Cochrane Review: 'Exercise therapy for chronic fatigue syndrome' 2017, Larun et al. - Recent developments, 2018-19

Yes, I useful document for the NICE committee.

 

I suspect they defer to eminence.

I am not sure that they had much idea of 'following standards'.

 

Depends who is holding the standard. If there might ultimately be an honour in it....

 

Thanks for pointing that out, John. Trish made the same remark to me. I've now corrected this in the text.

Had a quick look and some dictionaries do accept publically as a correct alternative, but that's probably because people make this mistake often enough so that it becomes accepted. At least that's my guess. One blog explained:

That's probably why people like me make that mistake.

 

Which rather fits with the touchy feely science.

 

[my bold]

I find that statement rather enlightening, as it strongly indicates a potentially unhealthy relationship between Cochrane and its reviewers. This is a major issue in play, and DV is striving to avoid falling out with AF. To me this strongly suggests there are almost certainly many other less significant, but nonetheless important, issues that just fly under the radar of proper scrutiny, simply to avoid any fallings out between authors and Cochrane.

Yes I understand there is quite rightly a relationship that will establish between Cochrane and many of its authors. In principle I'm fine with that, the world turns on healthy relationships. But here it is supposed to be a professional relationship, else it is not healthy. Instead it comes across as tacit acknowledgement of a much-too-cosy unhealthy relationship. Which totally undermines the credibility of Cochrane even further.

Is Carol Monaghan being kept aware of these Cochrane developments?

 

She can't answer the question because it would force her to admit she actually agrees with some points of the 'activist' criticism.

 

Yup And being former head of the RCGP explains a lot about how the lousy NHS internal training sourced from the "rousing reassurance" FINE trial happened. Also why, despite there being no evidence for it, the NHS qualifies ME as somatoform in practice and internal documentation, in contradiction with the NICE guidelines, which hint at it but at least refrain from making unevidenced statements.

Personally I find that a spouse of a controversial researcher pushing that spouse's highly controversial work by way of heading the GP system is extremely corrupt and inappropriate, but that may be one reason, among a few others, why I am not a regius professor of psychiatry at KCL. Really egregious case of "who you know" in a system that should rather be built on "what you can prove".

 

Hey, if some people didn't have double standards they wouldn't have any.

 

When they tried to get the CCC accepted in Scotland it didn't happen because GPs and neurologists would not accept it. Was it a coincidence that GPs were represented by her and neurologists by MS? And nobody mentioned any conflict of interest.

 

From reading the emails, I got the impression that Tovey and Cochrane are focussing on all sorts of minor points, just to avoid the elephant in the room so to speak. They are using all opportunities to downgrade the clinical effects of GET on fatigue, instead of acknowledging that these effects are probably not real but an artifact of how these trials were set up (lack of blinding + inadequate controls + subjective outcomes).

They are asking the authors to do a reanalysis with the PACE-trial excluded, to write that the results do not necessarily apply to other ME/CFS criteria, to do a reanalysis because of the heterogeneity the Powell et al. 2001 study created, to re-express SMD in terms of MD to show how small the effect on fatigue is etc. On some points such as the drop-outs and downgrading due to imprecision, I even have the impression that Cochrane was overplaying it a little.

I suppose we'll just have to wait and see what the revised review looks like.

 

Oh yeah, forgot about those. They were awful to the point where they should be considered disinformation. Extremely dishonest and clueless at best.

 

Were these training videos specifically for ME or more general videos?