Open (Victoria, AU) Study looking for healthy people aged 12-19 years to participant in an adolescent ME/CFS research study.

Dolphin

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https://vist.ly/38j43

Healthy Adolescents: We need you!
Researchers at Murdoch Children’s Research Institute (Parkville, Victoria) request your contribution to research that hopes to improve the lives of adolescents with Chronic Fatigue Syndrome.

You or someone you know might be suitable if you/they are:

  • Aged between 12 and 19 years
  • Healthy
  • Interested in brain function, thinking, and fatigue
  • Able to attend the Royal Children’s Hospital for one morning (parking reimbursed)
The study involves completing some problem-solving puzzles and questionnaires, an optional MRI and blood and urine collection.

For more information scan the QR code or to register your interest, please feel free to contact the researchers from the Chronic fatigue Research Team:

Email: Darcy Tatanis at cfsme.research@mcri.edu.au

Ph: 0447 902 442

 
What is the aim?
To improve the lives of adolescents with ME/CFS
That's not good enough.

The Royal Children's Hospital has one reasonable clinician - Katherine Rowe - but also some deeply invested in BPS thinking. It is not possible to tell from the advertisement if this research is going to be useful or harmful.

I see that the project is supported by Emerge. @Simone, can you tell us about the research? What are the puzzles and questionnaires focussed on?

The link
only goes through to Emerge's page of research opportunities. The information about this study there is the same as what is presented above.
 
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OMF Australia link
SPOT-ME: Serial Pediatric Omics Tracking for ME/CFS
Study aim
This study seeks to understand pathological mechanisms of pediatric ME/CFS (13 to 18 years old), using case-control and longitudinal study design that meshes clinical measures and omics methods.

STUDY HYPOTHESIS AND DESCRIPTION
Research on ME/CFS in teenagers is not very common, even though a lot of teens start showing symptoms of this disease. The goal of this research project is to collect detailed information from teenagers with ME/CFS during a single visit to a doctor. This visit will include an MRI scan, brain function tests, and collecting body fluids like blood or saliva. These samples will help scientists look at thousands of biological markers and check how well the mitochondria (energy-producing parts of cells) are working in these patients.

Additionally, the teens will get a kit to take home so they can collect more samples on their own. This will help us see what changes in their biological markers on days when they feel better compared to days when they feel worse.

This focus on teenagers is important because their ME/CFS often starts after the same kind of trigger, such as an infection by the EBV virus, and they are usually diagnosed early in the course of their illness. They also tend to have fewer other health issues compared to adults with ME/CFS. Understanding ME/CFS in teens is crucial because the disease can greatly affect their social life, schooling, and future job opportunities, not to mention the strain it puts on their families.

LEAD INVESTIGATORS
  • Natalie Thomas, PhD
  • Tracey Chau, PhD
  • David Fineberg, MBBS, FRACGP, DCH
  • Katherine Huang
  • Elisha Josev, PhD
  • Sarah Knight, PhD
  • Adam Scheinberg, FRACP, FAFRM, MMed(ClinEpi)
  • Paul Gooley, PhD
  • Christopher Armstrong, PhD

UPDATES AND POTENTIAL
  • IRB/clinical protocol completed and approved.
  • Recruitment has begun at the Royal Children’s Hospital in Melbourne and is ongoing. Recruitment ongoing and ending this year. Will require StudyME registry to help with final push.
  • Have expanded to include MRI study on the patients.
  • Protocol paper draft complete and submitted to BMJ Open.
  • Recruiting a PhD student currently to complete the data acquisition and analysis to occur over 2024-2025.
Objectives
  1. Deeply profile the biology of paediatric ME/CFS patients vs controls.
  2. Test cellular energy metabolism changes in ME/CFS vs controls.
  3. Evaluate “good day” signatures vs “bad day” signatures in pediatric ME/CFS.
  4. Assess biology for patterns that corresponds to patient symptoms in individuals.
  5. Cluster patients based on similar biology-symptom dynamics.
 
@MelbME - do you have some comments about this study? The OMF page sounds good. But I recall seeing a proposal for this study that included collecting a whole lot of psychological information as well as the cognitive and biological information. Is that still happening?

Has the protocol been published yet?
 
@MelbME - do you have some comments about this study? The OMF page sounds good. But I recall seeing a proposal for this study that included collecting a whole lot of psychological information as well as the cognitive and biological information. Is that still happening?

