Open letter to TEDxBristol regarding Esther Crawley's presentation on 2 November 2017

[Indigophoton]

Yes, I rather thought that was the subtext too, especially about the funding.

 

[Trish]

If patients are trying something and saying it helps, research is needed to see whether that is true or not

NO NO NO, Esther Crawley. If patients are trying something and saying it helps, it's the doctor's responsibility to examine that something carefully and the claims being made before advising anyone else to try it.

If they discover that the something involves telling children to lie about their symptoms and keep secrets about the process, her responsibility to the patients and their parents is to explain this and advise them that this is unethical and potentially dangerous and has no place in clinical practice.

 

[Indigophoton]

Funnily enough, @Trish , your first para is more or less what Crawley said on that point. I couldn't help wishing her research skills matched her vision. She's got it conceptually - research, test, verify - but when it actually comes to the research, she seems to be out of her depth.

 

[Luther Blissett]

Wearing a banana on my head kept the Ebola away for me this year Trish

I was mugged by the PG tips monkey though

 

[Graham]

@Indigophoton , I agree with you that some of her comments are worthwhile, but as a mathematician, I look at it from a probability perspective: if you put a bunch of monkeys in front of typewriters ....

 

[Indigophoton]

@Graham, yes, that may be it, you made me laugh, but I think it's really a failure of competence when it comes to execution. It's a shame, because she could really do some good were her research skills up to par.

 

[large donner]

What I don't understand is if she is a treating pediatrician how can she be a lead in research also.

Surely research is a whole specialty in itself.

What exactly qualifies a physician to be a researcher also. In her case its fairly obvious she doesn't even display a basic understanding in research. Does one even have to have any qualifications in research before they can get thousands of pounds to not even understand the tiniest design flaws will affect ones conclusions even in the most genuine research.

Is there even a body which oversees who can define themselves as a researcher?

 

[Justy]

What exactly qualifies a physician to be a researcher also.

Well, one would usually have to have a PHD and be a professor. I think you will find Dr Professor Crawley is both a PHD and a professor, so is actually fully qualified as a researcher.

http://www.bristol.ac.uk/social-community-medicine/people/esther-m-crawley/index.html

 

[Invisible Woman]

I think she has the talent of a politician.

Say something that sounds like it makes sense but all the while meaning something rather different.

ETA ...but actions do speak louder than words.

 

[Graham]

I think Esther Crawley has a lot to say.

 

[Louie41]

I see by the link supplied by @Justy that Crawley is a consultant pediatrician. In the U.S., this would mean a medical degree. Does she have a medical degree? Not sure how to interpret the English degrees.

 

[Trish]

She has a medical degree plus presumably specialist training as a paediatrician. She also has a PhD so presumably should know something about how to do medical research.

 

[Invisible Woman]

I see by the link supplied by @Justy that Crawley is a consultant pediatrician. In the U.S., this would mean a medical degree. Does she have a medical degree? Not sure how to interpret the English degrees.

Yes. A consultant paediatrician in the UK means a medical doctor who specializes in illnesses affecting children. Patients are usually referred to specialists by GPs in the UK (the US equivalent of a GP is a Primary Care Physician I think).

ETA crossed post with Trish

 

[Louie41]

Thanks, @Trish and @Invisible Woman! So for my education, which of her listed degrees is the medical degree?

 

[large donner]

Does she have a medical degree?

Yes, she just doesn't use it.

 

[Alvin]

Yes, she just doesn't use it.

She uses it, just in the wrong direction. She has a preconceived theory and chases it like a rabid dog, disregarding patients, results and reality to keep her lies afloat. Unfortunately we think of scientists as honest logical beings, we should hope they all strive to be but in the end they have the same human foibles as the rest of us.

 

[Invisible Woman]

Well I looked up BM BCh & found:

Bachelor of Medicine, Bachelor of Surgery, or in Latin: Medicinae Baccalaureus, Baccalaureus Chirurgiae (abbreviated in many ways, e.g. MBBS, MB ChB, MB BCh, MB BChir (Cantab), BM BCh (Oxon), BMBS), are the two first professional degrees in medicine and surgery awarded ...

English docs have lots of different groups of letters after their names depending on their specialities.

 

[Louie41]

@Invisible Woman Too complicated for me! Here it's just M.D. Osteopaths have a different designation and aren't necessarily considered medical doctors.

 

[Adrian]

Funnily enough, @Trish , your first para is more or less what Crawley said on that point. I couldn't help wishing her research skills matched her vision. She's got it conceptually - research, test, verify - but when it actually comes to the research, she seems to be out of her depth.

But there is a principle that you look at techniques and make an assessment about whether they are likely to work and hence worth testing. LP is not really credible but given its technique it is likely patients will claim it helps. There is no science behind NLP. The LP talks about Adrenalin claiming managing this would help so if she wanted to research say this aspect why not test Adrenalin levels.

There is always an opportunity cost in researching one direction it means others don't get done (given the limited pool of money) so a filter should be applied as to whether this is likely to work.

Then you need to look at how to test and verify. Crawley fails here in that her trial would likely measure biases.

There is a point that conceptually there is some sort of inspiration, intuition about what theory to put together and that is a critical step in any scientific process (but not a formal methodological step).

 

[Indigophoton]

@Adrian, yes, I agree that testing LP was never really feasible given that, apart from anything else, it demands patients stop 'doing' ME and blames the patient for negative thinking if they don't get better, and, even more perniciously, requires a signature at the start saying that the participant has complete confidence in the LP. No signature, no 'treatment'.

It was reasonable to consider whether LP could be tested, because of the number of people claiming success with it. Just baffling that, having considered it, they didn't see the problem with actually doing research on it.

There is a point that conceptually there is some sort of inspiration, intuition about what theory to put together and that is a critical step in any scientific process

The best step! (Theoretical physicist here ) OK, when theory and results agree, that's a very good moment too

Theory and experiment may or may not keep step with each other; a good theory gives new things to try, and good data prompts new ideas.

If nothing else, the BPS lobby have amassed a large body of results that, read correctly (where they can be read at all), show that their hypotheses are wrong. If ME were psychological, they'd have proved it by now.