The arguments about diagnostic criteria used in UK/Dutch CBT or GET studies is a distraction/aside when such studies have not provided any objective evidence of improvements.
I'm not at all amazed. Wyller's intended audience is not us, it is those in charge of making health policy and medical decisions. It is the perfect reply for that audience - an authorative "top scientists disagree", nothing to see here move along. If he engages with the details, they will go...
The truth was a bit more gloomy hey? I guess he didn't bother reading any of the studies on prognosis.
https://www.ncbi.nlm.nih.gov/pubmed/15699087
The rest of the conclusion about "prognosis for an improvement in symptoms" are still quite gloomy as the improvements are small
Yes, I've heard the 1/3 + 1/3 + 1/3 anecdotes over the place - but he is not the only one to repeat this nonsense, for example I've seen Michael Sharpe repeat it (ABC radio Australia) referring to the PACE trial results. Michael Sharpe should know better - but we know he doesn't seem to care...
This "thirds" idea crops up again and again in medicine for a wide variety of conditions. It is a common myth that is never supported by evidence. I think doctors like to believe myths like this as the truth is more gloomy.
The thirds claim also makes no sense as there has to be a specific time...
Mind if I ask which country you are from? The GET in Australia/America might be more pacing oriented than that of the UK/Netherlands.
One of the key Australian "GET" studies explicitly used the word "pacing" to describe their programme. (which was a fact not noted in the Cochrane review, so...
The elevated HR post exercise is not substantial enough to discriminate between patients and the various other groups you mentioned.
A meta analysis of the various HR findings is likely to be published this year...
It doesn't. People with other chronically fatiguing syndromes such as post-polio, GBS, Lupus etc also suffer PEM like symptoms.
There is one objective sign that cannot be faked, namely a reduction in ventilatory threshold on the 2 day maximum exercise test (CPET), the problem is this test isn't...
Rewarding 100% attendance means that people come into work/school when they are ill with infectious illnesses, spreading those illnesses to others. Why is this deemed praiseworthy behaviour, when say, antivaxxers are shunned? Both lead to the spread of infectious disease.
When you are looking at common symptoms, not underlying causes, the heterogeneity does not matter so much.
Lots of researchers have wondered about cytokines as a marker for fatigue in healthy people (or athletes), to no avail.
I am confident in saying none of the cytokines are markers for any...
Then, as now, we will not "acknowledge good intentions" while these researchers continue to fail to make any attempt to build trust with the patient community.
I spent a lot of time researching this a few years ago and came to the conclusion that none of the cytokines can be biomarkers for fatigue in patients or athletes. The presence (or lack of) and kinetics do not match at all.
I also spent some time looking at the various cytokine receptors and...
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