virology blog
About viruses and viral disease
By David Tuller, DrPH
I sent the following letter today to Professor Gillian Leng, chief executive of the National Institute for Health and Care Excellence (NICE). It was a follow-up to the letter I sent on September 1st about the agency’s decision to delay publication of it new ME/CFS guidelines. The letter has now been signed by more than 150 experts and more than 100 UK and international charities, support groups and other relevant organizations.
**********
By David Tuller, DrPH
Professor Trudie Chalder, Professor Peter White and like-minded members of the CBT/GET ideological brigades have appeared desperate in the last year to promote their favored interventions, publishing one shoddy paper after another. This stream of sewage has seemed intended to influence the new ME/CFS clinical guidelines that Britain’s National Institute for Health and Care Excellence (NICE) has been developing since 2017. NICE called off the scheduled August 18th publication of the new guidelines, which formally reject the longstanding treatment paradigm for ME/CFS, because of fierce objections from the cabal of CBT/GET true believers.
[Read more…] about Trial By Error: More Science-as-Promotion from the GET Campaigners
By David Tuller, DrPH
There is a lot going on in the ME and ME/CFS world that I don’t get around to. That’s why I’m always grateful that Jennie Spotila always deconstructs the numbers on the annual spending claims from the National Institutes of Health. Last month, on her blog Occupy M.E., Spotila submitted the NIH’s 2020 numbers to her usual sharp analysis. I am reposting it in full here with her permission.
**********
By David Tuller, DrPH
Two weeks ago, NICE abruptly announced that it was putting the brakes on publication of its new ME/CFS guidelines—a move precipitated by fierce opposition from key members of the GET/CBT ideological brigades in the British medical establishment. Then last week, Mayo Clinic Proceedings, a well-known journal, published a different set of ME/CFS guidelines that—like the unpublished NICE document—specifically advises against the traditional GET/CBT approach.
By David Tuller, DrPH
This morning, I sent the following letter to Professor Gillian Leng, the chief executive of the National Institute for Health and Care Excellence.
**********
Professor Gillian Leng CBE
Chief Executive
National Institute for Health and Care Excellence
Dear Professor Leng,
Please find below a letter urging NICE to publish the new ME/CFS guideline, signed by scientists, clinicians, academics and other experts from the UK, the US, and other countries.
I would be remiss not to mention another guideline for the illness, which was published last week by Mayo Clinic Proceedings. This document –“Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management”–was written by the US ME/CFS Clinician Coalition. In a statement that highlights the larger context of the current debate, the authors note that “the United States and other governments as well as major health care organizations have recently withdrawn graded exercise and cognitive-behavioral therapy as the treatment of choice for patients with ME/CFS.”
Best–David Tuller
[Read more…] about Trial By Error: A Letter Urging NICE to Publish ME/CFS Guideline Without Delay
by David Tuller
By David Tuller, DrPH
For many years, campaigners for psycho-behavioral interventions for ME/CFS have accused patients who objected to the research as being anti-scientific zealots. It was always a ridiculous charge, but developments this week have made it clear, if there was any doubt, that these entitled bullies are the ones immune to the actual evidence.
The National Institute for Health and Care Excellence (NICE), the British organization that develops clinical guidelines, began the process of revising its outdated 2007 ME/CFS recommendations four years ago. It selected an excruciatingly balanced committee, with representatives from various sides of the debate, including several patients. It would not be possible to argue convincingly that the process was stacked against the advocates of graded exercise therapy and cognitive behavior therapy, the two standard treatments.
by David Tuller
By David Tuller, DrPH
It is not often that a major news organization fact-checks BMJ, a leading medical publisher, in real time. But that’s what happened last week when The Times pushed back against biased BMJ reporting about the committee charged by the UK’s National Institute for Health and Care Excellence (NICE) with developing a new clinical guidance for ME/CFS. This isn’t the first time The Times has seen through the propaganda campaign emanating from those with financial and reputational interests in maintaining the GET/CBT approach despite widespread rejection of its theoretical and scientific underpinnings.
by David Tuller
By David Tuller, DrPH
The new ME/CFS clinical guidance from the UK’s National Institute for Health and Care Excellence (NICE) is finished—and is to be publicly released on August 18th. In the meantime, this final version has been sent to registered stakeholders—even as three of the 21 members of the committee responsible for the guidance have stepped down without public explanation, per an “exclusive” report on BMJ’s news site. All three quitters represented the wing of the committee that promoted the purported benefits of cognitive behavior therapy (CBT) and graded exercise therapy (GET) as core treatments.
by David Tuller
By David Tuller, DrPH
UPDATE: August 4, 2021
Dr Villemarette-Pittman, the managing editor of Journal of the Neurological Sciences, has informed me that she has learned from Elsevier that a corrigendum has in fact been written and will be published in the near future. She also informed me that she plays no role in deciding on or setting policy about corrections and corregendi, and when or how they are published. I am very glad to hear about the corrigendum. Had I been informed earlier in the cycle of e-mail exchanges that the lack of a corrigendum did not mean that none was forthcoming and that a response from Elsevier was being sought, I would have written the blog post differently and/or updated it sooner. Dr Villemarette-Pittman had responded on behalf of the journal to my initial e-mail about the error, so I assumed she understood the practices and policies around corrections and corregendi. I apologize to Dr Villemarette-Pittman for having made that mistaken assumption.
by David Tuller
By David Tuller, DrPH
A recent study of cognitive behavior therapy (CBT) for patients with “persistent physical symptoms” (PPS), a category alsocalled “medically unexplained symptoms,” reported null results for its primary outcome. These null results were not mentioned in the conclusion of the abstract, which instead focused on minimal reported benefits for a minority of secondary outcomes. This is not cool! The study was published in Psychological Medicine—a journal with close ties to the PACE investigators and other members of the CBT ideological brigades.