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Hooper's initial response to White re PACE Trial

Dolphin

Senior Member
Messages
17,567
Hi Dolphin,
Does the paper actually specify that they are refering to the empirical/2003 definition?
I had thought that they didn't specify which international criteria?
Thanks for any info,
Bob
The empirical definition is Reeves et al. (2005).

The paper references Reeves et al. (2003):
Reeves WC, Lloyd A, Vernon SD, et al. The international chronic
fatigue syndrome study group identifi cation of ambiguities in the
1994 chronic fatigue syndrome research case defi nition and
recommendations for resolution. BMC Health Serv Res 2003, 3: 2.

Thereafter allocation was
stratified by centre, alternative criteria for chronic fatigue
syndrome12 and myalgic encephalomyelitis,13 and
depressive disorder (major or minor depressive episode or
dysthymia),14 with computer-generated probabilistic
minimisation

Table 3 shows baseline and outcomes data, and fi gure 2
shows profi les for the primary outcomes. In the fi naladjusted
models (fi gure 3), participants had less fatigue
and better physical function after CBT and GET than they
did after APT or SMC alone. Outcomes after APT were
no better than they were after SMC. Allowing for
clustering eff ects caused by participants attending the
same main practitioner had little eff ect on these results;
intraclass correlation coeffi cients ranged from 002 to
011 for fatigue, and 001 to 003 for physical function.
Participant subgroups meeting international criteria for
chronic fatigue syndrome, London criteria for myalgic
encephalomyelitis, and depressive disorder criteria did
not differ in the pattern of treatment effects
(figure 2; all
pinteractions were non-signifi cant).

Our findings were much the same for participants
meeting the different diagnostic criteria for chronic
fatigue syndrome and for myalgic encephalomyelitis, for
those with depressive disorder, and after allowing for
clustering effects.
 

Dolphin

Senior Member
Messages
17,567
Here I think is the crucial comment on their views:
In conclusion, however we compared the results and however we defined CFS and myalgic encephalomyelitis, we found that cognitive behaviour therapy and graded exercise therapy provided a significant and clinically useful advantage of moderate size over adaptive pacing therapy and specialist medical care, but were no less safe.
This is in the published response this week.

Published comments are what are generally the most important/useful.
 

Dolphin

Senior Member
Messages
17,567
And I'm pretty sure that he is not referring to the CCC.
Yes, he did subgroup the participants using other definitions, but we haven't seen any results for those subgroups yet (have we?)
Figures 2B, 2C, 2F & 2G
 

Angela Kennedy

Senior Member
Messages
1,026
Location
Essex, UK
Here I think is the crucial comment on their views:

This is in the published response this week.

Published comments are what are generally the most important/useful.

Dolphin, for a number of reasons, this 'crucial' comment is problematic. You surely are aware of the complaints we have made about the cohorts? An appeal to publication authority is not relevant here. There are ramifications of this comment which I think you are not aware of, and therefore do not appreciate it's importance.

Can I suggest you read Malcolm Hooper's and my own complaint thoroughly? Do it again if you've already done it. There are very important issues thrown up by White's defence of his trial and its problems which strengthen the concerns we have already expressed.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Thanku for the info dolphin...

So the 'international criteria' used was not Holmes 1988, or CDC Fukuda 1994, or the CDC Reeves Empirical 2005, but something else from 2003. It's a paper that I've not seen before.
It looks to me like the 2003 paper is not an official CDC criteria that is in generally use in the USA, or a widely used or recognised 'international criteria'.
So I wonder why they chose this paper above the 1994 or the 2005 definitions?
Does anyone know if this paper is widely referred to in scientific literature?

By the way, does anyone know how many 'official' CDC definitions there are?

Sorry for so many questions.

Thanku Dolphin... I forgot that Figure 2 has graphs of the results for each of the subsets!
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Here I think is the crucial comment on their views:

In conclusion, however we compared the results and however we defined CFS and myalgic encephalomyelitis, we found that cognitive behaviour therapy and graded exercise therapy provided a significant and clinically useful advantage of moderate size over adaptive pacing therapy and specialist medical care, but were no less safe.

This is in the published response this week.

Published comments are what are generally the most important/useful.

I believe that the comments directed towards Malcolm Hooper are to be published, as they are an official response. That was my understanding anyway.

We need to see the context in which they were written.
 

Dolphin

Senior Member
Messages
17,567
What is this 2003 definition? Does anyone know?
Bob, I already gave the reference:
Reeves WC, Lloyd A, Vernon SD, et al. The international chronic
fatigue syndrome study group identifi cation of ambiguities in the
1994 chronic fatigue syndrome research case defi nition and
recommendations for resolution. BMC Health Serv Res 2003, 3: 2.

Best of luck, Angela, I think I'll leave this thread for the moment and return to other things which as you say I am more focused on.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Thanks for all the info Dolphin. Please don't leave the thread. You've been exceptionally helpful, as always. And discussion of these issues is good and healthy.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
So does anyone know how the 2003 paper corresponds to the 1994 and 2005 CDC definitions? And how can the 2003 paper be referred to as an 'international criteria'?

I've never seen any reference to the 2003 paper before, outside of the PACE Trial. But definitions are not one of my strong points.

I'm sure that all of this has been discussed before, so I'll try to find the info elsewhere.
 

Enid

Senior Member
Messages
3,309
Location
UK
Very interesting indeed Bob - CONCLUSION at post 29. (but you've deleted)
 
Messages
13,774
Is there a full copy of White's reply about? Did I miss it? It's difficult to judge his statements without seeing the full context.
 
Messages
74
I agree. White is saying he didn't study ME only Oxford "CFS".

....which is just Idiopathic Fatigue for Six Months! That's the only criterion!

The only good thing that came out of this PACE fiasco is that he basically ADMITTED he's not been studying M.E. patients, or M.E./CFS (such as by the Canadian) or even CDC 1994 CFS (as by the Fukuda --which is universally recognized as too relaxed).

He admitted it! So whenever he tries to say his work applies to us, just remind him he already said it doesn't. ;)