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I thought it might be useful to go through the main arguments against the review, to see if these make sense and if they would impact the results. I’m numbering the arguments to make it easier to discuss them. 1) Pooling different fatigue questionnaires I think it might be true that it’s...

So they should test positive for a Western blot, a standard test to detect acute Lyme disease? I suspect many chronic Lyme disease patients do not meet this requirement (or they had the test several times until it had a positive result). I suspect in many cases the diagnosis is made based on...

@duncan Honest question (I'm no expert at this subject) Suppose patients have no recollection of a tick bite, the erythema migrans rash or Lyme disease at the beginning of their illness and they present wich symptoms that meet case definitions of CFS or ME. What basis could there be for saying...

I agree with that, but I also think there might be a real problem of overdiagnosis. Belgium is probably a good example of this. A few years ago the main ME/CFS expert in the country, Kenny De Meirleir, started diagnosing pretty much all his ME/CFS patients with chronic Lyme disease on the basis...

Do you mean this: "We have added three new studies in this updated review (Jason 2007; Wearden 2010; White 2011)"? This is a statement that was already in the previous version. These studies (Wearden et al. 2010 is the FINE trial and White et al. 2011 the PACE trial) were added to the review...

@Sly Saint What do you mean by 3 added studies? As far as I know, no studies have been added to the data. In their discussion section, they mention 2 relevant RCT's (GETSET and Marques et al. 2015) that have been published since their literature search but the data of these aren't included in...

Just noticed that the changes made to the Cochrane review are not normally described as an update (which would include a new literature search and inclusion of new studies/data) but as an amendment. I have now changed this to the overviews I posted.

I see but I really meant something else. When I said something 'better' I referred to response bias and patients filling in the questionnaire in a way that pleases the investigators. Statistics isn't really my thing but here's basically the point I'm trying to make: the effect size is a...

The following changes were proposed but rejected: 1) Objective outcomes Tom Kindlon and Robert Courtney noted that with the exception for health resource use, Larun et al. have not reported on objective outcomes. The randomized trials included in the review had data on outcomes such as exercise...

Do you mean that some patients had such severe fatigue that they still would have the maximum score even after an improvement in fatigue? That could be but I suspect than in the trials changes on the CFQ were mostly determined by response bias, placebo effects and other non-clinical effects...

To clarify for others: Larun et al. set the minimal important difference (MID) for SF-36 physical function at 7 points, citing two studies, one on patients rheumatoid arthritis and one on patients with heart disease: Ward MM, Guthrie LC, Alba MI. Clinically important changes in short form 36...

A SMD of 0.64 seems pretty large compared to a 3.4 point difference on a 33 point scale. Just a thought: Is it possible that the SMD was inflated because the standard deviation in the studies was low? Some trials used the 11-point version of the Chalder Fatigue Scale, which has ceiling effects...

To clarify what I mean: I did a quick Pubmed search using the terms: (Chalder Fatigue Scale) AND (minimally important difference OR clinically significant). It gives only 10 results including the relevant paper by Sabes-Figuera et al. and the paper on Lupus which the authors was used in the...

As their source they refer to: Ridsdale L, Godfrey E, Seed P: Chronic Fatigue in general practice: authors reply. Br J Gen Pract 2001, 51:317–318 Which reads: Ok that's it. I don't trust a word of what Larun et al. or Cochrane say anymore .... I really thought they would have checked that...

Could this be it: Sabes-Figuera et al. (2012). Cost-effectiveness of counselling, graded-exercise and usual care for chronic fatigue: evidence from a randomised trial in primary care.BMC Health Serv Res. 2012 Aug 20;12:264. doi: 10.1186/1472-6963-12-264. It says: So they argued that a change...

While I was searching I found this one by Crawley on the "minimally clinically important difference of the SF-36 physical function subscale for paediatric CFS/ME". https://hqlo.biomedcentral.com/track/pdf/10.1186/s12955-018-1028-2

I thought it might be useful to get an overview of the major changes compared to the 2017 version. I prefer focusing on the main comparison of exercise therapy versus a passive control condition. I’ll update this forum post if anyone notices other changes so that we’ll maintain an overview of...

Thanks @Anna H and @MSEsperanza! I have now added you both to the list.

Not sure what you mean. There isn't a rapid response section for this article. I have sent my letter to the editors of the journal but they responded that "The journal does not accept commentaries based on the review/opion of one author's work." So then I have posted my comments on Pubpeer...

@PhysiosforME I would indeed be happy if you steal some of my wording. :) Thanks very much for your efforts on this. Please let me know if I can be of any help.