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Ben Goldacre: checking if clinical trials reported what they said they would

SOC

Senior Member
Messages
7,849
I'm sure that we're all caught up in the norms and expectations of our times, but it really does seem to me that most British public and grammar schools quite actively indoctrinate their children with strange values and standards that then go almost entirely unchallenged within 'polite' British society.
Is this why there seems to be an astonishing lack of independent thought and critical thinking going on in so-called scientific circles over there? Is education more about learning to accept authority than learning the most basic of scientific principles? Is the appeal to authority fallacy so strong over there that even the scientists don't recognize it for what it is?

It's completely illogical to say you are a skeptic or even a scientific thinker and then swallow whatever pap you're fed without bothering to consider whether it makes any sense whatsoever. What is sensible about that?

I gotta say, the whole situation has me both flummoxed and flabberghasted. I simply can't get my head around the cultural mindset that is letting this happen. So I end up rattling around trying to make sense of things that may never make sense to me because I grew up in a different world. I just didn't think we were all that different... until now.... :confused:
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
:thumbsup:
There's no rule we all have to agree. This would be a pretty boring (and scary) place if we were all a bunch of mindless drones with the same ideas about everything.
I will go further and say if almost everyone is agreeing almost all the time then its time to find a new forum. If people disagree but have an honest interest in understanding whatever the topic is, that is a good thing. From disagreement can come a little more wisdom.

Where it can go wrong sometimes is if someone presumes something is so obvious that when someone else does not get it they presume the fault is with that person. I have disagreed with many people here, and they with me, but that does not mean I presume they do not want to know the "truth", or that I know the "truth". Disagreement occurs for various reasons, and sometimes that is an opportunity to explore a topic to a deeper degree.

Sceptics need to be sceptical of even other sceptics. Scepticism is supposed to be an antidote to authoritative dogma. When it merely supports dogma its no longer scepticism. In empirical scepticism there is a requirement for two things - both sound evidence and sound reasoning on that evidence. PACE, for example, fails on both counts, and so any sceptic should look at it as poor science at best.
 
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Woolie

Senior Member
Messages
3,263
Is this why there seems to be an astonishing lack of independent thought and critical thinking going on in so-called scientific circles over there? Is education more about learning to accept authority than learning the most basic of scientific principles? Is the appeal to authority fallacy so strong over there that even the scientists don't recognize it for what it is?

It's completely illogical to say you are a skeptic or even a scientific thinker and then swallow whatever pap you're fed without bothering to consider whether it makes any sense whatsoever. What is sensible about that?

I gotta say, the whole situation has me both flummoxed and flabberghasted. I simply can't get my head around the cultural mindset that is letting this happen. So I end up rattling around trying to make sense of things that may never make sense to me because I grew up in a different world. I just didn't think we were all that different... until now.... :confused:
@SOC, I've worked in an academic environment both in the UK and the US. My experience of the difference is not deference to authority. I did find that those I worked with in the US were more open to new ideas from outside, whereas those in the UK were more interested in defending their own. But this just might be the particular individuals I worked with. The other thing is that there is a fairly established UK tradition in psychological interpretations of illness (also in some parts of Europe), and the funny thing about this area is that you are either working in the field (and share their view), or you're too far away from the field to be aware of the problems or to be interested in critiquing it.
 

SOC

Senior Member
Messages
7,849
@SOC, I've worked in an academic environment both in the UK and the US. My experience of the difference is not deference to authority.
Well that's a relief! :D I was starting to scare myself for a bit there...
The other thing is that there is a fairly established UK tradition in psychological interpretations of illness (also in some parts of Europe),...
That, otoh, while not surprising, is depressing... so old-school and disrespectful of the intelligence of patients.
...and the funny thing about this area is that you are either working in the field (and share their view), or you're too far away from the field to be aware of the problems or to be interested in critiquing it.
But isn't the whole culture -- the media, the government, the general populace, all caught up in this distorted belief system? It's not like it's just one little group of academics with funny ideas talking to themselves in a corner. The belief seems pervasive. Only the victims are seeing how nuts the whole idea is... and even some of them are having trouble letting go of psychological interpretations of disease.
 

barbc56

Senior Member
Messages
3,657
Or were you thinking of some other reason for moving to Members Only?

I think this thread could be misinterpreted in a negative way. It started out fine, maybe a few jabs and that's okay. Many of the posts have been very informative and bring up some important issues. I would probably agree more than disagree with them..

