On November 10th, the National Institute of Health and Care Excellence published
a draft of new clinical guidelines for ME/CFS. The draft represented a blunt rejection of the argument that the combination of “unhelpful cognitions” and deconditioning drive the illness. Under this once-hegemonic framework, indicated therapies include cognitive behavior therapy to overcome the unhelpful cognitions and graded exercise therapy to reverse the deconditioning. A
review of the literature published along with the NICE draft assessed the quality of evidence from dozens of CBT and GET studies as “low” or “very low.”
On December 10th, the journal
Clinical Child Psychology and Psychiatry published an article called
“Paediatric chronic fatigue syndrome: 25 year perspective.” Two of the four authors—Professor Trudie Chalder of King’s College London and Professor Esther Crawley of Bristol University—have long been leaders in the field. In particular, the article highlights CBT as an effective intervention. It cites some of the research that NICE has assessed as yielding only “low” or “very low” quality evidence.
Last year, after
an official investigation of her work, Professor Crawley was asked to make corrections in the ethics statements of almost a dozen papers. Also last year,
Archives of Disease in Childhood, a BMJ journal, slapped
a 3,000-word correction on her report of a major pediatrics trial of the Lightning Process as a CFS treatment. Professor Chalder was a lead investigator of the PACE trial for CFS, which is increasingly viewed internationally as an astonishingly bad piece of research–
an example of how not to conduct a clinical trial. (Disclosure: I had something to do with these developments.)
The authors do not mention the new NICE draft in the paper. Hello? ...........................
