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Lightning Process to be Evaluated in Research Study on Children

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
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ME agenda welcomes this opposition statement from the ME Association and The Young ME Sufferers Trust. The referrals to Trading Standards are also welcomed.

The joint press release says:

"If any trial is to be held, it should first be on adults, who can give informed consent."

My own position is that to undertake RCTs on any patient group would be legitimising the Lightning Process as having potential as a treatment and would also legitimise it, ethically, as a treatment. I would not want to see any RCTs for any diseases or conditions, whether undertaken with adults or children.
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
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Neuro Behavioural Training + Findley

(NB: This is not the LP pilot thread on Bad Science)

Comment on Prof Findley and the application of LP to a rehabilitation unit inpatient:

http://www.badscience.net/forum/viewtopic.php?f=3&t=15791&start=1825


Thread also mentions what has been referred to as the "Findley version of LP":

Neuro Behavioural Training: http://www.nebet.co.uk/

"Neuro Behavioural Training has its foundations in neurology.

"This training programme was developed after many years of practice in the field of CFS (Chronic Fatigue Sydrome) or ME (Myalgic Encephalomyelitis) and post viral fatigue syndrome both within an NHS Neurosciences Unit and with The National ME Centre and Centre for Fatigue Syndromes in Essex.

"It is influenced by many different therapies, treatments and theories including occupational therapy, clinical hypnotherapy, cognitive behaviour therapy, neurolinguistic programming and life coaching .

"It has been developed by Susan Codd, Occupational Therapist and Clinical Hypnotherapist, together with Audrey Norman, NLP Practitioner, Clinical Hypnotherapist, Life Coach and Relate Counsellor.

"Professor Leslie Findley, Consultant Neurologist and Clinical Director of the National ME Centre and Centre for Fatigue Syndromes in Essex has contributed to its development and Ged Codd, Chartered Physiotherapist and Judith Harding, Dietician and Nutritionist, both specialists in the management of CFS/ME have also contributed their expertise to aspects of the training."
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
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MEA and TYMES Trust 4 August 10 press release recipients

Tony Britton, ME Association Press and Publicity, has published a list of recipients of the joint 4 August Press Release on MEA Facebook site (this may not be a comprehensive list):

The press release has gone out to

The Times news desk
David Rose, health reporter, The Times
The Independent news desk
Steve Connor, science editor, The Independent
Jeremy Laurence, health editor, The Independent
Sunday Times news desk
Daily Telegraph news desk
Sunday Telegraph news desk
The Lancet news desk
BMJ news desk
Daily Star, news desk
The Sun, news desk
Daily Mail, news desk
Daily Mail, health editor
Fergus Walsh, BBC health correspondent
Western Morning News, newsdesk
Bristol Evening Post, news desk
Western Daily Press, news desk
Buckingham Advertiser
Bucks Herald
You and Yours, Radio 4
Today programme, Radio 4
Panorama, BBC 1
Dispatches, C4
Disability Now
Evening Gazette Colchester
Channel 4 news
Breakfast, BBC 1
GMTV news desk
Randeep Ramesh, health reporter, The Guardian (Sarah Boseley is on holiday til August 9)
The Guardian, news desk
Osteopathy magazine
East Anglian Daily Times, news desk
Daily Express, news desk
Daily Express, health editor
Private Eye, news desk
Anna Winkles, health reporter, BBC Online
Press Association, health editor
All Together Now magazine
Bath Chronicle.
News of the World
Tom Moore, health editor, Sky News. and his news desk.
Stacey Poole, the ME-aware health editor at Meridien, ITV station for south of England.
Emailed Times Ed Supplement, highlighting educational aspects of the release and suggesting they speak with Jane Colby.
 

Min

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Thanks for all you are doing Suzie.

The 'charity' Action for ME have stated on Facebook today that their sickening support for this unethical trial on children remains unchanged:

Action for M.E. sees no reason to oppose this pilot study.
"As was made clear when it was announced, the research at this stage is simply a pilot designed to see if it would be possible to set up a trial that can independently assess the Lightning process against specialised medical care.
"It is a fact that many parents are already taking their children to LP practitioners and so there are urgent questions that need to be addressed in order to assure the safety of those children. Dr Crawleys initiative aspires to find a way of answering some of those questions.
AYME (to whom Dr Esther Crawley is Medical Consultant) has not issued a position statement. But in an article in the April edition of its LINK newsletter describes the study as "an interesting piece of research".
In this LINK article, Dr Crawley comments:
"Lots of people are using LP. It's important to know whether it is helping or not. It is also important to know if there are significant side effects."
 

