I agree with Peter White that drs should not tell patients with ME/CFS that it is an incurable disease, because data shows some people get better, some improve, many dont; equally drs shouldn't tell patients GET is safe and effective, neither statement is true. Word games.
PACE author Peter White often uses a photo of a female patient with ME in a wheelchair feeding a horse in talks to drs, asking "whats wrong with this picture"? He panders to drs ignorance of medically unexplained symptoms -eg "why cant this patient walk, muscle tests are normal"?
..what follows is White's explanation of why patients might have ME, their beliefs, and behaviours. The story given to drs is not supported by science, but simply rests within a grand biopsychosocial model of all illlness. as I've detailed in a few of my papers. a CBT model.
Just to illustrate my point, Peter White PACE author gave that talk in 2008, he then published PACE 2011 stating GET cured 22% of ME patients, yet his most recent GETSET trial failed to show GET had any effect much greater than do nothing usual GP care sciencedirect.com/science/articl…
the only difference between GETSET and PACE GET is GETSET had skype/phone physio but exact same exercise programme and is in fact more real in terms of what an NHS clinic offer - and was run by NHS clinics. 22% recovery in PACE v 7% usual care, is in fact just 1 patient out of 10
so between PACE and GETSET trial, White lost his 1 patient extra out of 10 who said they benefited in terms of recovery, and the usual care group recovered to the same degree. No difference - exactly why @NHSEngland @NHS should scrap GET and drs should follow new @NICEComms guide
Q why were 2 out of 10 patients deemed cured in PACE, yet almost all patients seen in the GETSET trial remained sick at follow up? how can this be? was PACE somehow different? were recovery measures different? stats should be consistent - when they are not, so we ask questions!

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More from @keithgeraghty

11 Sep
Should Prof Black's 2008 Report on Work p14, 'that CBT should be used to return sick people to work', be considered as a strong pro-CBT bias for her to Chair a @NICEComms ME treatment guideline review, that recently downgraded CBT and GET use in ME/CFS? assets.publishing.service.gov.uk/government/upl…
I wonder what the ethics of using CBT as a return to work tool are in totality, perhaps some bioethics/philos experts like Dr Blease or others might investigate this trend @crblease - it seems to eminate from ME/CFS and be a template eg is cancer treatment a return to work tool?
Recap why Prof Black is too conflicted imo to chair the @NICEComms ME treatment guideline table
1. Ex-president of Royal College of Physicians (who now oppose the guideline)
2. heavily promotes CBT and BPS model
3. worked with PACE author
4. advisor to DWP who funded PACE trial
Read 4 tweets
9 Sep
How could @NICEComms appoint Prof Carol Black at the Chair of the roundtable to sort of the mess after some drs blocked dropping GET as a treatment for ME/CFS? Carol Black is a colleague of the PACE team lead Prof Peter White, where is COI screening and independence test here?
A few facts I found on google search: Prof Black is an advisor to UK Gov/DWP, was involved in the implementation of the "Biopsychosocial Model' in reforms, and was part of a team for the DWP working with PACE trial lead author Prof Peter White, both DWP advisors on disability.
Here is a screentshot I found on google of Prof Black PACE author Prof White and DWP Medical Advisor on a team sent to Sweden to advise the Swedish Gov on what they were doing in the UK re disability reforms using a biopsychosocial approach.
Read 6 tweets
31 Aug
The @RCPhysicians @bodgoddard opposition to @NICEComms ME/CFS treatment guidelines is comes from physicians who refuse to accept GET being removed. This slideshow reveals what physicians running NHS CBT-GET treatments really think about ME/CFS. twitdoc.com/upload/maxwhd/…
1. they view ME/CFS as a functional somatic syndrome, not a biological illness. twitdoc.com/upload/maxwhd/… ImageImage
2. they link Functional Syndromes to Somatisation - often without any evidence, I've looking at this - ie patient accused of overly focusing on bodily symptoms (as a psychological problem) linked to psychological factors (causes/triggers) Image
Read 8 tweets
30 Aug
@NICEComms have delayed publication of their ME/CFS guideline due to opposition by @RCPhysicians @bodgoddard
Dr @alastairmiller3 advisor on ME/CFS & LongCovid podcast makes claims about ME/CFS recovery using GET that are not factual. see tweets below
1. he says "PACE had bad press" no, many many academics wrote detailed reviews of PACE trial data and methods. His basically misleads on this podcast that it was somehow just bad press coverage. He fails to tell watchers of a post-hoc reanalysis done on PACE.
2. He fails to tell watchers of his close connections with the PACE team, including working on their trials, eg GETSET, and he fails to tell watchers of the Longterm follow results from GETSET showing poor results, that GET wasnt any more useful than GP care.
Read 5 tweets

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