Discussion in 'Latest ME/CFS Research' started by Valentijn, Dec 14, 2016.
Great work @Tom Kindlon and @Simon , thanks for all your hard work
Thanks for your hard work!
Full text at http://www.tandfonline.com.sci-hub.cc/doi/abs/10.1080/21641846.2017.1259724
I haven't read it closely yet, but it seems to be laying out the major flaws with the PACE "Recovery" paper (2013). So there's a lot of material which is familiar to us. I don't think it talks about the initial 2011 paper much, which is the one that covers improvement instead of recovery.
But it's very good to see a discussion of the PACE flaws published, since doctors, therapists, and politicians who can't understand or evaluate research papers themselves will need to hear it from a journal. Hopefully this will be useful to show to doctors, and be considered by evidence review panels, such as NICE. And it makes a nice rebuttal to BPS quacks raving about how great PACE is
There's a couple graphs that illustrate the questionnaire threshold problems very well:
@Valentijn Thanks for including those graphs for visual learners and for us dimmer folks.
Credit where credit is due
Dr Carolyn Wilshire was the lead author. Co-author Alem Matthees had an exhausting FOI battle to get the recovery data released. @Tom Kindlon and I were co-authors too. And here's our acknowledgement at the end of the paper:
Wow. Simply stunning! Thanks so much @Simon, @Tom Kindlon and everyone else that has contributed.
Clear debunking of the lowering of threshold:
Thank you so much @Simon and @Tom Kindlon
Some bonus graphs, not included in the original paper (uses new analysis from FOI data by Alem, but data isnt' in the paper either). They provide a bit more depth, though:
Note how adding in the CFS caseness and health change (CGI) criteria conveniently made only made only a modest difference to the final recovery rate in the published version (2013 PACE paper), but more than halved the recovery rate according to protocol (=planned).
Don't forget that 'planned' is as laid out in the 2007 protocol - "published" is as published in the 2013 PACE recovery paper at Psychological Medicine, where the analysis took place after the trial had completed. The authors have since acknowledged that their analysis was "exploratory" and not predefined.
Cumulative effect of applying the four PACE recovery criteria, for GET
Note that PACE applied the primary outcomes of self-rated physical function and fatigue as a joint category, I split them for more detail. A perhaps cleaner, but less pretty version of the graph is this, below - but same info shown
Very good to see this published.
I'm very curious to see what sort of letters this attracts from the PACE authors ... and it'll be interesting for them to not be allowed the last word this time
It's important to keep in mind that this re-analysis only corrects one layer of bias. Underneath this there is another layer of bias which is related to the lack of blinding, an inadequate control group and reliance on subjective measures. One cannot correct this flaw but only point out that even the meager results we're seeing are exaggerated.
This is an important aspect because these things by themselves are enough to produce highly misleading results.
Yes, and our paper discusses the problem of relying on self-reports in an unblinded trial. We point out that in these cricumstances the authors should have paid more attention to objctive measures of function, such as walking distance, physical fitness and sickness benefit (were there were no gains, apart from a small one in GET walking).
Well done to those involved. Huge thanks for your brilliant work.
Please pass on my (our) appreciation.
Just read the abstract and burst into tears.
Of joy and gratitude.
Thank you so much to all concerned.
Thank you to everyone involved!
I am very glad this has been published (and posted here - thanks @Valentijn ).
You should get out more .
Oh, you probably can't - I see the problem.
Thank you so much, @Simon and others!
Is "Fatigue: Biomedicine, Health & Behavior" connected to PubMed now? Will article be visible there?
You can also try a Google Site Search
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