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Lien 2019: some analysis and thoughts The day 2 differences for patients in lactic production, and power at the gas exchange threshold (GET), look pretty interesting – though the differences aren't huge. However, the big differences between patients and controls seen on for almost every outcome...

And for many outcomes such as fatigue, mood and pain nobody knows better than the patient the levels of fatigue, pain and mood they experience. I think it is important to respect patients' ability to describe their own experience. added (I agree that the SF36 PF has alternatives) This is...

It’s also worth considering the MID in relation to the smallest possible improvement for a patient on the actual scale. For the CFQ, this is one point. So the PACE threshold of two points effectively means “a clinically useful improvement is anything bigger than the smallest possible improvement...

Because the PACE trial is very large, it’s quite easy for small differences to achieve statistical significance. Which is why they used a “clinically useful difference“ threshold for the primary outcomes, of 0.5 SD effect size. This is a generic measure and so it’s reasonable to apply it to...

Certainly the SF36 SD problem has been well documented. I wasn't sure that CFQ SD had been shown to be "non-normal" (I think it's a pretty high threshold to reach, isn't the null hypothesis that every distribution is normal?).

More brilliant analysis, @Michiel Tack ,thank you Using Cochrane fatigue effect size, PACE trial CBT was ineffective. I think this is very important because it undermines the PACE trial claim of clinical effectiveness for CBT. They chose the widely used criterion for a clinically useful...

You are right that Cochrane has a very poor track record of actually listening to patients and doing anything differently. And I suspect the new approach coudl easily end up being effectively a whitewash. Yet the move to involve patients has potential, but will only come to anything useful if...

I think this is an excellent idea, @MSEsperanza , thank you. If the desired outcome is to actually get the editor-in-chief to agree, as opposed to make the point about the failures of the revised review, It might be worth slightly modifying the pitch. We are concerned that the revised review...

Re Chalder fatigue scale and the ceiling effect: The Chalder Fatigue Scale scoring deosn't quite work like that. It is a bit weird, see below. "If you have been feeling tired for a long while, then compare yourself to how you felt when you were last well. [score each of 11 items] Less...

The minimum score on shoulder is effectively 11, making it a 23 point scale. 3.4 point difference strikes me as credible for 0.5 SD, given that 0.5 SD isn't actually a very big difference (see the graph in my previous post). You're right that a ceiling effect would constrain the baseline...

Thanks very much, @Michiel Tack. Standard mean differences/minimal important differences I don't think there is a real issue with describing the effect on fatigue as measured by the Chalder Fatigue Scale as "moderate" , or the 3.4 point reduction as a "minimal important difference". The key...

@Michiel Tack That was a truly brilliant blog: a beautiful assembly of strong evidence against the use of non-blinded trials with subjective outcomes, and a great story about Louis XVI. Just one thing: please don't blog about biomedical research, else I'm out of a job.

My energy is very limited, but I would be willing to help if I can. I think the core principle needs to be something like “basing policy on the best available science, recognising the limitations of the current science research and avoiding claims that to go beyond what the evidence will...

Comments on the paper (Part 1) Overall, the paper looks quite solid, with many different approaches used to reach findings that fit together into a plausible model. Note that the paper is a pre-print, which means it hasn’t been reviewed. It is increasingly common for scientists to first...

Only a day to read the paper? Good going. I've now watched the video and taken a look at the paper - and will try to explain, starting with my attempt to explain what mitochondria do, to tee up the paper. Much of this will probably be way too basic for many people here but I usually find it...

My updated take on the Stanford symposium, With thanks to you @Michiel Tack For a great detailed summary and tweets and @Ben H (and Cort) for tweets

I was only able to follow the symposium on Twitter and this is how it looked from there. How did it look to those who saw more of it than me? Overall, I was disappointed by the lack of progress (hey, what's new: this is ME/CFS). In particular, there has been no progress on either the metabolic...

The results are certainly eye-catching. I've not yet read the full paper (and am hoping to avoid having to) . I wonder if those good people who made the effort could answer a few questions. 1. How do the Seahorse results from this study fit in with previous Seahorse results? I am aware that...

Thanks to you and your fellow advocates for all that you have done, and achieved. Please do, and thank you!

Launch of Canadian research network makes a big statement about ME The Canadian government has announced a modest $1.4 million investment in a new research network and delivered a big message: ME is a serious illness, deserves respect ("Let's remove the insult from this injury") and needs more...