Follow FrankTwisk on Twitter  





Journal of Health Psychology

besteedt uitgebreid aandacht

aan PACE-gate in een special








In een speciale uitgave besteedt de Journal of Health Psychology aandacht aan 'PACE-gate'.


Ondanks pogingen om publicatie tegen te houden, ging het tijdschrift over tot publicatie.

De hoofdredacteur zet in zijn editorial niet alleen vraagtekens bij de aanpak en gesuggereerde

resultaten van de PACE-trial maar ok bij de belangenverstrengeling van de hoofdonderzoekers.

Tevens maakt de hoofdredacteur beleidsmakers attent op het feit dat de richtlijnen m.b.t. 'ME/CVS'

recht zouden moeten doen aan de huidige ('nieuwe') inzichten m.b.t. het 'effect' van CGT en GET.


Je zou andere (wetenschappelijke en populaire) media dezelfde moed toewensen.



Alle artikelen zijn vrij toegankelijk (zie inhoudsopgave en hyperlinks hieronder).



Jammer genoeg laat de pers het (weer) opnieuw afweten om kritisch te berichten over CGT/GET.




Citaten uit de editorial:



We are proud that this issue marks

a special contribution by the Journal of Health Psychology

to the literature concerning interventions

to manage adaptation to chronic health problems.


The PACE Trial debate reveals

deeply embedded differences between critics and investigators.


It also reveals an unwillingness of

the co-principal investigators of the PACE trial

to engage in discussion and debate.


It leads one to question

the wisdom of such a large investment from the public purse (£5 million)

on what is a textbook example of a poorly done trial.




On the question of COI, the PACE authors themselves

appear to hold strong allegiances to

cognitive behavioural therapy (CBT) and graded exercise therapy (GET) –

treatments they developed for ME/CFS.




Persbericht Journal of Health Psychology



The PACE Trial: The Making of a Medical Scandal


28 July 2017


Journal of Health Psychology Special Issue on The PACE Trial, Vol. 22, No 9, Aug. 2017.




A Special Issue of the Journal of Health Psychology on the PACE Trial,

is to be published and freely available online on Monday 31 July 2017.


It marks a special contribution of the Journal of Health Psychology

to the literature concerning interventions to manage chronic health problems.


The PACE trial debate illustrates what can happen

when researchers become entrenched in a particular point of view, and

fail to engage in constructive exchange with critics and stakeholders.


It reveals an unwillingness of the Co-Principal Investigators of the trial

to engage in authentic discussion and debate.


It leads one to question the wisdom of such a large investment from the public purse (£5million)

on what is a textbook example of a poorly done trial.


Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

is a controversial and poorly understood disease

that blights the lives of over 250,000 people in the UK and 1.0M Americans.


People with ME experience a dramatic decrease in their stamina

for ordinary physical and cognitive activities,

a characteristic dramatic in­crease in symptoms

after minimal physical or cognitive exertion called post-exer­tional malaise, and

a myriad of symptoms including sleep dysfunction, orthostatic intolerance and

cognitive dysfunction as well as fatigue and pain.


Normal activities like walking, showering, having a conversation or writing an email

can leave people shattered for days or weeks or may simply be impossible.


Most people with ME cannot work and 25% are confined to their homes or beds.


The PACE Trial sought to test if two therapies,

a talking therapy called ‘Cognitive Behavioural Therapy’ (CBT) and

exercise in the form of ‘Graded Exercise Therapy’ (GET), might help.


The Trial attracted unprecedented criticism,

not only because it cost taxpayers an extraordinary sum (almost £5 million)

but the trial itself was deeply flawed.


The results are, at best, unreliable, and, at worst, manipulated

to produce a positive-looking result.


Patient groups have cried foul because they believe they are being sold a lie

that talk therapy and exercise can cure ME/CFS

when in fact many experience actual harm.


The PACE Trial was led by

Professor Peter White of Queen Mary University London (retired),

Professor Michael Sharpe of Oxford University and

Professor Trudie Chalder of Kings College London.


They published their results in the Lancet in 2011

with the contentious claim that

CBT and GET brought 30% of patients back to normal while 60% improved.


The patient community reacted with scepticism and after a long battle with the PACE authors,

a patient from Australia, Mr Alem Matthees,

won a Freedom of Information Tribunal case

to gain access to a small sub-set of the PACE trial data.


It was discovered that

the PACE authors had altered the way in which they measured improvement and recovery

to increase the apparent benefit of the therapies.


