BMJ  2007;335:528 (15 September), doi:10.1136/bmj.39332.455706.3A

Letters

NICE behaviour

ME guideline is unworkable

The first 150 words of the full text of this article appear below.

The National Institute for Health and Clinical Excellence (NICE) recommends that everyone with mild or moderate myalgic encephalopathy/chronic fatigue syndrome (ME/CFS) should be offered a course of either cognitive behaviour therapy (CBT) or graded exercise therapy (GET).1

This is despite published evidence remaining weak (especially for group CBT) and inconsistent 2. Patient evidence submitted to the chief medical officer's report concluded that CBT produced "no change" in 67% of cases and made the condition "worse" in 26% of cases.3 Around 50% of respondents reported that inappropriate exercise therapy had also made their condition "worse."3

When the NICE estimate on prevalence is used this controversial recommendation will affect some 200 000 people. A one to one course of CBT covering 12 to 16 sessions will cost well over £1500. The cost of a professionally supervised exercise therapy programme is also likely to be substantial.

So where is around £300 million of . . . [Full text of this article]

Charles B Shepherd, medical adviser

ME Association, Buckingham MK18 1TH

charles.c.shepherd@btinternet.com


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Relevant Article

Diagnosis and management of chronic fatigue syndrome or myalgic encephalomyelitis (or encephalopathy): summary of NICE guidance
R Baker and E J Shaw
BMJ 2007 335: 446-448. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • Morrison, D. S., Batty, G. D. (2009). The advantages of being called NICE: a systematic review of journal article titles using the acronym for the National Institute for Health and Clinical Excellence. J Public Health (Oxf) 31: 127-130 [Abstract] [Full text]  
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