So even if we find the perfect biomarker, we're not out of the woods yet...
Yes, some people will continue believing that a disease is psychosomatic even in the face of obvious biomedical pathology.
Fortunately everyone else in the world realizes that those people are bat-shit crazy, and won't pay any attention to them. Similar claims can be (and recently have been) carefully made about MS patients, etc, by those same people, but no one is listening to them.
As this study appears self paced... patients are less likely to make themselves sick over this to the point of relapse (well at least I hope).
Not really self-paced. Patients are supposed to exercise at a "negotiated" (researcher-determined) amount, and "planned" increase will also be determined. But patients are allowed to choose intensity, and allowed to fail to meet their goals of course:
Dr Katia Ferrar said:
The intensity of the gaming will be at the discretion of the participant. The duration of the gaming will be negotiated with the participant and the trained research assistant (accredited exercise physiologist) and a planned increase in volume to not exceed more than a 20% increase from week to week with a maximum of 5 minutes/day increase each week.
So there is a planned consistent increase every week. This is classic GET. They are simply clarifying that they will start at varying levels depending on the fitness of each patient, and that they will pretend to let the patient make decisions while manipulating the patient to go along with the exercise physiologist's goals. And they explicitly state they will be monitoring actual time spent exercising and whether those goals are reached or not, which is adding pressure for those who want to please the researchers.
Even with the statement that patients can fail to meet their goals if they need to manage symptoms, there is still that pressure to perform, especially with the exercise being tracked. On the plus side, they'll be able to see how spectacularly ME patients are unable to increase their activity levels (if they actually recruit ME patients). On the downside, the 2-day CPET, and the setting of unrealistic goals is probably going to harm every ME patient in the study.