Dear Dr Lubet
I am afraid that I did indeed jump to the conclusion that you had not looked in the detail I would have expected at the "case for the defence". Your blog seemed to me not to reflect what I know about the subject in general and PACE in particular, which is why I made what I am perfectly happy to accept was an erroneous conclusion. In a way I am now more, not less, surprised, by your blog, because I do think that the story is not as simple as you lay out, and you haven't convinced me otherwise.
The PACE authors have indeed responded to the many claims and allegations about PACE, most of which were sadly repeated in the comments that have appeared in response to your blog and my brief interjection. They will respond in due course to a couple of new claims - i will leave that to them.
I am also happy to clarify my use of the word "contested". I am not a lawyer, and I can see that could easily have been interpreted in a way I didn't intend. I meant that the field of consent, data sharing, open data and the like is indeed an area that is contested, as is clear from numerous articles, blogs, letters and so on that have appeared in the last few months on this, as I am sure you know. You write in a clear cut way in which "PACE is bad/wrong" etc and no reasonable person would think otherwise. But I have to differ on that and I know I am not alone. My reading is that this area is nothing like as clear cut. I suspect that there will be more cases, judgements and decisions still to come, and we are a long way short of knowing how this will end.
I also take issue with your reading of my nautical analogy. It was not about the evidence - the results are the results - but about how a trial is conducted. and on that matter, unlike the law, I do claim some expertise.
As for the rest, I stand by my comments. In answer to the question asked by another contributor, yes, I stand by my opinion of the PACE trial and in particular the key findings as laid out in the 2012 Lancet paper. I am of course aware of the hostility such sentiments engender from some quarters. I have looked at the responses since I posted, and they contain few surprises. Yes, it would be easier just to leave well alone and walk away. But it is because I do believe that the studies of CBT and GET for CFS (including but certainly not restricted to the PACE trial) are sound, and currently remain the best evidence that we have for anything that can offer at least some help for sufferers, that I think it is worth putting up with the slings and arrows that inevitably follow.
So to conclude, I genuinely apologise for my opening suggestion, which was made in good faith, but am happy to accept was erroneous. As for the rest, I think it's one of those "we will have to agree to disagree"
SW
Posted by: Simon Wessely |
November 14, 2016 at 01:03 PM