2014 Impact case study - Oxford University - CFS

[Sly Saint]

see the one for QMUL here:
https://www.s4me.info/threads/2014-impact-case-study-queen-mary-university-of-london-qmul-cfs.7076/

this one is also included on that thread but thought I'd go through it given recent events with MS.

so this is what we have to thank Oxford University for:

Summary of the impact
Chronic Fatigue Syndrome or CFS (also known as CFS/ME) affects two percent of the population.
Michael Sharpe and colleagues in Oxford developed a cognitive behavioural treatment (CBT) for CFS. In 1996 they published the first randomised controlled trial finding that CBT was substantially more effective than standard care, with patients three times more likely to improve. This was the first treatment ever to be shown to be effective for CFS in a clinical trial. The finding was subsequently confirmed in other trials. Sharpe’s research has benefitted people with CFS by:
[a]challenging the prevailing view of the illness as untreatable,
informing current NICE treatmentguidance,
[c] providing the leading evidence-based treatment.
In England alone, the treatment is implemented in 46 NHS specialist CFS centres, to over 7000 patients per year.

Since the early 1990s, Sharpe and colleagues have been at the forefront of characterising CFS, and then developing and evaluating the first effective treatment.
As recently as the 1980’s the condition was widely regarded as untreatable. It also lacked an agreed definition. Having published the first UK research diagnostic criteria for CFS (the ‘Oxford definition’) in 1991, Sharpe was a co-author on the International (CDC) criteria, which were basedon the Oxford definition, and have since been adopted worldwide (Fukuda et al., 1994).

..the key paper is that by Sharpe et al (1996) in the British Medical Journal, which reported a randomised controlled clinical trial, funded by the Wellcome Trust and based in Oxford, in which CFS patients were treated either with CBT or with standard medical care.
One year later, 73% of participants who had received CBT reported a substantial reduction in disability, compared with 23% who had received medical care alone; this is a large treatment effect (with a ‘number needed to treat’ of 4).
This seminal paper, the first of its kind, provided critical evidence to challenge the ‘untreatable medical illness’ view of CFS, and provided the first ever evidence-based treatment for patients suffering from the condition.

The most recent and influential replication was the UK-wide MRC funded PACE trial (White et al., 2011) of which Sharpe, then working inEdinburgh, was co-principal investigator; Oxford was a trial centre. Since returning to Oxford in
2011, Sharpe has continued to publish findings from this trial, which underline the value and costeffectiveness of CBT for CFS (e.g. McCrone et al., 2013).

[no mention of GET?]

A standard, and cost-effective, evidence-based treatment CBT has become a standard treatment for CFS. If two percent of the UK population have CFS (as has been estimated), then more than a million people suffer from the condition. As the number need to treat (NNT) in the 2009 Cochrane review of trials of CBT for CFS was 7 (using a conservative estimate), well over 100,000 patients hypothetically could benefit from this treatment.
This benefit has been confirmed by a national audit (Crawley et al., 2013; Source 9). These numbers do not take account of the many patients treated outside these centres in England, nor in the rest of the UK and in other countries.

CBT is also recommended for CFS by the Centres for Disease Control in the USA (Source 10).

[Not anymore it isn't].

The impact of this work has spread beyond CFS, and has influenced the conceptualisation and treatment of fatigue in other conditions such as multiple sclerosis (Van Kessel et al.,
Psychosomatic Medicine 2008; 70:205-213).

The benefit of CBT and the Sharpe trial are referenced in Wikipedia:

BACME is the UK organization for clinicians treating patients with CFS. It links the NHS treatment centres. The organizations aim is to “champion evidence-based approaches to the treatment of CFS/ME, such as those provided in the NICE guidelines.” The information page states: “Cognitive behaviour therapy (CBT) is a treatment that has been found to be effective in helping people with chronic fatigue syndrome (CFS)”.

 

[Esther12]

There are a number of REF2014 submissions relating to rubbish CFS/MUS research - so frustrating. It should matter that hyped junk-science is used to attract huge amounts of government funding!