The Prospects of the Two-Day Cardiopulmonary Exercise Test (CPET) in ME/CFS Patients: A Meta-Analysis, Eun-Jin Lim, 2020

https://www.mdpi.com/2077-0383/9/12/4040/htm

 

Strange that they only included 5 studies. I thought they were quite a few more: Keller et al. 2014, Lien et al. 2019, Davenport 2020, and the ones by Van Campen/Visser.

@Snow Leopard

 

It’s great that the work has been done, but surely 2-day CPET in its current form is never going to be useful as a diagnostic tool? Putting aside the ethical and practical issues, most ME patients aren’t going to get anywhere near VO2 max. I can barely get out of breath before my muscles start to give up.

It’s not necessary anyway. It’d be great to have a biomarker, of course, but properly trained primary care practitioners using a reliable case definition shouldn’t have much difficulty making a diagnosis even without one. The areas that really need attention are the ‘properly trained’ and ‘reliable’ parts!

 

Good to see a meta-analysis like this but indeed strange they only included 5 studies.

Has this group published about ME before? Never heard of them.

 

Van Campen/Visser and Keller 2014 were not case-control studies.

Not including Lien 2019 and Davenport 2020 is disappointing. The latter suggests the analysis was conducted before Davenport 2020 was published. The exclusion of Lien 2019 is likely due to Lien et al. not providing numerical values/SD for the parameters used in the meta-analysis.

This group has been conducting systematic reviews - eg of case definitions, prevalence etc. I expect this is so that they can be translated into Korean guidelines.

https://www.researchgate.net/scientific-contributions/Eun-Jin-Lim-2170994814

 

They were thorough and picked up over 200 studies, so they used strict inclusion criteria as a filter - see the flowchart in the text. I don't see a table of excluded studies (maybe online somewhere?), but I expect @Snow Leopard is right about Lien. They searched until June 2020, hence Davenport missing. This looks ok as a review & meta-analysis.