Efficacy of cognitive behavioral therapy targeting severe fatigue following COVID-19: results of a randomized controlled trial 2023, Kuut, Knoop et al

I received notification on Friday that my Correspondence is to be published.

I shall pop a link on here as soon as I have it. I am assuming that the authors will have right of reply.

 

The corrected proof has been uploaded. Note this is basically just a journal typeset of the paper—there's no actual corrections as far as I can tell.

 

I would guess they're probably publishing a selection of responses and the authors will respond to all of them with their usual stupidities and misrepresentations.

 

A rare exception to the adage that it isn't stupid if it works. Here it's definitely both. Because wow does it work 100% of the time, no matter how convoluted the excuses and reasoning are.

 

Trudie Chalder is using ReCOVer to promote CBT for Long COVID at the May ATS Symposium in Washington DC.

https://twitter.com/user/status/1661028822324502528


Evidence for Fatigue Management in Long COVID (abstractsonline.com)


The wheels are inspired by A new paradigm is needed to explain long COVID - The Lancet Respiratory Medicine, S4ME thread here.
(Only Chalder changed the content and added arrows so it's more noticeable the cogwheels don't work like that, very on brand.)

Claire Willis 2021 is her own editorial with Willis in the Journal of mental health: Full article: Concern for Covid-19 cough, fever and impact on mental health. What about risk of Somatic Symptom Disorder?

 

Priceless.

 

I laughed so hard at that. Maybe these people really just lack basic logic and don't even understand what they don't understand. Here we say about such things that they can be understood with "a peasant's rational sense". But somehow such basic logic escapes these people, despite being professors.

 

I finally had an email response from the authors (after an email to the editor).


Your comments on our study were sent to us by the editor of CID. We apologize for not responding directly to your mail. Your email ended in our spam box and was missed by us. Below we respond to the 4 remarks. We have send our response also to the editor.

1) The standard errors as reported in table 3 are correct. They seem identical because they are rounded to one decimal place. They are not identical.


2) Indeed, there is an omission in the caption of figure 2. The measure of uncertainty presented is the standard error with its 95% confidence interval, while we only referred in the text to the standard error. The caption of figure 2 should have been:


‘Checklist Individual Strength–fatigue scores and standard errors with their 95% confidence interval from baseline to the posttreatment assessment for the cognitive-behavioral therapy group and the care as usual group.’


3) As mentioned at 1) , the standard errors in the table 3 are rounded to one decimal place. When drawing the figure we used the unrounded standard errors. This can explain the small differences in the length of the error bars. The lengths of all error bars with their 95% CI are correct.


4) The error bars in figure 2 are not centered in the corresponding data points. This is a deliberate choice. If we had centered the bars, the individual error bars at baseline for both groups would not be visible for the reader as they overlap at that time point.

 

Thanks for sharing.

Doesn't change the problem in my view.

The standard errors at the start of the trial were very different compared to follow-up assessments. For example, for the primary outcome, CIS fatigue, it started at 0.7 then it was 1.4 at T1 en 1.7 at T2. So it more than doubled. This is unlikely to be due to a change in sample size because figure 1 says no participants were excluded form the analysis.

If the SE can be go from 0.7 to 1.7, it is a bit peculiar that they are exactly the same at T1 (1.4 and 1.4) and at T2 (1.7 and 1.7) in both groups. And that the same pattern appears in 3 to 4 of their other outcome measures. It's a bit like throwing a dice 8 times and and getting all 6s . It happens, but only about 1 in a million times.

 

A critical response to the CBT #longCOVID trial by Kuut et al. Eventhough they didn't touch on all the details, it looks pretty good. I don't think we've seen a collaboration of MDs voicing their concerns about CBT like this very often in the Netherlands. Is it a first? I think so. It's a clear sign things are changing! Anyways, well done to all the authors!

 

A couple of highlights.

 

Clinical Infectious Diseases have published my critical correspondence too:
https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciad397/7216395

 

Unfortunately paywalled. Are you able to share the full text with us?

 

Try this link:
https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciad397/7216395