Concerns about Cochrane

[Esther12]

Another blog from Hilda Bastian: https://blogs.plos.org/absolutely-m...biases-of-the-ideological-and-industry-kinds/

She raises concern about anti-industry bias from Gøtzsche and others, but goes on to say:

"I think bias from non-financial interests is a big deal. But Bero and Grundy convinced me that if you go past clearly justified and objective commercial interests, you open up a door where anything goes, everyone can be dismissed as having a conflict, and no one is trusted. We’re seeing that happen with the Cochrane HPV vaccine review."

 

[Esther12]

Crtical comment under that Bastian blog. Small excerpt:

"Of course, you are not responsible for the shadows. No, your position is much worse. That of the enabler. The enablers sat idly and watched injustice occur before their eyes – or closed their eyes to it. Or claimed to agree with the protestors, but not their methods. Without the enablers, the fire hoses would have had no water, the batons no force behind them.

On the issue of industry takeover of healthcare, people like you are not the enemy. No, you are something worse. You are the friend who does nothing in the face of corruption. The one who complains about it and decides the remedy is to walk away, only to return to criticize those who stayed behind to fight. “If only you were not so confrontational!” they said to the freedom riders. “If only you were not so confrontational!” you say to Gotzsche.

Your constant labeling of Gotzsche as “anti-industry” is an indictment of yourself, not him. You cast yourself as the neutral party, the fair arbiter in the whole ordeal. When you are really just an enabler. Gotzsche does not work from labels. He works from evidence. Sure, he calls researchers corrupt. And he calls them biased. But he does so based on evidence. His arguments do not rest on his assertions that people are biased or corrupt. Those assertions are merely explanations for why the research is biased. People do like to have human explanations. When research shows that non-blinded observers exaggerate effects by 37% on average, it seems entirely appropriate to explain the cause of this result: that the researchers are biased. When researchers are taking millions of dollars from companies and lying about it, while cranking out a new journal article every two weeks for years – to the benefit of those companies, only an enabler would refuse to call that corruption."

Then another commenter mentions PACE underneath [edit: Not Bastian]:

"I think non financial conflicts should be taken just a seriously as financial ones. The damage already done to ME patients by the PACE trial acknowledged to be scandalously poor science due to reputational and ideological interests is tragic. Yet Cochrane has given it a clean bill of health despite an unprecedented level of criticism. Just because it’s not a drug doesn’t mean patients can’t be seriously harmed by a treatment which powerful academics have built their careers on."

 

[Hutan]

Then another comment mentioning PACE:

"I think non financial conflicts should be taken just a seriously as financial ones. The damage already done to ME patients by the PACE trial acknowledged to be scandalously poor science due to reputational and ideological interests is tragic. Yet Cochrane has given it a clean bill of health despite an unprecedented level of criticism. Just because it’s not a drug doesn’t mean patients can’t be seriously harmed by a treatment which powerful academics have built their careers on."

Wow.
I'm not really following all of these Cochrane goings-on and I don't know about Hilda Bastian, I don't know how much influence she has. She says:

I am one of the members of the founding group of the Cochrane Collaboration and was the coordinating editor of a Cochrane review group for 7 years, and coordinator of its Consumer Network for many years.

Perhaps she could be another signatory for the open letter @dave30th?

Edit: sorry, I wasn't very 'with-it' yesterday. I have misunderstood things, that quote was not Bastion's.

 

[Jonathan Edwards]

everyone can be dismissed as having a conflict, and no one is trusted

We need honesty and reality. Dismissed is the wrong word, but everyone should realise that in science:

everyone can be considered as having a conflict, and no one should be trusted

Ultimately Bastian, Chalmers and Gotzsche were all interfering do-gooders with a biased view. They may have done good but propping up the idea of bias-free endeavour is in nobody's interest.

 

[Jonathan Edwards]

Perhaps she could be another signatory for the open letter @dave30th?

I think we have probably established (elsewhere) that Chalmers and Gotzsche don't get it when it comes to CBT and GET for ME. Bastian might have a slightly wider-angled view I agree. But I suspect she will want to mend fences as well.

 

[Jonathan Edwards]

Bastian ends with

We have to increase our skills at detecting bias, error, and the signs of fear mongering – and remember that it’s dangerously easy to be led astray by someone else’s passionately held conviction.

This sounds like an admission of naïvety to me. In my view it is actually quite easy not to be led astray if you watch people's body language. It took me about thirty seconds to see that Peter White was bullshitting at Bristol in 2014 and I had no preconceptions about the topic.

And if you do not have body language you have writing style. Phoney stuff shows itself pretty quickly. Maybe you have to have direct experience of the practical context of the science before that is apparent, though. What I don't understand is how people can not read the body language of the phoneys.

The reality is that if you take what she says seriously and get your skills of bias detecting up you agree entirely with Gotzsche. The corruption is pervasive. But that still does not mean that Gotzsche is bias free himself.

