Some notes so far, with a lot of overlap to others' comments: (When I say I 'Agree' with different parts of the report, I mean broadly agree, there are always details to pick them up on.) Lines 1-4. (Also lines 106-107.) COMMENT: The emphasis on ‘fatigue’ is problematic. At least four other symptoms need close consideration in defining this disease: pain, PEM, and haemodynamic and neurocognitive dysfunction. Line 4. COMMENT: There may not yet be a firmly established diagnostic test, but it is becoming clear that two stage testing to account for PEM is likely to be be at the core of reliable research tools and diagnostic tests. Line 6. COMMENT: This figure does not reflect results from several studies of the overall economic burden of ME/CFS, which indicate a minimum figure at least one order of magnitude greater. Lines 7-51. COMMENT: Agree. Lines 52-53 (and Lines 88-89 below). COMMENT: The reference to the gender imbalance in research is ambiguous and need rephrasing. Presumably it is trying to say that men have not been studied enough. Line 54, and 89-90. COMMENT: There is some data on minorities, but possibly not enough to be clear. Lines 55-73. COMMENT: Agree. Line 68. COMMENT: It is not just pharmacological psycho-therapy that is problematic and often inappropriately prescribed, but also non-pharmacological psycho-therapies as well. Line 70. COMMENT: There may be high medication costs, for at least some patients, but there is no good evidence of substantial therapeutic benefit nor broader economic value in those costs. Line 72-73. “All of these factors contribute to the poor quality of epidemiologic studies.” COMMENT: And to poor quality outcomes for patients. Lines 74-78. COMMENT: Agree. Lines 79-80, and 87. COMMENT: I respectfully suggest the bulk of education needed is for both the professional medical (clinical and research) community, and the broader general community. Patients already know their side of the basic story – the problem is inadequate research, and clinical and community support. Lines 80—81. COMMENT: Agree. Patients’ views have been basically ignored for far too long, using the unscientific and unethical excuse that we are somehow delusional about our situation, and need to be patronised, infantilised, and re-educated about the ‘reality’ of it all. Lines 82-86. COMMENT: Agree. Lines 88 and 90-91. COMMENT: Agree. Lines 92-106. COMMENT: Agree. The overwhelming focus on fatigue over the last 3 decades by the medical community, along with the generally grossly underfunded and hence underpowered research, has not been helpful in clarifying the matter. The relationship between ME and CFS and the over lapping conditions needs more attention. Lines 106-107. (See also lines 1-4.) COMMENT: Haemodynamic based symptoms also need equal attention, for both model building and clinical management. Lines 108-112. COMMENT: Agree. Lines 113-117. COMMENT: There is no methodologically robust evidence that CBT and GET offer any primary explanatory or therapeutic power. Nor, frankly, even much useful secondary palliative benefit.