Special Report - Online activists are silencing us, scientists say Reuters March 2019

Perhaps the retreat to treating quiescent and appreciative cancer patients, rather than cantankerous and contumacious ME patients, has been a long established trope within the BPS world and the intended retirement is only loosely associated with alleged intimidation. This was Wessely in the Forward to Sharpe's Biopsychosocial Medicine-an integrated approach to understanding illness. I have copied the minimum necessary to
make the point
upload_2019-3-23_17-15-1.png


[ATTed ACH=full]6530[/ATTACH]

This was in 2005 and was based on yet another conference with Novartis associations, this time in cooperation with One Health. It must be considered surprising that with over 15 years experience of the problems so little understanding was shown.

There is another point regarding the claims of being driven out of the field and their possible artificiality. Rereading the Kelland article one might form the view that it is in two parts. There is a reasonably serious attempt at an article with which one may disagree and which may be seen as polemical. But as an introduction to that are the eye catching claims about abuse and intimidation and the naming of alleged culprits. That might be seen as a tabloid approach. If you are going to do that you have to make sure that the evidence supports the claims. Here the evidence not only does not, but the claims appear to be non-compliant with Reuters own regulations for accuracy and freedom from bias. The whole piece falls apart at the second paragraph and there is no need to go further.
 
And to show his appreciation of high-quality science, our friend Mike has re-tweeted this today
Screen Shot 2019-03-24 at 22.04.52.png
Link to tweet for anybody not blocked by him
Code:
https://twitter.com/RecoveryNor/status/1109449543802863616

Of course Recovery Norge is the pseudo-patient group in Norway that exists to promote LP.
 
There was some junk science that led to people believing MMR vaccines cause autism. More rigorous research undermined these claims. A small group of campaigners then went on to try to use that specially selected anecdotes show that MMR really does cause autism.

Wonder what made me think of that?
 
Last edited:
I thought I'd go back through this and make a few notes on this article. That Larun stuff towards the end is particularly insufferable. Just to be clear, Cochrane's own report found every part of Courtney's complaint about Larun's review to be valid: http://www.virology.ws/2019/03/12/trial-by-error-cochranes-report-on-courtneys-complaint/ Larun had dismissed his concerns without any real engagement with the points he raised before his death. And she feels that she has been badly treated?

I should also link to the open letter raising concern about the PACE trial, signed by many more scientists than seem willing to try to defend this seriously flawed piece of work: http://www.virology.ws/2018/08/13/trial-by-error-open-letter-to-the-lancet-version-3-0/

There's also the two Wilshire & co papers releasing results for the PACE trial's prespecified outcomes:
https://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1259724?journalCode=rftg20

https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0218-3

All of the substantive science and criticism was ignored by Kelland, who just tried to focus only on tone and create a misleading narrative of 'activists' vs 'scientists'.


Eight years after he published results of a clinical trial that found some patients with chronic fatigue syndrome can get a little better with the right talking and exercise therapies

That's rather more cautious and vague than Kelland has been previously:

"It found that CBT, where a health professional helps patients understand and change the way they respond to symptoms, and GET, a personalized, gradually increasing exercise program, helped around 60 percent of CFS patients improve."

https://www.reuters.com/article/us-health-fatigue-treatment-idUSKBN0KN00920150114

Watton and Mayer have never been treated by Sharpe for their chronic fatigue syndrome, a little-understood condition that can bring crushing tiredness and pain. Nor have they met him, they told Reuters. They object to his work, they said, because they think it suggests their illness is psychological.

To be fair to Kelland she does use specific examples, name them, and has spoken to them and this is better than you get from most coverage like this. However I've seen Watton say that Kelland misrepresented his views and Mayer described her piece as a hatchet job. It would be ridiculous to object to PACE because "they think it suggests their illness is psychological", but we don't have quotes from them indicating that this is what led to their concerns.

Sharpe is one of around a dozen researchers in this field worldwide who are on the receiving end of a campaign to discredit their work. For many scientists, it’s a new normal: From climate change to vaccines, activism and science are fighting it out online. Social media platforms are supercharging the battle.

There is the matter of how solid the underlying science is - is that an issue? Or is it just people challenging the work of some scientists that's the problem?

