Cognitive Behavioural Therapy for chronic fatigue and CFS: outcomes from a specialist clinic in the UK (2020) Adamson, Wessely, Chalder

Indeed.

Generally speaking, if people were really doing much better and pleased, grateful for the therapy, there would be a much higher followup rate.

Publishing clinical data like this is only ever "suggestive" quality evidence, but I'm sure this will be cited as strong evidence for the acceptability, despite the fact that this is a self-selected (participation) group with a high dropout rate...

 

not sure if this is applicable but I coincidentally was just reading this on CBT watch

http://www.cbtwatch.com/whats-the-o...y-old-self-with-this-psychological-treatment/

 

"missing 25% or less"?

How was an individual's data processed if more than 25% was missing? Especially if it was missing because the individual was performing badly.

 

Partial evidence is on a par with partial truth. Low-quality-evidence by omission is on a par with untruthfulness by omission. If you omit significant evidence or truth, you can strongly imply falsehoods. It's why in a court of law you swear to tell the whole truth.

 

Interesting. I know this service. In this time frame. Poor CBT delivered by one of their ‘top‘ people who trains others. I didn’t submit a complaint at the time, just withdrew with my GP consent due to terrible note taking and significant fundamental factual inaccuracies made in a basic report indicating poor listening skills and also misuse of ‘drop down’ menus.

 

I am trying to catch up with threads for there days.

Just to note that there are no NICE criteria for diagnosis of CfS. Just criteria for when to consider the diagnosis.

 

So while Wessely was abusing his influence to have a puff piece published to an international audience loudly screaming they were being silenced and had to abandon research in whatever they think CFS is, he was working on this. Which, to be fair, is actually accurate because this is not research but technically massively hypocritical. Wessely did the same in the early 2000's with a round of airing of grievances about leaving the field even as he was actually working on PACE. The lies are so blatant.

Even worse is that this strictly used self-reported symptoms, which the BPS ideology considers to be worthless when it reports harm, illness or deterioration, yet somehow are valid when but only in their limited set of questions that miss 90% of the symptoms. What incredible jerks these people are.

A SF-36 of 60 is the average physical function of 80 year-olds in the general population. Similar standard deviation, even. Now that it's been normalized that they can use that absurd threshold of recovery, they simply use it again, because of course. Which means that whatever journal they publish this in has vetted and agrees that 20 year-olds with the physical function of 80 year-olds are perfectly fit and healthy. What a sick, cruel joke these people are.

Aside from the SF-36, which is non-specific, none of those scores are of any relevance to ME/CFS.

As Trish said this makes no sense whatsoever, Oxford criteria are the loosest ones. WTH is this nonsense? Again showing that peer review in clinical psychology is entirely over style and ignores substance.

 

Boy these people sure like to give me a lot of work!

 

Patients fatigue, physical functioning and social adjustment all significantly improved following CBT for CFS in a naturalistic outpatient setting. These findings support the growing evidence from previous RCTs and suggests that CBT could be an effective treatment in routine treatment settings.

This is the 'pragmatic trial' nonsense - doing trials in 'naturalistic settings'.

Worth noting that 'naturalistic' actually means 'to give the impression or appearance of reality'. Actual reality is called 'natural'. It seems that the BPS sorority continue to find ways to malaprop the language of philosophy.

 

This is such crap--the "growing evidence from previous RCTs." What growing evidence? Each study shows the opposite of what they claim it shows.

 

So they have toted out the captain of the titanic. While the conclusions are all optimism this seems to me like striking up the band. Someone got a glimpse of the iceberg and is trying to steer the behemoth away from the dangerous reality before them. Back to delusion land.

Stay tuned. Let's see if they make it safe to harbour this time. Or will covid-19n be the reality that breeches their impenetrable (sk) hulls.

 

And what about the next bit?

suggests that CBT could be an effective treatment in routine treatment settings.

This is quite a climbdown from 1989 when it was assumed that CBT was an effective treatment in routine settings that just needed a couple more trials...

