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Ugeskriftet: Is the glow surrounding Cochrane paling?

Discussion in 'Health News and Research unrelated to ME/CFS' started by Kalliope, Sep 14, 2018.

  1. Kalliope

    Kalliope Senior Member (Voting Rights)

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    Ugeskriftet for Læger - The Journal of the Danish Medical Association - is Denmark's main scientific journal within the health and medical fields.

    They've written an article about Cochrane as it is having its annual colloquial this weekend. The google translation seems a bit messy, so here's the main content:

    The article points out that Cochrane reviews once used to represent the gold standard for evidence. But today examples of poorly performed and even retracted reviews, a broad access to topics and fierce criticism from researchers and doctors have caused a strain for the network.

    Some of the latest criticism has involved a Cochrane review about HPV vaccination being accused for omitting relevant studies and committing wrong comparisons. Fiona Godlee is interviewed and makes a few comments.

    Has the Cochrane network left a mainly scientific contribution for a political one?

    "The role where one supports political agendas is contradictory to the role Cochrane always has played, to challenge authorities. It is our fundamental raison d'être - to ask uncomfortable questions. So obviously we risk getting into conflicts with some." Says Karsten Juhl Jørgensen, vice direktør for the nordic Cochrane center.

    The article also mentions a review on medical treatment of adults with ADHD which got retracted.

    Karsten Juhl Jørgensen comments: It was not about cheating or dishonesty, it was simply poorly made. This is not good for the credibility, but it is a good thing that bad reviews are retracted and that the collaboration are open about it.
    He thinks it should happen more often. And points to a review about the effect of prayer in recovery.

    The article says all the topics among Cochrane reviews on alternative treatments are lifting eyebrows.

    People are becoming more aware that even Cochrane reviewers can be biased.

    The leader of the Nordic Cochrane center, MD Peter Gøtzsche is on the Cochrane board and did not have time for an interview but signalled that the board meeting can turn ugly, because there is a power battle about the course from now on for Cochrane.

    Ugeskriftet: Blegner stråleglansen om Cochrane?
    google translation: Is the glow surrounding Cochrane paling?
     
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  2. Kalliope

    Kalliope Senior Member (Voting Rights)

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    If anyone wants to tell about David Tuller's blogpost on Cochrane, or otherwise bring their attention to Cochrane, ME and GET/CBT, here's the Journal's Facebook post on the article. (too foggy headed now to do it myself). If you prefer to contact the journalist directly her name and email address is Bente Bundgaard bbu(at)dadl.dk
     
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  3. Rick Sanchez

    Rick Sanchez Established Member (Voting Rights)

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    Sadly, I've got no energy today. So won't be able to write anything.

    But it's a very intersting article. Especially regarding the ridiculous Cochrane reviews on alternative treatments.
     
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  4. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    I have got the impression that Cochrane had a hidden agenda from the start but it remained hidden and perhaps benign for years. As for the SMC it may be hard to define exactly what that agenda was.

    If there is a power battle recognised by Cochrane board members then things are clearly way out of line. It seems as if Norway may have taken charge recently, perhaps because there is more money for such things in Norway.

    The people who really should be overseeing this are the medical Colleges who oversee professional standards - i.e. the Royal College of Physicians in the UK. I strongly suspect that it has not even crossed the minds of the RCP authorities that there is anything wrong with Cochrane and they might find it a bit unsettling having to give an opinion about it.
     
  5. Kalliope

    Kalliope Senior Member (Voting Rights)

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    That's not my impression, but then again only from an ME patient's perspective with compatriots in Cochrane reviews on Exercise Therapy and CFS. Despite lots of criticism for their work, the Norwegian Institute of Public Health (where the reviewers currently work) is doing nada.
     
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  6. strategist

    strategist Senior Member (Voting Rights)

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    A hidden agenda regarding ME/CFS? What was that agenda?
     
  7. Snowdrop

    Snowdrop Senior Member (Voting Rights)

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    https://www.cochrane.org/about-us/governance-and-management

    Can someone provide a brief explanation as to the responsibilities of the various layers of management?

    I presume the 'power struggle' is at the board level.

    Also, is there an alternative organisation in competition with the Cochrane group?
     
  8. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    The originator of Cochrane, Iain Chalmers, now has a position in a Norwegian institution, maybe NIPH. Two different Norwegian organisations seem to crop up in relation to key Cochrane names. I do not know quite what is going on but there does seem to be a major Norwegian link up. That would fit with NIPH not responding to criticism.
     
