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Effectiveness of an ACT‐based rehabilitation program for the treatment of chronic fatigue: Results from a 12‐months longitudinal study, 2020, Brugnera

Discussion in 'Health News and Research unrelated to ME/CFS' started by Andy, Aug 4, 2020.

  1. Andy

    Andy Committee Member (& Outreach when energy allows)

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    Paywall, https://onlinelibrary.wiley.com/doi/abs/10.1111/sjop.12672
    Sci hub, https://sci-hub.tw/10.1111/sjop.12672
     
  2. Trish

    Trish Moderator Staff Member

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    My bolding.

    So they jumbled together people with all sorts of pain, depression and fatigue, and diagnosed them all with 'chronic fatigue', citing loads of CFS studies to back up their assumptions.

    Sad that they seem to have no idea ME exists, let alone what it is. This study is meaningless.

    Edit: and there was no control group.

    Second edit: And they only had results for a little over half the patients at 12 month follow up. It gets more and more useless.
     
    JemPD, Mithriel, alktipping and 19 others like this.
  3. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    After extolling the 'findings' of White, Wessely, Chalder, Knoop,Bleijenberg etc
    oh the irony.
     
  4. strategist

    strategist Senior Member (Voting Rights)

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    Without an adequate control group, it cannot be safely assumed that the treatment has any effect. It appears that the authors have no idea what they're doing.
     
  5. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    I would have liked to see a scatter plot of hours worked vs change in hours worked, but alas this was not done. I mean it wasn't as if return to work was the primary outcome of the treatment. Oh wait, it was! Hmm...
     
    Mithriel, 2kidswithME, Amw66 and 12 others like this.
  6. Snowdrop

    Snowdrop Senior Member (Voting Rights)

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    They get a fail on transparency.
     
  7. rvallee

    rvallee Senior Member (Voting Rights)

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    Meet the new study, exact same as the previous identical studies. Really adding weight to the fact that there is no crisis of replicability in psychology, it's actually a crisis of validity. There are at least dozens of identical such studies, all with the same recipe and outcome: more research is needed. More research always occurs in this field, somehow, hence no crisis of replicability, failure is consistently replicated. The problem is validity, none of this has anything to do with objective reality, or even subjective reality for that matter.
    Literally none of those things are of any relevance. This is complete BS. Might as well do feasibility studies for large civil engineering projects based on how influencers may find the perfect snapshot for their daily vanity stroll. Completely irrelevant factors.
     
  8. Ebb Tide

    Ebb Tide Senior Member (Voting Rights)

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    Am I missing something re the hours worked?

    At 12 month follow up they give the following for change in hours worked:

    "At 12 months follow-up, 42 (55.3%) individuals reported to be
    working more hours per week than before starting the treatment, 26
    (34.2%) reported to work an equal amount of time, and eight (10.5%)
    reported to work a lesser number of hours per week than before."

    According to my calculator that adds up to n=76

    What happened to the rest of 195?
     
  9. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    Hmmm....

    The abstract clearly states

    Bolding mine.

    *Raises voice to ask if anyone's got a copy of the latest BPS dictionary? I need to look up "All"*
     
  10. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    maybe they were not working at all ie no change as

    "One-hundred ninety-five workers on sick leave..........intensive return-to-work rehabilitation"

    presumably that means that none of them were actually working before the 'treatment' (?)

    (so how could some be working less hours at follow up?)
    :confused:
     
  11. Hutan

    Hutan Moderator Staff Member

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    An 'increase in work hours' if a person's work hours before treatment was 0 certainly may not be very impressive. Add in the lack of a control arm and what seems to be a massive dropout for the final follow-up survey, and, well, it's less than convincing.
     
  12. Hutan

    Hutan Moderator Staff Member

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    Worth repeating.

    So physical health QoL didn't improve. But, never mind, that's not the aim with ACT.

    Whack-a-mole - if CBT is finally discarded as the treatment of choice, there's another therapy to take its place. And this one doesn't have to show any objective improvement in anything.

    The treatment was a 3.5 week inpatient programme! The cost of such a treatment must be enormous.

    There was no control, people! Argh
     
    Last edited: Aug 7, 2020
  13. Hutan

    Hutan Moderator Staff Member

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    Another typical problem of studies like this is the use of survey instruments without giving comparison figures for healthy populations, or, ideally, populations of people with a clearly physical and disabling health condition. There's an implicit assumption that the way sick people think is faulty, without any evidence.

    For example the Metacognition Questionnaire. I can't easily find good comparison data, but there is a Wells and Cartright Hatton 2004 study that reported that the mean score was 52 in men and 47 in women, with a standard deviation for each of about 13.5. This was in a sample of convenience of university and health-service employees.

    The study that is the subject of the thread reported that the MCQ score pre-treatment was 54 (SD 12). After treatment it was 51 (11). If you look at the questions, there's a section on cognitive confidence, e.g. 'My memory can mislead me at times'. So, it would not be surprising for someone with an illness that involves cognition issues at times to have a total score that is a bit higher.

    I haven't spent enough time on this to be sure, and it looks like there are various weightings that can be given to the questions. But it's looking to me as though a very large percentage of the sample population of this study had perfectly normal metacognition scores. To then spend 3.5 weeks training these people to see the world differently and only have the tiny change in reported outcome seems a failure in itself, without us even needing to mention the lack of a change in reported physical quality of life.
     
    Last edited: Aug 5, 2020
  14. Trish

    Trish Moderator Staff Member

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    This study reads more like promotional material for the rehab clinic, not serious science. I assume the study was done by the clinic staff who want to sell their inpatient rehab program to employers or government benefits agencies.
     

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