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Dr Keith Geraghty Profile picture
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2 Nov, 4 tweets, 2 min read
The 1st US female Thunderbirds fighter pilot had to retire due to tick borne illness - that UK doctors suggest doesnt exist in chronic form. The idea ME or Lyme patients stay sick due to psychological issues & fear of exercise is a myth in a CBT-GET model. cdmrp.army.mil/cwg/stories/20…
The myths and unscientific claims about patients with ME/CFS, Lyme and other medically unexplained chronic symptoms are outlined in my CBT model paper journals.sagepub.com/doi/full/10.11… and we see in the new NICE guideline drs tried to prevent authorities moving away from this flawed model.
The UK @BSRehabMed @RCPhysicians @rcpsych have stated they will continue to make CBT a central treatment for ME/CFS - yet its theoretical basis here is flawed. They say they will continue to make exercise a treatment, yet @NICEComms have asked them to stop doing graded exercise.
CBT is useful for many disorders, for example in depression beliefs about self may be negative, so changing those may be helpful. In ME/CFS the model says ME patients have a false belief of illness. That is wrong, so what will the new CBT offer, what cognitions will be changed?

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More from @keithgeraghty

Dr Keith Geraghty Profile picture
1 Nov
Some comments by Colleges & Drs: @BSRehabMed argued to NICE not to use the terms "flare" or "relapse" in ME/CFS because they sound too biological! This constant drive to keep ME/CFS away from anything biological: they wanted the term "decompensation" instead? thats an easy one Image
p109 British Rehab Med drs asked NICE to remove any critical comments about drs after many patients recounted negative and distressing experiences. @BSRehabMed argued drs would not read the guideline if it was critical of them! instead write the guideline about "all that is good" Image
add on to last, extraordinary that Rehab doctors admit that MS patients recounted similar problems with doctors, being disbelieved, and so on, yet the MS guideline or audit was written in a positive manner. Are doctors not able to take a little criticism and learn from mistakes?
Read 6 tweets
Dr Keith Geraghty Profile picture
24 Sep
A statement by 2 Royal Colleges is presented on the Sussex and Kent ME/CFS Society. The medical advisors to this charity are the same advisors who are telling Royal Colleges to keep Graded Exercise Therapy and are responsible for pausing the NICE guideline measussex.org.uk/royal-colleges…
Note the position of the Royal Colleges is that 'they think GET helps, they gave their evidence, they dont accept the new guideline dropping GET for lack of evidence - and they want NICE to put it back in, otherwise they wont accept the NICE guideline, a remarkable tale of power.
..it appears Royal Colleges are only going to a roundtable to demand that @NICEComms reverse dropping GET, that their experts know better than an entire NICE 3-year consultation and evidence review process: this is an extraordinary case of Evidence-Based-Medicine going wrong!
Read 4 tweets
Dr Keith Geraghty Profile picture
20 Sep
Why data from PACE trial author and London GET clinic is dubious and does not reflect real ME/CFS. 2021 paper attempts to show GET benefits = gains made on fatigue scale happen in 1st 4 hours/sessions then dont continue to normal levels. tandfonline.com/doi/full/10.10…
92 patients data since 2002 (almost 20 years) including 20 drop-outs still used as data. To take an ME/CFS patient and have them drop fatigue by 4th session may be an act of changing perception. Why then do patients not seem to be returning to normal fatigue levels by the end?
This paper can only be judged as an attempt by a PACE author to sure up evidence for GET use in the face of the impending dropping of GET by NICE, by clubbing together data from as many patients as could be mustered from their clinic over 20 years, no treatment uniformity at all.
Read 16 tweets
Dr Keith Geraghty Profile picture
11 Sep
Should Prof Black's 2008 Report on Work p14, 'that CBT should be used to return sick people to work', be considered as a strong pro-CBT bias for her to Chair a @NICEComms ME treatment guideline review, that recently downgraded CBT and GET use in ME/CFS? assets.publishing.service.gov.uk/government/upl…
I wonder what the ethics of using CBT as a return to work tool are in totality, perhaps some bioethics/philos experts like Dr Blease or others might investigate this trend @crblease - it seems to eminate from ME/CFS and be a template eg is cancer treatment a return to work tool?
Recap why Prof Black is too conflicted imo to chair the @NICEComms ME treatment guideline table
1. Ex-president of Royal College of Physicians (who now oppose the guideline)
2. heavily promotes CBT and BPS model
3. worked with PACE author
4. advisor to DWP who funded PACE trial
Read 4 tweets
Dr Keith Geraghty Profile picture
10 Sep
I agree with Peter White that drs should not tell patients with ME/CFS that it is an incurable disease, because data shows some people get better, some improve, many dont; equally drs shouldn't tell patients GET is safe and effective, neither statement is true. Word games.
PACE author Peter White often uses a photo of a female patient with ME in a wheelchair feeding a horse in talks to drs, asking "whats wrong with this picture"? He panders to drs ignorance of medically unexplained symptoms -eg "why cant this patient walk, muscle tests are normal"?
..what follows is White's explanation of why patients might have ME, their beliefs, and behaviours. The story given to drs is not supported by science, but simply rests within a grand biopsychosocial model of all illlness. as I've detailed in a few of my papers. a CBT model.
Read 7 tweets
Dr Keith Geraghty Profile picture
9 Sep
How could @NICEComms appoint Prof Carol Black at the Chair of the roundtable to sort of the mess after some drs blocked dropping GET as a treatment for ME/CFS? Carol Black is a colleague of the PACE team lead Prof Peter White, where is COI screening and independence test here?
A few facts I found on google search: Prof Black is an advisor to UK Gov/DWP, was involved in the implementation of the "Biopsychosocial Model' in reforms, and was part of a team for the DWP working with PACE trial lead author Prof Peter White, both DWP advisors on disability.
Here is a screentshot I found on google of Prof Black PACE author Prof White and DWP Medical Advisor on a team sent to Sweden to advise the Swedish Gov on what they were doing in the UK re disability reforms using a biopsychosocial approach.
Read 6 tweets

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