Vink, Mark, Vink-Niese, Alexandra · Healthcare (Basel, Switzerland) · 2022 · DOI
This study reviewed the evidence that was used to support two common ME/CFS treatments: cognitive behavioural therapy (CBT) and graded exercise therapy (GET). The authors found that the studies supporting these treatments had serious design problems—such as unclear definitions of recovery, not properly measuring actual improvements, and not publishing results that didn't support the treatments. The authors conclude that these flawed studies don't actually prove CBT and GET work, which aligns with the new British health guidelines recommending against these treatments.
This analysis is important because it directly addresses the controversy surrounding ME/CFS treatment guidelines and provides a critical examination of the evidence base for commonly recommended therapies. For patients, it validates concerns about these treatments and supports the need for redirected research toward physiological mechanisms and alternative interventions. For researchers and clinicians, it highlights the importance of methodological rigor in ME/CFS trials and supports a paradigm shift away from behavioural models toward biomedical research.
This study does not establish what treatments ARE effective for ME/CFS, only that the evidence for CBT and GET is flawed. It does not prove that CBT or GET are harmful in all patients—only that the existing trials contain serious methodological limitations. The review's conclusions are interpretative and depend on the authors' assessment of which design features constitute bias, which may itself be subject to professional debate.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Contribute
Private, reviewed by a human. Not a public comment thread.