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All things relating to NICE

INFORMATION RELATING TO THE
NICE CONSULTING GROUP
National Institute for Health and Clinical Excellence
Review of Clinical Guideline (CG53) – Chronic fatigue syndrome/ myalgic
encephalomyelitis (or encephalopathy): diagnosis and management of chronic
fatigue syndrome, myalgic encephalomyelitis (or encephalopathy) in adults and
children.
Stakeholder Comments

JUDICIAL REVIEW INTO NICE CFS/ME GUIDELINES
Norwich ME sufferer Wins Court Ruling
Review of JR Court Procedure
Response to the ruling concerning the NICE Judicial Review into ME
LINK

INFORMATION SENT OUT FROM
NICE
Letter to
Wider Group 23 12 05 (2)
CFS guidelines
full report amended`

RESPONSES FROM GROUPS AND INDIVIDUALS
Hooper letter to BMJ
re NICE.
Klimas, Wessely and NICE Redefining CBT.doc

Press and Web Response to
NICE Draft Guidelines
NICE draft Response
2.10.06.doc
MEDIA CAMPAIGN
NICE_press_release 25% Tymes & BRAME.
NICE Guidelines Agreed Statement by Charities

LInks to NICE ME/CFS Guidance Documents
http://guidance.nice.org.uk/CG53/niceguidance/pdf/English

Press and Web Responses to NICE Final Guidelines
25% ME GROUP
Margaret Williams

25% ME GROUPChronic fatigue syndrome / Myalgic encephalomyelitis (CFS/ME) guideline
(consultation)
Details have been sent out to all 25% ME GROUP
Patient Reps for Consultation on the Doc - 9/10/06
RESPONSE TO NICE Report Comments form - 25% ME GROUP.doc
Margaret Williams - Concerns re NICE Draft.pdf & ADDENDUM_to_Response_to_NICE.pdf
Some voices from the the international ME community2.doc
Item for Westminster APPG on ME Notes for Response to NICE.doc

Response from other Stakeholders and
Individuals to the Draft Document
BRAME Comments Proforma on NICE CFS ME Guidelines.
MEA response to NICE 17th Oct.doc
Response - Consortium of West Midlands Groups.
Warks Network for M E group comments on NICE draft guidelines.
TYMES Trust submission

Chronic fatigue syndrome/Myalgic
Encephalitis Implementation planning meeting - Thursday 5 October 2006
NICE
Implementation minutes.doc
CFS ME implementation planning mtg notes Oct 06.doc
MEA
Reply to Ms Polson at NICE.doc
25% ME GROUP - COMMENTS ON THE NICE IMPLEMENTATION PLANNING MEETING.doc
Ltr to Ms Polson Re mins 15th November 2006.doc
SUMMARY OVERVIEW OF SOME INITIAL RESPONSES.doc

Health Select Committee Inquiry into NICE
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INFORMATION RELATING TO THE DEPARTMENT OF WORKS AND PENSION (DWP)

THE WORK CAPABILITY ASSESSMENT – A CALL FOR EVIDENCE
This is the submission from the 25% M.E. Group to the Independent Review of the Work Capability Assessment

THIS SECTION RELATES TO THE CONSULTATION OF A GUIDANCE DOCUMENT FOR ME, WHICH WAS COMPLETED IN 2007
25% ME GROUP RESPONSE TO DWP GUIDELINES version 10
DWP cfs-me may 2007 final_V10

25% ME GROUP INFORMATION
READABLE VERSION of submission to DWP
We submitted a strong submission to an earlier draft of the Medical Guidance CFS/ME document, there were so many changes that we produced a 'readable' version in order to help you. A colour version with all changes made to the DWP document on 17.10.05 is not included here at this time.
It should also be noted that further drafts have been produced since this one.

Guidance Documents produced by the DWP
CFS_guidance revised version V8 March 2006.doc
CFS_guidance v9 final.doc

COVERING LETTER CONCERNING SUBMISSION 17th October 2005
SUPPORTING DOCUMENT CONCERNING SEVERELY AFFECTED

RESPONSES TO FURTHER DWP RELEASED DOCUMENTS
25% Group response 6.04.06.doc
DWP 25 GROUP RESPONSE - read version.doc
DWP 25 GROUP RESPONSE COLOUR.doc
GET issues.doc
Greg Crowurst - DWP Document.wps.doc
DWP Covering letter.doc
COMMENTS ON THE MARCH 2006 VERSION OF THE DWP -D. JONES.doc
Comments on the DWP version 8 of March 2006 - M Williams.doc
18th July 06 - DWP letter re Prof Wade
NOTES ON DWP MEETING

