Who Agrees That GRADE is (a) unjustified in theory and (b) wrong in practice?

Caroline Struthers said:
The author wanted to keep it moderate, but the outgoing editor in May 2019 (David Tovey) wanted it downgraded to low. But he left before it was decided. The new editor from June 2019 (Karla Soares Weiser) decided not to argue for what David wanted and so threw it over to Gordon Guyatt to arbitrate. The whole correspondence is here .

Gordon Guyatt was suggested to Karla by Andy Oxman, who works for Cochrane Norway https://www.cochrane.no/contact-us. Cochrane Norway is hosted by the review authors' institution, the Norwegian Institute of Public Health https://www.fhi.no/en/cristin-projects/ongoing/cochrane-norway/. Andy Oxman therefore has an interest in not upsetting the institution that funds his work. So Gordon Guyatt was not an independent choice.
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Thank you for clarifying and attaching.

Oh wow. Reading from the bottom-up as this is chronological just wow. What a read (and I've only scanned so far). And very clear it seems when you begin with that first email noting the clear result doesn't equal conclusion drawn issue. This kind of shows it all - everything on everything encompassed in one big email trail as a CFS 'issues' microcosm.

Says it all really doesn't it?
"Dear Gordon,
Many thanks for your willingness to arbitrate and help to resolve the disagreement
between Cochrane’s Editorial and Methods Department and the authors of the Cochrane
review."

There is a very 'pushy' advocacy for 'the authors' to the point I assumed they were the authors until I read the above quote?

I can't help but note the difference between his recommended arbitration of:

the judgment of moderate is contingent on rating certainty on a non-zero effect.

This implies that the authors do not claim an important effect and should avoid any language that claims an important effect. It would be reasonable to require in limitations that they highlight that they have not established an important effect.

Seems to me these are important qualifiers and conditions to the moderate certainty rating.
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And Atle's:

Since the authors have already agreed to delete all words that indicate anything about effect size, this means that we are talking about a non-zero effect. So, the answer is Yes.

I propose that I ask the authors to revise the text to ensure that all words indicating anything about effect size are deleted, and send you the revised version.
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Isn't that last line proposing the opposite to requiring it is 'highlighted' they have not established an important effect, but instead agreeing to 'not mentioning' effect size?

Now you've let me know the connection on who is hosted by who (institutions) it's interesting experience/context/etiquette to apply when reading the abrupt difference between these two in the email trail. Makes it seem read between the lines responses (familiar to me what these mean particularly when they are people of different power levels or communicating from/for someone on a bigger power level etc), rather than misunderstanding or just exhaustion, could be involved?

And where did the drop-outs get lost in that attrition-by-email?
 
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JemPD said:
i didnt have the energy to write anything, or even, tbh, to really read/absord whats being said about grade, my brain just wont take it in. but then i read Wonko's post & he has said precisely what i want to say about the whole thing.

It's much, much, worse than that.

The clinicians we are expected to trust the clinical experience of are the very same clinicians who either didn't spot that CBT/GET didn't work in their own trial (a 'poorly designed' trial designed to prove they did work, no matter what happened), or who fraudulently altered not just the results, and then suppressed them when even that didn't work, and either deliberately made false statements about the trials 'success', or knowingly allowed others to do so, and benefited, substantially in some cases, from doing so.

In short, they have shown that, in this case, either their clinical judgement cannot be trusted, or that they can't - I suspect both.

These are the people who are now holding us to ransom, these are the people we are supposed to trust, with our lives.

These are the people we are now supposed to sit down, and get all chatty with, to further their (not our) interests.

I f'ing hate politics.
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and @Wonko New post by Caroline with documents of the email trail here. 28 pages of emails, earliest one at the bottom Ie page 28

Even a scan is interesting from this point upwards, as I feel it pretty much starts to shed light on this 'curiosity'
 
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bobbler said:
Isn't that last line proposing the opposite to requiring it is 'highlighted' they have not established an important effect, but instead agreeing to 'not mentioning' effect size?
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This is exactly it. Guyatt said they should be required to highlight there is no important effect. And they told Karla they would take out any mention of effect size. That of course is not the same thing. And they got away with it.
 
Caroline Struthers said:
This is exactly it. Guyatt said they should be required to highlight there is no important effect. And they told Karla they would take out any mention of effect size. That of course is not the same thing. And they got away with it.
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That's where 'it' happened. And I think it happened twice if the bit at the bottom about a potential switcheroo in the order of the docs from 14th June is correct. His question/response to all was ignored on the Fri by all too, then his Sat response was ignored - he was cut out of the email trail by Karla on Mon - and one line taken/caveats ignored.

He got cut out of being copied in on that penultimate email [where the caveats aren't mentioned, instead a different question pretends to proxy it] sent straight after Guyatt's reply [which is basically about emphasising these caveats].

Given all were copied in on Guyatt's reply (Saturday) and Karla copied only the first line without the caveats two days later to Atle who had received not only Gordon's email (noting the caveats) but also was asked but did not answer the question in the email on Friday.

From: "Guyatt, Gordon"
Date: Saturday, 15 June 2019 at 6:10
To: Karla Soares-Weiser , "Fretheim, Atle"

Thanks, Karla.

Just to clarify, the judgment of moderate is contingent on rating certainty on a non-zero
effect.

This implies that the authors do not claim an important effect and should avoid any
language that claims an important effect.

It would be reasonable to require in limitations
that they highlight that they have not established an important effect.

Seems to me these are important qualifiers and conditions to the moderate certainty rating.
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Fra: Karla Soares-Weiser
Sendt: mandag 17. juni 2019 07.43
Til: Fretheim, Atle
Dear Atle,

Could you please confirm whether the judgement is based on rating certainty on a non-
zero effect? I am very keen to finalise this process.

With best wishes, Karla
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and then last email. I don't know if the timestamp would have different countries or anything but it looks like this reply was within 20mins.

From: Fretheim, Atle
Sent: Monday, June 17, 2019 8:06 AM
To: 'Karla Soares-Weiser'
Karla,

Since the authors have already agreed to delete all wordsthat indicate anything about effect size,
this means that we are talking about a non-zero effect. So, the answer is Yes.

I propose that I ask the authors to revise the text to ensure that all words indicating anything about
effect size are deleted, and send you the revised version.

OK?

Atle
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I'm very intrigued by the timestamps because on the emails before that (where there is a lot of between the lines language, like saying several times in one email 'we are happy to stand by your judgement) if these are all correct on the same time zone then the 14th June ones are in the wrong order on the trail of documents (11am has been placed in front of 9am).

This is actually important - because in the right time order according to timestamps it shows Guyatt's question to Atle was in response to Karla's request to mark it moderate. This direct question seems it was ignored by both Karla and Atle all day Friday (despite all the talk of them being in a rush)

so Guyatt then had to reiterate the caveats (which he did swiftly on a Sat - but Karla only did something with two days later), which were then ignored. At that point Karla cut him and his caveats out of the email trail to send her cut-down question to Atle.

I can't help but ask what could have taken place offline Fri-Monday.
 
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Not sure about posting links to other forum's dicsussions; also only skimmed yet, but thought this forum on statistics ( discourse.datamethods.org ) was interesting, and they also discussed some critique of GRADE:

Article: Going from evidence to recommendations: Can GRADE get us there? - research methods / meta-analysis - Datamethods Discussion Forum

https://discourse.datamethods.org/t...o-recommendations-can-grade-get-us-there/5445
 
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