"My response to an invitation to improve the Cochrane Collaboration by challenging its policies"
April 21, 2016James C Coyne
"The declared conflicts of interest of the PACE investigators in The Lancet paper constitute a high risk of bias. I am familiar with this issue because our article which won the Bill Silverman Award highlighted the importance of authors’ conflicts of interest being associated with exaggerated estimates of efficacy. The award to us was premised on our article having elicited a change in Cochrane policy. My co-author Lisa Bero wrote an excellent follow-up editorial for Cochrane on this topic.
This is a big deal and action is needed
Note that this 2016 systematic review has only three new studies considered that were not included in the 2004 review. So, the misrepresentations and incorrect calculation of effect sizes for two added trials– PACE and FINE – are decisive.
As it stands, the Larun et al Cochrane Review is an unreliable summary of the literature concerning exercise for “chronic fatigue syndrome.” Policymakers, clinicians, and patients should be warned. It serves the interests of politicians and re-insurance companies–and declared and undeclared interest of the PACE investigators.
I would recommend that Dr. Lillebeth Larun recuse herself from further commentary on the 2016 systematic review until complaints about her conflicts of interest and unreproducibility of the review are resolved. The Cochrane should also publish an Expression of Concern about the review, detailing the issues that have been identified here.
Stay tuned for a future blog post concerning the need to move “chronic fatigue syndrome” out of the Cochrane Common Mental Disorders group."