, of course, I would love a good treatment or a cure as much as anybody, and want competent research into...

This.

such as symptoms that cannot be explained medically.... physical symptoms where healthcare cannot demonstrate objective findings for physical illness. Can never demonstrate, or has not yet been demonstrated? Because it is a very critical distinction, which he did not make clear. In the first...

Phil Hammond is no friend to us.

What is the definition of structural in medicine? Is it confined to a specific tissue or group of morphologically coherent tissues (e.g. red blood cells, bone, muscle, an organ)? In particular, does structural pathology have to be either more-or-less static (e.g. a missing limb), or which only...

Yes, it is going to be interesting to see how far back the technology and knowledge existed to have enabled the basics to be revealed. If it turns out it enough of the basics could have been known decades back there will be hell to pay. :mad:

We postulate... we speculate... Yeah, we know.

Unfalisifiable, then. Alleged positive signs not withstanding.

Nor anything else. The Oxford criteria as basically just prolonged fatigue with no other (known) explanation.

:hug: For all therapeutic solutions, NICE rated all clinical trials as providing weak or very weak quality medical evidence, without exception. It is worse than even that. The vast majority (89%, IIRC) were rated as very weak, and the remainder as weak.

And please provide a robust definition of overactive, in this context.

It is like there are two different people writing their stuff, who never talk to each other.

He is an epidemiologist, was a professor in evidence synthesis for two decades, and is currently an emeritus prof in the same position, and has done a lot of work on systematic reviews and with the WHO, etc. He of all people should know what constitutes robust methodology. He has no excuse...

What is the evidence that 1) it is "overactive", and 2) is the primary problem, not an appropriate response to, nor an unavoidable consequence of, a more fundamental and serious problem, and 3) is amenable to 'brain retraining' that consistently delivers a meaningful practical benefit, let...

I don't think that is true. Directly or indirectly, concerns about methodology (which measurement definitely falls under) is the basic underlying issue dealt with here about almost everything coming out of the research. Particularly for the psycho-behavioural stuff, as they are by far the...

Yep. If you are going to be basing your claim on your own personal anecdote, then that data is as subject to scrutiny and criticism as any other form of data. And your methodology even more so.