Checking our blind spots: current status of research evidence summaries in ME/CFS

• Published in: British journal of sports medicine Vol. 53; no. 19; p. 1198
• Main Authors: Davenport, Todd E, Stevens, Staci R, VanNess, J Mark, Stevens, Jared, Snell, Christopher R
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.10.2019
• Subjects: Behavior modification; Chronic fatigue syndrome; Clinical trials; Cognition & reasoning; Evidence-based medicine; Exercise; Patients; United Kingdom > UK; United States > US; treatment; exercise; fatigue
• ISSN: 0306-3674; 1473-0480; 1473-0480
• DOI: 10.1136/bjsports-2018-099553

Correspondence to Dr Todd E Davenport, Department of Physical Therapy, University of the Pacific, Stockton, CA 95211, USA; tdavenport@pacific.edu The evidence-based practice (EBP) model hierarchically organises scientific information by level, from lowly case studies to lofty systematic reviews and clinical trials. Clinical trials best influence recommendations because they putatively have the greatest internal validity.1 This assumption is based on sound research ethics, such as scientific competence and good faith actors, as well as observed differences in outcomes. The extent of downward revision actually made it possible for a subject to be classified as ‘recovered’ on some criteria even if they worsened after enrolment into the trial.6 Indeed, a secondary reanalysis of the trial data revealed recovery rates in the GET and CBT groups were low (4% and 7%, respectively), not significantly higher than in the control group (3%) and inflated by an average of 4-fold compared with predicted by baseline criteria.6 Despite the severe limitations of the UK PACE trial and its conceptual offspring, it continues to exert outsized influence on research evidence summaries as one of the few published randomised clinical trials in ME/CFS.