Concerns about Cochrane

Cheshire said:
Turmoil erupts over expulsion of member from leading evidence-based medicine group
By Adam Marcus and Ivan Oransky

https://www.statnews.com/2018/09/16...m_source=twitter&utm_campaign=twitter_organic
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Things like this creep me out a bit: "in an email to a group of more than 100 experts in evidence-based medicine"

Is it any wonder that we've faced such problems with group think and prejudice?

I'm worried that this framing is going to work against us for trying to get Cochrane to raise standards for behavioural interventions:

"Gøtzsche, who was elected to the group’s board of governors in 2017, blamed the vote on his stance on the drug industry. “As most people know, much of my work is not very favourable to the financial interests of the pharmaceutical industry. Because of this Cochrane has faced pressure, criticism and complaints. My expulsion is one of the results of these campaigns.”

I don't really know a lot about the HPV vaccine issue, but politically it seems like a bad move for Cochrane to expel Gøtzsche rather than ignore him.
 
Jonathan Edwards said:
It's an unholy mess.

For the board not to have responded to the criticism of the mental health section they must be incompetent.

We all need to wake up and see that the imprimatur of Cochrane is no more authority than anything else. You have to judge for yourself.
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Maybe you want to leave a comment that the bias doesn't just concern pharmaceuticals but also CBT/GET? https://www.statnews.com/2018/09/16/expulsion-cochrane-peter-gotzsche-medicine/

(and probably other behavioural interventions)
 
BMJ EBM Spotlight - Cochrane - A sinking ship?
By Marianne Demasi, PhD


It began as a simmering personality clash, between the CEO and a board member, but now has boiled over into a spectacular war of words, where the underlying issues of Cochrane have bubbled to the surface, with many insiders predicting the beginning of the end of Cochrane.
...

The events that have unfolded in the last few days have consequences for Cochrane far beyond dealing with the public embarrassment of losing more than a third of its Governing Board.
 
Kalliope said:
BMJ EBM Spotlight - Cochrane - A sinking ship?
By Marianne Demasi, PhD


It began as a simmering personality clash, between the CEO and a board member, but now has boiled over into a spectacular war of words, where the underlying issues of Cochrane have bubbled to the surface, with many insiders predicting the beginning of the end of Cochrane.
...

The events that have unfolded in the last few days have consequences for Cochrane far beyond dealing with the public embarrassment of losing more than a third of its Governing Board.
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“We know that the biomedical journals publish articles which are neutral at best, but are mostly positive and tend to emphasize benefits and downplay or even ignore harms,” says Jefferson.

“What you end up within the medical journals is a shoe-horn version or a summarized version and you don’t know what criteria go into choosing which bits goes into the print version. So that introduces unfathomable bias”.

Jefferson’s answer to whether we should ignore evidence from journal articles was ‘probably’ unless urgent steps aren’t taken to address the issue of reporting bias: cherry picking and spin of research findings

This presents Cochrane with an enormous problem. The lifeblood of the organisation is in carrying out systematic reviews. The basic evidence, upon which these reviews are founded, is largely at risk of bias, especially for interventions where there is a huge market.

“The contention that Cochrane has been publishing reviews that are mainly beneficial to the sponsors of these interventions is probably a fact,” says Jefferson. “If your review is made up of studies which are biased and in some cases are ghost written or the studies are cherry picked and you don’t take that into account in your review, then its garbage in and garbage out – its just that the ‘garbage out’ is systematically synthesised with a nice little Cochrane logo on it”.
 
Esther12 said:
I'm worried that this framing is going to work against us for trying to get Cochrane to raise standards for behavioural interventions:
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My impression is maybe not. The can of worms being opened seems to be about conflict of interest regardless of type of treatment. And the psychiatrists are getting quite a bit of stick.

Esther12 said:
I don't really know a lot about the HPV vaccine issue, but politically it seems like a bad move for Cochrane to expel Gøtzsche rather than ignore him.
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I don't know the details of HPV but Jefferson says nobody does except the company. Hilda Bastian also says she needed to bone up on it but her piece is very confusing - to the extent that one cannot work out what her opinion of it is even after finding out.

I think Gotzsche may be a bit of a campaigner but it is very possible that HPV vaccine is a very different kettle of fish from MMR. It may be that nobody really knows if it does any good. It might well not. At least we know MMR stops epidemics.
 
Blog on the Cochrane situation from "Ray Moynihan, senior research fellow, Centre for Research in Evidence Based Practice, Bond University, Australia."

Not sure if this is at all relevent, but that's where Paul Glasziou is based, and they've work together (Glasziou is a co-author of the Cochrane CFS exercise IPD review protocol, and one of the few remaining people who will try to defend PACE).

https://blogs.bmj.com/bmj/2018/09/1...leeding-at-cochrane-theres-too-much-at-stake/

edit: It's not that interesting. Appeal for calm on both sides. Expresses view that there was an "overstatement of criticism" of Cochrane HPV vaccine review.

Two bits maybe relevant to Glasziou's Cochrane's CFS work was the view that Cochrane should be stronger on COIs and "Cochrane reviews might throw a lot more explicit scrutiny on the sometimes controversial definitions of disease on which they rely—highlighting the inappropriately lowered diagnostic thresholds which can drive overdiagnosis and overtreatment."

