Mark Vink

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Mark A. Vink, MD, is a General Practitioner and insurance doctor in The Netherlands. He lives with severe ME/CFS triggered by pneumonia and prolonged by graded exercise therapy (GET). As a result of his adverse experience with GET, he has been a vocal critic of the PACE trial.[1] One piece written about the PACE trial garnished him a nomination for the 2016 John Maddox Prize, an international award for an individual who promotes sound science despite difficulty or hostility in doing so.[2]

Before becoming ill with myalgic encephalomyelitis, Mark Vink ran marathons, competed in triathlons, was a Dutch national hockey captain, and a brown belt in judo.[3]

Aerobic Threshold / Lactic Acid Study[edit | edit source]

While bedridden with severe M.E., Dr Vink carried out a biomedical study on himself, collecting blood with finger prick lancets and pediatric sized tubes. By measuring creatine kinase, inorganic phosphate and lactic acid before and after trivial exercise (i.e., walking the 5 to 6 yards from his bed to the toilet and back), he showed that his aerobic energy production and lactic acid excretion were both impeded.[1]

The results of Vink's 2015 study were reported in a Dutch national newspaper as finding that the physical impact of going to the bathroom was similar to that of running a marathon for people with chronic fatigue syndrome,[4][3] although what Vink found was that his own lactic acid levels were higher than those at which most professional atheletes would have quit.[1]

An open letter to Psychological Medicine about "recovery" and the PACE trial[edit | edit source]

Dr. Vink was one of the signatories of an open letter to Psychological Medicine about “recovery” and the PACE trial dated March 13, 2017 urging Psychological Medicine to retract a paper claiming recovery for ME/CFS patients by using graded exercise therapy and cognitive behavioral therapy.

Notable studies[edit | edit source]

  • 2022, Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?[5] - (Full text)
  • 2021, CFS patients remain severely disabled after specialist treatment with CBT in the UK[6] - (Full text)
  • 2021, The draft updated NICE guidance for ME/CFS highlights the unreliability of subjective outcome measures in non-blinded trials[7] - (Full text)
  • 2021, Is ME/CVS-patiënten op hun herstelgedrag aanspreken zinvol? Een review van de literatuur[8] - (Full text) - In Dutch
  • 2020, Could Cognitive Behavioural Therapy Be an Effective Treatment for Long COVID and Post COVID-19 Fatigue Syndrome? Lessons from the Qure Study for Q-Fever Fatigue Syndrome[9] - (Full text)
  • 2020, Graded exercise therapy doesn't restore the ability to work in ME/CFS. Rethinking of a Cochrane review[10] - (Full text)
  • 2019, Work Rehabilitation and Medical Retirement for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. A Review and Appraisal of Diagnostic Strategies[11] - (Full text)
  • 2019, Cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective. Re-analysis of a Cochrane review[12] - (Full text)
  • 2018, Multidisciplinary rehabilitation treatment is not effective for myalgic encephalomyelitis/chronic fatigue syndrome: A review of the FatiGo trial[13] - (Full text)
  • 2018, Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review[14] - (Full Text)
  • 2017, FITNET's Internet-Based Cognitive Behavioural Therapy Is Ineffective and May Impede Natural Recovery in Adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. A Review[15] - (Full text)
  • 2017, PACE trial authors continue to ignore their own null effect[16] - (Full text)
  • 2017, Assessment of Individual PACE Trial Data: in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Cognitive Behavioral and Graded Exercise Therapy are Ineffective, Do Not Lead to Actual Recovery and Negative Outcomes may be Higher than Reported[17] - (Full text)
  • 2016, The PACE Trial Invalidates the Use of Cognitive Behavioral and Graded Exercise Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Review[18] - (Full text)
  • 2015, The Aerobic Energy Production and the Lactic Acid Excretion are both Impeded in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome[1] - (Full text)

Talks and interviews[edit | edit source]

