Review Interventions for the management of long covid post-covid condition: living systematic review, 2024, Zeraatkar, Flottorp, Garner, Busse+

ME/CFS Skeptic said:
https://twitter.com/user/status/1864344972675203469


We have written a blog article that summarizes the problems with the BMJ review on Long Covid interventions (Zeraatkar et al. 2024). Inconsistency in how imprecision was evaluated seems to be the key issue. Suspect that a correction will be needed.
https://mecfsskeptic.com/the-bmj-review-on-long-covid-interventions/
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Another excellent takedown. I hope you can work with David and others to make sure all of this gets back to the editor.
 
Robert 1973 said:
I wouldn’t be at all surprised to see a letter from them protesting that psychological illnesses like LC and ME/CFS are real. PR manipulation at its best/worst.

SW and co will no doubt be raising a cheer – a truly dreadful piece of research, which doesn’t provide any reliable evidence in support of its claims about CBT and rehab, has passed peer-review and been published in the BMJ. Now the Telegraph is using it to write headlines which are not even supported by the false claims in the BMJ paper.

“War is peace, freedom is slavery, ignorance is strength.”
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Thinking about this again after reading @ME/CFS Skeptic’s blog it occurs to me that what has happened is even more absurd. First, two badly designed studies (ReCover and REGAIN) have been published which provide no reliable evidence of efficacy of the interventions. Then the BMJ authors have done a “meta analysis” using those single studies for each outcome, which inflates the estimate of the effects sizes, resulting in recommendations that are not supported by the original datasets. Then the conclusions of the so-called meta analysis are spun to the media which inflates the already inflated results of the meta analysis, leading to headlines which suggests that CBT and rehab are not only effective treatments but probable cures.
 
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Andy said:
Still waiting on the peer review details, https://www.bmj.com/content/387/bmj-2024-081318/peer-review. They say, "Please note that it may take up to 5 days for the peer review documents to appear.". I won't be surprised if they aren't made available.
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How does it work in reality with these? can they sit it out waiting for ones they like to come through and then if not enough of those then they twiddle their thumbs about whether to let a critique through to make up the five or wait fur s friendly to pen something ?
 
bobbler said:
How does it work in reality with these? can they sit it out waiting for ones they like to come through and then if not enough of those then they twiddle their thumbs about whether to let a critique through to make up the five or wait fur s friendly to pen something ?
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Who knows? I certainly don't.

From the link they say, "In rare instances we determine after careful consideration that we should not make certain portions of the prepublication record publicly available. For example, in cases of stigmatised illnesses we seek to protect the confidentiality of reviewers who have these illnesses. In other instances there may be legal or regulatory considerations that make it inadvisable or impermissible to make available certain parts of the prepublication record.", so I wouldn't be surprised if they don't publish it using this clause as reason.
 
InitialConditions said:
There's also another new, critical response from someone who seems to work in clinical evidence synthesis amd medical statistics: https://www.bmj.com/content/387/bmj-2024-081318/rr-4
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It seems to highlight similar problems as ours:
In reality, this conclusion is based not on a meta-analysis of 3695 patients but on the results of a single small trial with a sample size of 114, [1] which the review authors themselves judged to be at high risk of bias in more than one domain, according to the information presented in the Supplementary Data file. The review authors have chosen to interpret these findings as of 'Moderate' certainty, downgrading just one level for risk of bias and ignoring the uncertainty in the estimate, the confidence interval width in relation to the minimum clinically important difference, and the possibility in heterogeneity of effects between studies, should future studies in addition to this single trial be published. This assessment appears to run contrary to the BMJ's own Best Practice guidelines for GRADE. [2]
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Hoping that the editors take notice.
 
I wonder if the fact that they called it a "living" systematic review is exactly because they have insufficient crumbs to use for the interventions they want to promote (CBT & exercise). So that when the inevitable criticism comes that bringing in 1 study for each main conclusion is not a "systematic review" they'll go: "Well, duh, it's living, it will be updated with additional publications."

Which would still make no sense for an organisation for which creating "living" systematic reviews can be appropriate (like Cochrane), and would be utterly ridiculous for what is just a journal publication.

(Handy if that's allowed if you want to produce smoke & mirror reference fodder for the promotion of your preferred intervention though.)


Edited to add: sorry if this has already been mentioned - I'm following this thread a bit, but haven't read it all.
 
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