2025: The 2019/24 Cochrane Larun review Exercise Therapy for CFS - including IAG, campaign, petition, comments and articles

[Sean]

NICE's guideline has no bearing on the correctness of our conclusions and has been widely criticized for failing to adhere to science.​

No, it has been loudly misrepresented and viciously defamed by a small group of hardcore psychosomatic fans who stand to lose big time from NICE's correct assessment of their empty claims, but who have also been be granted far more credibility and influence by Cochrane than they and their shitty pseudoscience deserve.

So there's that.

 

[Nightsong]

In a recent blog (link), Hilda Bastian references a curious paper assessing the fragility of evidence in Cochrane's systematic reviews -

Sharifan and colleagues used a reverse fragility index to estimate the fragility of the evidence in meta-analyses with non-significant results—studying 280 of them from 81 Cochrane systematic reviews: “In more than half of the meta-analyses,” they found, “changing three events or fewer was enough to make a nonsignificant result significant,” (when p values were between 0.05 and 0.20).

The paper in question is this one:

Reverse fragility index shows high fragility in Cochrane meta-analyses with P values between 0.05 and 0.20: A meta-epidemiological study

 

[Peter T]

In a recent blog (link), Hilda Bastian references a curious paper assessing the fragility of evidence in Cochrane's systematic reviews -

The paper in question is this one:

Reverse fragility index shows high fragility in Cochrane meta-analyses with P values between 0.05 and 0.20: A meta-epidemiological study

My interest is not Cochrane’s rejection of null results that are on the threshold of being significant, rather their promotion of unreliable results as robust. Certainly in relation to the CFS Exercise Review this is the case.

 

[Peter T]

In a recent blog (link), Hilda Bastian references a curious paper assessing the fragility of evidence in Cochrane's systematic reviews -

The paper in question is this one:

Reverse fragility index shows high fragility in Cochrane meta-analyses with P values between 0.05 and 0.20: A meta-epidemiological study

Which is more concerning in relation to Cochrane reviews, potential false negatives, as in this study, or the false positive as seen in the CFS Exercise Review? Although in principle the meta review approach to evidenced based medicine is a good idea, in practice how much are Cochrane failing patients?

 

[rvallee]

Although in principle the meta review approach to evidenced based medicine is a good idea

This is becoming obviously less and less true over time. A good idea, perhaps, if executed very differently, but a different execution is clearly impossible, so it becomes about as potentially good as a benevolent dictator. In theory? Great. In practice? Never works.

Lots of things sound great in theory, but when meeting reality they completely fall apart. Falling apart does not seem to bother many people, thus making it clear this system cannot be reformed.