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  1. Snow Leopard

    EXPLORER study: Exploring treatments for younger children with CFS/ME - Amberly Brigden, Esther Crawley

    Yes, they're going to claim that parents beliefs are unrealistic and somehow perpetuating the syndrome.
  2. Snow Leopard

    Independent advisory group for the full update of the Cochrane review on exercise therapy and ME/CFS (2020), led by Hilda Bastian

    Yes, there is a big difference between reporting what could happen or what a participant thinks they could do, versus what they have actually done/has actually happened. Biases such as recall bias certainly apply, which is why an outcome such as urinary incontinence needs to be recorded daily...
  3. Snow Leopard

    Independent advisory group for the full update of the Cochrane review on exercise therapy and ME/CFS (2020), led by Hilda Bastian

    Sure. The key point is that if participants (and any assessors) genuinely don't know which arm they are in, response biases and related distortions will be relatively similar across all arms. Objective outcome measures of functioning in an unblinded trial don't eliminate bias, but they show...
  4. Snow Leopard

    Independent advisory group for the full update of the Cochrane review on exercise therapy and ME/CFS (2020), led by Hilda Bastian

    Yet that is exactly the view of researchers in the field. They cannot personally think of a better way, so they assume their inadequate trials are good enough. Note: Professor Bentall co-authored the Powell 2001 et al. graded exercise 'education' trial and the FINE trial. See also...
  5. Snow Leopard

    Independent advisory group for the full update of the Cochrane review on exercise therapy and ME/CFS (2020), led by Hilda Bastian

    Notably, there has been no studies that actually ask patients which outcome measures are most relevant. Likewise, none of the PROMs have been tested to determine whether patients find them relevant, despite two systematic reviews on PROMs suggesting this is a major problem.
  6. Snow Leopard

    A general thread on the PACE trial!

    Horton is rushing out a book on COVID19 this month. I'm trying to remember what he was saying about travel restrictions and other COVID related issues back in Jan/Feb... It's easy to throw stones at people in glass houses... edit - seems he was somewhat concerned from Feb 1st, but didn't make...
  7. Snow Leopard

    FINE trial Step test data released in 2017

    Apparently (according to Richard Bentall) I'm profoundly ignorant as I believe that a lack of patient blinding can lead to response biases when patients talk to assessors and this bias reverts to the mean at long term followups. Richard Bentall is in the camp that believes that unblinded trials...
  8. Snow Leopard

    Independent advisory group for the full update of the Cochrane review on exercise therapy and ME/CFS (2020), led by Hilda Bastian

    No one wants to point out the emperor has no clothes because it means we would necessarily throw out a lot of evidence for non-pharmacological therapies for many different conditions. It means that many people would have to admit they were at least partially wrong (from policy makers, to...
  9. Snow Leopard

    Independent advisory group for the full update of the Cochrane review on exercise therapy and ME/CFS (2020), led by Hilda Bastian

    It's also important to consider that there is a difference between placebo effects and reporting biases. The former would be actual reduction in pain (in the case of trials of analgesics/anaesthesia), rather than a change (bias) in pain reporting behaviour. Both placebo effects and reporting...
  10. Snow Leopard

    Protective Effect of Hemin Against Experimental Chronic Fatigue Syndrome in Mice: Possible Role of Neurotransmitters, 2020, Kumar et al

    Indeed, torturing mice with forced swims might cause fatigue, but it certainly isn't CFS or ME. Side note: Heme oxygenase is HSP32. Heme is broken down into biliverdin (ultimately bilirubin) and Fe2+ Gilbert's syndrome is not uncommon in CFS patients, suggesting this pathway has increased...
  11. Snow Leopard

    Independent advisory group for the full update of the Cochrane review on exercise therapy and ME/CFS (2020), led by Hilda Bastian

    The "compromise" is to simply lump all studies that don't meet basic quality criteria into a "low quality evidence" basket. If all studies fall into this group, then the study must simply conclude all the evidence is of low quality. (The basic quality criteria would require studies to use...
  12. Snow Leopard

    Independent advisory group for the full update of the Cochrane review on exercise therapy and ME/CFS (2020), led by Hilda Bastian

    Isn't that kind of arbitrary? I mean any highly specific criteria is going to need sufficient scientific justification and I cannot think of any reasonable justification for excluding a study with 450 participants, instead requiring 500+
  13. Snow Leopard

    Independent advisory group for the full update of the Cochrane review on exercise therapy and ME/CFS (2020), led by Hilda Bastian

    If the "pivotal" study was actually excluded because it was of low quality, eg unblinded comparison groups, did not use objective outcome measures and the primary outcome measures had never been tested for relevance to patients (by asking them!), then I'd suggest that the review was correct in...
  14. Snow Leopard

    Coronavirus - worldwide spread and control

    I believe you are referring to the "original antigenic sin" hypothesis? https://www.jimmunol.org/content/202/2/335
  15. Snow Leopard

    Coronavirus - worldwide spread and control

    September? Why even bother at all!?!
  16. Snow Leopard

    The biology of coronavirus COVID-19 - including research and treatments

    CD4+ T-cells are supposed to have some degree of cross reactivity with the viral proteins, even without prior exposure, otherwise the adaptive immune system would never work correctly! https://en.wikipedia.org/wiki/Naive_T_cell But on the point I was making, the claim that there could be...
  17. Snow Leopard

    Coronavirus - worldwide spread and control

    Further on the topic of "asymptomatic", The Chinese authorities claim they have tested 9.9 million people in Wuhan!!! They claim 300 positive results, however they tried (and failed) to culture live virus from 106 of these samples to see if they were genuine. They also collected 3,343...
  18. Snow Leopard

    Chronic fatigue syndrome: progress and possibilities, 2020, Sandler and Lloyd

    I was never a coffee drinker before I was ill, but I've always found it to be counter productive. It counters drowsiness, but it can make it harder to concentrate, so what is the point?
  19. Snow Leopard

    Impact of symptom focusing and somatosensory amplification on persistent physical symptoms: A three-year follow-up study, 2020, Barends et al

    Continuing on with what Michiel mentioned, the full quote: Mhmm... Which means the "symptom amplification" hypothesis (that attentional bias or hypervigilance actually increases somatosensory signals or "heightened perceived threat and vulnerability") has no basis and it is simply...
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