Reply to Dr Ros Vallings
Bruce Arroll
1 * , Jenny Oliver 2
1 Department of General Practice and Primary Health Care, University of Auckland, New Zealand.
2 Monarch Life, Havelock North, New Zealand.
Journal of Primary Health Care 14(3) 285-285 https://doi.org/10.1071/HC22105
Published: 30 September 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
We are concerned that this letter seems to be part of an attempt to stop discussion about the Lightning Process. We suggest Dr Vallings and her supporters look at the actual evidence such as the very well-conducted trial by the Bristol Clinical Trials Unit which found a benefit for teenagers with Chronic Fatigue Syndrome (CFS) from the Lightning Process in 2017.1 The cost-effectiveness of the Lightning Process was UK pounds 1474 per QALY (2017 currency). Dr Vallings’ preferred Pacing Therapy is the least cost-effective at UK pounds 127 047 in 2013 UK pounds.2 CBT is UK pound 18 374 and graded exercise 55 235. This would suggest that Pacing is a modestly effective treatment that is expensive.
The NICE guidelines are quoted for the safety/harm of the Lightning Process. The claimed harms come from a qualitative study (not a cohort) where possibly two people claimed they were harmed (there were no harms in the Bristol Study). Clearly, something bizarre happened at the NICE Guideline on CFS as four people resigned, prompting a group of Scandinavian Psychologists to write an article in the Lancet saying that there was ideological capture of the Guideline group.3,4 We agree, having examined the NICE Guideline.
Conflicts of interest
Jenny Oliver receives fees for treating clients with the Lightning Process. There are no other conflicts of interest to report.
References
[1] Crawley EM, Gaunt DM, Garfield K, et al. Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial. Arch Dis Child 2018; 103 155–64.| Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial.Crossref | GoogleScholarGoogle Scholar |
[2] McCrone P, Sharpe M, Chalder T, et al. Adaptive pacing, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome: a cost-effectiveness analysis. PLoS One 2012; 7 e40808
| Adaptive pacing, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome: a cost-effectiveness analysis.Crossref | GoogleScholarGoogle Scholar |
[3] Flottorp SA, Brurberg KG, Fink P, et al. New NICE guideline on chronic fatigue syndrome: more ideology than science? Lancet 2022; 399 611–3.
| New NICE guideline on chronic fatigue syndrome: more ideology than science?Crossref | GoogleScholarGoogle Scholar |
[4] Torjesen I. Exclusive: Four members of NICE’s guideline committee on ME/CFS stand down. BMJ 2021; 374 n1937
| Exclusive: Four members of NICE’s guideline committee on ME/CFS stand down.Crossref | GoogleScholarGoogle Scholar |
