Yes. Those percentages refer to "much better' or 'very much better'". Useful find although I had mentioned before the results weren't as impressive as those two (smaller) studies.[wdb quoting the GET patient manual: (in bold)] "in previous research studies most people with CFS/ME felt either 'much better' or 'very much better'".
Equivalent claims are common, but it looks like the PACE results dispute the "most" part, when using these outcomes on a modified clinical global impression: 41% for CBT/GET vs 31% for APT and 25% for SMC.
Interesting to be reminded of the underlined bit.In the original protocol: "We propose that a clinically important difference would be between 2 and 3 times the improvement rate of SSMC." We are not given odds ratios for primary measures, and I don't know how they arrived at these values, but we are given OR for the clinical global impression:
APT vs SMC: 13 (0821); p=031 | CBT vs SMC: 22 (1239); p=0011 | GET vs SMC: 20 (1235); p=0013.
CBT vs APT: 17 (1027); p=0034 | GET vs APT: 15 (1023); p=0028.
ORs would only apply to some sort of categorical data. The primary outcome measures (there were three types) were in the form of categorical data in the published protocol but are not in the final paper.
There's an Odds Ratio calculator at: http://www.hutchon.net/ConfidOR.htm
So if one looks at those who improved by at least two points on the CFQ and at least eight points on the SF-36 PF, for CBT vs APT it gives an OR of 1.9834 (95% confidence interval: 1.2538 to 3.1375)
It probably helps that they are both patients. Patients can try as many "experiments" as they want - eventually they will tend to see they can't exercise all their symptoms away.biophile said:Some beliefs and cognitions can be rather difficult to change, but I agree there is double-speak and a disconnect between hypothesis and reality. I think they have toned down some of the rhetoric or at least worded it better for different audiences, and it is difficult to say how much goalpost-shifting has occurred over 20 years. The so-called "Wessely School" see themselves as the moderates between the purely organic position the purely psychological position. Their current theme in a soundbite is: CFS symptoms are "physical" but "functional" and misinterpreted as a disease process, primarily perpetuated by cognitive and behavioural factors. Wessely seems to think of CFS as a delayed recovery from an event that everyone else recovers from naturally, that's why he allows for an infectious "trigger". Their comparison to anorexia nervosa is a good example of how they view the "physiology" of CFS. There is an article on the KCL website about the "Physiological Aspects of CFS" which is a better example, limited to the effects of deconditioning, anxiety, hyperventilation, stress, depression and circadian rhythm disturbance, and we are told (in bold!) "It is important to point out that these changes are reversible with physical rehabilitation and/or exercise."
In my opinion, psychologists like Leonard Jason and Fred Friedberg are the real "moderates". They acknowledge that psychological factors can play a role in CFS but apparently have not been seduced by psychobabble, hyperbole, and the convenient dismissal of biomedical research.