Multidisciplinary rehabilitation treatment is not effective for ME/CFS: A review of the FatiGo trial, 2018, Vink & Vink-Niese

Open access at http://journals.sagepub.com/doi/10.1177/2055102918792648

 

I was just thinking about this trial, so this paper should be a helpful reminder of it. Marked for tomorrow.

 

Who the fuck calls a trial "Fatigo" anyway? Clearly they don't like patients much.

 

Thread merged.

Just published in Health Psychology Open, review of the FatiGo trial (Vos-Vromans), one of the 13 pieces of evidence NICE will review.


Mark Vink, Alexandra Vink-Niese,
First Published August 6, 2018 Review Article

Abstract
The FatiGo trial concluded that multidisciplinary rehabilitation treatment is more effective for chronic fatigue syndrome/myalgic encephalomyelitis in the long term than cognitive behaviour therapy and that multidisciplinary rehabilitation treatment is more cost-effective for fatigue and cognitive behaviour therapy for quality of life. However, FatiGo suffered from a number of serious methodological flaws. Moreover, it ignored the results of the activity metre, its only objective outcome. This jeopardizes the validity of FatiGo. Its analysis shows that there was no statistically significant difference between multidisciplinary rehabilitation treatment and cognitive behaviour therapy and neither are (cost-)effective. FatiGo’s claims of efficacy of multidisciplinary rehabilitation treatment and cognitive behaviour therapy for chronic fatigue syndrome/myalgic encephalomyelitis are misleading and not justified by their results.


http://journals.sagepub.com/doi/10.1177/2055102918792648

 

The person sitting on the panel to help the laypeople to understand research and the process is Professor Tony Kendrick. Most on the panel seem to be mental health researchers and providers. Nigel Beasly is an ENT, is a clinical lead in cancer Nottingham Uni Hospital and deals with clinical outcomes.

 

Why are they only reviewing 13 pieces of evidence? and how do we know which ones they are reviewing? Fluff a Duck how come they announce it this way ? In need of serious amounts of coffee

 

That sounds a bit unlikely to me. The only reference given in that sentence was to this, which does not support the point: http://journals.sagepub.com/doi/10.1177/2055102918792648

 

The reference given for that quote was Appendix B of the recent NICE surveillance report

"Of the approximately 300 pieces of evidence highlighted to NICE by stakeholders during the consultation, the following 13 met criteria to be included in the surveillance review. Any potential impact on the guideline of the evidence is also noted."

and they marked it "as unclear"

"Unclear – Multidisciplinary rehabilitation treatment (i.e. gradual reactivation, pacing, mindfulness, body awareness therapy, normalising sleep-wake rhythm and social reintegration combined with CBT) was more costeffective than CBT when using fatigue as primary outcome variable. Using QALY as the primary outcome, CBT was more cost-effective"


https://www.nice.org.uk/guidance/cg...ed-to-nice-during-consultation-pdf-4602203535

 

Thanks! That was just for the surveillance review though, so I didn't think it could be that. It looks like you're right that it is the source of the '13 pieces of evidence' claim though. To me this reads as if it's claiming that the full review of the NICE guidelines will only review 13 pieces of evidence:

 

https://twitter.com/user/status/1031996678579138560

 

This includes means scores from 21 different cohorts (including the two in the study). This could be useful to refer to in the future.

 

It might be useful to be cautious when quoting the 62.2 figure. The PCS scores are supposed to be norm-based with a mean of 50 and standard deviation of 10 for the general population. Though in the general population some people are somewhat disabled either through age, disability or illness.

 

Nice find to have a reference to backup this point.