Watt from MRC defends PACE in letter to Times

THE MRC WROTE
Activities have included a dedicated funding call – Understanding the mechanisms of CFS/ME – in 2011. We want to encourage a broad range of scientists, some of whom are wary of this controversial area, to apply to us for funding. At present, response-mode applications are encouraged through a cross-board highlight notice to undertake innovative research into the mechanisms underlying the chronic changes associated with CFS/ME, particularly in relation to immune regulation, pain, different symptom profiles, childhood CFS/ME and neurological inflammation.


Well that is fascinatiing- per their data.

I. 2010-11 the MRC spent £nil on CFS research ditto £nil in the following year.
2. In 2012-3 £504k, in 2013-4 £602k, in £2014-5 £652k.
3. In 2015-6 £287k and £286 in 2016-7.

if as the MRC estimates 0.2 to 0.4 percent of the population suffers from CFS then why is only 0.045% of their budget allocated to it in 2016-7?

it's most definitely a unloved cinderella.

Watt should be challenged on that ground alone. Disengenuous drivel.

 

As I understood it the problem with the 'controls' in PACE is that they are not equivalent in the sense that they should match/mimic all reasonable contextual influences not specific to the test. In other words a placebo control for a strawberry flavoured pink pill should not be a tasteless brown capsule. Standard medical care was pretty tasteless and brown.

 

I think that is just a lazy way of saying 641, or maybe they think it's catchier?!

 

Wasn't it more akin to inaccessible rather than lost?

 

or...it might mean that the trial data was stored in a box, on a shelf, above the trial participants. It's difficult to know what they mean when such precise language is used.

 

This is explained in a bit more detail a couple of pages later (in the third paragraph of page 137). The CBT and GET groups were offered many more appointments with their respective therapists than the people in the control groups were. This greater regularity of contact would have biased the trial results in favour of CBT and GET. In a well-designed trial patients in all the treatment arms would have had identical amounts of contact with their specialists.

 

They can't say 641 because one person withdrew consent and insisted their data was destroyed.

 

I picked up on this a good while back, but I think that may have been in the context of recruitment. Yes, I agree you are right, they do only have data for 640.

 

And Fiona Watts?

And Wessely, it might give him some food for thought for the next edition of his book "Clinical Trials in Psychiatry".

 

Starting at slide 25, Sensky's entire slide presentation from 2004 is here:

There are 24 slides that precede his presentation - not sure I understand their context.

 

I used to say that the recovery paper did not report any approval by any oversight committees. More recently I've simply stated it as a declarative. If they had approval, they would have cited it. Absent mention of oversight committee approval, as far as I'm concerned it means they didn't get it. They have never contradicted that point. They have been careful to point out that the new primary outcome was approved but have never made that claim about the new recovery definition, as far as I've seen.

 

In fact she withdrew consent after finishing the study when she found out the PACE authors had links with disability insurance companies. she was very angry not to have been told about these conflicts of interests. they tried to convince her to let them use her data but she refused. I don't know if her information was destroyed, but it was not used in the analysis.

 

Who is over-seeing this?(ie monitoring that there is no tampering).
And, as others have pointed out, given that QMUL said not so long ago that no-one could access the data because Peter White had left, who is in overall 'control', or have they pulled him out of retirement?

 

Unsupported assertion (thesis or topic sentence)

Arguing from authority/process /tradition

Argument from process/authority/tradition

Bandwagon/tradition/process/authority

Irrelevant. (Also undemonstrated assertion.)

Ad hominem

It’s all just assuming that processes/traditions work without bothering to check into what’s being said, then slamming critics for pointing out that the process/traditions can’t be assumed to be going right.

 

Action for ME have now issued a statement: https://www.actionforme.org.uk/news/pace-trial-and-behavioural-treatments-for-me/

[Thread: https://www.s4me.info/threads/actio...l-treatments-for-m-e-position-statement.5532/]

 

Is this a downright falsehood? I have read many though not all the the GET/CBT studies, but my understanding is that they all use the same flawed methodology of subjective outcomes in unblinded trials. If any objective measures were used, they are either quietly dropped from the reporting or show null results. Most also use the problematic Oxford criteria and a surprising number engage in unethical practises such as outcome switching.

Presumably we need Prof Watt to cite the studies she is referring to over and above Cochrane, or do we just assume that she is uncritically accepting the Cochrane review and overgeneralising from there?