Ehlers-Danlos syndrome.

448 BMJ | 1 SEPTEMBER 2007 | VoluME 335 hinder implementation of these recommendations. Recognising the condition and the impact it can have on the lives of patients and their families is therefore a necessary preliminary to improving care. • People with severe CFS/ME who are housebound or need prolonged bed rest require specialised care, but evidence is lacking about which treatments are most effective to reduce their symptoms. • Little research exists on CFS/ME generally, and specifically on its causes and diagnosis. • The guideline development group recognised the need for wider research on aetiology and pathogenesis, as a basis for developing new treatments. • For all people with CFS/ME the guidelines recommend an integrated, multidisciplinary approach, incorporating health and social care, with support for education and work when and if the patient is ready. This comprehensive approach can be difficult to achieve unless one named professional has responsibility for coordinating the patient’s care. Both authors were members of the Guideline Development Group for the NICE guideline (RB chaired the development group and EJS was a reviewer).