“Evidenced based” behavioral medicine as bad as bad pharma

[Simon]

“Evidenced based” behavioral medicine as bad as bad pharma

A slide show by James Coyne, who many will have heard of as a psychologist who makes a pain of himself critiquing flawed psychological research. A few teasers from the shortish presentation

• Are findings in behavioural medicine believable?
• Focused on lack of attention to conflict of interest throught 'investigator allegiance', a problem shown to bias findings [Cochrane Collaboration awarded them a prize for their work on this, and changed their guidelines too]
  
• Also lack of control treatment in unblinded trials

 

[alex3619]

In time this will get more attention. The problems with this area of psychiatry are not going to be fixed until they are acknowledged.

 

[Esther12]

Thanks. Lots of additional reading cited there. My list is growing much faster than I'm able to read.

Interesting the Lakens lecture was on pain. I often notice similar problems in pain research to those we've complained about with fatigue.

Also.... feeling rather frustrated that more action isn't being taken to address these concerns.

 

[Snow Leopard]

I truly think Coyne is listening to us (to some degree), but is tackling the problems in the field in general, rather than the CFS papers specifically.

 

[Esther12]

I'd be a bit surprised if Coyne was influenced by complaints from CFS patients tbh.

(Who knows though, some of the arguments I've seen in old CFS pieces do now sometimes turn up in academic blogs, etc... one only needs to convince one other person for an idea to spread).

 

[barbc56]

@Simon

Absolutely fantastic!

@Snow Leopard

While this does not specifically address me/cfs this information is critical when evaluating studies that do. In fact it's good information for anyone to know.

I don't think it can be said enough that we remember these same critical skills are also important when looking at studies in alternative medicine.

Thanks for posting this.
Barb

 

[Bob]

I truly think Coyne is listening to us (to some degree), but is tackling the problems in the field in general, rather than the CFS papers specifically.

I get James Coyne muddled up with Keith Laws, but one of them (I think it was Coyne) said on Twitter that (and I'm paraphrasing to the best of my memory) the ME community is doing a great job at fighting its corner against the harmful aspects of the psychiatric lobby. He seems impressed by the efforts of the ME community. He then said (and I'm paraphrasing again) that people with schizophrenia need more support to defend their corner, as they haven't built up a vocal lobby yet. It's unlucky for us that he hasn't got stuck into ME/CFS specifically, but it's probably a time issue for him that he focuses on other illnesses or problems in the field in general.

 

[Bob]

Article with same subject here:

Social sciences suffer from severe publication bias
Survey finds that ‘null results’ rarely see the light of the day.
28 August 2014
http://www.nature.com/news/social-sciences-suffer-from-severe-publication-bias-1.15787

 

[Esther12]

Keith Laws is the one involved in the CBT for schizophrenia debate.

I thought I remembered someone saying Coyne seemed to have swallowed some of the 'militant patients' spin. A quick google found this:

I know Simon Wessely and know that he has had death threats over his interpretation of a trial of CBT chronic fatigue.

I'd be pretty surprised if that were true, but who knows? Maybe Coyne did see good evidence of it.

"Because of how you interpreted results from that trial, I am now going to kill you..."

 

[alex3619]

I would be surprised if statements that might be interpreted as threats did not exist. I also suspect that most if not all are upset people making emotional statements, with no actual threat intended. Yet such things can be spun as threats. Yet real threats might also exist. Indeed I long ago suggested someone might make an FOI request to The Met to ask if there are indeed threats on file, though specifically not asking about the nature of those threats beyond their existence. If we ask for details any FOI request will probably be denied.

The real issue though is that apparent threats, or statements spun as threats, are conflated with genuine fact seeking actions, which are our right as health consumers and as people concerned with the science. For all the complaints of "harassment" that are made, I don't think we are asking nearly enough questions. The PACE trial is the worst "science" I have ever seen, its why I am trying (though on hold for now) to write a book. It will take a book to detail all the issues in so relatively few pages. There is that much wrong, and most of it is blatant. The fact its so blatantly wrong is very disturbing ... if the psychiatric, medical and scientific establishment cannot come to terms with such problems, and is still ignoring them, then the entire field is indicted, not just PACE.

 

[chipmunk1]

I know Simon Wessely and know that he has had death threats over his interpretation of a trial of CBT chronic fatigue.

Dramatizing.

If it happened someone ill and deeply hurt by WS nonsense wrote him an e-mail: "I hope you die" or "I kill you if you continue to publish this stuff" out of desperation and anger not because there were actual plans to carry out a murder.

 

[Bob]

Keith Laws is the one involved in the CBT for schizophrenia debate.

Ah, thanks Esther. In which case, I might have been referring to Laws, in my above post, and not Coyne.

 

[Bob]

If we ask for details any FOI request will probably be denied.

And interpreted as harassment, apparently.