The results they really didn’t want you to see: key ME/CFS trial data released



Researchers at Queen Mary University of London (QMUL), have been ordered to release a full data from a controversial ME/CFS (myalgic encaphalomyelitis/ chronic fatigue syndrome) study known as the PACE trial. A preliminary analysis of the data reveals a shocking difference to the original published results, if the trials original data analysis method had been followed. The new analysis suggests that the therapies tested in the DWP funded trial are not nearly as effective as the published results claimed them to be.

The new data calls into question the decision by the National Institute for Clinical Evidence (NICE) to recommend the therapies as standard treatment for ME/CFS in the NHS.

After repeatedly refusing to release the data, QMUL were ordered to do so by a freedom of information (FOI) tribunal appeal. QMUL spent £200,000 on legal costs trying to suppress this information.

The data released vindicates the many esteemed scientists and ME/CFS patients, who have heavily criticised the trial and its negative effects on the public perception of ME/CFS. One of the scientists critical of the study is Dr Jonathan Edwards of University College London, who said:

It’s a mass of un-interpretability to me…All the issues with the trial are extremely worrying, making interpretation of the clinical significance of the findings more or less impossible.

CFS is a disease characterised by…

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Featured image via Invest in Me Research, artwork by Wolfgang Stiller

Europe charges ahead in electric car use as UK efforts fall flat


Plans to equip every new or refurbished home in Europe with its own electric vehicle charging point have been announced in a draft European Union (EU) directive. But as Europe surges ahead with green transport solutions, the UK is falling behind because commitments to the number of ultra low emission vehicles on its roads are well below target.

The EU directive, designed to boost the electric car market, is due to come into force before the end of the year. It also states that by 2023 all new developments in the EU zone will require at least 10% of their parking spaces to have charge points.

For many people the perceived problems of short range, time spent recharging and limited charge points for electric cars are a big turn off. But the technology is constantly improving. Renault has just released an electric car with a 250 mile range, which will go a long way in allaying people’s fears. The increase in charge points is another turn on. Guillame Berthier, Renault’s sales director for electric cars, said…

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One simple app could help you lose weight – and save the NHS a fortune


Losing weight is hard. Losing weight and maintaining that weight loss is even harder. So anything that can possibly help lighten the load of this arduous task is worth further consideration. Promising research from the University of Southampton has shown there may be one more effective weapon in the battle against obesity: an online behavioural counselling tool called POWeR+

In a large scale study, the amount of weight lost by one group using the tool after 12 months was on average 4.3kg, compared to an average loss of 3 kg achieved by a control group receiving more conventional NHS weight loss advice, as would be given out as standard treatment to overweight/obese patients in the UK. Those using POWeR+ were also more likely to maintain clinically significant weight loss by 12 months, compared to the control group.

What makes this app particularly appealing is the possible cost savings to the NHS. When compared to the control group, which can be considered as equivalent to the cost of conventional NHS advice/treatment, the cost per kg lost was £25 lower for a POWeR+ using group.

The online tool called the Positive Online Weight Reduction (POWeR+) programme, was developed by Professor Paul Little of the Primary Care Research Department. He knew that behavioural counselling is effective in helping people lose weight but it is very costly due to the intensive counselling and support that is required.

The POWeR+ app aims to teach participants self-regulation and cognitive behavioural techniques via online behavioural intervention, enabling sustainable eating and physical activity habits to form, supported by brief contact with a practice nurse. It supplies the user with novel content, links to external content and email reminders. Little says:

Large patient numbers, limited staff training and time pressures mean that delivering face-to-face behavioural interventions in practice can be resource intensive. This has the potential to save the NHS money if obesity-linked health problems can be prevented. The intervention was mostly delivered online, the costs of the intervention are low, it is easy to roll out, and likely to be very cost-effective for the NHS

Obesity is a growing problem in the UK. The World Health Organisation (WHO) reported in 2014 that 28% of adults were clinically obese, that is having a Body Mass Index (BMI) of over 30, this is a huge rise over obesity levels in 1980 when around 7% of adults were obese.

Their are a number of serious health problems linked to obesity including: diabetes, heart disease, hypertension and stroke. This ill health, as well as causing misery to the ill, also has cost implications to society as a whole. The cost to the NHS of dealing with obesity/overweight related disease in 2015 was between £6bn and £8bn, this is predicted to rise to between £10bn and £12bn by 2030.

The study, published in *The Lancet Diabetes & Endocrinology, consisted of 818 people with a BMI of over 30. These were randomly allocated to one of three groups, who all took part in 24 web based sessions over 6 months and had a follow up session at 12 months.

