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I think they just want the last word. Don't forget the Barry et al paper was a response to their original paper.

Also, stating that SW is a Non Executive Director of NHS England but that this is irrelevant to this paper is laughable.

They've created a nice little cabal, with Garner providing a link to Cochrane and acting as an authority on evidence synthesis.

"Choosing the wrong trial end-points ----------------------------------------------- A major concern is selective reporting. For example, data from trial primary end-points at 12 months follow-up was left out. This led to the incorrect conclusion that neither CBT nor GET are effective...

Garner and co have written a rapid response to this paper: https://jnnp.bmj.com/content/95/7/671.responses#the-revised-nice-me-cfs-guideline-neither-robust-nor-thorough” "We conclude by calling for these guidelines to be withdrawn, the analyses of data to be redone, and the guideline...

He will probably get new business from this letter.

I wish we knew more — this is an area worthy of further research. I agree that dysuatonomia is only part of the picture. My life would be much better if I felt throughout the day how I do in the evenings. It's interesting that both ME and POTS/OI follow this pattern in most patients.

I think it's best not to think of OI as a symptom. It is an umbrella term for a set of symptoms and conditions (e.g., POTS) that appear or worsen with upright posture. I think we know that this is due to problems with the autonomic nervous system—that is, OI is a form of dysautonomia. There...

I should go to bed, because this has really wound me up: A whole study on symptom exacerbation/fluctuations in LC and, as far as I can tell, they've avoided any mention of ME/CFS or PEM (or related terms).

I'm not a clinician but I think an option for Observational Study might be worthwhile. I think this would be classed as such.

This is quite a bizzare comment piece, given that neither of the phrases 'myalgic encephalomyeltitis', 'chronic fatigue syndrome', or 'post-exertional malaise' appears in the study. Also, with regards to this thread heading, I'm not sure this is a Trial Report, unless I'm missing something.

I would search for 'meal prep' services. You'll likely need someone working from home on a small scale. They often cater for people on diets due to exercise/fitness regimes.

"I have not mentioned fatigue. People with ME/CFS say they do not have fatigue in its usual sense(s). People with renal failure or rheumatoid disease with fatigue do not ‘crash’. Moreover, fatigue associated with most conditions is often best relieved by sitting in a comfortable, but upright...

Thanks Andy

Hi Jonathan. Can you—or perhaps someone else—please upload a PDF version? Cheers.

Yeah I'm pretty sure there are strong links between all four. Carson has had peripheral involvement with ME/CFS.

Sometimes feels like Carson & Stone are the new Wessely & Sharpe. Is history repeating?

Can others access this? The page won't load for me. I've been having problems with archive.ph recently and wondering if it's the same for others.

Will try and share something soon.

Along with the known issues with NHS care and the Delivery Plan (which the NHS seems to have swallowed whole), I am very concerned about the research landscape. We're in a very bad situation. There are currently only two biomedical ME/CFS projects funded by government: DecodeME and a project on...