Opinion article on PACE trial on chronic fatigue syndrome
Carolyn Wilshire is the lead author on the recent critical commentary on recovery rates in the PACE trial on chronic fatigue syndrome, led by professors Trudie Chalder, Michael Sharpe and Peter White. They are convinced that cognitive behavior therapy and graded exercise therapy “are moderately effective and safe for patients with CFS/ME. To suggest that this is not the case is to propagate a myth”. Wilshire is “stunned by the absence of critical thinking” of the investigators who present only “one side of the story”.
Being relatively new to the field of Health Psychology research (my background is in Neuropsychology), I have been stunned by the absence of the kind of critical thinking that characterizes most fields of Science. Many articles in Health Psychology present only one side of the story; they are written to highlight findings that support the investigators' prior beliefs, and to obscure those that do not. The PACE trial, despite being one of the most prominent and best-funded studies in this field, seems to be no exception.
In our critical commentary, we pointed out a number of major problems with key conclusions from the PACE trial (those regarding recovery). Yet the PACE investigators have still not accepted or acknowledged a single one. Instead, they have used every strategy they can to deflect criticisms or distract readers from the central problems.
This is not some arcane academic debate. Being wrong here has real consequences for very sick people. Patients are fed up with being fobbed off with treatments that simply don't work - or worse still, make them feel sicker - and they desperately need ones that really help.
I urge the PACE investigators to approach this debate more objectively. The first step is to acknowledge valid criticisms. Only then can we really start to move this field of research forward and find better treatments for patients.
Our critical commentary, and our reply to the PACE investigators' letter of defence, can be found here: http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1259724
Carolyn Wilshire, School of psychology, Victoria University of Wellington, New Zealand