The control group used an existing online intervention to receive evidence based diet advice to replace unhealthy foods with similar but healthier choices, and increase fruit and vegetable intake. They also had brief visits to a nurse at 6 months and 12 months, similar to all groups, which did not provide counselling.

The POWeR+F group received automated behavioural counselling through the app, and three scheduled face-to-face nurse support sessions in the first three months. Four optional face-to face sessions were available in the following three months, the nurse would be alerted that a patient needed help if weight gains were recorded on two consecutive logins to the app.

The POWeR+R used the app but had less professional support than the +F group. Patients received the same automated counselling but the face-to-face contacts were replaced by phone or email contacts.

Although all the groups lost weight, the groups receiving help from the POWeR+ app lost more, and were more likely to have maintained clinically important weight loss (CIWL), which is when 5% weight loss is maintained at the12 month mark:

  • Control – lost 3 kg (avg) during 12 months, 21% maintained CIWL

  • POWeR+F – lost 4.5 kg (avg) during 12 months, 29% maintained CIWL

  • POWeR+R – lost 4.3 kg (avg) during 12 months, 32% maintained CIWL

Little said of the results:

Many people receiving the POWeR+ intervention were able to sustain weight loss over one year but also felt more enabled in managing their weight going forward, and fewer resorted to other activities such as commercial slimming programmes to lose weight.

The costs to the NHS

The intial results on weight loss alone look impressive but become even more so when combined with the cost savings to the NHS possible when using a tool like POWeR+.

The National Institue for Health and Care Excellence (NICE)has estimated that any intervention costing a *£100 per kg of weight lost, if maintained for life, would be a cost effective way of reducing the NHS spend on obesity/overweight related disease.

The estimated incremental overall NHS cost per kg lost of the POWeR+ groups, compared to the control group, was £18 for POWeR+F and – £25 for POWeR+R; meaning POWeR+R cost less or was more cost effective than the control strategy.

Both POWeR+ interventions achieve cost per kg weight losses below the NICE threshold (according to the report’s conclusions), even though the POWER+ interventions were only for 6 months, CIWL remained steady upto the 12 month mark.

To give a ball park figure of the possible cost saving involved we can take the figure for the adult population of the UK in 2014 at 64.6 million. If the 28% of these who were obese were to lose 1kg each, using this app, the ball park figure for money saved comes to £452.2 million; and that doesn’t include costs saved down the line due to treating less obesity related disease.

With such promising results you may be wondering when this online tool will be made available for public use. A University of Southampton spokesperson had this to say:

we can’t give a definitive timescale of the intervention going to market but we hope it is very soon as we have had widespread interest from various health organisations in the UK

The WHO rate obesity as being a major preventable causes of death. With rates continuing to rise across the UK and the western world, it is good to see new tools being created that can promote the health of the nation. And with this particular tool’s estimated cost effectiveness, if verified, it wont be long until cash strapped organisations like the NHS bring it into use.

How does it compare to other weight loss programs

The weight loss seen when using the POWeR+ tool compares well to the results seen from a trial of the commercially available weight watchers scheme. That study recruited 772 participants with a BMI of between 27 and 35. Paricipants were randomly assigned to either 12 months free membership of Weight Watchers or a group following national treatment guidelines for obesity; i.e. advice from their GP or other health proffesional.

At twelve months the Weight Watchers group had lost on average 5.1 kg compared to 2.3 kg for those receiving standard care. However some criticisms have been levelled at the study, it was funded by Weight Watchers and participants received a free 12 monthsWeight Watchers membership, which currently can cost upto £325/year.

Conrad Bower

Featured image via Wikimedia Commons

Do you want to live a longer healthier life? New evidence shows eating this food group can help

Increasing the amount of whole grains you eat is good for your health, and the more you eat the greater the health benefits. For every 48 grams of whole grains consumed per day, there is a 25% decline in cardiovascular disease-related deaths, and a 20% decrease in the number of total deaths (deaths due to all causes).

These are the findings of the first meta-analysis (which compiles the results of many studies and then uses statistics to calculate an ‘average’ of those results) review of studies associating whole grain consumption with life span and susceptibility to disease.

This may not come as a surprise, as whole grains such as whole wheat, oats and brown rice are generally accepted as being better for your health than the processed versions. Processing generally involves milling the grain, removing the outer husk which also contains health promoting components such as dietary fibre, B vitamins, and minerals.

This meta-analysis confirms the already large body of evidence supporting the health benefits of whole grains and other processed food. But will this change the way we eat?

The findings support the Dietary Guidelines for Americans, issued by the US government, which recommend at least three servings daily of whole grains. They also match the current UK Eatwell guide. Both guidelines offer limited advice which suggests cutting out processed foods.