V99

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Yes, let see how the side effect show themselves in children. Ala Nazi style. Gee why test an adult, it's much more fun to see a child suffer. "But how do you know they will suffer?" Crawley" Oh yea we don't!!!!!!

Child abuse thats all it is.

Can anyone else think of something else parents do with their children, that has never been tested?
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
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Thanks for all you are doing Suzie.

The 'charity' Action for ME have stated on Facebook today that their sickening support for this unethical trial on children remains unchanged:

“Action for M.E. sees no reason to oppose this pilot study.
"As was made clear when it was announced, the research at this stage is simply a pilot designed to see if it would be possible to set up a trial that can independently assess the Lightning process against specialised medical care.
"It is a fact that many parents are already taking their children to LP practitioners and so there are urgent questions that need to be addressed in order to assure the safety of those children. Dr Crawley’s initiative aspires to find a way of answering some of those questions.”
AYME (to whom Dr Esther Crawley is Medical Consultant) has not issued a position statement. But in an article in the April edition of its LINK newsletter describes the study as "an interesting piece of research".
In this LINK article, Dr Crawley comments:
"Lots of people are using LP. It's important to know whether it is helping or not. It is also important to know if there are significant side effects."


Hi Min,

Thank you for your kind words.

In the interests of accuracy, Action for M.E. published a position statement towards the end of March on their Facebook Wall, in response to my requesting a position statement from them. So their position has been known since March and I included it in a mailing on Co-Cure on 3 May (ACT: FOI request: Pilot study: Lightning Process and children 8 to 18).

Unfortunately, someone on AfME's Facebook Wall, reposted a comment of mine which included both the March position statement and some text which was not included in the AfME position statement - and I have had to post a clarification and a request that my posts on Facebook are not reposted without attribution or clarification.

This is what the original AfME position statement had said at the end of March:

*************************************

"Action for M.E. sees no reason to oppose this pilot study.

"As was made clear when it was announced, the research at this stage is simply a pilot designed to see if it would be possible to set up a trial that can independently assess the Lightning process against specialised medical care.

"It is a fact that many parents are already taking their children to LP practitioners and so there are urgent questions that need to be addressed in order to assure the safety of those children. Dr Crawley’s initiative aspires to find a way of answering some of those questions."


*************************************

When I reminded readers of Action for M.E's position statement from March, in the last day or two, I added some additional information about AYME:

"AYME (to whom Dr Esther Crawley is Medical Consultant) has not issued a position statement. But in an article in the April edition of its LINK newsletter describes the study as "an interesting piece of research".

"In this LINK article, Dr Crawley comments:

"Lots of people are using LP. It's important to know whether it is helping or not. It is also important to know if there are significant side effects."


Unfortunately, someone then posted both the statement and my comments without clarification. So it's not your fault.

But if you are posting AfME's position statement elsewhere, Min, could you post only what AfME had issued in March, please, and not my additional comments - or if you want to include this to make it clear they are not part of the original AfME position statement.

The background to this issue is here on my site: http://wp.me/p5foE-2Vt (which also includes the AfME position statement and links to Invest in ME's position and there are a number of other LP pilot related posts which follow that initial background posting).

Best,

Suzy
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
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Child Experimentation on the NHS by Peter Kemp

http://groups.google.co.uk/group/meshare/web/child-experimentation-on-the-nhs

This article and several others about the proposal to test the lightning process on children are now available on MESHARE for group newsletters.

Peter Kemp

Child Experimentation on the NHS

On 2nd March, 2010, the Royal National Hospital for Rheumatic Diseases announced that 164,000 had been awarded for a trial using the lightning process (LP) on children with CFS (1). This move has been condemned as unethical by the ME Association and Tymes Trust, leading UK charities (2).

Needless to say, lightning process practitioners are getting in on the act with this announcement blandished on the front page of the first 3 LP websites I looked at last week. And why not after all it does appear that the NHS is giving credence to this expensive alternative therapy.

The proposed research puts parents in a very awkward position when it comes to deciding whether to consent to their sick child participating. Parents may have been exposed to the hard-sell type websites that promote LP and a parents own vulnerability due to concern for their child with CFS would almost certainly affect their judgement. Could they deprive their child of a chance to get treatment that might restore their health?

Yet a parent that consents would be choosing a highly experimental treatment for their child, delivered in a way that fails to meet established ethical standards.

