StatPearls: Continuing Education Activity: Chronic fatigue syndrome

Sly Saint

Senior Member (Voting Rights)
Stat Pearls describes itself as
The Largest Library of Medical Education in the World.

https://www.statpearls.com/home/index

Treatment for any comorbid condition should be undertaken to minimize symptom burden.[83][89]

During the CBT sessions, the therapist emphasizes the role of the thought process and its impact on the patient’s actions and feelings and recognizes behaviors that cause them to feel more tired and hence minimize them. Multiple trials and Cochrane reviews have shown the positive benefits of CBT on improving fatigue, mood, and post-exertional malaise in both adolescent and adult patients.[89][90][91][92] Studies have also shown lower school absences when CBT is provided to the adolescent population.[93]

GET involves a supervised, gradual increase in the duration and intensity of physical activity. After the PACE trial, this therapy got much publicity, which showed effectiveness for fatigue and functional impairment with the GET.[80] The trial encouraged the participants to gradually increase the timing of their physical activity to a final goal of 30 minutes, spread over 52 weeks to a final goal of 30 minutes of light exercise five days per week while trying to avoid overexertion. Other studies have also supported its efficacy.[94][95][96]
https://www.statpearls.com/ArticleLibrary/viewarticle/21640

 
That is outrageous. None of the references appear to be later than 2012 (a quick glance). Edit, seen one from 2017, British Journal of Pharmacology.

There is so much disinformation on 'treatment' for ME or CFS in so many supposedly authoritative publications. It looks like a lifetime's task getting it all updated. In the meantime doctors and students are absorbing outdated damaging misinformation.
 
Last edited:
I skimmed some of the article. It's muddled and includes some clangers like symptoms being made worse by exertion and low upright posture.
It's clear the writers have just cobbled together bits from various sources and haven't a clue.
@dave30th is this something you can tackle?
 
It's clear the writers have just cobbled together bits from various sources and haven't a clue.
It certainly looks that way. I sent them a polite message explaining, in a few lines, the controversy surrounding the PACE trial and the limitations of CBT for MECFS. I received a response stating they will consider revising the article.
 
I checked back on the article; it's still peppered with BPS lingo and theorem. The passages quoted by @Sly Saint above are unchanged. However I note its new inclusion of two sentences:

Regarding the PACE trial:
"Further analysis of the available data questions the statistical significance of the benefit of CBT and GET."

And concerning CBT and GET in general:
"However, CBT and GET can be adjunct management options, but they are not curative."

Should we wish to address the article's general tenor, I think a more concerted approach is needed. Since that's beyond the scope of my energy limits I hope others on this forum can pick up the slack and raise the issue(s) with StatPearls :)
 
Statpearls is a private US based company. As far as I can see the business model is selling the Statspearls materials via its corporate access https://www.statpearls.com/home/groupsales/ which is then sold on as courses via the Statspearls website. The institutional base seems to be mostly if not all US based and I think we have to expect that Statpearls' preferred references will be moderated by the interests of its institutional customers so if there's lots of therapy to sell, it's unlikely Statpearls is going to downplay the role of therapy (CBT etc) in treating a condition.

If there's any movement to be had I think it's going to be from referencing publications by the CDC and IOP. The difficulty is going to be that Statpearls probably has little incentive to change what looks like a strongly sciency article which can serve as a tick sheet for 'learning'.
 
Back
Top Bottom