Gebruik makend van de gegevens uit de PACE-trial studies en het oorspronkelijke protocol,

onderbouwt Mark Vink in een uitgebreide review de stellingname:

1. dat de studie zeker geen patiënten met CVS, laat staan ME, betreft,
2. dat er in subjectieve termen, zoals vermoeidheid, geen meerwaarde voor CGT en GET is,
3. dat er in objectieve maatstaven, bijvoorbeeld conditie, helemaal niets veranderde,
4. dat er vraagtekens gezet mogen worden bij de gesuggereerde "veiligheid" van CGT en GET, en
5. dat het fundament onder het luchtkasteel (bewegingsangst, deconditionering. etc.) ontbreekt.

Een soortgelijke boodschap, maar dan samengevat, kunt u hier en hier vinden.

Voor een gedetailleerde onderbouwing lees de uitgebreide studie van Mark:klik hier.

The PACE trial invalidates the use of cognitive behavioral and graded exercise therapy

in Myalgic Encephalomyelitis/chronic fatigue syndrome: A review.

J Neurol Neurobiol 2(3): doi 10.16966/2379-7150.124.

Vink M.

Abstract

The main findings reported in the PACE trial were that

cognitive behavioral therapy (CBT) and graded exercise therapy (GET)

were moderately effective treatments

for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and

fear avoidance beliefs constituted the strongest mediator of both therapies.

These findings have been challenged by patients and, more recently, a number of top scientists,

after public health expert Tuller, highlighted methodological problems in the trial.

As a doctor who has been bedridden with severe ME for a long period,

I analysed the PACE trial and its follow-up articles from the perspectives of a doctor and a patient.

During the PACE trial

the eligibility criteria, both subjective primary outcomes,

and most of the recovery criteria were altered,

creating an overlap of the eligibility and recovery criteria;

consequently,

13% of patients were considered "recovered," with respect to 1 or 2 primary outcomes,

as soon as they entered the trial.

In addition,

46% of patients reported an increase in ME/CFS symptoms,

31% reported musculoskeletal and

19% reported neurological adverse events.

Therefore

the proportion negatively affected by CBT and GET would be between 46% and 96%,

most likely estimated at 74%, as shown in a large survey recently conducted by the ME Association.

Medication with such high rates of adverse events would be withdrawn with immediate effect.

There was no difference in long-term outcomes

between adaptive pacing therapy, CBT, GET and specialist medical care, and

none of them were effective,

invalidating the biopsychosocial model and use of CBT and GET for ME/CFS.

The discovery that an increase in exercise tolerance did not lead to an increase in fitness

means that an underlying physical problem prevented this;

validates that ME/CFS is a physical disease and

that none of the treatments studied addressed this issue.

Keywords:

Chronic Fatigue Syndrome; CBT; Cognitive Behavioral Therapy; GET;

Graded Exercise Therapy; Myalgic Encephalomyelitis; PACE Trial; Pacing

https://www.sciforschenonline.org/journals/neurology/article-data/JNNB-2-124/JNNB-2-124.pdf