Trial By Error: CBT and Irritable Bowel Syndrome

Trial By Error: My Letter to Professor Moss-Morris
Last week I wrote about the recently announced licensing deal between Mahana Therapeutics and King’s College London. The deal involves a web-based course of cognitive behavior therapy designed to treat irritable bowel syndrome. In a major study, the reported improvements in symptoms among participants in the web-based program were modest at best. Yet Mahana is promoting these improvements as “dramatic” and “potentially game-changing for patients.”


On Monday, I e-mailed Mahana Therapeutics with a few questions. I have not heard back, although I followed up my initial e-mail with two nudges. On Friday, I sent the following e-mail to Professor Rona Moss-Morris, the study’s co-investigator. (Professor Moss-Morris has stock options in the company and has received payment as a consultant.).
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http://www.virology.ws/2020/02/03/trial-by-error-my-letter-to-professor-moss-morris/
 
I'm really curious to see reactions in the IBS and IBD community, professionals and patients. I would expect the IBD experts to be outraged by this but at this point I don't even know if reality matters anymore.

Surprised there hasn't been much. This stuff here is touting some almost miracle treatment. Not that people should take the claims seriously but the fact that people are making those claims with powerful institutional backing should get some reaction at some point.
 
Invisible Woman said:
So now they're claiming CBT is effective as a primary treatment rather than an adjunct therapy. At least this is how that reads to me. Deliberately misleading.
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This is surely false advertising? CBT is not used to treat MS. At best, it's a management therapy. I'm sure most medical groups would say the same thing (that a management approach is not a treatment).
 
clinically and cost-effective treatments

Arnie Pye said:
Can anyone see the purpose of the word "clinically" in that quote?
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If I am not mistaken it is a direct quote from the NICE protocol for its guidelines - in which case the fault lies in the first place with NICE but in the second place with someone happy to use a meaningless phrase just because it is regulation requirements.
 
adambeyoncelowe said:
This is surely false advertising? CBT is not used to treat MS. At best, it's a management therapy. I'm sure most medical groups would say the same thing (that a management approach is not a treatment).
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It does look like "treatment" and "treated" are also part of the words that have been redefined to fit BPS needs.

Wessely did say he "treated" thousands of ME patients. Which means nothing more than he saw those patients, whoever they are. So by very loose definition of the word, it looks like "treated" merely means a "treatment" was applied, not that it did anything.

This is the essence of the behavioral paradigm where many are considered "treated" of CFS because they did CBT or GET. All it means is they went through it, that's been an accepted standard for years by now. It's a terrible standard but it has precedent to point to for a weasely, no pun intended, lawyer who will insist they never meant anyone was successfully treated, just that they went through some treatment.
 
dave30th said:
yes but they're not offering it yet. it's like they're branding it before they intend to launch it.
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I just assumed that if this deal has been announced they will now be in the process of trying to sell it to NHS commissioners not sure if that would be nationally or locally.. It won’t be launched to the public unless they manage to secure a contract/contracts.
 
NelliePledge said:
I just assumed that if this deal has been announced they will now be in the process of trying to sell it to NHS commissioners not sure if that would be nationally or locally.. It won’t be launched to the public unless they manage to secure a contract/contracts.
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yes, I assume they will. but does the advertising standards agency get involved at this stage, when it is not yet available to anybody?
 
dave30th said:
yes, I assume they will. but does the advertising standards agency get involved at this stage, when it is not yet available to anybody?
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Ah ok see what you mean

also if eventually it is provided as NHS service people aren’t directly paying for possibly Advertising Standards would say it’s outside their remit? Ah I see they ruled against a tv ad about Universal Credit recently so remit does cover public sector ads.
 
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It might be interesting to hear what his views now are. I think he has suggested that he would now express himself in different terms. As he would need to.
 
chrisb said:
It might be interesting to hear what his views now are. I think he has suggested that he would now express himself in different terms. As he would need to.
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He could do this any day. Never has, never will. Literally nothing is preventing him other than the fact that he badly does not want to.
 
Sly Saint said:

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So this ACTIB thing is going to become the basis for the IAPT and NHS documentation on IBS (and IBD?) the same way PACE did for ME. Similarly, it's not even a linear process, the evidence is made up at the same time as it is applied into practice and internal training.

I really love the "evidence base" for the BPS model shown, from the mid-90's no less, is literally just 3 bubbles with labels and no specific anything. You could put anything in those bubbles and it would be just as valid.

And this is just pure insanity, you could replace "greater perfectionism" with literally any pseudoscientific concept and it works just the same. Could be karma, spiritual energy, thetans, whatever, makes no difference:


And the head of the NHS was talking about the danger of Goop? Good grief.
 
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