Watt from MRC defends PACE in letter to Times

Wow, so not only does she do the ultimate insult, reduce it to chronic fatigue, thanks and how helpful, she turns this again into scaring off CFS researchers, except its actually doctors and researchers this time not patients.
The MRC suck when it comes to this illness, how about putting in some actual money lady? I very much doubt that this wasn’t a comment informed by others in the MRC or beyond, as she speaks the same language without, I doubt , having personally much to do with it

The old boys' network apparently admits old girls now, too. All they do is close ranks and toe the party line.
 
I think a letter to the Times is in order. I would be happy to sign. If I did I would make some tiny changes (partly typos).

Great letter, @Peter Trewhitt, but I found the leading, 106-word sentence extremely hard to read and I fear that a lot of people won't make it to the end.

How about (with a few other little things edited):

The PACE study has egregious and well documented faults. When subjected to objective analysis, it produced null results. Related studies had similar failings of being unblinded and using subjective outcome measures. The study has been rejected by the international scientific community and by the consensus of MPs in British Parliamentary debate. A number of universities use it as an example of how not to conduct a research trial. Given all this, Professor Watt's reply supporting PACE raises serious concerns about the competence of the MRC's system of peer review, the project's independent steering committee and the relevant journals' peer review systems. This highlights a potentially serious failing at the heart of British academia.

Will Professor Watt accept that if she has got her and the MRC's rejections of the criticisms of PACE wrong, then the MRC urgently needs to overhaul its procedures and to apologise to people with ME/CFS for the MRC's part in the mismanagement of the condition?
Edit: IIRC, journalists are trained to write sentences not much over 25 words, for ease of reading. Here's why:

"Writing guru Ann Wylie describes research showing that when average sentence length is 14 words, readers understand more than 90% of what they’re reading. At 43 words, comprehension drops to less than 10%...

"Long sentences aren't just difficult for people who struggle with reading or have a cognitive disability like dyslexia or attention deficit hyperactivity disorder. They're also a problem for highly literate people with extensive vocabularies.

"This is partly because people tend to scan, not read. In fact, most people only read around 25% of what’s on a page. This means it’s important to get information across quickly."

https://insidegovuk.blog.gov.uk/2014/08/04/sentence-length-why-25-words-is-our-limit/
 
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An excellent letter, @Jonathan Edwards, thank you. Perhaps it is time to re-send it and ask whether, perhaps, Prof Watt, being a busy person, may have overlooked it.

This is the paragraph which for me demonstrates the dire effect of PACE for our futures in the UK. Particularly the well made point that by palming all MUS patients, including ME, off on unqualified therapists with no medical knowledge or supervision, there will continue to be a complete lack of medical awareness of or interest in ME. If no consultant of any specialism ever sees ME patients, we are truly f***ed.

In the longer term, PACE continues to have a disastrous effect on clinical care, equally relevant to research. It seems likely that treatments are being provided that do not work and cause distress. PACE is a major prop for the £1B expansion of so-called evidence-based therapies proposed now not just for ME but for any unexplained symptoms. The more I see the more I suspect none of this ‘evidence’ means much. Even Simon Wessely, who helped set PACE in train, is looking on, like the Sourcerer’s Apprentice, as PACE is used to underpin subcontracting care to providers whose staff are not even formally trained in CBT, let alone have useful knowledge of the illness. Commissioning groups are dispensing with physician contact. Whereas in the past physicians like Stephen and I could gain experience with the clinical picture and ponder possible causes we are faced with a future in which nobody even knows what the problem is that requires scientific input
 
How about this @Jonathan Edwards and others?

Sir,

We are surprised by Professor Watt's wholehearted and inaccurate defence of the PACE trial.

The trial steering committee contained members with a financial interest in the outcome of the trial and several others with an allegiance to the model underlying the interventions being tested. It had no independent researchers.

The peer-review for the main study was fast-tracked by The Lancet and there are doubts that such a long paper for such a large trial could have been properly reviewed in the time allowed. With so many people from so many institutions in such a small field involved in PACE, questions have been asked as to whether properly independent peer-reviewers could have been found.

When the question of hostility toward the researchers was raised in a First Tier Tribunal hearing to release some of the data under the FOIA, no examples could be given.

That a number of other researchers with the same beliefs in the effectiveness of the interventions have found similar results in smaller trials repeating the major flaws of PACE cannot be seen as endorsement of its findings.

When the data from the trial have been reanalysed, no evidence has been found for the claims the interventions are effective. The trial findings have been rejected by every major institution in the USA, the international scientific community and in debate in Parliament. A number of universities now use it as an example of how not to conduct a research.

There are many questions raised by this massive failure, not least about the MRC's own role in the trial and the competence of its system of peer-review.
 
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I hadn't realized her KCL connection. I think that must have played a role.

I also think we're seeing how the system works once a trial has been conducted and published: everything then swing in its favour as all the institutions involved have a massive interest in defending it, not least the MRC and The Lancet. It's their baby now so to speak. They would have to admit they stuffed up, so instead they just dig in. As we all know, it took 12 years for The Lancet to retract Wakefield.
 
How about this @Jonathan Edwards and others?

Sir,

We are surprised by Professor Watt's wholehearted and inaccurate defence of the PACE trial.

The trial steering committee contained members with a financial interest in the outcome of the trial and several others with an allegiance to the model underlying the interventions being tested. It had no independent researchers.

The peer-review for the main study was fast-tracked by The Lancet and there are doubts that such a long paper for such a large trial could have been properly reviewed in the time allowed. With so many people from so many institutions in such a small field involved in PACE, questions have been asked as to whether properly independent peer-reviewers could have been found.

