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Do more people recover from chronic fatigue syndrome with CBT or GET than with other treatments?

Discussion in 'Latest ME/CFS Research' started by Dolphin, Feb 16, 2017.

  1. Dolphin

    Dolphin Senior Member

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    Hutan, slysaint, Cheshire and 5 others like this.
  2. Dolphin

    Dolphin Senior Member

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    Doesn't look like it was sent out for peer review
     
  3. Jonathan Edwards

    Jonathan Edwards Senior Member

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    We seem to live in a world full of people digging holes for themselves. What is perhaps more surprising is to see who is passing them a fresh spade.
     
  4. Sasha

    Sasha Fine, thank you

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    I'm surprised it's not open access.

    But the argument seems to be "our results are consistent with other results therefore our methodology must have been right", completing ignoring the fact that their methodology was screamingly and demonstrably wrong.

    So if a faulty methodology produces similar results to other studies, it suggests that something was wrong with those other studies too.

    Except in PACEland, apparently.
     
  5. Sasha

    Sasha Fine, thank you

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    What do you mean? Surely the journal is obliged to provide them with a platform for a response?
     
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  6. trishrhymes

    trishrhymes trishrhymes.wordpress.com

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    So what they are basically saying is, we made sure we changed the criteria for recovery so our results would be in line with previous research - which was all small studies, mostly done by us, and using equally invalid measures...

    So that's all right then...

    In fact what they are admitting, though they may not be bright enough to realise it, is that there was no point doing the PACE trial, since the sole aim was to fiddle the data to fit previous results.

    They show a breathtaking lack of understanding of scientific method.

    :rolleyes::cry::vomit::bang-head:
     
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  7. Sidereal

    Sidereal Senior Member

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    Bizarre argument I haven't seen trotted out before. No one claimed that baseline expectations influenced self-reported outcomes at 12 months but that the CBT/GET which consists of altering patient beliefs and expectations over months and months of "treatment" influenced how they rated their symptoms at the end of the study.
     
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  8. AndyPR

    AndyPR I'm a DAD, I Donate, Advocate and Demonstrate

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  9. A.B.

    A.B. Senior Member

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    That the results are consistent with SOME of the rest of the literature doesn't mean that they are correct. The typical CBT/GET trial suffers from bad methodology in the form of lack of blinding, subjective primary outcomes and an inadequate control intervention just to name the most obvious problem.

    A useful analogy here is that throwing a loaded dice over and over again will give nicely consistent but biased results.

    Wilshica et. al. are telling them the dice is loaded. They respond by saying that the results are nicely consistent.
     
    Last edited: Feb 16, 2017
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  10. user9876

    user9876 Senior Member

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    I think this is a lie. They didn't mention recovery in there statistical analysis plan. They refer to their paper which is a post-hoc evaluation and not a detailed analysis plan.

    If it is meaningful to recover at an sf36-pf of 60 I would challenge them to give an example set of answers that they think are recovered.
     
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  11. user9876

    user9876 Senior Member

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    I notice they have not responded to the issue that the sf36 distribution is wrong for using the mean and SD

    I think their data may support occasional recovery or remission is possible because I seem to remember one or two patients who did seem to have good walking distances - but this was at random (SMC group if I remember).

    They don't seem to have tackled the objective vs subjective issues either.

    An interesting insight into their reasoning processes. There is no right answer but their are definitely wrong answers, given there is set of possible reasonable definitions of recovery (right answers) their definition falls well outside of that.
     
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  12. user9876

    user9876 Senior Member

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    As usual their response fails to address the main issues with their recovery paper but this is to be expected. The response is very very weak which suggests they must know that there paper is undefendable - yet they still defend it. They should simply have issued an apology and withdrawn their recovery paper - it is so obviously wrong that even a casual glance says it is dodgy.

    There response really does say that they don't understand basic principles of running a trial and this should be enough to block them from getting any new research money. Unfortunately it won't.
     
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  13. user9876

    user9876 Senior Member

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    They do provide a better explanation here about their fudging the Oxford definition that in their recovery paper. Since it is obvious in the data they had to release maybe they no longer care. But the figures provided for those no longer meeting the Oxford criteria in the recovery paper included a number of patients who met the criteria as judged by a doctor by simply no longer met the trial entry criteria.

    At the time they published their paper some of their supporters were justifying their results as patients no longer had ME according to the oxford definition but that was untrue.
     
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  14. user9876

    user9876 Senior Member

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    I wondered if that was refering to the virology blog post with the detailed reanalysis? They do include it in the references. I think the analysis holds water as they have failed to manage to give any sensible criticisms of it.
     
  15. suseq

    suseq

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    Well said Professor Edwards. The wilful delusion continues - shame on them. I'm so thankful for the efforts of everyone who continues to call out this nonsense.
     
    Last edited: Feb 16, 2017
  16. trishrhymes

    trishrhymes trishrhymes.wordpress.com

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    Since PACE was a study of people with at least 6 months fatigue, not a study of CFS or ME, the results are irrelevant, except in so far as they proved that their 'therapies' don't even work for this much wider group.

    And, of course at long term follow up it proved to be a null trial, even by their own definitions.
     
  17. user9876

    user9876 Senior Member

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    By their definition it wasn't a null trial because by their definition CBT and GET worked they just need to manipulate the figures to show it. Of course if you start with a defined outcome there is no point in doing a trial.
     
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  18. dyfalbarhau

    dyfalbarhau

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    I think they mean, "getting the last word". Is that why we produce papers these days? Is it truly necessary to provide an alternative view every time someone uses your work for further analysis? It smacks of something other than comradely scientific discourse given the regularity with which it occurs from this particular group.
     
    Last edited: Feb 16, 2017
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  19. Esther12

    Esther12 Senior Member

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    WTF? So a study which used criteria closer to the Matthees analysis had similar results to White's analysis, and this somehow supports the validity of White's criteria?

    The more obvious interpretation is that exciting early findings in small cheap trials were undermined by the null results from PACE.

    Then they move on to the Flo study which used the same [similar] BS criteria as PACE... how can they think that this is helping to justify their criteria changes? It's just noise.
     
    Last edited: Feb 16, 2017
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  20. Esther12

    Esther12 Senior Member

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    'Great work' to everyone involved in the Wilshire paper.... White at al. clearly had nothing of substance that they could pick up on.

    I'm surprised that they said that. They must have known that it was not true.
     
    Last edited: Feb 16, 2017

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