Senior author of the study, Assistant Professor Qi Sun from Harvard T.H. Chan School of Public Health, explained the strengths of this study:

Previous studies have suggested an association with consumption of whole grains and reduced risk of developing a multitude of chronic diseases that are among the top causes of deaths, although data linking whole grain intake and mortality were less consistent

The study found that for every serving of whole grains (16 grams) consumed per day, there was a……

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“Putting lipstick on a pig” thats the end result of billions spent by government on IT projects

A scathing report on government digital policy says it has failed in its objective of “transforming government”. The numerous iterations of applying technology to government has amounted to no more than expensive window dressing or, as colourfully described in the paper, “putting lipstick on pigs”.

The term e-government is used as a catchall term for words commonly used in associating information technology and government, including: electronic, digital and online.

One of the major reasons for this failure, according to the report, is the assumption that government is a service industry. This leads to the adoption of a private sector model for plans to use technology to enhance government activity. The report states, in no uncertain terms:

Governments do policy, not services…Citizens are not customers

Because of this service industry mindset, the authors argue, work done on researching and implementing e-government tends to be done by people with technology and management backgrounds. The people who should be leading this work are those with a public administration or political science background, who best understand the role of government and how it can be improved. These improvements can then be adopted digitally.

The paper argues that cosmetic changes have been made to the front-end websites, whereas little significant change has happened at the back-end. One of the authors of the report, Paul Waller of Brunel University, says…….

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People with ME/CFS have long been told it’s all in their head – these scientists disagree

A conference bringing together the brightest minds in Myalgic Encephalomyelitis a.k.a Chronic Fatigue Syndrome (ME/CFS) research, presented results that promise to bring a new dawn in understanding this debilitating disease. A hot topic at the conference was the search for reliable biomarkers to diagnose ME/CFS which can also aid understanding the mechanisms behind the disease.

A biomarker is something that can be measured reliably in the body to determine if someone is ill with a particular disease, or recovering due to treatment. For example high levels of glucose in the blood is a biomarker for diabetes. Currently there are no biomarkers available clinically to diagnose ME/CFS, diagnosis relies on a set of symptoms which are also common in other illnesses.

Dr Ian Gibson was chair of the conference, organised by the charity Invest in ME Research, and also an author of ……


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Featured image via Invest in Me Research, artwork by Wolfgang Stiller

More and more people are dying from cancer – there’s a solution, but the government won’t like it

Cancer deaths have increased in countries affected by austerity and unemployment according to a new study. However countries with universal health care, such as the NHS in the UK, were protected from these effects and had fewer deaths.

The study published in The Lancet estimated that 260,000 extra cancer deaths had occured in countries belonging to the Organisation for Economic Co-operation and Development (OECD), during the years 2008 to 2010, when the global recession was at its peak.

Seventy five high and middle income countries were included in the study, which investigated possible links between unemployment, public health care spending and cancer deaths. The data analysed is published by the …….


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EU backs Open Science policy, while UK considers censoring scientists

The EU has agreed all publicly funded science within the EU should be available free of charge. This momentous decision supports the Open Science concept, which promises to increase access to research data and enhance its use.

This enlightened leap by the EU is in stark contrast to the UK government’s recent moves that, with an astonishingly cynical backdrop,  could prevent publicly funded academics from ensuring their work benefits the public via evidence based policies.

The EU Competitiveness Council announced after its meeting in Brussels that all scientific papers funded fully or partly by public money will be made free to access by 2020. This occurs under the Netherlands presidency of the EU, who have been strong proponents of Open Science. Chair of the council Sander Dekker, who is also a cabinet minister in the Netherlands, said …….

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Food science “corrupted by commercial influences”, claims obesity charity

Official dietary advice is wrong and commercial influences may be corrupting food science, according to a controversial report released by the National Obesity Forum (NOF) and the Public Health Collaboration (PHC) on Monday.

The report suggests a higher fat/low carbohydrate diet which is also low in processed low fat foods could help you lose weight, prevent diabetes and is better for your health than the Public Health England (PHE) recommended diet……

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Featured image via Wikimedia Commons.

A disease ridden global catastrophe approaches: its time to act!


The world is faced with an antimicrobial resistance (AMR) crisis that threatens to throw our health and medical practices back to the Dark Ages according to a report released by economist Jim O’Neill.

The report estimates that even today 700,000 people a year die of resistant infections around the world, and that this is likely to rise to 10 million lives a year by 2050, with an estimated cost to the world economy of £69 trillion a year.

The report sets out a 10 point plan to combat the problem, that needs to be implemented globally to be fully effective…

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Featured image via Connor Conway