Mark Vink

Nominated for the 2016 John Maddox Science Prize

In this article, we analyzed the systematic review by Kuut et al. into the efficacy of cognitive behavioral therapy (CBT) for my-algic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a disease that predominantly affects women, and the eight trials in it. We found many issues with the studies in the review, but also with the review itself. For...

Abstract BACKGROUND: Three systematic reviews all concluded that exercise is an effective treatment for long COVID. OBJECTIVE: To determine if exercise therapy is also an effective treatment for long COVID patients who suffer from post-exertional malaise (PEM) or post-exertional symptom exacerbation (PESE). METHOD: The authors analyzed the evidence...

Dear Editor, I have read the article entitled, “Long covid: where are we, what does it say about our pandemic response, and where next?”[1] with interest. I would like to add a few things. One of their reference is an article by Choutka et al.[2] who note the following: “The…similar symptom profiles of individual PAISs, irrespective of the infe...

We read with interest the article "Myalgic encephalomyelitis/chronic fatigue syndrome: a review of the current evidence" [1] had read. However, literature search and analysis are methodologically inadequate and the results are at odds with the current evidence.

Myalgic encephalomyelitis/chronic fatigue (ME/CFS) is a post-infectious, chronic disease that can lead to severe impairment and, even, total disability. Although the disease has been known for a long time, and has been coded in the ICD since 1969 (G93.3), medical research has not yet been able to reach a consensus regarding its physiological basis...

Instead of treating Long Covid as a functional disorder without any evidence to back up that claim, first and foremost we should step up our efforts to find out what the exact underlying pathophysiological mechanisms are to be able to find effective treatments for millions of patients.

The German Institute for Quality and Efficiency in Healthcare (IQWiG) recently published its draft report to the government about myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The IQWiG concluded that graded exercise therapy (GET) and cognitive behavioral therapy (CBT) should be recommended in the treatment for mild and moderate ME/C...

We read the study by Fleischer et al. [1] with interest. The authors conclude that post-COVID-19 syndrome, also known as long Covid, might be psychosomatic without providing any evidence supporting this conclusion. Their line of logic seems to be that if neurological tests are normal then the condition under study is psychosomatic. However, first o...

Ik heb met interesse het artikel, “Moeheid, Artikel voor onderwijs en opleiding” gelezen.1 Helaas zijn er een aantal onvolkomenheden in dat artikel. Zo claimen de auteurs bijvoorbeeld dat de gecombineerde therapie bestaande uit mindfulness en cognitieve gedragstherapie (MCGT), “een gunstig – en soms blijvend – effect [heeft] op de moeheid bij een d...

The British National Institute for Health and Care Excellence (NICE) recently published its updated guidelines for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). NICE concluded, after an extensive review of the literature, that graded exercise therapy (GET) is harmful and should not be used, and that cognitive behavioural therapy (CBT...

We read the study "Graded exercise therapy for patients with chronic fatigue syndrome in secondary care – a benchmarking study" [1] with interest. However, we feel the authors’ conclusions that "Graded exercise therapy for patients (GET) is a safe and efficacious treatment for patients with CFS/ME in a clinical specialist environment" misrepresents...

For the last few decades, medical guidelines have recommended treating patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) with graded exercise therapy (GET) and cognitive behavioural therapy (CBT). Moreover, doctors have questioned the recovery behaviour of these patients and stimulated them to follow these treatments so that...

Samenvatting Doel: Inzicht krijgen in het percentage van patiënten met het chronischevermoeidheidssyndroom (CVS) dat na behandeling met gedrags- en oefentherapie weer aan de slag is om vast te stellen of het zinvol is om hen op hun herstelgedrag aan te spreken. Methode: Analyse van gedrags- en oefentherapeutische studies die berichten over werksta...

The National Institute for Health and Care Excellence (NICE) recently published its draft updated guideline on the diagnosis and management of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). NICE concluded that ME/CFS is a complex multisystem chronic medical condition for which graded exercise therapy should not be used and cognitive b...

An increasing number of young and previously fit and healthy people who did not require hospitalisation continue to have symptoms months after mild cases of COVID-19. Rehabilitation clinics are already offering cognitive behavioural therapy (CBT) as an effective treatment for long COVID and post-COVID-19 fatigue syndrome based on the claims that it...

Background: Cochrane recently amended its exercise review for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in response to an official complaint. Objective: To determine if the amended review has addressed the concerns raised about the previous review and if exercise is an effective treatment that restores the ability to work in ME...

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome leads to severe functional impairment and work disability in a considerable number of patients. The majority of patients who manage to continue or return to work, work part-time instead of full time in a physically less demanding job. The prognosis in terms of returning to work is poor if patients...

Analysis of the 2008 Cochrane review of cognitive behavioural therapy for chronic fatigue syndrome shows that seven patients with mild chronic fatigue syndrome need to be treated for one to report a small, short-lived subjective improvement of fatigue. This is not matched by an objective improvement of physical fitness or employment and illness ben...

Supplemental_material – Supplemental material for Cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective. Re-analysis of a Cochrane review

The FatiGo trial concluded that multidisciplinary rehabilitation treatment is more effective for chronic fatigue syndrome/myalgic encephalomyelitis in the long term than cognitive behaviour therapy and that multidisciplinary rehabilitation treatment is more cost-effective for fatigue and cognitive behaviour therapy for quality of life. However, Fat...

The analysis of the 2017 Cochrane review reveals flaws, which means that contrary to its findings, there is no evidence that graded exercise therapy is effective. Because of the failure to report harms adequately in the trials covered by the review, it cannot be said that graded exercise therapy is safe. The analysis of the objective outcomes in th...

The Dutch Fatigue In Teenagers on the interNET (FITNET) study claimed that after 6 months, internet based cognitive behaviour therapy in adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), led to a 63% recovery rate compared to 8% after usual care, and that this was maintained at long term follow up (LTFU). Our reanalysis...

Protocols and outcomes for the PACE trial were changed after the start of the trial. These changes made substantial differences, leading to exaggerated claims for the efficacy of cognitive behavior therapy and graded exercise therapy in myalgic encephalomyelitis/chronic fatigue syndrome. The small, self-reported improvements in subjective measures...

The PACE trial concluded that Cognitive Behavioral Therapy (CBT) and Graded Exercise Therapy (GET) are moderately effective in managing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and yielded a 22% recovery rate. Nonetheless, the recently released individual participant data shows that 13.3% of patients had already recovered, on one...

The main findings reported in the PACE trial were that cognitive behavioral therapy (CBT) and graded exercise therapy (GET) were moderately effective treatments for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and fear avoidance beliefs constituted the strongest mediator of both therapies. These findings have been challenged by pati...

Abstract Background: In this study the muscle bioenergetic function in response to exercise in severe ME was explored to see if the underlying metabolic problem in ME, responsible for the severe difficulties with trivial exercise, and the severe loss of muscle power, could be discovered. Methods: Inorganic phosphate, creatine kinase and lactate we...