BMJ: Chronic fatigue syndrome and Long Covid, moving beyond the controversy, 2021, Newman

I hadn't thought about this before but it seems odd that a freelance journalist should be writing for the BMJ. Traditionally medical journals have taken material submitted by doctors and scientists without payment. More recently authors have often had to pay to publish. Editorial pieces were produced by the journal editorial staff from time to time but most editorial was solicited from people in the field and unpaid.

Surely Newman would only write for BMJ if being paid for the assignment?
Why would a medical journal pay a journalist to write commentary?
My guess is that this has something to do with a drive to be more accessible - with more 'public engagement'.

But who is going to be impressed by something that looks to be out of a tabloid and gets everything muddled up?
 
Dolphin said:
Hopefully a number of e-letters go in.
Over the years, the BMJ has tended to post most e-letters.
Best not to personalise criticism too much.
Ideally, do it in the format of a medical journal article with numbered references at the bottom (websites can be used as references)
Ideally have at least 2 references, but one easy one is to start with referencing the original article itself.
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Don't feel up to write a comment myself.

In case it could be helpful -- here are the references to Trish's response to and comment on some of Garner's BMJ pieces:

1) response: https://www.bmj.com/content/370/bmj.m3026/rr-7

2) comment: https://blogs.bmj.com/bmj/2021/01/25/paul-garner-on-his-recovery-from-long-covid/#comment-5242526040

short link to 2) http://disq.us/p/2ep9izc
 
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Jonathan Edwards said:
Surely Newman would only write for BMJ if being paid for the assignment?
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Information below the article:
  • Competing interests: None declared.

  • Provenance and peer review: Commissioned; externally peer reviewed.

It's clear from her Tweets that she was 'briefed' for her article.
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Code: 
https://twitter.com/Melanie_Newman/status/1408039875656491015

It seems odd to me that she's retweeting some angry comments she gets, e.g.:
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Code: 
https://twitter.com/MatthewJDalby/status/1408018674791878658

Other articles by the author:

https://pubmed.ncbi.nlm.nih.gov/?cmd=search&term=Newman+Melanie[au]&dispmax=50

Edit: I'm sure I saw a list of BMJ's freelance authors' declaration of COI on the journal's website when I looked yesterday, but can't find it anymore. Anyway, Melanie Newman wasn't listed there.
 
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Trish said:
This one just seems to summarise some of the points made on the BMJ article, including repeating Sharpe's criticisms of patients and quoting the PACE trial as a success.
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Ahead of publication of some editorials, articles, Views & Reviews etc, the BMJ sends out a press release. The BMJ peer-reviewed commentary I co-authored with Prof Allen Frances, MD, in March 2013 (The new somatic symptom disorder in DSM-5 risks mislabeling many people as mentally ill) was press released before publication.

The BMJ editors also sent a heads-up to Joel E. Dimsdale (Chair of DSM-5 Somatic Symptom Disorder Work Group) and Prof Michael Sharpe (one of two UK members of the DSM-5 SSD Work Group) for their review and response. Which meant that the first comment to be published on the day of publication was a critical response from Dimsdale and Sharpe.

Apparently, Melanie Newman originally trained as a lawyer.
Some background here: https://www.thebureauinvestigates.com/profile/melanienewman
and here: https://muckrack.com/melanie-newman
 
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Caroline Struthers said:
Yes, she was. She was behind METRIC http://www.virology.ws/2019/01/28/trial-by-error-my-letter-to-professor-chew-graham-about-metric/ and one of the FINE investigators. And then she had a change of heart...https://www.virology.ws/2020/10/21/trial-by-error-professor-chew-grahams-apparent-shift-in-position/. @dave30th did you ever hear from her?
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Chew Graham has now been joined by colleagues.... https://blogs.bmj.com/bmj/2021/06/2...ications-around-long-covid-can-harm-patients/
What on earth is going on???
 
petrichor said:
I think if you put all the biological findings on ME/CFS together you get a pretty compelling argument that it's not a psychological condition, but I don't think there's anything that's actually really solid or conclusive.
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Or perhaps -- just putting all the findings together is really confusing and gives rather the impression that it isn't an organic disease, but sifting those findings, focusing on the very few findings that seem plausible and view them in the context of a clearly observable specific pattern of symptoms, would give a pretty compelling argument that those findings can't be explained by psychological mechanisms?
 
