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Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome

Discussion in 'Latest ME/CFS Research' started by A.B., Mar 31, 2017.

  1. A.B.

    A.B. Senior Member

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    Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome
    Anthonie Janse, Stephanie Nikolaus, Jan F. Wiborg, Marianne Heins, Jos W.M. van der Meer, Gijs Bleijenberg, Marcia Tummers, Jos Twisk, Hans Knoop

    Some people commented on the study on Twitter:







    http://dx.doi.org.sci-hub.cc/10.1016/j.jpsychores.2017.03.016
     
    Laelia, Valentijn, GreyOwl and 11 others like this.
  2. Snow Leopard

    Snow Leopard Hibernating

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    South Australia
    Seems these authors are in on the same game as the PACE authors in fudging thresholds.

    No surprise it's published in the Journal of Psychosomatic research, a journal known for it's poor quality peer review.
     
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  3. Dolphin

    Dolphin Senior Member

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    This paper uses a threshold for fatigue of 35+.

    In the abstract, this is called a threshold for "severe fatigue". However scores lower than that are also called "fatigue scores in the normal range"

    Here is something Andrew Kewley wrote on this which regards to another paper by some of the same team:

    https://www.ncbi.nlm.nih.gov/pubmed/28265678#cm28265678_65392

     
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  4. Dolphin

    Dolphin Senior Member

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    Even their own data shows that using a threshold of SF-36 physical functioning of 65+ is not a good threshold for impairment as 39% had scores of 65+ before treatment (see figure 3).
     
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  5. Dolphin

    Dolphin Senior Member

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    Plenty of material here to respond to if anyone is inclined:

    http://www.jpsychores.com/content/authorinfo

     
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  6. Dolphin

    Dolphin Senior Member

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    Note that readers of the abstract aren't given what thresholds are used.
     
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  7. Dolphin

    Dolphin Senior Member

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    They do do a new analysis of fatigue scores in this study which does get you have around 35 (indeed mean +1 standard deviation = 38.52):
    They never say that these are healthy people however.
     
  8. RogerBlack

    RogerBlack Senior Member

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    Unless you're excluding the same illnesses in your cohort of CFS patients as you exclude in determining 'healthy' people, it would be wrong to compare to healthy people.
    You want (ideally age-matched) controls of similar health other than CFS.
     
  9. Dolphin

    Dolphin Senior Member

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    They don't mention the results here for the control group:

    In Deale et al., the percentage with CFQ <4 was exactly the same as the CBT group.
    There wasn't a statistically significant difference in terms of who scored >83 on the SF 36 PF (48% vs 32%). Slightly fewer people scored <4 on General Health Questionnaire following CBT versus controls (48% versus 54%). On the clinical global inventory, 68% marked themselves as much better or very much better following CBT compared to 36% in the controls..

    In Sharpe et al., there was no statistically significant difference for CBT over the no individualised therapy group for both fatigue and physical functioning.
     
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  10. Dolphin

    Dolphin Senior Member

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    Some results from the text:

     
  11. Dolphin

    Dolphin Senior Member

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    This is interesting. There is no mention of this bias in the abstract.
     
    Last edited: Apr 1, 2017
  12. Dolphin

    Dolphin Senior Member

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  13. Dolphin

    Dolphin Senior Member

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    It would have been interesting to have known more about people's work status. My guess is a lot of the CFS people were not working full-time.
     
    Last edited: Apr 1, 2017
  14. Dolphin

    Dolphin Senior Member

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    They don't mention that the Dutch form of CBT encourages patients to see themselves as not CFS patients.
     
  15. Dolphin

    Dolphin Senior Member

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    Something to look forward to … not.
     
  16. Dolphin

    Dolphin Senior Member

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    They don't mention a lack of objective measures e.g. actometers though this study does look at work status.
     
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  17. Dolphin

    Dolphin Senior Member

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  18. Dolphin

    Dolphin Senior Member

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    I'm not sure if that has been explicitly mentioned before in this thread, but the big issue with this study is we don't now how a similar group who didn't have CBT would have fared.
     
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  19. Dolphin

    Dolphin Senior Member

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    This image is from Wilshire et al. (2016). The threshold for normal physical functioning in the current study is 65+

    Wilshire Kindlon fig 1.png
     
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  20. Keith Geraghty

    Keith Geraghty Senior Member

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    the small drop in physical function with increasing fatigue ie those recovered are having more fatigue as time goes on - just doesnt add up; CFS patients experience clear problems with physical function and social function and fatigue --- one wouldnt fall without the other

    when it doesnt add up.....?
     
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