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Rethinking the treatment of chronic fatigue syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT

Overview of attention for article published in BMC Psychology, March 2018
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  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#2 of 525)
  • High Attention Score compared to outputs of the same age (99th percentile)

Citations

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47 Dimensions

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137 Mendeley
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Title
Rethinking the treatment of chronic fatigue syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT
Published in
BMC Psychology, March 2018
DOI 10.1186/s40359-018-0218-3
Pubmed ID
Authors

Carolyn E. Wilshire, Tom Kindlon, Robert Courtney, Alem Matthees, David Tuller, Keith Geraghty, Bruce Levin

Abstract

The PACE trial was a well-powered randomised trial designed to examine the efficacy of graded exercise therapy (GET) and cognitive behavioural therapy (CBT) for chronic fatigue syndrome. Reports concluded that both treatments were moderately effective, each leading to recovery in over a fifth of patients. However, the reported analyses did not consistently follow the procedures set out in the published protocol, and it is unclear whether the conclusions are fully justified by the evidence. Here, we present results based on the original protocol-specified procedures. Data from a recent Freedom of Information request enabled us to closely approximate these procedures. We also evaluate the conclusions from the trial as a whole. On the original protocol-specified primary outcome measure - overall improvement rates - there was a significant effect of treatment group. However, the groups receiving CBT or GET did not significantly outperform the Control group after correcting for the number of comparisons specified in the trial protocol. Also, rates of recovery were consistently low and not significantly different across treatment groups. Finally, on secondary measures, significant effects were almost entirely confined to self-report measures. These effects did not endure beyond two years. These findings raise serious concerns about the robustness of the claims made about the efficacy of CBT and GET. The modest treatment effects obtained on self-report measures in the PACE trial do not exceed what could be reasonably accounted for by participant reporting biases.

Twitter Demographics

The data shown below were collected from the profiles of 1,500 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 137 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 137 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 19 14%
Student > Bachelor 15 11%
Student > Postgraduate 14 10%
Student > Master 14 10%
Student > Ph. D. Student 10 7%
Other 38 28%
Unknown 27 20%
Readers by discipline Count As %
Medicine and Dentistry 24 18%
Nursing and Health Professions 20 15%
Psychology 20 15%
Agricultural and Biological Sciences 7 5%
Sports and Recreations 7 5%
Other 25 18%
Unknown 34 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 1778. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 October 2021.
All research outputs
#3,430
of 19,206,351 outputs
Outputs from BMC Psychology
#2
of 525 outputs
Outputs of similar age
#76
of 293,368 outputs
Outputs of similar age from BMC Psychology
#1
of 1 outputs
Altmetric has tracked 19,206,351 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 525 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 19.9. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 293,368 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them