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The effect of counselling, graded exercise and usual care for people with CF-Ridsdale

Discussion in 'Latest ME/CFS Research' started by Dolphin, Mar 9, 2012.

  1. Dolphin

    Dolphin Senior Member

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    Free full text: http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8501666 or
    http://journals.cambridge.org/actio...bodyId=&membershipNumber=&societyETOCSession=

    This uses a lot of the same measures as the PACE Trial so some people interested in that might be interested.

    No results for CFS alone given unfortunately.

    * I gave each sentence its own paragraph.

    WSAS scores are sometimes given out of 40 i.e. multiply these scores by 5.
     
  2. Valentijn

    Valentijn Activity Level: 3

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    Hehe, increased anxiety in the CBT group, and more than 65% dissatisfaction. No objective measurements for anyone of course.

    52% dissatisfied with GET, and 54% dissatisfied with counseling. And that's with Oxford criteria patients :p

    The authors seem to be concluding that dissatisfaction will contribute to the treatment failing, but they're not saying it plainly.
     
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  3. Dolphin

    Dolphin Senior Member

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    Missing outcome measures

    The trial's protocol is here: http://www.controlled-trials.com/ISRCTN72136156

    3 of the secondary outcome measures are not reported:
    The paper even gives impression outcome measure #5 was only measured at baseline:
    I'm not confident we are going to see those results. The WSAS scores and the "certified sickness absence" would tend to go together if one was going to publish them as a separate paper.
     
  4. Bob

    Bob

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    Thank you Dolphin.

    I haven't read it through yet, but after an initial look at the results, it looks like this confirms that the meagre results of the PACE Trial are not transferable from a clinical trial setting to general practise setting.

    Have you looked at it enough to know if you would agree with that?
     
  5. Dolphin

    Dolphin Senior Member

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    Not sure one can say that from this study.
     
  6. Bob

    Bob

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    OK, thanks, I'll read it more closely later.
     
  7. Enid

    Enid Senior Member

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    Be nice to know if they have their "numbers" right - bit more than number crunching ME/CFS. Recognised pathologies ?.
     
  8. Dolphin

    Dolphin Senior Member

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    Unfortunately the fact that usual care involved Trudie Chalder's booklet complicates things.
     
  9. Bob

    Bob

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    I've had a closer look at it now, and it seems that it's yet another study without an adequate control group.

    Why on earth use a CBT booklet in the 'usual care' control group to muddle things up?

    I can't quite see the motivation of this study, unless it was to promote CBT and GET taking place in secondary care settings (i.e. the Maudesly Hospital.)


    It concluded that GET was useless in a primary care setting.

    And they conclude that patients get better over time, and so positive CBT/GET studies that have not used a control group in the past, cannot be relied upon.

    "Our findings suggest that many patients improve substantially in the first 6 months. This factor, time, is likely to explain the improvement suggested in prior trials that used evidence from cohorts as comparators rather than randomized control groups (Ridsdale et al. 1993, 2001, 2004)."


    On the down side, they can use the study to:

    Promote GET and CBT in a secondary care settings
     
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  10. Snow Leopard

    Snow Leopard Senior Member

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    Ah, I just posted this on another thread. I hadn't seen it until today...
     
  11. Esther12

    Esther12 Senior Member

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    Only just seen this. Interesting little read though. Ta D.
     
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  12. alex3619

    alex3619 Senior Member

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    "The results of the current study do not support
    early implementation of a short course of either GET
    or counselling for chronic fatigue in primary care."

    They are focussed on chronic fatigue of short duration, with an implication that CBT/GET is warranted for fatigue of more than six months duration. They seem to use CF and CFS interchangeably. I may say more after I have read further. Bye, Alex
     
    taniaaust1 likes this.

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