Is NICE losing its standing as a trusted source of guidance? 2023, Jonathan A Michaels, honorary professor of clinical decision science

Jonathan Edwards said:
A lot of medical professionals, psychologists and physios have challenged the guideline although BACME has fallen in line. But the numbers simply reflect how many professionals have vested interests in a quiet life, or alternatively a busy practice in therapy. Nothing whatever to do with societal issues or cost-effectiveness.
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Thank you for this insight - one of the challenges is that some supporters of e.g. exercise, & CBT, are medical professionals - assumed to be caring and to have the best interests of their patients at heart. Your comment illustrates that we have to consider that medical professionals are subject to the same incentives/disincentives as everyone else!
 
A few relevant links re Prof Jonathan Michaels:

Biography (jonathanmichaels.co.uk)

It's somewhat ironic that he posts a link to this webpage Vascular Services Research (sheffield.ac.uk) from his personal website, whilst apparently knowing nothing about the vascular problems associated with M.E. and, at the same time, criticising the changes to the NICE Guideline!

Check out what he has to say about "Epistemic injustice" on page 6 of this transcript: ep-5-NICE-episode-transcript-Updated.pdf

He's not only ignorant, but also a hypocrite.
 
Jonathan Edwards said:
He is arguing for patient preference to be taken into account in NICE guidelines, rather than just evidence cost-effectiveness.
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Rather inappropriate of him to use the opposition to the ME/CFS guidance to make his case against NICE because it was about something completely different. Seems like he lacked good examples and thus fitted this one in.
 
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Hutan said:
These are fair points, but actually the NICE ME/CFS Guideline process resisted these pressures (including incredibly overt texted pressures) to just look at the evidence.
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And clearly failed to take those into account in a number of other conditions, like the recent awful chronic pain guidelines. Actual examples where this failed exist, but he chose one where it actually worked out. He doesn't seem to have any personal connection to ME, so is simply taking his cues from widespread condemnation by several professional bodies, assumes this criticism could not possibly be misguided. Which should be fair, but clearly shows the limits of trusting experts when all they have is "trust us, we're experts" to support their position. This is not edifying at all for the "science" of clinical decision-making, which is clearly more art than science.
 
ME/CFS Skeptic said:
Rather inappropriate of him to use opposition to the ME/CFS guidance to make his case against NICE because it was about something completely different. Seems like he lacked good examples and thus fitted this one in.
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It's even a major element of criticism from the detractors, that it took far too much patient input into account rather than relying on the evidence. Even though no evidence supports the paradigm.

By which, of course, they mean the wrong patient input, because the same people who whine about patient activism love to pretend to support patient input, as long as it's from carefully selected patients who repeat the same words they taught them. Which makes a completely mockery of patient input and focus.
 
Jonathan Edwards said:
A lot of medical professionals, psychologists and physios have challenged the guideline although BACME has fallen in line. But the numbers simply reflect how many professionals have vested interests in a quiet life, or alternatively a busy practice in therapy. Nothing whatever to do with societal issues or cost-effectiveness.
Click to expand...

Absolutely, vested interests.
 
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