The researchers themselves are in a very awkward position. Any medical professional that cooperates with the research would be in breach of ethical codes governing such research. The General Medical Council (GMC) rules are unequivocal: Children or young peopl should be involved in research only when research on adults cannot provide the same benefits (3). The Declaration of Helsinki also remarks on using vulnerable groups who are deemed incompetent to give informed consent for research i.e. children:

For a potential research subject who is incompetent, the physician must seek informed consent from the legally authorized representative. These individuals must not be included in a research study that has no likelihood of benefit for them unless it is intended to promote the health of the population represented by the potential subject, the research cannot instead be performed with competent persons, and the research entails only minimal risk and minimal burden. (4).

And the Royal College of Paediatrics (RPC) states: Research with children should be undertaken only if work with adults is clearly not feasible. (5)

So why choose children for lightning process research?

Among several possible reasons for choosing to experiment on children with the LP might be the fact that children are impressionable. They can be controlled and manipulated more easily than adults. As the RCP remarks: Many children are vulnerable, easily bewildered and frightened, and unable to express their needs or defend their interests. (5)

This appears to be something that could be taken advantage of. As Marshall and Williams note from a discussion in 2005 which included several Wessely school theorists:

At this point, Trudie Chalder made a truly disturbing contribution: Rather than start with the physicians, which might be quite a difficult task, we could make a start with youngsters in schools. My experience is that they are much easier to educate. The only barrier is the parents. Once we have the child on our side we are in a very good position. (6)

Removing the barrier of at least some parents to permit experimentation with LP on children, might not be a very difficult task. Parents on a low income for whom the cost of LP would be prohibitive might leap at a chance to save around 700 by getting the treatment for their child for free. Parents on higher incomes might choose to play it safe and wait until the trial results come out. Then if the results look good and the risks seem low, they may then choose to purchase LP for their child.

This means that financial inducement could be acting on those who choose participation. This is because the research is proposing to give a commercial product free of charge. The RCP (5) state: For consent to be freely given researchers must: offer families no financial inducement.

As the lightning process might be described simplistically as thought control, children are probably the group most likely to be easily and profoundly affected. They are also the group who could suffer the longest lasting negative effects if things go wrong; as the RCP point out (5):

Children are unique as a research group for many reasons. They are the only people, in British law, on whose behalf other individuals may consent to medical procedures. Many children are vulnerable, easily bewildered and frightened, and unable to express their needs or defend their interests. Potentially with many decades ahead of them, they are likely to experience, in their development and education, the most lasting benefits or harms from research.

In the same dialogue reported by Marshall and Williams (above); Professor Malmgren made a spookily prophetic suggestion:

Helge Malmgren, Professor of Theoretical Philosophy, Goteborg University, Sweden, said: Considering that so many people go to alternative and complementary medicine practitioners, perhaps we should not only confront alternative medicine, but also try to make alliances. In particular, we could try this with practitioners who use brands of alternative medicine that we think have some plausibility. (6)

Is this what is happening?

Peter Kemp
Aug 2010

REFERENCES


(1) Royal National Hospital for Rheumatic Diseases. 164,000 awarded for new research into the treatment of a chronic childhood condition. 2nd March 2010. Media Release. [Online]. Available at:
http://www.rnhrd.nhs.uk/index_sub_menus/news/documents/FINALRNHRDCFS_ME_fundingfeb10.pdf
Accessed Aug 6th 2010.

(2) ME Association and Tymes Trust. Study involving children and the Lightning Process is unethical, says joint charity statement. [Online]. Available at: http://tinyurl.com/MEA-TYMESTrust-LP-Statement . Accessed Aug 5th 2010.

(3) General Medical Council. 0-18 years: guidance for all doctors. [Online]. Available at:
http://www.gmc-uk.org/static/documents/content/GMC_0-18_0911.pdf . Accessed Aug 5th 2010.

(4) The World Health Organization. Declaration of Helsinki 2008. [Online]. Available at:
http://www.wma.net/en/30publications/10policies/b3/17c.pdf . Accessed Aug 5th 2010.

(5) Royal College of Paediatrics, Child Health: Ethics Advisory Committee; and PROFESSOR SIR DAVID HULL. Guidelines for the ethical conduct of medical research involving children. Archives of Disease in Childhood. 2000;82;177-182. [Online]. Available at:
http://www.rcpch.ac.uk/doc.aspx?id_Resource=2222 . Accessed Aug 5th 2010.

(6) Eileen Marshall, Margaret Williams. PROOF POSITIVE? 30th August, 2005. [Online]. Available at:
http://listserv.nodak.edu/cgi-bin/w...3C6A87C14EE59B163&Y=counsellingme@yahoo.co.uk . Accessed Aug 5th 2010.
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
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Context for quote (6) in the Peter Kemp piece:

http://mefreeforall.org/index.php?id=1641

08/10/07

Re: Appropriate treatments for M.E., 10 August 2007

From: Douglas Fraser, M.E. sufferer, London
To: Sir Peter Spencer, Chief Executive Officer, Action for ME.