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  9. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    No, a hidden agenda for medicine as a whole. Maybe to do with knocking pharma and rooting for home grown therapies. Cochrane was set up by a GP rather than an academic, as I understand it.
     
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  10. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    I have no idea how the management works but there does not seem to be much scrutiny of what goes on in terms of the actual reviews.

    I am not aware of any alternative organisation and I doubt there would be.
     
  11. Snowdrop

    Snowdrop Senior Member (Voting Rights)

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    Thanks for your response.
     
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  12. Snowdrop

    Snowdrop Senior Member (Voting Rights)

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    Cochrane's website declares their commitment to 'transparency'. I think it would be good to have more clarity as to how they operate. It does seem that no one pays much attention and that what they do flies under the radar.
     
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  13. Kalliope

    Kalliope Senior Member (Voting Rights)

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    Huh. Didn't know that. You are right, his name pops up at NIPH, but can't find a job title.

    https://www.fhi.no/personer-og-kontaktsteder/senter-informerte-helsebeslutninger/sir-iain-chalmers/
     
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  14. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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  15. Snowdrop

    Snowdrop Senior Member (Voting Rights)

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    Last edited: Sep 15, 2018
  16. inox

    inox Established Member (Voting Rights)

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    Letter by Peter C Gøtzsche, posted 14.september at Nordic Cochrane.

    Not able to read the whole 3 pages of this letter now, but this is the first pharagraph. Seems to be lot of drama...

    https://nordic.cochrane.org/news/mo...atic-collaboration-and-scientific-pluralism-0

    pdf-link directly to the letter:
    https://nordic.cochrane.org/sites/n...s/public/uploads/moral_crisis_in_cochrane.pdf
     
  17. inox

    inox Established Member (Voting Rights)

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  18. Hutan

    Hutan Moderator Staff Member

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    From Peter C Gøtzsche's letter:

    There has also been great resistance and stalling on the part of the central executive team to improving Cochrane ́s conflict of interest policy. A year ago, I proposed that there should be no authors of Cochrane reviews to have financial conflicts of interests with companies related to the products considered in the reviews. This proposal was supported by other members of the Board, but the proposal has not progressed at all.​

    However, it's unclear to me what impact, if any, the events will have on the issues that concern us the most. The disagreements seem to have had more to do with what has been perceived as a cosiness with Big Pharma (as well as an overly commercial focus and a lack of democracy):

    As most people know, much of my work is not very favourable to the financial interests of the pharmaceutical industry. Because of this Cochrane has faced pressure, criticism and complaints. My expulsion is one of the results of these campaigns.
    Regardless, it seems that this will affect Cochrane's management:

    As a result of this decision, and a number of broader issues concerning the inadequate governance of Cochrane, in accordance with its principles and objectives, four other members of the Board have resigned. As a result, the Cochrane Collaboration has entered an unchartered territory of crisis and lack of strategic direction. A recovery from this dire situation would call for the dissolution of the present board, new elections and a broad-based participatory debate about the future strategy and governance of the organization. In just 24 hours the Cochrane Governing Board of thirteen members has lost five of its members, four of which are centre directors and key members of the organization in different countries.​
     
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  19. Esther12

    Esther12 Senior Member (Voting Rights)

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    OT: I know that Hilda Bastian was recently critical of Gøtzsche's criticism of Cochrane's HPV vaccine review, and it scares me a bit that without knowing the evidence at all, my instinct was strongly to trust her view over Gøtzsche's.

    When I first started looking at medical evidence I was appalled at the way people would seem to trust the brands of certain personalities, rather than take the time to look at the evidence, or else be honest about the fact that they're just ignorant. Now that I am more familiar with a lot of the personalities I can feel myself wanting to do the same thing.
     
  20. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    It looks as if Cochrane has become just another commercial outfit like everything else in Trumpland.

    But my suspicion is that this may have been the reality all along, but in a previous world where idealism diluted money making. The problem seeems to be all about vested interest. I think from the start Cochrane had an anti-Pharma bias. It may be recently that has been reversed by a board takeover, maybe gradually over a decade or two. So the question is whether the people leaving are the old anti-Parma lot, or people who are genuinely idealistic about keeping vested interest out or what.

    I agree that it may be tangential to the ME situation but not irrelevant. The problem for ME is the commercial vested interest that masquerades as public service psychotherapy. And it looks as if there is a new Cochrane CEO who will be looking around for what to do with his eye on what makes money and what 'gives the people what they want' - the classic Murdoch approach.

    Maybe the brand will not survive if it cannot be seen to be independent. But there is little sign things go back to being done properly these days.
     

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