S. Wessely - Death threats, abuse, smear campaigns - Standing up for Science: 29 March

[char47]

many thanks @user9876 thats helpful much appreciated

 

[Keith Geraghty]

Wessely seems to realise he went a bit too far:

https://twitter.com/i/web/status/848125525482774530

https://twitter.com/i/web/status/848449307980304384

Wessely let the truth slip in - and is now trying to explain it away - when in fact its the crux of the whole thing

...they realised no-one would recover so they changed things lol

 

[lilpink]

Wessely let the truth slip in - and is now trying to explain it away - when in fact its the crux of the whole thing

...they realised no-one would recover so they changed things lol

Yep the genie is out of the bottle.

 

[Sean]

Why can't he just say "It's been pointed out that my answer was disgraceful nonsense" instead of trying to reframe the story as usual?

Because reframing and misdirection is this show pony's one trick, and he is extraordinarily good at it. Got him to where he is now, one of the most powerful and influential people alive.

I'm deeply embarrassed that - despite my many years experience in the art of obfuscation - on this occasion I spoke a little too candidly. I will try not to let it happen again.

 

[Jonathan Edwards]

It's been pointed out that for once my answer wasn't sufficiently ambiguous.

...because it was blindingly obvious to us that CBT and GET weren't having the desired effects long before we started analysis. But hopefully by offering a 'clarification' on the *timing* of the change I can create the impression that I mispoke when I blurted out the *reason* for the change.

I'm deeply embarrassed that - despite my many years experience in the art of obfuscation - on this occasion I spoke a little too candidly. I will try not to let it happen again.

If any of the lurkers here are members of the Royal College of Psychiatry I would be tempted to ask why they are keeping so quiet when their president is make such a complete fool of himself. He may be used to talking to dumb people but this is transparently obfuscatory (I decided to pick a vague word there). He has blown it. They have all blown it.

All it needs now is for someone to write that chapter in the psychiatric trials textbook on examples of really bad trials.

 

[Jonathan Edwards]

Why can't he just say "It's been pointed out that my answer was disgraceful nonsense" instead of trying to reframe the story as usual?

Presumably because that would be a direct lie; it was not nonsense was it? The ambiguity was that it might have given the impression that the decision was made after formal analysis had been made and we are now assured that was not intended to be implied. So we can be happy that although the authors realised from what the therapists were saying that nobody was going to be recovered and so changed the endpoint, they were not silly enough to actually do the calculations based on the old endpoint.

 

[Large Donner]

. So we can be happy that although the authors realised from what the therapists were saying that nobody was going to be recovered and so changed the endpoint, they were not silly enough to actually do the calculations based on the old endpoint.

Otherwise known as fraud?

Lets say this was a book keeping exercise for a money treasurer and during an audit they decided to count all the £1 coins as if they were five pound notes because, "they realised they would have lost loads of assets otherwise after they took an initial peak at the money pile and they would not have recovered the initial sum expected, would that be fraud?

Then again I think I just described the current banking system, so on those standards its probably all just fine.

 

[RogerBlack]

Reasonable people differ as to the interpretation of recovery.
They do not do so as to the value of pound coins.

That 'reasonable people differ' standard leaves a hell of a large gate to drive the excuses of 'Oh, yes, now I look at it and now that people have pointed it out to me 82 times I now realise that I should have read that bit of the paper at the time, as that's quite wrong. Silly me, what am I like.'.
Or 'I did not review that part of the paper'.

Getting to intent is almost impossible.

 

[Large Donner]

The thing is when Volkswagen interpreted their emissions tests anyway they wanted in order to continue to gain a market based and financial incentive, just as the BPS school do via their many sources of income, didn't they face fraud allegations?

Surely it can easily be argued beyond reasonable doubt that the PACE investigators could not have possibly believed that the way they conducted the trial, the reporting of it and their continued insistence that the treatments have been proven safe and effective and are the best treatments available, the very treatments they have staked their careers and financial in comings on, is a known falsehood?

 

[Esther12]

Presumably because that would be a direct lie; it was not nonsense was it? The ambiguity was that it might have given the impression that the decision was made after formal analysis had been made and we are now assured that was not intended to be implied. So we can be happy that although the authors realised from what the therapists were saying that nobody was going to be recovered and so changed the endpoint, they were not silly enough to actually do the calculations based on the old endpoint.

It's also not clear whether the decision was made after they had already analysed data for the 'normal ranges' released in the Lancet.

 

[Valentijn]

Reasonable people differ as to the interpretation of recovery.

Only to a minor extent. To equate "recovery" with the average SF36-PF scores of an 80 year old is far from reasonable.

