Saturday, 6 May 2017

Liaison psychiatrist suggests that Cochrane Review on exercise therapy in CFS was heavily influenced by controversial PACE Trial| 6 May 2017

From The British Journal of Psychiatry, 2 May 2017.

Controversy over exercise therapy for chronic fatigue syndrome: key lessons for clinicians and academics


Alex J Mitchell
Professor of Psycho-Oncology and Liaison Psychiatry at the University of Leicester.


Chronic fatigue syndrome (CFS) is syndrome of unremitting fatigue of at least 6 months’ duration that causes significant disability. Exercise therapy has a proven track record in medicine and could be effective for some patients with CFS. An updated Cochrane review of eight studies appeared to suggest that exercise helps fatigue symptoms, but with only a small probability of recovery and/or improvement in daily function. Provisional data on acceptability suggest that most patients are willing to participate. However, one key study (PACE), which was well powered and influential in the Cochrane review, has been met with considerable controversy owing to lack of clarity on outcomes. Following release of the PACE study primary data, re-analysis suggested smaller effect sizes than initially reported.

MEA editorial note: The Cochrane Review that Professor Mitchell refers to can be found here:

from ME Association



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