‘More (in-)convenient thruths’
One can certainly understand the fact that fatigue professor Jos van der Meer is trying to trivialize the very serious scientific flaws the PACE-trial is known for.
The Dutch fatigue researches, not unfamiliar to Van der Meer, are suffering from comparable very severe scientific shortcomings.
Van der Meer commented on a blog Jim Faas published in Medisch Contact (more (in)conveniant thruths). According to the fatigue professor it lacks nuance toward the description of CBT (talking therapy) and GET (moving).
However, a real example of a lack of nuance and a lack of underpinning, can be found in the overenthousiastic publications of Dutch fatigue researchers and their claims in the press about the allegedly great results of cognitive behavior therapy and graded exercise therapy.
The Dutch fatigue studies show very clearly that these therapies have no curative effect whatsoever.
Just some of the problems:
- There were no objective outcome measures used in the studies, or they were only reported years later, or they were not reported at all. The effects of this objective measures were non-existent.
- One out of two inclusion criteria was not used in defining and measuring recovery or improvement. The results by the way, were very poor.
- There was no controlgroup, or essential oucomes were not measured in the controlgroup.
- Also not unimportant: diagnostic criteria were very loosely applied allowing for a very heterogenious group of patients. Conflating is the adequate English description for this phenomenon.
- Recovery was defined post hoc, meaning severly ill patients were considered to have recovered.
We could easily add more problems to this list, however, let’s ask a comment on these facts first:
Dear mister Van der Meer, we are looking forward to your, no doubt seriously underpinned, explanation concerning the overoptimistic expressions of what was in fact a multiple null effect.
Translation of Van der Meers comment in Medisch Contact
“In a blog one can of course take a leap with nuance, be biased, and claims do not have to be scientifically substantiated. However, colleague Faas is stretching the limit too far.…
CBT reduced to “talking” and GET defined as “moving” is a disqualifying simplification. I don’t want to discuss here the way in which critics have been given opportunity in the Journal of Health Psychology to criticize the PACE trial . It can be noted, however, that the PACE trial is not the only trial that has shown a positive effect of CBT (whether or not combined with a Graded Excercise Program), but Faas has apparently put aside all of these researches. Then he makes a Cartesian giant swing towards his positive appreciation for the Montoya et al. and the Rituximab studies of Fluge et al. However, I have to disappoint Faas: there is very fundamental criticism towards these studies and the results need to be confirmed indepently.”