The FINE Trial. BMJ ARTICLE. Nurse led, home based self help treatment for patients in primary care

What is the second positive RCT that you are referring to, Dolphin? (Assuming that PACE is the first.)

The NICE guidelines last time used this systematic review as the basis - it lists the RCTs, including those which were seen as positive, etc:

Thanks Dolphin.
I think there may also have been a number (or at least a couple that I seem to have read, but I haven't been keeping track of them) of review papers over the past couple of years or so, that have framed CBT/GET in a negative light. I haven't followed them closely, but I imagine you might have done.
Do you think there might be enough evidence, as per those reviews, and papers like the 'harms' paper, that might provide the right kind of evidence to present to NICE next time?
I'm not saying that they'll change their minds, but do you think we've got enough of the right kind of evidence to give the psychiatric lobby a good run for their money?
Just interested in your thoughts, off the top of your head, based on any research you've been following.

Well, off the top of my head, I think if one looks at objective measures* like the 6-minute walking test, with no difference for CBT and only a small improvement for GET, and then combine it with the evidence about potential harms, I think one has quite a good case against these treatments. However, things like the SF-36 "physical functioning" scale tends to be seen as actually measuring physical functioning, and there are more results for that than for the 6MWT, which I don't think has been used in other CBT or GET studies (off the top of my head) (or not many anyway).

However, a problem is that I don't think other treatments can easily be pushed for.
I think patients should have tried to stay away from NICE in the ME/CFS area. So many patients seem to push for things, focusing on possible good outcomes, rather than thinking negative outcomes are also possible and weighing things up. It's a bit like how so many people can be wont to recommend exercise for M.E. patients.

But I think it's probably worth the fight: one might win some battles, put doubt in people's mind about the so-called evidence and then by the next time around, one might be in a stronger position: then there could be a drug on the table with sufficient effidence and it'd be CBT/GET vs the drug.

* I know it may not be perfect test. But it seems reasonable to call it an objective measure. A blood test reading could be described as an objective measure, but that doesn't mean that there can't be confounders that affect its interpretation.