[...]

However an example of how PACE trialists Chalder, Deary and Gerada-Wessely use information offered them in good faith by members of the public and recycle this against other members of the public, can be observed in an IoP video produced by Satrorious, Goldberg and Gask, during which they practise their contrived art of outsmarting members of the public, a technique apparently requiring role playing because its only by rehearsing the skills that you need that youll be able to use them when faced with the real situation.

This video was originally titled: Maudsley videos: The treatment of chronic fatigue (ME) in primary care Dr Tylee interviews Dr Trudy Chalder of the Maudsley Hospital. The package demonstrates how not to get into arguments with the patient, how to form a therapeutic alliance with them, and how to carry out a plan of treatment aimed at the restoration of normal function, and was recently put online in March 2006 at :

http://webcasts.prous.com/Chronic_Fatigue/program.asp

Encouraging Chalder, Deary, Gerada-Wessely, Deale and the others involved in this self-promotional video, and without a flicker of doubt about their unscientific methods, ignorance of human behaviour, armchair speculation about others, dangerous advice to GPs, specious reasoning and contrived explanations of M.E., Andre Tylee gives voice very expicitly to what they project throughout this performance in terms of their obvious collective contempt at the stupidity of M.E. sufferers, with the familiar excuse over failure: its these chronic fatigue syndrome patients [that] are difficult. Chillingly, one of this group of social determinists, naively unaware of the dark lessons of social engineering from the past, recently voiced her ambitions that (Chalder T in PD White 2005): Rather than start with the physicians, which might be quite a difficult task, we could make a start with youngsters in schools. My experience is that they are much easier to educate and to treat. The only barrier is the parents. Once we have the child or older youngster on our side we are in a very good position. They take up the messages up very quickly.
 
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Is this based on some shakespear tragedy? The plot is unbelievable but their a GMC and NICE box office hit. The actings pretty rubbish, so is the treatment and dangerous advice. May we have a refund?
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
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25% ME Group position statement on Bath/Bristol LP pilot study in children

25% ME Group position statement on Bath/Bristol LP pilot study in children:

I am advised, today, by Simon Lawrence, Chair, 25% ME Group Management Committee, that the group will be issuing a position statement, shortly.

Simon also confirmed that an email of concerns and attachments has been forwarded, at my request, to the group's Medical Advisers, Dr Nigel Speight (former NHS paediatrician with a special interest in ME and CFS) and Dr Byron Hyde.

A copy of the group's statement will be posted here and on my site, as soon as it is available.

Suzy Chapman
 

V99

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But why has it taken 4 months for the 25% ME Group to agree that they will issue a statement?

That is a good question. Were they attempting to do something else first, before speaking out? Is it normal for them to take them time issuing a statement? Please tell me they haven't fallen to the dark side?
 

Dx Revision Watch

Suzy Chapman Owner of Dx Revision Watch
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That is a good question. Were they attempting to do something else first, before speaking out? Is it normal for them to take them time issuing a statement? Please tell me they haven't fallen to the dark side?

Simon has given me no indication of the 25% Group's position or whether they have been making representations to any institutions, agencies, government departments etc.

The group has a committee of management for which Simon is the Chair. I believe they employ a member of staff.

In the past, position statements (for example the 25% Group's DSM-5 submission) have sometimes been prepared by Margaret Williams, and Doris Jones has represented the group at public meetings.

I haven't seen any 25% Group literature for some years but the last figures I had for membership were, I think, around the 800 mark.

The group has two medical advisors - US, Dr Byron Hyde and UK retired paediatrician, Dr Nigel Speight, who has a particular interest in children and young people with ME and CFS and has advocated on behalf of families facing social services or court intervention.

I appreciate that the group is under-resourced and that many of the trustees on the committee of management are very unwell themselves. Nevertheless, I have been disappointed that it has taken four and a half months for the 25% Group chair to confirm that a position statement will be issued "soon".

In the past, the 25% Group has been a signatory to joint statements prepared by the ME Association and co-signed by the Young ME Sufferers Trust, Invest in ME and a number of local and regional ME support groups. The group had been made aware, several weeks ago, that the MEA were intending to issue a position statement and consideration might have been given to approaching the MEA board with a view to supporting a joint statement.

So although I don't think we need fear that the group has gone over to the dark side, I am disappointed that it has taken over four months for an indication that a statement will be issued.

