supporting evidence remains restricted to small trials.4–7
Surveys by patients’ organisations in the UK have
reported that CBT and GET are sometimes harmful, and
have recommended pacing and specialist health care.8,9
We designed the pacing, graded activity, and cognitive
behaviour therapy: a randomised evaluation (PACE)
trial10 to compare pacing, defi ned as adaptive pacing
therapy (APT), CBT, and GET, when added to specialist
medical care (SMC) with SMC alone. We sought evidence
of benefi t and harm. We also aimed to compare APT
against CBT and GET and examine these comparisons in
subgroups satisfying diff erent diagnostic criteria for
chronic fatigue syndrome and myalgic encephalomyelitis.
We postulated that CBT and GET would be more eff ective
han would APT and SMC, and that APT would be more
eff ective than SMC alone.
defined