Peter Denton White was part of a small committee involved with this report it seems.
There is no mention of the employment outcome measures from the PACE Trial which cost £5m of UK taxpayers' money, yet the subjective outcomes are mentioned.
https://www.gov.uk/government/uploa...fectious-diseases-imeg-20-Sept_2013-clean.pdf
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There is no mention of the employment outcome measures from the PACE Trial which cost £5m of UK taxpayers' money, yet the subjective outcomes are mentioned.
https://www.gov.uk/government/uploa...fectious-diseases-imeg-20-Sept_2013-clean.pdf
27 September 2013
IMEG Report on Infectious diseases and sequelae in recent deployed service
1. Following several claims for deployment related febrile illness and their sequelae, IMEG was asked by Minister to investigate and report on the AFCS approach to these disorders, with a particular focus on Q fever and post Q fever fatigue syndrome (QFS).
This short report was informed by literature search and discussion with relevant military and civilian experts.
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14. A variety of treatments ranging from steroids to anti-infective treatment has been provided for fatiguing illness following infection. In general, for all types of persistent fatigue state, optimal management is based on: i) accurate diagnosis of all disorders including co-morbid sleep problems, depression and pain; ii) treatment of co-morbid conditions; iii) focus on the fatiguing illness with active rehabilitation.
Research findings show that individually (not group) delivered Cognitive Behavioural Therapy (CBT) and Graded Exercise Therapy ( GET) as compared to specialist medical care alone are moderately effective (effect sizes 0.5 to 0.8) when added to specialist medical care and delivered in courses of suitable intensity and duration by well qualified and trained therapists (14).
15. The published literature on the natural course, duration, prognosis and effective interventions for fatiguing illness of all types is limited.
Disability, functional outcomes and employability have not been a major focus of studies and comparison of studies and interpretation is hindered by different case definitions and whether patients are drawn from primary or specialist care settings, the latter usually being the more severe cases. The prognosis for patients receiving specialist care for persisting fatiguing illness (spontaneous and post infective) without specific treatment is poor.
A 2005 meta-analysis of 14 studies, of sample sizes between 20 to 3201, with defined entry criteria, published between 1991 and 2002 and followed for between 5 and 10 years showed untreated, a median full recovery rate of 5% (with a range across the studies of 0-31%) while there was symptomatic improvement at follow-up in a median of 39.5% cases ( range 8-63%).
Better outcomes were associated with less severe fatigue at the onset, patients having a sense of control over symptoms and not attributing illness to a physical cause (15).