Has the protocol been published yet?


Yeah we have submitted protocol for publication.

This is an NHMRC funded study, the point was to build a lot of biological information on teenagers with ME/CFS.

ME and HC go to the clinic for a blood draw, urine samples, cognitive tests and MRI. Blond draw is for extensive omics (metab, proteomics, transcriptomics, genomics) and some cellular studies for labelled substrate.

ME are provided with longitudinal kits to collect blood samples at home on baseline and PEM days. They have biostrap wearables and at home symptom surveys.
 
This is an NHMRC funded study, the point was to build a lot of biological information on teenagers with ME/CFS.
Yes. It sounds great. But are the young people expected to complete detailed psychological surveys in order to build a bank of psychological information too? As I say, my recollection of the proposal of this study was that a battery of psychological tests was planned.

My son participated in a study run by one of the lead investigators in this study that had surveys including a question on fear of spiders and a whole lot of other questions that had no obvious connection with the topic of the study. I think it's important for informed consent that the young people and their parents know exactly what is planned. It's not right if young people think they have signed up for a biological study and then feel they have to complete detailed psychological surveys. The inclusion of such surveys can suggest to the young people something about the scientists' views about ME/CFS. They can cause harm.
 
Yes. It sounds great. But are the young people expected to complete detailed psychological surveys in order to build a bank of psychological information too? As I say, my recollection of the proposal of this study was that a battery of psychological tests was planned.

My son participated in a study run by one of the lead investigators in this study that had surveys including a question on fear of spiders and a whole lot of other questions that had no obvious connection with the topic of the study. I think it's important for informed consent that the young people and their parents know exactly what is planned. It's not right if young people think they have signed up for a biological study and then feel they have to complete detailed psychological surveys. The inclusion of such surveys can suggest to the young people something about the scientists' views about ME/CFS. They can cause harm.


No there isn't detailed psychological surveys for the teenagers to my knowledge. There are scales for cognition, quality of life, pain, fatigue. There are behaviour surveys for guardians. Closest thing to what you are asking that is used is the HADS I think.

Which investigator used a question on spiders? They only use standard scales, its possible that sometimes you might get a odd question on a scale but these scales are standard for all manner of disease.

These investigators see the disease as a physical disease but they do care about psychological well-being given that ME/CFS in teenagers can be even more detrimental for mental health than in adults. There research is largely MRI imaging these days.

Also, before consent the patient and guardian are given full details and able to talk through any questions.
 
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The inclusion of such surveys can suggest to the young people something about the scientists' views about ME/CFS. They can cause harm.

Harm is an important issue. Unfortunately, almost every study on patients causes harm. Even a blood sample or the energy to fill a survey. Do you think researchers do a good job explaining all the dangers of being involved in research broadly?
It is difficult to assess because it varies from person to person. At what point do you let the participant make a judgement call?


Also, I think a good researcher shouldn't have views based on anything but data. I think the problem with the psych research we all know was damaging is that it wasn't conducted by good researchers, they were clearly biased.

We scientists are meant to be testing things that might disprove our theories, not changing tests or data to fit our theories. We all here think that me/cfs is not a psychiatric disease, but we should still conduct psychiatric tests to prove or disprove our theory. I think this field and patients have been hurt by bad faith researchers/clinicians. I don't know enough to know if poor research is common in psychiatry or not.
 
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Do you think researchers do a good job explaining all the dangers of being involved in research broadly?

On @Hutan's point about psychological questionnaires, the problem is that they often appear to be sneaked into assessments. If there's a good reason to do them and the participant knows about them from the outset, then fair enough. There should never be "but we always ask this" components, though. Every section—even whether or not it's necessary to have participants' postal addresses—needs to be justified, every time.

More generally, one of the things some researchers get wrong is failing to understand the importance of allowing people to review all the questionnaires before they decide whether to consent. I've done several web-based versions that can't be progressed until the questions on the current screen are answered, and that really isn't good enough. I won't complete them because I can't give informed consent.
 
On @Hutan's point about psychological questionnaires, the problem is that they often appear to be sneaked into assessments. If there's a good reason to do them and the participant knows about them from the outset, then fair enough. There should never be "but we always ask this" components, though. Every section—even whether or not it's necessary to have participants' postal addresses—needs to be justified, every time.

