A paper by independent researchers (someone not associated with an academic institution), Mark Vink – also a person with ME/CFS, and Alexandra Vink-Niese, has confirmed the conclusion by NICE that CBT is not an effective treatment for ME/CFS.
In the paper, the authors re-examine an existing systematic review – a specific type of study that uses repeatable methods to search for, select, and combine all available evidence to answer a specific research question, by Kuut and colleagues on the efficacy of cognitive behavioural therapy (CBT) for ME/CFS which found that:
“CBT for ME/CFS can lead to significant reductions of fatigue, functional impairment, and physical limitations”.
In the reanalysis of the review by Kuut and colleagues, Vink and Vink-Niese not only identify issues with the systematic review itself but also with the eight studies included in the review.
Methodological issues of the included studies are highlighted and include “non-blinded trials, subjective outcome measures, and poorly chosen control groups”, all of which can lead to biased results – those that do not accurately reflect what is really happening.
However, the main issue identified was related to the research team that carried out the systematic review. In their article, Vink and Vink-Niese point out:
- At least one of the authors of the systematic review had been involved in all eight included studies – effectively, the researchers conducting the review were assessing their own work.
- “Three of the professors in the systematic review, have all built their careers on the cognitive behaviour model and the reversibility of ME/CFS through CBT and graded exercise therapy (GET).
- Two of the systematic reviewers have a potential financial conflict of interest but failed to inform the readers.
Importantly, the authors of the reanalysis state that “conducting a review in this manner and not informing the readers, undermines the credibility of a systematic review and its conclusion”.
The issues identified by Vink remind ME Research UK of a BBC Radio 4 programme entitled “The Truth Police”, in which the presenter met a group of people trying to detect untrustworthy studies by considering the credibility of published articles. The programme emphasised the need for openness and transparency in research to increase trustworthiness, and the need for “post-publication review” – such as that carried out by Vink and Vink-Niese.
