BMJ: Pressure grows on Lancet to review “flawed” PACE trial

Only just seen this, not got access yet: https://www.bmj.com/content/362/bmj.k3621.short?rss=1

 

Sci hub now has it: http://sci-hub.tw/https://www.bmj.com/content/362/bmj.k3621.full

 

From the Pharmaceutical Journal:

Ingrid Torjesen is a freelance journalist specialising in health and health policy. She is a regular contributor to The BMJ and the Health Service Journal and is editor of The Advisor, a magazine for people working in smoking cessation services. In the past she has acted as news editor for The BMJ; opinion, features and news editors for the HSJ and features editor for Nursing Times. Staff posts include associate editor and news editor of GP newspaper, news editor of Pulse, and reporter at Australian Doctor, based in Sydney. She has a degree in Biological Sciences specialising in Genetics.

 

One can post replies on the BMJ website.

They generally post a lot/most of them. One can increase the chances of them posting it if you do it in the style of scientific article by having a reference section. Even just one reference would qualify, which could be the Torjesen article

 

There are some problems with this coverage, but in many ways it seemed so fair to us that it made me wonder if the BMJ editor who normally assess ME/CFS stuff was on holiday. This didn't read like it was part of a propaganda campaign against us.

Really, they should have mentioned that this reanalysis was conducted according to the trials 2007 protocol, while the PACE team had deviated from their own protocol with their analysis.

I hate the emphasis on this 'all in the mind' stuff - it's such a distraction, and always gives the impression patients start with foolish assumptions about mental illness or the way mind and body can interact. Was this ever the issue driving concerns about PACE? Certainly not amongst the people I'd been speaking to about it. Anyway, even if ME/CFS was a MH problem, the problems with PACE would still remain, and would still need to be spoken out against. I think that the main way that the stigma of MH affected the debate around PACE was that authority figures in UK medicine thought that there was no need to engage respectfully with the concerns of patients suspected of having MH problems.

The inclusion of that McGrath quote makes this piece so much better. Go @Simon M ! Your blog is so clearly the best thing the BMJ has ever published on ME/CFS... even after they made it worse by editing it without your consent!

 

Also - this coverage in the BMJ is another reason to be grateful for the coverage from Whipple in the Times. Even if that coverage didn't have room to say much (and repeated the 'all in the mind' line) it helped indicate that this was a story deserving of coverage.

 

I would have preferred if it was clear that there were over 100 academics alone who signed it and then mentioned the others.

 

https://twitter.com/user/status/1032239746091835398

 

I wonder if the BMJ is ever going to get around to correcting their 2011 coverage of the PACE trial:

https://www.meassociation.org.uk/20...-coverage-of-the-pace-trial-23-february-2011/

 

No. Why?

 

I got this ad.

The 6th World Conference on Research Integrity (WCRI) to be held on June 2-5, 2019 in Hong Kong.

http://www.wcri2019.org/

 

Absolutely. I am sure this would not have happened without the Times article. Even the opening phrasing is similar, and the list of universities represented. Coverage generates coverage. This article in BMJ has now made it news not just in the general world but in the medical journal world. Whatever the limitations of any specific article, it's clear that the CBT/GET ideological brigades no longer control the narrative.

 

A reply to the article:

https://www.bmj.com/content/362/bmj.k3621/rr

 

Are you planning to reply to the BMJ article, @Jonathan Edwards, @dave30th?

 

written by
Andrew J Kewley
Student
South Australia

 

https://twitter.com/user/status/1032311526252851200

 

I would appreciate a comment that introduces the idea that PACE-like methodology is common in this area of medicine and that this is hurting patients and impairing progress.

 

I have sent a comment trying to make that point and seconding Andrew's comment.

 

I'm planning to write an open letter to Godlee about this article and some other things. It bugs me that they don't even bother to cite the open letter, in case people want to read it.

 

This, this and this again

The original PACE trial and the reanalyses showing its flaws tell us one clear fact: regardless of the underlying pathology of ME/CFS (be it immunological, metabolic, neurological or psychological), Graded Exercise Therapy does not work. Now, that may provide evidence that the 'false illness belief' hypothesis is itself false - because one would think that if patients really thought erroneously that exercise would make them ill, then getting gradually to do exercise would undermine that belief leading to recovery - but is isn't the main case. And, speaking personally, I would have bloody loved it if a well-designed trial showed a therapy to be effective regardless of the pathology underpinning that treatment; I'd much rather have a condition shown to be psychological and curable than physical and not.