Trial Report Cost-Effectiveness of Online CBT for Children with CFS/ME Compared to Online Activity Management: FITNET-NHS Trial Findings, 2023, Crawley

Unfortunately the interesting bit is behind a pay wall

https://www.valueinhealthjournal.com/article/S1098-3015(23)03636-7/fulltext

Cost-Effectiveness of Online Cognitive Behavioral Therapy for Children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) Compared to Online Activity Management: FITNET-NHS Trial Findings

https://www.valueinhealthjournal.com/article/S1098-3015(23)03636-7/fulltext

• M. Cochrane
• A. Annaw
• B. Shirkey
• C. Metcalfe
• G. Treneman-Evans
• E. Crawley
• W. Hollingworth

Most children in the UK with chronic fatigue syndrome/ myalgic encephalomyelitis (CFS /ME) do not have local access to specialist support. We assessed the cost-effectiveness, from a UK healthcare perspective, of delivering online cognitive behavioral therapy (CBT) for children with CFS/ME and their parents, compared to online activity management (AM). In addition, we conducted subgroup analyses for children with and without mild/moderate comorbid anxiety/depression. We also assessed cost-effectiveness from a wider perspective incorporating parental/carer and educational costs.

 

How do they get funding for this crap? Will their next (funded) project be comparison of the effectiveness of coloured underwear vs white for treating ME?

 

It's a poster presentation, the PDF of the poster can be seen here, https://www.ispor.org/docs/default-...neee238poster129030-pdf.pdf?sfvrsn=7e519db0_0

Also attached

 

They did a cost-effectiveness study of 2 useless interventions, found they are equally useless, and will continue using both. And wasted over £1M on this crap. And they'll likely get more to do it again some time later.

The aristocrats
Evidence-based medicine

It's one of those things that should go without saying, but clearly it has to be said: there is zero reason to do any analysis of any kind, let alone an economic one, for something that is ineffective. It's like multiplying by zero and being proud to show a large number with no one seemingly bothered to point out that it just doesn't make sense.

 

From the poster. They're most probably not referring to the NICE guidelines:

 

probably should have read: "an approach recommended in national guidelines at the time we wrote the protocol for this piece of crap."

 

don't you need a no-underwear group as well? and will they stratify by boxers and briefs?

 

Yes, the more things we compare, the more likely we are to get a significant result

 

This is the first sign of actual FITNET results, isn't it?

 

I suggested that in this post on Twitter/X

21k views and 22 hours later no one has corrected that view.

ETA: I have just seen we sort of cross-posted as you had just seen that on Twitter/X.

 

yup! I checked on pubmed and haven't found anything about previous findings. So these findings really document for the first time what a boondoggle this was. I love how they boast about this being the first study to assess the cost-effectiveness of online CBT for pediatric "CFS/ME" cases--as if it's a good thing that money was wasted on this crap to produce these null results.

 

and it seems fair for me to assume that those who deteriorated were 'dropped out' and so the 0.532 vs 0.530 is the best they could fudge having filtered out the illest, kept the potentially misdiagnosed, and including all the bias and potential coercion (and perceived threats 'if you don't get better') involved...

 

I assume actually they likely incorporated the drop-outs by doing an "intention-to-treat" analysis, which is a way of taking a more conservative approach than leaving the drop-outs out of the analysis altogether. Even so, the results were shit.

 

From 2016, they literally sold it as effective from the start. Again. Like they do every time, and their scam gets promoted as is. 7 years later, the scam is exposed, and I don't think there is any doubt that no one will change anything, they'll still be pushing CBT as a cure, online or not, because nothing matters in evidence-based medicine.

https://meassociation.org.uk/2016/1...overage-of-the-fitnet-story-13-november-2016/

On BBC News 24 the breaking news ticker headline repeatedly announced across the screen: “A successful treatment for children with CFS is being trialled by the NHS.”

The BBC’s Charter says that its primary function is to inform, educate and entertain, but the BBC breached its own Charter by its 24-hour non-stop promotion of a study of myalgic encephalomyelitis/chronic fatigue syndrome in children and adolescents (the £1 million FITNET trial, which stands for Fatigue In Teenagers on the interNET) and which claims success for a behavioural modification intervention when there is no objective evidence of any such success in either children, adolescents or adults. Moreover, the study had not even started to recruit participants: this was not made clear and it was heralded as “Landmark chronic fatigue trial could cure two-thirds” but that was later changed to the nonsensical “Landmark chronic fatigue trial could treat two-thirds”. Chronic fatigue is not the same as ME/CFS.​

Any thinking person should immediately balk at the words "a successful treatment is being trialed". This is nonsense, it's blatant rejection of the scientific method, of every rule and principle society has developed around providing proof and evidence for things. It also makes a complete mockery of evidence-based medicine, but this is what evidence-based medicine really is.

It's as wrong as "guilty defendant who 100% did it on trial", which no lawyer would ever spoke out loud as it would cause them trouble, and no journalist or editor would ever publish as they would get sued.

But in evidence-based medicine, it's the whole game. They did the same with PACE, with FINE, and with all their prior trials, and got away with it. Everyone loves it, except the patients. This is a complete aberration from all norms about fairness, about science and even about philosophy, about how to know things and how to find out what's true and what isn't.

 

Trial By Error: Disastrous Results for Professor Crawley’s Pediatric Online CBT Trial

Pediatrician Esther Crawley, Bristol University’s mathematically and factually challenged grant magnet, has released what seem to be the first outcome results from her much-hyped but fatally flawed FITNET-NHS trial—and they are disastrous. The trial, a pediatric study of online CBT based on similar Dutch research that (falsely) claimed to have proven the effectiveness of the intervention, was granted around one million pounds by the UK’s National Institute for Health and Care Research.

The findings were presented in a poster presentation at a conference last month in Copenhagen. The title: “Cost-Effectiveness of Online Cognitive Behavioural Therapy for Children with Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis: FITNET-NHS.” The poster was published in the journal Value in Health this month. The conclusion was blunt: “FITNET-NHS (online CBT) is unlikely to be cost-effective compared to online Activity Management within the first 12-months.”

And here’s the larger take-home message: If you spend years over-interpreting unimpressive research findings and making inflated and grandiose claims about the rehabilitative powers of treatment with CBT/GET, regardless of whether the intervention is delivered individually or in groups, in person or online, accompanied by music therapy or not, naked or fully clothed (to ensure I don’t get accused of inaccuracy, I’ll point out this last point is a joke!), at some point your bullshit will come to light. This maxim applies in spades to Professor Crawley, a repeat violator of long-standing scientific standards.

https://virology.ws/2023/12/30/tria...rofessor-crawleys-pediatric-online-cbt-trial/

 

David could give Marina Hyde a run for her money.

 

If you already know it works, you wouldn't be trialling it. As stupid as these headlines obviously are, they really harm us. They run these marketing scams hoping parents will read this trash in the BBC and enrol their children in the trial.

 

Hm. yes, that's a good point.

 

I could google this, but it's more fun just to ask: Who is Marina Hyde?