Reuters contacted a dozen professors, doctors and researchers with experience of analyzing or testing potential treatments for chronic fatigue syndrome. All said they had been the target of online harassment because activists objected to their findings.

Were these researchers chosen as a random sample to give an accurate understanding of how widespread this problem is? Any chance researchers like Fluge and Mella were in there? Wilshire for the PACE analysis work? Why do I suspect that the dozen of people contacted were quite carefully selected?

Only two had definite plans to continue researching treatments. With as many as 17 million people worldwide suffering this disabling illness, scientific research into possible therapies should be growing, these experts said, not dwindling. What concerns them most, they said, is that patients could lose out if treatment research stalls.

How noble.

No cause has been identified, no formal diagnosis established and no cure developed.

The BMJ claimed PACE found a cure for just under a third of patients. A number of researchers claim that patients should be provided with explanations of their symptoms as a part of their treatment. How can this be? Will Kelland go on to investigate the ethical issues surrounding this bewildering paradox?!

Many researchers cite evidence that talking therapies and behavioral approaches can help in some cases. Yet some patients and their advocates say this amounts to a suggestion that the syndrome might be a mental illness or psychosomatic, a notion that enrages them.

What "evidence that talking therapies and behavioral approaches can help in some cases"? Is it solid? Did Reuters check?

Some patients and their advocates? I suppose that there are some idiots in every group. Amongst those raising concerns about the PACE trial it's the serious problems with the trial's design, execution and presentation of results that is relentlessly explained to be the central problem. Unfortunately, some journalists like to ignore these important issues.

At the PACE information tribunal Mr Matthees laid out his reasons for concern about the PACE trial, persuading the tribunal to rule against the PACE trial researchers and order the release of some PACE trial data. Here's what the ruling said about the reasons he provided:

"Mr Matthees' concerns relate to the methodology of the PACE trial, in particular that the criteria for 'recovery' following treatment are inappropriately defined or altered."


"Public Interest in Disclosure


  1. Concern expressed by academics, clinicians and scientists about the analysis and reporting in the PACE trial. Pp91-97/B7 and pp102-105 highlight scientific criticisms of PACE trial.
  2. Scientific importance of pre-publishing and adhering to trial protocols and then reporting on pre-specified outcomes to prevent post-hoc revisions and potential biases.
  3. Failure by QMUL to acknowledge or address criticisms.
  4. PACE trial researchers are causing distress and harm to patients by exaggerating their trial results.
  5. Researchers are more likely to suffer reputational damage by their continued refusal to address criticisms and allow disclosure.
  6. 12,000 people have signed a petition calling for the retraction of questionable claims and disclosure of the data.
  7. Increasing trends of transparency and open data in the research community, especially when that research is publicly funded.

  8. All concerns of commercial interest and confidentiality are surmountable."
http://www.informationtribunal.gov.uk/DBFiles/Decision/i1854/Queen Mary University of London EA-2015-0269 (12-8-16).PDF

Notice the absence of "OMG they say I'm a mental - makes me so enraged! Garble-farble!"

Which 'advocates' do say this? Anyone that is respected by other patients, or just some lone tweeter? Kelland provides no quotes or specific examples here. If she did find a couple of idiots, why has she chosen to focus upon them?

Many researchers cite evidence that talking therapies and behavioral approaches can help in some cases. Yet some patients and their advocates say this amounts to a suggestion that the syndrome might be a mental illness or psychosomatic, a notion that enrages them. They would prefer that research efforts focus on identifying a biological cause or diagnosis.

One of those leading the campaign against research into psychological therapies for CFS/ME is David Tuller, a former journalist with a doctor of public health degree from University of California, Berkeley.

I think that many readers would take that as a claim that Tuller is enraged by "evidence that talking therapies and behavioral approaches can help in some cases" as "this amounts to a suggestion that the syndrome might be a mental illness or psychosomatic".

Furthermore, who says that Tuller is "leading the campaign against research into psychological therapies for CFS/ME"? He's pointing out and raising concerns about a number of poorly designed research projects, and a number of researchers with a history of making misleading claims. Why is that seen as "leading the campaign against research into psychological therapies for CFS/ME"?

