1. Patients launch a $1.27 million crowdfunding campaign for ME/CFS gut microbiome study.
    Check out the website, Facebook and Twitter. Join in donate and spread the word!
The Lipkin Microbiome Crowdfunding Campaign Launches!
An ambitious $1.27m international, patient-led fundraising campaign storms into action. Sasha invites you to join it!
Discuss the article on the Forums.

Research brief: CBT & GET have little effect on pain in PACE Trial

Discussion in 'Phoenix Rising Articles' started by Mark, Sep 5, 2013.

  1. Phoenix Rising Team

    Phoenix Rising Team

    Messages:
    643
    Likes:
    912
    View the Post on the Blog


    View the Post on the Blog
    Bob, Jenny, Sean and 2 others like this.
  2. Dolphin

    Dolphin Senior Member

    Messages:
    6,299
    Likes:
    4,044
    Thanks Simon.

    This a comment from the thread on the paper: I thought I'd give it more exposure. If anyone can make the table easier to read, feel free to do so in a post underneath (and I'll try to link to it):
    -----

    Anyone else think it's a little suspicious that they only concentrated on muscle pain and joint pain given the table below. This is all the data we got for the other three pain symptoms.

    Looking at tender lymph nodes, for example, the raw changes in percentages were:
    -8% (APT),
    -4% (CBT),
    0% (GET)
    and
    -7% (SMC).

    Or in percentage terms of those with the symptom at baseline:
    26.3% reduction (APT),
    10.7% reduction (CBT),
    1% reduction (GET)
    and
    22.1% reduction (SMC only).

    The results for sore throat, although not as clear cut, also don't suggest much difference or evidence for CBT and GET (headache is intermediary)

    All they say is:
    (note: protocol doesn't mention they are going to do this, so there is a chance they may have had a feel for how things were going, or know from other situations)

    Table 2. Presence of individual symptoms, valid % (n)
    APT APT CBT CBT GET GET SMC only SMC only
    Baseline 52 weeks Baseline 52 weeks Baseline 52 weeks Baseline 52 weeks
    Symptom n=159 n=151 n=161 n=145 n=160 n=144 n=160 n=149
    Muscle pain 71 (113) 60 (91) 64 (102) 50 (73) 71 (114) 50 (72) 72 (115) 60 (89)
    Joint pain 52 (84) 49 (74) 50 (81) 34 (49) 51 (81) 39 (56) 52 (83) 45 (67)
    Headache 37 (59) 31 (47) 39 (63) 28 (40) 37 (59) 29 (42) 36 (58) 34 (50)
    Sore throat 32 (51) 31 (50) 33 (53) 28 (41) 29 (46) 31 (44) 30 (48) 27 (40)
    Tender lymph nodes 31 (50) 23 (35) 32 (51) 28 (41) 29 (46) 29 (41) 32 (51) 25 (37)

    ---
    Another point for what it's worth: the numbers whose data we don't have are:
    APT: 8,
    CBT: 16
    GET: 16
    SMC only: 11
    i.e. the biggest numbers are for CBT and GEt. One wonders what their data might be like.
    Valentijn and Simon like this.
  3. Firestormm

    Firestormm Content Team Lead

    Messages:
    5,258
    Likes:
    4,640
    Cornwall England
    These 'Research briefs' are a great idea and this was a good one to start with - though I still don't get the 'cohen' chart concept - despite SImon's help! :confused: :lol: :thumbsup:
    Simon likes this.
  4. Simon

    Simon

    Messages:
    1,040
    Likes:
    3,079
    Monmouth, UK
    I think that choosing the two most frequent symptoms, plus fibromyalgia as a comorbid disease is a justifiable selection - though it's a good point that the results for other pain symptoms aren't as good. Just looking at the results for other symptoms, my take on it is:
    • Headache: CBT best (CBT 39% -> 28% = -11%; GET -8%; APT -6%; SMC -2%)
    • Sore throat: looks like nothing made a difference
    • Tender lymph nodes: APT best (-8%, all others probably not significant)
    I don't know how much difference that makes to the overall study findings which found CBT/GET made small or insignificant difference to the two most common pain symptoms. Including all symptoms would have made the results a bit weaker, but they are already pretty unimpressive!
    Valentijn likes this.
  5. taniaaust1

    taniaaust1 Senior Member

    Messages:
    6,749
    Likes:
    3,329
    Sth Australia
    This is such a great idea to do research briefs on the PACE trial!

    Thanks Simon
    Sean and Simon like this.
  6. Sean

    Sean Senior Member

    Messages:
    1,045
    Likes:
    1,284
    That's gotta hurt.

    :p
    Dolphin and Firestormm like this.
  7. Legendrew

    Legendrew

    Messages:
    452
    Likes:
    539
    UK
    Nice article - particularly like the graph. Makes it easy to understand the small effect these ''treatments'' have.
    Simon and Sean like this.
  8. Dolphin

    Dolphin Senior Member

    Messages:
    6,299
    Likes:
    4,044
    It wasn't that long a paper so I think they should just have given the same data for all the pain symptoms esp. given it is known there are different sorts of pain (and drugs that target different types of pain) and the title, "Pain in chronic fatigue syndrome: response to rehabilitative treatments in the PACE trial."

    It would, of course, made the discussion section (conclusions, etc.), and how people will interpret the findings, less clear cut, although as you have pointed out, even for those three, the results aren't clear cut themselves.
  9. user9876

    user9876 Senior Member

    Messages:
    634
    Likes:
    1,317
    Its worth pointing out that they didn't follow the proper fibromyalgia diagnostic criteria as they left out the tender points. I had always thought that was a major part of the diagnosis.

  10. Simon

    Simon

    Messages:
    1,040
    Likes:
    3,079
    Monmouth, UK
    I thought that too, but it seems that the 2010 criteria don't require a tender point examination:
    The American College of Rheumat... Wolfe 2010] - PubMed - NCBI

    So I don't really understand the authors point about 'with the exception of tender points when the paper they cite does not require tender points'. I'm afraid at that point, I thought 'whatever' and left it at that.
    user9876 likes this.
  11. Dolphin

    Dolphin Senior Member

    Messages:
    6,299
    Likes:
    4,044
    From my post to the thread http://forums.phoenixrising.me/inde...eatments-in-the-pace-trial.24886/#post-382774 :


    user9876 and Simon like this.

See more popular forum discussions.

Share This Page