Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?, 2022, Vink and Vink-Niese

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Andy, Feb 18, 2022.

  1. Andy

    Andy Committee Member

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    Abstract

    For the last few decades, medical guidelines have recommended treating patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) with graded exercise therapy (GET) and cognitive behavioural therapy (CBT). Moreover, doctors have questioned the recovery behaviour of these patients and stimulated them to follow these treatments so that they would be able to go back to work. In this article, we reviewed trials of GET and CBT for ME/CFS that reported on work status before and after treatment to answer the question of whether doctors should continue to question the recovery behaviour of patients with ME/CFS.

    Our review shows that more patients are unable to work after treatment than before treatment with CBT and GET. It also highlights the fact that both treatments are unsafe for patients with ME/CFS. Therefore, questioning the recovery behaviour of patients with ME/CFS is pointless. This confirms the conclusion from the British National Institute for Health and Care Excellence (NICE), which has recently published its updated ME/CFS guideline and concluded that CBT and GET are not effective and do not lead to recovery.

    Studies on CBT and GET for long COVID have not yet been published. However, this review offers no support for their use in improving the recovery of patients with an ME/CFS-like illness after infection with COVID-19, nor does it lend any support to the practice of questioning the recovery behaviour of these patients.

    Open access, https://www.mdpi.com/2227-9032/10/2/392/htm
     
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  2. CRG

    CRG Senior Member (Voting Rights)

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    Small niggle - British v UK v NI, Scotland, Wales, England; this is obviously a hassle for authors wanting a short hand for Abstracts but the use of the term British has increasingly sensitive overtones - in this case although NICE is actually an England specific organisation, it would have been acceptable to use UK, given that NICE reports do inform healthcare in the devolved Nations in various ways. Britain specifically excludes NI which more directly uses NICE than does Scotland, which is included. An explainer: https://brilliantmaps.com/eng-gb-uk/ but note problems with the term British Isles.
     
  3. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    I read something recently that is relevant to this paper, but I can't remember where or in what context. As far as I can remember it was something like this :

    When a research paper or article title has a question mark on the end, the answer is always No. If the answer was Yes the authors wouldn't have used a question they would have stated that.
     
  4. CRG

    CRG Senior Member (Voting Rights)

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    Betteridge's law of headlines = "Any headline that ends in a question mark can be answered by the word no."

    https://en.wikipedia.org/wiki/Betteridge's_law_of_headlines
     
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  5. Kitty

    Kitty Senior Member (Voting Rights)

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    I think there's a similar rule that any newspaper headline containing the word 'baffled' signifies that the doctors / archaeologists / physicists / etc are not and have never been baffled about any aspect of the story.
     
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  6. Trish

    Trish Moderator Staff Member

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    Maybe just me, but the phrase 'questioning the recovery behaviour' didn't immediately make its meaning clear to me.

    I've skimmed the paper, and it's much clearer from that that what they are looking at is whether therapies based on changing behaviour are effective in the specific area of getting people back to work, as often required by insurance companies and benefits agencies.

    And the answer from their review of studies that recorded this for people with CFS under various definitions is clearly no, CBT/GET - that questions and aims to change patients beliefs and behaviour around exercise and recovery - either has no effect or makes things worse.
     
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