Tom Kindlon
Senior Member
- Messages
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In press, Fatigue: Biomedicine, Health and Behaviour
https://www.researchgate.net/public...arpe_Chalder_Johnson_Goldsmith_and_White_2017
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Naomi Chainee
I just love this "recovery is relative" bullshit. Maybe there's a little wiggle room on the concept, but reasonable people do not consider those with the physical function of class II congestive heart failure "recovered".
For example, the definition of recovery used in the studies
by Deale et al. [8] and Knoop et al. [9] were a lot stricter than
the revised criteria used in PACE. If the Deale et al. recovery
criteria are applied to the PACE data, for example (it is
possible to use three of the four criteria), the PACE recovery
rates fall to a maximum of 9% for CBT, which is very
different from the 24% for CBT cited in Deale et al.
Sharpe et al. [3] challenge our conclusion
that none of the “recovered” patients achieved
normal walking distance in the six minute walking
test. They argue that the norms we used were
inappropriate, because they were obtained from a
version of the task that included periodic verbal
encouragement (“you’re doing well” or “keep up
the good work” every minute, as specified in the
American Thoracic guidelines [12]) whereas
PACE’s version did not. However, a recent large
study that investigated the effect of standard verbal
encouragement in this test did not find it to have a
significant effect on distance walked. [13] Further,
even if we reduce our lower bound for normal
performance considerably (by, say 31m, which is
the largest difference that has ever been attributed
to encouragement in any study, including non-
standard administrations [14]), only two patients
who counted as recovered by the original protocol-
specified definition achieved this new shorter
distance, and both were in the group that received
the comparison treatment, Adaptive Pacing
Therapy.3 None of the CBT or GET patients
achieved this threshold.
You've lost me...
“Rekt”, also known as #rekt, is an Internet slang term which is shorthand for “wrecked,” which is often used in online gaming to indicate that someone has been defeated or embarassed, in a similar vein to the term “pwned”
The original paper and this rejoinder are on recovery. One of the reviewers directed us away from talking about efficacy in general.Nice article. Did you consider pointing out that the subjective "improvement", which is all that's left in favor of the treatment, is comparable to the strength of a psychological placebo intervention as found by Wessely et. al. in a review on the topic?
So this treatment really appears to be completely useless. It's ironic that Wessely himself would provide the proverbial final nail in the coffin.
If you considered pointing this out, can you explain why it was ultimately not done? Is it because ultimately it boils down to belief (in whether a placebo effect is useful or useless despite not leading to objective improvement)?