The PACE trial [pro]: It’s time to broaden perceptions and move on. Keith Petrie, John Weinman

[Yabisa]

Wow. What a lot of BS. Why can't PACE authors acknowledge that they've made major mistakes and correct them? Then we can move on.

Because they loose patients and patients mean money??
That's their unique goal.
We have been on psicotic hands and we ( patients ) have discovered it .
Why are they psychotic? Simply, when instead of giving us a chance to recovery investing in REAL science these people spend 5 million of £ saying the origin of our illness is "Psychological" they are LIYING, because good science doesn't harm people.
When somebody like PACE author calls themselves doctors when they know everything they have spot is a fake , they just don't think about their patients but about their STATUS.

 

[ladycatlover]

Watch this.
John Weinman on You Tube talking about non-adherence, what Atlantis healthcare is all about.....patients must do what they're told!

 

[Jonathan Edwards]

ATLANTIS Healthcare IS interesting. But it is also very worrying:

http://www.atlantishealthcare.com/news/details/the-nhs-change-day

This is quite remarkable. The company appears to be a for hire brainwashing service with Petrie and Weinman as 'academic' front men. It seems pharmaceutical companies or insurance companies or healthcare providers can hire them to ensure the patients have the right beliefs as in 'Our belief-driven behaviour change approach'. It never occurred to me that such an organisation should exist. The way their 'approach' is wrapped up in talk of 'empowering patients' is very creepy and quite seriously worrying.

Not surprising they want to put their oar in and defend PACE. A pity they cannot think of anything to say other than quotes from the PACE team.

I think there is serious conflict of interest here.

 

[A.B.]

I think there is serious conflict of interest here.

They declared no conflicts of interest in their PACE apology piece, if that is what you mean.

 

[adreno]

The way their 'approach' is wrapped up in talk of 'empowering patients' is very creepy and quite seriously worrying.

Real empowerment is about enhancing choice, enhancing opportunities. This seems more like the exact opposite; the narrowing down of choice to just one --theirs.

 

[Binkie4]

http://www.rcpsych.ac.uk/files/pdfversion/CR202.pdf

Competing interests in the Royal College of Psychiatrists are outlined on page 2. I think there are serious competing interests here, although not disclosed. ( EDIT- last 3 words added after TiredSam's 'like')

@Jonathan Edwards

 

[Barry53]

This is quite remarkable. The company appears to be a for hire brainwashing service with Petrie and Weinman as 'academic' front men. It seems pharmaceutical companies or insurance companies or healthcare providers can hire them to ensure the patients have the right beliefs as in 'Our belief-driven behaviour change approach'. It never occurred to me that such an organisation should exist. The way their 'approach' is wrapped up in talk of 'empowering patients' is very creepy and quite seriously worrying.

Not surprising they want to put their oar in and defend PACE. A pity they cannot think of anything to say other than quotes from the PACE team.

I think there is serious conflict of interest here.

The essence of it seems to be cutting costs by virtue of behaviour change. I can appreciate that some behaviour changes are going to be valid, but I suspect a great many cases put cost cutting ahead of real patient well-being.

 

[adreno]

The essence of it seems to be cutting costs by virtue of behaviour change. I can appreciate that some behaviour changes are going to be valid, but I suspect a great many cases put cost cutting ahead of real patient well-being.

Clockwork Orange, anyone?

 

[lilpink]

I think there is serious conflict of interest here.

I think so too. Are you in a position to raise this and be heard Jonathan? The rest of us are simply 'white noise' where these journals are concerned.

 

[Jonathan Edwards]

I think so too. Are you in a position to raise this and be heard Jonathan? The rest of us are simply 'white noise' where these journals are concerned.

The editor has done a very good job in allowing people with various views to express them in the journal. I do not want to make things difficult for him and as another contributor to the series of commentaries I think I have to be careful. It might be better for someone else to raise the issue. I appreciate that it is not immediately obvious who but somebody might feel in a position to do so. I don't think patients are actually white noise to the editor, David Marks, who has taken this debate very seriously. I wonder if there is someone with experience of the rules here, or who knows someone with experience.

 

[lilpink]

I wonder if there is someone with experience of the rules here, or who knows someone with experience.

That would be helpful. It would be nice to see a letter in response to this article published alongside it with reference to the issues I've raised here. Or at the very least a note of concern apropos lack of proper disclosure of these vested interests.

