I’ve recently been contributing to a draft book chapter about how clinical practice guidelines have been developed for chronic fatigue syndrome (CFS) in different countries, despite uncertainty. Last week I was motivated to work on it, when I read in New Scientist that researchers have associated CFS with a retrovirus called XMRV. The paper is in Science (That’s the second time in three blog posts I’ve referenced the journal Science, while I haven’t referenced Nature yet. A faux pas, given this blog’s location?).

I duly updated the chapter with references to this latest research, and marvelled at how exciting science is. I became a journalist because I was interested in news, and to me, discoveries in science are the epitome of news. The saying goes that history repeats itself, but science, by nature, is prone to turning things upside down with a new discovery. Revolutions tend to happen in the midst of technological change.

This link between a retrovirus and CFS is not necessarily revolutionary – though CFS sufferers that have had the XMRV virus may feel that way. Other researchers in the same issue of Science called for lab and epidemiological studies to see if there’s a causative role. But for the people who’ve had the virus whose symptoms were labelled psychiatric, the discovery gives hope that they might be treated differently by doctors.

Doctors are put in a hard position, given that science is never about definitive truth (as Henry Gee recently ranted about in his blog), but doctors nevertheless need to make definitive decisions in the face of uncertainty. This contradiction is so interesting that there are two books called How Doctors Think (I read – and enjoyed – the Jerome Groopman one; I’m aware of Kathryn Montgomery’s because I saw a copy on my boss’s desk).

I don’t envy people working at the practical end of the spectrum when it comes to controversial issues. I wonder if they suffer a horrible feeling in their guts whenever they come across research suggesting they might have made a wrong decision? Or do they accept that you can’t make the right call every time?