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Dr James Coyne tackles the PACE follow-up paper

Discussion in 'General ME/CFS News' started by Sidereal, Oct 29, 2015.

  1. Sidereal

    Sidereal Senior Member

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    Uninterpretable: Fatal flaws in PACE Chronic Fatigue Syndrome follow-up study

    It's a long read. Here's the summary:

     
    Last edited: Oct 29, 2015
  2. Cheshire

    Cheshire Senior Member

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  3. Sidereal

    Sidereal Senior Member

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    This is the key point. It is highly unusual and runs contrary to the practice of conduct and reporting of RCTs to focus on the within-group changes when you have between-group comparisons. This is Clinical Trials 101. All groups will tend to report some improvements over time due to various factors like regression toward the mean, placebo effect etc. The key outcome in any RCT is not changes over time but differences between trial arms. And of course we know that this was a null finding in the follow-up paper which is why the press releases have grotesquely spun the story to focus on the within-group changes over time.
     
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  4. Sidereal

    Sidereal Senior Member

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    Exactly. The two other groups have caught up with the CBT and GET groups over time. There is no effect of CBT or GET at 2.5 years' follow-up. None. There is only a significant effect of time but not treatment arm.
     
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  5. Sidereal

    Sidereal Senior Member

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    :thumbsup:
     
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  6. dancer

    dancer Senior Member

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    He says at the end of the article that he'll write more on some of the other problems with PACE if folks are interested, so let's be sure to affirm our interest. :)
     
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  7. Sasha

    Sasha Fine, thank you

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    BTW, we must go to his blog and thank him and give htm the traffic. He says, "[To be continued later if there is interest in my doing so. If there is, I will discuss the disappearance of objective measures of functioning from the PACE study and you will find out why you should find some 3-D glasses if you are going to search for reports of these outcomes.]

    http://blogs.plos.org/mindthebrain/...ace-chronic-fatigue-syndrome-follow-up-study/
     
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  8. Sidereal

    Sidereal Senior Member

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  9. adreno

    adreno PR activist

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    Coyne completely demolishes the study.
     
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  10. Sidereal

    Sidereal Senior Member

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  11. Sidereal

    Sidereal Senior Member

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    leela, Effi, Bob and 3 others like this.
  12. Cheshire

    Cheshire Senior Member

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    It really is a GREAT article!!
     
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  13. Simon

    Simon

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    Perfect additional point of one-eyed interpretation by the authors. I thought peer reviewers were supposed to pick up stuff like this. It is fair enough - good practice even - to point out where analyses are post hoc, but needs to be done consistently
     
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  14. alex3619

    alex3619 Senior Member

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    I think this demonstrates deliberately deceptive conduct. I wonder what a panel reviewing the paper would consider it to be? I guess it depends on who is on the panel.
     
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  15. Sidereal

    Sidereal Senior Member

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    Let me see if I can explain this better than I attempted to do above. Simply looking at changes over time WITHIN a trial arm defeats the entire purpose of doing a randomised controlled trial. If you want to look at changes over time you can just naturalistically follow up a group of people getting CBT/GET and not bother with pesky randomisation into CBT/GET vs "control" groups. The whole point of doing an RCT is to show that changes over time in the CBT/GET arm are OVER AND ABOVE the changes over time seen in SMC and APT arms because, as everyone knows, changes in symptom scores that happen over time have many potential causes, not just the effect of a treatment so the difference in change BETWEEN the groups demonstrate the effect of treatment while the remainder is attributed to placebo, SMC treatment, passage of time, regression to the mean etc.
     
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  16. adreno

    adreno PR activist

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    Yes, it's hard to believe they could be this incompetent. Which means it must be deliberate. Actually, they can choose between incompetent or deceptive.
     
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  17. ScottTriGuy

    ScottTriGuy Stop the harm. Start the research and treatment.

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    I posted on his blog:

    Thank you for writing this response to the waste of research money and harm to patients by these unscrupulous people (can’t bring myself to call them researchers).
     
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  18. Sean

    Sean Senior Member

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    Great article. Thank you, Mr Coyne. :)
     
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  19. WillowJ

    WillowJ คภภเє ɠรค๓թєl

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    Ditto from me. Though I think it's Dr. Coyne.
     
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  20. A.B.

    A.B. Senior Member

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    So Coyne finally wrote about it, and he found some new problems too. Impressive.

    It looks like he wouldn't mind writing some more about it.
     
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