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Ebola virus disease sequelae: a challenge that is not going away
- Thread starter Dolphin
- Start date
trishrhymes
Senior Member
- Messages
- 2,158
Oh god, don't let them inflict CBT and GET on the poor Ebola survivors. Surely they've suffered enough.
RogerBlack
Senior Member
- Messages
- 902
Commented
The above comment notes about CFS 'evidence based treatment programs include graded exercise and CBT'. Unfortunately, the evidence for these actually helping is weak or nonexistant.
A recent reanalysis [1] on if patients actually recovered during the largest randomised trial of graded exercise therapy and CBT [2] found they did not recover statistically significantly compared to controls, and the level of 'recovery' was very far from 'to normal'.
" When recovery was defined according to the original protocol, recovery rates in the GET and CBT groups were low and not significantly higher than in the control group (4%, 7% and 3%, respectively)."
The PACE trial suffered from outcome switching, as well as other changes in the pre-trial protocol, dilution of the patient population using criteria that may have included patients with depression and recovery thresholds that meant some of those going in were already classed as 'recovered'.
Due to the low recovery thresholds, even if the initial rates of recovery were sustained in the long term (they were not), the treatments effect approaches clinical insignificance, even if you believe the original trial numbers.
The original recovery threshold is equivalent to patients with class II congestive heart failure.
1] http://dx.doi.org/10.1080/21641846.2017.1259724
2] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60096-2/abstract
The above comment notes about CFS 'evidence based treatment programs include graded exercise and CBT'. Unfortunately, the evidence for these actually helping is weak or nonexistant.
A recent reanalysis [1] on if patients actually recovered during the largest randomised trial of graded exercise therapy and CBT [2] found they did not recover statistically significantly compared to controls, and the level of 'recovery' was very far from 'to normal'.
" When recovery was defined according to the original protocol, recovery rates in the GET and CBT groups were low and not significantly higher than in the control group (4%, 7% and 3%, respectively)."
The PACE trial suffered from outcome switching, as well as other changes in the pre-trial protocol, dilution of the patient population using criteria that may have included patients with depression and recovery thresholds that meant some of those going in were already classed as 'recovered'.
Due to the low recovery thresholds, even if the initial rates of recovery were sustained in the long term (they were not), the treatments effect approaches clinical insignificance, even if you believe the original trial numbers.
The original recovery threshold is equivalent to patients with class II congestive heart failure.
1] http://dx.doi.org/10.1080/21641846.2017.1259724
2] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60096-2/abstract