An open letter to The Lancet, again
On November 13th, five colleagues and I released an open letter to The Lancet and editor Richard Horton about the PACE trial, which the journal published in 2011. The study’s reported findings–that cognitive behavior therapy and graded exercise therapy are effective treatments for chronic fatigue syndrome–have had enormous influence on clinical guidelines for the illness. Last October, Virology Blog published David Tuller’s investigative report on the PACE study’s indefensible methodological lapses. Citing these problems, we noted in the letter that “such flaws have no place in publis...
Source: virology blog - February 11, 2016 Category: Virology Authors: Vincent Racaniello Tags: Information chronic fatigue syndrome Lancet mecfs myalgic encephalomyelitis PACE request for data Richard Horton vexations Source Type: blogs
Reexamining Chronic Fatigue Syndrome Research And Treatment Policy
In recent months, two developments have provided some degree of optimism to people with the illness variously called chronic fatigue syndrome, myalgic encephalomyelitis (“inflammation of the brain and central nervous system, with muscle pain”), CFS/ME, and ME/CFS — the term often used these days by U.S. agencies. Taken together, these developments herald the welcome possibility of significant changes in research and treatment policies for the illness, which is estimated to afflict between 1 and 2.5 million people in the U.S. They also reinforce a critical but often overlooked point: patients can possess far more ...
Source: Health Affairs Blog - February 4, 2016 Category: Health Management Authors: David Tuller Tags: Drugs and Medical Technology Equity and Disparities Featured Hospitals Public Health Quality chronic fatigue syndrome NIH PACE trial Research Source Type: blogs
A request for data from the PACE trial
Mr. Paul Smallcombe
Records & Information Compliance Manager
Queen Mary University of London
Mile End Road
London E1 4NS
Dear Mr Smallcombe:
The PACE study of treatments for ME/CFS has been the source of much controversy since the first results were published in The Lancet in 2011. Patients have repeatedly raised objections to the study’s methodology and results. (Full title: “Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome: a randomized trial.”)
Recently, journalist and public health expert David Tuller docu...
Source: virology blog - December 17, 2015 Category: Virology Authors: Vincent Racaniello Tags: Information chronic fatigue syndrome clinical trial Declaration of Helsinki Freedom of Information mecfs myalgic encephalomyelitis PACE Queen Mary University of London Richard Horton The Lancet trial data request UK Source Type: blogs
Trial by error, Continued: PACE Team’s Work for Insurance Companies Is “Not Related” to PACE. Really?
By David Tuller, DrPH
David Tuller is academic coordinator of the concurrent masters degree program in public health and journalism at the University of California, Berkeley.
In my initial story on Virology Blog, I charged the PACE investigators with violating the Declaration of Helsinki, developed in the 1950s by the World Medical Association to protect human research subjects. The declaration mandates that scientists disclose “institutional affiliations” and “any possible conflicts of interest” to prospective trial participants as part of the process of obtaining informed consent.
The investigators promised in th...
Source: virology blog - November 17, 2015 Category: Virology Authors: Vincent Racaniello Tags: Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behaviour therapy Declaration of Helsinki graded exercise therapy insurance company mecfs PACE specialist medical care The Lancet Source Type: blogs
A cluster randomised controlled trial comparing the effectiveness and cost-effectiveness of a school-based cognitive behavioural therapy programme (FRIENDS) in the reduction of anxiety and improvement in mood in children aged 9/10 years
National Institute for Health Research (NIHR) - Anxiety in children is common, impairs everyday functioning and increases the risk of severe mental health disorders in adulthood, yet few children with anxiety are identified and referred for treatment. The aim of this study was to investigate the clinical effectiveness and cost-effectiveness of a universal school-based preventative programme in reducing symptoms of anxiety and low mood.
