AHMF: MP: UK PACE Trials

Re UK Medical Research Council-funded PACE Trials
White, Sharpe, Chalder et al

The American Association for Chronic Fatigue Syndrome Newletter August 2003
(Workshop summary by Editor Daniel Clauw, MD, from notes by Eleanor Hanna)

Scientific Workshop, sponsored by the NIH Office of Research on Women's Health
June 12-13 2003, Bethesda, Maryland
Presentation of Peter White, MD
CNS and ANS Responses to Exercise in Patients with CFS
Excerpt:
"He (Dr White) focused on the fact that CFS patients view exercise as being more exhausting than controls, and that this could be evidence for a more widespread abnormality in enteroception in CFS.

"Re: appropriate models, Dr White explained that the cognitive behavioural model of CFS posits that the symptoms and disability of CFS are perpetuated predominantly by dysfunctional illness beliefs and avoidant coping. Beliefs associated with a poor outcome in CFS include that exercise is dangerous or damaging, that the cause of CFS is a virus, and that CFS is a physical illness."

The UK multi centre studies of PACE by using broadly defined patient cohorts will have serious and long term implications worldwide for the management of people with ME/CFS.

The AHMF asks:

What precise measures will be used to assess benefit from these trials? For instance, improved swallowing, less abdominal pain and distension, less vomiting, improved gastric emptying, reduced diarrhoea, weight gain,
able to cease nasogastric tube feeding, or headache eased, rolling over in bed unaided, etc?
Will such patients be classified as somatoform disorder and therefore excluded?
Will the beliefs of the researchers be strongly associatedwith / reliably predict the trial outcomes?

"Truth is the child of time, not of authority" - Bertold Brecht, Life of Gallileo

Chris Hunter