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Can one design a trial such that it inevitably produces a positive result?

Discussion in 'Other Health News and Research' started by wdb, Sep 7, 2013.

  1. wdb

    wdb Admin

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    Talks about alternative medicine but I think it would equally apply to most psychological research.

    http://edzardernst.com/2013/09/can-...l-which-inevitably-produces-a-positive-result
     
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  2. Marco

    Marco Old blackguard

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    I wonder would the author like to comment on the PACE trial assessed against his own criteria.

     
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  3. Valentijn

    Valentijn Activity Level: 3

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    Wow, it's kinda creepy how spot-on that is for how CBT/GET trials are run. :eek:
     
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  4. Bob

    Bob

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    Uncanny. It precisely describes the PACE trial, word for word!
     
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  5. Dolphin

    Dolphin Senior Member

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    Despite the title, this one isn't too complicated. It's written by Edzard Ernst MD, PhD, FMedSci, FSB, FRCP, FRCPEd whose job for many years was to test alternative/complementary therapies. He has those in mind but it could apply to other therapies also, including many suggested for ME/CFS:


     
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  6. Esther12

    Esther12 Senior Member

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    If psychological treatments were tested with the same scepticism as 'alternative' treatments, the medical world would be a very different place. Ta d.
     
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  7. alex3619

    alex3619 Senior Member

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    Lets be clear about one thing. Psychogenic medicine IS alternative medicine, but without even the evidence that the use of herbs or minerals or vitamins has. It is however a century and a half old (more or less) and became part of mainstream medicine a long time ago, so its taught in all the medical schools.

    This is essentially what Popper said about Freudian psychoanalysis. I see no reason its not as valid for psychogenic medicine today. Anything that fits this definition fits Popper's definition of nonscience, and probably pseudoscience as well.

    Sound familiar?

    This is a different way of stating our position on the use of CBT/GET to cure ME and CFS. For which we get labelled extremists etc.
     
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  8. Bob

    Bob

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  9. Bob

    Bob

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    I think the Edzard Ernst blog is worth keeping somewhere handy for future reference, as it destroys the credibility of the CBT/GET research literature that we are familiar with.
    They don't say it any more, but it would have been handy when we were told that the PACE trial was 'gold standard'.


    I've just noticed some comments relevant to the PACE trial in the discussion after the article:

    Shaun:
    ...I wonder if it is possible at all to do a clinical trial in mental health for those that do not involve drugs or operations. I thought therapies such as cognitive-behavioral therapies or meditation-based-stress-reduction are accepted treatments for not-too-severe depression/anxiety, for instance. Would a-no-placebo-test be one way to find out whether it is effective?

    EEdzard:
    one would need a ‘attention control’ i.e. a control group where patients are given the same amount of attention but without the experimental treatment.

    Andrew:
    An ‘attention control’ is insufficient for therapies which are delivered in such a way where the patients perceptions are deliberately altered, such as cognitive-behavioral therapies, where patients may well change their questionnaire answering behaviour, but not their behaviour in general.
    In terms of RCTs to treat fatigue, objective measures are needed, neuropsychological testing and actigraphy at a minimum.
    http://onlinelibrary.wiley.com/doi/10.1111/cpsp.12042/abstract
    http://www.rehab.research.va.gov/jour/2013/506/ickmans506.html
     
  10. CBS

    CBS Senior Member

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    We mustn't lose sight of the true utility of psychological therapies while mistakenly assuming that the treatment is intended to benefit the patient. Untestable theories provide a less threatening alternative when physicians are confronted with their own impotence.
     
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