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Key Concepts for Informed Health Choices: a framework for helping people learn how to assess treatment claims and make informed choices.

Discussion in 'Health News and Research unrelated to ME/CFS' started by Woolie, Jan 28, 2018.

  1. Woolie

    Woolie Senior Member

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    Key Concepts for Informed Health Choices: a framework for helping people learn how to assess treatment claims and make informed choices.

    Chalmers I, Oxman AD, Austvoll-Dahlgren A, et al. BMJ Evidence-Based Medicine 2018; 23:29–33.

    http://ebm.bmj.com/content/ebmed/23/1/29.full.pdf. (full text is free)

    A list of some of the key concepts:
     
    Michelle, Hutan, rainy and 20 others like this.
  2. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    It all seems very sensible and plausible. So why is Chalmers associated with the Norwegian centre where courses are run by Larun and Brurberg, who write Cochrane reviews that make all these mistakes?
     
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  3. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Michelle, MSEsperanza, Woolie and 3 others like this.
  4. Andy

    Andy Committee Member (& Outreach when energy allows)

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    Michelle, MSEsperanza, Woolie and 4 others like this.
  5. strategist

    strategist Senior Member (Voting Rights)

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    Research really needs patient interests to be properly represented, doesn't it.
     
  6. Esther12

    Esther12 Senior Member (Voting Rights)

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    Glasziou P has been attempting to defend PACE, and is one of the co-authors of the Cochrane protocol for the CFS exercise review.
     
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  7. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    The irony seems palpable:

    'Our survey shows that information on the policies and processes used by research funding agencies to reduce waste and support methodological research and research infrastructure is generally not transparent or readily available. It appears that the processes of governance do not, in general, hold accountable the funding agencies we have surveyed for assessing whether and how they address the questions raised by the reduce research waste framework.'
     
    Last edited: Jan 28, 2018
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  8. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    So what is really going on here?

    Is it that Chalmers, like Taverne, has unwittingly spawned a Frankenstein's monster of an organisation that propagates the opposite of what is intended, or is this a group of people who genuinely do not understand that they are prime examples of their own bêtes noirs?

    I am reminded of the chap in Edinburgh (?Macleod) who gave his inaugural lecture on bad science, and of course of Ben Goldacre.

    Is this in fact a new psychiatric disease idiotruncumoptosis (having a beam in one's own eye) potentially resistant to all forms of psychotherapy?
     
  9. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    So the question is: did @Woolie know that one of the authors of this piece was also on a GET Cochrane review supporting the BPS approach? Was that the reason for posting?
     
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  10. Barry

    Barry Senior Member (Voting Rights)

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    Or is it people wanting to be seen promoting best practice, so their other endeavours will be presumed, by association, conforming to that best practice?
     
  11. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    That would certainly apply to some of the co-authors of the GET review, but where does Chalmers stand? As far as I know he has o'other endeavours' beyond furthering best practice.
     
    Invisible Woman, Barry, BurnA and 2 others like this.
  12. Woolie

    Woolie Senior Member

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    I smelt hypocrisy right away. Especially give that it was recommended on twitter by some of the worst offenders. What they say seems reasonable - even useful to put it all together - but we know some of these authors do not follow their own advice.
     
  13. strategist

    strategist Senior Member (Voting Rights)

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    Mimicry is a survival strategy employed by many animals. It seems that humans may employ what could be called virtue mimicry (giving the impression of embracing certain virtues, when in reality doing no such thing). Or maybe I'm just overthinking this and reinventing hypocrisy... but a case could be made for this being a deliberate strategy.

    Richard Horton also came across as big on hypocrisy. I'm guessing it helps to be seen on twitter showing compassion with poor African children while helping PACE authors exploit hundred thousands of patients with pseudoscience.
     
    Last edited: Jan 29, 2018
  14. Barry

    Barry Senior Member (Voting Rights)

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    No, I don't feel you are overthinking this at all, you are spot on. It's part of the hiding in plain sight strategy some people do - whether they do it consciously, or is just second nature, is another matter. But I think it is more than hypocrisy, because there is an objective behind it.
     