BRAME STATEMENT Word DOC

DWPMEOrganisationsResponse.V9.doc
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Information relating to the Parliamentary Inquiry into CFS/ME
setup by Dr Ian Gibson in December 2005

Feedback on the Gibson Inquiry
A few facts about the Gibson Report
Margaret Williams 29th November 2006
LINK
Digest of Gibson Report on CFS.ME.doc

Information from the Parliamentary Panel
Press Release - Group on Scientific Research into ME.doc

Official Gibson Report
LINK

Summary of Gibson Report
Summary of Key Points in Gibson Inquiry report (2).doc
Official Inquiry Website
LINK

Information from the 25% ME GROUP
Letter to Dr Gibson in response to the Official Press Release
Cover submission letter.doc
25% ME GROUP Submission to Gibson (2).doc
You can learn a lot about the UK from the lives of people with ME.doc
Outline of 25% ME Group Presentation to Gibson Inquiry.doc
Gibson Inquiry - Day 1 - Comments by Prof Malcolm Hooper
A CRITICAL RESPONSE TO GIBSON INQUIRY REPORT LINK

Information from BRAME
BRAME EvidenceGibsonInquiryonME.doc

Information from the Scottish Cross Party Group
Covering letter inc. key issues.doc
1 CMO report on research.doc
2 MRC Research Strategy.doc
3 Evidence review.doc
4 Concerns regarding Exercise.doc
5 Carruthers Contents.doc
App II Debate 9.6.05 - LOST FILE
6 Subsequent developments.doc
7 Briefing Paper extracts.doc

Information from Doris Jones
Dr Ian Gibson letter.doc
Memorandum for Health Committee 2.doc
Second Memorandum for Health Committee 2.doc
MEMORANDUM TO HEALTH COMMITTEE.doc
Dr Ian Gibson letter Jan06.doc
Second submission to Gibson Inquiry 2.doc
Nancy Turnbull letter.doc
Dr Ian Gibson 4 letter.doc
Dr Ian Gibson 5 letter april 06.doc
SYMPTOM FREQUENC april 06Y.doc

Information from Margaret Williams
Marg Williams-Obs on DLA Handbook for Gibson Inquiry.doc
Organic evidence for Gibson.doc
ME WHY NO ACCOUNTABILITY.doc
FOR UK PARLIAMENTARY INQUIRY INTO ME.doc
SQUARING THE CIRCLE.doc
http://www.meactionuk.org.uk/FINAL_on_NICE_for_Gibson.html
Concern about misinformation to the gibson Inquiry.doc
Notes re the evidence of Raymond Perrin PhD to the Gibson Parliamentary.doc
http://www.meactionuk.org.uk/For_the_attention_of_the_Gibson_Inquiry.htm

