David Tuller: Trial By Error: More on the CDC; Reader’s Digest; and BBC’s Newsbeat

Andy · May 23, 2018

It’s been almost a year since the CDC removed its recommendations for GET and CBT as treatments for ME/CFS (or CFS, or ME, or CFS/ME, or even SEID or whatever else one calls this illness or cluster of illnesses). When questioned about the decision, the agency explained that people had misunderstood what was meant by CBT and GET—not that the science behind the recommendations was indefensible, as was clearly the case. Despite the CDC’s unwillingness to provide a credible explanation for its actions, the change marked a significant victory over the CBT/GET ideological brigades.

And yet the treatments continue to be recommended by major medical organizations and websites in the U.S. Here, for example, is a section about ME/CFS treatment from the Mayo Clinic’s site:

Graded exercise. A physical therapist can help determine what exercises are best for you. Inactive people often begin with range-of-motion and stretching exercises for just a few minutes a day. Gradually increasing the intensity of your exercise over time may help reduce your hypersensitivity to exercise, just like allergy shots gradually reduce a person’s hypersensitivity to a particular allergen.

The passage presumes that the illness involves a “hypersensitivity to exercise” comparable to an allergy, and that gradual exposure is the solution. What is this hypersensitivity? Is it attitudinal or psychological in nature? Is it biological? Is there any evidence that such a hypersensitivity is an actual phenomenon, and that exercise can reduce it? The Mayo site does not provide answers to these questions.
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http://www.virology.ws/2018/05/23/trial-by-error-more-on-the-cdc-readers-digest-and-bbcs-newsbeat/

Alvin · May 23, 2018

Very well explained, especially the second half, thanks @dave30th

Inara · May 24, 2018

NICE recommends that both CBT and GET are offered to CFS/ME patients, and this advice is based on good evidence from multiple studies and randomised controlled trials (RCTs) showing that these treatments are safe and useful for some patients. These recommendations have been in place for many years, and the evidence-base for these treatments has grown with time. CBT and GET can help patients with conditions such as cancer, chronic pain, and multiple sclerosis, so their use in CFS/ME does not infer that a condition is a mental illness.
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Oouuuccchhhh
Aaarrrggghhh

There's nothing to be said...just speechlessness...

Edit:

Scientists and clinicians are also increasingly frustrated with the distinction made between ‘mental illnesses’ and ‘physical illnesses’ when the latest clinical evidence shows that the two are closely entwined.
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Yeah, sure...In your dreams...

Barry · May 24, 2018

I think if there were a competition for what is the most abused word in science, my vote would be "evidence".

Sean · May 24, 2018

Biopsychosocial would be a hot contender.

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David Tuller: Trial By Error: More on the CDC; Reader’s Digest; and BBC’s Newsbeat

Andy Committee Member (& Outreach when energy allows)

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David Tuller: Trial By Error: More on the CDC; Reader’s Digest; and BBC’s Newsbeat

Andy Committee Member (& Outreach when energy allows)

Alvin Senior Member (Voting Rights)

Inara Senior Member (Voting Rights)

Barry Senior Member (Voting Rights)

Sean Senior Member (Voting Rights)

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