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Caroline Struthers said:
Chew Graham has now been joined by colleagues.... https://blogs.bmj.com/bmj/2021/06/2...ications-around-long-covid-can-harm-patients/
What on earth is going on???
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I think it is clear they now recognise they can't go on openly promoting GET/CBT with the new NICE guideline, so they are re positioning themselves to be at the forefront of a 'new' approach called something like 'individualised rehabilitation' in which the therapist knows best what is right for each patient. Same old same old in new wrappers.
 
The pandemic has seen Sharpe back in Oxford, helping to set up a multidisciplinary long covid clinic involving medical specialists, physiotherapists, occupational health practitioners, and psychologists. Clinics of this sort, with a similar range of clinical expertise, have been set up around the UK.
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My understanding (from published papers) is that Sharpe had been back in Oxford since 2012/2013.
 
Trish said:
I think it is clear they now recognise they can't go on openly promoting GET/CBT with the new NICE guideline, so they are re positioning themselves to be at the forefront of a 'new' approach called something like 'individualised rehabilitation' in which the therapist knows best what is right for each patient. Same old same old in new wrappers.
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I think this is precisely what they will try to do.

I also expect to see more gaslighting of the ME community. Poor quality papers & articles have a double benefit for them if we don't challenge the science, then it all.sounds reasonable to the fresh batch of fodder for the clinics.

If we challenge them it's back to the difficult patient narrative & they live in hope it will put the newly ill off engaging with support groups and knowledgeable patients so the newly ill remain willing fodder for the clinics.

It's the heads we win, tails you lose strategy all over again.
 
Trish said:
I think it is clear they now recognise they can't go on openly promoting GET/CBT with the new NICE guideline, so they are re positioning themselves to be at the forefront of a 'new' approach called something like 'individualised rehabilitation' in which the therapist knows best what is right for each patient. Same old same old in new wrappers.
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I've been wondering what the new approach will be, given that the draft guideline only makes recommendations against treatments. That's sound enough, as we don't have any evidenced treatments, but it leaves patients in a zero-option limbo that's particularly difficult for the newly-diagnosed.

We all still need support, and much of what's required does fall within the remit of NHS GP clinics. Given the recruitment and retention crisis, we're unlikely to see the development of an ME nursing specialism anytime soon – but I still think it's a safer option than all the 'therapists' with their opaque qualifications and professional standards.
 
Has this been posted yet?

Godlee F. How can we manage covid fatigue? BMJ 2021; 373 :n1610 doi:10.1136/bmj.n1610
https://www.bmj.com/content/373/bmj.n1610

What’s the long term outlook after covid? And what’s the prognosis for health systems and staff struggling with covid pressures, waiting lists, and stretched resources?
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Most people make a good recovery, but the wide range of covid related illness and organ damage weave a complex prognostic picture. Of patients discharged from hospital, more than one in 10 will die within six months, writes Emily Fraser (doi:10.1136/bmj.n1565).1 Some patients with lung damage will have persisting respiratory symptoms, but for those who were previously fit and without other complications the outlook is good, with functional recovery better than expected from the radiological evidence.
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Over to Postcovid & ME:

"Up to 376 000 people in the UK have reported ongoing symptoms more than 12 months after contracting the virus, with persistent mental and physical fatigue a troubling reality for many (doi:10.1136/bmj.n1559).2

"This presents clinicians with a range of challenges.

"Should patients with fatigue follow the dominant advice of the CFS/ME communities: that pacing rather than graded exercise therapy is the safest route, as is now also recommended in controversial draft guidance from the UK National Institute for Health and Care Excellence?

"Or does this risk sentencing patients to a lifetime of symptom monitoring and long term disability?

