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

A.B.

Senior Member
Messages
3,780
That Cochrane review is a problem. The Cochrane brand is still highly respected.

I think there's a good chance that the average reader will see the Cochrane review and conclude that CBT/GET cannot possibly be ineffective. They don't know about the conflicts of interest at play here, or about the switched outcomes in the review to make CBT/GET look effective.
 

Hilary

Senior Member
Messages
190
Location
UK
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.........
 

Cheshire

Senior Member
Messages
1,129
Another aspect of people’s causal beliefs about illness is that they often demonstrate a modern-day version of Cartesian dualism and a rather crude division between mind and body. Thus, for the same illness, people may believe strongly in either a physical or a psychological cause, sometimes in a rather simplistic way. In reality, most diseases are caused and perpetuated by a complex mix of behavioural and physical factors and hence will be best managed by a range of treatments (e.g. lifestyle change, self-management and medication). A failure to appreciate this may inevitably result in sub-optimal management and poorer outcome.

OMG
What a load of bullshit
 
Messages
47
Location
Scotland

me/cfs 27931

Guest
Messages
1,294
And I lost count of the number of times they mention intimidation of researchers.
Perhaps we should count this as a positive. They obviously have no idea about the biomedical side of ME research, so presumably they are referring to psych researchers feeling intimidated, and if this is the case, I can only feel heartened that pysch researchers are discouraged from ME "research".
 
Messages
2,391
Location
UK
The continued debate on the PACE trial seems to miss the fact that science is incremental.
Oh no it does not! The point being missed is that science should not be so bad that it is detrimental to patients and detrimental to incremental scientific progress. The only proper way to then redress that is to fully investigate, and sort the real problem out. Genuine (strictly within the law) justice is what helps abused people to move on.

An unfortunate outcome of the PACE controversy and intimidation of researchers may be less research in the area.
Less research by cr*p scientists? Fine by me.

It is time to move on from criticism and collect more data on effective treatments.
Hmmm ... that would suit you all just fine wouldn't it ... see above.
 
Last edited:
Messages
13,774
That Cochrane review is a problem. The Cochrane brand is still highly respected.

I think there's a good chance that the average reader will see the Cochrane review and conclude that CBT/GET cannot possibly be ineffective. They don't know about the conflicts of interest at play here, or about the switched outcomes in the review to make CBT/GET look effective.

Yes, I was speaking to a medical professional (who is fully aware of the many problems with PACE) about the problems with the Cochrane review and they were like: "Cochrane too?! But everyone just trusts them."
 

user9876

Senior Member
Messages
4,556
Look over there: it's a dangerous dualism. Don't mind the null results and outcome switching please. That dualism is the real problem.

I don't think they understand what they are talking about but they feel if they use big words that sound complex then it will support their argument. But they don't actually put forward an argument beyond saying they believe mind and body are linked and hence they are right.
 

user9876

Senior Member
Messages
4,556
Yes, I was speaking to a medical professional (who is fully aware of the many problems with PACE) about the problems with the Cochrane review and they were like: "Cochrane too?! But everyone just trusts them."

Cochrane equally know the problems with their review and have failed to act - given that they should be treated as untrustworthy. David Tovey who is their editor in chief is taking a huge risk of completely destroying the Cochrane brand and questions should be asked as to why.
 
Messages
2,391
Location
UK
I don't think they understand what they are talking about but they feel if they use big words that sound complex then it will support their argument. But they don't actually put forward an argument beyond saying they believe mind and body are linked and hence they are right.
As has been said in one of the other PACE threads - that is religion not science.
 

user9876

Senior Member
Messages
4,556
In reality, most diseases are caused and perpetuated by a complex mix of behavioural and physical factors and hence will be best managed by a range of treatments (e.g. lifestyle change, self-management and medication). A failure to appreciate this may inevitably result in sub-optimal management and poorer outcome.

That is quite an incredible statement. I would note they they don't support it with more that a comment that behavioural seems to be the ability to follow advice and take medicine. You don't need a psychologist for that!

Earlier in the paper they say:
In our experience as health psychologists, patients with other illnesses such as cancer, renal disease, heart disease or chronic respiratory problems are usually very keen to adopt psychological interventions that can reduce fatigue, improve functioning and well-being. Indeed for these disorders a common complaint is that psychological support and interventions are not readily available.

Coyne has written quite a lot on the lack of evidence for psychological interventions in cancer. One trial showed an advantage but this was based on quoting a mean value on a small sample with a single outlier patient who got a lot better. This only came out later when people looked at the data.

I can't help but think that psychologists who think they can cure or have a significant impact on a range of diseases are delusional or dangerous.
 

user9876

Senior Member
Messages
4,556
This is the best they can do? Getting more and more embarassing.

http://journals.sagepub.com/doi/full/10.1177/1359105317703789

They've got that badly done Cochrane review, that Cochrane are failing to correct, some prejudices about patients promoted in the media, and that's it.

The Cochrane review is badly done. But it does nothing to speak to the methodological failings of PACE in terms of the lack of proper control, subjective outcomes, outcome switching and hiding of secondary outcomes.

However, the PACE methodology failures reflect on the Cochrane review in that they include the PACE results as well as other trial with similar methodological failings.

So saying Cochrane published a review does not provide any form of coherent defense against the failures of PACE yet this is the strongest argument they put forward.