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So what is Chales Shepherd claiming to have been achieved? Sorry, I haven't had a chance to look at the source material. Edit: I listened to Charles. I am unclear what he thinks has been achieved as yet.

Yes but we don't want an MDT, surely. In my view we want a physician and someone with nursing training who has acquired OT skills. If other people are (occasionally) needed they can be brought in as for any patient. As soon as you have the MDT mentality you have the BACME approach.

So the new WHO policy is just turning the handle on half-understood concepts of method and no application of common sense. Par for the course.

Yes, but endocrinologists don't know any immunology. Nor do they tend to remember the widespread connective tissue changes of hypothyroidism that are unlikely to be reversible just by correcting hormone levels - carpal tunnel narrowing, pretibial myxoedema, thyroid acropachy, and so on. These...

I would be led more in that direction if the problem was chiefly an increased hangover. Failure to metabolise alcohol might aggravate things but I don't see it being the primary cause of the unpleasant reaction.

Reposted here: If blinding of an allocated trial intervention is not feasible (for example in trials of different types of patient management or surgical procedures), blinded or masked outcome assessment should be pursued for objectively determined outcomes, for example through use of a...

Quite possibly. Once we have thought of all the reasons it might be wrong and not found too many!

I have also been consulted on the Suffolk and North Essex plan. Suffolkres knows a lot about this. Last time I spoke to a person drawing up a commissioning plan there was no guarantee of physician involvement and it looked very much like just buying in BACME services as far as I could gather. I...

If blinding of an allocated trial intervention is not feasible (for example in trials of different types of patient management or surgical procedures), blinded or masked outcome assessment should be pursued for objectively determined outcomes, for example through use of a prospective randomized...

Nope. Sorry. Above my pay grade.

Not specifically suggesting degeneration, just a change in neurotransmitter function. Degeneration seems unlikely since nobody has reported any structural change in hypothalamus.

Well it might point to the hypothalamus being crucial - and not just as part of some 'HPA axis' or 'Autonomic function'. If ME/CFS was a bit like Parkinson's disease of the hypothalamus it might make sense.

We now have over 100 votes so I shall welcome discussion of interpretation. The first thought for me is that the effect reported does not look like just an Antabuse reaction to acetaldehyde due to a metabolic failure. (That would have weighted everything to hangover.) The second is that the...

Oops. I will ask Qeios to change that.

Or the symptoms might be due to antibodies binding to thyroxine associated proteins throughout the body, since hypothyroidism's usually an autoimmune disease.

But that isn't really the issue, Simon. I have highlighted certain things to make certain strategic points relating to how we can justify a concept of ME/CFS. I emphasised a relation to lying flat (not actually OI per se) because it seemed to me a bit different from the usual story and maybe...

I can understand the concerns but I have no intention of creating diagnostic criteria. I have always thought they were pretty unhelpful in rheumatology. Each patient's problems are different and managed accordingly. For research purposes it is usually best to study very typical cases and...

Cochrane blasts off for a (no -return) trip to planet Zog.

Part of their policy is to allow people to publish and get peer dialogue and then publish elsewhere if they want.

Nice to start your abstract with the second statement contradicting the first.