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Treatment outcome in adults with chronic fatigue syndrome: a prospective study in England based on the CFS/ME National Outcomes Database

  [ 9 votes ]   [ 1 Comment ]
By E. Crawley et al. • • April 2, 2013

Editor's Comment: The authors of this study do not state in their abstract how the data for the statistical analysis were gathered. In the full article, the authors reveal that the data were generated from a questionnaire. No psychiatric or objective measurements of improvement were employed. The accuracy of questionnaires, as well as other self-reporting techniques, has been called into question by numerous statisticians.

~Source: QJM. March 28, 2013.

By E. Crawley et al.

Background: Chronic fatigue syndrome (CFS) is relatively common and disabling. Over 8000 patients attend adult services each year, yet little is known about the outcome of patients attending NHS services.

Aim: Investigate the outcome of patients with CFS and what factors predict outcome.

Design: Longitudinal patient cohort.

Methods: We used data from six CFS/ME (myalgic encephalomyelitis) specialist services to measure changes in fatigue (Chalder Fatigue Scale), physical function (SF-36), anxiety and depression (Hospital Anxiety and Depression Scale) and pain (visual analogue pain rating scale) between clinical assessment and 8–20 months of follow-up. We used multivariable linear regression to investigate baseline factors associated with outcomes at follow-up.

Results: Baseline data obtained at clinical assessment were available for 1643 patients, of whom 834 (51%) had complete follow-up data. There were improvements in fatigue [mean difference from assessment to outcome: -6.8; 95% confidence interval (CI) -7.4 to -6.2; P < 0.001]; physical function (4.4; 95% CI 3.0–5.8; P < 0.001), anxiety (-0.6; 95% CI -0.9 to -0.3; P < 0.001), depression (-1.6; 95% CI -1.9 to -1.4; P < 0.001) and pain (-5.3; 95% CI -7.0 to -3.6; P < 0.001). Worse fatigue, physical function and pain at clinical assessment predicted a worse outcome for fatigue at follow-up. Older age, increased pain and physical function at assessment were associated with poorer physical function at follow-up.

Conclusions: Patients who attend NHS specialist CFS/ME services can expect similar improvements in fatigue, anxiety and depression to participants receiving cognitive behavioural therapy and graded exercise therapy in a recent trial, but are likely to experience less improvement in physical function. Outcomes were predicted by fatigue, disability and pain at assessment.

Source: QJM (2013) doi: 10.1093/qjmed/hct061 First published online: March 28, 2013. E. Crawley, S.M. Collin P.D. White, K. Rimes, J.A.C. Sterne, M.T. May, CFS/ME National Outcomes Database

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Article Comments Post a Comment

What Esther fails to mention
Posted by: simmons1
Apr 2, 2013
Esther Crawley does has forgotten to mention her work on children with ME or her hope to get more children referred to her as she can now treat them with the Lightning process a controversial psychological therapy similar to CBT and GET she only mentions CBT or GET.

Doctor Speedy and ME in search of medical honesty
Friday, September 17, 2010
Lightning Process led by Dr Esther Crawley kills XMRV
Suzy Chapman for ME agenda:

A pilot study on the controversial Lightning Process led by Dr Esther Crawley using children as young as eight has received the go ahead from a South West Region Research Ethics Committee (REC), despite widespread public concern and condemnation by two UK national patient organisations.

The organisations said: “We are issuing this joint statement due to widespread public concern, together with our own serious reservations, about a forthcoming study of the psychologically-based Lightning Process on children."

In June, ME agenda reported that Alastair Gibson, who had previously identified himself as one of two Lightning Process coaches involved with the NHS study, was the subject of an Advertising Standards Authority (ASA) ruling.

The ASA upheld a complaint about unsubstantiated claims made for the efficacy of the Lightning Process in ME and CFS in an advertisement for Mr Gibson’s “Withinspiration” company.

The South West Regional Manager for the National Research Ethics Service (NRES) confirmed to me, in May, that there is apparently no process through which REC decisions might be challenged by the public.

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