But IMHO the tone has degeneratd into attacking people and not addressing the substance of the issues. Whether this happens on the BS forums, here or some other forum, I won't be a part of it.

I understand the need to vent and the anger. But maybe there's a more appropriate place for that.

I do take resonsibility if I have contributed any negative posts. I probably have.

Unfortunately, this takes away from the real issues and it takes down those who have made some good points.

Which posts do you think others will remember?

I have taken this thread off my alerts and will focus on other threads. Sorry @Simon.

Barb
 

Woolie

Senior Member
Messages
3,263
But isn't the whole culture -- the media, the government, the general populace, all caught up in this distorted belief system? It's not like it's just one little group of academics with funny ideas talking to themselves in a corner. The belief seems pervasive. Only the victims are seeing how nuts the whole idea is... and even some of them are having trouble letting go of psychological interpretations of disease.
I guess I'm only able to speak about full-time academics, and that's only one aspect of what feeds into these beliefs. There's the medical profession too. I didn't work much with doctors in the UK. But I did find, from the perspective of a patient, that many doctors were condescending to their patients and sometimes even rude. And patients on the whole were incredibly meek and grateful to even be seen, it was astonishing to see! This aspect of the culture might have a lot to do with the problem.
Very different experience with doctors in the US. I worked with some and loved the experience, they were so genuine and respectful of their patients.
 

Esther12

Senior Member
Messages
13,774
@SOC, I've worked in an academic environment both in the UK and the US. My experience of the difference is not deference to authority. I did find that those I worked with in the US were more open to new ideas from outside, whereas those in the UK were more interested in defending their own.

I think that people in the UK are more homogenised in the sort of authority they defer to, and this can leave them blind to viewing it as any form of deference. eg: in the US there are far more creationists, and this is related to a deference to religious authority. In the UK we're fairly united in deferring to more 'sensible' sources of authority, and this can leave people thinking that they're well informed, reasonable and sceptical, when really they're just parroting the views of a certain type of authority.

Also, our political system allows a self-perpetuating group of 'sensible' people a lot of power outside of any democratic accountability. Our civil service stays in place as governments change, so lots of people who would be political appointees in the US have jobs for life in the UK. They inevitably build up social connections, confidences, etc that I think have played a role in the problems which surround ME/CFS. Wessely and the PACE researchers are seen by this class as 'sensible people whose work can be trusted', and that's played a role in their immunity to justified criticism from patients.

As with lots of cultural stuff, this is all contestable and I can't be sure I've not got the wrong end of the stick.

PS: Also - taking the time to look more seriously at medical research made me realise how much I just had faith in those who should not be trusted.
 
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Messages
41
Ben Goldacre has said many things that I agree with.

For example:

“Anyone withholding the methods and results of a clinical trial is already in breach of multiple codes and regulations, including the Declaration of Helsinki…”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4396123/

I don’t know the motivations for his silence on PACE, but he is sending the message that Bad Science is unacceptable, unless it’s the work of friends/colleagues/potential employers/your alma mater (Oxford). I don’t think he is one of the bullies, but he stood at the corner watching and walked away.
 

adreno

PR activist
Messages
4,841
I guess the rationale is that it's fine to criticize others work as long as it gets you popular, and you can make a living out of it. However, if there is a price to pay, it's better to keep silent.
 

BurnA

Senior Member
Messages
2,087
Ben Goldacre has said many things that I agree with.

For example:

“Anyone withholding the methods and results of a clinical trial is already in breach of multiple codes and regulations, including the Declaration of Helsinki…”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4396123/

I don’t know the motivations for his silence on PACE, but he is sending the message that Bad Science is unacceptable, unless it’s the work of friends/colleagues/potential employers/your alma mater (Oxford). I don’t think he is one of the bullies, but he stood at the corner watching and walked away.

As far as I am concerned if you don't speak up in the face of injustice then you are an accomplice.
The fact that he should be so knowledgable on this general topic of bad science yet remains so silent is worse still.

It calls into question his integrity.
 

Undisclosed

Senior Member
Messages
10,157
I have been reading posts on and off on Bad Science since about 2008 or 2009. There was another thread on PACE previously. There are some members on Bad Science who are mean, insulting, and downright rude about everything, all the time-- not restricted to ME/CFS patients. The moderation on that Board allows for members to be ripped down to nothing which is a shame and one of the moderators has been totally nasty about ME and ME patients so you can't even complain about personal attacks.

