AHRQ review and the CFSAC recommendation

Dolphin

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http://www.hhs.gov/advcomcfs/recommendations/10302009.html

AHRQ is expected to complete a review of CFS for the NIH State of the
Knowledge Workshop. After this process, we recommend that the findings be
communicated immediately to key medical education, accreditation, licensing,
specialty, and certification boards and organizations. In addition, we
recommend a Surgeon Generals letter be disseminated to inform clinicians
and other health professionals throughout the US and its territories on the
impact of CFS on the health of US adults and children.
Does anyone know about anything about this review? Normally CFS reviews come out recommending Graded Exercise Therapy (GET) and Cognitive Behavioural Therapy (CBT) as effective treatments for CFS.

If this happened with the AHRQ review, if I was in the US, I wouldnt like that message going out in the way suggested.
Anyway, Im not in the US so Ill leave it up to others to see what to do if anything.
 

Tammie

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What is AHRQ?

Since I have no idea what that is, I also have no idea what is likely to come out of this review......could be really bad, or in a wishful little dream world, it could actually be a long long overdue spread of good info and then this kind of dissemination would be truly wonderful (& miraculous)
 

Dolphin

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2001 ARHQ review on CFS

Here is some information on the 2001 systematic review.
These sort of reviews can only deal with what is in the medical literature.

http://www.ahrq.gov/research/dec01/1201RA29.htm

You Are Here: AHRQ Home > Research Findings > Research Activities > December 2001

Evidence-based Medicine

Cognitive behavioral therapy and graded exercise therapy show promise for managing chronic fatigue syndrome

People with chronic fatigue syndrome (CFS) typically suffer from debilitating fatigue, headaches, disturbed sleep, difficulty concentrating, and muscle pain that often impair their ability to function. The cause of CFS remains unknown, but immunological, virological, psychological, and neuroendocrine factors have been suggested as possible causes. Health care professionals continue to debate appropriate ways to treat this problem.

A recent review of studies on CFS treatment concluded that cognitive behavioral therapy and graded exercise therapy had promising results. However, most of the studies had methodological problems that made it difficult to gauge the true impact of various treatments on patient outcomes.

More research is needed to better understand which treatments improve the health of CFS patients, suggests Cynthia D. Mulrow, M.D., M.Sc. Dr. Mulrow and colleagues at the San Antonio Evidence-based Practice Center (EPC) at the University of Texas Health Sciences Center conducted a systematic review of the evidence on managing CFS in adults. The EPC is supported by the Agency for Healthcare Research and Quality (contract 290-97-0012).

The researchers analyzed results of 36 randomized controlled trials and 8 controlled trials evaluating interventions to treat CFS in nearly 3,000 patients. All three trials evaluating graded exercise therapy found an overall beneficial effect compared with controls. Three of the four studies comparing cognitive behavioral therapy with controls also found an improvement in physical, psychological, or quality of life outcomes of CFS patients. All seven trials were considered quite valid. Treatment with either immunoglobulin or hydrocortisone showed some limited effects, but overall, the evidence was inconclusive. There was insufficient evidence to assess the effectiveness of medications ranging from antidepressants to ancyclovir; supplements (for example, essential fatty acids and magnesium); and complementary/alternative methods ranging from massage to homeopathic remedies.

See "Interventions for the treatment and management of chronic fatigue syndrome: A systematic review," by Penny Whiting, M.Sc., Anne-Marie Bagnall, Ph.D., Amanda J. Sowden, Ph.D., and others, in the September 2001 Journal of the American Medical Association 286(11), pp. 1360-1368.

Editor's Note: Copies of the Evidence Report/Technology Assessment No. 42, Defining and Managing Chronic Fatigue Syndrome (AHRQ Publication No. 02-E001) are available from the AHRQ Publications Clearinghouse http://www.ahrq.gov/research/order.htm#clear .

A summary http://www.ahrq.gov/clinic/epcsums/cfssum.htm of the report (AHRQ Publication No. 01-E061) is also available from the AHRQ Publications Clearinghouse.
 

Hope123

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AHRQ is the US gov't Agency for Healthcare Research and Quality. It puts out guideline but they are not enforced in the same way as in the UK. AHRQ generally does good work and had a bit of power in the 1990s but was threatened by pharma companies, industry, etc. for criticizing (rightfully) them and its power is less now than before.

According to the notes I have, NIH is suppose to hold a State-of-The-Art Conference on CFS next year with AHRQ's help. These are reviews of the knowledge to date of a particular illness or condition. I suppose they would prioritize areas of research from there.

I think what will be important will be to make sure they include reviews of exercise physiology studies in CFS (work by Pacific Fatigue Lab and the Light lab out of Utah).
 

Tammie

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"http://www.ahrq.gov/research/dec01/1201RA29.htm

You Are Here: AHRQ Home > Research Findings > Research Activities > December 2001

Evidence-based Medicine

Cognitive behavioral therapy and graded exercise therapy show promise for managing chronic fatigue syndrome"

Ugh......evidenced based, my butt!

if this is what they are going by it is most definitely not very promising to say the least.....they need to read the study that was on here about a month ago re exercise....I think it originally came from cocure
 

Dolphin

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"http://www.ahrq.gov/research/dec01/1201RA29.htm

You Are Here: AHRQ Home > Research Findings > Research Activities > December 2001

Evidence-based Medicine

Cognitive behavioral therapy and graded exercise therapy show promise for managing chronic fatigue syndrome"

Ugh......evidenced based, my butt!

if this is what they are going by it is most definitely not very promising to say the least.....they need to read the study that was on here about a month ago re exercise....I think it originally came from cocure
I agree with the sentiment. But often these reviews just look at clinical trials and dont look at other studies (e.g. exercise abnormalities). Studies on graded exercise therapy (GET) and cognitive behaviour therapy (CBT) based on GET use outcome measures which make them look like they helped a lot. There are all sorts of other problems with the studies as well e.g. the Oxford criteria may be used so all patients need to have to satisfy the criteria is chronic fatigue for 6 months which isnt necessarily real CFS or M.E.

But I think they shouldnt have recommended this be circulated until they see what it contained it could have been in the next set of CFSAC recommendations.

One lesson one needs to learn in the ME/CFS area I think is to be careful what you wish for.

(By the way, you will have to be more specific about what paper you are talking about).
 

Dolphin

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I think what will be important will be to make sure they include reviews of exercise physiology studies in CFS (work by Pacific Fatigue Lab and the Light lab out of Utah).
Exactly (not sure how easy this will be).