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UK: NIHR funding opportunity: 22/37 Non-pharmacological interventions for fatigue management in adults with long-term health conditions

Discussion in 'Psychosomatic news - ME/CFS and Long Covid' started by Andy, Mar 25, 2022.

  1. Andy

    Andy Committee Member

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    Introduction
    The aim of the Health Technology Assessment (HTA) Programme is to ensure that high quality research information on the clinical effectiveness, cost-effectiveness and broader impact of healthcare treatments and tests are produced in the most efficient way for those who plan, provide or receive care from NHS and social care services. The commissioned workstream invites applications in response to calls for research on specific questions which have been identified and prioritised for their importance to the NHS, patients and social care.

    Research question
    What is the clinical and cost-effectiveness of non-pharmacological interventions and strategies for the management of fatigue in people with long-term physical and/or mental health conditions?

    • Intervention: Non-pharmacological fatigue management interventions and strategies.
    • Patient group: Adults with one or with multiple long-term physical and/or mental health conditions.
      (The following conditions are covered elsewhere - cancer, long-COVID, post-viral fatigue, medically not yet explained conditions, acute conditions resulting from accidents or injuries, and developmental disorders).
    • Setting: Any setting.
    • Study design: Evidence synthesis through a comprehensive review of the available evidence, including quantitative, qualitative and other relevant research. Applicants should suggest and justify the most appropriate methods for the evidence synthesis.
    • Important outcomes: A synthesis of the existing evidence and recommendations for the design of future research.
    • Other outcomes and outputs to consider: Facilitators and barriers to uptake of interventions; fatigue and other health-related quality of life measures; healthcare resource use; identification of promising interventions and components of interventions that could be tested further; recommendations for possible future primary research (including questions focused on under-researched populations). Applicants should consider whether a cost effectiveness evaluation would be contributory. Meta-analysis and subgroup analyses should be undertaken as appropriate. Existing Core Outcomes should be included amongst the list of outcomes unless a good rationale is provided to do otherwise. Applicants are encouraged to report recruitment and findings disaggregated by sex (and other demographic factors where relevant).
    https://www.nihr.ac.uk/documents/22...adults-with-long-term-health-conditions/30105
     
    Ariel, Peter Trewhitt and Hutan like this.
  2. Sean

    Sean Moderator Staff Member

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    Shouldn't they be establishing the (alleged) efficacy of these interventions first?
     
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  3. Hutan

    Hutan Moderator Staff Member

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    Oh, they know that they work already, it's just a question of how much further they can be applied. (and how they might be tweaked to be more effective)
     
  4. Hutan

    Hutan Moderator Staff Member

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    Excuse my skepticism, but this looks like the psychosomatic gravy train rolling on. In fact, it's probably more like a steam roller, with the NICE ME/CFS guideline, the Long Covid guideline and others sitting like cupcakes on the road ahead:
    The deadline for submission of a proposal is September. It would be terrific to see an unbiased team apply, although probably a futile gesture.

     
    Last edited: Mar 25, 2022
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  5. Trish

    Trish Moderator Staff Member

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    Ha ha, yes, they clearly haven't heard about the NICE ME/CFS guideline evidence review finding these sort of studies are worthless.
     
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  6. MEMarge

    MEMarge Senior Member (Voting Rights)

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  7. MEMarge

    MEMarge Senior Member (Voting Rights)

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    HTA award was for £75,432.00 https://fundingawards.nihr.ac.uk/award/97/41/08

    "Headline:
    Group cognitive behavioural therapy was found to be as effective as using individual therapy in treating symptoms of fatigue, mood and physical fitness in chronic fatigue syndrome/myalgic encephalopathy; however, it did not bring about improvement in cognitive function or quality of life."
     
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  8. MEMarge

    MEMarge Senior Member (Voting Rights)

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    So, synthesis of evidence, with no specific objective measures of activity/being able to do more physically or cognitively, specified.

    More scarce funding down the drain.....
     
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  9. CRG

    CRG Senior Member (Voting Rights)

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    Scepticism is certainly justified - I wonder however whether this is not a political move "away" from the failed CBT/GET focus rather than a retrenchment into it.

    If the NIHR is true to its word https://www.s4me.info/threads/uk-be...-address-nice-research-recommendations.24954/ and is going to set NICE research recommendations securely within the NIHR programme then the NIHR needs to have a way forward that takes the 2021 NICE ME/CFS guideline recommendations into account. This funding "could" be the commission that provides a route map.

    Not that I'd expect any new routes to be uncontested.
     
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  10. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    The approach is just plain stupid. If you ask for people who are interested in doing a review of the effectiveness of X you will get applications from people who have a vested interest in showing the effectiveness of X. Anyone with a reasonable degree of scepticism and at least minimal knowledge of the field will be aware that there is nothing worth reviewing.

    And why lump together non-pharmacological interventions anyway?
     
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  11. rvallee

    rvallee Senior Member (Voting Rights)

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    This is entirely useless. A huge grab bag of random things with no discernible overlap, both in terms of the treatments and the conditions. It doesn't even make sense to begin with, is a complete misunderstanding of what patients mean by fatigue, and lumping many various concepts thrown in the kitchen sink that is now the medical definition of fatigue makes even less sense.

    The very idea that you can take the consequences of illness, alone and detached from the illness itself, and treat it is nonsense. The vast majority of drugs simply mitigate or lessen the symptoms of illness, usually at the cost of other issues, they rarely actually treat them. Especially with the most common symptoms. This whole circus has left obsession behind and accelerated straight into fanaticism.
    This is completely false. All BPS research of this type explicitly don't bother with specific diseases, they are as vague and generic as they can be precisely because it allows complete ambiguity.

    It's literally currently litigious over the entirety of the "chronic fatigue" BPS pseudoresearch that they only ever use the mere presence of something that can be labeled as fatigue, from people whose main goal is literally to de-medicalize those diseases, they literally don't believe they exist, how can this research be "disease specific"?
     
    Last edited: Mar 25, 2022
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  12. FMMM1

    FMMM1 Senior Member (Voting Rights)

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    "UK: NIHR funding opportunity: 22/37 Non-pharmacological interventions for fatigue management in adults with long-term health conditions"

    I laughed when I read the title. Perhaps someone like @Brian Hughes Could consider whether anything meaningful (like funding for an MSc project) could come out of this.

    All NIHR have to do is get someone to read Brian' blogs.
     
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  13. Hutan

    Hutan Moderator Staff Member

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    I've received a copy of the 10 page Commissioning Brief - Background Information, attached here (there does not seem to be any constraint on posting it).


    A. It includes summaries of a number of studies on various specific health conditions e.g.

    ME/CFS and indeed anything that usually falls in the MUS bucket is not mentioned.

    I assume these studies largely involve subjective outcomes with unblinded treatments when it comes to assessing fatigue.

    B. Then there was a list of relevant studies currently in progress - again no MUS.

    C. And then there was a list of NIHR funded studies - there was only one MUS type study, the rest being on a range of non-MUS diseases such as cancer, sickle cell anaemia and arthritis. There was also a general CBT review.

    D. and then it closed with just this

    As a background briefing paper, it does not seem very adequate, particularly given the broad scope of this funding opportunity (e.g. the call covers mental health, but no research about fatigue in mental health conditions is mentioned).
     

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