Watt from MRC defends PACE in letter to Times

On thinking, I don't think Watt's reference to Cochrane can have had anything to do with my comment,other than perhaps as a memory jogging. It would be an extraordinarily risky tactic.

Cochrane has become a fairly standard defense from the PACE team which is one of the reasons I think they (or probably the SMC) wrote at least a draft of that letter.
 
In addition to the CBT & GET ones, there's this too: 'Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome'
yeah, I saw that. but she seemed to be talking about CBT/GET, so I'm going to assume the 2004 first version of the exercise review is what it's supposed to be referring to. but it's pretty unclear so that's really just a guess.
 
yeah, I saw that. but she seemed to be talking about CBT/GET, so I'm going to assume the 2004 first version of the exercise review is what it's supposed to be referring to. but it's pretty unclear so that's really just a guess.

Seems weird to say 'three reviews' if she means the current CBT and GET ones, and then one of the earlier versions of either. Also seems weird to refer to the Chinese medicine one, or the IPD one (the published protocol or the unpublished review). Whatever she's referring to, it's weird.
 
Thought I’d paste the letter here for those who don’t want to / are unable to click through to Twitter:

FATIGUE SYNDROME
Sir, Professor Fiona Watt (letter, Aug 27), the executive chairwoman of the Medical Research Council, defends the much-criticised Pace trial that continues to dominate medical treatment for patients with ME/chronic fatigue syndrome. She is confusing well-founded constructive criticism from clinicians, researchers and people with ME/CFS about the Pace trial with hostility to the research community.

We all want to see good-quality research that will improve our understanding of the underlying cause of ME/CFS along with robust clinical trials that will objectively assess the safety and efficacy of potential treatments. However, in my experience the Pace trial did not do this. Consequently the 250,000 people with this devastating chronic illness continue to have inappropriate management of their condition and suffer the inevitable consequences.
Neil Riley

Chairman, ME Association
 
I actually think the letter is typically inoffensive and non boat rocking. It might achieve what they wanted to get out there but ...

It kindly allows Fiona to be confusing rather than conveniently conflating ideas of hostility and legitimate criticism. maybe that’s fair enough.

It says in his experience PACE isn’t such and such, well one mans experience is neither here nor there, far better to save characters for something useful and say it as fact.

It to me, leaves it open that PACE is a reasonable treatment but a poor trial whereas it’s all rotten , theory, practise , studies, cost to tax payer

Says “we’d like to see” good research rather than demanding or calling for MRC to step up, that’s along with the physician led services MEA “would like to see” , decent severe care they’ve been wanting to see for years.

“Inevitable consequences” isn’t going to be understood by the public as “harm, disability, waste of life” so saying that is better

No mention of scandalous waste of resources and imbalance in MRC funding

A rare chance to publicly engage with MRC seems more like afraid to bite the hand that feeds it, as did Chris pointing twitter response.
 

I’m sure some people would have liked them to say more. But a letter to a newspaper needs to get published before it is seen as good in my mind. It is easy to write one that is too long or doesn’t run smoothly.

The fact that at least two other letters went in should probably have helped it so thanks to those who wrote in like @JohnTheJack and @Robert 1973.
 
It says in his experience PACE isn’t such and such, well one mans experience is neither here nor there, far better to save characters for something useful and say it as fact.

I thought the 'in my experience' bit was odd too, but I think it's probably wise to present Watt as confused rather than cynically manipulative. It wouldn't surprise me if she was being cynically manipulated by others.
 
It seems a non story about women being bullied. Men get bullied in science too, and recently the main bully was a woman. It is a dog eat dog business full of bad interpersonal relations but what's new?

The real problem is patronage and pecking order, which MRC have always had a problem with. Defending the PACE authors seems to me more like her male colleagues defending their own against troublemaking minions. All rather two legs good four legs bad.
 
It’s disappointing when people only perceive the negative effects of the establishment through public organisations in so far as it affects them, in this case as an employee, and can’t see the negative impact on those the public organisations are supposed to serve. For me a key part of being a decent public servant in any profession is to be able to put yourself in someone’s shoes.
 
Cochrane has become a fairly standard defense from the PACE team which is one of the reasons I think they (or probably the SMC) wrote at least a draft of that letter.

Nearly without fail, physicians quote Cochrane as the source for their support of CBT/GET. It seems to be the gold standard for evidence-based medicine. The fact that Cochrane miscategorized ME in mental health and completely ignores the body of evidence while referencing a paper on Chinese herbal medicine is just scandalous.

A lot of people have f*cked up massively in this but few have such impact as Cochrane as far as implementing the psychosocial BS. I doubt that the fact that it is based in London is coincidence. I don't think Cochrane actually did their work in good faith, it is just awful and non-professional.

What does that say about everything else they publish? Depending on how things unfold in the future, this should have a massively negative impact on their reputation, but accountability seems to be the exception rather than the norm in medicine. Reputation above ethics.
 
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