More generally, one of the things some researchers get wrong is failing to understand the importance of allowing people to review all the questionnaires before they decide whether to consent. I've done several web-based versions that can't be progressed until the questions on the current screen are answered, and that really isn't good enough. I won't complete them because I can't give informed consent.

You can ask your data to be deleted at any time if you participate in research. And it will be adhered to. This should be in all consent forms

Reviewing some scales may not be possible because of impact on the test itself. It can also be quite lengthy to review. It's not really about sneaking them in, it's just a lot of info to provide, the purpose and the theme of the questions would be added. We don't name every metabolites or protein or SNP we'll be trying to measure either.

Maybe making it clear you can ask for data to be deleted instantly at any point. Would that help?
 
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No there isn't detailed psychological surveys for the teenagers to my knowledge.
That's great. Perhaps you can just keep an eye out for such surveys.

There are behaviour surveys for guardians. Closest thing to what you are asking that is used is the HADS I think.
What specific survey tools are used for the 'behaviour surveys' for the guardians?
HADS has a lot of problems when used in chronic illness samples. If you haven't had a close look at HADS, I recommend doing so, imagining how you might answer the questions if you had ME/CFS. Given the inaccuracy, it is probably better to just ask simple direct questions with a scale, about feelings of sadness, depression and anxiety.

Which investigator used a question on spiders? They only use standard scales, its possible that sometimes you might get a odd question on a scale but these scales are standard for all manner of disease.
I won't answer that here, as I think the investigator means well but it looks as though you have a good idea of who they are. Yes, that was the answer I got when I queried the survey, that it was a standard one. But, as Kitty says, 'we always do it this way', or 'everyone always does it this way' is not good enough. Questions about fear of spiders, or whether the young person repeats actions in order to try to prevent bad things happening, or whether the young person chews tobacco or whether they always think the worst about what is going to happen should have no place in most ME/CFS studies. The problem is particularly acute with ME/CFS - there are lots of people questioning your sanity and keen to apply a 'conversion disorder' label. Even psychologically robust people do ask themselves 'am I just imagining all of this, could I be well if I tried harder?'.

I encouraged my son to participate to attend the Royal Children's Fatigue service and to participate in the study that we were told about there. I think both caused harm to his perception of himself and the disease, although the clinic appointments were a lot more consequential. He subsequently refused to see any more doctors about his illness. He is by no means overly sensitive or anxious; it was a reasonable decision based on the likelihood of the doctors helping (low) versus the likelihood of the doctors making him feel bad in various ways (high) and the effort of getting there (also high).


Also, before consent the patient and guardian are given full details and able to talk through any questions.
That was not the case in the earlier study.
Do you think researchers do a good job explaining all the dangers of being involved in research broadly?
So, no, my experience is that they do not.

We all here think that me/cfs is not a psychiatric disease, but we should still conduct psychiatric tests to prove or disprove our theory.
I agree with that, but in many cases there have been a long series of studies e.g. trying to prove people with ME/CFS are perfectionist or catastrophisers. While there is no credible evidence for either, that does not stop further investigation of these ideas. And, as we are saying here, informed consent is required and there is the likelihood of harm to consider. If you study adults using a flawed survey tool applied after disease onset and then write a paper saying that ME/CFS people are catastrophisers or anxious, many of the participants will be able to dismiss that idea because they have had many years living their life to know who they are. But, if that paper is about a sample of young people, that can do damage to their developing self-image. In much the same way as we are cautious about drug trials in young people with developing bodies and brains, we should be cautious about psychological studies.

Maybe making it clear you can ask for data to be deleted instantly at any point. Would that help?
Yes. But I think it is more important that it is made clear that it is not necessary to participate in detailed psychological surveys in order to participate in a study that has a biological focus. I mean, hopefully the surveys aren't there, especially in studies of young people, but, if they are, it should be clear that they are optional and there should be some discussion of possible harm. (That of course may skew the type of person who completes the survey, making the results even more dubious. I think psychologists may need to think hard about the approach they take to gathering data as self-report surveys have so many problems.)
 
Oh, I should have said, @MelbME, thanks for engaging here and considering these issues, I really appreciate it.

I have said before that filling out psychological surveys with the risk of being found to be psychologically flawed has seemed to be the tax we have to pay for good biological studies. In the past we have accepted that, because it seemed to be the only way to get good studies. It shouldn't have to be that way, we should be able to participate in good biological studies without the detailed psychological surveys.
 
