Snow Leopard
Hibernating
- Messages
- 5,902
- Location
- South Australia
Certainly an interesting view... From someone who wrote a thesis "The Case of the Triggered Memory-Serendipitous Discovery and the Ethics of Clinical Research"
https://dalspace.library.dal.ca/handle/10222/63140
Samofserendip has a wordpress blog btw. (no direct links thanks)
A quote from the paper:
The major argument that an RCT itself doesn't provide evidence for mechanism, therefore theorising about how the Rituximab may help patients shouldn't be used for justification for further Rituximab trials is weak and just shows ignorance.
The fact is the primary justification is still benefit of the drug for patients. The secondary justification is the begging of the question - if b-cell depletion leads to improvement, then somehow b cells must be involved.
This is a fair cop - and of course Ritixumab has its risks too.
https://dalspace.library.dal.ca/handle/10222/63140
Samofserendip has a wordpress blog btw. (no direct links thanks)
A quote from the paper:
Samantha Marie Copeland said:The projected values of new research directions are often framed by monocausal models of CFS. Empirical investigations into cognitive behavioural therapy and graded exercise therapy as treatments for CFS have been interpreted as demonstrations that the syndrome is primarily or solely psychiatric in nature [13]. This, combined with the lack of a physiological explanation for symptoms, has frequently led to the conclusion that the pathophysiology of CFS can be reduced to a psychological cause [14–16]. This tendency towards psychological reduction has generated opposition among researchers and especially patients.
Historically, the categorization of CFS as a primarily psychological disorder has led to the stigmatization of patients and to the (perceived and actual) neglect of the syndrome by medical practitioners and research [12,14,15,17]. On the other hand, research into biological causes and related interventions has yet to yield sufficient explanations or effective treatments for more than small samples of CFS patients [18–20]. Thus, reductive monocausal approaches to CFS have so far been unable to establish an effective standard of care for CFS patients as a group. The case I analyse in this paper stands both as a cautionary tale for grounding the projected value of an unexpected finding in a single causal relationship and also against promoting a monocausal approach to CFS. As I conclude, this unexpected finding is rather likely to have diverse valuable contributions to make to CFS research and may ground a causally complex approach to treating patients diagnosed with the syndrome.
The major argument that an RCT itself doesn't provide evidence for mechanism, therefore theorising about how the Rituximab may help patients shouldn't be used for justification for further Rituximab trials is weak and just shows ignorance.
The fact is the primary justification is still benefit of the drug for patients. The secondary justification is the begging of the question - if b-cell depletion leads to improvement, then somehow b cells must be involved.
Samantha Marie Copeland said:Finally, when this theoretical claim is emphasized as the aim of ongoing empirical research, consequent assumptions about the generalizability of research results can harm patients. Institutions often limit treatment options for patients who may require diverse approaches [60]. Indirectly, harms can take the form of reducing or dismissing patient experiences [17,61]. Assumptions are made that because a treatment works for many patients in what is known to
be a broad and diverse category, it will work for all, despite claims from patients themselves to the contrary. This has happened with regard to the positive results that cognitive behavioural therapy and graded exercise therapy have produced in groups of patients diagnosed with CFS, when they have been used as justification for reducing the treatment options available to CFS patients, possibly even causing direct harms to some [49,62,63].
This is a fair cop - and of course Ritixumab has its risks too.
Last edited: