RACP Guidelines for CFS

Laurence E Budd MB BS

Thankyou for the opportunity to comment on the Revised Draft 2001Guidelines.

This document reflects an extensive examination of a difficult subject. In my view it epitomises limitations with the scientific methodology and the application of "evidence based medicine". Inevitably conclusions have been reached that represent opinion or consensus view, rather than a statement of the obvious that insufficient evidence exists to allow an accurate and definitive conclusion to be reached. That a number of similar opinions can be assembled from published sources is not in itself "evidence" that an opinion or point of view is correct. The history of medical practices and opinions is littered with consensus points of view that eventually have been shown to be incorrect – the history surrounding Emmanuel Semmelweiss and puerperal sepsis is simply one glaring example with which I am familiar.

The really positive feature of this document is acknowledgement of the reality of CFS, and the responsibility of the medical profession to support and assist those afflicted by this condition not only in a physical sense, but socially as well by acting as advocates for sufferers in their work situation.

Importantly the document accurately identifies:-

There are some specific issues, in my view, that cause concern as to how these "guidelines" may be used.

I welcome the Draft Guidelines and the opportunity to comment. My comments are made in good faith and based on professional experience with afflicted people including adolescents and adults. CFS is a complex disorder that can have a devastating impact on those affected and their families. My personal experience with CFS patients clearly indicates that the medical profession has an obligation to provide professional support of the highest integrity, despite the many unknowns and difficulties in understanding a most puzzling and complex disorder.

Yours faithfully,

Dr Laurence E Budd
Consultant Paediatrician
10 Glenreagh Street
PO Box 1653

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