NICE guideline on ME/CFS: Stakeholder consultation submissions (July 2017)

[Esther12]

Woohoo, that,s exciting!

That was before the release of the recommendation to not revise the guidelines though, so could be a misplaced expectation.

 

[lilpink]

I don't know if anyone has highlighted this document before, apologies if they have. From "Great Yarmouth & Waveney Joint Health Scrutiny Committee 4 April 2017 Item no 7 "


[PDF]Great Yarmouth & Waveney Joint Health Scrutiny Committee 4 April ...


On page 52 (big) -

" A recent review of the evidence of interventions for ME/CFS seriously questioned the validity of CBT, GET and other psychological therapies, when studies using the Oxford Criteria (Sharpe, Archard et al. 1991) were excluded [Agency for Healthcare Research & Quality (AHRQ), 2016]. " etc .......

......" The treatment outcomes in these studies may well have been overestimated by the use of Oxford criteria, (Green, Cowan et al. 2015). It is expected that the next NICE revision will reflect the reappraisal of the evidence." (my emboldening)

It has been pointed out to me that the quotes from page 52 of this document were part of a feasibility study report written by Luis Nacul, Eliana Lacerda and Caroline Kingdon that was commissioned by 6 CCGs in Suffolk and Norfolk. Luis Nacul, Eliana Lacerda and Caroline Kingdon also wrote this paper for the Journal of Health Psychology in March 2017- http://journals.sagepub.com/doi/full/10.1177/1359105317695803 entitled "How have selection bias and disease misclassification undermined the validity of myalgic encephalomyelitis/chronic fatigue syndrome studies?" So it's not as surprising as I thought at first glance that they explained about the deficiencies in the evidence in relation to the CBT and GET, or that they expected that there would be reappraisal of the research evidence at the time of the next NICE guidelines review.


But it's good to see that 6 CCGs together commissioned this team to conduct this study and write a report that recommended a more directed approach to the diagnosis and treatment of CFS/ME patients in East Anglia. For those who are up to it, I'm not at present, I think it is probably worth looking at this feasibility study in more depth.