Wednesday, May 18, 2011

Study Blowback Shows Controversy Over Chronic Fatigue Syndrome

By Katherine Hobson, MAY 17, 2011, The Wall Street Journal:

We could have told the Lancet it would get a lot of blowback on a study it recently published suggesting that chronic fatigue syndrome can be helped by cognitive behavioral therapy and a slowly ramped-up exercise program — we got 53 comments on our original post about the research, many of them critical.

Sure enough, the medical journal said today that the paper was one of those that, every few years, “elicits an outpouring of consternation and condemnation from individuals or groups outside our usual reach.”

Many patients have long been told that their problems are psychological in nature, while they report symptoms that are similar to those seen in viral diseases. Suggesting that the condition can be significantly improved by psychotherapy and exercise didn’t sit well with many people. (The WSJ’s Amy Dockser Marcus has written about the search for a biological cause of CFS, also known as myalgic encephalomyelitis.)

The Lancet says it received 44 formally submitted letters to the editor, and published eight, along with a response from the paper’s authors. (You can read them all here, on the lower right.)

Critics focused on whether or not the exercise and cognitive behavioral therapy programs actually produced a clinically useful difference and, as the Lancet summarizes, “critique the definitions of secondary outcomes, question protocol changes and express concern over generalizability.”

In their reply, the authors go over their methods and say that “however we compared the results and however we defined CFS and myalgic encephalomyelitis,” exercise and cognitive behavioral therapy programs combined with specialist care showed a “significant and clinically useful advantage of moderate size” over specialist care alone, as well as over that care combined with therapy teaching patients how to recognize symptoms and ratchet down their activity as needed.

See also: Lancet Editor Dr Horton and PACE trial's chief investigator Prof White: no one with ME gets cured by CBT or exercise

See also: Two videos that clearly show how the "results" of the PACE study were manipulated

See also: Dr. Hilary Jones, When you say, "ME is controversial", did you check that with Alison, Annabel and Sophia?

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