From ME/CFS Research Review.
Professor Jonathan Edwards told NICE it should not recommend either CBT or graded exercise as all the trial evidence for them used subjective outcomes in unblinded trials, giving unreliable results. He showed why blinding in ME/CFS trials is essential, despite PACE supporters claiming it is not. Edwards said it was also unethical to tell patients that the treatmens are safe, effective and based on sound theories as there are serious doubt about all three claims. Finally, he argued that quality control in research for these kind of studies is broken and needs fixing.
In 2007, NICE recommended cognitive behavioural therapy (CBT) and graded exercise therapy as the only suitable treatments for ME/CFS. Its new draft guidelines, published in November 2020, say no to all graded exercise. And no to any CBT that assumes ME/CFS is caused by patients’ flawed beliefs or behaviours.
The driving force for this U-turn was the guideline committee’s evidence review, which rated almost all of the evidence for CBT or graded exercise as very low quality. The remainder was rated as low quality.
Probably the main reason for these damning ratings was Professor Jonathan Edwards’ expert testimony to the ME/CFS guidelines committee.
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