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1) 🇩🇪 There's a new randomised trial of cognitive behavioural therapy (CBT) for Long Covid, from the Johannes Gutenberg University Mainz in Germany. It claims that CBT lowered fatigue but it has the usual fatal limitations that make the results unreliable.

15/7/26, 8:17 am15 reposts58 likes

ME/CFS Science

@mecfsscience.org

15 July

2) First major error: there was no control intervention. The control group was simply put on a waiting list to receive CBT for 16 weeks. This creates an enormous bias so that the results are likely distorted by expectancy and placebo effects.

ME/CFS Science

@mecfsscience.org

15 July

3) Second major error: all the outcomes were subjective questionnaires while patients nor therapists could be blinded. There was no actigraphy (step counter), exercise or fitness tests, employment rates, healthcare use, or any other objective outcome.

ME/CFS Science

@mecfsscience.org

15 July

4) If people in the trial know what the intervention is and you use subjective questionnaires, than the results will again be distorted by placebo effects and response bias. Patients will respond to what they suspect the therapists/researchers want to hear.

ME/CFS Science

@mecfsscience.org

15 July

5) CBT also targets cognitions and interpretation of symptoms, and patients have close contact with therapists for multiple sessions. This makes this treatment highly likely to cause distorted results on symptom questionnaires.