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September 21, 2016


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Thx !! See also
The PACE Trial Invalidates the Use of Cognitive Behavioral and Graded Exercise Therapy in Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome: A Review

Grumpy Ninja

Thank you for this.

One small correction. You said:

"In other words, there is no statistically significant support for the theory that CBT or GET can lead to improvement or recovery. "

The re-analysis from Matthees et al deals with claims of recovery, not of improvement.

The PACE team have recently self-published a protocol-defined re-analysis of improvement [1,2] which showed a similar reduction in the percentage of patients who report improvement as Matthees et al report for the recovery rates, compared to the much weaker post-hoc revised protocol [3]. These new results from PACE for improvement are clearly marginal and still leaves patients way below anything resembling a practically useful degree of functional improvement, let alone good health.

Furthermore, this was an unblinded trial using only subjective self-report measures for the primary outcomes and the reported effect size is well within the range of standard confounders for such measures. There is also no support for this effect from any of the objective measures used in PACE (besides a very marginal improvement in the GET arm on the Six Minute Walk Distance test of just 35m after a year-long intervention, which does not reach clinical significance, and still leaves patients scoring around half the healthy average) [3].

Lastly, the 2.5 year long-term follow-up results were released last year, and even with the benefit of using the post-hoc revised protocol, it still delivered a null result [4].

It is long past time this matter was properly dealt with by the medical scientific community.





Justin Reilly

Thanks for this great piece, Steve!

Steve L.


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