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Interesting theory. They later claimed at some point that they didn't mean to claim that PACE was "definitive," and that they'd only said "definitive" one time--that it wasn't their overall opinion. Or something like that. No one funds major trials after small trials to get "preliminary...

that's kind of important, don't you think? does the training require you to learn how to change things if something doesn't work out over and over? that might be difficult for some people.

Wow, quick! I literally posted that a minute ago.

I assume so.

that is, in fact, the intent. but it seems the format can still leave it hard to pin people down on some of these things.

They were always going to measure WSAS at the other time-points but designated the 52-week as the primary outcome. I'm not sure if the other time points would automatically be inferred to be secondary outcomes? Or just to have no defined category? And I'm not sure oft he same about the other...

The point is also this was a major trial funded after other trials provided "preliminary evidence." It wasn't I assume supposed to produce preliminary evidence but actual actionable definitive evidence. Which of course it didn't produce. Has anyone seen a mininal clinically important...

Of course, PACE was randomized and this is what it showed.

I've always found it very weird that they claimed it was Fukuda except for the four required additional symptom. WTF? I mean, it's mind-boggling. Take those away and it's Oxford, period. It was very bizarre.

Right, only 3/4 did the six-minute walking test by the end. There is so much to criticize. Hard to include everything in a letter. I decided to focus on factors that would undermine White's claim of "effectiveness" sufficiently to require a correction.

Who are these people who dream this stuff up? It's incomprehensible to me.

Does anyone understand how this differs from unidimensional perfectionism? What dimensions are they talking about?

And yet more research is needed because they have some indications of improvement in vague secondary outcomes.

And the WSAS is a 40-point scale. So even if the 1.5 difference for the primary outcome were statistically significant, it would be unlikely to beclinically significant. This is just trash. I'm going to write to the journal after I finish my post about Peter White's most recent GET defense in...

I don't really disagree with this. But there seems to be some sense that no one who has a personal interest in something should investigate it because of "therapeutic allegiance." Of course studies should be rigorous and meet independent standards. That's why we have ethics committees, peer...

I do have some concerns about the idea that someone with an interest in a particular intervention because they use it professionally is automatically assumed to have an interest that should bar them from any research in that area. I mean, Kennair is right that those who are involved in a field...

absolutely.

I don't know. but it is certainly worth a letter bringing it to the journal's attention. These people seem incapable of doing studies without outcome-switching, made up end. points, and the like. Or claiming success based on failed primary outcomes but marginal secondary outcome measures. It...

good catch. classic outcome-switching

This seems to be what they're saying, yes.