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

[Marco]

He can't touch it without being ostracised from his cosy establishment circle jerk.

A centrist; technocratic; NHS-eulogising; 'we know better' establishment.

Little wonder PACE is a 'third rail' issue.

 

[TiredSam]

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.

Well if that's true it's excellent progress - here we were thinking our best chance was to persuade some credible non-ME suffering journalists and academics to listen to us, then represent us in the hope that reasonable people in the middle ground would listen to them and become aware of the situation. Now it turns out that die-hard nasties are shutting up and melting away. Sounds like a huge step forward to me.

 

[Esther12]

He's never done anything useful or edgy.

I think he's done some useful stuff. He gets over-acclaimed for it, and he seems a bit of a dick, so there's a draw to be dismissive about it. Also, I think he's done some harmful stuff: not sure how it balances out.

 

[Cheshire]

How researchers dupe the public with a sneaky practice called "outcome switching"

But that doesn't always happen. "In Study 329," explains Ben Goldacre, a crusading British physician and author, "none of the pre-specified analyses yielded a positive result for GSK’s drug, but a few of the additional outcomes that were measured did, and those were reported in the academic paper on the trial, while the pre-specified outcomes were dropped."

"When we get the wrong answer, in medicine, that’s not a matter of academic sophistry — it causes avoidable suffering, bereavement, and death. So it’s worth being as close to perfect as we can possibly be."

http://www.vox.com/2015/12/29/10654056/ben-goldacre-compare-trials

Rings a bell?

 

[TiredSam]

We’re not just [tallying] the prevalence of bad reporting in clinical trials. We’re doing something that's a little more risky for us, depending on how confident you feel the academic community is going to have a serious public conversation about this stuff.

We’re holding individual journals and trials to account. I think it’s amazing that we have five medical students working on this, giving up their time every week to grade all these trials. They’re a real inspiration, because they are fearless and they are meticulous, and I hope fearless and meticulous medical students can help us fix the problem.

Can we borrow a couple of his fearless medical students please, seeing as he's been too spineless to crusade against outcome switching in the PACE trial and hold the authors and journals to account himself for the last 4 years.

 

[Sean]

Ben Goldacre, a crusading British physician and author, "none of the pre-specified analyses yielded a positive result for GSK’s drug, but a few of the additional outcomes that were measured did, and those were reported in the academic paper on the trial, while the pre-specified outcomes were dropped."

"When we get the wrong answer, in medicine, that’s not a matter of academic sophistry — it causes avoidable suffering, bereavement, and death. So it’s worth being as close to perfect as we can possibly be."

http://www.vox.com/2015/12/29/10654056/ben-goldacre-compare-trials

WTF is wrong with this idiot that he can't see the 800 pound PACE gorilla in the room?

Takes a very special kind of cognitive dissonance to be able to do what he does.

 

[Undisclosed]

I am sorry but Ben Goldacre is coming across as a hypocrite. He has published two books about 'Bad Science', yet he can't admit the obvious -- PACE trial is BAD SCIENCE.

It suggests to me, he can't be unbiased. Too much history with Wessely. Therefore, he is not to be trusted. No guts to admit the obvious. In short, he is an arse.

It's sad.

 

[BurnA]

I am sorry but Ben Goldacre is coming across as a hypocrite. He has published two books about 'Bad Science', yet he can't admit the obvious -- PACE trial is BAD SCIENCE.

It suggests to me, he can't be unbiased. Too much history with Wessely. Therefore, he is not to be trusted. No guts to admit the obvious. In short, he is an arse.

It's sad.

I agree and I think it is up to us to expose him.
He uses Twitter to promote his work - for starters I suggest raising PACE as a reply to every tweet that BG is associated with.

 

[user9876]

I am sorry but Ben Goldacre is coming across as a hypocrite. He has published two books about 'Bad Science', yet he can't admit the obvious -- PACE trial is BAD SCIENCE.

It suggests to me, he can't be unbiased. Too much history with Wessely. Therefore, he is not to be trusted. No guts to admit the obvious. In short, he is an arse.

It's sad.

I think there is a bigger issue that he is missing and should regret. PACE is an example of a trial where the PIs are campaigning against open data and arguing that they shouldn't have to release data and lobbying to change the FoI rules. When they published in PLOS One they didn't release data and Ben said that they should put data in a service requiring research proposals to access data.

Its not just hypocrisy but they are setting case law in FoI courts and lobbying for changes to openness. Next it could be a different trial that Ben cares about which relies on PACE as an example. But it will be too late then.

 

[Valentijn]

Next it could be a different trial that Ben cares about which relies on PACE as an example.

Does he actually care about any of those trials and open data? Or is he riding the coattails of a movement which is pretty well underway, to make a name for himself? Or is he just attempting to set himself up as a gatekeeper who dictates what is good and bad science, but in a deliberately biased manner, similar to the Science Media Centre?

The result is the same in the end, I suppose: he's not a reliable source.

 

[Keela Too]

. . . Or is he just attempting to set himself up as a gatekeeper who dictates what is good and bad science, but in a deliberately biased manner, similar to the Science Media Centre?

The result is the same in the end, I suppose: he's not a reliable source.

The more I think about it, the more of an intentional ploy this seems to be. Set yourself up as some-one (or some organisation) calling for clarity, transparency and so on. Appear as though you are the arbitrator of all that is good versus bad in science.

Then give certain select trials a soft landing. Everyone assumes you are the ruthless seeker of truth, so you can slip some things through....

Hmmmmm.... maybe that game is up?

 

[PhoenixDown]

http://www.nursingtimes.net/clinica...-challenge-no-cure-for-me/5025951.fullarticle

Counselling and exercise could help reverse the effects of ME, a new study has suggested.

Experts have identified two types of treatment for chronic fatigue syndrome, potentially helping thousands of sufferers.

It is a widely accepted belief that ME cannot be cured, but the landmark study - which is the most comprehensive to date - questions this.

Scientists involved in the research spent eight years working on it, and believe that it could spark a new era of ME treatment.

They hope the result will change the belief that nothing can be done for the quarter of a million sufferers who are living with the condition in the UK.

Researchers found six in 10 patients reported significant improvements after undergoing either cognitive behavioural therapy (CBT), while encouraging them to increase their activity - or graded exercise therapy, which is based on gradually increasing exercise.

Half of these people reported a return to “normal” energy levels.

Just look at the garbage that has resulted from the PACE trial going unchallenged, where are they getting the 6/10 figure from? I remember hearing only 22% "recovered" and that's after they moved the goal posts. As for "significant improvements" this video demonstrates aptly what those improvements really were:

As for Ben Goldacre I've been suspicious of him for years now, since before everyone here jumped on the bandwagon, here's a post from 3 years ago: http://forums.phoenixrising.me/inde...ben-goldacres-bad-evidence.21146/#post-321853

PS: I'm still waiting on Ben to properly bash the PACE trial, he seems so eager to bash everything else yet he ignores the poor & misrepresented science that's right on his doorstep.

 

[worldbackwards]

6 in 10 come from the figures if you don't take the control group into account. About 40% of controls improved to the same degree as well, which is a point worth making, you might expect.

But the powers that be churn this stuff out time after time. One can only assume that they do it for a reason.

This is amusing:

Scientists involved in the research spent eight years working on it, and believe that it could spark a new era of ME treatment.

My arse it will. There's no money for mental health anyway, and less still for stuff that doesn't work and that no-one wants. The authors are still moaning about no one getting the treatments nearly a decade after NICE. That won't change unless they manage to start taking people's benefits away.

 

[Sean]

Scientists involved in the research spent eight years working on it, and believe that it could spark a new era of ME treatment.

[vomit icon]

 

[alex3619]

WTF is wrong with this idiot that he can't see the 800 pound PACE gorilla in the room?

Ummmm ... is it sitting on him?

 

[Sean]

...and believe that it could spark a new era of ME treatment.

Actually, ironically that could be true. Just not in the way that spin is trying to imply.

 

[Jonathan Edwards]

Actually, ironically that could be true. Just not in the way that spin is trying to imply.

You beat me to it. Just as PACE paved the way for the IOM report.

 

[Hip]

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.

That is a very good point. Alternative medicine is easy pickings as a target for criticism for those who are medically educated.

Though when Goldacre first came on the media scene (approx 12 years ago I think), alternative medicine had reached a peak level of acceptance and influence (in the UK media at least), and I thought Goldacre performed a necessary job in bringing alternative medicine and alternative medicine gurus down a peg or two.

 

[Cheshire]

Another article by Ben Goldacre

Make journals report clinical trials properly
There is no excuse for the shoddy practice of allowing researchers to change outcomes and goals without saying so, says Ben Goldacre.
You might think that this problem is so obvious that it would already be competently managed by researchers and journals. But that is not the case. Repeatedly, academic papers have been published showing that outcome-switching is highly prevalent, and that such switches often lead to more favourable statistically significant results being reported instead. This is despite numerous codes of conduct set up to prevent such switching, most notably the widely respected CONSORT guidelines, which require reporting of all pre-specified outcomes and an explanation for any changes. Almost all major medical journals supposedly endorse these guidelines, and yet we know that undisclosed outcome-switching persists.

http://www.nature.com/news/make-jou...ials-properly-1.19280?WT.mc_id=TWT_NatureNews

 

[TiredSam]

We expected that journals would take these discrepancies seriously, because trial results are used by physicians, researchers and patients to make informed decisions about treatments. Instead, we have seen a wide range of reactions...

The editors at Annals of Internal Medicine, for example, have responded to our correction letters with an unsigned rebuttal that, in our view, raises serious questions about their commitment to managing outcome-switching... Furthermore, they have declined to publish our response to their 850-word letter in the journal.

Gosh, I bet he finds that annoying.