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RoB 2: a revised tool for assessing risk of bias in randomised trials (2019) Sterne et al.

Discussion in 'Health News and Research unrelated to ME/CFS' started by Michiel Tack, Aug 29, 2019.

  1. Michiel Tack

    Michiel Tack Senior Member (Voting Rights)

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    https://www.bmj.com/content/366/bmj.l4898.full?ijkey=gzAdEdyR713TWzf&keytype=ref
     
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  2. alktipping

    alktipping Senior Member (Voting Rights)

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    or you could bin the subjective abstracts and print the entire trial its methods and most importantly its data that will actually shed light on some of the preposterous conclusion/beliefs of the people publishing come to .
     
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  3. Esther12

    Esther12 Senior Member (Voting Rights)

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    Does this seem to make it easier to allow the sort of outcome switching seen in PACE?

    Seems that they wanted to make it easier to class trials as having a low risk of bias because so long as a trial is randomised it is good:

     
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  4. Esther12

    Esther12 Senior Member (Voting Rights)

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    From their appendix:

    That makes it easier to spin results.
     
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  5. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    https://www.bmj.com/content/366/bmj.l4898.full?ijkey=gzAdEdyR713TWzf&keytype=ref#
     
    Last edited: Aug 30, 2019
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  6. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    I get the strong impression that these quality assessment groups have completely lost sight of the PSYCHOLOGY of bias in scientific studies. Unblinded studies are fine if the endpoints are objective. There seems to be no mention of this, or the fact that bias for subjective measures is about psychology.

    A tool like this is at best an approximation to what an intelligent experienced set of expert would conclude in a given case. It can never be better than that but it can easily be much worse if the people devising it are not particularly intelligent or experienced - which is almost certainly the case.
     
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  7. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    So the list of affiliations is very much as we might expect - professional 'quality experts' rather than people with intelligence and experience.
     
  8. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    I think Sandra Eldridge at the Pragmatic Trials Centre has come up before. I am pretty sure that pragmatic trials are a phoney way to pretend to get efficacy information with a method that cannot do that (as it says on Wikipedia).
     
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  9. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    So someone has pointed out that the corresponding author for this - presumably the head honcho - is an author on the SMILE trial. You could not make it up.
     
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  10. Michiel Tack

    Michiel Tack Senior Member (Voting Rights)

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    The feasibility publication of the SMILE trial writes: "The authors would like to thank Professor Jonathan Sterne who provided trial methodology advice."

    I wonder what kind of advice that was.
     
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  11. strategist

    strategist Senior Member (Voting Rights)

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    Are we sure that we're not misunderstanding something? Are they really saying that randomization is sufficient for a clinical trial to achieve a low risk of bias status? Why is there no widespread outrage over this apparent attempt to pass off garbage methodology as good?
     
  12. NelliePledge

    NelliePledge Senior Member (Voting Rights)

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    I’m betting he’s wondering why he ever let them put his name on that one. Oops.
     
  13. Lucibee

    Lucibee Senior Member (Voting Rights)

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    These two look familiar.
     
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  14. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    Are we seeing an attempt to protect the vast amounts of research investment into unblinded trials with subjective out comes, not just in relation to ME, but more widely in relation to CBT and further in psychology in general?
     
  15. NelliePledge

    NelliePledge Senior Member (Voting Rights)

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    Does he realise by working with his mate on this dodgy paper he’s put his professional reputation at risk?
     
  16. Pi

    Pi Established Member

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    This isn't marking your own homework, it is revising the marking guidelines to allow the answer you have already given (and intend to keep on giving).

    It is absurd that the use of randomised, uncontrolled, unblinded trials with subjective outcomes can be given the green light by someone someone who practices this methodology themselves.
     
  17. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Er, yes.

    Maybe it was the other way around?
     
  18. obeat

    obeat Senior Member (Voting Rights)

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    To achieve the status of psychotherapist, my sister could have submitted a portfolio of her own work with her own critique. No outside assessment was needed. She has chosen to leave the CBT industry.
     
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  19. rvallee

    rvallee Senior Member (Voting Rights)

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    Well, there it is. Making the dumbening of medical research official, lowering the bar to pave the way for the psychologisation of illness. Nevermind that the results are disastrous, I guess that's a minor inconvenience and a sacrifice people are willing to make to be able to launder their personal opinion into "evidence".

    This makes as much sense as returning to horse and buggies. How is regressing an entire field of science a good idea? Medicine is in serious need of major reform, this whole self-regulated thing is clearly not working.
     
  20. rvallee

    rvallee Senior Member (Voting Rights)

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    Seems like it. The MUS project, and more specifically IAPT, cannot withstand genuine scrutiny and so the bar is being lowered all around to keep them artificially alive. In protecting failure, more failure is being added to the mix.

    Rejecting reality and substituting their own.

    This could explain the delays to the Cochrane reviews. With this new standard in place, they can be made to seem acceptable.
     
    Last edited: Aug 30, 2019
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