Evidence-based psychological interventions for adults with chronic pain: precision, control, quality, and equipoise, 2021, Williams, Eccleston et al.

Moved from this thread:
Embodied: The psychology of physical sensation (2015) by C. Eccleston


Edit: See post #16 for the full published article

Evidence-based psychological interventions for adults with chronic pain: precision, control, quality, and equipoise

Williams, Amanda C de Ca,*; Fisher, Emmab,c; Hearn, Leslieb; Eccleston, Christopher

appears to be embargoed until 2022?

https://researchportal.bath.ac.uk/e...ological-interventions-for-adults-with-chroni

https://twitter.com/user/status/1441385380255838209

 

Presumably a thesis?

Except that the first author is about 60 and has a doctorate

 

What on earth is that picture about?
Is somebody selling degrees in business studies at Bridlington Virtual University?

 

Silly me, someone is marketing CBT of course, but why would Cochrane employ a marketing executive who believes in 'pushing' treatments?

You can't make it up.

 

In embracing the belief that it's all just a messaging problem, that the evidence is infallible and it's just a matter of getting the message out, it seems perfectly natural, especially for Cochrane, who seem to have adopted this approach, along with the whole of the EBM effort.

What do you do when you have a safe and effective treatment that would work for millions if only they understood... I guess the usual sales pitch is "the relationship between the mind and the body, or whatever"? You sell them the idea better than ever, of course. Fitting that the golden age of psychosomatics would also happen along with the era of MBA medicine, right there with artificial targets that completely replace the original goal and become the whole point. Dog wagging its tail is now also chasing its own tail, and wagging it more in response, so chasing it harder than ever on and on.

 

He was my first boss at Cochrane. We didn't get on terribly well...

 

oh sorry - he is last author . But I worked with Amanda Williams too as she is an senior editor of the Cochrane Pain Group. She seemed very nice. But I recently commented on a Cochrane review on managing chronic pain with psychological therapies. I don't think she got my point about subjective outcomes any more than anyone at Cochrane ever does. https://www.evidentlycochrane.net/chronic-pain-psychological-therapies/#comments

 

I think her reply is interesting. Also interetsting that she didn't feel the need to reply again to your reply and Andrew Kewley's comment.

Did you see she co-authored a comment in the Lancet on the NICE guideline on chronic pain after she had resigned from the committee for that guideline?

https://www.s4me.info/threads/new-d...ture-over-medication.16182/page-9#post-378328

(Which all seems a bit weird to me, since with regard to that guideline, criticism I think was justified -- didn't read her comments though, so no idea whether her/their criticism made sense in that case.)

(Edited to add a line about the exchange between Caroline, Amanda and Andrew about the Cochrane review.)

 

ah yes, I had forgotten that. Will have a look at that

 

Off-topic, sorry.

I realised ages ago that there is some significance to the order in which authors are listed on any research paper or article, but I have never seen an explanation of what that significance is. Can anyone enlighten me?

 

This is not gospel, but what I think is the case from working alongside health researchers since 2008. The last author is usually the most senior. The one that adds gravitas to the whole endeavour. The one who holds the grant funding if there is any. etc. They may not have done much (or any) of the hands on research themselves. But they should have read the paper and take responsibility for the content, along with the other authors. Having said that, I have just had a paper accepted for publication where that is not the case...because my boss had no part in the research at all. And there was no specific funding for the research.

 

Thanks, @Caroline Struthers

 

Simplified: The first one or two people did most of the work, the people in the middle chipped in and the one or few people at the end secured the research funding or provided a supervisory role.

 

It varies across fields, but in medicine and related fields, what @Snow Leopard and @Caroline Struthers say is usually the case:

First author: did the work

Last author: paid for the work, hosted it in their lab, may or may not have done any actual work on it.

Middle authors: a mix of people, some might have done some real work, others may be getting their names on it as a part of a quid pro quo agreement (author name sharing is a common practice in medicine "I'll add your name to my paper if you do the same for me". It is an easy way to inflate he research productivity of every researcher in your group or institution.)

 

Thanks, @Snow Leopard and @Woolie

 

We know how Cochrane deals with that. They defend it as they find it all very... desirable. Whatever that is as a standard. Which sounds a lot like a recognition that this is a "if it worked" thing without having the courage to actually say it.

Problem is that the fix has to work both ways: it's garbage in, and also garbage out. It's not just garbage out because what goes in is garbage, the process itself is garbage and essentially unreliable. Even if what goes in improved, it's still a fully arbitrary process that amounts to a popularity contest depending on who is in the room doing the arbitration. It says nothing about the quality, validity or applicability of the evidence. All it says is that it's common and... desirable. In the end it's always the same issue: bias, bias everywhere. Wanting to help more than caring to find whether it did.

Medicine doesn't use feedback loops. Instead they use this Rube-Goldberg process that is actually more costly and inefficient than doing full quality-control across every single thing they do. This is what happens when you don't use feedback loops, the only way to learn from mistakes.