I know that people like Angela Kennedy have been complaining about the use of the London criteria in the PACE Trial for many years so I don't claim I am saying anything novel; however, I just thought I'd post my thoughts/observations for what they are worth. ------------- PACE Trial - 97% of the participants who didn't have a psychiatric disorder satisfied the definition of M.E. used In the Lancet paper on the PACE Trial (by White et al (2011)), it said: ---------- ----------- I was not 100% sure what "no primary depressive or anxiety disorder (interpreted as an absence of any such disorder)" meant in relation to the percentage we were given for "any psychiatric disorder" i.e. could there be an overlap. The following is an extract of a letter that clarifies it (see underlined bit in bold) - the letter was written by PD White, KA Goldsmith, AL Johnson, R Walwyn, HL Baber, T Chalder, M Sharpe, on behalf of all the co-authors (of the PACE Trial) --------- (source: http://www.meactionuk.org.uk/whitereply.htm ) ------- The figures from the paper (Table 1) show that, of the 640 participants, 300 (46.9%) had "any psychiatric disorder" and 51.4% (329) satisfied the London criteria*. This means that of the 340 patients in the trial (i.e. who satisfied the Oxford criteria**, with a principal symptom of fatigue, who did not have a psychiatric disorder), 329 (96.8%) satisfied the London criteria for M.E., the definition of M.E. used in the trial! This is an amazingly high figure for a definition of M.E. given the "looseness" of the Oxford criteria e.g. unlike the Fukuda CFS criteria or Carruthers ME/CFS criteria, it doesn't require other symptoms apart from fatigue. It seems to me the definition for M.E., at least as it was used in this trial, is very suspect. And hence it is questionable what can read into how people with M.E. responded in the trial. --- *One can how the London Criteria were used here: ** One can how the Oxford Criteria were used here: Annex 1: We already cannot be sure if the participants are representative of patients in the community based on who refused to take part, were excluded, etc.