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Publications (30)
Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling and complex chronic disease of unknown origin, whose symptoms, severity, and progression are extremely variable. Despite being relatively common, the condition is poorly understood and routine diagnostic tests and biomarkers are unavailable. There is no evidence...
The use of graded exercise therapy and cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome has attracted considerable controversy. This controversy relates not only to the disputed evidence for treatment efficacy but also to widespread reports from patients that graded exercise therapy, in particular, has caused the...
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 thi...
Background:
The PACE trial was a well-powered randomised trial designed to examine the efficacy of graded exercise therapy (GET) and cognitive behavioural therapy (CBT) for chronic fatigue syndrome. Reports concluded that both treatments were moderately effective, each leading to recovery in over a fifth of patients. However, the reported analyses...
BACKGROUND: The PACE trial was a well-powered randomised trial designed to examine the efficacy of graded exercise therapy (GET) and cognitive behavioural therapy (CBT) for chronic fatigue syndrome. Reports concluded that both treatments were moderately effective, each leading to recovery in over a fifth of patients. However, the reported analyses...
Reporting of harms was much better in the PACE (Pacing, graded Activity, and Cognitive behavioural therapy: a randomised Evaluation) trial than earlier chronic fatigue syndrome trials of graded exercise therapy and cognitive behavioural therapy. However, some issues remain. The trial’s poor results on objective measures of fitness suggest a lack of...
Resumen
La notificación de daños fue mucho mejor en el ensayo PACE (estimulación,
actividad graduada y terapia conductual cognitiva: una evaluación aleatoria)
que en los ensayos anteriores sobre el síndrome de fatiga crónica de la terapia
graduada y la terapia cognitiva conductual. Sin embargo, quedan algunos
problemas. Los malos resultados del ens...
BACKGROUND: Recently, we critically evaluated the claim from the PACE trial that cognitive behavioural therapy (CBT) and graded exercise therapy (GET) can lead to recovery from chronic fatigue syndrome. We showed that the trial’s definition of recovery was so loose it failed to capture the term’s core meaning. Also, this definition was substantiall...
BACKGROUND: Publications from the PACE trial reported that 22% of chronic fatigue syndrome patients recovered following graded exercise therapy (GET), and 22% following a specialised form of CBT. Only 7% recovered in a control, no-therapy group. These figures were based on a definition of recovery that differed markedly from that specified in the t...
Friedberg and Adamowicz1 make several interesting observations in their review of recovery rates reported in White et al.2 However, we disagree with them that a previous trial of an active behavioural intervention, Deale et al, which reported very similar recovery rates to White et al, ‘used similar recovery criteria’.1-3 The White et al2 recovery...
One reason that the minutes are sought for the PACE (Pacing, Graded Activity, and Cognitive Behaviour Therapy—a Randomised Evaluation) trial, which looked at the effectiveness of treatments for chronic fatigue syndrome, is to find out why outcome measures were changed.1 None of the three …
Eur J Clin Invest 2012; 42 (12): 1360–1361
Across different medical fields, authors have placed a greater emphasis on the reporting of efficacy measures than harms in randomised controlled trials (RCTs), particularly of nonpharmacologic interventions. To rectify this situation, the Consolidated Standards of Reporting Trials (CONSORT) group and other researchers have issued guidance to impro...
Wearden and colleagues published the protocol for this study in 2006,1 so it is strange that they do not mention many of the measures in the current paper.2 The most important omission is one of the outcome measures—the step test: time to take 20 steps (or number of …
After the unsuccessful High Court challenge to the NICE guidelines on chronic fatigue syndrome (CFS),1 the results of two recent reviews may temper many clinicians’ enthusiasm for cognitive behavioural therapy for CFS.2 3A meta-analysis by Malouff et al calculated the mean …
Sir, In their reply to Dr Bramsen, De Lange et al . (2008) use a type of circular reasoning: cognitive behavioural therapy (CBT), they say, has previously been shown to be ‘effective’ for chronic fatigue syndrome (CFS) so the change they measured must be due to CBT.
First, it needs to be pointed out that CBT is far from a panacea for CFS. A recent...
BMJ 2003;327:E190-E191 (4 October), doi:10.1136/bmjusa.03020004 (published 26 March 2003) Link is: http://www.bmj.com/cgi/content/full/bmjusa.03020004v1
My name is given as Kinlon TP - their error - Kin(d)lon TP.