Maybe making it clear you can ask for data to be deleted instantly at any point. Would that help?

No, that isn't really what I'm trying to get at—I know consent can be withdrawn.

It's more that, as a theoretical participant:

• If there's a psychological screening, as an ME/CFS patient I might want to know the reason for its inclusion. That doesn't mean an analysis of every question, just a paragraph or two saying what the screening tool is for, and what would be lost if it weren't used. ME/CFS research has such a terrible history that these questionnaires need to be regarded as almost as sensitive as, for instance, asking people questions about their religious beliefs.

• If I weren't happy that the screening justified, or it had mandatory questions I didn't want to answer, I could choose not to take part. As long as I could see questions beforehand, no one's time would be wasted; I wouldn't start screenings that I'd abandon partway through, and the research team wouldn't be tied up answering my questions.

It can also be quite lengthy to review.

Going back to me rather than my theoretical participant—I don't mind that, I've already done it a couple of times. Questionnaires just need to be available as PDFs, or set up online so that anyone who wants to read it can skip through each screen without having to commit answers.

Reviewing some scales may not be possible because of impact on the test itself.

I'd only want to preview the questions on the screening for transparency's sake. I don't need to understand the scales or the scoring system.

This whole issue of psych screening may become less sensitive as trust builds between patients and researchers, but there's still a long way to go—which is why it's great that you're giving up your time so generously to engage with us.
 
Harm is an important issue. Unfortunately, almost every study on patients causes harm. Even a blood sample or the energy to fill a survey. Do you think researchers do a good job explaining all the dangers of being involved in research broadly?
It is difficult to assess because it varies from person to person. At what point do you let the participant make a judgement call?


Also, I think a good researcher shouldn't have views based on anything but data. I think the problem with the psych research we all know was damaging is that it wasn't conducted by good researchers, they were clearly biased.

We scientists are meant to be testing things that might disprove our theories, not changing tests or data to fit our theories. We all here think that me/cfs is not a psychiatric disease, but we should still conduct psychiatric tests to prove or disprove our theory. I think this field and patients have been hurt by bad faith researchers/clinicians. I don't know enough to know if poor research is common in psychiatry or not.
I think there is a survey or questionnaire (from my memory might be a london clinic?) that asked children questions like ‘do you steal things’ that’s one of the more recent issues ?

which is of course pathetic behaviour of both writer behind it and shows how much ethics boards have gone to the dogs . ME has been the area where things no novelist could think would happen, or wouldn’t use due to believability get away with it because the more outlandish it is the more people assume it can’t have happened. :laugh:

it indicates that under certain hierarchies children being shipped in under ME and other specific illness terms have been allowed to be used as a free for all that’s almost beyond where eg you get a survey on an airplane from a holiday company and they either sold or let their mates in a tv company add in questions to do with that. Then about sportswear. And so on. Until the survey is 200 questions long adding all sorts of random stuff

At least in that circumstance it’s only being trapped on a flight that might mean anyone fills any of it in plus incentive of prize and small risk. You feel less conned when you’ve wasted 45min and give up having turned the page to see there are ten more because most don’t have limited energy and wouldn’t have been using that time to do something more vital anyway. There was no power difference

But kids feeling the pressure to help seem to be being taken advantage of snd the ‘could get harmed crossing road’ equivalent when people raise inappropriate questions and unnecessary length of surveys is often their common answer.

it means everyone now has to ask sadly. Blame the bad ‘researchers’ I say :) but sadly it somehow gets reflected on the people who’ve seen it all and have to warn people or double check

I understand the dilemma though re questions and whether they can be given out before recruitment and guarantees on it not being a fishing expedition but..
 
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Excellent input from all of you.


I wonder if the psychologists are aware of the harm they've created by trying to treat in such a way that has resulted in ME/CFS patients distrusting CBT and other psychological therapies that would be needed to help anyone with the mental toll of dealing with a chronic disease with so little tools to help them.

It's just unbelievable the amount of damage that was done because a group of people thought they understood the mechanism of the disease with such little research and then developed radical methods instead of just sticking to a method to help resolve secondary mental health consequences.
 
Excellent input from all of you.


I wonder if the psychologists are aware of the harm they've created by trying to treat in such a way that has resulted in ME/CFS patients distrusting CBT and other psychological therapies that would be needed to help anyone with the mental toll of dealing with a chronic disease with so little tools to help them.

