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Wilshire and Kindlon respond to Sharpe, Goldsmith and Chalder in BMC Psychology


Senior Member

Response: Sharpe, Goldsmith and Chalder fail to restore confidence in the PACE trial findings
BMC Psychology20197:19
© The Author(s). 2019
  • Received: 7 March 2019
  • Accepted: 19 March 2019
  • Published: 26 March 2019
Open Peer Review reports
In a recent paper, we argued that the conclusions of the PACE trial of chronic fatigue syndrome are problematic because the pre-registered protocol was not adhered to. We showed that when the originally specific outcomes and analyses are used, the evidence for the effectiveness of CBT and graded exercise therapy is weak. In a companion paper to this article, Sharpe, Goldsmith and Chalder dismiss the concerns we raised and maintain that the original conclusions are robust. In this rejoinder, we clarify one misconception in their commentary, and address seven additional arguments they raise in defence of their conclusions. We conclude that none of these arguments is sufficient to justify digressing from the pre-registered trial protocol. Specifically, the PACE authors view the trial protocol as a preliminary plan, subject to honing and improvement as time progresses, whereas we view it as a contract that should not be broken except in extremely unusual circumstances. While the arguments presented by Sharpe and colleagues inspire some interesting reflections on the scientific process, they fail to restore confidence in the PACE trial’s conclusions.


Senior Member
An excellent reply by Carolyn and Tom to the feebly argued attempt by Sharpe, Goldsmith and Chalder to defend the indefensible (aka the PACE trial). Well worth reading in full.
to defend the indefensible (aka the PACE trial). Well worth reading in full.
So this just came out: regarding GET and CBT from Britain....survey data....from 2200 plus victims.


So I've simply been pondering why CBT would make a percentage get worse. So what about the therapy causes a worsening? Wondering what folks think about this.....If the CBT resulted in: doing an activity that in the end caused PEM, then of course that makes sense..."I feel sick today, but I am not sick, I am all powerful being, so I will mow the lawn, despite my body suggesting thats not a good idea".

For me 1) talking for one hour to anyone will exhaust me. Figure that is mental, emotional and my throat/ which does not hold up long before it gets really sore from just talking. 2) where is this therapist? I have to go out, somewhere to find them. At the moment, I am looking for one (hopefully one block away). So when I have to go out, then some level of crash will occur. 3) previously my therapist was in a different town. That created another physical stressor for the simple act of: seeing the person. And I had to drive there. Currently, worsening Marine Fog and Eye Blurr has precluded me driving more than a few blocks. So all this type of stuff associated with a conversation somewhere else (or in my living room)....can worsen the situation.

so if I were to go once a week, and talk for one hour, I likely would have 2-4 day length crashes following. So frankly that could make me worse.