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Why the Cochrane Collaboration needs to clean up conflicts of interest (on GET for CFS review)

Discussion in 'General ME/CFS News' started by Tom Kindlon, Mar 20, 2016.

  1. Tom Kindlon

    Tom Kindlon Senior Member

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    Last edited: Mar 20, 2016
  2. A.B.

    A.B. Senior Member

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    I made a comment (on Coyne's blog) that Cochrane Common Mental Disorders group made a recent review on exercise therapy for CFS. This group is coordinated from Bristol in the UK and lists CFS among its major interests. Lillebeth Larun was author of that review.

    These reviewers likely already consider CFS to be a mental disorder even if this has not been proven, and will probably be biased towards conclusions that support this view rather than conclusions that contradict it. Finding that psychotherapy and exercise are helpful for CFS undoubtedly supports the view that CFS is a mental disorder. This conclusion may also be good for the careers of the reviewers.

    A fair review would include people from different fields, and also discuss the possibility that CBT and GET may appear to work only because of the placebo effect. Asthma medication would not be considered effective if it didn't objectively improve breathing, but claims are made about CBT and GET being effective despite a lack of objective improvement.
     
    Last edited: Mar 20, 2016
  3. BurnA

    BurnA Senior Member

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    This is my favourite bit

     
  4. Tom Kindlon

    Tom Kindlon Senior Member

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    That's the review that is discussed:
     
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  5. A.B.

    A.B. Senior Member

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    Yes. I have concentration problems at the moment and wasn't sure which one Coyne was referring to exactly. Anyway I think I make enough sense to be understandable. There seems to be an implicit bias in the group that is producing this review (since they already consider CFS a mental health disorder), combined with low standards that are accepted as the norm.
     
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  6. Sasha

    Sasha Fine, thank you

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  7. alex3619

    alex3619 Senior Member

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    This very much looks at some of the big issues with EBM, though not all of them. Rapid reviews of papers miss methodological and bias issues. As a result the outcome of an EBM review or meta-analysis risks reaffirming bias. I have been saying much the same thing.

    What Coyne does not say is why this issue has arisen. I think there are two main issues other than the ones he cites. The first is that huge numbers of poor papers can get published by virtue of funding bias. This will distort a review. The second is that it is very time consuming to properly review papers. Which means someone is out a lot of time and often a lot of money. There seems to be an imperative in EBM methodology to get things done fast. Fast leads to poor review .. and yes, I think the months to a year in many reviews is too fast unless they are very well funded and resourced, and this does not happen.
     
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  8. Yogi

    Yogi Senior Member

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    Cochrane have responded:

    https://community.cochrane.org/news/cochrane-and-conflict-of-interest

    Great bit for the ICO Tribunal that QMUL will be defending.

     
    Last edited: Apr 18, 2016
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