Online presence[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. 1.01.11.21.3 Vink, Mark (September 10, 2015). "The Aerobic Energy Production and the Lactic Acid Excretion are both Impeded in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Journal of Neurology and Neurobiology (ISSN 2379-7150). 1. doi:10.16966/2379-7150.112.
  2. "The John Maddox Prize – Sense about Science". senseaboutscience.org. Retrieved November 12, 2018.
  3. 3.03.13.2 de Visser, Ellen (October 3, 2017). "For patients with CFS, going to the bathroom is similar to running a marathon". Anil van der Zee. Retrieved December 29, 2018.
  4. 4.04.1 de Visser, Ellen (October 3, 2017). "Als je CVS hebt is naar de wc gaan al een marathon". volkskrant.nl. Retrieved December 29, 2018.
  5. Vink, Mark; Vink-Niese, Friso (February 2022). "Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?". Healthcare. 10 (2): 392. doi:10.3390/healthcare10020392. ISSN 2227-9032.
  6. Vink, Mark; Vink-Niese, Alexandra (May 27, 2021). "CFS patients remain severely disabled after specialist treatment with CBT in the UK". Journal of the Royal Society of Medicine. 114 (6): 284–284. doi:10.1177/01410768211013447. ISSN 0141-0768. PMC 8212546. PMID 34042529.
  7. Vink, Mark; Vink-Niese, Alexandra (January 28, 2021). "The draft updated NICE guidance for ME/CFS highlights the unreliability of subjective outcome measures in non-blinded trials". Journal of Health Psychology. 27 (1): 9–12. doi:10.1177/1359105321990810. ISSN 1359-1053.
  8. Vink, Mark; Vink-Niese, Friso (April 1, 2021). "Is ME/CVS-patiënten op hun herstelgedrag aanspreken zinvol?". TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde (in Nederlands). 29 (4): 44–49. doi:10.1007/s12498-021-1362-x. ISSN 1876-5858.
  9. Vink, Mark; Vink-Niese, Alexandra (December 11, 2020). "Could Cognitive Behavioural Therapy Be an Effective Treatment for Long COVID and Post COVID-19 Fatigue Syndrome? Lessons from the Qure Study for Q-Fever Fatigue Syndrome". Healthcare. 8 (4): 552. doi:10.3390/healthcare8040552. ISSN 2227-9032. PMC 7764131. PMID 33322316.
  10. Vink, Mark; Vink-Niese, Friso (January 1, 2020). "Graded exercise therapy does not restore the ability to work in ME/CFS – Rethinking of a Cochrane review" (PDF). Work. 66 (2): 283–308. doi:10.3233/WOR-203174. ISSN 1051-9815.
  11. Vink, Mark; Vink-Niese, Alexandra (September 20, 2019). "Work Rehabilitation and Medical Retirement for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. A Review and Appraisal of Diagnostic Strategies". Diagnostics. 9 (4): 124. doi:10.3390/diagnostics9040124. ISSN 2075-4418.
  12. Vink, Mark; Vink-Niese, Alexandra (January 2019). "Cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective. Re-analysis of a Cochrane review". Health Psychology Open. 6 (1): 205510291984061. doi:10.1177/2055102919840614. ISSN 2055-1029. PMC 6498783. PMID 31080632.
  13. Vink, Mark; Vink-Niese, Alexandra (July 2018). "Multidisciplinary rehabilitation treatment is not effective for myalgic encephalomyelitis/chronic fatigue syndrome: A review of the FatiGo trial". Health Psychology Open. 5 (2): 205510291879264. doi:10.1177/2055102918792648. ISSN 2055-1029. PMID 30094055.
  14. Vink, Mark; Vink-Niese, Alexandra (July 2018). "Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review". Health Psychology Open. 5 (2): 2055102918805187. doi:10.1177/2055102918805187. ISSN 2055-1029. PMID 30305916.
  15. Ghatineh, Simin; Vink, Mark (August 11, 2017). "FITNET's Internet-Based Cognitive Behavioural Therapy Is Ineffective and May Impede Natural Recovery in Adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. A Review". Behavioral Sciences. 7 (3): 52. doi:10.3390/bs7030052. PMC 5618060. PMID 28800089.
  16. Vink, Mark (April 27, 2017). "PACE trial authors continue to ignore their own null effect". Journal of Health Psychology. 22 (9): 1134–1140. doi:10.1177/1359105317703785. ISSN 1359-1053.
  17. Vink, Mark (2017). "Assessment of Individual PACE Trial Data in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Cognitive Behavioual Therapy and Graded Exercise Therapy are Ineffective, Do Not Lead to Actual Recovery and Negative Outcomes may be Higher than Reported". J Neuro Neurobiol. 3 (1). doi:10.16966/2379-7150.136.
  18. Vink, Mark (2016). "The PACE Trial Invalidates the Use of Cognitive Behavioral and Graded Exercise Therapy in Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome: A Review". Journal of Neurology and Neurobiology. 2 (3). doi:10.16966/2379-7150.124. ISSN 2379-7150.
  19. Johnson, Cort (September 25, 2015). "How Walking to Bathroom Can Be Harder Than Running a Marathon: A Doctor's ME/CFS Case Study". Health Rising. Retrieved December 29, 2018.

graded exercise therapy (GET) - A gradual increase in exercise or activity, according to a pre-defined plan. Focuses on overcoming the patient's alleged unhelpful illness beliefs that exertion can exacerbate symptoms, rather than on reversing physical deconditioning. Considered controversial, and possibly harmful, in the treatment or management of ME. One of the treatment arms of the controversial PACE trial.

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

subjective outcome An outcome of a clinical trial that depends on the judgement or opinion of the assessor or patient, e.g. asking if fatigue has increased or decreased "a little" or "a lot", patient questionnaires like the Chalder Fatigue Scale, and other patient-reported outcome measures (PROMs).

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

graded exercise therapy (GET) - A gradual increase in exercise or activity, according to a pre-defined plan. Focuses on overcoming the patient's alleged unhelpful illness beliefs that exertion can exacerbate symptoms, rather than on reversing physical deconditioning. Considered controversial, and possibly harmful, in the treatment or management of ME. One of the treatment arms of the controversial PACE trial.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

PACE trial A controversial study which claimed that CBT and GET were effective in treating "CFS/ME", despite the fact that its own data did not support this conclusion. Its results and methodology were widely disputed by patients, scientists, and the peer-reviewed scientific literature.

graded exercise therapy (GET) - A gradual increase in exercise or activity, according to a pre-defined plan. Focuses on overcoming the patient's alleged unhelpful illness beliefs that exertion can exacerbate symptoms, rather than on reversing physical deconditioning. Considered controversial, and possibly harmful, in the treatment or management of ME. One of the treatment arms of the controversial PACE trial.

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From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.