  15. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    Code:
    https://twitter.com/EricTopol/status/1161003716448624640

    (Not sure whether this deserves its own thread.)

    Edit:
    Maynard, Matt/ Oxman, Andrew/ Pullin, Nicola et al (2019), Key concepts for making informed choices, Nature, vol 572 (15 Aug 2019),
    https://www.nature.com/magazine-assets/d41586-019-02407-9/d41586-019-02407-9.pdf


    Andrew Oxman is mentioned as an advisor in the e-mail exchange on the Cochrane review between Atle Fretheim and David Tovey
    see https://www.s4me.info/threads/cochr...developments-2018-19.10030/page-4#post-179971
     
    Last edited: Aug 13, 2019
    Invisible Woman, rvallee and Andy like this.
  16. rvallee

    rvallee Senior Member (Voting Rights)

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    A quick look at this list suggests every single thing produced as part of the psychosocial model of ME fails on every single point. PACE particularly excels, along with others in the series of bad acronym trials. Literally. Every. Single. Point. It's even missing several things that those trials did because they are so evidently fraudulent that it's expected no one would actually try them. And yet here we are.

    Somehow I guess this will be exempted. Somehow.

    I will still put forward that I would very much this framework to apply to all research on ME. One day, when we are taken off the blacklist anyway.
     
  17. Hutan

    Hutan Moderator Staff Member

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    Oh, the irony.

    Here's the full list of authors:
    Iain Chalmers, Andrew D Oxman, Astrid Austvoll-Dahlgren, Selena Ryan-Vig, Sarah Pannell, Nelson Sewankambo, Daniel Semakula, Allen Nsangi, Loai Albarqouni, Paul Glasziou, Kamal Mahtani, David Nunan, Carl Heneghan, Douglas Badenoch

    I was looking at David Nunan's publications, because he is on the 2021 Cochrane ME/CFS Exercise Therapy Review. And I saw this publication and thought, super, maybe this guy will be ok, because he's familiar with all of the sources of bias. And I thought, oh, that list of things to be aware of is pretty good, I'll post it on S4ME. And in the process, I see we already have a thread on it.
     
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  18. Hutan

    Hutan Moderator Staff Member

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    From the description of the paper in google scholar:

    So, apparently Ugandan primary school children with poor reading skills were taught to apply key concepts - these ones:
    • Treatments can harm.*†

    • Anecdotes are unreliable evidence.*†

    • Association is not the same as causation.†

    • Common practice is not always evidence-based.*†

    • Newer is not necessarily better.*

    • Expert opinion is not always right.*†

    • Beware of conflicting interests.*
    • Comparisons are needed to identify treatment effects.*†

    • Comparison groups should be similar.*
    • People should not know which treatment they get.*

    • Consider all the relevant fair comparisons.*†
    • Fair comparisons with few people or outcome events can be misleading.*
    Oh, for a Ugandan primary school child with poor reading skills when you need one.


    So, David Nunan was the person on the 2021 Cochrane review I was really hoping would be good. Maybe he will be. But looking at this, and all of the Cochrane reviews he has done, he's very much associated with Cochrane.
     
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  19. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Chalmers: the Godfather

    Astrid Austvoll-Dahlgren: Norwegian Institute of Public Health
    Andrew Oxman: Tovey/Fretheim exchange
    Allen Nsangi: working with Oxman at Oslo
    Paul Glasziou: author on previous exercise review with Larun
    Loai Albarqouni: works with Glasziou - a successor to Hilda.
    David Nunan: on the new review

    Nelson Sewankambo: Ugandan physician
    Daniel Semakula: Ugandan physician
    Douglas Badenoch: Evidence based health care (National Elf Service)
    Kamal Mahtani and Carl Heneghan: Oxford Centre for Evidence Based Medicine
    Selena Ryan-Vig: Cochrane educator
    Sarah Pannell: school biology teacher involved in public education in medicine
     
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  20. Michiel Tack

    Michiel Tack Senior Member (Voting Rights)

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    It seems that Henegan has been quite controversial because of his statements about COVID_19.

     
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