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Chronic fatigue syndrome in children: a cross sectional survey

Discussion in 'Latest ME/CFS Research' started by Dolphin, Mar 1, 2014.

  1. Dolphin

    Dolphin Senior Member

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    Free full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1719321/pdf/v088p00894.pdf

    * I gave each sentence its own paragraph
     
  2. Dolphin

    Dolphin Senior Member

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    This is a cross-sectional study with no control group so isn't as interesting as a controlled trial.
    For that reason, it isn't that important. But given I've read it, I thought I'd post some comments somewhere.

    The abstract says:
    One might think this means that they divided up who attended and who didn't, but they didn't do that. They simply listed the attendance rates before and after.

    Patients could have improved due to the passage of time, or to getting a diagnosis and the benefits it brings, rather than specific effects from treatment.
     
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  3. Dolphin

    Dolphin Senior Member

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    One might think from a lot of the results of this that the children are doing quite well. However, there is a big effect on education.

    Here is the occupational classification of the parents:
    The authors acknowledge some of the poor results in the discussion section:
    *Note again that this was simply a before versus after comparison: they didn't look at other patients and so can't really say that receiving treatment was associated with increased school attendance.

    The underlined bit is useful. Most studies use school attendance alone as a measure of the effect of an intervention on education. However, simply getting back to school doesn't mean one gets back to a good standard of educational achievement.
     
    Last edited: Mar 1, 2014
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  4. Dolphin

    Dolphin Senior Member

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    The Chalder Fatigue Questionnaire was used. Note how they used a threshold of 3/4 for caseness. The PACE Trial was initially going to do this but then switched to a looser definition in the end.

    The scores were pretty good in this case although more than half are still "cases" of fatigue.
    Total fatigue score (bimodal): 4.38
    SD:3.61
    Range: 0–11
    Caseness: 19 (52.8%)

    They make this rather annoying piece of speculation:
    It could also be said that patients may still feel more tired than healthy people but not recognise it, but I don't recall this ever being said (wasn't said in this paper anyway)
     
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  5. Dolphin

    Dolphin Senior Member

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    Probably my final point: this was a survey sent out by a clinic. I recall one teenager once telling me that she told the clinic she was well to get away from them. Jane Colby told she has heard similar things. So it's possible patients may have said they were better than they were/said they were well, so they wouldn't be brought back for more "treatment".
     
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  6. Dolphin

    Dolphin Senior Member

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    One other point I nearly forgot:

    This must cost quite a lot of money.
     
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  7. Min

    Min Senior Member

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    UK
    My friend's granddaughter is receiving treatment at one of Esther Crawley's clinics. She is becoming more and more ill as she is forced to attend school and forced to be active. Her parents were told to buy her a dog to make sure she gets up in the morning and goes for walks. It seems more like child abuse than medical treatment for a physical illness to me.
     
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  8. Esther12

    Esther12 Senior Member

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    Lots of selective "It has even been suggested that..." - building a narrative while trying to avoid any responsibility for what they imply.
     
    Last edited: Mar 1, 2014
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  9. user9876

    user9876 Senior Member

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    I suspect it is quite common to overplay activity with these clinics since they aim to force activity. For example the comment about home tutoring being controversial. With the potential of threats from doctors you just exaggerate.
     
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