Thread by @b_m_hughes

Here is a thread breaking down that statement by "medical leaders" on the new NICE guideline for #MECFS

TL;DR It's pretty weak...

1/12

rcplondon.ac.uk/news/medical-l…

"Medical leaders" have "signed" (although not using their names(!)), but have their members been balloted? No.

#MECFS #pwME

2/12

They agree that it is "important that all patients with this condition are given access to the best possible services and treatments available." Whoopy do. Nobody disagrees, *especially* not NICE

#MECFS #MillionsMissing

3/12

The guideline doesn't go far enough? Nice try!

The "patient groups" point is vague, but notably these groups have conspicuously welcomed the new guideline.

#MECFS #pwME

4/12

Non sequitur. That mental and physical health are linked is of course a truism. But it does not follow that a mental therapy (e.g. CBT) can be used treat a physical harm (e.g. your broken leg). Sometimes, psych therapy is useless. CBT doesn't "cure" MECFS

#MECFS

5/12

This "considerable disquiet" is anecdotal. By contrast, patient, clinician, and scientist disquiet with the old CBT/GET guidance is very much on the record. If disquiet really mattered, we'd have had a new #MECFS guideline years ago

6/12

So they now *agree* that GET as described in PACE (and as defended for years) should never be used.

Glad to see them finally throwing the PACE trial under the bus. Good riddance

#MECFS #pwME

7/12

All #pwME should have access to whatever psychological supports they need. There is nothing special about CBT.

But, again, CBT doesn't *cure* MECFS, which is what the PACE defenders have been claiming for years.

#MECFS is not caused by faulty cognition

8/12

This paragraph sounds like: "all we have is X, so we should give them X (even if it is useless or irrelevant)".

Patients would surely be poorly served by such a throw-it-at-the-wall-and-see-what-sticks approach

#MECFS #pwME

9/12

We all agree that frontline staff should be trained up on the new guideline. Goes without saying.

In fact, bring it on.

#MECFS #pwME

10/12

"Holistic" is not a particularly scientific term, at least in medicine.

What *is* important is that medical care be based on evidence, which is the core principle of the new NICE guideline

#MECFS #pwME

11/12

Argument from authority is not science.

Thankfully, the new #MECFS guideline sticks to the facts and cares little for your self-important reputations.

While the guideline isn't perfect, patients are well served by its modernisation of standards.

So well done, NICE

12/12