Efficacy of web-based cognitive–behavioural therapy for chronic fatigue syndrome: randomised controlled trial (2018) Knoop

Yeah, they (Blijenberg) don't want anyone in the trials that are fighting for their benefits. It's considered a perpetuating factor. Disability means you have a chronic illness.

 

What did they say about the actometer?

 

Nope - it's tripe.

 

Are there any real world, objective outcomes at all?

What about return to work/study figures?

How many people no longer needed/qualified for benefits?

 

Yes, it looks like a lot did not do their 'preventing relapse' module.

The protocol driven iCBT had requirements for participants to do things by a certain time, and they'd have therapists get in contact at regular intervals. The on demand iCBT was more hands off. They expected protocol driven iCBT to be more effective than on demand iCBT, but they were both the same.

I cut out the bits I saw under this section of my longer post. I may have missed some from tables, etc, but there didn't seem to be much info, and it looked like some info that was supposed to be in their supplementary material was missing:

"I don't really understand what was happening with their actigraphy, why they were not planning to assess results, and why they then did. The mentions it gets:"
https://www.s4me.info/threads/efficacy-of-web-based-cognitive–behavioural-therapy-for-chronic-fatigue-syndrome-randomised-controlled-trial-2018-knoop.2224/#post-40417

 

To put the actometer results in some context:

 

I find it a little odd that they don't do a sensitivity analysis where the 6 who do not satisfy the CDC criteria are excluded.

 

It's not really that tailored:

 

Not alone are participants with CFS told not to sleep during the day but they shouldn't lie down!

 

It can already be done, known as electroshock therapy.
Then again they may invent a home version, you connect it to the internet and the doctor electrocutes your brain remotely.

Finally they may become unhinged enough to steer people to the "natural" version, telling patients to walk outside during thunderstorms

 

Wow. These people are special. They'll freak out when they find out some people do relaxation as part of CBT lying down. No recumbent cycling as part of your GET either. No yoga. No stretching. Zero tolerance to the horizontal.

 

So you're against cost saving efficiencies in the NHS?

There isn't a magic money tree you know.

 

There is, its called rejecting trickle down economics. But thats a concept far too advanced

 

A bit disappointing they don't calculate the DALYs considering they have the data.

But then they don't even give the results for the EQ-6D unless they are going to be in another paper.

 

I wonder how interesting it is that the protocol-driven feedback didn't do better and indeed on the SF 36 physical functioning subscale, only the feedback on demand group was statistically better than the waiting list group (i.e. the protocol-driven feedback group wasn't).

 

I criticised this point about a lower placebo response reported in that paper in this thread:
http://forums.phoenixrising.me/inde...ic-review-meta-analysis-cho-et-al-2005.46408/

 

So how many participants' outcomes were in fact measured?

 

I find this a bit bizarre. They tend to make grand claims about CBT yet here they downplay a positive result.

 

This all seems a bit risky to me given that the chances are people won't recover after a CBT program.

I wonder how many people actually follow instructions like this.