When the question of hostility toward the researchers was raised in a First Tier Tribunal hearing to release some of the data under the FOIA, no examples could be given.

That a number of other researchers with the same beliefs in the effectiveness of the interventions have found similar results in smaller trials repeating the major flaws of PACE cannot be seen as endorsement of its findings.

When the data from the trial have been reanalysed, no evidence has been found for the claims the interventions are effective. The trial findings have been rejected by every major institution in the USA, the international scientific community and in debate in Parliament. A number of universities now use it as an example of how not to conduct a research.

There are many questions raised by this massive failure, not least about the MRC's own role in the trial and the competence of its system of peer-review.
Even though this looks short, from what I recall most published letters are shorter. How about also sending a shorter version. I previously did this with other newspapers with success.
 
Wow, so not only does she do the ultimate insult, reduce it to chronic fatigue, thanks and how helpful, she turns this again into scaring off CFS researchers, except its actually doctors and researchers this time not patients.
The MRC suck when it comes to this illness, how about putting in some actual money lady? I very much doubt that this wasn’t a comment informed by others in the MRC or beyond, as she speaks the same language without, I doubt , having personally much to do with it
I’d say there is a good chance she didn’t suggest the title, “chronic fatigue”, and instead it was someone in the paper.
 
I think Tom is right. How about a shortened version:

Sir,

We are surprised by Professor Watt's wholehearted and inaccurate defence of the PACE trial.

Questions have been raised about the independence of both the trial steering committee and the peer-review, and the speed with which the main paper was fast-tracked by The Lancet. In a First Tier Tribunal hearing to release some of the data under the FOIA, no examples of hostility to the researchers could be given. The small trials that have found similar results to PACE repeated its major flaws.

When data from the trial have been reanalysed, no evidence has been found for the claims the interventions are effective. The trial findings have been rejected by every major institution in the USA, the international scientific community and in debate in Parliament. A number of universities now use it as an example of how not to conduct a research.

There are many questions raised by this massive failure, not least about the MRC's own role in the trial and the competence of its system of peer-review.
 
I’d say there is a good chance she didn’t suggest the title, “chronic fatigue”, and instead it was someone in the paper.

If that’s the case then complaints are warranted because changing the narrative that ME is CF is one of our key aims as we struggle for proper recognition and the media have got to take responsibility too. I’m trying to think of a comparable example, I can only think if there was a high level debate going on about migraines and the lay heading was “headaches” , not that that would happen. I realise it’s partly a product of the CFS name too or the too complex “ME/CFS” hybrid. I take your point it’s likely the paper
 
That is a pretty uncompromising statement, indicating that she does not understand basic aspects of experimental design. She produces no arguments, relying on the fact that others thought PACE was OK.

The MRC are making complete fools of themselves internationally. Perhaps now is the time to copy on the forum the letter that I sent her a while back.

I consider this document now in the public domain and have no problem with it being copied elsewhere.


This isn't about understanding good experimental design this is a civil servant whose job it is to ensure high research standards giving in to lobbying and backing the unbackable. Also standing by her organizations failure to act in the past. In effect this is the MRC saying it is happy with outcome switching and will not apply any standards of governance past a review panel which may be made up of those who have also done poor quality trials. Perhaps it is a good thing that the MRC will be scrapped.

I think MPs should be demanding that Watt appears in front of the science and technology subcommittee to justify her comments and the lack of governance.
 
Watt's response fails to engage with any specifics, but tries to hide behind processes.

In a First Tier Tribunal hearing to release some of the data under the FOIA, no examples of hostility to the researchers could be given.

Wasn't there the example of a mug being thrown? I think that it would be a mistake to make broad claims about 'hostility to the researchers' as it gives them a justification for coming back with any examples they have, and that's just not really a helpful topic for us to focus on.
 
Watt's response fails to engage with any specifics, but tries to hide behind processes.



Wasn't there the example of a mug being thrown? I think that it would be a mistake to make broad claims about 'hostility to the researchers' as it gives them a justification for coming back with any examples they have, and that's just not really a helpful topic for us to focus on.

Could leave that out then.

Sir,

We are surprised by Professor Watt's wholehearted and inaccurate defence of the PACE trial.

Questions have been raised about the independence of both the trial steering committee and the peer-review, and the speed with which the main paper was fast-tracked by The Lancet. The small trials that have found similar results to PACE repeated its major flaws.

When data from the trial have been reanalysed, no evidence has been found for the claims the interventions are effective. The trial findings have been rejected by every major institution in the USA, the international scientific community and in debate in Parliament. A number of universities now use it as an example of how not to conduct a research.

There are many questions raised by this massive failure, not least about the MRC's own role in the trial and the competence of its system of peer-review.
 
The old boys' network apparently admits old girls now, too. All they do is close ranks and toe the party line.

But only when the old girls act even more like old boys than the boys themselves.


It is shocking Watt would make such an ignorant statement. Unless the context is recognized that she is nothing but a mouthpiece.

I will admit taking some pleasure in witnessing these BPSers hang themselves in desperate attempts to hold onto their political and financial power.
 
Wasn't there the example of a mug being thrown? I think that it would be a mistake to make broad claims about 'hostility to the researchers' as it gives them a justification for coming back with any examples they have, and that's just not really a helpful topic for us to focus on.
But Watt's letter refers to hostility towards the PACE authors, and the tribunal ruled that there was no significant issues in that regard, so I would argue it would be a mistake not to address it. Her bringing it up is a justification for us to say "yes, claims in that regard where made at the information release tribunals and were dismissed by the independent judges as an issue".
 
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