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Full paper: http://www.ehps.net/ehp/issues/2007/v9iss3_August2007/EHP_Aug07_Coyne&Palmer.pdf
I'm sure I've seen others discuss this on here, but cannot find any thread about it.
It focuses on claims that psychological therapies increase life-span for cancer patients, but it also makes general points relevant to CFS.
I was going to quote relevant sections, but it's only four pages long, and is almost all relevant. These are the five main points, and I quoted the final three in full, as they seem particularly relevant.
1. Primary sources, even classics, often go unread.
2. Critical appraisal skills and the ability to apply
basic standards for interpreting clinical trials are
in short supply in psychology.
3. Findings that are in sync with cultural beliefs and
values can take on a life of their own, and
dethroning these findings does not make one
popular.
In the case of the claims made by Spiegel and his
colleagues, as well as later commentators, the idea that
patients should view their illness as a personal
responsibility to be overcome through the hard work of
psychotherapy appealed to strongly held values,
particularly in North American culture. Of course, the
study ought to have shown that patients can extend
their lives. Didn’t we know that already, even if there
had not yet been a study? Skeptics risk being seen as
rejecting what we already know and as undermining the
coping efforts of patients.
4.
Numerous groups had a vested interest in the
results of studies being seen as having positive
outcomes.
We often think of “conflict of interest” as more a
circumscribed issue than it most likely is in practice.
Beliefs are shaped by needs as much as evidence. As
Lesperance and Frasure-Smith (1999) pointed out
“Prevention of mortality has always been one of the
most important factors in determining the allocation
of funding for research and clinical activities.”
Findings that psychotherapy prolongs the lives of
cancer patients is extremely useful, even vital for
advancing the claims of diverse groups, ranging from
researchers seeking funding for
psychoneuroimmunology studies to promoters of the
virtues of mind control and positive thinking, most
recently seen in the huge popularity of Rhonda
Byrne’s 2006 book, The Secret. Those who see a
benefit for the credibility of their own claims are
going to have a stake in promoting and protecting the
claim that psychotherapy promotes survival.
5. A persistent champion can play a key role in
promoting the value of an intervention in the face
of contrary evidence.
Spiegel and his colleagues repeated claims that the
original study had shown that psychotherapy
prolongs life over two dozen times in journal articles,
as well as in numerous presentations to lay and
professional audiences, and even on national
television. As was discovered by Bernard Fox and
others, critics were excoriated (cf. Goodwin et al.,
1999). Moreover, one might have assumed that a
consistent pattern of failed attempted replications
would have caused a reevaluation of the original
study. However, champions of the original study
countered these new results by reinterpreting other
studies as positive and of equivalent value (Spiegel &
Giese-Davis, 2003), despite these studies not being
designed to test whether psychotherapy improved
survival and also having confounded psychosocial
intervention with improved medical care (Coyne et
al., 2007). There was a distinct bracket creep in what
was considered relevant evidence, allowing portrayal
of the overall subsequent literature as being mixed,
rather than more uniformly negative.
This is the conclusion:
What larger lessons are to
be learned? First, we need to read original sources. We
encourage prospective authors to read carefully the
studies they cite, even when there is near unanimity in
secondary sources about the nature of findings being
reported. Second, we encourage scholars to acquire and
apply the critical skills needed to appraise the claims
they find in published articles. These skills are sorely
needed, and critical application of them can be an
important contribution to the literature. But yes, if you
take on the task of challenging entrenched, but
erroneous, claims you must be prepared to take some
heat.
I'm sure I've seen others discuss this on here, but cannot find any thread about it.
It focuses on claims that psychological therapies increase life-span for cancer patients, but it also makes general points relevant to CFS.
I was going to quote relevant sections, but it's only four pages long, and is almost all relevant. These are the five main points, and I quoted the final three in full, as they seem particularly relevant.
1. Primary sources, even classics, often go unread.
2. Critical appraisal skills and the ability to apply
basic standards for interpreting clinical trials are
in short supply in psychology.
3. Findings that are in sync with cultural beliefs and
values can take on a life of their own, and
dethroning these findings does not make one
popular.
In the case of the claims made by Spiegel and his
colleagues, as well as later commentators, the idea that
patients should view their illness as a personal
responsibility to be overcome through the hard work of
psychotherapy appealed to strongly held values,
particularly in North American culture. Of course, the
study ought to have shown that patients can extend
their lives. Didn’t we know that already, even if there
had not yet been a study? Skeptics risk being seen as
rejecting what we already know and as undermining the
coping efforts of patients.
4.
Numerous groups had a vested interest in the
results of studies being seen as having positive
outcomes.
We often think of “conflict of interest” as more a
circumscribed issue than it most likely is in practice.
Beliefs are shaped by needs as much as evidence. As
Lesperance and Frasure-Smith (1999) pointed out
“Prevention of mortality has always been one of the
most important factors in determining the allocation
of funding for research and clinical activities.”
Findings that psychotherapy prolongs the lives of
cancer patients is extremely useful, even vital for
advancing the claims of diverse groups, ranging from
researchers seeking funding for
psychoneuroimmunology studies to promoters of the
virtues of mind control and positive thinking, most
recently seen in the huge popularity of Rhonda
Byrne’s 2006 book, The Secret. Those who see a
benefit for the credibility of their own claims are
going to have a stake in promoting and protecting the
claim that psychotherapy promotes survival.
5. A persistent champion can play a key role in
promoting the value of an intervention in the face
of contrary evidence.
Spiegel and his colleagues repeated claims that the
original study had shown that psychotherapy
prolongs life over two dozen times in journal articles,
as well as in numerous presentations to lay and
professional audiences, and even on national
television. As was discovered by Bernard Fox and
others, critics were excoriated (cf. Goodwin et al.,
1999). Moreover, one might have assumed that a
consistent pattern of failed attempted replications
would have caused a reevaluation of the original
study. However, champions of the original study
countered these new results by reinterpreting other
studies as positive and of equivalent value (Spiegel &
Giese-Davis, 2003), despite these studies not being
designed to test whether psychotherapy improved
survival and also having confounded psychosocial
intervention with improved medical care (Coyne et
al., 2007). There was a distinct bracket creep in what
was considered relevant evidence, allowing portrayal
of the overall subsequent literature as being mixed,
rather than more uniformly negative.
This is the conclusion:
What larger lessons are to
be learned? First, we need to read original sources. We
encourage prospective authors to read carefully the
studies they cite, even when there is near unanimity in
secondary sources about the nature of findings being
reported. Second, we encourage scholars to acquire and
apply the critical skills needed to appraise the claims
they find in published articles. These skills are sorely
needed, and critical application of them can be an
important contribution to the literature. But yes, if you
take on the task of challenging entrenched, but
erroneous, claims you must be prepared to take some
heat.