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Internet-Based Therapy for Adolescents With Chronic Fatigue Syndrome: Long-term Follow-up (2013)

Discussion in 'Latest ME/CFS Research' started by Dolphin, Sep 19, 2013.

  1. Dolphin

    Dolphin Senior Member

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    The original paper is discussed in this thread: http://forums.phoenixrising.me/index.php?posts/360343/. I see a few people have posted about the follow-up paper. However, that's all the way down in message #149.

    I missed the opportunity to post an e-letter on this paper (they have to go in within three months of publication) but would like some observations to show up on search engines and the like. So thought I'd be best to have a separate thread.
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  2. Dolphin

    Dolphin Senior Member

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    Possibly the most interesting statistic in this paper isn't in the abstract
    ---

    The figures in the abstract are further apart:
    But the 52.8% group includes people who had undergone FITNET at that stage.


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  3. Dolphin

    Dolphin Senior Member

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    The same questionable definition of recovery is used as in the first paper. This means the points in the two published letters are still relevant. Both are available for free:





  4. Dolphin

    Dolphin Senior Member

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    is frustrating.

    They just give the figures for the various measures for the "recovered" and "non-recovered" groups. That is to say, we can't compare the FITNET-recovered with the others that claimed to be recovered.

    In the original paper, we could and the results for the FITNET-recovered weren't as good as the others that claimed to be recovered, or healthy controls, as the two published letters highlighted.
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  5. Bob

    Bob

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    England, UK
    My conclusion was that there was no significant difference between patients receiving FITNET and patients receiving ‘usual care’, at long-term follow-up. (FITNET reportedly sped up improvement, but didn't increase improvement.)
  6. Dolphin

    Dolphin Senior Member

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    As I mentioned, the letters cover a lot of points regarding this definition. Unfortunately they don't cover all the points raised in the original thread i.e. drawing attention to the question on self-rated improvement

    The original paper lists the wording in more detail:

    Can't put my hands on more details on the other two options apart from "have the same complaints", or
    "have become worse".

    Seems odd to me that somebody would say that they weren't "completely recovered" and be counted as recovered. I think data on people who just say they have "completely recovered" would be interesting.
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  7. Dolphin

    Dolphin Senior Member

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    They don't give any data on using more strict recovery criteria ( >1 SD vs >2 SD) except to say:

    Note that 66 is out of 112. So this represents 58.9% and 57 represents 50.9% (i.e. using >1 SD threshold, 50.9% would be classed as recovered). It doesn't break it down between the FITNET and usual care groups.

    In the original paper, the effect of using the >2SD threshold over the >1SD threshold was greater (63% vs 36%).
  8. Dolphin

    Dolphin Senior Member

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    These seem not too bad.
    However, I think this is somewhat misleading. These figures/percentages don't necessarily represent the "number of adolescents [who] experienced a relapse during the follow-up period". These figures/percentages relate to a single timepoint: some of the other people could have had relapses but just at the timepoint of the follow-up measurement they could be classed as recovered.
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  9. Dolphin

    Dolphin Senior Member

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    This seems like it might be questionable that those working part-time should be classed as recovered, but the numbers are small so might not make a huge difference:
    ---
    so calling them adolescents is a bit odd.
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  10. Dolphin

    Dolphin Senior Member

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    They haven't adjusted for checking for lots (16!) of factors in
    They looked at 16 things but only two were significant at p<0.05 (at p=0.02 and 0.03). (So, for example, using p<0.01, none would be significant).




    ---
    They also did not confirm some earlier findings:
    Note: this analysis relates just to people who ever did FITNET:

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  11. Dolphin

    Dolphin Senior Member

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    Note that the parents were already part of this treatment, so it's not clear how interesting or useful the finding is relating to mothers:

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