It's just unbelievable the amount of damage that was done because a group of people thought they understood the mechanism of the disease with such little research and then developed radical methods instead of just sticking to a method to help resolve secondary mental health consequences.
A lot of them aren’t real psychologists anyway but nurses, physios, ‘CBT professors’ without the broad psychology that looks at whether either CBT is the right treatment or what it’s instituting as thinking is harmful or unhealthy just whether it’s effectively instigated (unlike the way ‘proper CBT’ was developed, so yes I’m surprised they let its name be used) oh yes and psychiatrists often with strange specialisms. Crawley is / was a doctor with a theoretically non-psych specialism I think.

Which is pretty weird in itself. Anyone’s allowed to whack in personality questions even though real psychology wouldn’t touch it with a barge pole because it’s based at best on correlations and claims concepts with no internal validity (everyone says something different when you pin them down to describe ‘a perfectionist’ in specifics).
 
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You can ask your data to be deleted at any time if you participate in research. And it will be adhered to. This should be in all consent forms

Reviewing some scales may not be possible because of impact on the test itself. It can also be quite lengthy to review. It's not really about sneaking them in, it's just a lot of info to provide, the purpose and the theme of the questions would be added. We don't name every metabolites or protein or SNP we'll be trying to measure either.

Maybe making it clear you can ask for data to be deleted instantly at any point. Would that help?
I can’t cut and paste on phone but on that last paragraph you might want to go to the ME Association PROMS thread with Sarah Tyson and Pete Gladwell and scroll back a few pages to where survey 3 was released with new terms and conditions- which seemed to specifically include not being allowed to ask for your data to be removed after it had been filled in
 
I can’t cut and paste on phone but on that last paragraph you might want to go to the ME Association PROMS thread with Sarah Tyson and Pete Gladwell and scroll back a few pages to where survey 3 was released with new terms and conditions- which seemed to specifically include not being allowed to ask for your data to be removed after it had been filled in

Well I completely disagree with that.
People deserve control of their data.
 
Excellent input from all of you.


I wonder if the psychologists are aware of the harm they've created by trying to treat in such a way that has resulted in ME/CFS patients distrusting CBT and other psychological therapies that would be needed to help anyone with the mental toll of dealing with a chronic disease with so little tools to help them.

It's just unbelievable the amount of damage that was done because a group of people thought they understood the mechanism of the disease with such little research and then developed radical methods instead of just sticking to a method to help resolve secondary mental health consequences.
I use the term callous indifference or wilful ignorance for the determination you get to not hear but focus on man not ball arguments to prove oneself right rather than seek to learn anything that tends to be the response of too many

there’s that wonderful delusion people can wrap themselves up in of claiming good intentions justifies all but no one really probes underneath the ‘to help’ claims enough either

I think things like eg BACMEs ‘for the public benefit’ aim in their charity statement is insightful for example

but that’s behaviourism for you (appears to act normal over healthy and/or happy)
 
No, that isn't really what I'm trying to get at—I know consent can be withdrawn.

It's more that, as a theoretical participant:

• If there's a psychological screening, as an ME/CFS patient I might want to know the reason for its inclusion. That doesn't mean an analysis of every question, just a paragraph or two saying what the screening tool is for, and what would be lost if it weren't used. ME/CFS research has such a terrible history that these questionnaires need to be regarded as almost as sensitive as, for instance, asking people questions about their religious beliefs.

• If I weren't happy that the screening justified, or it had mandatory questions I didn't want to answer, I could choose not to take part. As long as I could see questions beforehand, no one's time would be wasted; I wouldn't start screenings that I'd abandon partway through, and the research team wouldn't be tied up answering my questions.



Going back to me rather than my theoretical participant—I don't mind that, I've already done it a couple of times. Questionnaires just need to be available as PDFs, or set up online so that anyone who wants to read it can skip through each screen without having to commit answers.



I'd only want to preview the questions on the screening for transparency's sake. I don't need to understand the scales or the scoring system.

This whole issue of psych screening may become less sensitive as trust builds between patients and researchers, but there's still a long way to go—which is why it's great that you're giving up your time so generously to engage with us.
Important things raised @Kitty and of course you’ve reminded me of the other issue:

using intrusive or presumptive questions and titles is a great way to filter the sample to those who agree that it was eg their obsessive tidiness mindset that triggers their ingrown toenails.
 
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