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Letter to the Editor: Comments on ‘Recovery from chronic fatigue syndrome after treatments given in the PACE trial’

Published online by Cambridge University Press:  19 July 2013

SUSANNA AGARDY
SUSANNA AGARDY*
Affiliation:
c/o PO Box 6156, Hawthorn West PO 3122
*
(Email: [email protected])
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Abstract

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Type
Correspondence
Information
Psychological Medicine , Volume 43 , Issue 8 , August 2013 , pp. 1787
Copyright
Copyright © Cambridge University Press 2013 

In their paper on recovery rates in the PACE trial, White et al. (Reference White, Goldsmith, Johnson, Chalder and Sharpe2013) acknowledge that ‘objective measures of physical activity have been found previously to correlate poorly with self-reported outcomes’. Yet, there is no attempt to utilize the Six Minute Walking Test results. The best results were a mean of 379 metres walked in the graded exercise therapy condition, a gain of 67 metres in 52 weeks, 35 metres more than the specialist medical care (SMC)-only group (White et al. Reference White, Goldsmith, Johnson, Potts, Walwyn, DeCesare, Baber, Burgess, Clark, Cox, Bavinton, Angus, Murphy, Murphy, O'Dowd, Wilks, McCrone, Chalder and Sharpe2011). The cognitive behaviour therapy group showed no improvement compared with the SMC group. The distance of 379 metres is exceeded by patients listed for lung transplantation (Kadikar et al. Reference Kadikar, Maurer and Kesten1997) and by older patients with chronic heart failure (Lipkin et al. Reference Lipkin, Scriven, Crake and Poole-Wilson1986). Given the recognized problem with self-reported outcomes, reliance solely on such measures leaves open the question of the validity of the recovery criteria of PACE.

Declaration of Interest

None.

References

Kadikar, A, Maurer, J, Kesten, S (1997). The Six-Minute Walk Test: a guide to assessment for lung transplantation. Journal of Heart and Lung Transplantation 16, 313–319.Google ScholarPubMed
Lipkin, DP, Scriven, AJ, Crake, T, Poole-Wilson, PA (1986). Six minute walking test for assessing exercise capacity in chronic heart failure. British Medical Journal 292, 653–655.CrossRefGoogle ScholarPubMed
White, PD, Goldsmith, K, Johnson, AL, Chalder, T, Sharpe, M; PACE Trial Management Group (2013). Recovery from chronic fatigue syndrome after treatments given in the PACE trial. Psychological Medicine. Published online: 31 January 2013. doi:10.1017/S0033291713000020.Google ScholarPubMed
White, PD, Goldsmith, KA, Johnson, AL, Potts, L, Walwyn, R, DeCesare, JC, Baber, HL, Burgess, M, Clark, LV, Cox, DL, Bavinton, J, Angus, BJ, Murphy, G, Murphy, M, O'Dowd, H, Wilks, D, McCrone, P, Chalder, T, Sharpe, M; PACE Trial Management Group (2011). Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet 377, 823–836.CrossRefGoogle Scholar