 

[RogerBlack]

This seems a paper which it is not particularly important to criticise.
It comes along with a pile of other more relevant papers, and it seems almost intended to only be of comfort to the existing true believers while persuading nobody else.
There are much more important targets to hit, and likely to be so in the near future.

 

[A.B.]

This seems a paper which it is not particularly important to criticise.
It comes along with a pile of other more relevant papers, and it seems almost intended to only be of comfort to the existing true believers while persuading nobody else.
There are much more important targets to hit, and likely to be so in the near future.

Yes, but it is important to make conflicts of interest visible. Readers will soon see that most PACE supporters have relevant conflicts of interest. At least that's how it seems to be.

Are we sure that these are relevant conflicts of interest? To me it seems that yes they are, as the company is selling belief and behavioural based management programs for chronic illness in the UK (and elsewhere).

So what would be the best way to raise this issue with the journal?

 

[lilpink]

This seems a paper which it is not particularly important to criticise.

Completely disagree. Where there is a hidden agenda this MUST be exposed. One brick at a time.... eventually you take down the whole wall.

 

[lilpink]

More from Atlantis. No sign of Patrick Duffy.

https://issuu.com/pfmagazine/docs/pf_magazine_september_2016/10

 

[Binkie4]

Apologies for a misleading comment.

I posted earlier a document which outlined the rules of professional practice of the Royal College of Psychiatrists with reference to conflicts of interest. I did this in the mistaken belief that Professors Petrie and Weinman were Professors of Psychiatry, but on rereading the item saw that they were Profs of Psychology, so it is not directly relevant.

Can I just say that I have repeatedly read that section wondering how several well known Professors of Psychiatry could not have contravened those rules. .?!?!

Presumably psychologists have an equivalent regulatory body?

 

[Jonathan Edwards]

Apologies for a misleading comment.

I posted earlier a document which outlined the rules of professional practice of the Royal College of Psychiatrists with reference to conflicts of interest. I did this in the mistaken belief that Professors Petrie and Weinman were Professors of Psychiatry, but on rereading the item saw that they were Profs of Psychology, so it is not directly relevant.

Can I just say that I have repeatedly read that section wondering how several well known Professors of Psychiatry could not have contravened those rules. .?!?!

Presumably psychologists have an equivalent regulatory body?

I think the issue is a general one for publication. Regulatory bodies might be involved in terms of professional sanctions but the definition of a competing interest relevant here will lie with the journal and the protocol of publishing. Nevertheless, the definition in the RCPsych blurb is helpful in that it presumably reflects the more general rules of acceptability. So it probably does not matter that the authors are not psychiatrists. Whether psychologists have a slightly different blurb or not is irrelevant.

 

[Wolfiness]

"Wessely number" (Can't find the original post)
As in Erdős number?
LOL Brightened a very tough day for me, thank you.

 

[Wolfiness]

Well it's just wrong - "the weight of evidence would seem to support these treatments" (CBT and GET). No it wouldn't. But hey, let's just keep saying black is white and suggesting these patients are more or less deranged.........

This only works if you can convince people it is a minority view. Which is good, because both the most effective and the easiest thing for us to do is to make it clear that we're not the minority. This should be Job No.1 for patients.

 

[Barry53]

I think this is deeply flawed but better than mind-brain dualism. Its was a good argument thirty years ago. The hardware and the software are in this case the same. Another flawed but better view is of the brain as a neural network. I actually think this view could probably be right if it were rigorously updated.

The brain does have a deep information processing architecture, some of which is innate, but most of which is adaptive. It just tends to derive similar architecture from similar internal and external environments, based on its own innate rule set.

One of the problems is the brain is indeed capable of being modified through training, but what can be consciously modified is probably a teeny tiny subset of the whole. This is largely still black box territory, and its the unknowns here that seem to give some proponents of psychogenic theory a presumed licence to go beyond evidence.

I was not trying to say/presume that was how the brain/mind works - that would be highly presumptive, and indeed flawed! . The real world is what it is, whatever our perceptions of it. But in our attempts to model how things might be, identifying a broad architectural structure can help. My way of trying to get my head round this, is considering the notion of the physical matter of the brain, contrasted with a more ethereal notional entity that results from the brain's physical operation - the mind. Not terribly well explained, but best I can manage.