PACE trial: NICE and NHS should stop ineffective and harmful treatments (CBT and GET) for M.E.

Posted on 15 May 2011 by Dr John Greensmith:

Letter in reply to Course to help ease stress of chronic fatigue, Swindon Advertiser, 13 May 2011

If I read the details of the five-week course, being run by the NHS Swindon Primary Care Psychology Service, for people with the nebulous diagnosis of chronic fatigue, correctly (Course to help ease stress of chronic fatigue, Swindon Advertiser, 13 May 2011), there doesn’t seem to be a rule in the book of fundamental principles of experimental design, which should have been covered at secondary school level, that hasn’t been broken or flouted.

The causes, onsets and progress of each person’s condition are so uniquely different that they are essentially self-selected (not even referred by a doctor) samples of one, being treated in a variety of ways by different course leaders. You couldn’t make it much more random, or less controlled, if you really worked at it. Any conclusions drawn will be untrustworthy for the two main requirements of validity and reliability.

My greatest concern is that they will then apply any recommendations from this flawed study to people who have M.E. (Myalgic Encephalomyelitis), which is not a psychiatric, or somatoform, but a neurological illness of physiological origin and should not, therefore, be treated by these methods, by applying the faulty reasoning that Chronic fatigue is the same as M.E, when there probably wasn’t a single M.E. sufferer in the set because they wouldn’t be able to travel there and sit for the two-hour sessions required to get through this programme.

Far from being a one-off, this is the way that all NHS chronic fatigue clinics round the country are working, with the blessing of the government ministers, who presumably believe that its health advisers NICE (National Institute for Health and Clinical Excellence) are offering the best advice based on the best scientific and ethical practices.

This Research Psychologist and veteran M.E. sufferer of 23 years calls on GPs to stop referrals and for clinics to suspend such treatments, especially Graded Exercise Therapy (GET), pending further research, to prevent M.E. sufferers receiving ineffective and potentially harmful treatment.

Yours sincerely
Dr John H Greensmith
ME Free For All.org