Tom Kindlon
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My new 1000-word BMJ rapid response (i.e. e-letter) on the £5m PACE Trial, "PACE Trial: Simply giving a reason why an outcome measure was changed is not necessarily sufficient".
It lists all sorts of reasons why I'm unhappy with the changes made to the PACE Trial outcome measures.
I'm afraid I knew it would be too long to get published, so didn't spend as much time on the wording as other letters where I'm hoping they might be published in the print edition.
http://www.bmj.com/content/347/bmj.f5963?tab=responses
Sean Lynch, a psychiatrist, has now responded, approx. 24 hours after my comment went up. Authors get automatic alerts for responses - I wonder whether there might be a connection?
His defence of the changes to the PACE Trial protocol largely seem to depend people trusting him as some sort of expert, perhaps an unbiased expert. There is little substance in them. It's like an appeal to authority.
Sean Lynch was one of the co-authors of the Royal Colleges of Report on CFS (1996) (Word file of this is available here: http://bit.ly/HFQeOM ).
As well as recommending CBT and GET, and little else, it gave very few suggestions for biological research.
He calls for more trials like the PACE Trial.
[..]I feel that there is a need for a new debate now. PACE has in my view made an important contribution to the research evidence and has been a well-designed and conducted trial, but there is a need for further research to build on its contribution in my opinion.
so that'd be CBT and GET trials and the like.Pragmatic trials might have advantages of larger sample size and seeing how well the best- evidenced treatments of that time are applied and fare in real world situations and their cost-effectiveness (6).
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