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

saves insurance Billions? In US there is a 2 year cap disability for mental vs non mental. So by supporting CBT they save having to pay for years to disable people.

 

I haven't read the emails yet, but I understood the choice of phrasing to mean that they would withdraw it ONLY because of the practical difficulty in that the authors couldn't all agree on the changes, therefore there was no conclusive document to publish; NOT because Cochrane was declaring they believe the whole thing to be invalid - ie retracting their belief in it as a statement of fact/truth.

 

Exactly!

 

IMO, any new review MUST only include trials that undertake physical monitoring of patients' objective symptoms, before, during and after. This is vital for harm minimisation, and yet is the key element that is almost always ignored by the so-called 'biopsychosocial' practitioners. In practice, the 'bio-' part of the equation is consistently ignored, but is the most crucial in terms of whether patients will derive any lasting benefit from the therapy in terms of improved functionality/ ability to participate in normal life activities again.

 

There may be some kind of logic in that. However if the authors cannot agree what they think they are claiming it should never have been published in the first place claiming the treatments proved evidence of being moderately effective etc.

Either Cochrane adjudicate over things they accept to publish or they don't. Once they realise a published paper is worthless in its claims and will affect health care policy and makes no attempt to assess potential harms of a treatment it should be a straightforward retraction.

If this was an electrical goods item or a car part would it make sense for Volkswagen for example to say to the manufacturer, "ah just go see if another car company will buy it from you even if its potentially dangerous"?

 

My oven is moderately effective at hammering nails, that doesn't mean that I should recommend it is used for that purpose. Especially for those that aren't physically capable of picking up a large kitchen appliance and wielding it in a fashion necessary for knocking in nails.

Even, and this is important, no one has yet figured out that many smaller objects could be used more effectively, because the 'experts' (who just happen to manufacture ovens) insist that the best available tool is an oven, no one has examined the nail insertion characteristics or rocks, or a hammer, or even yoghurt..

 

Esther Crawley wasn't embarrassed to do the LP study, but then that had extra dimensions to it. It was carried out on children potentially without the correct informed consent and the participants are sworn to secrecy regarding the nature of the "treatments".

Maybe that is the key. Perhaps if the LP study is withdrawn rather than retracted in the future from its publishers Cochrane could publish it once the authors all agree how effective it is according to their own logic.

 

What if you wanted to make nail sized holes in your oven, then what?

 

Clearly I would then need two ovens, significant surgery, and at least 6 months heavy training, or one of those augmentation suits beloved of alien loading docks.

In a culture that hasn't invented a hammer yet these could be significant obstacles.

It's just simpler to research the alternatives, starting with rubber chickens and working up to atomic weapons.

Given the time, resources, and sheer devastation this could cause it's probably a good idea to come up with an alternate design choice.

 

It's almost inevitable that proponents of spiritual-based alternative medicine will use this opportunity opened by psychobabble-based alternative medicine. It will be quite interesting, to watch people slowly come to that realization and be confused about why people can't tell the difference now that they erased all distinctions. Slippery slopes don't distinguish.

For all practical matters, aside from intent and ideology there is no functional difference between the psychosocial ideology and any of those fringe belief systems, the evidence base is just as hollow and the methodology just as poor. The only genuine difference is the appearance of credible science, which is entirely a matter of editing and terminology. That's very easy to abuse by motivated people.

The Cochrane section on CFS listed, until recently, a paper on Chinese herbal medicine. I saw a few papers on acupuncture and other types get published as well that had all the language and appearance of credible science. Just wait until China uses that wedge to its full extent in its promotion of Chinese traditional medicine. They have every reason to, it's been normalized already and it's likely to be the turning point in realizing the full horror of what's been done.

Edit: The Chinese herbal medicine was not in the GET review but rather listed as a relevant paper (1 of a handful...).

 

Think there's a typo there, and you meant that Cochrane had a Traditional Chinese Medicine review for CFS, rather than the review on GET?

 

https://twitter.com/user/status/1145702320388345858

https://twitter.com/user/status/1145704472028549121

 

Maybe the line "With this methodology, homeopathy can be shown to be effective" should be used more often in criticism of this stuff. Even better if references to such "trials" can be found.

 

The only point omitted in the drafting of that was "whether in this world, or the next".

 

The difficulty is that such a review would be one sentence long. "There were no trials of adequate standard."

If it is any comfort I can point out that the UK NICE committee have a document from me that makes the various points raised in recent posts, including the fact that homeopathy would get the same result and that failure of peer review has let through a mass of meaningless material, and which also references the two Vink/Vink-Neise reviews that do what Cochrane should have done. The document will be officially published as part of the NICE review process.

It remains true that you can take a horse to water but you cannot make it drink. On the other hand if the objective is to bring the various points raised to the attention of those making decisions, I think it has proved possible to achieve that.

 

Thank you

 

There is no elephant in the room, what the hell are you talking about!?!

 

This!