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ME/CFS Science @mecfsscience.org · 21/04/2026

4) The authors note that this limitation gave all the exercise trials a high risk of bias according to the Ris of Bias (RoB) tool. They write: "our risk of bias assessment using the RoB 2.0 tool indicated a prevalent high risk of bias across the included studies."

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ME/CFS Science @mecfsscience.org · 21/04/2026

5) But they don't think this is a big issue: "while these methodological constraints are important to note, they represent inherent challenges of the field rather than fatal flaws that would completely invalidate the clinical value of these trials."

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Simon McGrath @simonmcg.bsky.social · 21/04/2026

That was always Simon W's argument and that of the psychosocial field: blinding isn't possible, so we'll just ignore it as an issue. Which explains a lot about the state of the field.

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ME/CFS Science @mecfsscience.org · 21/04/2026

6) That seems to be the most crucial line in the whole review. At least the authors are upfront with it! We disagree and think it likely is a fatal flaw. For more info on why blinding is important, see this brief history that we wrote about it here:

mecfsscience.org

Turning a blind eye to blinding - ME/CFS Science

Blinding is the process of keeping key persons involved in the conduct of a clinical trial unaware of group assignment.

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