There are also some really nice reasonable members who don't deserve to be included in diatribes about that forum. We don't like it when ME/CFS are described as militants, I am sure the nice members on Bad Science don't like to be included under the umbrella of being rude vitriolic so and so's. I found the worst post on the present thread about PACE came from one of our fellow patients who insulted Coyne and the rest of us. The present thread is very positive and the usually crew of nasties haven't posted -- why -- because they probably finally get that they were and are wrong about the PACE trial. They can't post that we were wrong because we weren't wrong.

I am not sure why this thread turned into a discussion about the Bad Science forum. Ben G. started that forum as a means to discuss his book 'Bad Science' other than that he has nothing to do with it. It's a concern that he constantly discusses how bad research needs to be called out, yet he can't publicly discuss the PACE research. Probably down to too many personal conflicts with those that trained him. If he views ME/CFS patients asking questions as harassing him, then why does he even deserve our attention. All his work so far about calling out 'bad science' and then refusing to call out the PACE trial as 'bad science' shows him as being disingenuous and nothing more. He will have to sort that out in is own mind. I doubt he is in an easy position though -- he might have to wait until he is retired to say the truth.
 

JayS

Senior Member
Messages
195
Taking tweets from several years ago that are possibly out of context and say Ben Goldacre feels this or that way about me/cfs doesn't always mean the conclusions are accurate. This is just as inappropriate when others do the same to us.

What I admire about Ben Goldacre and I have a lot of respect for him, is that he appears to not have preconceived ideas and proceeds from there. He keeps an open mind. He's a psychiatrist and works in the same department as Wessely but we don't know how much that impacts what he believes. That's guilt by association and that's a logical fallacy. I think his stance on big Pharma probably indicates his objectivity.

There may be reasons for animosity about me/cfs being a sore point on Bad Science.. The xmrv studies were looked at with a critical eye pretty quickly when negative studies were published.They were attacked from (supposedly) ME patients. Several years ago on a thread about ME/CFS and then a similar thread about Dr. Myhill some of the responses were so inappropriate it was shocking even though these were posted by the same few people.

But on the whole, I love the Bad Science Forum. Ben Goldacre really doesn't have much to do with the forum and in fact may not have his name on it because he doesn't have the time to give the proper attention to it.

I think it is disingenuous to say that any researcher who is not addressing the PACE trial is against us. We are living through this and because of that we, and I include myself, we sometimes think that everyone should focus on our issues. In a perfect world but the reality is that there are so many issues in this world.. Are we against research on illnesses here simply because they are not mentioned on the forum?

Barb

I've often wondered if others may have preconceived notions about him because he debunks a lot of alternative medicine. Who knows?

Let's start with the idea that there were trolls doing irritating things on ME/CFS threads on Bad Science years ago. Granted. One in particular on the xmrv thread who should've been banned a long time before they were, but since they did go ahead & ban that poster, one wonders why they were kept around, as that poster offered nothing beyond the same thing over and over again. It almost seemed like they were allowed to stay almost as a personal plaything--'look, it's a CFS troll.' Similarly, another, the volcano, on other threads. Granted. It would be foolish to deny any of that.

If you're going to compare anything they or anyone else posted to the nasty, vicious, personal insults hurled at people arguing the scientific merits of the xmrv hypothesis--or, rather, the issues with some of the negative reactions towards that hypothesis, which at the time hardly seemed unreasonable; arguing that ME/CFS is a serious, primarily physical condition better described by the Canadian Consensus Criteria than, say, the Oxford Criteria; or those arguing against the PACE papers, then I'd say your judgment is in serious question. But I guess it never gets old: patient or patient advocate tries to explain that this is a physical disease, but makes the fatal of error of arguing that CFS is 'real'; cue the horde to stomp that person into submission, because of course mental illness is just as 'real,' and shame on the CFS patient for perpetuating the stigma of mental illness, which is something that nobody should be ashamed of. Especially CFS patients, since PACE didn't say it was a psychological illness anyway!

Never gets old. Science, good; patients, bad. CFS not necessarily psychological, but just look at the things these people say, and don't they have a lot of energy to post all the time! Psychiatrists = dedicated, conscientious researchers determined to ease suffering; patients = anti-science, anti-psychiatry malcontents comparable to animal rights extremists or climate change denialists hassling researchers with vexatious FOI requests.

