The effects of therapies for Myalgic Encephalomyelitis and chronic fatigue syndrome should be assessed using objective measures

Abstract

There is controversy with regard to therapies proposed to be effective for Myalgic Encephalomyelitis (ME) and chronic fatigue syndrome (CFS), especially behavorial therapies: cognitive behavioral therapy (CBT) and graded exercise therapy (GET). As will be exemplified by the PACE trial and other studies, the positive effects of CBT and GET are almost exclusively based on strongly varying subjective criteria (measures and cut-off thresholds for fatigue, physical functioning, et cetera). Depending on the subjective criteria used 'recovery' rates vary from 7% to 69%. Looking at the objective measures, e.g. work rehabilitation, physical fitness, and activity levels, CBT and GET seem to have a negligible effect or no effect at all. Trials into proposed therapies for ME and CFS, including CBT, GET, rituximab and rintatolimod, should use objective measures to impartially assess the effectiveness.