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Yea, I agree that CDC needs to be careful about what treatment it promotes. The problem for me is that isome of the statements the site makes about exercise suggest they are promoting a form of treatment or a benefit that's not supported by the evidence while they also leave off important...

Of course you are right - there are no trials that spell this out. But that, especially in the face of the exercise is good medical narrative, is why its so important this section err on the side of caution and provide the information needed to help doctors decide what specific "exercise" they...

Great point. Activities of daily living can use up or exceed a patient's capacity

I agree. But the problem is that while its getting better, the CDC's site lacks the specificity that is needed and that you would expect one of the experts to provide - what kind of exercise, with what intensity, for which patients, with what risks (at each level of severity), and to what...

Yes, true but that section was intended for the general public, not for health care providers. I was referring to the need to a HCP page on pediatrics. And about the current pediatrics section for the general public - there are a number of issues with that have previously been reported to them...

@MsUnderstood I get the concern about the disclaimer. But I am wondering if this statement might allow more information to be posted on this site than the CDC review process would normally allow Overall, this is an improvement but it needs improvement in the following areas as noted by others...

Yes, that's what I have. Thanks for emailing

I emailed but did not get a reply. Perhaps a bad email. If they send me their email, I'll be glad to update the list

IMO, this would be preferable to guidelines that try to cover everyone. Regarding "treated immediately" - the key question will be how. I know of one clinical guideline in the US that recommends moderate exercise for patients suspected of having ME but for whom a diagnosis is not yet definitive...

But mild and moderate cases of what? While its true that studies like PACE included some patients who experience PEM, GET and CBT were never evaluated in studies using definitions that require these hallmark criteria. And in PACE's reported pool of improvers, how many were just Oxford CFS =...

I agree that all people who do not fit a defined syndrome also need care. But I think it would be a problem if the NICE ME/CFS criteria were to be used for both people with ME and for people with other causes of chronic fatigue for which there is not yet a medical explanation. Especially when...

I am admittedly unfamiliar with how British GPs use guidelines. But that sounds concerning as it suggests that ME/CFS will continue to be equated to and subsumed in a bin of medically unexplained fatigue. I would have expected clinical guidance to make it clear that ME/CFS is no more a part of...

I was referring to what range of clinical presentation the new ME/CFS NICE guidelines are intended to cover. They are not intended to encompass all people with medically unexplained chronic fatigue, are they?

If PEM is not one of the key hallmarks of the condition, then what is the range of clinical presentation that will be covered by the new NICE guidelines for ME/CFS diagnosis and management? Others may feel differently but IMO, the range of clinical presentation should not encompass anyone with...

I agree with you on this - like Cochrane, the AHRQ review also failed to properly consider the serious problems with these studies - what the IOM report referred to as the lack of internal validity of the studies. That is an essential point that of course NICE must understand. But IOM's...

Just to clarify - the AHRQ evidence review was not done by an AHRQ "committee" but was commissioned by them and done by one of the evidence review practice centers in the US. Their 2014 review included Oxford studies like Cochrane did and concluded that CBT and GET were moderately effective. But...

I appreciate your point. But presumably evidence-based clinical guidelines for a particular disease should be based on an evidence base of good science in people that actually have that disease. That PACE and related studies are bad science is a critical point. But equally important is what...

At this time, both ME and CFS are included under "postviral fatigue syndrome" in the the neurological chapter in the version of ICD-11 released this past month. Neither term is under Bodily Distress Disorder, the term in the released version of ICD-11. @Dx Revision Watch can add more about...

They emphasize that this will be based on the evidence and they acknowledge the questions on CBT and GET. But they fail to acknowledge the problems with the use of non-specific definitions such as Oxford and what they intend to do about that.

@Robert 1973 - just an FYI in case its useful to you CDC updated its website on May 18 and added a section on managing PEM. Some of the text is better but the statements about exercise could suggest the only problem is with vigorous aerobic exercise and that increasing exercise is needed to...