Michael Sharpe skewered by @JohntheJack on Twitter

Thanks @Lucibee, I don't know how to copy tweets here. If you click on the blue bird icon on the tweet you will see my whole 'conversation' with him. I was trying to pin him down to giving evidence of approval for and justification for the use of 60 as the SF36 recovery criteria.

As you see, I failed miserably. No surprise there. I have no idea what his answer ''OK not really curious questions are these'', means. Not English as I know it.

I hate twitter anyway - a great medium for frustrating miscommunication and misunderstanding - don't know why I bothered.
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.
 
Michael Sharpe said:
the recover paper was a secondary analysis that explored different ways of defining 'recovery' withing the limits of the data available. if you look it is multidimensional.
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?
 
LOL - I'd really love to know how it is he thinks he's deciding which questions are 'real' or 'curious', and which are 'accusations' or 'tricks'. He must have some internal rationale that he imagines makes sense, or else why would he be behaving like this publicly?
I think anything questioning the integrity of PACE that he can't answer is an accusation.
 
Michael Sharpe said:
the recover paper was a secondary analysis that explored different ways of defining 'recovery' withing the limits of the data available. if you look it is multidimensional.
[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.
 
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Well...it does no harm for his attitude and answers to appear in the public domain.
I think it is worth it for that.

The best way to take somebody down is usually with their own words and actions. It is what will eventually do Wessely in, his decades long incontrovertible trail of pronouncements on the public record.

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To be sure his words do not get deleted, keep a copy yourself (probably best and easiest to do so in PDF format, via the print function in your browser), and make sure there are backup copies of it.
 
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[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.
My brain exploded trying to read this, can you translate into simpler english (and do you have any brain reconstruction glue on hand?)
 
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?
For explore read manipulate?
 
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.
 
My brain exploded trying to read this, can you translate into simpler english (and do you have any brain reconstruction glue on hand?)
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.
 


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):



What is Sharpe doing?
 
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.
 
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.
 
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