The 12th Invest in ME Conference, Part 1
OverTheHills presents the first article in a series of three about the recent 12th Invest In ME international Conference (IIMEC12) in London.
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analysis of five Dutch hallmark studies

Discussion in 'Other Health News and Research' started by Lou Corsius, Feb 2, 2018.

  1. Lou Corsius

    Lou Corsius

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    The Netherlands
    An analysis of Dutch hallmark studies confirms the outcome of the PACE trial:
    cognitive behaviour therapy with a graded activity protocol
    is not effective for chronic fatigue syndrome and Myalgic Encephalomyelitis.

    Gen Med Open. 2017. 1(3): 1-12. doi: 10.15761/GMO.1000117.
    Twisk FNM, Corsius LAMM.
    Abstract
    Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS)
    are considered to be enigmatic diseases.
    Several studies propose that
    the combination of cognitive behaviour therapy with a graded activity protocol (CBT+),
    justified by a so-called (bio)psychosocial (explanatory) model,
    is an effective treatment option for CFS (ME).
    Objective
    A critical review of five Dutch hallmark studies that allegedly support this claim.
    Methods
    An analysis of the five CBT+ studies with special attention to
    the patients studied,
    the criteria (subjective and objective measures and cut-off scores)
    used to select participants and to define improvement and recovery,
    the consistency of the definitions of caseness (being diagnosed as a CFS patient at entry)
    versus the definitions of improvement and recovery after CBT+, and
    the objective effects.
    Results
    The studies investigated suffer from various methodological flaws.
    Apart from these methodological shortcomings,
    the claim that CBT+ is an effective treatment option for CFS
    is not substantiated by the data reported.
    Some studies investigated CFS patients,
    other studies investigated CF patients, labelled as CFS patients, or
    combinations of CFS and CF patients.
    No study investigated the effect of CBT+
    in a group of patients meeting the (original) diagnostic criteria for ME.
    The effects of CBT+ on subjective measures, for example fatigue and disability,
    if present, are insufficient to achieve normal values.
    Impressive recovery and improvement rates
    are based on very loose criteria for subjective measures.
    Cut-off scores for subjective measures used to define improvement and recovery in studies
    show overlap with cut-off scores for CFS caseness in one or more of the other studies.
    More importantly, looking at the objective measures,
    the proof of clinical improvement after CBT+ is lacking.
    Conclusion
    Solid evidence of effectiveness of CBT+ for CFS, let alone ME,
    is lacking in the five hallmark studies.
    The lack of objective improvement indicates CBT+ is ineffective.
    This conclusion confirms the outcome of the large-scale PACE-trial in the UK.
    Keywords:
    Myalgic Encephalomyelitis, chronic fatigue syndrome, cognitive behaviour therapy,
    graded exercise therapy, measures, effectiveness
    http://www.oatext.com/pdf/GMO-1-117.pdf
     
  2. Sundancer

    Sundancer Senior Member

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    Holland
    That's good, now we have to hope that the message seeps through to doctors and society.
    Nice to see a landsman btw
     
    Dolphin and Lou Corsius like this.
  3. Tom Kindlon

    Tom Kindlon Senior Member

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    Sundancer and anni66 like this.
  4. Tom Kindlon

    Tom Kindlon Senior Member

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  5. Dolphin

    Dolphin Senior Member

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    Good to see the Knoop et al., 2007 full recovery paper being criticised.
     

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