Michael Sharpe skewered by @JohntheJack on Twitter

Re: this tweet from SW:



This is one thing that bothers me particularly about what they've done over the years, and I probably need to investigate further.
They claim to have looked into biological causes/treatments, and then abandoned them. It's almost as if they've done it so that they can say, "been there, done that, didn't work" - but what worries me is that they have found things, but then later referenced those findings as a dismissal, or even a confirmation of their theory, knowing that no-one ever checks the references.

They also have a habit of doing "clinical trials" to test aetiological hypotheses. You can't do that. In the LD hydrocortisone trial mentioned, they say,
...one possibility is that low circulating cortisol could act as a biological factor that contributes to fatigue chronicity and interacts adversely with perpetuating cognitive and behavioural processes. Thus, a rise in cortisol concentrations might improve fatigue.

We set out to test the hypothesis that low-dose hydrocortisone therapy would improve fatigue in chronic fatigue syndrome using a randomised, double-blind, placebo-controlled, crossover design.
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They found that LD hydrocortisone did produce a small effect on lowering CFQ score. They claim it as a success, but right at the end, they say, "we would not recommend the widespread use of hydrocortisone as a treatment strategy." Reason, because they claim that CBT is more effective. Extraordinary.

The effects of hydrocortisone on disability are less than those seen after CBT, although this greater improvement takes up to 12 months. With CBT, fatigue is reduced less dramatically than disability, which suggests that such therapy is effective at changing the behavioural and cognitive factors that contribute to the generation and perpetuation of avoidance, disability, and sleep disturbance, but that subjective fatigue may be related to factors modified more indirectly by therapy. This explanation would be consistent with our suggestion that fatigue is perpetuated, at least in some patients, by low concentrations of cortisol.
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They simply cannot let go of their theories in the face of any other evidence, and any other evidence is simply confirmation of their theories. It's all such a muddle.
 
Simon Wessely said:
I certainly hope there will be an inquiry But if it is independent I suspect that the results will be nothing like the assumptions in this thread.
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I think he means independent in the same way that Cochrane is independent.

For anyone who is not aware, in 2106, giving evidence under oath in defence of QMUL, Chalder stated:
“disclosure to the Cochrane review does not count as disclosure to independent scientists as all three of the PACE principal investigators sat on the review panel.” (Kennedy B et al. First-Tier Tribunal, Information Rights. Appeal Number: ΕΑ/2015/0269. 2016: http://www.informationtribunal.gov.uk/DBFiles/Decision/i1854/Queen Mary University of London EA-2015-0269 (12-8-16).PDF)

He must be hoping he can keep Trudie Chalder’s mouth shut this time.
 
Indigophoton said:
Except psychologists and psychiatrists should presumably be quite good at putting themselves in the other person's shoes, and at empathy. Where are they without theory of mind, after all?
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Yes, I've pondered this. I think some of them mistake this for putting their mind into the minds of others. For some there seems to be a built in arrogance that makes true empathy very unlikely.
 
Last comment then that’s it.
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Well that was an interesting scientific debate, thanks. We do realise you live a busy life and have to be off somewhere important.
Jonathan Edwards said:
Maybe Wessely is still under the illusion that he can talk everyone round with a nice chat over a beer (what he offered me).
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I think he offered James Coyne a bottle of wine if memory serves, but only if Coyne could prove that Wessely had really said something.

An analysis of who he offers what drink to would be interesting - water instead of dinner, beer with a chat, wine for a bet - there's obviously some kind of scale in his head. I wonder what it would mean if he offered someone a cup of tea and a biscuit?
 
TiredSam said:
An analysis of who he offers what drink to would be interesting - water instead of dinner, beer with a chat, wine for a bet - there's obviously some kind of scale in his head. I wonder what it would mean if he offered someone a cup of tea and a biscuit?
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A few years ago, there was a UK journalist Sonia Poulton whom he invited for coffee:
…anyway, he invited me to meet him for a coffee to discuss his stance further…
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http://blacktrianglecampaign.org/20...esponds-to-journalist-sonia-poultons-article/
 
I'm sorry I can't accept that, he has to actually offer a cup of tea to a real person.

Whilst researching the chances of me losing my bet my new paper - Gender Differences in the Incidence of Proferred Beverages, a Narrative Review - I came across the following paper, which is fascinating for the way in which Simon Wessely starts by constructing fantasy characters based on his prejudices:

https://academic.oup.com/bmb/article/69/1/197/523356

And goes on to write the following:

One of us (Wessely) has a long history of engagement with the problems of chronic fatigue and its syndromes. For many years, it was unusual to find a newspaper article that did not use the epithet ‘Yuppie flu’ to describe the condition. This was understandable—the same articles contained case histories that frequently conformed to the stereotype of the hard driving professional who had succumbed to his or her illness because of ‘weakness’ of the immune system brought on by long hours, stress, overactive lifestyle and devotion to duty, rendering the sufferer vulnerable to infection. Most media case histories came from the articulate middle classes, and a surprising number from the health or teaching professions.

This finding was based on empirical evidence—study after study had confirmed the over representation of the professional classes and almost complete absence of ethnic minorities in specialist clinics and self help groups concerned with the condition. But these early studies were methodologically weak, being based on deterministic designs that merely confirmed the researchers’ preconceptions and categorizations. As Wessely and latterly others began to conduct rigorous epidemiological studies, it became clear that in reality the symptoms that made up the chronic fatigue syndrome concept were actually commoner in lower socio-economic classes and ethnic minorities. But these people were less likely to use terms such as chronic fatigue syndrome or myalgic encephalomyelitis to describe their health problems, and less likely to access medical care at all levels.
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The whole paper is about as good an example of "just make shit up and call it science" as I've seen from him, and that's saying something.
 
Jonathan Edwards said:
'Last comment then that’s it. I didn’t mean to trigger all this but have followed your career with interest since those happy days at Lamar which will always be precious to me . If you are ever in london it would be good to catch up for our own version of “40 Years On”.'

Maybe Wessely is still under the illusion that he can talk everyone round with a nice chat over a beer (what he offered me).
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By all accounts he invites you out then makes you pay. I wonder how strong the beer was he wanted you to drink.
 
large donner said:
Is anyone else worried that the "solution" to all this will be, "the PACE trial was done so badly it all needs to be funded and done again"?
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I'm not worried. The PACE authors know CBT/GET doesn't work. And no one else seems really interested in CBT/GET except perhaps Crawley, who is doing a fine job eroding her own credibility.

However I believe that unless the PACE authors don't face consequences or the UK adresses its junk science problem, there will be a risk that over time someone will follow the exact same recipe. The MUS and FND people seem to be already positioning themselves to take their place.
 
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