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A Response To Criticism Of The PACE Trial

Thursday 30 August 2018


From the UK's Medical Research Council:



Criticism of the PACE trial

28 August 2018
Copyright 2018. Medical Research Council.

The Times recently reported on a letter to The Lancet which called for the journal to reanalyse the data from the PACE trial. Independent scrutiny and analysis are to be welcomed in the quest for robust and reproducible research results. The MRC is keen to encourage more research into different aspects of CFS/ME because scientists still know relatively little about this serious condition.

Executive Chair, Professor Fiona Watt, responded in a letter to The Times (27 August 2018), an extended version of which appears here:

‘Call for review of ‘flawed’ ME research’ (The Times, 21 August 2018) discusses claims that the scientific evidence provided by the PACE trial for using cognitive behavioural therapy (CBT) and managed exercise in the treatment of chronic fatigue syndrome (CFS, also known as ME) is fundamentally unsound.

As funders of the trial, we reject that view: the PACE trial was funded following expert peer review, was overseen by an independent steering committee, and its published findings were also independently peer reviewed. The process through which PACE was funded, supervised and published therefore meets international standards for clinical trials.

CFS/ME is considered to be a spectrum of disorders and understanding the causes and informing the development of new treatments, or the targeting of existing treatments, will require research across a range of approaches and from a holistic view point. The PACE trial investigated the important issue of which available treatments were most likely to benefit patients, and patient consultation resulted in the addition of a treatment to the trial.

While most of the criticism focuses on the PACE trial, there is a large amount of evidence from other studies that also shows CBT and graded exercise therapy (GET) can be helpful to some CFS/ME patients. Other research groups, using different study designs, have drawn similar conclusions about the benefit of these treatments. This evidence is summarised in three Cochrane reviews. Cochrane reviews are systematic reviews of primary research in human healthcare and health policy, and are internationally recognised as the gold standard in evidence-based healthcare.


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