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Pro-CBT Occupational Guidelines due to be updated with data from PACE in 2011, still not

Messages
13,774
Chalder, White, etc involved with it.

Review Date: 2011

Key findings of the review:
• Cognitive behavioural therapy and graded exercise therapy have been shown to be effective in restoring the ability to work in those who are currently absent from work

A large multicentre RCT, PACE is currently under way in the UK, comparing standardised specialist medical care with CBT, GET and pacing. PACE will include work outcomes.

I'd have thought they'd be keen to disseminate the data from PACE showing that the addition of CBT and GET to SMC did not lead to improvements in work related outcomes. Otherwise there's a danger that they could promote an exaggerated view of the efficacy of these treatments - oh-oh! From what I remeber the only evidence they ever had to argue for the value of CBT and GET in returning ability to work was really tenuous, and from a spun meta-analysis of a couple of poorly done studies.

They've also got predictors of poor outcomes like these:

membership of a self-help group
• being in receipt of sickness benefit at the start of treatment
Which seems to be contradicted by PACE's data (so far as we know).

I've not read the whole things, but thought I'd post those little notes.

I was looking at the full guidelines: http://www.nhshealthatwork.co.uk/chronic-fatigue.asp
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
UK's entire "Establishment" system is in COMPLETE denial
I could point out a huge list of the incredible crimes, insanity, inhumanity and stupidity of it all...but too ugly too draining
it IS germane though, the medical or scientific facts of PACE simply DO NOT MATTER!
Our mad system will push through any ludicrous bullshit the bureaucrats, the "old school tie brigade" the "we meet on the golf course and work out dirty deals" scumbags come up with.
Makes the freakin' Soviet's look absolutely open and humane by comparison, ye gods!
And no I am not kidding or exaggerating.

please see, in this arena (medical/health) the many many disasters of NHS "Trusts" leading to enormous clusters of deaths caused by bollock brained management forcing things through purely to meet "targets" without any understanding of pracitical necessities, risks or even any understanding of how the bloody world works, scientifically, statistically, logistically and not even humanitarian concerns moved the swines' consciences.

Alas in the UK, the increasing stratification of leadership like a "caste" system increasingly exclusively from certain privileged but DUMB backgrounds is causing incredible harm...least in times past wars culled many of the bloody morons, Darwin-style :/
 

ukxmrv

Senior Member
Messages
4,413
Location
London
These were the guidelines that AFME were involved in producing. Their old Director Chris Clark was the "patient representative" and he was responsible for involving one of the shrinks (he directly recommended him to the group)

(snip)


The Guideline Development Group included Prof. Trudie Chalder, a member of the 'Wessely School' and Chris Clarke, Director of AfME up till April 2006; Mr Clarke has worked directly with Simon Wessely and Michael Sharpe (Lancet 2002 article promoted GE/CBT). The two external assessors were Peter White and Michael Sharpe, both widely perceived to be members of the 'Wessely School'. Both have done work for the insurance industry and White does consultancy work for the DWP, yet under 'Conflicts of Interest' the document says 'none declared'. Dr Madan said that one of the psychiatrist assessors had been recommended by Chris Clarke. Dr Madan rejected any suggestions of bias in this respect.

www.erythos.com/rime/Docs/APPG070517.rtf‎
 
Messages
13,774
Ta ukxmrv.

This was from the golden period when I was uninterested in CFS politics, so didn't know the history. I noticed the blank COI too.
 
Messages
13,774
Still not updated - was reminded of this because Chalder was involved in a recent paper which assessed their ability to 'educate'/indoctrinate OTs about CFS.
 

Dolphin

Senior Member
Messages
17,567
Chalder, White, etc involved with it.


I'd have thought they'd be keen to disseminate the data from PACE showing that the addition of CBT and GET to SMC did not lead to improvements in work related outcomes. Otherwise there's a danger that they could promote an exaggerated view of the efficacy of these treatments - oh-oh! From what I remeber the only evidence they ever had to argue for the value of CBT and GET in returning ability to work was really tenuous, and from a spun meta-analysis of a couple of poorly done studies.

They've also got predictors of poor outcomes like these:
membership of a self-help group
• being in receipt of sickness benefit at the start of treatment

Which seems to be contradicted by PACE's data (so far as we know).
I don't think we haven't got data from the PACE Trial on predictors?

But the overall results for CBT and GET in their of work-related outcomes in the PACE Trial weren't good like you say.
 
Messages
13,774
I don't think we haven't got data from the PACE Trial on predictors?

But the overall results for CBT and GET in their of work-related outcomes in the PACE Trial weren't good like you say.

We haven't had the full results, but there were a couple of abstracts from conferences which made it sound like they didn't really find anything one way or the other.

If they had found supporting evidence for their past claims, I'd be surprised if they under-played this.
 

Dolphin

Senior Member
Messages
17,567
We haven't had the full results, but there were a couple of abstracts from conferences which made it sound like they didn't really find anything one way or the other.

If they had found supporting evidence for their past claims, I'd be surprised if they under-played this.
We have information like this:
http://forums.phoenixrising.me/inde...-to-free-txt-help-sought-to-explain-it.13888/
However, not sure if self-help groups or receipt of sickness benefit has been commented on.

However, you could be right that they'd be mentioning it if they had things that supported their views.
 
Messages
13,774
However, you could be right that they'd be mentioning it if they had things that supported their views.

Yeah - at the same time, I probably have slipped into assuming that they've not found anything, when we're still waiting for the data.

Actually - in response to an FOI didn't they say that they no longer had a statistician attached to PACE? Maybe they're planning to avoid releasing that data?

edit - details:


The processes would include work of a statistician to perform the various
programming and data file operations as well as the calculations to
produce accurate data. Moreover, as there is no longer a statistician
employed by the PACE trial, one would need to be recruited for this
operation and trained.

https://www.whatdotheyknow.com/request/6min_walking_test_data_recovered#incoming-454571
 
Last edited:

Dolphin

Senior Member
Messages
17,567
Yeah - at the same time, I probably have slipped into assuming that they've not found anything, when we're still waiting for the data.

Actually - in response to an FOI didn't they say that they no longer had a statistician attached to PACE? Maybe they're planning to avoid releasing that data?
Papers can take a long time to go through the pipeline e.g. a year or more from when first submitted sometimes. I think there was also a FOI on this where they refused as they said they'd release it in the predictors and mediators paper.

And I'm pretty sure there's going to be at least one longer term follow-up paper.