David Tuller: Trial By Error: Professor Sharpe’s Pre-Hearing Briefing for Monaghan

Andy

Andy

Retired committee member
Before this month’s hearing in Westminster Hall, Professor Michael Sharpe sent the following briefing notes to Carol Monaghan MP. To anyone who knows the details of the PACE scandal, it is immediately evident that the document is full of half-truths, untruths, misrepresentations and absurd arguments. It repeats the kind of irrelevant and non-responsive responses the PACE investigators and their defenders have raised repeatedly–and remarkably have gotten away with, at least until the last couple of years.

I could easily make a point-by-point rebuttal to these briefing notes, as I did to the arguments the PACE investigators raised after the publication of my initial 15,000-word investigation, but I’m not going to bother this time. It’s a waste of energy. The momentum is clear–the PACE era is coming to its much-deserved end. Except for the dwindling ranks of the CBT/GET ideological brigades, no one in this field takes Professor Sharpe’s assertions at face value anymore. Poor guy! He just seems incapable of acknowledging or coming to grips with the new reality. He must be having a difficult time of it.
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http://www.virology.ws/2018/07/02/t...or-sharpes-pre-hearing-briefing-for-monaghan/
 
- Between us, we have very many decades of clinical and research experience in trying to help people with Chronic Fatigue Syndrome (CFS), also called Myalgic Encephalomyelitis (ME).

Ah, here comes the Schrödinger logic again. PACE is at the same time both about CFS, also called ME - and exclusively about CFS.

 
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OMG, this is an exercise in bad faith, nearly all their statements are contentious (going from half truths to blatant lies "There was no ‘outcome-switching’.")

This remark is particularly laughable:
Very lengthy critiques have been produced alleging myriad flaws in the trial. Some of these include quotes from scientists, none of whom are experts in clinical trials.
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I could easily make a point-by-point rebuttal to these briefing notes, as I did to the arguments the PACE investigators raised after the publication of my initial 15,000-word investigation, but I’m not going to bother this time. It’s a waste of energy.
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I couldn't disagree more. It's essential that we keep on debunking this nonsense. I'm happy to take on the task if no-one else has the energy!
 
Lucibee said:
I couldn't disagree more. It's essential that we keep on debunking this nonsense. I'm happy to take on the task if no-one else has the energy!
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well, I kind of disagree with myself as well. I just didn't want to spend time repeating the same things I've written 500 times. I assumed commenters would take on the task. I'd just rather spend time clipping my toenails or watching milk sour or something else.
 
dave30th said:
well, I kind of disagree with myself as well. I just didn't want to spend time repeating the same things I've written 500 times. I assumed commenters would take on the task. I'd just rather spend time clipping my toenails or watching milk sour or something else.
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:wtf: He he! I think it was good to post it quickly. I’ve used a screen shot to point out the ME/not ME inconsistentency over on Twitter.

 
There has been many false allegation made about this research by activist groups and a small number of associated academics
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Right now there are about 4 or 5 hardcore BPS proponents who can bring themselves to try to defend the PACE trial and most of them were involved in it in some way, at least the philosophy before hand.

The so called small number of academics opposing it is actually now well into the hundreds judging by all the letters, critiques, reanalysis and signed support against PACE.

Also show me a charity that actually supports the PACE trial to the extent he can claim the only other critiques in the patient sector are "activists".
 
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We also found that if people who had had CBT and GET were followed up for 18 months after the trial had finished, the benefits in physical function and fatigue they reported at 12 months were maintained.
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Clinical trials are to compare treatments with each other, placebo, or no treatment at all, not to compare treatments with themselves over time.

Sharpe himself says so earlier in the same document:

The trial aimed to compare four different ways of treating patients with CFS.
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It is a fact that the CBT & GET arms maintained their effect size at follow-up. But that is not the relevant fact, which is that there was no difference between trial arms at follow-up.

From abstract of PACE's own follow-up paper, on which Sharpe is listed as lead author:

There was little evidence of differences in outcomes between the randomised treatment groups at long-term follow-up.

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(15)00317-X/fulltext

The follow-up paper reported a null result. Neither CBT nor GET offered any long-term benefit over APT or SMC.

Therefore, PACE provided no justification for using CBT or GET for patients with CFS or ME.

There is no other possible interpretation of those results.

Kalliope said:
- Between us, we have very many decades of clinical and research experience in trying to help people with Chronic Fatigue Syndrome (CFS), also called Myalgic Encephalomyelitis (ME).

Ah, here comes the Schrödinger logic again. PACE is at the same time both about CFS, also called ME - and exclusively about CFS.

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A little later down the page, he says:
A substantial proportion of participants also met one definition for ME.
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Keela Too said:
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I do find it oddly comforting that even he himself cannot keep up with his own bullshit. No, wait, I'm sure he is on top of it and what he intended to communicate was that some people which are very much not him use 'ME' and 'CFS' interchangeably but he has no control over that and has to clarify yaddayaddayadaa... Which reminds me of other things I am sure he was always on top of.

In the incredibly unlikely event that there is any chance whatsoever that he, in fact, was not completely on top of everything at some point while chasing the bounties Coyne spoke of, is there any chance we might ever get to see what Sharpe wrote about someone diagnosed with ME as an assessor? It's just that it would really make my day if I could admire how much dexterity it takes to never confuse, say, appropriate recommendations and realistic assessments of someone with ICC-ME with the same thing in someone with 'PACE-CFS'.
 
Intro:

We write as clinicians and researchers to clarify some points of scientific evidence.

Between us, we have very many decades of clinical and research experience in trying to help people with Chronic Fatigue Syndrome (CFS), also called Myalgic Encephalomyelitis (ME).
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Sign off:

Michael Sharpe, Professor of Psychological Medicine, University of Oxford on behalf of the PACE trial investigators. 13/6/18
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So how many PACE investigators read and approved this document before it was sent?

Also - this document had one reference. I can't tell if that's meant to be a joke or not.
 
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