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by AnthonBerg
996 days ago
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The PACE trial has been widely discredited. From Wikipedia: ”A 2010 meta-analysis of trials that objectively measured physical activity before and after CBT showed that although CBT effectively reduced patients' fatigue questionnaire scores, activity levels were not improved by CBT and changes in physical activity were not related to changes in fatigue questionnaire scores.“ Source: https://en.wikipedia.org/wiki/Chronic_fatigue_syndrome_treat... See especially the section on “PACE trial controversy”. It’s easy to see that it’s a poor study. — The paper I pointed towards describes multiple demonstrated means of neurological injury from SARS-CoV-2 infection. It’s just one single paper selected at random. It shall not be dismissed as “proposed mechanism”. — The unproven and unprovable negative claim was indeed yours to prove. |
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> These are politicized by certain patient advocacy groups and associated publishing circles but the evidence is considered pretty strong in the broader medical sphere.
The “critiques” of the PACE study are mostly based around p-hacking the objectives until you get the results you want. PACE participants saw significantly fewer hospitalizations, lower mortality, and better reported questionnaire scores as a bonus.
Because there is a lot of ire against recommending CBT among patient advocacy groups (including threatening to kill the authors and their families), some researchers have critiqued PACE because they have found some metrics in post-analysis that PACE did not improve (classic p-hacking). But that does not represent the broader view of the field.
Described by other scientists: “[The critiques come from a] fairly small, but highly organized, very vocal and very damaging group of individuals who have, I would say, actually hijacked this agenda and distorted the debate so that it actually harms the overwhelming majority of patients.'
> It shall not be dismissed as “proposed mechanism”.
That is literally how the paper self described. I am linking you multiple RCTs demonstrating impact and you are linking speculative causes of a disease that do not yet meet Koch’s postulates. But even if a neurological mechanism holds up (not at all unlikely in my view), this is likely to not be the case for all populations currently diagnosed with long covid - but rather a subset. CBT will likely be helpful for both populations, given the evidence I have linked.
My proof of my claim is that I have researched alternative treatments for long covid and CFS and none of them have these effect sizes :) If you have contrary evidence, that’s on you to prove, but fwiw I am not going to keep replying.
And again, I’ve linked RCT evidence for the effectiveness of CBT in long covid, which I guess you have nothing to say about.