Despite herself Bastian is stimulating the haemorrhage of mistrust - all to the good.

 

[Hoopoe]

I like that comment that says iatrogenic harm is so big that people can not believe it's true. A lot like PACE where the problems are so many that it becomes hard to believe it's really that bad.

As for Bastian, I'm pretty sure that wanting to avoid discussing evidence is the best way to erode trust further.

 

[inox]

Wow.
I'm not really following all of these Cochrane goings-on and I don't know about Hilda Bastian, I don't know how much influence she has. She says:



Perhaps she could be another signatory for the open letter @dave30th?

Foggy head, not sure if I'm misreading you? But that quoted comment about PACE wasn't by Bastian, it's from the comment section under the blog, someone named Caroline Struthers.

Not sure if this is the same person
https://www.csm.ox.ac.uk/team/caroline-struthers

But if so, she is also involved with Cochrane

A lifelong interest in healthcare (and a great eye for detail) led me after many years in print and digital publishing to apply for a job as information specialist for Cochrane. Six whirlwind years led me through additional roles as managing editor, training coordinator and, most significantly, project manager of an NHS-funded public engagement project for the Cochrane Dementia and Cognitive Impairment Group - the ALOIS Community Project.

 

[Kalliope]

A statement from today by Cochrane's Governing Board

Cochrane is a collaboration: an organization founded on shared values and an ability to work effectively, considerately and collaboratively. The Governing Board’s decision was based on an ongoing, consistent pattern of disruptive and inappropriate behaviours by Professor Gøtzsche, taking place over a number of years, which undermined this culture and were detrimental to the charity’s work, reputation and members.

 

[Sasha]

I don't think I've seen any specification of what Prof G's 'disruptive and inappropriate behaviours' actually were. Do we know?

 

[Jonathan Edwards]

I don't think I've seen any specification of what Prof G's 'disruptive and inappropriate behaviours' actually were. Do we know?

Maybe he cracks his finger joints during committees? It's laughable.
Maybe the opposite of dis-rupt is co-rrupt?

 

[Sasha]

Maybe he cracks his finger joints during committees? It's laughable.
Maybe the opposite of dis-rupt is co-rrupt?

If Cochrane are accusing him of 'disruptive and inappropriate behaviours' without specifying what those things are then I think it's far worse than laughable - it's an open-ended smear, allowing people to think the very worst of Gotzche. Making arguments about privacy is no good when someone is saying that someone else has done bad things.

But I'm still not sure whether Cochrane have failed to be specific or whether I've simply missed the bit where they made a specific accusation.

 

[Trish]

If Cochrane are accusing him of 'disruptive and inappropriate behaviours' without specifying what those things are then I think it's far worse than laughable - it's an open-ended smear, allowing people to think the very worst of Gotzche.

I thought 'inappropriate behaviours' was usually used as a euphemism for sexual misconduct. They really should be more careful with their wording.

 

[Jonathan Edwards]

But I'm still not sure whether Cochrane have failed to be specific or whether I've simply missed the bit where they made a specific accusation.

I think they are quite specifically failing to be specific and yes it is far worse. The only good thing I see hear is that their handling of the situation is so bad they will lose all credibility. Cochrane is busted I think.

 

[Sasha]

I thought 'inappropriate behaviours' was usually used as a euphemism for sexual misconduct. They really should be more careful with their wording.

This is exactly what I thought about when I read 'inappropriate' and exactly why they need to either be specific or say nothing. By default, they've accused him of something terrible and are dragging his reputation through the mud (unless, as I say, I've simply missed where they said something specific about what he did).

To make a vague and very public accusation without saying what it is and producing evidence to back it up would be incredibly unprofessional (at the very least).

 

[Esther12]

I've been surprised by how much medical researchers seem keen to give Cochrane the benefit of the doubt in the face of their vague attacks on Gøtzsche. I think that there's a strong desire from people outside of Cochrane to keep the Cochrane brand respected. The trustworthiness of Cochrane reviews might be viewed as a useful myth.

 

[inox]

A statement from today by Cochrane's Governing Board

Cochrane is a collaboration: an organization founded on shared values and an ability to work effectively, considerately and collaboratively. The Governing Board’s decision was based on an ongoing, consistent pattern of disruptive and inappropriate behaviours by Professor Gøtzsche, taking place over a number of years, which undermined this culture and were detrimental to the charity’s work, reputation and members.

I don't think I've seen any specification of what Prof G's 'disruptive and inappropriate behaviours' actually were. Do we know?

I'm not buying it.


There seems to be a devide between the center leaders and the central board members, located in London. Can't find the source for it now, but am sure I read somewhere the other members leaving the board in sympathi were also center leaders....? Leaving the remaining board to be the Central Executive Team (CET) in London. (but do take this with a grain of salt)

Goetzhe was elected to the board in 2017, his written presentation have info about a split between CET and the cochrane centers. He seems to have been elected on the basis of beeing a distruptiv force and to possibly change the course of the cochrane ship...?