Report
Summary
Abstract (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - November 17, 2015 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Local authorities, public health and health inequalities Source Type: blogs
An open letter to Dr. Richard Horton and The Lancet
Dr. Richard Horton
The Lancet
125 London Wall
London, EC2Y 5AS, UK
Dear Dr. Horton:
In February, 2011, The Lancet published an article called “Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomized trial.” The article reported that two “rehabilitative” approaches, cognitive behavior therapy and graded exercise therapy, were effective in treating chronic fatigue syndrome, also known as myalgic encephalomyelitis, ME/CFS and CFS/ME. The study received international attention and has had widespread infl...
Source: virology blog - November 13, 2015 Category: Virology Authors: Vincent Racaniello Tags: Commentary Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behaviour therapy graded exercise therapy mecfs PACE specialist medical care The Lancet Source Type: blogs
PACE trial investigators respond to David Tuller
Professors Peter White, Trudie Chalder and Michael Sharpe (co-principal investigators of the PACE trial) respond to the three blog posts by David Tuller, published here on 21st, 22nd and 23rd October 2015, about the PACE trial.
Overview
The PACE trial was a randomized controlled trial of four non-pharmacological treatments for 641 patients with chronic fatigue syndrome (CFS) attending secondary care clinics in the United Kingdom (UK) (http://www.wolfson.qmul.ac.uk/current-projects/pace-trial) The trial found that individually delivered cognitive behaviour therapy (CBT) and graded exercise therapy (GET) were more effecti...
Source: virology blog - October 30, 2015 Category: Virology Authors: Vincent Racaniello Tags: Commentary Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behavior therapy Dave Tuller exercise graded exercise therapy mecfs myalgic encephalomyelitis outcome PACE trial recovery Source Type: blogs
TRIAL BY ERROR: The Troubling Case of the PACE Chronic Fatigue Syndrome Study
By David Tuller, DrPH
David Tuller is academic coordinator of the concurrent masters degree program in public health and journalism at the University of California, Berkeley.
A few years ago, Dr. Racaniello let me hijack this space for a long piece about the CDC’s persistent incompetence in its efforts to address the devastating illness the agency itself had misnamed “chronic fatigue syndrome.” Now I’m back with an even longer piece about the U.K’s controversial and highly influential PACE trial. The $8 million study, funded by British government agencies, purportedly proved that patients could “recover” fr...
Source: virology blog - October 21, 2015 Category: Virology Authors: Vincent Racaniello Tags: Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behavior therapy Dave Tuller exercise graded exercise therapy mecfs myalgic encephalomyelitis outcome PACE trial recovery Source Type: blogs
Masters Assignment on Autistic Writers
In 2013 I submitted as assignment on autistic people's writings as part of my Masters in Autism (Adults) for the University of Birmingham. The title of the topic as set by the university and my essay follows: There is an ever-increasing body of literature from people diagnosed with autism who are willing to share their experiences. Discuss and evaluate the potential impact of this body of literature upon other people on the autistic spectrum, upon autism researchers and upon providers of support and services.This essay will describe the growing body of writing by autistic writers, particularly that which has flourishe...
Source: The Voyage - April 21, 2015 Category: Child Development Source Type: blogs
Link Feast
Our pick of the best psychology and neuroscience links from the past week or so:Dos and don’ts of a January detoxAs we start a new year, David Robson at BBC Future takes a scientific look at how to get healthier'Detoxing' has been debunked. Maybe it's time to debunk thatOliver Burkeman argues that scepticism about the benefits of detoxing has gone too farAre Understandings of Mental Illness Mired in the Past?In the latest issue of The Psychologist magazine, Vaughan Bell and John Cromby disagree about the place of biology in our understanding of psychiatric illness. Flicker: Your Brain on Movies by Jeffrey Zacks – how H...
Source: BPS RESEARCH DIGEST - January 10, 2015 Category: Psychiatrists and Psychologists Authors: Research Digest Source Type: blogs
How does chronic pain management work? A hypothesis to ponder
There have been increasing calls for clinicians and researchers to move away from using grouped results from randomised controlled studies because these fail to distinguish between those people who do really well and those who do not. Eminent researchers like Amanda Williams, Chris Eccleston and Steven Morley have said it’s time to move away from “black box” RCTs in chronic pain, and begin to use more sophisticated methodologies to examine not only outcomes but processes during therapy (Williams, Eccleston & Morley, 2012). While early studies comparing CBT-approaches to chronic pain vs waiting list ...
