COMPASS - Navigating your long term condition - Moss-Morris project

https://www.compass-southwark.co.uk/evidence

RE-EDITT and Compass

https://www.kingshealthpartners.org/our-work/mind-and-body/our-projects/reeditt-compass

Ok Computer
by Dr Joanna Hudson – 19th March, 2020
https://digitalhealth.london/ok-computer/#.XntkAq8n530.twitter

(ME/CFS not specifically mentioned but assumed included as LTC)

 

The finest snake oil that works for everything.

I can't wait for the day that psychological ideas are held to the same high standards as other kinds of ideas. How would people react to the claim that there is, for example, a drug that generally works regardless of the actual health problem the person has?

 

It's amazing how the body of evidence "supporting" the ME-BPS model exists when convenient and doesn't when it's not. There are literally hundreds of papers and trials on this, including by Moss-Morris and some of her colleagues. She's basically negging her own work to better promote it. Just amazing.

PACE is often cited as strong evidence for this model but it exists in a state of superposition where it's both the definitive trial that "proved" something while also being just one piece of (very expensive) evidence among a mass of other evidence that also only exists when convenient.

And here we are. Even the word theory has had to be stripped of its real meaning. Here it means "theory" in common parlance, of a set of general ideas that in a scientific model qualify as a hypothesis. They know it's not a scientific theory. It doesn't even have a formal hypothesis. The model was invalidated at every attempt so it can't be called a scientific theory. But it can be called a "theory" to the broader public, knowing full well it means the lesser everyday meaning and not the formal meaning of the word.

There is frankly a huge parallel with the chloroquine nonsense happening over COVID. The paper on which this was built was found to have been mostly fraudulent and so unreliable as to be uninterpretable. And yet enormous resources have been spent by some people to score political points. It "could be" or "may be" useful, even though we likely already know it won't because there is no basis to say so. Same as with the BPS model. It could be relevant. But it's been used in practice for decades. So it could work. Even though we know it doesn't. But let's push it anyway.

This is all legitimately the dumbest thing medicine has ever produced in its millennia-strong history. Dumber than the humours and any of the numerous ideologies invented to fill the gaps of ignorance at the time. Except here the excuse of ignorance does not justify this level of failure and incompetence. Seriously, the people involved in this are literally the worst medical professionals in history, with every resource and knowledge base available at their fingertips and still they produce garbage that could have been created in antiquity. In fact it probably was. Then created again and again, a straight line from our barbaric past to the HD idiocy on display today.

 

Yep.

The longer this goes on the harder it is to excuse it as ignorance. This is long past the stage of wilful ignorance even.

 

https://twitter.com/user/status/1285910603505311744


think this is taken from lecture in 2016(?)
I spotted Pariante and SW in the audience.

 

Isn't this like the unfortunate trans Atlantic liner metaphor. A compass, on its own, is only useful if you already know your intended direction of travel. Now, if they had a map as well they might find out where they were.

 

A compass also famously only ever points in the same direction wherever you are. You can go in any direction you like and it will always point the same way.

It will seriously be fascinating to study the psychopathology of conversion disorder beliefs. They tell on themselves constantly, completely unaware of it. The projection alone could fill volumes. And then there's Dunning-Kruger. Oh, the Dunning-Kruger.

 

from thread:

 

What does previous standards of achievement even mean? Children get this FFS, their future standards of achievement are obviously far above what they can do, physical function peaks at around 25 and cognitive peaks later on. And people don't whither into a puddle of weakness and cognitive goo when they reach 40.

What incredible nonsense. The worst part of this is by far that otherwise intelligent people listen to this and find nothing wrong with it.

 

I’m baffled.

Three doctors and a professor are putting in plain text:

- there was no scientific evidence
- so we just made our own theory about how things work
- and made up a treatment we have no idea about will help


And seemingly expect no backlash from doing so...? What does this tell us about the state of psychology?

Imagine if this was a medicine, vaccine or surgery?

Is it even legal to treat patient with untested treatments? Or is this like LP, just call it a ‘program’ - then there is no need to have supporting evidence...?

What if you are harmed by this program/untested treatment, will you be covered by patients rights for medial injuries?

 

Clinical efficacy of COMPASS, a digital cognitive-behavioural therapy programme for treating anxiety and depression in patients with long-term physical health conditions: a protocol for randomised controlled trial

First published October 25, 2021.

Abstract

Introduction Approximately 30% of people with long-term physical health conditions (LTCs) experience mental health problems, with negative consequences and costs for individuals and healthcare services. Access to psychological treatment is scarce and, when available, often focuses on treating primary mental health problems rather than illness-related anxiety/depression. The aim of this study is to evaluate the clinical efficacy of a newly developed, therapist-supported, digital cognitive-behavioural treatment (COMPASS) for reducing LTC-related psychological distress (anxiety/depression), compared with standard charity support (SCS).

Methods and analysis A two-arm, parallel-group randomised controlled trial (1:1 ratio) with nested qualitative study will be conducted. Two-hundred adults with LTC-related anxiety and depression will be recruited through national LTC charities. They will be randomly allocated to receive COMPASS or SCS only. An independent administrator will use Qualtrics randomiser for treatment allocation, to ensure allocation concealment. Participants will access treatment from home over 10 weeks. The COMPASS group will have access to the digital programme and six therapist contacts: one welcome message and five fortnightly phone calls. Data will be collected online at baseline, 6 weeks and 12 weeks post-randomisation for primary outcome (Patient Health Questionnaire Anxiety and Depression Scale) and secondary outcomes (anxiety, depression, daily functioning, COVID-19-related distress, illness-related distress, quality of life, knowledge and confidence for illness self-management, symptom severity and improvement). Analyses will be conducted following the intention-to-treat principle by a data analyst blinded to treatment allocation. A purposively sampled group of COMPASS participants and therapists will be interviewed. Interviews will be thematically analysed.

Ethics and dissemination The study is approved by King’s College London’s Psychiatry, Nursing and Midwifery Research Ethics Subcommittee (reference: LRS-19/20–20347). All participants will provide informed consent to take part if eligible. Findings will be published in peer-reviewed journals and presented at conferences.

Trial registration number NCT04535778.

https://bmjopen.bmj.com/content/11/10/e053971?rss=1

 

so end points are questionnaires ? again?
are there any objective assessmenst at any point?

 

This really, really, really annoys me.

I am aware that there are some people who might obsess about some things.

However, there are a great number of people, chronically ill and apparently healthy, who feel new symptoms or existing symptoms becoming worse and don't do anything at all about it. They either dismiss it or they wait and see.

I lost someone, someone who meant a great deal to me, someone who quite literally dropped dead at a relatively young age because they mistook warning signs for a flare of symptoms of a long term health problem.

So, will this be subject to a yellow card system? Will there be long term follow up where there is some means of recording death, avoidable hospitalization, decrease in quality of life because of damage caused by ignoring symptoms?

I'm betting not.

 

Wouldn’t it be nice if they could just add in another arm to the trial in which people received social worker support to access benefits/financial support or help with daily living such as cleaning/shopping or a wheelchair…. But that would cost more money even though I bet that the outcomes would be much the best in that group…..

 

The " social" of BPS - what a novelty!
( sarcasm)