Michael Sharpe skewered by @JohntheJack on Twitter

Maybe they are egging him on, in the hope if one falls out the lifeboat the rest might be able to stay in.

 

Having read the whole thing, I think what he's saying is that the questions are not being asked out of curiosity, but for another reason. So he shut up.

 

Interesting he uses the word "explored". It may have been an exploration to him, but that exploration has greatly impacted medical thinking and PwME for a good while now. If all the recovery paper did was to "explore" different ways of defining recovery, why was it not made clear at the time it was simply an exploration, a thought experiment almost? Why pretend such fantasy to be reality, with all the real-world consequences that has brought down on PwME?

 

[My bold]
MS is saying here that the individual dimensions (that get aggregated to arrive at a recovery measure) are not individually critical for a definition of recovery, but that it is effectively the resulting 'vector' of those aggregated dimensions that matters. So even if individual dimensions fall short, so long as the overall vector result still comes up with an acceptable answer then all is OK. A very simple/crude 2D analogy would be if you are in a rectangular field and need to unreel a ball of string to a certain length - it doesn't matter what combination of x,y coordinates you end up at, so long as the vector you end up with gives the right length of string. That's what he is effectively arguing here.

So it seems that at the heart of the recovery argument that MS presents, is whether it really is a truly multi-dimensional issue, and that some kind of vector result is all that is needed to deem recovery? He seems to be saying that even if a dimension was pushed to sub-standard, that doesn't count because the vector result was not. But the real question is ... is that the right way of modelling the issue? Is it simply a multi-dimensional issue the way MS suggests? If not, then his argument falls flat, but it would be good to have a solid explanation for why it is not a multi-dimensional problem in the way he describes, but instead each criterion having to pass muster in its own individual right.

 

Which itself poses the question, why would you be thinking to explore different ways of defining recovery post hoc? Not, surely, to "best fit" with the results you were hoping to get but didn't?

 

My brain exploded trying to read this, can you translate into simpler english (and do you have any brain reconstruction glue on hand?)

 

For explore read manipulate?

 

It's all a game to him. I'm not going to respond.

 

The answer is "yes and so are all the experts who signed the letter to the Lancet, authors who submitted to JHP, authors and readers of the recent reanalysis etc etc ...", but yes, what's the point. He's basically saying "well I'm not going to talk about it if you don't promise to be nice to me", not answering questions and throwing meaningless questions back. Waste of time and energy. He's behaving like a two-year-old for all the world to see, which is something I suppose.

 

First of all a disclaimer: These are just my thoughts on this, as was my original post. I'm not clued up enough to know for sure if what I'm saying is on the ball. More intended as food for thought and others to maybe discuss as well.

I think MS is saying that they measured various different things in PACE, physical function, fatigue, etc, etc, (but all self reported note), and it was a blend of all these things that gave them their published definition of recovery. He seems to be saying that even if one or two of the things measured were atrociously bad for some people, once blended with their other measures ... the blended end result came out OK according to their interpretation. When he glibly and obtusely says "it is multi-dimensional", I think this is where he is coming from.

So to me this sounds like: Suppose you were victim of a car crash and ended up with all sorts of things wrong with you, and they took you in for a period of treatment. After some months MS et al might deem you recovered if you said your damaged neck was not too too bad now, and your broken ribs seem to be mending OK, even though your broken ankle for some reason has never healed, and if anything is now worse. It's as if MS, overall, would look at the list of 10 things or so they originally measured your health by when starting treatment, and so long as most of them were OK'ish now it wouldn't matter that your ankle was still extremely painful and you still couldn't walk and it might now never heal properly; could tick the you off as an overall plus and forget about you. And of course everything is just based on your own self reporting.

The PACE recovery paper allows someone to be deemed recovered, even if they report their physical function to still be atrociously bad, worse in fact than to be to be allowed onto the trial in the first place. MS argues, I believe, that such a person could only be deemed recovered if their other measures were good enough to 'counteract' the bad physical function, so their blended overall result still came out as a 'pass'. Most other people see that the final blend is by no means all that counts - if something as fundamental as physical function is still atrocious (worse, even, than they could have been allowed onto the trial with), then no-way-no-how can the person be considered recovered.

 

This is where the ACR criteria for improvement in arthritis do the job. You only score improvement to the degree that you improve on both subjective and objective endpoints. It is a bit more subtle than that but that is the basic idea.

Simon Wessely has said that psychiatry is for grown ups. But the science is kindergarten level.

 

MS seems to be having a few days of catching up on tweets.

Just when you thought it couldn't get any more surreal...
https://twitter.com/user/status/977316766832578561

https://twitter.com/user/status/978935323806674945

https://twitter.com/user/status/978197027061424128

https://twitter.com/user/status/978495259305902080

https://twitter.com/user/status/1000364018488500225

Since MS has a record of expressing strong views on ME, he's now confirmed himself as, in his own estimation, probably biased

 

https://twitter.com/user/status/1000398400116940800


The reanalyses provided results for the outcomes pre-specified in the protocol Sharpe was a co-author of.

Also, he wasn't 'Simply responding to accusations of bias' - this is his tweet that started the exchange (easily found by anyone who scrolls up):

https://twitter.com/user/status/977658477341495296


What is Sharpe doing?

 

He is using classic gaslighting.
There is no "winning" with a gaslighter besides ignoring them when they're doing it.
Everything one does or says in response becomes fuel for further reality-twisting.

Don't feed the trolls! Trust me, he jizzes a little every time someone engages him on this.

Just keep tweeting the truth without responding to his trollery.

 

Normally I'd agree about not feeding him, but in his case I think he makes odd little comments here and there that will come back to bite him hard in due course, the usefulness of which to our cause may not be immediately evident. He thinks he's much too clever to get caught out, and is enjoying having a laugh at our expense, but I think that is his weakness ... in due course there will be some of these things he's been saying he'll wish he'd kept quiet about.