The middle of page 4 have this question:
"5. How do you see Cochrane developing or changing in the future (i.e., what is your ‘vision’), and why?"

[snip] Even after 23 years, I still see the Collaboration much more as an idealistic grassroots organisation than a business, and we could face deep trouble if we start losing some of our many thousands of unpaid volunteers. I have talked to many people who have been active in the Cochrane Collaboration for many years and who have expressed concerns about recent developments in our organisation. Some of the criticisms are:

probably quoting a bit to much... but some selected points, that would make him rather unpopulare with the CET part of the board:

(any bolding is mine)

The CET should be serving those people who do the bulk of the work, above all the authors and editors of reviews, but also those working in centres and methods groups. It has been noticed, however, that the CET has assumed a much more directive role, which has had unfortunate implications for the collaborative spirit and potentially for essential future contributions from those who are the backbone of the Collaboration and are creating the royalties without which there would probably be no Collaboration. Although there was general agreement that more direction and uniformity in the quality of our output was needed, and also that the CET has contributed importantly to this, many people feel that the process has gone too far.

In line with this, people have wondered why so many of our resources go to salaries of centrally employed staff and they worry that volunteers may stop contributing their time for free when they see that people with similar tasks get a salary. This worry is particularly pronounced in the methods groups. People have also pointed out that the more employees there is at the CET and at affiliate offices, the more work they will create for themselves and others, which might not always be productive.

The Cochrane Collaboration is now run much more as a business with a brand than it was just a few years ago. Many see this as problematic, as it could lead to a lack of funding, e.g. from governments that might think we could do well on our own. The raison d’être for the Collaboration is research, not business, and this is also the reason why people still want to support us. Our brand has no value of its own, but derives its value from our research.

Some centre directors have argued strongly against the CEO’s idea that it should no longer be a priority for centres to carry out methodological research or to be strong in research and thereby be good examples for others to follow. In my experience, one cannot be a good science educator without being a researcher oneself, and I believe this view is pretty universal, e.g. also at our universities.

I agree with many of these pretty widespread concerns. One issue that has come up repeatedly is: Should the CET decide on what centre directors should be doing when it doesn’t provide their salary and when the centres are on government finances, which come with expectations that might not always coincide with what the CET would want? I believe we need to avoid that too much decisive power becomes concentrated at the CET and, if elected, I will work on refocusing on our central values and aims.

https://community.cochrane.org/site...inline-files/Gotzche Peter -Application_1.pdf

I'm not able ro read more now, but it continues with the next question:
"6. What do you see as the most important issues to be addressed by the Board during your term of office?"

 

[Kalliope]

New article from Danish Ugeskriftet
Går Peter Gøtzsche eller går han ikke?
google translation: Is Peter Gøtzsche leaving or not?

I've tried to fix some of the worst parts of the google translation:
While the medical world is waiting for answers to these questions, Peter Gøtzsche has published on his
personal website the attorney's report on which the board justified his exclusion.

The Board of Directors has so far maintained that the report could not be presented openly - at least not in its entirety - for legal reasons and for personnel reasons. Now Peter Gøtzsche has done it himself.

...

Of the many fact-intensive pages, it is clear that the relationship between Peter Gøtzsche and Cochrane's CEO Mark Wilson is bad, very bad indeed. Wilson is the man who has direct contact with Peter Gøtzsche in connection with the many questions and complaints, and the material presents, for example. allegations that Mark Wilson has shouted at Peter Gøtzsche and "lost his head".

...

The overall impression of the lawyer's report - which the lawyer apologizes for is very long, he has not had time to make it shorter as he writes - is this:

Peter Gøtzsche may have been too close to the limits of what he can allow himself to do, and he has probably overstepped a bit concerning spokesman's policy, but the rules are unclear and he has not done it to such an extent that It should trigger criminal measures.

The message from the lawyer is, in fact, directed at the Cochrane Co-operation Board: Control your rules and policies so that there is no doubt about them.

Here is link to the full report from the lawyer

 

[Kalliope]

Ugeskrift-journalist Bente Bundgaard with a good summary of the story thus far (at least until the lawyer's report was published)

Hvad nu, Cochrane?
google translation: What now, Cochrane?

If Cochrane researchers are not specifically more independent than anyone else, if they are dealing with reviewing junk topics and if their reviews are no longer considered qualitatively better than others, what is Cochrane's mission really?

If the cooperation does not find an adequate answer to that question, the network's special position has ended. Then the glamor of Cochrane is not just faded. Then the star is completely switched off.

 

[inox]

From the article in Ugetidsskriftet, it's still uncertain wether or not they can remove him from Nordic Cochrane:

After appealing his exclusion, the rest of the board confirmed last week that it was maintained and added something new: now Gøtzsche was also removed as head of the Nordic Cochrane Center. Peter Gøtzsche himself contends that Cochrane has the power to remove him from that post and, at the time of writing, it is unclear how that dispute ends.