Anyone who wants to can go back & read those threads for themselves and make their own decisions and judgments (not that I would recommend or encourage this; my feeling is that it would be more aggravating than it's worth for most patients). Most of it was painfully childish, including them coming onto this forum themselves. To what end? They 'won' every argument: the xmrv hypothesis was officially withdrawn; ME/CFS, in spite of the IOM report, still, clearly, isn't taken any more seriously by medical science than most people would the condition described by Oxford criteria, and there seems little chance we'll see much change anytime soon from the existing paradigm of NICE Guidelines/CDC/Mayo Clinic; and PACE stands. In spite of recent attempts by Tuller & Coyne & Laws (patients don't count, really) to call attention to perceived flaws. They could've banned annoying people, but chose to come here instead. I suppose, though, that this might not actually be all that surprising, if you consider the 'piglets' episode (or that they're dismissing Tuller & Julie Rehmeyer, and referring to Coyne's recent talk as conspiracy theory).

And oh, by the way, isn't it interesting that that NHS Choices writer who went for the double punch of 'death threats' and 'too lazy' on Twitter just happened to have a fellow Twitterer copied in on one of those tweets who...just happened to be one of the most vicious, nasty, abusive posters on the ME/CFS threads.

Then there's that one thread that people can't read for themselves. Based on this post it's reasonable to conclude you don't know why that thread isn't there anymore. :rolleyes: Well, I can't offer my speculation as to why it 'disappeared,' only for the reason that I don't want to potentially affect any legal actions that may still be in play. If you honestly believe that the 'attacks' from patients on the Myhill thread were worse than the things that were said about her...I honestly don't know what to say. It's hard not to say something that's not very nice. I'm no supporter of Myhill (or alternative medicine, for that matter--funny how skeptics always slam 'CAM' and NCCAM without ever considering that Stephen Straus might've been as wrong about CFS as he was about 'CAM'), and never was, either. But the idea that her sins were so grave that she deserved the posts on that thread is beyond bizarre, so your putting it on one 'side' while not saying a word about the 'other side' is, in my view, ludicrous and offensive.

You want to go ahead & be supportive of Goldacre, that's your choice. Everything he's about, speaks to the current reappraisal of PACE, yet he hasn't said a word. Coyne has tweeted at him several times, with the only response being that he's 'too busy' to get involved in Coyne's 'CFS spat.' This was a publicly funded trial; if you don't want to believe that it would have been entirely consistent for him to take a look at the recent analysis, you are certainly entitled to that, too. You can also believe whatever you want as to why he de-linked the forum from his website. Funny, isn't it, how that thread was 'quarantined,' just prior to it being 'lost.' Gee. What a boo-boo. Whoops.

I guess you didn't see it.
 

barbc56

Senior Member
Messages
3,657
Think it was I who really took it OT: Sorry Simon! I just didn't want my googling to go to waste.

No, no, I wasn't referring to you at all. You stated your position and backed it up with why. I may have had a different perspective but it was fair debate. :)

Barb
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
Also, our political system allows a self-perpetuating group of 'sensible' people a lot of power outside of any democratic accountability. Our civil service stays in place as governments change, so lots of people who would be political appointees in the US have jobs for life in the UK.

It is much the same in the U.S. Political appointees in the cabinet and the top layers of bureaucracy come and go, while powerful "civil servants" like Fauci and Collins have built nice little fiefdoms for themselves. They have so many awards and important connections that they are untouchable, and they know it.
 

biophile

Places I'd rather be.
Messages
8,977
We are monitoring all trials published in the top five medical journals (NEJM, JAMA, The Lancet, Annals of Internal Medicine, BMJ). We are analysing each trial for outcome switching, by comparing the clinical trials registry and trial protocol with the trial report.

There will be little excuse for Ben Goldacre's team not to evaluate PACE eventually after these tweets:



Now on a lighter note, with respect to Goldacre's tweets promoting scathing articles on ME/CFS militants:

(edit: about international politics not ME or PACE)


 
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Woolie

Senior Member
Messages
3,263
@biophile, these two last tweets do not seem to be about anything to do with ME or PACE, more about international politics. But anyone twitter-skilled out there might want to point out that another great example is the way the "death threats" to psychiatrists from ME patients reported in 2011 have been used to silence the views all patients.

On another note, I wonder if Gerald Blair is still waiting for his death threats? We don't seem to have heard much from him lately.
 

Sidereal

Senior Member
Messages
4,856
Ben Goldacre is about as conventional as it gets. He's never done anything useful or edgy. It's very fashionable and safe to rail against alternative medicine, Jenny McCarthy and big pharma in academic circles. Psychosomatic medicine, on the other hand, is a third rail issue. He can't touch it without being ostracised from his cosy establishment circle jerk.