Dr David Tuller: PACE Team Stages a Comeback Tour


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Trial By Error: PACE Team Stages a Comeback Tour
11 April 2022

By David Tuller, DrPH

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Professors Peter White, Trudie Chalder and Michael Sharpe seem to have embarked on what could be called the PACE Rehabilitation Tour.

This is an apparent effort to salvage their reputations and save professional face now that the UK’s National Institute for Health and Care Excellence (NICE) has officially rescinded its previous recommendations for graded exercise therapy and cognitive behavior therapy as treatments for what the agency currently calls ME/CFS. It is also an effort by these professors to gain a foothold in the long Covid marketplace. They hope their crumbling GET/CBT treatment paradigm for ME/CFS can revive its fortunes in a post-coronavirus world.

Last week, HealthSense, a UK watchdog group formerly called HealthWatch, posted Professor White’s umpteenth defense of the £5.000,000 PACE trial, which he co-led with Professors Sharpe and Chalder. The trial purported to show that GET and CBT were effective treatments. Professor White’s article was a feeble response to a cogent HealthSense commentary by Caroline Struthers, a Senior EQUATOR Research Fellow at Oxford University (also a friend and colleague), called “It is not only drugs and devices that can harm.”

And yesterday, The Guardian published a letter from the PACE trio in response to a compelling personal account of long Covid from Ravi Veriah Jacques, a 23-year-old who has been disabled from the illness. In discussing ME/CFS, Veriah Jacques included information about the debunking of the PACE trial findings. He also mentioned the publication last fall by NICE of new clinical guidelines for the illness, which reversed the agency’s earlier position. (Apparently, the letter was in The Observer, The Guardian‘s Sunday sister paper, but it was published on The Guardian‘s website, so from my perspective that means it was published by The Guardian as well, whatever The Observer‘s editorial role.)

In their response, the PACE trio suggested that Veriah Jacques was “misinformed” about the trial. (This is their routine response to criticism—it is based on a misunderstanding or miscommunication or on mistaken assumptions or on the other person’s failure to have read the article in question.) They acknowledged that NICE no longer recommends the treatments. (The guidelines allow for CBT as supportive care.) Their counter-argument was that objections to the NICE decision were raised by four trade groups of doctors. Since these trade groups essentially serve as campaigners and lobbyists for advancing physicians’ professional and financial interests and preserving their status, their testimony is not necessarily convincing, especially when they argue against the evidence.........