Article abstract:

PACE-GATE: An alternative view on a study with a poor trial protocol by Bart Stouten in Journal of Health Psychology [Published 12 May 2017]

The controversies surrounding the effectiveness of cognitive behavioural therapy and graded exercise therapy for chronic fatigue syndrome are explained using Cohen’s d effect sizes rather than arbitrary thresholds for ‘success’.

This article shows that the treatment effects vanish when switching to objective outcomes. The preference for subjective outcomes by the PACE trial team leads to false hope. This article provides a more realistic view, which will help patients and their doctors to evaluate the pros and cons.

Extract from conclusion:

Conclusion: where to go from here?

The results above lead me to conclude that White et al. systematically overestimate the effectiveness of CBT because they focus on subjective rather than objective outcomes.

Their vigorous defence of their findings gives me the impression that they are not open to constructive criticism. This understanding is strengthened by their statement that Geraghty misunderstands and misrepresents their work, without providing sound evidence. I would appreciate a more constructive debate, where they attempt to understand why others do not share their views, and subsequently advance findings in this field in a more scientific way.

Given the evidence that the objective improvements reported for CBT and GET are at most modest, I agree with Geraghty that these should be downgraded to adjunct support-level status.