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Examples of misleading statements in CFS papers from biopsychosocialists

Discussion in 'Latest ME/CFS Research' started by biophile, Jan 23, 2012.

  1. Snow Leopard

    Snow Leopard Senior Member

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    Australia
    Thanks, that is what I'm after.
  2. Valentijn

    Valentijn Activity Level: 3

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    Code:
    Table 5: Number of patients with paid work and total worked hours per week before and after CBT
    # of hours   0.5-8   8.5-16   16.5-24  24.5-32  32.5-40   Average        N
     paid work   hrs(N)  hrs(N)   hrs (N)  hrs (N)  hrs (N)   hrs(st. dev)
    Before CBT     4       6       12       6        13        24.9 (11.9)   41
     After CBT     6       4       15       2         4        20.0 (9.9)    31
    
    Table 6: Number of (university) student patients and study hours per week before and after CBT
    # of hours   0.5-8   8.5-16   16.5-24  24.5-32  32.5-40   Average        N
    study/week   hrs(N)  hrs(N)   hrs (N)  hrs (N)  hrs (N)   hrs(st. dev)
    Before CBT     4       5       2       2         2        17.3 (12.2)    15
     After CBT     4       5       2       1         0        12.7 (7.1)     12
    
    Table 7: Number of patients active in sports and hours doing sports per week before and after CBT
    (this probably includes working out in a gym, etc)
    # of hours   0.5-1   1.5-2   2.5-3   3.5-4   4.5-5    More than  Average        N
    sport/week   hrs(N)  hrs(N)  hrs(N)  hrs(N)  hrs (N)  5 hrs (N)  hrs(st. dev)
    Before CBT    11       4       1       3         5       0         2.4 (1.64)   24
     After CBT    10      18       2       0         4       2         2.3 (1.65)   36
    
    Table 8: Number of hours of active social contact per week before and after CBT
     # of hours       0     0.5-1   1.5-2   2.5-3   3.5-4   4.5-5   More than  Average        N
    active social   hrs(N)  hrs(N)  hrs(N)  hrs(N)  hrs(N)  hrs(N)  5 hrs (N)  hrs(st. dev)
       contact
     Before CBT       36      24      17       8       6       0        6       1.64 (2.0)    100
      After CBT       35      25      20       7       3       2        6       1.58 (1.9)    100
    
    Table 9: Number of  hours of passive social contact per week before and after CBT
     # of hours       0     0.5-1   1.5-2   2.5-3   3.5-4   4.5-5   More than  Average        N
    passive social  hrs(N)  hrs(N)  hrs(N)  hrs(N)  hrs(N)  hrs(N)  5 hrs (N)  hrs(st. dev)
      contacts
     Before CBT      16      27      25      12      10       5        5       2.16 (1.9)     100
      After CBT      19      31      25      12       3       5        5       1.93 (1.9)     100
    I think it's extremely interesting that structured exercise increased after CBT, and all other forms of activity dropped. As far as I can tell, an extra 25.2 hours of structured exercise (total for the entire group of 100) correlates with a drop of 508 hours per week spent at work or at studies.

    I doubt that each person exercised an extra 15 minutes and worked/studied 5 hours fewer. My guess is that those 12 (or more) people that started exercising after CBT (which is the point of CBT) had some serious trade-off in the form of working/studying less, stopping work, and/or dropping out of university altogether.
  3. biophile

    biophile Places I'd rather be.

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    Nater et al 2012 (emphasis added):


    PubMed entry : http://www.ncbi.nlm.nih.gov/pubmed/22608645

    Full text on CO-CURE : https://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind1205d&L=co-cure&F=&S=&P=12748

    Double-blind CBT/GET trials? <smirk>

    The credit for this find goes to Esther12 for pointing it out on another thread (http://forums.phoenixrising.me/inde...-handbook-of-clinical-neurology-vol-106.17640).
  4. taniaaust1

    taniaaust1 Senior Member

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    That Table 5 with the CBT results.. can someone please tell me what paper/study that comes from?
  5. biophile

    biophile Places I'd rather be.

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    I think it is this: http://home.planet.nl/~koolh222/cgtbijmecvsvanuitperspectiefpatient2008.pdf

    Abstract summary is in English:

    English translation of parts of the full text here: https://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0803A&L=CO-CURE&P=R890&I=-3

    http://translate.google.com should help further.
  6. Valentijn

    Valentijn Activity Level: 3

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    It's from the link Biophile just provided. I added the tables here, because the tables for those sections weren't completely translated to English.
  7. biophile

    biophile Places I'd rather be.

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    How to exercise people with chronic fatigue syndrome: Evidence based practice guidelines. (Van Cauwenbergh et al, 2012)

    Just adding the example to this thread, but see full details on the dedicated thread for this paper:

    http://forums.phoenixrising.me/index.php?threads/scary-new-paper-on-cfs-and-exercise.17782

    This systematic review presents itself as making evidence-based recommendations about what exercise CFS patients can do without significant exacerbation of symptoms, ie starting with 5-15 minutes of aerobic activity (walking, swimming, cycling) 5 times per week and increasing sessions to 30 minutes, but these conclusions seem to be based on presumptions and hypothetical goals in CBT/GET studies rather than evidence of what patients actually did. There are many patients who cannot even start at that level of exercise without consequences, and there is no convincing objective evidence that patients generally increase activity after CBT/GET anyway, the limited evidence available suggests no significant changes.

    The authors even admit that there is limited or no evidence of compliance in these CBT/GET studies. They do have other important caveats about the generalizability of the results and the methodological weaknesses of the reviewed studies, but they don't go far enough. I compare the potential danger of this paper with that of the PACE Trial, where it will be presumed safe to increase activity as per rationale for these therapies, despite these studies not actually showing such occurred rather than just aimed for.

    This new paper depends on self-reported fatigue and physical function only and does not review actigraphical data or employment outcomes etc. The paper also claims that the FINE Trial demonstrated significant improvements in both fatigue and physical function, but the FINE paper itself does not confirm this for physical functioning, and neither does the FINE authors' BMJ rapid response.
  8. Enid

    Enid Senior Member

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    Biopsychosocialists - what a name - still trying to hang in there - doesn't fool me (I doubt even the current slugs in the garden too which are much more specialised).
  9. Esther12

    Esther12 Senior Member

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    Not particularly important, but I just noticed that this is not on-line. Anyone got a copy to paste up for biophile post? I've started trying to remember to save these things, or maybe I should start attaching them. The internet can change so often.

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