Trial By Error: CBT Model of Medically Unexplained Symptoms, Explained; CBT Trial for Q-Fever Fatigue

[Andy]

"As I have recently written, four major clinical trials of CBT for so-called MUS have documented the opposite of what the investigators hoped to prove. In fact, the evidence from this research suggests that CBT is not an effective treatment for these conditions. That hasn’t stopped these investigators from claiming otherwise, of course. As my earlier post indicated, they have deployed a range of methodological, statistical and rhetorical strategies to obfuscate or downplay their poor results. Three of these studies were based at King’s College London, and one—the now-discredited PACE trial—at Queen Mary University of London.

A 2007 article in the journal Clinical Psychology Review—“The cognitive behavioural model of medically unexplained symptoms: A theoretical and empirical review”–sheds some light on the background and possible genesis of these various trials. (One of the co-authors of the review was a lead investigator in all four of the MUS clinical trials.) This review outlined the rationale behind the CBT treatment approach to MUS, including specifically chronic fatigue syndrome (CFS) and irritable bowel syndrome (IBS), and suggested that these conditions are essentially self-sustaining. The review also helped clarify–for me—why I get a sense of déjà vu whenever I read another article from this group of investigators. Each one basically says the same thing, except with a change in the targeted condition."

https://www.virology.ws/2021/07/22/...toms-explained-cbt-trial-for-q-fever-fatigue/

 

[Sean]

...why I get a sense of déjà vu whenever I read another article from this group of investigators. Each one basically says the same thing, except with a change in the targeted condition."

The empire franchise is on the march.

 

[Barry]

The empire franchise is on the march.

Production line science.

 

[Trish]

Production line science.

Production line pseudoscience.

 

[rvallee]

Sounds like at some point it could be useful to ask the funding institutions what they think of continuously funding research whose only purpose is to do more research, endlessly identical and providing no scientific value.

I frankly don't think they care one bit, no one expects this junk to be of any use other than serving as justification for medical austerity and denying sick people the "right" (clearly a privilege, then) to health care, but it would be useful to have their blatantly indefensible answers on record. For later, when things get litigious and people ask why this was allowed to go on and we can say "this is why, they just didn't care".

 

[Invisible Woman]

Sounds like at some point it could be useful to ask the funding institutions what they think of continuously funding research whose only purpose is to do more research, endlessly identical and providing no scientific value.

I agree we definitely should bring it to their attention.

I also agree they don't give a d***.

I suspect they fund research so they can say they fund research and are actively contributing to....something.

What we should do is make sure to remove any deniability they have further down the line so they can't at some future point claim not to have been made aware that at the very least the research they've funded has done no good & it may even have stifled other research as people assumed it's an area already thoroughly explored. It may also have facilitated the introduction or continuation of treatments that have actually caused harm.

we need to break the circle of deniability where they all stand around pointing at each other and no one takes responsibility even though they are all responsible.

 

[TiredSam]

In any event, as the 2007 paper suggested, the proof is in the pudding

The thumb is in the pudding.

This is not how science is supposed to go. “Self-correcting” is supposed to mean what it says. But the onus isn’t really on “science.” It is on scientists. And if scientists refuse to self-correct no matter how poor their results, then what’s the point?

They do self-correct - if the results are poor, they correct them themselves.

 

[Peter T]

The thumb is in the pudding.

Is there a research project to be found here looking at how accurate different researchers are at identifying whether what they pulled out is in fact a plum, rather than something else completely different?

[Is it also apt that the original nursery rhyme is about a property swindle in 16th-century England?]

 

[TiredSam]

Well they all say "what a good boy am I".

 

[dave30th]

[Is it also apt that the original nursery rhyme is about a property swindle in 16th-century England?]

interesting, I realized as I wrote it that I had no idea where it came from or what it originally meant.

 

[Peter T]

interesting, I realized as I wrote it that I had no idea where it came from or what it originally meant.

There are arguments about its origin, but one explanation is that a number of property deeds were sent up to London hidden in a pie as a bribe for the King to stop the destruction of the super wealthy Glastonbury Abbey and the seizure of all its land. This version goes that the bribe was processed by a civil servant, Thomas Horner (not Jack), who kept one of the best parcels of land for himself, before passing the rest onto the King. This parcel of land included some lead mines, with ‘plum’ being a pun on the Latin word for lead, ‘plumb’ as well as idiom for the best.

Obviously this had no impact on the King going on to dissolve the monasteries. So let’s hope these BPS illusory plum findings have no lasting impact on the long term course of medical history.

 

[MEMarge]

There are arguments about its origin, but one explanation is that a number of property deeds were sent up to London hidden in a pie as a bribe for the King to stop the destruction of the super wealthy Glastonbury Abbey and the seizure of all its land. This version goes that the bribe was processed by a civil servant, Thomas Horner (not Jack), who kept one of the best parcels of land for himself, before passing the rest onto the King. This parcel of land included some lead mines, with ‘plum’ being a pun on the Latin word for lead, ‘plumb’ as well as idiom for the best.

Obviously this had no impact on the King going on to dissolve the monasteries. So let’s hope these BPS illusory plum findings have no lasting impact on the long term course of medical history.

Their illusory findings about their myth of the aetiology and pathogenesis of ME have already had disastrous consequences on lives measured by decades, not centuries.