Tuller refers to researchers who explore and test treatments for CFS/ME that feature a psychological element as “insane” and a “cabal” suffering from “mass delusion.” They are bent on pursuing “bogus and really terrible research,” he told Reuters.

It's not fair to imply that Tuller refers to all researchers 'who explore and test treatments for CFS/ME that feature a psychological element' in that way. He has made specific criticisms of a number of researchers and their work and also spoken dismissively of those who try to ignore important and robust criticisms of research, and those who continue to try to promoted CBT and GET as evidence based treatments for ME/CFS. It probably would be useful if Tuller was always perfectly precise with his language when he speaks of this group, but it can be difficult when the researchers whose work warrents criticism often use language in misleading ways themselves. Using language like "insane" was never going to be helpful.

Of more than 20 leading research groups who were publishing treatment studies in high-quality journals 10 years ago, Sharpe said, only one or two continue to do so.

Were these groups doing high quality work? The way Kelland relentlessly ignores the need to engage in a meaningful assessment of the science is pretty rediculous.

There's too much annoying fluff in here to respond to piece by piece so I'm skipping over a lot.

Recent tweets directed at Wessely include one accusing him of playing “pathetic ego driven games” with the lives of people with CFS/ME, another saying “Wessely is a dangerous and evil individual” and another saying “We die, b/c of u.”

They went back to 20th March 2017 for this recent one - which didn't even @ Wessely so I'm not sure how 'directed at' him it is:



I'm not sure I see much point in quibbling over things like that though seeing as some people on twitter seem to have decided Kelland's piece is a great reason to send abusive messages to researchers. From a look at twitter it seems that these sorts of messages, and far worse, are unfortunately normal - I don't think that Trump being sent unpleasant messages on twitter undermines the need for journalists to critically examine his claims or work though.

Wessely’s employers at King’s College London have taken advice on the potential risk and have instituted X-ray scans of his mail, he says. “Everything I say and do in public, and sometimes even in private, is pored over and scrutinized,” he said.

There's never been a mention of Wessely having been sent anything dangerous, but here it seems that people scrutinising his comments and actions is presented as part of some threatening or abusive campaign. Is scrutiny of public figures now a bad thing? The Prime Minister's mail is scanned and their statements examined too. Should journalists stop examining May's speeches?

Fink said he and the organizers of a conference he addressed at Columbia University in New York in October 2018 were hounded by complaints and protests from CFS/ME activists. A petition calling for Fink to be disinvited was signed by 10,000 people. Tuller – who in his blog wrote that the person who invited Per Fink to speak at the conference must be “uninformed or stupid or both” – called Fink a “scary guy” whose methods had “destroyed families.” Tuller urged readers of his blog to go to the Columbia conference and demonstrate.

A number of people had raised concern that protesting against Fink in this way, rather than (for example) calling for the a debate section where he could attempt to defend his views, was likely to do more harm than good and I think that some criticism of him has been less careful than it should have been.

Tuller did include this section in his blog on Fink, so it's difficult to present him as fighting to "silence" Fink:

"(I am personally uncomfortable with uninviting people—even horrible people—once they have been invited to talk somewhere. But I understand why others feel differently. Fink is not just giving a speech. In this case, conference attendees can receive continuing medical education credits, which they need to maintain their professional standing. Fink will undoubtedly be offering harmful and unscientific advice to clinicians unaware of his background. So I am sympathetic to the request to remove him from the schedule, despite my own overall uneasiness about such a strategy.)"

Generally, presenting Tuller as a part of any attempt to "silence" researchers seems absurd when he has tried so hard to get them to engage in meaningful debate. He has repeatedly offered those he criticises the right to reply with whatever they they want, to be placed unedited along-side his own work.

Most researchers say they are happy to engage in discussion.

Who said that? Where are they happy to engage in discussion? Why have so many of them failed to respond to so many important criticisms of their work?

To be continued...!
 
Last edited:
Originally the piece claimed that:

Tuller has also posted a 15,000 word review of it via the website of a Berkeley colleague.

This was not true - Tuller piece was hosted by Professor Racaniello of Columbia University. This was then changed to:

Tuller has also posted a 15,000 word review of it.

