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Andrew Gelman The PACE trial and the problems with discrete, yes/no thinking

Sidereal

Senior Member
Messages
4,856
So if this is true, the "independent" review of the data is yet engaged, with a group the PACE team agreed to share the data with. Not a good sign, they know enough people that would be ready to happily do the job. And there are several countries where that could take place. (My bet is on the Netherlands.)

Yes, it sounds like they're getting their cronies to "independently" re-analyse the data so they can point to the re-analysis and say there is no need to share the raw data with skeptics. Extremely worrying development.

As for Gelman's blog post, inexplicable. Surely the issue of normal range is the key issue when you have a continuous outcome variable like SF-36-PF. After all, what difference does it make if scores went up by (statistically significant) 10 points when mean score at the end of treatment is still in the range you see in heart failure and lupus.
 

Jonathan Edwards

"Gibberish"
Messages
5,256
As for Gelman's blog post, inexplicable. Surely the issue of normal range is the key issue when you have a continuous outcome variable like SF-36-PF. After all, what difference does it make if scores went up by (statistically significant) 10 points when mean score at the end of treatment is still in the range you see in heart failure and lupus.

I get the impression that Gelman is a statistician who likes taking pot shots at bad statistics he can put right in books and blogs. What he did not realise is that the problems of PACE are not mostly about the unreliability of numbers, they are about the unreliability of what people say. Or, as sidereal says, about what numbers mean in real life. These areas may be outside Dr Gelman's comfort zone. He will have been leant on like me. A pity that he has not seen the human impact of blogging about other people's business. But then - out of comfort zone?
 

A.B.

Senior Member
Messages
3,780
An "independent" review of biased data, according to a biased protocol is more of the same pseudoscience.

I write "independent" because PACE trial authors have a history of refusing independent scrutiny so I think it's likely the reviewers will either be the Cochrane group containing PACE trial authors, or Durch CBT proponents with a significant conflict of interest.
 

Jonathan Edwards

"Gibberish"
Messages
5,256
Aren't all BPS proponents living in a barrel of their own? Or can they be found in the real world?

Dear Cheshire,
I apologise for using an obscure English metaphor. You may well be right about living in a barrel. In case it was confusing, shooting fish in a barrel means betting on a horse when there are no other horses running; you are unlikely to miss the fish/horse.
 

Cheshire

Senior Member
Messages
1,129
Dear Cheshire,
I apologise for using an obscure English metaphor. You may well be right about living in a barrel. In case it was confusing, shooting fish in a barrel means betting on a horse when there are no other horses running; you are unlikely to miss the fish/horse.

Yes, I understood. I was a bit ironical in saying I bet on Dutch, there aren't many others.
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
I get the impression that Gelman is a statistician who likes taking pot shots at bad statistics he can put right in books and blogs. What he did not realise is that the problems of PACE are not mostly about the unreliability of numbers, they are about the unreliability of what people say. Or, as sidereal says, about what numbers mean in real life. These areas may be outside Dr Gelman's comfort zone. He will have been leant on like me. A pity that he has not seen the human impact of blogging about other people's business. But then - out of comfort zone?

But I think he's potentially a strong ally and it's nice to see someone taking an open-minded interest in PACE. People have put some good comments on all of his blogs and he may well find it interesting to learn about some of the issues in clinical trials in general, and PACE in particular. Certainly he has colleagues at Columbia who I hope are engaging with him (I'm thinking about Bruce Levin, for example).
 

A.B.

Senior Member
Messages
3,780
Andrew,
Thank you for continuing to delve into the mirk. Having previously appeared to give succour to those determined that PACE must die, you should prepare yourself for a rapid fall in popularity amongst that constituency. As you identify the issue of greatest concern is the lack of open data – and the protestations that it’s all about blinding, ring very hollow, given that Professor White has recently called for all UK Universities to be exempt from Freedom of Information legisaltion, the very legislation upon which UK citizens rely to get access to data which those Universities, as with QMUL feel free obfuscate.

Open data is a matter of international concern, in the case of PACE there is also a more parochial issue and that is the way that a particular school of psychological research, with backroom support from NHS management, is using the vastly overstated value of PACE to continue garnering research funding in order to flog the dead horse of CBT/GET into a shape sellable to patients. In this scenario we aren’t looking at simply finessing research which has limited scope into something with wider application, but a use of scarce funding to back researcher prediliction. ME/CFS patients almost universally have well established differences of perspective from Professors, Wessely, Sharpe, White and Chalder and want their health service to value their voices at least as strongly as any academically derived weak evidence base. There isn’t a methodological solution for that problem, ultimately a social and political solution is required.

I thought this comment was worth looking at since it's so weird.
 

A.B.

Senior Member
Messages
3,780
I couldn't actually understand it so just ignored it!

It contains one totally incoherent argument which appears like an attempt to distract from lack of blinding. Some negative remarks about advocates. It vaguely wants to suggest that the problem is not that CBT and GET don't work or that the research is bad but that patients view the illness differently (my interpretation).

What I read from between the lines is that this posters thinks the problem is patients refusing to accept that they have a psychosomatic illness rather than the psychosomatic model of illness being wrong.
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
It contains one totally incoherent argument which appears like an attempt to distract from lack of blinding. Some negative remarks about advocates. It vaguely suggests (to me at least) that the problem is not that CBT and GET don't work or that the research is bad but that patients view the illness differently.

Still ignoring it!

A rude comment now on there, unfortunately. This kind of thing lets us down.

If anyone wants to make a friendly comment (even if it's a critical one), now would be a good time.
 

sarah darwins

Senior Member
Messages
2,508
Location
Cornwall, UK
What I read from between the lines is that this poster thinks the problem is patients refusing to accept that they have a psychosomatic illness rather than the psychosomatic model of illness being wrong.

I think it's coming from the opposite point of view, but a bit confusingly expressed. Surely most people here would agree with "a particular school of psychological research, with backroom support from NHS management, is using the vastly overstated value of PACE to continue garnering research funding in order to flog the dead horse of CBT/GET into a shape sellable to patients."
 

Jonathan Edwards

"Gibberish"
Messages
5,256
It contains one totally incoherent argument which appears like an attempt to distract from lack of blinding. Some negative remarks about advocates. It vaguely wants to suggest that the problem is not that CBT and GET don't work or that the research is bad but that patients view the illness differently (my interpretation).

What I read from between the lines is that this posters thinks the problem is patients refusing to accept that they have a psychosomatic illness rather than the psychosomatic model of illness being wrong.

This is indeed strange but my thought now is that the comment about lack of blinding refers to QMUL's claim that data must be blinded in the sense of anonymised in relation to release. I cannot work out how it could mean anything else.
 

adreno

PR activist
Messages
4,841
What I don't understand is, why would Gelman even start posting on the PACE trial, while constantly making excuses like this?
Regarding my own take on all this: I’m not sure, again, this whole thing is far from my substantive areas of expertise.