Lancet Infectious Diseases: Editorial, "A proper place for retraction", 2017, mentions PACE in passing

Andy

Andy

Retired committee member
My bolding.
The Committee on Publication Ethics (of which The Lancet Infectious Diseases is a member) states that the purpose of retraction is to provide a “mechanism for correcting the literature and alerting readers to publications that contain such seriously flawed or erroneous data that their findings and conclusions cannot be relied upon”. This is not the case with the Cochrane review. Although the authors of the critique disagree with the review's conclusions, they do not outline any “seriously flawed or erroneous data”. There is a lack of data, which is the point made by the authors of the Cochrane review, and seemingly agreed with by the authors of the critique.

Other recent work targeted by calls for retraction include studies of cognitive behaviour therapy and graded exercise therapy for the treatment of chronic fatigue syndrome. In these cases the criticisms have centred on the methods, but the fact that similar criticisms have been repeated on subsequent studies suggests that it is the conclusions that are at issue.
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http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30458-9/fulltext

Proof, if we needed it, that they still don't understand the criticisms of PACE.

Highlighted in @Lucibee 's blog here - https://lucibee.wordpress.com/2017/08/27/a-case-for-retraction/#more-745
 
I don't really follow their meaning. If the conclusions are dodgy, something in the study process must have been dodgy....
Or are they saying "conclusions are the issue" meaning patients (and researchers and informed clinicians) just don't like what they found out...

Apologies I should really have read the article before rambling.
 
Lucy's letter in response was published in the Lancet in October 2017:

A case for retraction?
Lucy Bailey

A Cochrane review is not primary research. Therefore, it is not the data that are at fault, but the methods used by Cochrane to summarise it. In omitting data, on the basis of flawed methodology, the authors misrepresent the research and come to an erroneous conclusion.

It is that conclusion that the IDSA and AASLD are asking to be amended. And given the potential harm that such a review could pose to patients, retraction does not seem to be far off the mark. Indeed, a precedent has been set: a 2012 Cochrane review in a neighbouring field was withdrawn for similar reasons.6 The case for retraction here seems clear.
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The editors also mentioned the calls for retraction of “studies of cognitive behaviour therapy and graded exercise therapy for the treatment of chronic fatigue syndrome” (ie, the PACE trial). By contrast with a review, primary research that involves patients' trial data should not be retracted unless there are clear signs of fraud or serious ethical or procedural issues. Some have claimed that there were procedural issues with conduct in the PACE trial and that is why they have called for its retraction, or, at the very least, independent re-analysis.7, 8, 9

However, I believe that all registered clinical trials should be published in some form, even if flawed, to ensure that researchers don't make the same mistakes again and again. Asking for corrections to be made via the correspondence sections of journals does not go far enough. Full expungement from the record goes too far. A better strategy needs to be sought. Involvement of those most affected (ie, patients and their carers) is crucial.
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http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30527-3/fulltext
 
I was asked to submit my letter in order to "continue the debate". But so far, I can see no evidence of that debate continuing at all. It seems to have been stifled!
This is why I am not a fan of journal Correspondence. It very rarely furthers debate, and in this day and age, it is way too slow.
 
Rick Sanchez said:
Of course it's the conclusion that is the issue.

You should never be able to conclude that a given treatment is effective when a study is as methodologically flawed as PACE.

The Lancets nonchalant attitude towards flawed methodology is incredibly concerning.
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Yes, the conclusion is part of the problem, because the whole thing is built on sand ... bad methodology the lot.
 
Am I right in thinking @Lucibee that when you say ...
However, I believe that all registered clinical trials should be published in some form, even if flawed, to ensure that researchers don't make the same mistakes again and again. Asking for corrections to be made via the correspondence sections of journals does not go far enough. Full expungement from the record goes too far. A better strategy needs to be sought. Involvement of those most affected (ie, patients and their carers) is crucial.
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... you mean long the lines of:
  1. That correspondence corrections are far too weak, and delay-prone.
  2. That full retraction effectively removes all evidence from the formal record of a trial that was deeply flawed, a bit like sweeping history under the carpet? Akin maybe to allowing revisions in a legal document to have text removed, rather than struck through?
  3. That from '2' because the lessons learnt are themselves lost, it becomes easier for perpetrators to do it again?
Sounds to me like retraction is still the right thing, but the nature of retraction that is wrong. Maybe retraction should not mean completely purging from the record, but being left in evidence - literally and obviously - that the publication has been retracted and why.
 
An application of my proposed Bayes' Alchemy in action again @Woolie ?

A usage of a mathematical tool that I'm sarcastically calling 'Bayes' Alchemy'[...], in which a number of 'cans' (or 'probablies', or 'coulds') is strung together, with the result that the less likely something is, the greater the probability at the end of the equation. This seems to happen a lot with psychologists for some reason.
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