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2 Good Letters in the BMJ re PACE

Discussion in 'General ME/CFS News' started by Orla, Sep 26, 2013.

  1. Tom Kindlon

    Tom Kindlon Senior Member

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    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.
    [..]
    so that'd be CBT and GET trials and the like.
    Last edited: Nov 8, 2013
    MeSci likes this.
  2. Tom Kindlon

    Tom Kindlon Senior Member

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    Esther12, Bob, MeSci and 1 other person like this.
  3. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    Cornwall, UK
  4. peggy-sue

    peggy-sue

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    I started this thread on a paper from the BMJ that appeared in my inbox this-morning.
    I thought it might be another very relevant reference for criticising PACE...

    which is an outstanding example of the use of non-specific composite outcome measures.:thumbsup:;)

    As well as that, of particular relevance is the matter of using stringent criteria for diagnosis of subjects.

    http://forums.phoenixrising.me/inde...utcome-measures-in-clinical-trials-bmj.26704/
    Esther12 likes this.
  5. Dolphin

    Dolphin Senior Member

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    I've just read the paper. It is mainly that composite measures reduce the likelihood that statistically significant results will be found e.g. if one measures death from all causes, the difference between treated and untreated groups might be small but if one just measures the specific items that are thought to be influenced by a treatment, one might see more dramatic reductions.

    So I'm unsure this is relevant for the efficacy measures in the PACE Trial. However, it could be relevant in terms of adverse events.

    Also to me it shows why it is important to have a good knowledge of the aetiology and pathophysiology so one knows better what to be measuring.
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  6. Tom Kindlon

    Tom Kindlon Senior Member

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  7. alex3619

    alex3619 Senior Member

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    I liked the Sean Kirby letter. Well written and to the point.

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