Maintaining musculoskeletal health using a behavioural therapy approach: a population-based rct, (the MAmMOTH Study), 2021, Macfarlane et al

Well, of course, what next, as I throw up my cake. The Mammoth Study, with a huge price tag. Old study, back in 2015.

Here's the schtick which I found on the Versus-Arthritis.org site.

https://www.versusarthritis.org/res...gia-maintaining-musculoskeletal-health-study/

 

Thanks, @Hutan.

Maybe I should posted this in the humor section.

 

The following seems to say a lot (first 3 paras is one para I have broken into 3, my bolding):

Doesn't it say more about the measures used vs the spoonfeeding the 'treatment' might involve in relation to said scales? Please see final quote and comment (as I didn't want to interrupt the order of this para) at the bottom

And yes, looking at the next sentence that giving better answers to these perception-based scales doesn't change the outcome. And it perhaps it more obvious when someone tries to do a study were there is a time-order that means claims of causation can't be muddied/cart-before-horse self-kiddology isn't possible?

.... or if you really want to kid yourself then claim it's because you didn't catch people early enough because 'it happened in childhood' really? why is it we live in a world where people think they can get away with that and won't be laughed out of rooms?

There we go ... the classic BPSm lesson, never feel you have to stick with the primary outcome that you sold/got funded for the project on if it doesn't work and watch out for anything objective in particular, the more objective and less subjective the worse. Goodness knows why whether people were 'moving in and out of meeting criteria' in some sort of claimed pattern or if it was 'one way' shouldn't really make a difference for a study that helps prevent things surely - unless they are trying to say it works for those who were diagnosed because they can fluctuate back, but those who weren't might have been in an 'ebb' and timing meant they'd fluctuate back in within a year like some sort of cycle of the moon meaning more would be likely to wax 'back in' if they were 'on the wane' when recruited?

Is that ... straw-clutching?

Doesn't that prove that the causality isn't there... even if you 'treat symptoms' and get people to report they perceive them as better it makes little difference to whether they go on to end up meeting the criteria for the condition - so basically the condition isn't caused by these things then.

I'm also puzzled quite how they've claimed the quality of life year calcs

I note that the introduction includes the following claims of healthcare usage/costs:

I find the claim of average 25 visits/year to primary care hard to believe. This would mean getting an appointment once a fortnight, which even in 2015 would have been impossible for most and certainly not something that would have continued for that long without some sort of red flag at most GPs given triage etc was happenning back then. It's also pretty impossible if you are trying to keep a job to be able to get to said appointments.

So basically what was different here is the fact that for the primary outcome itself, because it is a prevention study they can't mention the illness or prime people for it. And so that's the measure they can't change because how can you 'disappear something' when you can't describe anything close to it?

It would be like trying to do cfs-CBT gaslighing people they only have false beliefs that exertion makes them worse, encouraging them that 'too much rest is making them tireder' and having to describe it as 'maintaining cardiovascular health'. Even if people were better at managing the perception of things in order to report what is desired on the questionnaire, they blinking obviously know and still notice when whatever it is that is underlying it is objectively getting worse and needs checking out. And it isn't like they can train them to answer the 'future medic's questions' without giving away the game. ?

.... unlike most of the dodgy BPSm 'CBT' studies where the treatment is 'talking' and 'reframing what people say to cerain quesions' priming people what they need to reply specifically to the questions that they will have asked of them later, and basically a learn-by-rote training session where their answers get fudged upwards and drilled in by the therapist in preparation for 'surprise surprise they said they focus on their symptoms less by one point on the scale' because their therapist has spent the whole sessions gaslighting them that it's 'on them' and 'over-focusing is bad'. ...