Causal overstatements in modern physical activity research, 2024, Skarpsno

Well we can't read because paywall but I'd put a high note on the whole "PACE showed that 1 in 7 report some minor statistical improvement on a fatigue questionnaire after a year-long exercise training programs" means that exercise cures CFS. It basically agues that 1/7 of something like 10% improvement, so at best 0.01% = 100%. It's beyond absurd, we are literally 4 orders of magnitude off here, and the benefits are qualitative and never matched by objective benefits. And PACE was the best they could do, it even hides the massive harm their model causes.

It probably takes the top rank of widely misleading overstatements in history, certainly top 10. Like someone saying they can easily lift 10,000 kg but then only do it with 10 kg and call it a success. Even worse is the audience who sees it happening and cheers wildly.

 

This. A principle of scientific models (or theories) is that they have to be predictive, if not of all things, at least of one thing, and then very accurately. Models that can't predict accurately aren't very useful, while models that can't predict anything are functionally useless. They may have some intellectual value, but in the real world they aren't worth a damn.

Evidence-based pragmatic models can't ever predict anything, they are not scientific models, have no theory behind them. All the biopsychosocial/psychosomatic models can't predict a damn thing all put together, not one bit of useful prediction. That makes them useless, it's simply wrong to apply them in real life as anything but a "heh, maybe it could work for you, probably coincidentally, but I wouldn't personally spend $5 on this if I were you".

Which would be fine if they stuck to this, but as know, even though pragmatic trials aren't supposed to infer any causality, the entire premise of not just ME/CFS, but of all psychosomatic rehabilitation in general, is built entirely out of "those trials kinda show that it can be of help to some, therefore they are considered 100% safe and effective and that means that they are psychological disorders". This is the wrong part. I harp on it a lot, but even PACE's best results is some trivial 10% benefit for 1 in 7, and out of that the entire profession took away that it's 100% a cure and that it means that "chronic fatigue" is psychological/behavioral. This is the insane part, they know this is wrong and do it anyway, all because of permissive language that makes them get away with it.