"What of the researchers braving this often toxic academic terrain?"
 
Edit - from MSEsperanza's post above

Should patients with fatigue follow the dominant advice of the CFS/ME communities: that pacing rather than graded exercise therapy is the safest route, as is now also recommended in controversial draft guidance from the UK National Institute for Health and Care Excellence?
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So the old guidelines that left the majority of patients exposed to risk of harm weren't controversial because a small number of well placed people were happy. The new draft guidelines that rated the evidence properly, agreed about the risk of harm but annoyed a small number of well placed people is controversial?

"What of the researchers braving this often toxic academic terrain?"
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As long as they're not trying to rerun the same or very similar trials over and over, design the trials properly and report them honestly and without spin I don't see why they should have a problem.

Edit - autocorrect
 
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"What of the researchers braving this often toxic academic terrain?"

If they do their job competently and honestly, they will not have a problem. And vice-versa.

FFS, it is not difficult to grasp this. If you pervert and abuse the scientific process, smear and malign your critics, and harm your patients for decades, they are hardly likely to be grateful to you, do have every right to strongly criticise you, and they certainly do not owe you a shred of apology about anything.

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My view is that they are now aware that they have lost the basic scientific and ethical arguments, and are trying bargain their way out behind this smokescreen of smear. They are trying to get us to apologise in some way so they can save face on their way out.

Under no circumstances should we do so until it is proven we have done anything serious to apologise for.

Now is the time to start demanding that the UK authorities set up a proper formal inquiry, with full legal teeth, to transparently investigate exactly what the real situation is regarding the alleged 'harassment and threats', including its full context.

My prediction is that the likes of the BMJ and Lancet and senior BPS crowd will run a mile from it, because they know they will not be able to defend their grotesquely hyperbolic claims under rigorous public scrutiny.
 
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That sounds awfully expensive and time consuming.

Can't we just chuck them into a very deep pit full of people to help them get over their dysfunctional delusion that they have been thrown into a very deep pit?

If it was good enough for 'us'.....
 
Sean said:
They are trying to get us to apologise in some way so they can save face on their way out.
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Maybe we should apologise along the lines of we are sorry for pointing out the methodological flaws, spin and data hiding issues behind some research into ME. We realize that it is particularly distressing for researchers to have the flaws in their work picked apart by patients whose place it is to receive treatments that established authorities believe in even when other patients report no gain of significant harm. We now realize that science in this community does not progress through an assessment of the evidence but rather by unevidenced statements from established authorities.
But perhaps the BMJ should be more honest about this rather than claiming to support evidence based medicine and patient involvement in research.
 
Somehow, Fiona Godlee has published an op-ed (it's linked a few comments down) with no purpose other than to attack us. Just like there is no clear point being made in this commissioned text here, Godlee's text has no point or substance, seems only to be a vehicle to attack us.

None of this is normal, it's nakedly political and what's far worse is that the reception to this is that it's basically normal. No one seems to question substance anymore in medical research, it's just a mutual admiration society where people build status and brown nose.
 
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Jonathan Edwards said:
I hadn't thought about this before but it seems odd that a freelance journalist should be writing for the BMJ. Traditionally medical journals have taken material submitted by doctors and scientists without payment. More recently authors have often had to pay to publish. Editorial pieces were produced by the journal editorial staff from time to time but most editorial was solicited from people in the field and unpaid.

Surely Newman would only write for BMJ if being paid for the assignment?
Why would a medical journal pay a journalist to write commentary?
My guess is that this has something to do with a drive to be more accessible - with more 'public engagement'.

But who is going to be impressed by something that looks to be out of a tabloid and gets everything muddled up?
Click to expand...
It's marked as commissioned to the BMJ so they had to solicit and pay for it, no other explanation. Which itself is inexplicable given how poor of a job it does at summarizing the facts, this is not journalism, not the regular kind and even less scientific.

But more importantly it is also marked as being peer-reviewed and that just makes a mockery of the entire system. Why even pretend that this is a scientific article when it is obviously a commissioned editorial pushing an obviously political agenda?
 
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