They didn't want any info in there that might not imply something negative about Tuller!

Their note says: "(This March 13 story edits 31st paragraph to remove reference to website)". They fail to say why they removed reference to a website or note that they removed an inaccurate claim.


The campaign to have evidence-backed treatments discredited was “doing a terrible disservice to sufferers from this condition,” said Wessely. “Patients are the losers here.”

At the heart of the attacks on Sharpe, Wessely and other chronic fatigue treatment researchers is a study known as the PACE trial, which sought to evaluate the effectiveness of different types of therapy in CFS/ME patients.

Is this Reuter's claiming that there's a "campaign to have evidence-backed treatments discredited"? Criticism of PACE is at the heart of this campaign?

Richard Horton, the editor of The Lancet, said his journal had received emails and letters about PACE but has no plans to retract it. He said what is needed to allow for progress in any field of medical research is “an open and respectful approach by all parties to one another.”

Is this the same Horton who refused to publish the letter from academics that he had requested they send?

Tuller himself hasn’t conducted or published any peer-reviewed clinical trials on CFS/ME. He has co-authored a critique of PACE.

Was the critique peer-reviewed?

His argument is that the therapies evaluated in the PACE trial are based on a misguided hypothesis that CFS/ME patients suffer from “unhelpful” beliefs that they have a biological disease, and that their symptoms of fatigue are made worse by deconditioning due to inactivity. He also says he thinks the trial’s methodology was flawed. The scientists involved reject those arguments.

Describing the model underlying CBT is not an argument. The central problems with PACE are with the methodology - that's not an aside to be added at the end. This does show how even mentioning the problems with the underlying model for CBT/GET can be used to distract from and dismiss the real reasons for concern with PACE. It doesn't matter what model they used for their treatments - if the methods remained the same it still would have been junk-science, and presenting these underlying models as the central reason for criticism of PACE really misses the point. I guess it's useful to trying to dismiss PACE criticism as being motivated a a fear of the stigma of mental health though.

He said his work is helping patients by “clearing out the bad science to make way for some good science,” such as research into the condition’s biological basis.

I wonder what Tuller actually said that was paraphrased as "such as research into the condition’s biological basis"? Kelland seems to be keen to present everything in psychological vs biological terms.

Another campaign, which goes by the acronym MAIMES, or Medical Abuse in ME Sufferers, operates from Britain. It has a standard letter for people to send to their local member of parliament demanding a public inquiry into the PACE trial. There’s also a Facebook page called “Abuse of ME Patients by Health Care Professionals” which has some 680 followers. The page runs stories from unnamed patients who accuse Sharpe and others of harming sufferers by calling them “lazy” and forcing them to exercise when they can’t.

The campaigner and doctor behind MAIMES, Sarah Myhill, has posted YouTube videos setting out her views: “I liken it to child abuse,” she says in one that has been viewed more than 8,000 times. “This amounts to a form of abuse, because these people” – CFS/ME patients – “do not have the energy to defend themselves.” Myhill has published several books advocating what she calls a “naturopath’s” approach to treating symptoms of CFS/ME – one using a tailored combination of nutrition, rest and medicines. She hasn’t published peer-reviewed research on the efficacy of her approach.

Myhill told Reuters that she had complained to the General Medical Council – the body that maintains the official register of medical practitioners in the UK – about Sharpe and other scientists involved in the PACE trial, but her complaint was rejected. Myhill showed Reuters the letter she received from the General Medical Council. It said it was “not able to identify any issues which would require us to open an investigation” into the researchers. Contacted by Reuters, the Council did not elaborate.

It's not a surprise that Myhill's involvement with ME/CFS is not helpful. Reuters decided to focus on her campaign as it has 680 followers on facebook? Most of my old school friends seem to have more connections that that.

As well as dissuading researchers from working in the CFS/ME field, scientists fear that pressure from campaigners has also begun to show in the wording of guidance for patients and doctors from national health authorities.

Throughout the piece this presentation of a unified view of 'scientists' is such a cheap propaganda trick. Never any mention of the scientists concerned by PACE and pleased the CDC updated their advice.