Source: HealthSkills Weblog - August 24, 2014 Category: Occupational Therapists Authors: adiemusfree Tags: Cognitive behavioral therapy Coping strategies Research biopsychosocial Chronic pain Clinical reasoning Cognitive Behavioural Therapy pain management self management Therapeutic approaches Source Type: blogs
Coalface conversations
Knowing about something doesn’t hit the heart or mind nearly as well as doing it. As regular readers of my blog will know, I teach various aspects of pain management to postgraduate health professionals who come from a wide range of disciplines. Hopefully I can guide people towards thinking about the range of factors that can influence what goes on between delivering a treatment and the eventual outcome. It’s difficult, though, because much of what I need to do is based on giving access to information rather than opportunities to practice and then integrate this material.
I thought about this the other day when...
Source: HealthSkills Weblog - July 27, 2014 Category: Occupational Therapists Authors: adiemusfree Tags: Back pain Clinical reasoning Cognitive behavioral therapy Coping strategies Pain conditions biopsychosocial Chronic pain Cognitive Behavioural Therapy pain management Therapeutic approaches Source Type: blogs
Social Anxiety Institute
Dr. Thomas A. Richards currently runs all our treatment programs and is a leading clinical authority on the treatment of social anxiety disorder. Dr. Richards began seeing patients with social anxiety in the early 1990s and has seen thousands of patients since that time. The first CBT therapy group for social anxiety started in 1994. International therapy groups began in 1998.
Our emphasis is on treatment of social anxiety disorder (i.e., how do you get over it?) Our CBT therapy programs allow people to overcome social anxiety.
Cognitive behavioral therapy for social anxiety disorder must be comprehensive and cover all asp...
Source: PsychSplash - June 30, 2014 Category: Psychiatrists and Psychologists Authors: Psych Central Resource Editor Tags: Anxiety Anyone Assessment Instruments Behaviour Management Books Cognitive Cognitive Behaviour Therapy Computerised CBT Features For Forums Foundation Website Newsletter Resources Search Engine Social Psychology Social Supp Source Type: blogs
Non-drug approaches for people with fibromyalgia
No-one wants to be told their pain is “in your head”. But given our increasingly sophisticated understanding of pain neurobiology, there’s plenty of reason to agree that thinking, feeling and doing things differently makes life far more rewarding and rich than feeling helpless, fatigued and sore. Some proponents of purely biomedical interventions, notably musculoskeletal physicians, argue that if only the “source of the nociception” was found, the nerve “zapped” or anaesthetised, then all this psychosocial claptrap could be safely ignored. I think this belief shows ignorance and pe...
Source: HealthSkills Weblog - March 23, 2014 Category: Occupational Therapists Authors: adiemusfree Tags: Coping strategies Pain Pain conditions Research Therapeutic approaches biopsychosocial CBT Chronic pain Cognitive Behavioural Therapy fibromyalgia pain management Source Type: blogs
Teams, roles, and contributions
I’m quite keen to generate some more discussion about how individual professions can contribute within Interdisciplinary/Interprofessional Team without being defensive of their contribution, nor allowing other disciplines to encroach on their specialist skills.
I really struggle with the whole concept of “role definition” because so often I see “the OT role is…” without considering that there are a number of core areas many health professionals in pain management use such as goal setting, relaxation, pain “education”, activity pacing/management, relaxation, biofeedback, cogni...
Source: HealthSkills Weblog - February 5, 2014 Category: Occupational Therapists Authors: adiemusfree Tags: Interdisciplinary teams Professional topics Uncategorized Chronic pain chronic pain management healthcare occupational therapist Source Type: blogs
