And this fluctuation in activity , with PEM kicking in then not through conscious choice, would have been good data. If it was simple choice without physical consequence then there would be no significant fluctuation in activity levels.Interesting that if you were to apply this strategy to people with a long term persistent activity limiting illness, the odds are you might find minor improvements in the motivationally driven activity for a while, that would likely fade as the motivational effect hits its low ceiling, and reality once again kicks in as the physical activity limitation reasserts its dominance once more. Which feels familiar ground to me.
Seems to me that this is exactly what Sharpe is angling for. Not very successfully either.I hope we don't see a misleading quote in the press at some point in the future, such as, "I've received abuse on Twitter. I had to block dozens of activists."
So if Sharpe gets cancer, or Parkinsons, or [insert choice of fatal disease here].Presumably, you also choose how ill to be.![]()
I just love how they impute to patients secondary gains and vested interests in 'playing the sick role', when they themselves have a mountain of secondary gains and vested interests from playing their expert role.It seems clear this is an example of sunk cost phenomenon. The PACE PIs have invested their careers in this, and can't admit now that they were mistook, so everything has to be explained in increasingly bizarre terms in order to shore up their position.
There it is.He doesn't trust the patients to walk to their full potential he just trusts them to say they could.
Also, re this tweet from Sharpe:
This response to it and his explanation is worth reading. Note the year - 2005.
http://fumblings.com/weblog/msharpe.html
The best Sharpe can claim here is that he was very naive in using that line.
I'm pretty sure that's not the sense in which Sharpe means it though - he's already said that there is nothing that can be objectively measured in ME not because of the limitations caused by influence, but because there is nothing to ME but an idea. So I think his dismissal of actigraphs as objective stems from that perspective.
I suppose we can't expect everyone to understand the issues like we do, though that galls me that ridiculous nonsense is convincing to people. I suppose that explains politicsYes. Some patients on Twitter seem to be buying Sharpe's excuses. He is not giving any real answers to the bigger problems and just looking for ways to assume the "misunderstood reasonable researcher" role.
Thats an interesting question, though the crux of his beliefs seems to be there is no medical test showing a dysfunction in ME/CFS patients hence it has to be psychological and besides world cup players are not "claiming" disability. However i notice he never acknowledges the results from biomedical findings, likely because they would undermine his theory. Mind you i have not gone through all his tweets and public writings so might be wrong on this one.Could England win the world cup playing in Russia in the summer by improving their performances using GET and CBT. No because they might not try, you choose how well play to play!
But, they could win the world cup by undergoing CBT and GET not going to the world cup and then at the end of the course being asked, did you win the world cup?
Not necessarily, entire countries are run by people who voted for alternative facts despite all the concrete evidence to the contrary. So he probably thinks the CBT/GET just wasn't strong enough, which may be why the UK locks up patients involuntarily, because they think its necessary to "fix" people who won't listen to "the truth"If we were inactive because we have false beliefs about our capacity to be active, then CBT or GET would surely change that and lead to an increase in activity.
Direct activity measures is the best way to confirm or eliminate that hypothesis.
We had an informal look at just those patients who didn't receive any post-trial therapy. Not much there to support your claim I'm afraid.
As far as I know, the plan was always to provide CBT and GET after the trial endpoint, but I guess they had hoped they would still get a good between-groups effect at long-term follow-up anyway, so wouldn't have to do any special pleading.
So patients are motivated enough to participate in the PACE-trial, but they aren't motivated enough to get more productive? Is that what Sharpe is saying?
Thats basically the crux of the argument, he is desperately searching for an excuse that can't be skewered.But there's not too much point worying about what he meant, because we know it's just an excuse
[n.b. this post inspired by Alvin, not directed at Alvin]Thats basically the crux of the argument, he is desperately searching for an excuse that can't be skewered.
@Alvin is honoured to have inspired posts.[n.b. this post inspired by Alvin, not directed at Alvin]
I agreeThe foundation of all his arguments is his core belief system that the illness itself is a choice.
TrueI don't see much merit in further engaging him directly, as it comes down to trying to achieve the equivalent of him admitting his entire set of core values and life's work was wrong. Few people are brave/humble enough to make a shift like that; and fewer still on the public stage.
I understand what your getting at but if we don't challenge him then many will believe his tripe, we have not defeated the PACErs yet, we may be on the way but we are still fighting in the trenches and its still not retracted and dust binned. The problem with ignoring reality deniers is it empowers them to gain supporters, when your the only voice in the right place at the right time people tend to listen to you.I think it makes more sense to simply keep presenting the facts and their proofs to the general public without wasting energy on making him or anyone else wrong. They are wrong, we know it, we've said it, and we are in the midst of a sea change in public opinion. Who cares what he thinks, as long as we keep grabbing the reins of the narrative and steer away from the propaganda.
We can, and are, changing the narrative without the need to repeatedly personalise the counter-arguments.
I'm not suggesting never mentioning him or addressing him, I'm trying to point out what is at the basis of any conversation like that, and why our energy might be better spent focusing on the widespread dissemination of the counter-narrative that happens to be the truthful one.
In Germany, at the moment there is a tendency to build up digital archives where researchers can/should store their data. Once a psychologist told they can't provide their raw data because people could re-check their findings and that would be a problem; another one yesterday told they can't provide raw data because they regularly manipulate them (pick probands in order to get the wanted results, dismiss unwanted results etc.) and people could find out.Thinking like a PACE author for the moment, I think it might have been wise on their part not to publish the LTFU data. But perhaps their proposal bound them to it. And perhaps people would have said "why are you hiding the data?".
But then the evidence would be there (and in this thread) of what a feeble and fabricated smear campaign that is. Would be the same old tactics, but hopefully now in a more exposed environment.I hope we don't see a misleading quote in the press at some point in the future, such as, "I've received abuse on Twitter. I had to block dozens of activists."
But then the evidence would be there (and in this thread) of what a feeble and fabricated smear campaign that is. Would be the same old tactics, but hopefully now in a more exposed environment.