BMC family practice integrated GP care for patients with persistent physical symptoms, 2020, Chalder et al

Given where this study comes from, at first I thought "integrated care" must be just another euphemism for psychiatry. But apparently it is a thing - devised to free up GP time by referrals to "other roles such as pharmacists, counsellors, physiotherapists and nurse practitioners"
https://www.england.nhs.uk/integratedcare/case-studies/integrated-care-in-action-primary-care/

But yes, in this instance it's another opening for the sea lion.

 

https://twitter.com/user/status/1315197638778785794

 

https://twitter.com/user/status/1315208267853950977

https://twitter.com/user/status/1315212387289640960

 

Testing to infinity is basically correct, at the very least without a breakthrough independent of this ridiculous ideology this could go on exactly as is for several centuries more, never delivering a damn thing, never changing anything of substance. Always saying the same things no matter what happens.

I'd be very curious if someone did the work of actually collating all the identical experiments that have been performed over the last few decades. I would be surprised if it's fewer than 1,000 of this exact same formula. Most so small as to be insignificant but nonetheless, all identical, all the same formula, the same intent and rhetoric, the same methods and flaws, the same everything except for trivial changes to the substance, which itself is never actually reviewed in any capacity.

Because this is really important, no matter the number of those identical experiments with tiny trivial differences, when you read reviews, commentary and praise for it, the actual substance of those interventions is never actually discussed. Not rarely. NEVER. Because it is entirely irrelevant. If this were a drug, its formula or effect would never be discussed, it would simply be a generic The Pill, or whatever. Simply the act and ritual of taking The Pill, never what it is or does. Basically Obecalp (read it backwards, actual thing).

The same experiments over and over again, without change, without learning anything, without any oversight or accountability. Going strong for a full century or more, and possibly many more in the future if they could get away with it, with the only peripheral changes having to do with progress in the rest of science and technology, such as computers allowing for faster mathemagics and real scientists taking patients away from them and forcing them to say the same things about different people without skipping a beat.

And the worse thing is that they keep doing the same things over and over again but actually expect the same results. This is double insanity. It is not science, it may be just about the most literal example of how not to science.

 

Like the medical belief in the four humours which originated with the Ancient Greeks, for example. That belief lasted for about 2000 years.

https://en.wikipedia.org/wiki/Humorism#Four_humors

 

This could have been a positive outcome if they had then decided their biopsychosocial approach did not work in this context. Instead, they seem to believe the findings mean they need to refine the approach.

 

Has anyone seen any news coverage of this? Has King's College London has promoted this thing as a success like they promoted the CBT for IBS study and the CBT for dissociative seizures study? Haven't seen news coverage so far but I could have missed stuff.

 

Nothing that shows up in a Google search on either the title or the URL of the study.

 

Maybe they are a bit more wary of promoting their null results as the study involved GPs, ie doctors, who when they notice the bluff may get listened to.

 

I have added this note to the first post in this thread.

"[Worth noting that the intended study title was probably "Integrated GP care for patients with persistent physical symptoms: feasibility cluster randomised trial", i.e. the title minus the name of the journal, BMC family practice, it was printed in.]"

But I've not amended the thread title as it is what is, currently at least, used in the journal.

 

Trial By Error: Professor Chalder’s PRINCE Has Arrived

https://www.virology.ws/2020/10/14/trial-by-error-professor-chalders-prince-has-arrived/

 

They have been investigating / researching optimising their BPS treatments, what is it, going on 30 years now? And yet here they are continuing to work on 'adapting' the treatment.

In no paper have they ever questioned the initial assumption that these symptoms patients experience are anything other than perpetuated by the patients aberrant thought process. In the BPS world view no other explanation can be possible.

Their interpretations for reasons why the patient is experiencing these symptoms really reveals more about this group of researchers and not much of anything about those being studied (over and over and never getting to a place where the treatment actually works)

And yes, the people who fund this stuff are just burning money in a closed academic system that does not respond to anything in the real world.

 

I think the above is coded-speak for convincing patients there is nothing really wrong with them, and condition them into believing the NHS should not be having to waste its time and resources on them ... and so the NHS can wash its hand of them.

 

Like the free market academics economists whose theories never cut it outside the university.
https://www.nytimes.com/2019/08/24/opinion/sunday/economics-milton-friedman.html

 

Ah yes, it's all that absolute positivity mindset about how things will work themselves out. And just like our BPS nemesis they too never ever think that there might just be a downside. In the real world. In this case to the whole freakin' planet.

 

For Professor Chalder to arrive at these questions, she would need help. As we have seen from her researcher colleagues having their work questioned resulted in them claiming persecution. Rigid thought doesn't allow questioning. Fluid thought scares the hell out of rigid thinkers.

Cognitive rigidity prevents Professor Chalder from seeing the contradictions and making the connections. Professor Chalder's history proves she is unable to problem solve using free thought, she follows the same rigid belief in each of her studies, so she arrives at the same conclusions over and over. What universal conclusion? I need more money for a bigger study to prove CBT never fails.

Cognitive rigidity prevents Professor Chalder from conducting self-analysis which shows in her work. That's why Professor Chalder is like a robot, if you need a task repeated over and over she's your woman.

There's a story of a professor of CBT who was asked by his student, what thought is causing this headache? The professor explained that not everything is caused by a thought, take some aspirin and stop thinking so rigidly. Trudie Chalder never received that lesson.

 

Not if they think they are the ones that failed to improve (hang on a minute, isn't this how all this stuff works?)