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Science Media Centre expert reaction to Journal of Health Psychology’s Special Issue on The PACE Tri

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user9876

Senior Member
Messages
4,556
I did wonder if it is noticeable that two organisations that have failed to ensure good research standards are making statements to back PACE.

Programme Manager for population sciences and public health
Dr Neha Issar-Brown - Neha.Issar-Brown@headoffice.mrc.ac.uk

Population sciences and public health research with generic health relevance including:

  • Lifestyle and socioeconomic impacts on health
  • Behavioural research
  • Health inequalities
  • Chronic diseases including multimorbidity
  • Areas of generic health relevance relevant to above (including longitudinal studies, population and disease cohorts)
Click to expand...

It looks like Dr Issar-Brown has some responsibility for research areas that seem to intersect with PACE. Clearly the MRC failed to ensure a high standard of research was carried out in PACE as they allowed an unblinded trial to be measured with subjective outcomes. Then they allowed outcome switching. If the PACE team are to be believed they approved the switching of outcomes and I for the reasons given in papers which are weak and for the recovery criteria simply wrong. The MRCs head of governance did her best at the FoI tribunal to help suppress data.

Perhaps the MRC don't want their governance failures to come out in public. It should be a real embarrassment for them. It may even become an issue if it is out in the open as all the research councils merge and I assume jobs reduced. PACE could damage their image in such a shakeup. But then so could their failure to tackle ME - other research councils look for gaps in research and ensure they are filled.

So when Dr Issar-Brown claims the MRC and others applied rigourous review and claiming that it followed standard trial processes I wonder if she had looked at what happened or if it is simply a knee jerk reaction in the MRC trying to cover their own back. Since we are still waiting for secondary outcomes like the step test to be properly published I don't think that PACE is even compliant with the CONSORT guidelines. I would draw the conclusion that through Dr Issar-Brown the MRC are saying that not following Consort is acceptable and high standard!

Seems like she has something to do with ME funding in the MRC

https://twitter.com/i/web/status/781413565685198848

https://twitter.com/i/web/status/781415619484942336
 
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Jonathan Edwards

Jonathan Edwards

"Gibberish"
Messages
5,256
user9876 said:
He seemed to think that outcome switching was the only issue so maybe he didn't bother to read the articles but just wrote something in support of his friends.

What is perhaps made obvious by Macleod's response and CoI is that he is prepared to support his friends allowing them to retain a publication on PLOS without releasing the data.
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I think he made it very clear that he does not consider patients' health important enough to bother reading something before criticising it.

One of my faults is giving everyone the benefit of the doubt, not once but twice. When this all started I was prepared to believe that the SMC might not be quite as bad as painted. Now I can stop worrying. I find it very hard to understand the motivation for making oneself look either very very stupid or very very insincere. Maybe it is just that the assumption is that the only audience that matters are also very very stupid or very very insincere.

UK medical politics really does stink. I am not sure it is any better anywhere else but I will give the the benefit of the doubt.
 
slysaint

slysaint

Senior Member
Messages
2,125
Reading the comments from the honourable gentlemen of the SMC made me think of a programme I watched last night commemorating the Battle of Passchendaele ( I know how S.W likes his history). I was reading about it and found this:
"British high command was a top down system that prevented the free flow of information, paralysed any discussion, made innovation difficult and allowed faulty decisions to stand even when the commanders at lower levels knew that there were serious problems." Sounds familiar.
 
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Jonathan Edwards

Jonathan Edwards

"Gibberish"
Messages
5,256
user9876 said:
I did wonder if it is noticeable that two organisations that have failed to ensure good research standards are making statements to back PACE.
It looks like Dr Issar-Brown has some responsibility for research areas that seem to intersect with PACE.
Click to expand...

Yes, I take Dr Issar-Brown's comments as meaning 'yup, sure thing, we at the MRC have no idea what we are doing either'.
 
Seven7

Seven7

Seven
Messages
3,444
Location
USA
look at the good side, I would take all the names of the commenter and follow the relationships / money trail. We can uncover the net of the PACE plp. When they go down, we know who the collaborators / plp benefitting from PACE $$.
It will only make the investigation easier for the class action law suit.
 
C

Chrisb

Senior Member
Messages
1,051
slysaint said:
Reading the comments from the honorable gentlemen of the SMC made me think of a programme I watched last night commemorating the Battle of Passchendaele ( I know how S.W likes his history). I was reading about it and found this:
"British high command was a top down system that prevented the free flow of information, paralysed any discussion, made innovation difficult and allowed faulty decisions to stand even when the commanders at lower levels knew that there were serious problems." Sounds familiar.
Click to expand...

There is another relevant story there.

Apparently when the battle was all over Haig's chief of staff went to see the battlefield for the first time. He was dumbfounded by the conditions and moved to tears. "Did we really send men to fight in that? If only we had known." Or words to that effect.

To which his driver replied "It gets worse further up."
 
Marco

Marco

Grrrrrrr!
Messages
2,386
Location
Near Cognac, France
S

Sean

Senior Member
Messages
7,378
They were trying, but they had nothing to try with.

The only two possible interpretations left of PACE are that it is either

too methodologically compromised to deliver any reliable data, or

delivered at least some reliable data which clearly reports no clinically meaningful effect from CBT or GET.​

Neither possibility supports the underlying psycho-behavioural causal model PACE was testing, nor the clinical and policy advice based on it.

The sooner the UK medical establishment accepts this and gets to properly addressing the situation, the better for us all. The longer they leave it, the greater the damage to their own reputation and authority, not to mention patients' lives.
 
Snow Leopard

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
One of the pro-PACE articles published in the JHP talked about "moving on". We'll move on when they admit they've not conducted a best-practise study (and greatly exaggerated their results) and apologise.

Outcome switching should not be defended. http://compare-trials.org/
Studies that are unblinded and have improvements on subjective, but not objective outcomes are at high risk of bias. It is a double standard to trust the PACE study when we wouldn't trust an unblinded pharmacological or alt-med study with the same results.

Continuing to pretend they've done nothing wrong will mean they will never gain the trust of patients.
 
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