"What’s at stake in the current bloody fight unfolding within Cochrane’s Governing Board, is not just the credibility of individuals or organisations, it’s the future of reliable trustworthy evidence in a world of increasing falsity and fake news. [1,2] To see this future threatened foreshadows a disaster for all of us."

I fear that the problems we've seen around PACE are part of a wider corruption of academia which is leading to justifiable cultural cynicism about the value of even trying to work out what is true. If people decide that trying to be well informed often just leads to one being misled and believing even more misguided things than if just relying on ones own ignorant prejudices, we're in a lot of trouble as a culture/species.
 
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Wasn't aware of this, so it's not just Gøtzsche/HVP-vaccines/the nordic Cochrane group.

The entire US Cochrane Centre has already closed down in the spring of 2018, in frustration over management and other centre directors are also contemplating leaving Cochrane. Whereas those who’ve been critical of Cochrane’s direction, have simply withdrawn, Gøtzsche spoke out publicly and has borne the consequences.
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Kalliope said:
Ugeskriftet for Læger - The Journal of the Danish Medical Association - is Denmark's main scientific journal within the health and medical fields.

They've written an article about Cochrane as it is having its annual colloquial this weekend. The google translation seems a bit messy, so here's the main content:

The article points out that Cochrane reviews once used to represent the gold standard for evidence. But today examples of poorly performed and even retracted reviews, a broad access to topics and fierce criticism from researchers and doctors have caused a strain for the network.

Some of the latest criticism has involved a Cochrane review about HPV vaccination being accused for omitting relevant studies and committing wrong comparisons. Fiona Godlee is interviewed and makes a few comments.

Has the Cochrane network left a mainly scientific contribution for a political one?

"The role where one supports political agendas is contradictory to the role Cochrane always has played, to challenge authorities. It is our fundamental raison d'être - to ask uncomfortable questions. So obviously we risk getting into conflicts with some." Says Karsten Juhl Jørgensen, vice direktør for the nordic Cochrane center.

The article also mentions a review on medical treatment of adults with ADHD which got retracted.

Karsten Juhl Jørgensen comments: It was not about cheating or dishonesty, it was simply poorly made. This is not good for the credibility, but it is a good thing that bad reviews are retracted and that the collaboration are open about it.
He thinks it should happen more often. And points to a review about the effect of prayer in recovery.

The article says all the topics among Cochrane reviews on alternative treatments are lifting eyebrows.

People are becoming more aware that even Cochrane reviewers can be biased.

The leader of the Nordic Cochrane center, MD Peter Gøtzsche is on the Cochrane board and did not have time for an interview but signalled that the board meeting can turn ugly, because there is a power battle about the course from now on for Cochrane.

Ugeskriftet: Blegner stråleglansen om Cochrane?
google translation: Is the glow surrounding Cochrane paling?
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New story from Ugeskriftet and from same journalist. She is reporting from Edinburgh.
Not a lot of new things than what has already been shared in the thread, so will just add links to the article. But do let me know if something in the google translation needs clarification and I'll try to help.

Ugeskriftet: Peter Gøtzsche smidt ud af Cochrane
google translation: Peter Gøtzsche thrown out of Cochrane
 
Esther12 said:
If people decide that trying to be well informed often just leads to one being misled and believing even more misguided things than if just relying on ones own ignorant prejudices, we're in a lot of trouble as a culture/species.
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In the fast pace (sorry!) of the modern world it seems to me that people think that being informed is simply asking the opinion of someone who appears to be influential in the field.

Now, I can understand in some fields you would need many years of education to truly understand specific problems. In which case it is only common sense to ask more than one person and preferably people with opposing views?

Even that seems like too much effort for many folk in power No, just find one person, quote them and offload responsibility for the opinion onto them. Then, if it all goes wrong, you've got someone to blame.

Disheartening in an age where it is easier to access information than ever before.
 
Not everyone agrees this is a crisis for Cochrane, or more likely - trying to calm the waters?.

At this stage in a fast-unfolding story, I am not convinced that the Cochrane Collaboration is experiencing a crisis of either morality or democracy. Its brand, now as ever, stands for rigour, independence, and a commitment to using science to achieve high-quality patient care and social justice. We should cut it some slack while it gets its house in order.
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Long statement from the Cochrane board:

https://www.cochrane.org/news/statement-cochranes-governing-board

I've not read all of it, but it looks like they go after Gøtzsche hard:

This Board decision is not about freedom of speech.
It is not about scientific debate.
It is not about tolerance of dissent.
It is not about someone being unable to criticize a Cochrane Review.

It is about a long-term pattern of behaviour that we say is totally, and utterly, at variance with the principles and governance of the Cochrane Collaboration. This is about integrity, accountability and leadership.
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While others are talking about setting up a new shop. Seems to be the Nordic and the Austria Cochrane groups that are revolting.

We consider the Board’s use of its authority to expel Peter from Cochrane to be disproportionate. The general public, consumers, students, and researchers involved in Cochrane value the plurality of opinions, views, and perspectives Cochrane has worked hard to give voice to since its foundation. We believe that the expulsion of inconvenient members from the Collaboration goes against Cochrane ethos and neither reflects its founding spirit nor promotes the Collaboration’s best interests. We are concerned that these actions might cause great damage to the reputation of the Collaboration.
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