Trial By Error: NICE Rejects Current Guidance, Plans “Full Update”

David Tuller


By David Tuller, DrPH.


Let’s give credit where it’s due. Apparently someone with decision-making authority at the National Institute for Health and Care Excellence (NICE) has a grasp on reality and is willing to challenge the claims of the biopsychosocial ideological brigades. That’s the only logical explanation for last Wednesday’s welcome but unexpected announcement that the agency would pursue a “full update” of the guidance for the illness it calls CFS/ME. From what I gather, that means NICE will essentially start the whole guidance development process from scratch.

In announcing the decision, NICE noted the many concerns stakeholders raised about the existing guidance, which was developed in 2007 and promotes treatment with cognitive behavior therapy (CBT) and graded exercise therapy (GET). At the same time, NICE rejected the recommendation of the internal team to which it had delegated the task of reviewing the literature and producing what was called a surveillance proposal consultation document. That consultation document concluded that no changes should be made to the guidance, After NICE released the consultation document in July, it invited input from stakeholders. The agency had previously indicated that it would announce its decision in October.


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