BMC family practice integrated GP care for patients with persistent physical symptoms, 2020, Chalder et al

Arnie Pye said:
2) GP care for patients with persistent physical symptoms was integrated with something but I don't know what
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Given where this study comes from, at first I thought "integrated care" must be just another euphemism for psychiatry. But apparently it is a thing - devised to free up GP time by referrals to "other roles such as pharmacists, counsellors, physiotherapists and nurse practitioners"
https://www.england.nhs.uk/integratedcare/case-studies/integrated-care-in-action-primary-care/

But yes, in this instance it's another opening for the sea lion.

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Kalliope said:
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Testing to infinity is basically correct, at the very least without a breakthrough independent of this ridiculous ideology this could go on exactly as is for several centuries more, never delivering a damn thing, never changing anything of substance. Always saying the same things no matter what happens.

I'd be very curious if someone did the work of actually collating all the identical experiments that have been performed over the last few decades. I would be surprised if it's fewer than 1,000 of this exact same formula. Most so small as to be insignificant but nonetheless, all identical, all the same formula, the same intent and rhetoric, the same methods and flaws, the same everything except for trivial changes to the substance, which itself is never actually reviewed in any capacity.

Because this is really important, no matter the number of those identical experiments with tiny trivial differences, when you read reviews, commentary and praise for it, the actual substance of those interventions is never actually discussed. Not rarely. NEVER. Because it is entirely irrelevant. If this were a drug, its formula or effect would never be discussed, it would simply be a generic The Pill, or whatever. Simply the act and ritual of taking The Pill, never what it is or does. Basically Obecalp (read it backwards, actual thing).

The same experiments over and over again, without change, without learning anything, without any oversight or accountability. Going strong for a full century or more, and possibly many more in the future if they could get away with it, with the only peripheral changes having to do with progress in the rest of science and technology, such as computers allowing for faster mathemagics and real scientists taking patients away from them and forcing them to say the same things about different people without skipping a beat.

And the worse thing is that they keep doing the same things over and over again but actually expect the same results. This is double insanity. It is not science, it may be just about the most literal example of how not to science.
 
rvallee said:
Testing to infinity is basically correct, at the very least without a breakthrough independent of this ridiculous ideology this could go on exactly as is for several centuries more, never delivering a damn thing, never changing anything of substance. Always saying the same things no matter what happens.
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Like the medical belief in the four humours which originated with the Ancient Greeks, for example. That belief lasted for about 2000 years.

https://en.wikipedia.org/wiki/Humorism#Four_humors
 
dave30th said:
Has anyone seen any news coverage of this? Has King's College London has promoted this thing as a success like they promoted the CBT for IBS study and the CBT for dissociative seizures study? Haven't seen news coverage so far but I could have missed stuff.
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Nothing that shows up in a Google search on either the title or the URL of the study.
 
Arnie Pye said:
Okay, this is annoying me and I want to understand the hodgepodge of nouns and verbs in the following title to try and make sense of it.

Title of article : "BMC family practice integrated GP care for patients with persistent physical symptoms"

"BMC Family Practice" is the name of the journal this was published in. BMC appears to be the initials of "BioMedCentral" - another meaningless mess.

So, my translation has come up with the following :

1) The article referred to is published in a journal with a name containing some meaningless initials.

2) GP care for patients with persistent physical symptoms was integrated with something but I don't know what.

3) I think there should be a colon between practice and integrated in the title. But it is still meaningless. So my final attempt at understanding this is :

4) Change the title to "BMC Family Practice : GP Care For Persistent Physical Symptoms Has Been Integrated With Something But I Don't Know What"
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I have added this note to the first post in this thread.

"[Worth noting that the intended study title was probably "Integrated GP care for patients with persistent physical symptoms: feasibility cluster randomised trial", i.e. the title minus the name of the journal, BMC family practice, it was printed in.]"

But I've not amended the thread title as it is what is, currently at least, used in the journal.
 
Trial By Error: Professor Chalder’s PRINCE Has Arrived
So here’s yet another paper with Professor Trudie Chalder of King’s College London as the senior author. That usually means there’s a lot to dig into! In this case, the journal is BMC Family Practice and the paper is titled “Integrated GP care for patients with persistent physical symptoms: feasibility cluster randomized trial.” Professor Chalder’s co-investigators include her KCL colleague, Professor Rona Ross-Morris, and other leading members of the biopsychosocial ideological brigades.
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https://www.virology.ws/2020/10/14/trial-by-error-professor-chalders-prince-has-arrived/
 
None of the outcomes provided evidence for trial arm differences; all estimated effect sizes were small…The intervention needs to be optimised, possibly with therapist input, to bring about meaningful, enduring change in participant outcomes...Our low intensity intervention requires adaptation before we can test the efficacy in a fully powered randomised controlled trial.”
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They have been investigating / researching optimising their BPS treatments, what is it, going on 30 years now? And yet here they are continuing to work on 'adapting' the treatment.

In no paper have they ever questioned the initial assumption that these symptoms patients experience are anything other than perpetuated by the patients aberrant thought process. In the BPS world view no other explanation can be possible.

Their interpretations for reasons why the patient is experiencing these symptoms really reveals more about this group of researchers and not much of anything about those being studied (over and over and never getting to a place where the treatment actually works)

And yes, the people who fund this stuff are just burning money in a closed academic system that does not respond to anything in the real world.
 
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Patients with PPS tend to feel dissatisfied with the care they receive and often feel misunderstood
...

There is evidence to suggest that psychological therapies, including cognitive behavioural therapy (CBT), can be used to change the way patients perceive their symptoms in order to help manage them more effectively.
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I think the above is coded-speak for convincing patients there is nothing really wrong with them, and condition them into believing the NHS should not be having to waste its time and resources on them ... and so the NHS can wash its hand of them.
 
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Why are they ignoring this discrepancy? Why don’t they explain why they only found a prevalence of 1.5%, and discuss any implications for their framework?

In fact, they don’t seem to recognize the apparent contradiction.
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For Professor Chalder to arrive at these questions, she would need help. As we have seen from her researcher colleagues having their work questioned resulted in them claiming persecution. Rigid thought doesn't allow questioning. Fluid thought scares the hell out of rigid thinkers.

Cognitive rigidity prevents Professor Chalder from seeing the contradictions and making the connections. Professor Chalder's history proves she is unable to problem solve using free thought, she follows the same rigid belief in each of her studies, so she arrives at the same conclusions over and over. What universal conclusion? I need more money for a bigger study to prove CBT never fails.

Cognitive rigidity prevents Professor Chalder from conducting self-analysis which shows in her work. That's why Professor Chalder is like a robot, if you need a task repeated over and over she's your woman.

There's a story of a professor of CBT who was asked by his student, what thought is causing this headache? The professor explained that not everything is caused by a thought, take some aspirin and stop thinking so rigidly. Trudie Chalder never received that lesson.
 
cfsandmore said:
Cognitive rigidity prevents Professor Chalder from seeing the contradictions and making the connections.
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You are too kind. I am less so with each new 'paper' the likes of Chalder spew out.

The only words I ever want to hear from them now are something like:

'I was wrong, and I unreservedly apologise for any and all harm I have done to millions of sick, vulnerable, innocent patients and their loved ones, and to broader society.

Effective immediately, I resign from all positions of influence on medicine, science, and any public policy, and I will not seek nor accept any such position again.

I will also cooperate fully with any formal inquiries and legal proceedings related to my role in this easily avoidable catastrophe.'​
 
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