Identifying disrupted biological factors and patient-tailored interventions for chronic fatigue in ... Q-Fever FS, CFS and ..., 2022, Vroegindeweij

Andy

Andy

Retired committee member
Full title: Identifying disrupted biological factors and patient-tailored interventions for chronic fatigue in adolescents and young adults with Q-Fever Fatigue Syndrome, Chronic Fatigue Syndrome and Juvenile Idiopathic Arthritis (QFS-study): study protocol for a randomized controlled trial with single-subject experimental case series design

Abstract

Background
Chronic fatigue with a debilitating effect on daily life is a frequently reported symptom among adolescents and young adults with a history of Q-fever infection (QFS). Persisting fatigue after infection may have a biological origin with psychological and social factors contributing to the disease phenotype. This is consistent with the biopsychosocial framework, which considers fatigue to be the result of a complex interaction between biological, psychological, and social factors. In line, similar manifestations of chronic fatigue are observed in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and juvenile idiopathic arthritis (JIA). Cognitive behavioral therapy is often recommended as treatment for chronic fatigue, considering its effectiveness on the group level. However, not everybody benefits on the individual level. More treatment success at the individual level might be achieved with patient-tailored treatments that incorporate the biopsychosocial framework.

Methods
In addition to biological assessments of blood, stool, saliva, and hair, the QFS-study consists of a randomized controlled trial (RCT) in which a single-subject experimental case series (N=1) design will be implemented using Experience Sampling Methodology in fatigued adolescents and young adults with QFS, CFS/ME, and JIA (aged 12–29). With the RCT design, the effectiveness of patient-tailored PROfeel lifestyle advices will be compared against generic dietary advices in reducing fatigue severity at the group level. Pre-post analyses will be conducted to determine relevance of intervention order. By means of the N=1 design, effectiveness of both advices will be measured at the individual level.

Discussion
The QFS-study is a comprehensive study exploring disrupted biological factors and patient-tailored lifestyle advices as intervention in adolescent and young adults with QFS and similar manifestations of chronic fatigue. Practical or operational issues are expected during the study, but can be overcome through innovative study design, statistical approaches, and recruitment strategies. Ultimately, the study aims to contribute to biological research and (personalized) treatment in QFS and similar manifestations of chronic fatigue.

Open access, https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-022-06620-2
 
The paper said:
More treatment success at the individual level might be achieved with patient-tailored treatments that incorporate the biopsychosocial framework.
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No True Biopsychosocial. It's always biopsychosocial. But it's never biopsychosocial enough.

Of course most of the hundreds of trials of CBT were individual and personalized, at least as much as psychic séances are personalized. And biopsychosocial. Whatever that means. And they make up a significant evidence base that has justified their use in standard care for many years now. This is why it has to be tested all over again, as if it never has been, even though it has, because I guess everyone working in BPSland is suffering from crippling amnesia combined with laziness, or maybe they're just dishonest and find no issue pretending something that is obviously false.

If I'm guessing right, what they mean by "group" is not actually group, as in several people present at once, but that if they pool results from trials, you could make a claim that it works for some, as long as "work" means nothing. That's always been the excuses, dating back decades, that it seems to work on some, but they can't tell on whom, because the only effects come up by grouping people who often have little in common other than what some physicians think of them.

Madness is not doing the same thing over and over again and expecting different results. True madness is doing the same thing over and over again, pretending it's always the first time while also being part of a large evidence base featuring the same, knowing what the results are, and simply not caring that this is about real people in real life with disastrous consequences that they have been made aware and simply choose to ignore, because they can, because no one cares, or checks, or validates anything here, to the point where you can write nonsense like this study, claiming, somehow, that CBT has yet to be tested individually from a "biopsychosocial perspective".

There's a concept of flip-flopping in politics, people who change their facts and opinions constantly based on what's expedient. The BPS ideology has completely shattered this amateur practice and turned it into an industrial process. The death of expertise continues unabated.
 
This is consistent with the biopsychosocial framework, which considers fatigue to be the result of a complex interaction between biological, psychological, and social factors.
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When I was at uni, an extraordinary claim such as this would be met with a stern "citation needed" at the very least.

I'm always shocked they can spout this bollocks with straight faces.
 
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Art Vandelay said:
When I was at uni, an extraordinary claim such as this would be met with a stern "citation needed" at the very least.

I'm always shocked they can spout this bollocks with straight faces.
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I missed that one and wow is it impressive circular reasoning given the sentence before:
Persisting fatigue after infection may have a biological origin with psychological and social factors contributing to the disease phenotype. This is consistent with the biopsychosocial framework, which considers fatigue to be the result of a complex interaction between biological, psychological, and social factors.
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See, it's biopsychosocial because it's how biopsychosocial is defined. Also: "may have", "considers". What a bunch of quackery.

Literally, and I mean literally:

e2976b663c8b5d3af6576c24cc19993d4fba480c0daddbe10d11564d94c423ab.jpg

Neat.
 
This is consistent with the biopsychosocial framework, which considers fatigue to be the result of a complex interaction between biological, psychological, and social factors.
Click to expand...

Art Vandelay said:
When I was at uni, an extraordinary claim such as this would be met with a stern "citation needed" at the very least.
Click to expand...

Translation they have no idea what fatigue is. You can always tell someone doesn't know what they are talking about when they use the word "complex" and then fail to go on to describe a complex model.
 
I've heard of Q-Fever but never read anything about it until a few minutes ago (soooo - not an expert...).

I read the wikipedia article https://en.wikipedia.org/wiki/Q_fever

Based on what it says there, I can't see why the BPS stuff needs to be invoked at all. The disease can be diagnosed with blood tests and treated with antibiotics. So why even mention the psychosocial stuff?

The biggest issue I can see is that infected people in the UK would probably end up with the chronic condition because they wouldn't get the necessary tests to diagnose the acute condition.
 
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