Cochrane is een instituut die meta-analyses doet over onderzoeken. In het kort komt het er op neer dat ze alles op één hoop gooien en kritisch bekijken. Eventueel zaken er van tussen halen, opmerkingen geven en zo.
Voor ik iets van onderzoeken over CVS op Cochrane wist zei ik het volgende:
Ik denk dat je nog niet zo zeker moet zijn dat CGT door Cochrane als positief zou bevonden worden.
Het klopt inderdaad dat er heel wat rammmelende onderzoeken zouden afvallen.
Onderzoeken met maar enkele patiënten, maar met een positief uitkomst zouden samengevoegd worden met grotere onderzoeken met negatieve uitkomst.
Er zou gezocht worden naar de negatieve onderzoeken die niet gepubliceerd geraakt zijn.
Er zou op gewezen worden dat de afvallers in de onderzoeken aangeven dat CGT voor deze patiënten waarschijnlijk niet goed was en dat er dan eigenlijk ook rekening moet gehouden worden met deze patiënten, wat in sommige onderzoeken zeker niet gedaan zal zijn...
Ze zouden bv ook aangeven dat de onderzoeken werken met ideale patiënten. Mensen die maar een beetje ziek zijn, waardoor CGT eventueel wel werkt (of minder kwaad doet)
Als ze kunnen gaan ze terug naar patiënt per patiënt gegevens om zo hun oordeel te kunnen vellen.
Misschien komen ze ook wel toch het oordeel dat de onderzoeken (alles samen) nog geen goed beeld geven en er geen uitspraak over te doen is.
Ik zou ze het voordeel van de twijfel geven
Asje kwam dan met een studie af:
Cochrane Summaries
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Exercise for chronic fatigue syndrome
Edmonds M, McGuire H, Price JR
Published Online: 7 August 2013
Based on five included studies, this systematic review cautiously concludes that exercise therapy is a promising treatment for chronic fatigue syndrome. However, studies of higher quality are needed that involve different patient groups and settings, and that measure additional outcomes such as adverse effects, quality of life and cost effectiveness over longer periods of time.
Show Abstract (click to read)
Health topics:
Mental health > Chronic fatigue syndrome
Neurology > Chronic fatigue syndrome
More like this
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Exercise therapy for chronic fatigue syndrome (individual patient data)
- See more at: http://summaries.cochrane.org/CD003200/ ... Gru8C.dpuf
En had ik het volgende te melden:
Er is ook nog een oudere studie, met een leuk zinnetje:
At follow-up, 1-7 months after treatment ended, people who had completed their course of CBT continued to have lower fatigue levels, but when including people who had dropped out of treatment, there was no difference between CBT and usual care.
Dat is dan toch niet zo positief!
Chronic fatigue syndrome (CFS) is a very common and disabling condition, in which people suffer from persistent symptoms of fatigue that are unexplained. Cognitive behaviour therapy is a psychological therapy model that is commonly used to treat a range of psychological and chronic pain conditions. This review aimed to find out whether CBT is effective for CBT, both as a standalone treatment and in combination with other treatments, and whether it is more effective than other treatments used for CFS. The review included 15 studies, with a total of 1043 CFS participants. The review showed that people attending for CBT were more likely to have reduced fatigue symptoms at the end of treatment than people who received usual care or were on a waiting list for therapy, with 40% of people in the CBT group showing clinical improvement, in contrast with 26% in usual care. At follow-up, 1-7 months after treatment ended, people who had completed their course of CBT continued to have lower fatigue levels, but when including people who had dropped out of treatment, there was no difference between CBT and usual care. The review also compared CBT against other types of psychological therapy, including relaxation techniques, counselling and support/education, and found that people attending for CBT was more likely to have reduced fatigue symptoms at the end of treatment than those attending for other psychological therapies. Physical functioning, depression, anxiety and psychological distress symptoms were also more reduced when compared with other psychological therapies. However at follow-up, the results were inconsistent and the studies did not fit well together, making it difficult to draw any conclusions. Very few studies reported on the acceptability of CBT and no studies examined side effects. Only two studies compared the effectiveness of CBT against other treatments, both exercise therapy, and just one study compared a combination of CBT and other treatments with usual care. More studies should be carried out to establish whether CBT is more helpful than other treatments for CFS, and whether CBT in combination with other treatments is more helpful than single treatment approaches.
