As a follow-up to my prior comment to Dr. Breus’ unequivocal endorsement of the PACE trial, here is another comment I just posted on his blog post that illustrates clearly how “journalism” like his serves the insurance industry in their quest to deny disability claims patients are entitled to:
If you still have any questions about how you are playing into the hands of insurers and re-insurers, check out this post by SwissRe, the world’s second largest re-insurer that is collaborating with Peter White of the PACE “trial”:
[Update 5/15/2016: Some time around January 2016, SwissRe took down the document that I linked to above and quoted from below. That was likely triggered by David Tuller’s series eviscerating the PACE trial and the resulting scrutiny of the fatal flaws of PACE. Before SwissRe deactivated it, the link lead to a SwissRe document entitled “Managing claims for chronic fatigue the active way,” which was published in a SwissRe newsletter. Please scroll down past the quotes to see screen shots.]
Swiss Re’s UK Life & Health Claims team arranged a web-based discussion group with Professor Peter White to describe recent UK-based research into treatments for Chronic Fatigue Syndrome (CFS) in the PACE trial.
Results for those in the group that received “pacing” with SMC were no different than for those receiving SMC alone, which surprised the research team. It had been hypothesized that provision of any therapy in addition to medical care, would have had a better outcome than medical care alone. It is thought that behavioural activation helps to treat the illness itself, whereas “pacing” (staying within limits imposed by the illness) only results in adaptation to the illness.
The key message is that pushing the limits in a therapeutic setting using well described treatment modalities is more effective in alleviating fatigue and dysfunction than staying within the limits imposed by the illness traditionally advocated by “pacing”. If a CFS patient does not gradually increase their activity, supported by an appropriate therapist, then their recovery will be slower. This seems a simple message but it is an important one as many believe that “pacing” is the most beneficial treatment.
It is likely that input will be required to change a claimant’s beliefs about his or her condition and the effectiveness of active rehabilitation. Funding for these CFS treatments is not expensive (in the UK, around £2,000) so insurers may well want to consider funding this for the right claimants.
A final point specific to claims assessment, and a question we’re often asked, is whether CFS would fall within a mental health exclusion, if one applies to a policy. The answer to this lies within the precise exclusion wording. If the policy refers to functional somatic syndromes in addition to mental health, then CFS may fall within the exclusion. If the policy doesn’t refer to functional somatic syndromes as well as mental health then it would be difficult to apply. The point made is that a diagnosis of Myalgic Encephalomyelitis or ME (a term often used colloquially instead of CFS) is considered a neurological condition according to the arrangement of the International Classification of Diseases (ICD) diagnostic codes whereas CFS can alternatively be defined as neurasthenia which is in the mental health chapter of ICD10.
It is well established that pacing is essential for the survival of ME patients. “Pushing” is well established to be a recipe for disaster and lasting worsening of health or worse.
Do you find it all improper, Dr. Breus, that Peter White of the PACE “trial” consults for SwissRe on how to use the “trial” results for the insurance company’s benefit? If you don’t agree with the tactics of insurance companies to use the PACE “trial” to deny benefits claimants are entitled to, then I don’t see any other option for you than to distance yourself from your blog entry by posting a correction and an apology in all the places where you posted this sad piece of “journalism.” Of course, if you agree with SwissRe’s and others’ tactics, then you should stand by this post by doing nothing.