Other Information to the Gibson Inquiry
ME_overview.pdf
KS to Ian GibsonMP 15 April 2006.pdf
KS to Gibson Group 1 May 2006.pdf
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Dangerously Diminishing
A response to the RCPCH Evidence Based Guidelines for the Management of CFS/ME
on behalf of the 25% ME GROUP
Greg & Linda Crowhurst
April 28 2005
LINK TO WORD DOCUMENT
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[1] Heterogeneity of ‘CFS/ME’ – dangers of failure to subgroup
From ScotME submission to the Gibson Parliamentary Inquiry, January 2006. Highlighting the need to subgroup patients as currently diagnosed in the interest of safe and effective healthcare. ScotME are acknowledged in the document. Useful to argue for appropriate action on the part of the NHS, Health Ministry etc.
[2] Distinguishing ME/CFS from Depression and Somatisation
Relevant extracts from the ‘Canadian’ and overview Canadian documents. Useful for General Practitioners and other medics, particularly if an ME patient is being wrongly labelled.
[3] Autonomic Dysfunction
Covers:
Personal testimony regarding problems relating to low blood pressure / autonomic dysfunction, illustrating the need for testing to identify such problems and how this can be conducted;
Research illuminating patients’ presentation;
Information on the Management and Treatment of Autonomic Dysfunction;
Capacity to distinguish patients from healthy controls and other patient groups on the basis of Testing for Orthostatic Intolerance.
[4] Is Exercise Safe?
The case against exercise, including many examples of research findings challenging the wisdom of exercise for people with ME. (From ScotME submission to the Gibson Parliamentary Inquiry, January 2006.) Could do with review / update, even if only to say that nothing that has happened since / been published since changes the thrust of this paper in any way.
[5] Sources of Evidence and Priority Status
Unpicks the argument that ‘Randomised Controlled Trials’ are necessarily the best source of evidence, providing some contrasting findings from patient surveys and citing CMO’s Report assessment of the disparity.
[6] Consideration of Evidence on CBT and Graded Exercise
Referenced extract from the ‘Canadian’ criteria paper.
The general theme of the following four documents is the existence of evidence for interventions that may be helpful and that doctors in the NHS are unlikely to be aware of:
[7] Essential Fatty Acids - rationale for use and evidence from treatment trials*
Referenced extract from: Carruthers, B. et al. Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols Journal of Chronic Fatigue Syndrome, Vol. 11 (1) 2003; pp7-115
[8] Immunoglobulins – rationale for use and evidence from treatment trials
Critical scrutiny of York review coverage, with some material from ‘Canadian’ paper backing rationale for immunological intervention.
[9] Gancyclovir Study – comparison of original publication with reporting in York review
Comparative extracts, indicating that the coverage in the ‘York Review’ for the National Institute for Health and Clinical Excellence failed to do justice to the reported findings of this small study.
[10] Human Tragedy and the Heart of the Matter - the work of Martin Lerner MD
Relating to the tragic death of a young ‘CFS’ sufferer in the US with summaries of relevant and revealing research on antiviral therapy by Martin Lerner MD (who is also the author of the gancyclovir study above
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SCOTTISH GOOD PRACTICE STATEMENT (SGPS) ON ME IN SCOTLAND
Guidelines for General PractitionerS in Scotland
Latest - 2010
Scottish Good Practice Statement for GPs – info and call for feedback (already submitted)
This document covers the SGPS & the Group’s position on the SGPS, flags up future plans, and seeks feedback about how members are finding the SGPS is impacting in practice, and also any experiences of consultations with clinicians who were on the working group or peer review group involved in producing it. Includes helpful extracts regarding the care of severely affected patients that members may wish to draw to the attention of their general practitioner and others involved in their care. The extracts on the evidence for effective pain relief for neuropathic pain may be of assistance to members throughout the UK.

Long Term Conditions ‘Self Management’ Approach
The NHS approach to M.E. in Scotland, for the most part, appears to fall under the generic remit of ‘long term conditions’ (new term for chronic illnesses). ‘Self management’ is the overarching approach. Advocacy of self management may look like a statement of the obvious – if only we could hand our ‘condition’ over to someone else to ‘manage’. What does it mean? Well, according to the Self Management Strategy.......:
Main Document

CHALLENGING EXERCISE AND CBT
A summary of “Reporting of Harms Associated with Graded Exercise Therapy and Cognitive Behavioural Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome” by Tom Kindlon
Is exercise safe_.rtf
Sources of Evidence and Priority Status.rtf
CBT and Exercise

PACE RELATED INFORMATION
Publication of ‘PACE’ Trial Findings in The Lancet’
25% ME Group Press Release
Prof Hooper Press Release
Prof Hooper What is 'Normal'_ Concerns re PACE benchmarks from Malcolm Hooper.rtf
PACE - SLIDES FOR HOOOPER PRESENTATION to FORWARD ME.ppt
TYMES Trust Press Release
Joint letter to Guardian :-
The letter above, highlights some key concerns about ‘PACE’, including the very low recruitment rate (20%).
It was submitted to ‘The Guardian’ by a group of patients and carers in response to some unfortunate reporting. It was not published.
PACE article does not mention FINE findings - Letter to Lancet
This is being sent on behalf of Professor Malcolm Hooper.
"In view of the content of the "Health Report" broadcast that was hosted by Dr Norman Swan on Australian radio (ABC Radio National) and the comments of Richard Horton, Editor-in-Chief of The Lancet, Professor Hooper has decided to place his complaint in the public domain forthwith so that people can read it for themselves and form their own judgment.
It is important to make very clear that ME/CFS is not a somatoform disorder but a serious multi-system organic disease."
Please click on the links below to view the complaint on a web page or download as a Word doc. Permission to repost.
WEBPAGE
WORD DOC
THE ‘PACE’ & ‘FINE’ TRIALS: UPDATE - 3/8/11

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