 

Can I ask a dumb question? If there is such a huge dropout how can they get away with such blatant lies in the results section of the Abstract?

If only 52% of patients were followed up, how can 90% of them be satisfied at follow-up?

Ahh found it. They made up the results to get the follow-up numbers in the results section
[EDIT - the following quite only applies to "Predictors of outcome" section which showed there were no predictors]

Okay. Let's look into drop out some more. Note - , the study goes back to 2002!!! Notice they say a 31% dropout.

But as @Trish highlighted about 48% of patients were not followed-up in any one of the questionaires.


So let me summarise.
1. Reading the abstract, data was available for 995 patients and 85% felt the treatment showed an improvement. That sounds good.
2. Quick look at the meat and potatoes
- They used Oxford and CDC criteria that don't required PEM a key no-no in any modern CFS paper, and even then only 754 (76%) participants met Oxford criteria for CFS and 518 (52%) met CDC criteria for CFS. So even the loosest of critera only about 50% of those starting CBT actually had CFS
- 48% dropped out of answering some questionnaires, but only 31% dropped out of answering all questionnaires,
- They "made up the answers" for dropouts which was about half the participant number and then presented final results as if all had participated.

Do they even discuss how the CBT treatment changed over those 14 years and what versions of questionnaires were used when?

Okay, I know I repeated others statements, but I had to verify them for myself as they are quite outrageous. It's the abstract and analysis in the paper that is outrageous.

EDIT : I'm surprised that they didn't present a subsection of analysis on only patients that met the CDC criteria? That implies that the results for that are not as stunning!

 

very helpful summary. Since this is Trudie Chalder of "back-to-normal" fame, I guess it's possible to find a way to claim success no matter how awful the results.

 

The evidence that it's possible to get away with total BS as long as it comes "from a BPS perspective"? Hard to dispute that. They can even actually use the words randomized control (sic?) trial even though they haven't actually done a single actual controlled trial. And they get away with it, nobody's stopping them.

It's actually remarkable and pretty much unique in all the fields of science to build hundreds of careers entirely out of pure bullshit pseudoscience. I mean seriously this is impressive in some ways. These people turned con artistry into con science, it's no small achievement, while being celebrated for it, no less.

They can even get away with making bullshit statements about getting away with bullshit pseudoscience and get that published. This genuinely deserves a medal made out of the crushed bones of their victims, it's no small feat to destroy millions of lives on purpose while actually being awarded for it BY THE MEDICAL PROFESSION. No one can touch that level of destructive psychopathy, these people truly are the worst people to have ever practiced a serious profession. There is definitely growing evidence of that.

 

Ah! Nice one. I remember they did the same with PACE on some of the data for dropouts.

Enforcement is 9/10 of the law. Same is true in any system of rules, once flaunting the rules is normalized for some they will do nothing but keep flaunting them. This whole thing where people are exempted from the rules? Yeah, it always leads to the same outcome: disaster. Well, disaster for many, knighthoods and unlimited funding for a few.

 

Uhhhhhhh.

OK found it, this is a 14-year retrospective study:

So if we take at face value, this goes back to 2006, they blame ~30% of dropouts on data not being available before 2007, meaning those dropouts occurred between 2006-2007? Or the data are available but are simply buried in this BS excuse. Why would they even be included then? This excuse makes no sense!

Yet scored an average of less than 60 on the SF-36. Bald-faced lies. How do they get away with lying all the damn time?! These people are sadists, they ruin lives and then lie, lie, LIE.

Note the keywords:

 

I was personally seen at this clinic. It took 12+ months to get an appointment - once I did I had an assessment, and after the assessment it was a further 12 months for a first appointment. The ‘therapy’ was just talking about increasing activity and addressing sleep (why didn’t I think of that??) and I found myself repeating the same thing week after week so I ended up discharging myself. The therapist was pleasant but the protocol was completely ridiculous.

 

Data from 2002 to 2018 from patient visits 2002-2016