Wessely gets touchy feely

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alex3619 said:
I think it was Peter White who made the claim that objective measures are not that important, if I recall correctly. He was defending using subjective outcomes in PACE.
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"in the later stages of treatment patients are encouraged to increase their activity (which must ultimately be the aim of any treatment)"

Wessely, David, Butler, & Chalder – 1990

For once I, and probably every patient, agree with Wessely, et al: Increase in overall activity capacity must be the primary goal of any non-palliative treatment. (The primary goal of palliative treatments is the reduction of discomfort and distress.)

It is a goal that also just happens to be definitely suitable to objective outcome measures, ranging from direct physical measures such as actometers, to more indirect measures such as employment levels.

Which is why the psychs, including Wessely, are now running a million miles from objective outcome measures.
 
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Sean said:
It is a goal that also just happens to be definitely suitable to objective outcome measures, ranging from direct physical such as actometers, to more indirect measures such as employment levels.

Which why the psychs, including Wessely, are now running a million miles from objective outcome measures.
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That is my current interpretation. They have moved away from objective outcome measures when they found that all of them reliably discredit their conclusions.
 
Jonathan Edwards said:
A shortish trick cyclist named Simon
Claimed that his chums all loved rhymin'
Too bad his own prose
Just gets up your nose
Like those dreadful never-ending repetitive piano tunes by Michael Nyman
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A poetic celebration of Sir Simon, Regius Professor at King’s College London, who thinks with his soul and feels with his mind!

There was a professor at King’s
who thought of the matter of things.
He noticed his mind
was nowhere to find;
the soul much more clarity brings!
 
Doctors who feel with their mind and think with their soul
Should really crawl back in their endarkenment hole.
On why they have fingers
The question still lingers
As they search after some useful role.
 
The ballad of Trofim Lysenko, or how things went badly wrong for Soviet science

There was a young chap called Wessenko
Who was eager and willing to please
Feeling political pressure he began to manipulate peas
But peasants were easy and peas were too tough
Getting them back on the land would be enough.

His master's were pleased, he rose to the top
His concepts were crap he cared not a jot
Millions were hurt but he reigned supreme
Science had lost yet again.

I am Prostetnic Vogon Jeltz
 
I expect Wessely probably was pretty smart at Uni. Lots of these apparent idiots are probably technically intelligent. It just goes to show its all about training and standards. A smart person who enters a field with low quality standards will probably just absorb those standards and produce work in accordance with them.

It does surprise me that doctors - who mostly had to do well at school to get into medicine - can be so poor at actually thinking. Its not the raw capacity, its the culture and the way they are trained.
 
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Woolie said:
I expect Wessely probably was pretty smart at Uni. Lots of these apparent idiots are probabl technically intelligent. It just goes to show its all about training and standards. A smart person who enters a field with low quality standards will probably just absorb those standards and produce work in accordance with them.

It does surprise me that doctors - who mostly had to do well at school to get into medicine - can be so poor at actually thinking. Its not the raw capacity, its the culture and the way they are trained.
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There may also be an aspect to it that historically illnesses that are not understood are viciously psychologized (if we cannot find out what's wrong, then the patient's thinking, feeling, or behaviour must somehow be causing the symptoms or an incorrect perception of illness).

Psychiatry is given these patients and expected to somehow fix or at least help these patients. They're given a problem that is impossible to solve with the skills and tools they have. Much confusion also seems to result from a failure to distinguish between treatment of a disease and nonspecific interventions that would make many feel better (like massage, a good social network, good eating, etc). Even if we ignore the issue of nonspecific treatment effects, it's still incorrect the assume that a response to these interventions is suggestive of a psychosocial etiology of illness. Such an assumption could then lead to a situation where researchers, citing previous modest results with nonspecific interventions, continue to try and understand and solve the illness from a psychosocial angle, with the end result being a lack of meaningful progress.
 
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Woolie said:
It does surprise me that doctors - who mostly had to do well at school to get into medicine - can be so poor at actually thinking.
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They are best at thinking inside the box, at reproducing known methods and results.

But not so much at thinking outside it, which is what is required for original insightful productive research.

Doctors, who largely come from the top percent or two of school students, don't generally make good researchers. Different skill and mind sets. Clinicians have to apply known knowledge, and they are mostly very good at it, and we should be grateful for that.

But when faced with serious unknowns, they are not so good, including not so good at admitting it. That is where the research skill and mind sets need to come into play.

Quite rare for both to exist in one person to a high degree.
 
Barry said:
When the pressure is on to use real objective outcome measures, they start spouting (as I've seen somewhere in the recent past) stuff that suggests objective measures are overrated anyway.

It's like stepping back 500 years.
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Funny, that was exactly I thought of.... :D

There used to be similar fights between the church and...anyone else who dared to contradict them :)
 
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