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A couple of sceptical posts on the value of psychosocial interventions for cancer patient's pain

Discussion in 'Other Health News and Research' started by Esther12, Aug 5, 2012.

  1. Esther12

    Esther12 Senior Member

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  2. alex3619

    alex3619 Senior Member

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    There are a lot of interesting comments on this site in various articles. Following various links I found articles showing that DSM-V is widely criticized by psychiatric organizations. I found articles on how surveys before and after treatment are not sufficient to show benefit from the treatment. And so on.

    The two parts of the article in question are about failures in meta-analysis. About how criticism appears to be ignored. About how both small and poor quality studies are included, but the meta-analysis hides this by not giving sufficient information to properly evaluate the studies it uses. Sounds familiar.

    Bye, Alex
  3. Firestormm

    Firestormm Guest

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    From Esther's first article:

    I found this extract informative. He's talking about Faux Evidence-Based Behavioural Medicine, but I'd not been aware of this explicit example of a possible conflict of interest:

    I just hadn't (not surprising really) thought about it. I mean that DSM-5 would be a commercial product. Just goes to show how little I know - I figured it was all state-funded!

    Anyway, I guess this gets to the crux of the matter with regard to the article's and future articles' purpose:

    So... is PACE and/or it's interpretation to be regarded as a (similar) 'meta-analysis' or is/are CBT and GET more specifically?

    Am feeling rather dumb today (every day!) HA!! :)

    I get this:

    and I wonder if these thoughts can be applied to our condition:

    It would be good if it could (well it wouldn't) but we perhaps are not in a position to compare e.g. pain medication to psychological behaviour management therapies aimed at replacing them - or are we?

    One of the critiques of the PACE trial for example would be a lack of adequate comparison (in my view) e.g. Standard Medical Care did not include what I have come to understand as such e.g. the prescribing for example of pain relief medication.

    Whilst the NICE Guidelines have to some extent sought to address the bolded questions above I don't think they do so adequately.

    Indeed I think you could reasonably argue that because specific studies have not been produced for any drugs and ME patients - they have used 'publication bias' to argue that such interventions have no merit, or to quote from the Guidelines themselves:

    but, that

    and, in respect of CBT/GET:

    Publication bias? Evidence bias? Are these the only 'treatments' to have been tested and found to have been of benefit for people with our condition?

    With cancer it is then perhaps more clear-cut. You have specific pain medication tested on cancer on the one hand and behavioural interventions on the other and patients who might wish to try either or who are fearful of the medications themselves or who are not being afforded clear direction and advice.

    Hmmm...
  4. Firestormm

    Firestormm Guest

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    Doesn't this just make you want to kick-something?! :mad:

    And I don't suppose any of that kind of thing will change under open publishing proposals either. Journals will still 'protect' their members when articles are published and discussed. Papers might attract comment but not articles in 'members only' clubs Journals.
  5. Esther12

    Esther12 Senior Member

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    Thanks for the summary/highlights Fire.

    Have you got links?

    It's nice to know that some of the most ridiculous things about how CFS is treated are recognised as problems by those other than patients (I've noticed that other conditions, like depression, tend to get much more respectable discussions around them than CFS, where psychosocial quackery seems to reign.)
  6. Firestormm

    Firestormm Guest

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    I think it's great you have found a sceptic psychologist :thumbsup:

    I shall return to his blog and read that cancer stuff later. Thanks Esther :)
  7. alex3619

    alex3619 Senior Member

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    http://www.psychologytoday.com/blog...-evidence-based-treatment-some-sticky-wickets

    Mercer has a series of blogs. Click on the previous blog or following blog links on upper right. Other authors have other interesting blogs.

    Just because we have to deal with psychobabble, and come to expect it, does not mean that all psychiatric/psychological authors are into babble. There are plenty who are not. The primary resistance to DSM-V appears to me to be a very skeptical audience of psychs.

    Bye, Alex

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