The 12th Invest in ME Research Conference June, 2017, Part 2
MEMum presents the second article in a series of three about the recent 12th Invest In ME International Conference (IIMEC12) in London.
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Critiques sought of the Cochrane Reviews of CBT and exercise therapy for CFS

Discussion in 'General ME/CFS Discussion' started by Tom Kindlon, Jun 9, 2017.

  1. Tom Kindlon

    Tom Kindlon Senior Member

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    I'm dealing with a journalist who is interested in any critiques of the Cochrane Reviews of CBT and exercise therapy for CFS.

    Please post them here and/or feel free to private message me or email me at tomkindlon at Hotmail dot com.
     
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  2. Tom Kindlon

    Tom Kindlon Senior Member

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    In the attached file, on printed pages numbers 113-133, you will find some detailed comments by Robert Courtney and me on the exercise therapy review for CFS. Also replies from one of the Cochrane review authors, which I find unsatisfactory.
     

    Attached Files:

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  3. Barry53

    Barry53 Senior Member

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    A quick google search shows the following so far, will look further later.

    Liaison psychiatrist says that Cochrane Review on exercise therapy in CFS was heavily influenced by controversial PACE Trial| 6 May 2017
    http://www.meassociation.org.uk/201...enced-by-controversial-pace-trial-6-may-2017/

    Concerns regarding the use of unplanned primary outcomes in the Cochrane review
    https://sites.google.com/site/mecfs...ic-fatigue-syndrome/primary-outcome-switching

    Probing an untrustworthy Cochrane review of exercise for “chronic fatigue syndrome”
    http://wames.org.uk/cms-english/201...stworthy-cochrane-review-of-exercise-for-cfs/

    Edit: Realised I should have added the titles for clarity
     
    Last edited: Jun 9, 2017
  4. A.B.

    A.B. Senior Member

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  5. Barry53

    Barry53 Senior Member

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    Why the Cochrane Collaboration needs to clean up conflicts of interest
    https://jcoynester.wordpress.com/20...tion-needs-to-clean-up-conflicts-of-interest/

    Why I am formally requesting the data set from a Cochrane review
    https://jcoynester.wordpress.com/20...questing-the-data-set-from-a-cochrane-review/

    Conflicts of interest in Cochrane reports on psychological interventions
    https://www.coyneoftherealm.com/blo...chrane-reports-on-psychological-interventions

    My response to an invitation to improve the Cochrane Collaboration by challenging its policies
    https://www.coyneoftherealm.com/blo...ane-collaboration-by-challenging-its-policies

    An open letter to the Cochrane Collaboration: Bill Silverman lies a-moldering in his grave
    https://www.coyneoftherealm.com/blo...-bill-silverman-lies-a-moldering-in-his-grave
     
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  6. Barry53

    Barry53 Senior Member

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  7. user9876

    user9876 Senior Member

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    The Cochrane review is based in part on the PACE data but also each of the trials they use have similar flaws. I think @Jonathan Edwards commentry on the PACE trial methodology in Health Psychology applies to all the trials included in the Cochrane review. They are all open label trials using subjective measures.

    Its somewhat false to use an argument that Cochrane supports GET/CBT even if PACE is bad is some what strange when PACE is included as data and PACE is one of the better run trials.
     
  8. GreyOwl

    GreyOwl Dx: strong belief system, avoidance, hypervigilant

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    Chalder told the Tribunal that "disclosure [of the PACE data] to the Cochrane review does not count as disclosure to independent scientists as all three of the PACE principal investigators sat on the review panel."
    (page 31). Does that count?
     
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  9. Jonathan Edwards

    Jonathan Edwards "Gibberish"

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    er, no
     
  10. Jonathan Edwards

    Jonathan Edwards "Gibberish"

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    I have not had time to read through the whole Cohcrane document but the summary and what I can find tend to confirm the comment from user9876. My critique of PACE in J Health Psychol almost certainly applies to all the studies included, making them all valueless. The situation seems to me very simple. In order to get reliable evidence for exercise therapy you either need to use very robust objective primary outcome measures or devise a completely new method for making use of subjective outcomes in the face of the impossibility of blinding. Until then methodologies capable of giving us useful data are simply not in place. I have great respect for the work done on the more detailed failings of these studies but they fall at the first fence anyway. There is no way that my boss would have allowed me to devise trials like this using pharmacological agents - we both knew that human nature is too fickle to believe any results in this context. The Cochrane authors' responses are naïve and ill-informed.
     
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  11. Tom Kindlon

    Tom Kindlon Senior Member

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    Okay, I have passed on the commentary and your comments above. Thank you.
     

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