Discussion in 'Latest ME/CFS Research' started by Dolphin, Mar 8, 2017.
Free full text:
The protocol paper is available for free here:
It would be interesting to see whether everything has been reported.
No objective outcome measures were reported for CBT. Subjective improvement has often not led to objective improvement e.g. has measured by actometers.
If the infection is over then antibiotic therapy should not work, or in other words is a sham treatment. Lack of objective measures means some of the same biases we see in PACE may be present.
So patients in the doxycycline and placebo groups were monitored for adverse events more frequently than the CBT group.
By the standards of most CBT trials, good to have a placebo group.
Not sure how big the difference between CBT and placebo was... less than their own standards for a clinically meaningful improvement from baseline:
Functional impairment measured by Sickness Impact Profile (SIP8) questionnaire total score.
The do mention the potential for bias:
So even the gains of the placebo group are taken to show the benefits of expert management?
I've not been pulling out annoying/misleading references to CFS, but  is the null PACE LTFU paper.
From the flowchart in Figure 1:
If you can't adhere to a therapy, that may mean one is suffering adverse events and so it is not necessarily safe.
I would be interested in seeing the supplemental files on the journal's website if anyone wishes to post them or private message them to me.
How is their grossly misleading claim anything but straight fraud?
I think what this shows is that using CBT you can get people to change the way they mark fatigue by telling them to ignore symptoms and be positive. That is not surprising and is backed up by PACE where there were subjective improvements for people who had interventions aimed at changing "illness beliefs" and were told if they did that they could get better. Of course no evidence is given of real improvements in any case.
Such trials are just a waste of money, effort since the way they are designed will give no useful information.
Now if only the patients gave a fuck about their fatigue scores
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