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Telephone-based guided self-help for adolescents with CFS: A non-randomised cohort study-Lloyd et al

Discussion in 'Latest ME/CFS Research' started by Dolphin, Sep 3, 2013.

  1. Dolphin

    Dolphin Senior Member

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    This abstract doesn't list lots of areas where there were no improvement/no differences, or indeed how some of the differences mentioned in the abstract aren't clear cut (some other people might have left them out). I'll try to list them below.


  2. Dolphin

    Dolphin Senior Member

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    This study used the Oxford criteria.

    ---------

    Measurements were generally taken at 5 timepoints:
    Baseline
    At: 2 months later (just before treatment/therapy started)
    At: 5 months (i.e. 3 months later, after therapy had just finished)
    At: 8 months (i.e. 3 months after therapy had finished)
    At: 11 months (i.e. 6 months after therapy had finished)
  3. Dolphin

    Dolphin Senior Member

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    The very first sentence is:
    The usual way of putting it is something like not explained by other physical or mental illness.

    In the introduction, all the examples given are from psychological conditions/disorders e.g. anxiety, depression, OCD and eating disorders.
  4. Dolphin

    Dolphin Senior Member

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    Although a telephone intervention, it wasn't aimed at the most ill/disabled:
    -------
  5. biophile

    biophile Places I'd rather be.

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    So perfectionism is now good in CFS?
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  6. Dolphin

    Dolphin Senior Member

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    (Actually, the period from baseline to pre-treatment was only two months, versus three months between the pre-treatment end of treatment).

    Anyway, for five of the six measures there wasn't a statistical difference on this!

    Measure where there was a difference:
    Fatigue

    Measures where there wasn't a difference:
    -School attendance
    - Impairment (Social Adjustment Scale) (despite the title, this isn't measuring a psychological construct but physical functioning/similar)
    -Depression
    -Adjustment
    -Anxiety.

    You might ask how does this fit in with what is in the abstract:
    Here's an example:
    School attence:
    36.28%: Baseline
    42.99%: At: 2 months later (just before treatment/therapy started)
    48.80%: At: 5 months (i.e. 3 months later, after therapy had just finished)
    53.40%: At: 8 months (i.e. 3 months after therapy had finished)
    59.27%: At: 11 months (i.e. 6 months after therapy had finished)

    So there is a difference between the pre-treatment and 6-months follow-up (42.99% vs 59.27%) but one can't be sure this wasn't just due to the passage of time as in the two months at the start before treatment, there was an improvement (from 36.28% to 42.99%).
    [Actually the Wald test only compares 36.28% and 42.99% vs 42.99% and 48.80%, but one appears a similar trend might also explain the 59.27% attendance figure.
    Esther12 likes this.
  7. Dolphin

    Dolphin Senior Member

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    So a 7-point CGI scale (as in the PACE Trial)


    It is unclear to me whether "some degree of improvement" would include a CGI of 3 or not i.e. "a little better".
    Esther12 likes this.
  8. Dolphin

    Dolphin Senior Member

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    (For some reason Adjustment is blank for "school attendance")
    This means that they looked at 11 possible predictors for fatigue and none were predictors on their own.

    For school attendance, they looked at 10 possible predictors for fatigue and none were predictors on their own and two were statistically significant. This is at the level of p<=0.05. However given the number of predictors checked, this finding could be due to chance

    Also, the confidence intervals for the two that were statistically significant only barely missed zero:

    If one number had been minus, it wouldn't have been statistically significant.

    Perfectionism wasn't set as a categorical measurements so these may be points per unit which makes them a little stronger.
    Esther12 likes this.
  9. Dolphin

    Dolphin Senior Member

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    Interesting. This must be what this erratum refers to:
    The original paper has:

    in abstract

    and they then go on to talk about this (when the corrected version says the opposite happened)

    So it looks like the wording in the abstract is not good.

    An erratum has been posted for this paper:

    so perhaps it deals with this point.
    biophile likes this.

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