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

Amw66 said:
The scale is weird , but perhaps unsurprisingly so

Given the choice I suspect many more would enter "a little worse" making the intervention seem more effective
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Yes, if someone knows they are not very much worse, yet definitely more than a little worse, then it's something of a Hobson's choice. I agree they will very possibly go for being a little worse.
 
Ahhh!!! I’m feeling rather stressed after my parents forwarded me the following email they received from a doctor friend of theirs:

“Here it is as a PDF. Problems downloading, let me know. I hope it is useful. A quick perusal gives me the impression it's the real deal.
Remember, the fact that she has had CBT in the past is no guide to its present utility.”

The attached PDF was the Wessely/Chalder paper being discussed in this thread :( :wtf: :banghead:

I’ve suggested that my parents send their doctor friend a link to David Tuller’s blog about this paper. Thank goodness for David Tuller! And thank goodness for this forum and all the amazing work you wonderful people are doing. Seriously, I don’t know where I’d be without you all.
 
Looks like the BPSers are out promoting this paper this week in a vain attempt to push back the tide.

Clinic-based report of CBT for CFS showing patients get better - as reported in the RCTs that some spend a huge amount of energy trying to dismiss. CBT remains the only effective treatment for this condition. Hope NICE take note of evidence over anecdote here.
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Code: 
https://twitter.com/ProfRobHoward/status/1359756904059305985



I can't see that tweet by Brendon Stubbs via the forum account, I don't know if he's done a "Greenhalgh" (mass blocking of accounts that may or may not disagree with them) or not.
 
The study:

https://journals.sagepub.com/doi/pdf/10.1177/0141076820951545

Limitations This naturalistic study had high ecological validity.However, the lack of a control condition limits us from drawing any causal inferences, as we cannot be certain that the improvements seen are due to cognitive behavioural therapy alone and not any other extraneous variables. Furthermore, therapist effects were not considered, due to lack of power and results from our previous study in the same setting which suggested therapist effects were minimal.30Future studies should include a waiting list control sample within naturalistic settings to address these issues.
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Future studies should include a waiting list control sample within naturalistic settings to address these issues.
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Waiting list controls are a source of bias as not getting any treatment leads to resentment. A control for CBT could be a group with tea, cake and chat as often as the CBT sessions.

No one does it anymore, but there should also be a control group getting CBT who have not got ME either another illness or, say, newly retired whatever. Then of 5% of people with ME are satisfied with the treatment it would be obvious there is a problem if 60% of this group were satisfied.

It is also a good control for drop outs. They are always explained away as "difficulty with transport" or something else that does not relate to the treatment but if there are less in the healthy control group it makes it more likely that the treatment itself is at fault.
 
Trial by Error: Hughes-Tuller Comment of Wessely-Chalder CBT Study Rejected by Journal, Posted Here

Because the paper made unwarranted causal statements and glossed over the huge number of drop-outs and questionnaire non-responders, among other methodological and ethical issues, Professor Brian Hughes and I co-wrote a response and submitted it formally to the journal two weeks ago through the online editorial manager.

As of this morning, the commentary was still awaiting administrative action, so Professor Hughes wrote directly to the journal editor. As he was in the process of posting the commentary to a pre-print site, he received a brief note from the editor stating the following: “Thank you for submitting your article to the JRSM. I read it with interest but I am afraid that I am unable to offer publication on this occasion. I am sorry to disappoint and wish you luck elsewhere.”

So I have posted it below. And here’s the version on the pre-print site. We will also send it to members of the NICE committee in case this flawed study gets raised in discussion by CBT proponents to support their position. It would be nice to find a journal willing to publish such a critique, but at least rejection no longer presents an obstacle to making something public.
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Kalliope said:
Trial by Error: Hughes-Tuller Comment of Wessely-Chalder CBT Study Rejected by Journal, Posted Here
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Kalliope said:
The Science Bit: Apart from the sampling ambiguity, weak measurement, survivor bias, missing data, and lack of control group, the study wasn't that bad
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I’m not at all surprised that the Journal of the Royal Society of Medicine didn’t publish your response, but I enjoyed it very much. Thank you @dave30th and @Brian Hughes. I hope we see it in another journal soon, is that the intention?
 
Skycloud said:
I’m not at all surprised that the Journal of the Royal Society of Medicine didn’t publish your response, but I enjoyed it very much. Thank you @dave30th and @Brian Hughes. I hope we see it in another journal soon, is that the intention?
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Well, I wasn't at all surprised they rejected it. It would be nice to get it published, but it would be somewhat unusual for an unrelated journal to publish a commentary on something they didn't publish.
 
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