Reanalysis showed that

the improvement rate fell from 60% to 21% and

the recovery rate fell from 22% to just 7% when using the original study protocol.


The genie was out of the bottle.


In 2016 the Journal of Health Psychology published

an Editorial by Dr. Keith Geraghty of the University of Manchester entitled 'PACE-GATE'.


Geraghty suggested that the PACE authors had altered their procedures

to make CBT and GET look more beneficial.


The PACE trial team reacted with anger and submitted a cursory reply.


A host of experts on both sides of the debate were invited

by JHP Editor Dr David F Marks to write Commentaries on the PACE Trial.


All Commentaries were peer-reviewed.


The majority agreed

that the PACE Trial was flawed,

that the PACE authors had altered their methods,

breaking a fundamental principle of clinical trials, and

that results from the trial were unreliable.


It also highlighted that

the PACE Co-Principal Investigators had conflicts of interest

by acting as consultants to large insurance companies and

Professor White had also worked as an advisor to the Department of Work and Pensions,

a main funder of the PACE trial,

with a special interest in reducing social security benefits to disabled ME/CFS claimants.


Despite many serious concerns about the PACE Trial,

the trial continues to be used by UK Governmental agencies,

the NHS and the National Institute for Clinical Care Excellence (NICE)

as part of the evidence-base to recommend CBT and GET to sufferers of ME/CFS.


The current review by NICE of these treatments presents an opportunity

to bring clinical practice properly in line with scientific evidence.







Journal of Health Psychology

Special Issue: The PACE Trial


Volume 22, Issue 9, August 2017


Table of Contents



Volledige tekst


HTML versie

PDF versie










Special issue on the PACE Trial

David F Marks

pp. 1103–1105




'PACE-Gate': When clinical trial evidence meets open data access

Keith J Geraghty

pp. 1106–1112




Response to the editorial by Dr Geraghty

Peter D White, Trudie Chalder, Michael Sharpe, Brian J Angus, Hannah L Baber,

Jessica Bavinton, Mary Burgess, Lucy V Clark, Diane L Cox, Julia C DeCesare,

Kimberley A Goldsmith, Anthony L Johnson, Paul McCrone, Gabrielle Murphy,

Maurice Murphy, Hazel O’Dowd, Laura Potts, Rebacca Walwyn, David Wilks

pp. 1113–1117










Once again, the PACE authors respond to concerns with empty answers

David Tuller

pp. 1118–1122




Investigator bias and the PACE trial

Steven Lubet

pp. 1123–1127




The problem of bias in behavioural intervention studies:

Lessons from the PACE trial

Carolyn Wilshire

pp. 1128–1133




PACE trial authors continue to ignore their own null effect

Mark Vink

pp. 1134–1140




The PACE trial missteps on pacing and patient selection

Leonard A Jason

pp. 1141–1145




Do graded activity therapies cause harm in chronic fatigue syndrome?

Tom Kindlon

pp. 1146–1154




PACE team response shows a disregard for the principles of science

Jonathan Edwards

pp. 1155–1158




Bias, misleading information and lack of respect for alternative views

have distorted perceptions of

myalgic encephalomyelitis/chronic fatigue syndrome and its treatment

Ellen Goudsmit, Sandra Howes

pp. 1159–1167




PACE investigators' response is misleading regarding patient survey results

Karen D Kirke

pp. 1168–1176




Distress signals: Does cognitive behavioural therapy reduce or increase distress in chronic fatigue syndrome/myalgic encephalomyelitis?

Keith R Laws

pp. 1177–1180




Cognitive behaviour therapy and objective assessments

in chronic fatigue syndrome

Graham McPhee

pp. 1181–1186




PACE trial claims for

recovery in myalgic encephalomyelitis/chronic fatigue syndrome –

true or false?

It's time for an independent review of the methodology and results

Charles Bernard Shepherd

pp. 1187–1191




PACE-GATE: An alternative view on a study with a poor trial protocol

Bart Stouten

pp. 1192–1197




The PACE trial: It’s time to broaden perceptions and move on

Keith J Petrie, John Weinman

pp. 1198–1200




Defense of the PACE trial is based on argumentation fallacies

Steven Lubet

pp. 1201–1205




Chronic fatigue syndrome patients have no reason

to accept the PACE trial results:

Response to Keith J Petrie and John Weinman

Susanna Agardy

pp. 1206–1208




Further commentary on the PACE trial:

Biased methods and unreliable outcomes

Keith J Geraghty

First Published June 14, 2017; pp. 1209–1216