NICE MECFS replacement guideline doesn’t mention objective post exertional malaise . Uses setbacks & relapses again as in 2007 guide
It mentions post exertional symptom exasperation instead in severe section
& mentions fear of relapse or post exertional symptom exacerbation
NICE MECFS guide context section started MECFS is a multisystemic disease .
No mention aerobic activity rehabilitation is contraindicated
It says GET and it’s evidence bace is “controversial” and further research being done and another update
The context section says no Brain inflammation
Post exertional symptom exasperation (used for PEM) defined in terminology list as being days weeks long .Not months years
No mention objective not subjective symptom proven via two day cpet test & of impaired energy metabolism
“Flares” & managing “setbacks & relapses” defined separately
Guide 2007 had no evidence 4 managing “setbacks & relapses/PEM” & didn’t recognise #2daycpet
Nature #MECFS & PEM still not defined/recognised & not in scope
Says no brain inflam. #MECFS is inflammatory disease
Yet the NICE #MECFS replacement guideline has included physical maintenance and physical activity and energy management . With these defined in the terminology section of the guideline .
It’s also says regards using term MECFS that little evidence of pathological Brian inflammation - indicating the disease isn’t pathological , that “NICE” doesn’t consider a pathological perspective , but a behavioural one .
Which was outside the scope of the evidence review
Context section “people” consider CFS too broad simplistic & judgemental.
No,that proven impaired energy metabolism, in any patient,being made a functional somatic syndrome /symptom problem descriptor in IAPT ,under umbrella non organic MUS by misleading psych social research
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