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Court rules in favour of NICE on CFS/ME guideline

Sunday 15 March 2009

National Institute for Health and Clinical ExcellenceTwo individuals in the UK issued a legal challenge in the High Court. It involved a set of guidelines for doctors produced in August 2007 by The National Institute for Health and Clinical Excellence (NICE).

The individuals issuing the challenge claimed that the NICE Guidelines, which promotes the use of Cognitive Behaviour Therapy (CBT) and Graded Exercise Therapy (GET) as treatments for ME/CFS, were “perverse and irrational” (see earlier article).

The High Court ruled on Friday (13 March) in favour of NICE.

NICE has issued a press release following the ruling:

“The High Court has today ruled in favour of NICE on all grounds brought against the Institute in the judicial review of its clinical guideline on chronic fatigue syndrome / Myalgic encephalomyelitis (CFS/ME). The claim against NICE was brought by two CFS/ME patients. The grounds of challenge, all of which the Judge has dismissed, included an allegation of bias against the guideline development group and its members, that the guideline is irrational compared to the evidence, and claims about the classification of the condition and treatments recommended.

Professor Peter Littlejohns, NICE Clinical and Public Health Director, responded to the High Court judgement saying: “We are pleased to have won convincingly on all counts in this case - this judgment is a welcome endorsement of the rigorous methods we use to produce our guidelines. This result is very good news for the thousands of people with CFS/ME, who can continue to benefit from evidence-based diagnosis, management and care for this disabling condition. The 2007 guideline was welcomed by patient groups as an important opportunity to change the previous situation for the better, helping ensure that everyone with CFS/ME has access to care appropriate for the individual. Today’s decision means that the NICE guideline is the gold standard for best practice in managing CFS/ME.”

Professor Littlejohns continued: “The guideline was developed by an independent group comprising clinical specialists in CFS/ME, patient representatives and experts involved in the diagnosis of the condition and provision of care. This guideline development group (GDG) considered a range of complex issues in great depth taking full account of the views of patient groups and health professionals. We agree with the judge that the GDG were a dedicated group of individuals who worked together to produce the best possible guideline, and that the accusations that they were biased were completely unfounded. The judge recognised the key role that professionals and patients have in contributing to the development of NICE guidelines and therefore understood the vigorous approach NICE took in defending these health experts. We are pleased that all members of the GDG and those involved in selecting the GDG were totally exonerated from the unfounded claims made against them. The judgment acknowledges the robust procedures that NICE follows in ensuring that its guidance is independent, evidence-based and fit for purpose. We’re delighted that this issue is now closed and look forward to continuing to produce world-class guidance which benefits everyone who uses the NHS.”.”

The press release can be downloaded here:


NICE: Court rules in favour of NICE on CFS/ME guideline (PDF, 815KB)



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