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Dr C. Wilshire:The problem of bias in behavioural intervention studies: Lessons from the PACE trial.

Discussion in 'Latest ME/CFS Research' started by Yogi, Mar 24, 2017.

  1. Yogi

    Yogi Senior Member

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    Help ....I can't keep up !!!

    This is the snowball effect we have been talking about over the last year.

    https://www.researchgate.net/public...ervention_studies_Lessons_from_the_PACE_trial

    Retweet and like:

    The editor of the journal:



     
  2. hixxy

    hixxy Senior Member

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    :p
     
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  3. charles shepherd

    charles shepherd Senior Member

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    This is getting a bit like London buses -

    You can hang around for ages waiting for the one you want - then three appear all at once!

    Same here - and there are still more critical commentaries on the PACE trial to come in the JHP…...

    Yesterday I wrote to the JHP editor to see if they could all be made open access - rather than most of them being restricted to 100 word abstracts as far as the public domain is concerned

    Dr Charles Shepherd
    MEA
     
  4. missfire

    missfire Knock Down, Bounce Back

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    Don't say that about London. I enjoyed the transportation system. Chronic fatigue is hard to work with when you're doing the Underground / Tube!
     
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  5. Barry53

    Barry53 Senior Member

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    Fantastic.
     
  6. charles shepherd

    charles shepherd Senior Member

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    Yes - agree!

    As someone who is up in London once or twice a week, I think there's a really good and reasonably priced public transport system in operation - apart from trying to use parts of it if you are using a wheelchair

    And while Londoners sometimes moan about it, they should try using almost non existent rural public transport

    But I still don't understand why some London buses on the same route still sometimes arrive almost one after another…….and then don't appear for ages
     
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  7. missfire

    missfire Knock Down, Bounce Back

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    I will try to answer that question upon my return. I rather moan and groan about paper work than transit! :)
     
  8. Cheesus

    Cheesus Senior Member

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    As someone who used to catch the bus to work, I can tell you this happens because the bus in front has to keep stopping to pick people up, which clears the bus stops of people. The bus behind therefore does not need to stop, so it can catch up.

    Once the second bus catches up with the first, they start leap-frogging each other: one is stopped whilst the other one passes, and then that bus has to stop at the next stop, allowing the first to pass. This allows the third bus to catch up, and now you have three busses travelling in a convoy.

    You can tell my commute to work was terribly boring.
     
  9. Valentijn

    Valentijn WE ARE KINA

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    In Seattle this would happen due to really bad traffic, such as from baseball games drawing a huge crowd. The traffic would be in a pretty small time period, then suddenly disappear entirely. And this creates a knock-on effect where the delayed bus has more and more people now at each stop, more stops to make, and a longer delay in people maneuvering around each other to disembark.

    Then the following bus, which starts out on time, has very few people to pick up, and ends up ahead of schedule because they usually can't stop anywhere to wait a bit. So people miss that bus because it arrives too early, and the following bus is delayed by having extra passengers again.

    The other factor was that buses usually have another route before starting on their current one, and delays build up again. One route I'd ride featured buses feeding in from two different routes. Buses from one route were consistently late, and the buses from the other route were usually on time.

    So generally it was poor planning and/or a failure to respond adequately to different conditions, even when those conditions were predictable weeks in advance :p And a certain level of not caring how happy the customers are with the service probably contributes.
     
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  10. Cheesus

    Cheesus Senior Member

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    Okay, how many people thought this thread would turn into a discussion about busses? Be honest...
     
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  11. missfire

    missfire Knock Down, Bounce Back

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    Yeah, in Canada. Bus 2 and 3 just park, read a book, could 20 minutes and proceed. LOL
     
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  12. Cheesus

    Cheesus Senior Member

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    Get out of here with your Canadian rationality! ;)
     
    Last edited: Mar 24, 2017
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  13. trishrhymes

    trishrhymes Save PR. Sack the President of the Board.

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    I am not qualified to comment on London buses, since I haven't travelled on one for 30 years.

    I can however comment on Caroline Wilshire's paper. It's truly excellent.

    Another very important nail in the leaky coffin that is PACE.
     
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  14. Jan

    Jan Senior Member

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    Careful Trish, poor sensitive Simon may see that as a death threat :rofl:
     
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  15. user9876

    user9876 Senior Member

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    Its a really good paper that summarizes the biases that are obvious from the way the trial was run and the ways that the PACE PIs have failed to understand or acknowledge the potential failures.

    One of the points made is that the different treatment arms set different expectations which is very likely to lead to reporting biases in favor of CBT and GET. Hence this is another argument for the need to share the full data set so that we can understand the relationships between the subjective and objective outcomes.

    It also makes points about the lack of robustness in the LTFU data which would lend support to the interpretation of reporting bias being the main cause of differences with CBT and GET.
     
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  16. trishrhymes

    trishrhymes Save PR. Sack the President of the Board.

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    :rofl::rofl::rofl::rofl::rofl::rofl:

    Ah, but I was only placing PACE in a leaky coffin, not simple Simon. If he should choose to jump in with it, that, as the saying goes, is his funeral... :D
     
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  17. Tom Kindlon

    Tom Kindlon Senior Member

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    If anyone wishes to share this on social media, here are a few links:

    https://www.facebook.com/TomKindlon...41828.656049027876559/796608413820619/?type=3
    https://www.pinterest.com/pin/174584923036055684/
     
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  18. Sean

    Sean Senior Member

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    Thank you, Dr Wilshire. :thumbsup::hug:
     
    Last edited: Mar 24, 2017
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  19. Demepivo

    Demepivo Dolores Abernathy

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    On a tweet today about the article I saw

    "The best evidence against CBT/GET is the PACE trial" :)
     
  20. Tom Kindlon

    Tom Kindlon Senior Member

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