I wonder if this trial could prove to be a turning point in ME/CFS research, unlikely though that might seem? It is, by far, the largest clinical trial ever published with nearly 300 participants. In a lot of ways it's more rigorous than previous trials - they even had a statistician as a co-author.
The result for this trial was negative, while the smaller, less rigorous pilot trial of the same approach claimed over 60% of patients 'recovered' versus under 10% for the waiting list control group.
I think maybe the therapy was proved unsuccessful because it was a good, robust trial. Also, the therapy uses a model that assumes deconditioning is the main factor underlying this illness. The therapy failed: what does that say about the deconditioning model?
And as the trial used the Oxford Criteria rather than one of the more tightly defined criteria eg CDC, the failure is even more striking.
Negative results can sometimes be as telling as positive ones.
The PACE trial is due to publish later this year and I'm optimistic that it will be a rigorous trial giving a reliable result. They've recruited 600 patients and the protocol alone runs to 13 pages. Many of the authors have suspect research records but I think the PACE trial will be in a different league. Time will tell.
I'm not up on the UK stuff but I'm more inclined to think this is a big blow to these types of efforts; its a big expensive study - they threw everything they had at it - they rigorously trained the nurses, they videotaped them and they brought in a more representative set of patients. This study demonstrates that its impossible to do this type of therapy effectively on a large scale on the broad swath of CFS patients - its basically stating in my view, since CBT done by therapists is so expensive, that that branch of the medical community has little to offer CFS patients.
It can only hurt; now the government has to contemplate (a) spending massive amounts of money for trained therapists to do this type of work -something they probably would never do (b) going in a different direction (c) forgetting about the public health aspect of CFS. The possibility of treating CFS patients on a broad scale using these therapies just got a heck of a lot harder to do in the UK.