Publishers, too, are feeling the heat. In a move described as “disproportionate and poorly justified” by the researchers involved, editors of the Cochrane Reviews science journals said in October that they would be temporarily withdrawing a review that analyzed evidence from eight studies on exercise therapy for CFS/ME patients.

How is that a sign that publishers are "feeling the heat"? Has Kelland examined the Larun review and found that Courtney's complaints about it were unfounded?

Tuller told Reuters in emails in October that he considered the Cochrane Review to be “fraught with bias” and said its authors have bought into “delusions that these studies (the ones they reviewed) represent good science.” After hearing news of the review’s temporary withdrawal, Tuller said he’d had a “long meeting” with Cochrane editors in Britain last summer, and had “pressed them hard.” “So did others,” he said.

I think language like "delusions" is a mistake when talking about this work. Does 'pressed them hard' just mean 'explained the problems with their work'? Any sort of threat of physical violence? Or just pointing out the clear problems Courtney had already explained but that Kelland seems keen to ignore?

Cochrane’s editor in chief, David Tovey, confirmed that he had met with Tuller, but said the meeting had nothing to do with his decision to temporarily withdraw the review. He said complaints about the review from patients and campaigners had raised “important questions” about how the review was conducted and reported which he and his fellow editors felt needed to be addressed.

What were these important questions - did Kelland have any interest in finding out and then informing readers? Seems not.

Lillebeth Larun, a scientist at the Norwegian Institute of Public Health who led the Cochrane Review, is one of several scientists who vociferously disagreed with Tovey’s decision to withdraw it. For her, the move is a sign that the activists who have plagued her for years have now got to her editors. In the decade or so that she’s been conducting research in this area, she told Reuters, she’s endured online attacks and abusive emails, and at various points had to take a break from working due to the pressure. Returning to a CFS/ME project would make her feel physically sick with anxiety.

What on-line attacks? People pointing out that the problems with her work and the shameful way she dismissed Courtney's careful attempts to explain the problems to her?

“Attempts to limit, undermine or manipulate evidence based results, pressure or intimidate researchers into or away from any given conclusions, will ultimately have a negative effect,” she told Reuters. “It will only lead to those researchers choosing to work in other areas and reduce the resources dedicated to providing the help patients so desperately need.”

From Larun, after her failure to correct such indisputable problems with her own work, this is ridiculous.

Speaking by phone, Watton said he has been ill with CFS/ME and unable to work in his former job as a builder for 15 years, and feels let down by the medical establishment. Reuters was unable to independently verify his account.

How did Reuters try to verify his account? Did they independently verify every other claim made in this article? Wessely had claimed: "Everything I say and do in public, and sometimes even in private, is pored over and scrutinized" - did Reuters independently verify this?

Colin Barton, chairman of the Sussex and Kent CFS/ME Society – a patient group in southern England – said talking therapies and graded exercise helped him recover to the point that he can lead an almost normal life. He told Reuters that in his experience, patients who talk about having been helped by psychological or graded exercise therapies come in for abuse just like the researchers. They face accusations that they were never ill in the first place; that their condition was misdiagnosed; and that their recovery is therefore fake, he said. As a result, he said, many recovering or recovered CFS/ME patients feel forced to withdraw from the debate.

Colin Barton gets plenty of criticism, but that's for the poor quality of his arguments and misleading claims promoted from a charity that seems to lack any democratic oversight from members - that he has an astrologer as a trustee of his charity doesn't inspire confidence in his commitment to rigorous research either. As far as I was aware no-one knew he'd recovered, or what he thought had helped lead to recovery.

edit: There's almost no discussion of the science in this article, which is obviously rather peculiar, and means that there's not much science that needs to be referred to in any response. Figures from one research paper were used, but they were slightly misrepresented by Kelland:

"In Britain there are at least 50 specialist chronic fatigue syndrome services that treat around 8,000 adults each year under government guidelines, offering behavioral and psychological therapies. Research published in July 2017 showed around a third of adults affected by the illness who attended these specialist clinics reported substantial improvement in their health."

Kelland says "around a third of adults affected by the illness who attended these specialist clinics reported substantial improvement" rather than "around a third of those adults who attended these clinics and then went on to complete follow-up questionnaires reported substantial improvement". That the previous sentence says services "treat around 8,000 adults each year" emphasises that her "around a third" should apply to all those who attended these services imo.

