NICE Statement about graded exercise therapy in the context of COVID-19

I have just updated from my earlier thread https://twitter.com/user/status/1336765954055958528

 

Trial by Error by David Tuller: GP Group Removes Online GET/CBT Medical Training Program

...the GET/CBT treatment approach pushed by METRIC has been thrust into an existential crisis. Last month, the National Institute for Health and Care Excellence published a new draft of medical guidelines for what it now calls ME/CFS that reverses its previous advice and dumps the recommendations for GET and CBT. This NICE draft led to whines of protest from the usual suspects, who have apparently recognized, to their dismay, that they no longer control the disease narrative.

They also can’t control the impact of the new draft on subsequent developments. Two weeks after the draft was published, the British Journal of General Practice posted an opinion piece about outdated medical practices that compared the GET/CBT approach to other “rubbished” treatments. Now the Royal College of General Practitioners has apparently thought better of its “evidence-based” METRiC program. The METRIC site currently includes this advisory:

“The course is currently offline while being reviewed to be in accordance with new NICE guidelines.” [bold in the original]

 

Trial By Error by David Tuller: Letter to Author of Removed GET/CBT Training Program for GPs

David Tuller has sent a letter to professor Carolyn Chew-Graham:

If this position has in fact changed, do you feel an obligation to acknowledge that you and your colleagues were wrong, and/or to apologize to ME/CFS patients who have been inappropriately prescribed biopsychosocial interventions as curative treatments? Since ME/CFS patients experience post-exertional malaise (or post-exertional symptom exacerbation, as it is called in the NICE draft), are you concerned that some or many might have suffered harm from the GET/CBT approach that has dominated clinical care for the past thirty years?

 

That mention of Chew-Graham's role in general practice research caught my eye, as I have recently come across reference to the General Practice Research Unit, and wondered if there is any connection. The reference I had in mind was:

One of his outstanding contributions was to focus attention on the role of the NHS general practitioner in the treatment of patients with minor psychiatric illness, an important facet of the General Practice Research Unit which he established under the auspices of the Depart ment of Health and Social Security. It is revealing to compare prevailing opinions in 1965 and those 20 years later on this issue.

This appeared in the obituary of Michael Shepherd, former professor of Epidemiology at the Maudsley and believer in "illness behaviour".
michael-shepherd.pdf (cambridge.org)