Cochrane Review: 'Exercise therapy for chronic fatigue syndrome' 2017, Larun et al. - Recent developments, 2018-19

Don't think this the core of the issue to be honest. If a treatment like CBT or GET was crafted a little better as a convincing placebo than it might produce larger improvements in fatigue questionnaires. The lack of an adequate control group and the fact that therapists are not blinded to the intervention are the reason why I think there is no evidence for a clinical effect in these studies, not that they used low MCID's.

But perhaps you agree and simply meant that one has to use every argument to explain the case that these results do not reflect real clinical improvements?

 

What is "clinically important" is qualitative, it cannot be defined by some arbitrary statistical procedure and most importantly, it needs to be defined by patients, rather than defining it as what is most convenient to researchers.

 

I would agree that the whole point of a clinically important difference is that it has nothing to do with statistics.

 

It needs to take cost, time and effort into account. A cheap and simple intervention, like adding some magnesium and salt to your water bottle every day doesn't need to produce as large effects to be worthwhile as a costly and time consuming intervention like two hours of some therapy every week.

 

I agree it's not a core issue in itself, but think it could still be important.

It could also be that a well done study, that properly explained to patients the potential problems with bias and nonblinded trials before assessing their attitudes to MCID in different circumstances, could be useful for highlighting other problems with GET research.

 

This is a published letter on clinical useful difference:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60689-2/fulltext

 

https://twitter.com/user/status/1156851565652774912



"The Bill Silverman Prize
Purpose
Please note that this Prize is not for the preparation of a Cochrane Review; rather, it is for a published paper which demonstrates originality and critical thinking, either in evaluating any aspect of the preparation, maintenance or dissemination of Cochrane Reviews or about the work of Cochrane more generally. It should be of high quality, have been accompanied by constructive suggestions on how the relevant aspects of Cochrane’s work could be improved; and have had, or is likely to have, a positive impact on the scientific quality, relevance and use of Cochrane Reviews.

Eligibility
Peer-reviewed papers that fulfil the criteria described above under ‘Purpose’, and were published in the twelve-month period 1 April 2018 to 31 March 2019 are eligible for nomination in 2019.
"

pity didn't find out about this earlier (nominations close 2nd Aug).

 

Mark Vink and his papers (co-written by a relative (I presume) whose name escapes me) might be suitable??

 

Are there any more recent emails/correspondence on this available @Kalliope
(sorry I can find the link to the website where they came from)

 

I don't know about updates, but this is the old link:
https://einnsyn.no/saksmappe?id=http://data.einnsyn.no/noark4/Saksmappe--983744516--10566--2017

 

Yes. From @Snow Leopard 's link there are three new letters. Have now asked for them.

 

https://s4me.info/threads/cochrane-...developments-2018-19.10030/page-4#post-179971

 

Just saw this. Wonderful idea. I've tried to nominate him with this short text:

"Mark Vink wrote two detailed critiques on Cochrane's reviews on CBT and exercise therapy for ME/CFS. His analysis helped Cochrane to adjust and update the review on exercise therapy for ME/CFS. Vinks efforts are quite exceptional given how sick he is due to ME/CFS. In his papers he thanks his parents for writing out his speech memo's as he is too ill to write."

 

Ahh. So I was late by one day? Frustrating.

I did manage to fill in all the forms, so maybe they might get the nomination after all. I hope so.

 

Hi so sorry was on holiday and missed this!

 

Not as far as I know. The letters that I thought were new had already been written about in @Marit @memhj 's link. I had just gotten confused with the dates.

Who knows what the next step will be. I feel anything could happen

 

Just for fun I'm going to guess August 23rd as the date.