There's some discussion of the paper Kelland is referring to in this thread: https://www.s4me.info/threads/the-i...e-abuse-is-halting-research.8780/#post-155149
 
Last edited:
That this piece is so weak on substance, and yet so confidently one-sided... could this be a sign that Kelland has been told Cochrane is going to help cover-up problems with PACE, Larun's review, etc? The comments from Tovey in the piece don't really indicate that, but surely she must think that there's something of weight coming to support her framing of things? Maybe she just knows that being wrong in support of the Establishment does not hurt the career of a UK journalist?
 
Last edited:
I think it's instructive to look at what the author chose to quote from what David T said or has written:
(not sure if anyone has mentioned this yet - there's been a lot to sift through lately.)

“insane”
“cabal”
“mass delusion.”
“bogus and really terrible research,”
“uninformed or stupid or both”
“scary guy”
“destroyed families.”
“debunk”
“a piece of crap”
“garbage”
“I refuse to act in the normal bounds of academia.”
“no other personal stake.”
“clearing out the bad science to make way for some good science,”
“fraught with bias”
“delusions that these studies (the ones they reviewed) represent good science.”
“long meeting”
“pressed them hard.” “So did others,”

Pretty transparent effort in my view to make DT sound like an insane person while neglecting the substance of his criticisms.
 
As far as I was aware no-one knew he'd recovered

if he has recovered then its a recent thing:
"25 Aug 2017 - In the studio now is Colin Barton who is chairman of the Sussex and Kent M.E. Society and lives with the condition."

quote is from an article on MEA website, which appears to be inaccessible at the moment.

eta: or maybe he recovered from his 'current episode' of CFS that White explained was what they considered recovery?
 
Last edited:
And to show his appreciation of high-quality science, our friend Mike has re-tweeted this today
View attachment 6549
Link to tweet for anybody not blocked by him
Code:
https://twitter.com/RecoveryNor/status/1109449543802863616

Of course Recovery Norge is the pseudo-patient group in Norway that exists to promote LP.
If what this patient says is correct and they were diagnosed with a new onset EBV, what is known as glandular fever in the UK or mononucleosis in the USA, this can be very severe in adults and cause a post viral fatigue sydrome lasting several months. When or if this transitions into ME/CFS is, to some extent, a matter of opinion, however the long term prognosis in this subgroup is relatively good.

As one of the replies to his tweet says, if value is given to this anecdote then equal credence should be given to those who have been made worse by BPS therapies, like the hundreds who've reported harm in patient surveys of graded exercise therapy. I suppose as this patient was apparently held to meet criteria for inclusion in the Rituximab study, MS couldn't resist twitching, it felt too good, so he dropped his usual standards for criticism against himself of requiring peer review and scientific replication.
 
Last edited:
Have you seen the whole original tweets about which Reuters were complaining? this does not appear to be serious journalism.
I didn't but I don't think you need to see anything other than Paul's tweet to know that it was not abusive or threatening or anything of the kind.

Edit: But I'm not sure I understand what you mean by the whole original tweets. You mean, did I know Paul was responding to a tweet of Sharpe's? Yes.
 
Last edited:
Colin Barton, chairman of the Sussex and Kent CFS/ME Society – a patient group in southern England – said talking therapies and graded exercise helped him recover to the point that he can lead an almost normal life.

changed his tune for this article somewhato_O

RESEARCHERS at Sussex University are leading the way in studying ME or Chronic fatigue syndrome and Fibromyalgia by investigating the post-exertional malaise that is a key marker of the illnesses and also looking at the mechanisms of chronic pain and fatigue.
Colin Barton, chairman of the Sussex ME Society said: “We are very pleased to be assisting with these important studies that should increase biomedical understanding of these potentially life ruining illnesses.”
https://www.gscene.com/news/me-taken-very-seriously/
 
Claire Fox, the tweeter from earlier in this thread:



I have never heard an English teacher say more "y'know"s, "Kind of"s, "like"s and other irritating and unnecessary fillers. Worse than any student I've ever had.

Espousing her interesting views on generation snowflake.
 
Back
Top Bottom