Trial By Error: The Cochrane Controversy
3 SEPTEMBER 2018
By David Tuller, DrPH
Cochrane–formerly called the Cochrane Collaboration–is respected worldwide for its systematic reviews of medical treatments. These reviews are often cited as the definitive source of information about treatment efficacy and safety. In taking on the thankless task of assessing the data on commonly used interventions, Cochrane performs an invaluable public health service and has advanced the cause of evidence-based decision-making in medicine.
But like any organization, Cochrane can get things wrong—as it has in the case of chronic fatigue syndrome. (Cochrane generally uses the term CFS, so I will also when referring to these systematic reviews.) Cochrane’s review of cognitive behavior therapy for CFS was published in 2008, pre-PACE. The most recent review of exercise therapies for CFS, which mainly included studies of graded exercise, was published in 2014. These systematic reviews and previous versions, all of which reported benefits from the treatments, were conducted by Cochrane’s Common Mental Disorders group.