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

We have another CBT trial to look forward to:

From the protocol paper:

 

The intervention sounds designed to bias self-report outcomes.

Maybe actometer results were poor for the next step of the trial, and that led to them playing them down their positive results here? I can see how an 'easy-to-ignore' form of internet CBT would be less likely to be unhelpful, and therefore if some people might still benefit from it, that could lead to better results than we see for face-to-face CBT. It's so hard to say anything when this group have such a history of misrepresenting the evidence.

 

Quite possibly. I just found it interesting because if (in isolation from any other flaws the trial might have) I had an objective measure that appears to show a statistically significant benefit, I wouldn't be squirreling that away.

 

Just to point out that the actometer data was neither a primary nor a secondary outcome measure.

There is a chance they might not have published it if it didn't suit.
They used actometers in Nijhof et al. (2012) https://bmcneurol.biomedcentral.com/articles/10.1186/1471-2377-11-23 but have never published the data.

 

"Hmmm. Disappointing. Well, let's move on to you, Captain Piett. Have you found these
online sessions helpful?"

 

https://twitter.com/user/status/1021743820202024961


Direct link to the text:
Cambridge Core: Frank Twisk & Lou Corsius: Cognitive-behavioural therapy for chronic fatigue syndrome: neither efficacious nor safe

The authors label their intervention CBT. However, looking at the protocol, the intervention investigated not only incorporated CBT, aimed at ‘behaviours and beliefs’ perpetuating ‘fatigue and impairment’, but also included a graded activity programme, known as graded exercise therapy (GET). Several large-scale patient surveys and studies, for example Cheshire et al,4indicate that CBT, especially when combined with GET, can cause iatrogenic harm and is not safe.

In conclusion, the study does not substantiate the claim that iCBT/GET for CFS is efficacious, while there are several indications CBT/GET is not a safe therapy.

 

https://twitter.com/user/status/1021744071277244421

 

Response from White and others to the letter from Corsius and Twisk, https://www.cambridge.org/core/jour...B85E1E18395A44E4535281167FD413#fndtn-comments

ETA: Corrected my claim that the response was from the authors of the paper.

 

Response from Knoop, Janse and Bleijenberg to the Twisk and Corsius letter, originally published online 26 Nov 2018.
https://www.cambridge.org/core/jour...ous-nor-safe/34A724F77E1A7C55D2B4A7E15F161B3A

 

The reply doesn't address anything. It just describes their flaws drily and says there's no problem there because they don't see the flaws as a problem.

TL;DR:

 

This study is one of the 3 trials the German IQWiG draft report assessed (cited as Janse 2018)

https://www.s4me.info/threads/germa...-by-11-november-2022.21266/page-2#post-441477

Did I understand correctly that this is another example of the studies who used actimetry as part of the treatment but not as trial outcome measures and didn't report results?

Do the authors nevertheless claim that there was an increase in activity measured by actometers or is their argument that only subjective measures on a perceived increase in activity are relevant so they didn't even analyze the actometer data?