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New paper on FINE in PLOS: "Therapist Effects and the Impact of Early Therapeutic Alliance"

Discussion in 'Latest ME/CFS Research' started by worldbackwards, Dec 15, 2015.

  1. worldbackwards

    worldbackwards A unique snowflake

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    Haven't read it. Doesn't look like they found anything. This is the conclusion:
    This stood out to me:
    According to James Coyne, data has been made available to those at PLOS, which is a start. That said, it's not like FINE can do too much damage compared to PACE.
     
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  2. Sidereal

    Sidereal Senior Member

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    Problem in the first paragraph already:

    The primary outcome measure was one-year follow-up and the effect of pragmatic rehabilitation compared to control group didn't "attenuate", it was null.
     
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  3. ScottTriGuy

    ScottTriGuy Stop the harm. Start the research and treatment.

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    They didn't manipulate their data well enough!
     
  4. A.B.

    A.B. Senior Member

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    Excerpt from a Tuller article on the FINE trial:

    Trial By Error, Continued: Why has the PACE Study’s “Sister Trial” been “Disappeared” and Forgotten?


    Can anyone explain what the point of looking at the effect of therapeutic alliance is here?
     
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  5. alex3619

    alex3619 Senior Member

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    My guess is that this will be cited by the PACE authors to demonstrate a lack of bias in their methods, which it does not, but most will be taken in by the claim.
     
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  6. Gijs

    Gijs Senior Member

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    This contradicts the ideas of professor Blijenberg e.a. He said that only special therapists (with licence for CFS) can give CBT and GET -:) I think the Pace authors wanted that this therapy CBT can be used by any therapist because this is much better for there implementation in the daily care practice. Now every therapist can give CBT and make a lot of money with this scam.
     
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  7. jimells

    jimells Senior Member

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    The various contradictions are very useful. We know from patient testimonies that UK benefits are sometimes denied if CBT isn't done "correctly" by "special therapists" (who probably have long wait lists). Who cares about consistency when there is money to be made by therapists and money to be saved by disability insurers?
     
  8. A.B.

    A.B. Senior Member

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    My thinking is more along the lines: if the effect is 0%, what's the point of trying to figure out how much of that 0% is attributable to the therapeutic alliance?

    It all seems rather bizarre.
     
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  9. Freddy

    Freddy

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    Does anyone (e.g. James Coyne) plan to reanalyse this specific data?

    Given their claims that Rehab. is significantly more effective than listining (at least at 20weeks as they claim)?
    ...which seems very marginal in my (not relevant) opinion?
    And challenging the "attentuation" euphemism (at 70 weeks follow-up).

    I just got the bad feeling there is "slight";) exaggeration wherever we look at... which needs to be challanged.

    Any plans known?
     
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  10. alex3619

    alex3619 Senior Member

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    ... but that is not how they will cite it.
     
  11. Esther12

    Esther12 Senior Member

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    The public release of this data screws so many of PACE's arguments against the release of their data.

    I had thought that maybe their decision to publish like this reflected some desire to distance themselves from PACE? Had the indefensible PACE spin become an embarrassment? Reading the paper makes that seem unlikely. Pro-biopsychosocial bias to everything.

    Some sleepy notes:

    To their credit, they did include this:

    Which is clearer than they often are. To me, their introduction still seems to imply PR is a valuable intervention though.

    Also, are they saying PR did worse at 20 weeks with likert scoring? [edit: No they're not, I misunderstood]. In the BMJ RR where they first provided likert results they said:

    http://www.bmj.com/rapid-response/2011/11/02/fatigue-scale-0

    Is there a contradiction there? I'm half-asleep.

    They went on to mention a certain @Tom Kindlon commenting on some outcomes mentioned in the trial protocol not being released... maybe this played a role in them now releasing their data via plos?

    At the end of their discussion they say:

    So it was effective in the introduction, ineffective in the results section, but effective in the discussion?

    I'm so relieved I finished that - bed, here I come!
     
    Last edited: Dec 18, 2015
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  12. Sean

    Sean Senior Member

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    And it passed peer-review.

    :mad:
     
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  13. Esther12

    Esther12 Senior Member

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    Okay, I wasn't just tired, this makes no sense [yes it does, I was being thick, and misunderstood the sentence as saying PR only had a significant effect at 20 weeks when calculated 0011 rather than 0123, when they were saying it only had a significant effect at 20 weeks when scored 0011, not at 70 weeks]:

    But then, this was the graph they provided in a RR when they released likert (0,1,2,3) results there:

    [​IMG]

    http://www.bmj.com/rapid-response/2011/11/02/fatigue-scale-0

    Anyone digging into the data they provided want to explain what's going on here? Maybe hard to do without TAU data?
     
    Last edited: Dec 24, 2015
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  14. worldbackwards

    worldbackwards A unique snowflake

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    I'm suspecting you're a bit tired now. Unless one of the other eleven Esthers has gotten control :)
     
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  15. Esther12

    Esther12 Senior Member

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    You mean the double post? Yeah - sure I tried to post the above about 4 times, then double posted... right now. Trying to keep up with well people on PACE has been an pleasure and a nightmare. Relieved Tuller seems to have givgen us a break from his excellent work!
     
  16. Snow Leopard

    Snow Leopard Hibernating

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    Now we're up to Esther13. Be afraid!
     
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  17. Valentijn

    Valentijn Senior Member

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    It's a bit odd. The calculated values for PR and SL match up with the points on the graph. Specifically, at week 70 PR has an average Fatigue score of 23.76 while SL has 26.5.

    There are a lot fewer patients at week 70, compared to week 20. SL is down to 88 out of 101 (87%), and PR is down to 76 out of 95 (80%). Maybe they couldn't get statistical significance unless they imputed or similar?
     
    Last edited: Dec 17, 2015
  18. Esther12

    Esther12 Senior Member

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    Sorry Val - I was being thick, and misunderstood the sentence as saying PR only had a significant effect at 20 weeks when calculated 0011 rather than 0123, when they were saying it only had a significant effect at 20 weeks when scored 0011, not at 70 weeks. Blame it on being too tired when I first read it. Tricked myself.
     
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  19. Dolphin

    Dolphin Senior Member

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    Trying to make my way through it. A lot of papers are easier to read/less technical.
    Anyone got the questions from the California Psychotherapeutic Alliance Scale (CALPAS)? I find it's easier and better to read such papers when you can see the questionnaires used.
    Or has anyone found any questions from it. Often if you get a question or two, the questionnaire will show up with enough searching e.g. full questionnaires are often not given in open access papers but often turn up in student theses.

    All I've found so far is the questionnaire is scored 1-7, 1 = “Not at all” to 7 = “Very much so”
     
  20. Dolphin

    Dolphin Senior Member

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    No mention of this finding
    from:

     
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