CBT combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a feasibility study, 2020, Wyller et al

But the BMJ's careful investigation found that "this was not due to error on behalf of the authors"! Not even an error.

Given the way that those complaining about problems in CFS research can still get dismissed for not sticking to niceties I worry that anything which encourages harsher language could be counter-productive. At least, unless it's all carefully laid out with an explanation of why the use of such language is now needed. I think that we need to consider how we come across to the academics who are part of a culture that would almost never accuse another researcher of lying. It seems that this sort of tone/language stuff is the main defence those doing poor quality CFS research are able to hide behind.

 

I have good reason to think I know how I come across to these people. (I get feedback.) Nobody has challenged me for a while now. People know that I do not say things without justification. The main effect of making critical statements in my case seems to have been to be invited into smoke-filled rooms and on to the highest advisory boards to give my opinion - something quite unfamiliar to me as it happens!

Maybe others should not follow my example but I think it is my job to say things as they are and, being genuinely free of any competing interest, I don't see how people can manipulate that.

All around people in the BPS camp are floundering, producing worse and worse drivel. And they know it. When you have Trish Greenhalgh spouting tripe daily on twitter there is no point in getting the doilies out.

 

Yeah, but it could be an excuse for evading the debate!

I think that's more my concern. That we need to be careful about the tone and language that surrounds this sort of criticism as it will spread.

 

Tolerance of bad behaviour is what allowed the situation to get so out of control.

It is impossible to explain the pattern of problems with the BPS research as unintended errors or mere incompetence. It's deliberate and the fear that many people have to call it out for what it is allows BPS researchers to keep engaging in their fraudulent and criminal behaviour.

 

I'm a bit puzzled by the apparent strategy of not blaming the authors, which would mean the editorial process broke in multiple ways and would require changes or reforms in response so that this does not happen again. Especially because there is a habit of it, with Crawley's multiple violations as one example.

But of course there won't be changes or reforms in the right direction to the editorial process. Because this is the process, it worked as intended for a political aim, and they got caught. I guess they assume that nobody cares and will let them eat their cake, sell it as derivative product and proudly display it at the same time. Which may be correct and frankly the real problem here: where politics and ideology desire a specific health care outcome, science is pushed aside and the normal process is simply bypassed in the pursuit of that goal, the ends justifying the means.

Bit like the research integrity or whatever authority giving a pass to the PACE team for clear research misconduct, the end product of which has been condoning, even blessing, research misconduct, in effect tarnishing the entire process and explicitly the body who delivered a cowardly judgment. It did not clear anyone, instead of sullied everything.

 

It is interesting to reflect on whether the behaviour of BPS researchers should be considered a crime.

The goal of the studies in question would be to produce useful knowledge. If the study is intentionally designed to not be fit for this purpose, but for the purpose of advancing the careers or some business interests then what the investigators are doing in my view is essentially defrauding the funder which is typically the taxpayer as far as I know. The sums involved are often large. Then there is the potential for harm, potentially much greater, that could come from people acting on these misleading study results. One misleading study can also inspire several other similar studies which can waste even more money.

Much smaller offences than this lead to jail sentences.

The difficulty here is proving the intent. Perhaps that's why the BPS people act like fraudsters but play the believer who just cannot see that they have done anything wrong.

 

Yes, I get that. The point I was trying to make is that it's odd that both the reviewer and the editors somehow managed to ignore the title of the submitted paper. In the light of the note that the journal is concerned to not blame the authors that seems even odder to me.

Probably I'm being unfair, but that the reviewer addressed only the most obvious muddle could have been due to her wanting the paper not to look too muddled so that the first sentence of the abstract could still sound convincing:

"Cognitive behaviour therapy (CBT) is effective in chronic fatigue syndrome."

(She didn't ask the authors to clarify that, did she?)

 

@dave30th
I realize you covered most or probably all of that in your blog articles, but not able to search now all of them. Have just found again and re-read the one that includes the letter to the reviewer.

This part appears to me particularly relevant:

"Perceptive editors would have noticed that this response was non-responsive. The reviewer did not ask how the study 'should be regarded' now that it was already done. The reviewer asked whether the study started out as a fully powered trial or as a feasibility study. She wanted the authors to clarify this point, not to fudge it."

https://www.virology.ws/2020/05/28/...eer-reviewer-of-bmjs-cbt-music-therapy-paper/

Also, you point out that the title of the first submitted paper included the term "exploratory randomized trial".

I'm afraid I don't know what an "exploratory randomized trial" actually is. It seems to be not the same as a feasibility study, but just somewhat weaker than a fully powered RT?

The reviewer referred in her criticism of the conclusion to the study as an " underpowered exploratory study." Could this mean, she was aware of the title of the paper?

Anyway -- I would be interested but didn't find out whether she responded to your excellent questions:

"Are you surprised that the investigators responded to your comments by reporting how they thought the study 'should be regarded' after it was done rather than how they originally designed it?
"If you reviewed and approved the revised version, do you stand by that approval?"

 

Hi, of course I never heard back. I have no idea what an "exploratory randomized trial." I assume they used to the term to indicate that it was a trial but that it was "exploratory" so they could then apply for more money since they didn't have enough participants to make it "fully powered." BMJ is making it up that it's all the fault of BMJ. The authors bear huge responsibility for rewriting the history and purpose of their research. You can't do that. It's called research misconduct in most normal situations.

 

Link to BMJ's retraction note is now live:

https://bmjpaedsopen.bmj.com/content/4/1/e000620ret

 

The new publication:
Cognitive-behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a randomised controlled trial - Malik et al

in the footnotes:

• Provenance and peer review Not commissioned; externally peer-reviewed. This is an amended, republished version of a retracted paper: http://dx.doi.org/10.1136/bmjpo-2019-000620.
  

 

The above link states: “This has undergone editorial and peer review as a new submission. It has been published with the DOI http://dx.doi.org/10.1136/bmjpo-2020-000797, and clearly links back to this retracted version so that the history of the paper can be seen.”

Clearly links?

You did well to find that hidden away at the bottom of the full text, @Kalliope, below the references, in the bit that most people don’t read.

Anyone coming to this paper new will have no idea that it was previously retracted. Also, because it is a new publication, Michiel’s letter is no longer listed as a response. Can I suggest that you resubmit an amended version of your previous letter, @Michiel Tack?

It also seems odd that they have simultaneously retracted and republished. The decision to retract must have been taken some time ago but for some reason they have chosen to leave a paper which they know to be factually incorrect until a new the revised paper has been drafted, peer-reviewed and published. There can be no excuse for that delay.

Conclusion in retracted paper:

Conclusion in revised paper:

I don’t understand how the editors could have read Michiel’s comments and agreed to publish this revised version of the paper in good faith.

Finally, thanks to Michiel, @dave30th and others for their work on this.

 

It seems the the 'review history' for this new version is not linked to.

 

haven't read it yet. More letters to BMJ are likely forthcoming. it's pretty disgraceful.

 

They say:

Their commitment to open peer review might be helpful for understanding exactly what happened here, once they've been reminded that their new peer reviews seem to be missing from this paper.

 

maybe those are coming soon? Fiona Godlee did let me know once about BMJ's serious IT challenges, which apparently made it difficult to change the notice on the Lightning Process paper from an obscure page to the main one.