-----------------------

FOI update

On 17 June, the University of Bristol's FOI response to most of the questions raise by me on 16 May, had been:

"This information is intended for future publication when the study protocol and
other related documents are published online. It is therefore exempt from
disclosure under section 22(1)(a) of the Freedom of Information Act.

"The study is currently going through the ethics approval procedure and this
information is expected to be published around August / September 2010. We
cannot see that there is any public interest in disclosing this information
before that time."


In the last couple of days, I have contacted the U of Bristol's Information Rights Officer for certain clarifications around the publication of information and documents.

I have been advised that:

the information is intended for publication on the University of Bristol website (URL as yet unconfirmed);

that the Information Rights Officer will send me the link once the information is online;

that it is intended that the information relating to the ethics approval will be included in the online information and that it was hoped that the information published would cover questions 8-10 [of 15 May FOI request for information];

that it was hope that the information published would answer all of the questions posed in my original request;

that [University of Bristol] are hoping the information will be online before the end of August.

-----------

Which suggests that either the ethics team has already provided its opinion or that a decision is due before the end of the month.


My request for an internal review of the decision to withhold almost entirely all information and documents requested is due for response on or before 19 August.

The FOI to the National Research Ethics Service (copy on ME agenda site here) is due for fulfilment on or before 31 August (assuming the information is held and assuming that they do not apply Clause 22(1)(a) of the FOI Act).


It is still not established which research ethics committee(s) are reviewing the application for ethics approval.

If anyone is interested in the process for regional REC applications there are two documents on my site:

REC Application flowchart

REC Application Researcher Training Pack

Although these documents set out the process (and there is more information on the National Research Ethics Service website) they do not answer the question: Do RECs rely solely on what is set before them by applicants in the application form and accompanying documents or is the committee permitted to obtain their own information in order to inform themselves around potential risk and safety issues when arriving at an opinion.

Applicants may be asked to provide further clarifications; or to submit modifications which may be reviewed by an REC in a different SHA domain. There is an appeals procedure if an unfavourable opinion is handed down - which would result in delays.

According to copies of correspondence between the funders and Dr Crawley, obtained by other individuals under FOIA, the funders have stipulated the requirement that the study must start by October.


From scrutinising several previous papers published by Dr Crawley and her research team, it appears that the South West Region REC 3 is the committee that her studies are reviewed by.

For example:

The study:

http://repository.peerproject.eu:80...1/PEER_stage2_10.1007%2Fs00787-009-0029-4.pdf

Anxiety in children with CFS/ME Esther Crawley, Linda Hunt and Paul Stallard

Esther Crawley (): Centre of Child and Adolescent Health, Hampton House, Cotham hill, Bristol, UK BS6 6JS Tel: 0117 331 0896 , Fax: 0117 331 0891, Email: esther.crawley@bristol.ac.uk

Linda Hunt : Dept of Clinical Sciences at South Bristol, Institute of Child Life & Health, UBHT Education Centre, Upper Maudlin Street, Bristol UK BS2 8AE

includes the following:

"The local Research and Ethics committee* decided that the collection and analysis of this data was service evaluation and as such did not require ethical review by a NHS Research Ethics Committee or approval from the NHS R&D office (07/Q2006/48)."

*South West 3 REC (Previous name: North Somerset and South Bristol Research Ethics Committee)

I'll keep you posted.

Suzy Chapman
 

V99

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Thanks for the info on the 25% group Suzy. I'm very surprised it is taking them so long to issue a statement. Hope it's a good one.
 

Min

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My understanding too is that the 25% Group is desperately short of money, having lost their lottery funding, and that Mr Lawrence is quite ill at present.

Shame when Action for ME, who always support the misconception that ME is a psychological disorder, are rolling in money.
 

V99

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My understanding too is that the 25% Group is desperately short of money, having lost their lottery funding, and that Mr Lawrence is quite ill at present.

Shame when Action for ME, who always support the misconception that ME is a psychological disorder, are rolling in money.

That is what I feared.

It's disgusting. Every penny AfME have should be going to the 25%, and similar charities.
 

Min

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That is what I feared.

It's disgusting. Every penny AfME have should be going to the 25%, and similar charities.

AfME spend almost 400K ($624K)`of the money raised by their subscribers (only the executive are members with AGMs and voting rights-including the rights to vote their own salaries I guess) on salaries & Sir Peter Spencer, the Chief Executive earns 80K ($125K) of the money raised (don't know what he also earns from his other job as non-executive director of the Bath Hospital for Rheumatic Diseases)!

In contrast, Simon Lawrence,who runs the 25% Group for the severely affected, gives his time for free.

Guess which charity is actually demanding biomedical treatment based on biomedical research?