 

[user9876]

Presumably because that would be a direct lie; it was not nonsense was it? The ambiguity was that it might have given the impression that the decision was made after formal analysis had been made and we are now assured that was not intended to be implied. So we can be happy that although the authors realised from what the therapists were saying that nobody was going to be recovered and so changed the endpoint, they were not silly enough to actually do the calculations based on the old endpoint.

The timelines and what happened for approving changes is far from clear. The primary end points are changed within the statistical analysis plan but when I read it I couldn't find a mention of the changes. It looks like secondary outcomes were also dropped here (the step test and Borg scale). I wonder if approval was given to the statistical analysis plan rather then the changes and they assume one implies the other.

They also talk of some people seeing blinded data although the timings are not given (from their stats analysis plan)

Blinding of the statistical analysis This document has been developed without reference to the PACE trial database. No analyses of outcomes relating to this strategy have been, or will be, conducted prior to final written approval of the analysis strategy by the TSC. Reports have been prepared with data presented descriptively by intervention (coded to maintain blinding) for the closed sessions of the Data Monitoring Committee. Consequently, both DMC and TSC were blind to intervention group, as were the trial statisticians. Data cleaning will be performed as blind to intervention allocation as possible. Decisions made during analysis concerning data or additional analyses will be documented.

So they may have seen some of the data when making decisions although only descriptive variables and without knowing which treatment they would be enough to say that 2 treatments did not stick out enough to give good results.

Of course they will have seen enough prior to that as it is a non-blinded trial and with (non-blinded) doctor rated results as well they will have had a very strong clue.

Then with recovery it is even less clear. Recovery was originally a secondary outcome but it seems to be dropped in the stats plan (was approval for this explicit). Then the 'normal range' published in the lancet was described as posthoc and requested by the reviewers. This would seem to suggest that the recovery definitions they eventually used were posthoc definitions after having analyzed the data. I don't think they have ever claimed they had ethics committee approval for the recovery definition they used - there wording is quite evasive.

 

[Barry53]

In most crimes, intent is obvious in that someone carried out a physical act which requires intentional actions. It's less clear when the inappropriate action could be due to gross incompetence instead of only intent.

If SW keeps spieling they way he currently is, he will make it abundantly clear.

 

[Barry53]

To be clear the change was before the analysis

Yes, but what analysis? The formal analysis? Or the informal "how is it shaping up" analysis I bet was done, to check if things needed tweaking before doing the formal analysis?

 

[Mary]

I don’t mind people disagreeing on measures of recovery. They changed the recovery measure because they realized they had gone too extreme and they would have the problem that nobody would recover.

It all makes sense now - the PACE investigators were simply grading their students - oops, er, subjects rather, on the curve - you know, like they do in high school when a test is deemed too hard and almost no one passes. This is how you can be sicker post-study than when you entered, and yet still “pass” (recover). Someone just needs to explain to them the difference between high school and rigorous scientific study.

Hopefully Sir Simon will keep talking!

 

[Wolfiness]

Let's ask them to staff their offices for a fortnight exclusively with PACE recoverees or equivalent.

 

[IreneF]

Except they dropped all the objective measures and the subjective measures provided a null result once the data was released after they changed the recovery definition because "they realised no one would have recovered otherwise", and people could be defined as recovered yet still ill enough to enter the trial at the same time.

Laughter from the scientific community worldwide.

Real objective laughter.

Except Wessely is still living in the subjective wherby he can just ignore the rest of the scientific community worldwide because, well, "thats what we do in the world of psychiatry".

The laughter is because they "know" that CFS/ME patients aren't really sick, and thus will never recover.

 

[IreneF]

If the route doesn't turn out to be too popular, they can always change it half-way along.

It's happened. There was a "last minute" change to the Olympic torch route here in SF before the Beijing Olympics, because the planners were worried about pro-Tibet protesters. It was worked out well ahead of time.

 

[Wolfiness]

I don’t mind people disagreeing on measures of recovery. They changed the recovery measure because they realized they had gone too extreme and they would have the problem that nobody would recover.

I think they're safe as long as he didn't say "had" instead of "would have". By "safe" I mean still being able to present themselves as idiots instead of liars. Those are their two options AFAICS.

 

[lilpink]

Some elements of Wessely's talk:

https://twitter.com/i/web/status/847156337092018177

I assume that the photo here is from the SAS lecture? If you zoom in to the slide projection - and search for each 'abusive' statement, then you find that they all come from just one perhaps dubious online site - uk.people.support.cfs-me.narkive.com/.../dr-simon-wessely-the-next-dr-shipman . Did anybody at the lecture notice if SW made it clear that this was the case, or did he (by omission) imply that they were from different people?