"No More Mr NICE Guy…" by Prof. Brian Hughes

Copied and discussion moved from this thread:
NICE ME/CFS guideline - draft published for consultation - 10th November 2020


The Science Bit by Brian Hughes - No More Mr NICE Guy...

NICE’s verdict on psychosocial treatments for ME amounts to nothing less than an utter repudiation. That it comes from an authoritative agency and is based on a thorough empirical review is extremely significant.

This is not just a turning point for people with ME, CFS, and related conditions — it is a high-profile exposure of exactly how, for years, entire subfields of the psychological sciences have been willing to overlook, if not embrace, shoddy standards.

In all respects, this public shaming is long overdue.

It is richly deserved.

ETA: This article was a feast to read!

 

WOWEE, this is so powerful, brilliant article. I hadn't appreciated NICE had come up with such damning critique of all those CBT/GET papers. Very therapeutic read!

 

Did someone say ouch!
It wasn't me, I promise.

 

What about the Daily Telegraph.

 

From the Brian Hughes article:

"Overall, across no fewer than 172 CBT studies, NICE graded 153 (89%) as “VERY LOW” quality and the remaining 19 (11%) as “LOW” on quality. Not a single study was found to have exceeded that abysmal threshold.

A similar bloodbath befell studies of graded exercise therapy (GET). Of a total of 64 studies of GET, NICE determined 52 (81%) to be “VERY LOW” quality and 12 (19%) to be “LOW” quality. Again, not a single study was any better than “LOW” quality."

I assume the very few CBT/GET papers which formed the basis of the 2007 guidelines would have been included in this latest analysis of papers?

How is it then that in 2007 these papers were deemed good quality evidence used to justify NICE recommending CBT/GET for the next 13 years, yet now NICE is saying, admitting, they are of very low or low quality?

I think NICE has some explaining to do.

I think there needs to be an independent inquiry to fully look into how this occurred and the impact this serious failure has had both on both patients and on ME research over the past 13 years.

NICE should be held to account over this.

 

Great post from @Brian Hughes . One point I would make is that he uses the now well-known phrase "Replication Crisis" while showing this terminology to be both a major understatement and misleading.

172 CBT studies and 64 GET studies. I don't know if any of these were strict replications, but presumably they all corroborate each other with positive conclusions about the treatments. The problem is not that findings can't be replicated - they are ad nauseum. It's that the evidence is useless - as the NICE review recognized and Hughes points out - but interpreted... inappropriately. So CBT/GET research is not part of a replication crisis but part of a much larger "Evidence Crisis" within which lots of replicated research is garbage as well.

Of course if the evidence is useless there should not have been a study to interpret in the first place. So the crisis starts in the gatekeeping - review boards, peer review, journal editors. What we have is a lot of spam. A "Spammageddon", to put it technically.

 

I would suggest the funders as well. Although often the funding is not mentioned as I expect it comes internally from the University department. So, while we're at it how about educators who do not do anything to highlight these problems in psychology research.

I also find that there is a problem with language abuse and the constant obfuscation of meaning to create sentences that come together that sound like science but say nothing. So really no one's the wiser as to what the details are. In research unsurprisingly, details matter.

 

And of course the funding from insurance companies and DWP - If i'm getting that department's initials correct. So we can add "Education Crisis" and "Incentive Crisis" to our list of crises

 

Merged thread

https://thesciencebit.net/2020/11/21/no-more-mr-nice-guy/

https://twitter.com/user/status/1330245867476017154

 

There's a good case to make for a crisis of ethics. Especially given how common it is to openly discuss ways to get around rejection of consent and to bring about acceptance of blatant pseudoscience by exploiting the power imbalance patients face, vastly amplified in discriminated diseases.

Probably the foundation of it all. If ethics were respected here none of this would follow, it all derives from a fundamental rejection that we are deserving of basic respect, that it is acceptable to gaslight us and lie to and about us, that the ends justify the means. Even with ideology, even with poor methodologies and a reliance on logical fallacies, the absence of ethical considerations here guarantee failure.

 

Its a shame the comments section is closed i for one would like to thank him for bringing a very clear spotlight on a major problem not just for people with M E but also in British medical practice where psych bs is the go to for every quack and overworked medical profession who's need to meet targets outweigh the needs of patients .

 

Indeed & the worst of it is that they kid themselves that they are the ones being supremely ethical & with our best interests at heart.
They think they are my mother, whom when i was a toddler would rename vegetables that i said i didnt like (that she knew i did as i had eaten & enjoyed them before, before i knew what they were called - thus peas became 'petit pois'

"I dont like peas"
"Oh i know you dont like peas Jem, no i would never give you peas because i know you dont like them, but these are not peas these are petit pois they are veerrry special, a real treat, & although they look a bit like peas they taste very different, they taste quite sweet not like peas, peas are yuk!"

It seems funny doing that to a 4yr old who did like peas but was just flexing her 'i get to choose' muscles & would have eaten biscuits for every meal given the choice (ie my mum did know whats best for me & manipulated me ethically with my best interests at heart). But assuming the same dynamic is at play when you are an adult psychiatrist talking about and to, a competent adult patient, just reveals that you think we are toddlers and you are the all knowing parents.

 

He's a member here, so I'll tag him and he might see it at some stage.
@Brian Hughes

 

Just amazing! There's so much power in this blog. So much guts and so much love! Really impressive!

 

Fantastic!

 

And assume everyone is too stupid to "read the [tables in the] paper" as an emminent Oxford Professor might put it.

Thank you @Brian Hughes!

 

Blimey, I enjoyed reading that.

Obviously it's not a laughing matter. This isn't a barbed argument between warring academics; Brian is talking about the 'experts' who colluded to build the framework underpinning taxpayer-funded medical abuse, entirely for their own benefit and with not a thought for their victims.

You'll just have to forgive me for enjoying seeing it set out in such devastating terms...

 

Absolutely brilliant article, thank you so much Brian Hughes for repeatedly speaking out on this !