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Who said: don't bother testing patients?

Discussion in 'General ME/CFS news' started by JaimeS, Nov 6, 2018.

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  1. Lucibee

    Lucibee Senior Member (Voting Rights)

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    Found it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539651/

    Oh oh oh oh oh - I see Martin Bland (Stats Prof) has found it too... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1127546/

    ETA: I've now found my previous post about this: https://www.s4me.info/threads/who-said-dont-bother-testing-patients.6532/page-6#post-119882

    And I'll just add that in Wessely's reply, he (correctly) points out that this flaw doesn't change the conclusions of their study. OK. But it does indicate that if they are so sloppy with their stats, how many other mistakes might they have made? They also ignore all the other points that Martin Bland made.
     
    Last edited: Feb 23, 2019
  2. Lucibee

    Lucibee Senior Member (Voting Rights)

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    Although maybe this isn't so true either. Their conclusion is that "fatigue is closely associated with psychological morbidity" - but that's only true if you can assume that the GHQ is a good measure of psychological morbidity, which only a few posts ago, we saw is not necessarily true either. Again, it is the strong reliance on self-reported subjective questionnaires, and the assumption that they will accurately tell you whatever you want them to mean in all circumstances.
     
    Last edited: Feb 23, 2019
  3. Lucibee

    Lucibee Senior Member (Voting Rights)

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    Oh this just keeps getting stranger and stranger. Someone found the original manuscript: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1127330/

    Seems there were Gremlins at the BMJ - but Bland's other points still haven't been addressed.

    ...and it's clear that Anthony Pelosi was one of the referees!

    (and his explanation is completely different from the other referee...)
     
    Last edited: Feb 23, 2019
  4. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    Makes you wonder why the actual authors didn't bother to read it to make sure there were no errors in the publication.
     
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  5. Lucibee

    Lucibee Senior Member (Voting Rights)

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    They rarely do. They expect it to appear exactly as they wrote it.
     
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  6. Guest 102

    Guest 102 Guest

    Behan also diagnosed Charles Shepherd, medical advisor to MEA - via muscle biopsy, I think a couple years before me. Dr Chaudhuri took over from Behan at Southern General in Glasgow, in 1990s, I think. Behan also wrote preface to Melvin Ramsay's 1986 book.
     
  7. Lucibee

    Lucibee Senior Member (Voting Rights)

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    Do you think this quote from Wessely Archive Ref1 is a direct reference to CS?:
     
  8. Lucibee

    Lucibee Senior Member (Voting Rights)

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    and back to the "it's just depression" thing that @EzzieD mentioned, I found this in the very same reference:
    He's laying down the tracks without having to take responsibility for where they end up.
     
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  9. chrisb

    chrisb Senior Member (Voting Rights)

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    Given that the paper was dated March 1988 , did CS publish anything before that date? I would have thought not. Would it have been Dr Anne Mcintyre?
     
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  10. Lucibee

    Lucibee Senior Member (Voting Rights)

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    I had a look - but AM doesn't appear in publication record until 1991. CS was publishing in 1989 at least, so may have encountered SW at conferences and asked a few awkward questions?
     
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  11. chrisb

    chrisb Senior Member (Voting Rights)

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    I think AM was associated with the MEA by 1987. I had a feeling that there was something in SW's book that made me think it was her. I will look.
     
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  12. JaimeS

    JaimeS Senior Member (Voting Rights)

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    From that:

    Sounds familiar.

    Sorry, maybe I'm brain fogged. Is he saying his copy of the paper had the values that were published at first? Or that his paper had the correct values?
     
  13. Lucibee

    Lucibee Senior Member (Voting Rights)

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    He (reviewer 1) is saying that his copy has the correct values that SW put in his reply to Bland. But I would say that the precision of the estimates is suspicious (and slightly meaningless) given that the data are clearly skewed (not normally distributed), which MB also picked up on.
     
  14. JaimeS

    JaimeS Senior Member (Voting Rights)

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    So I take from this that Wessley's papers have always kind of slid by somewhat inexplicably, even when they don't make sense.

    I'd say he has a lot of friends in high places, but what kind of 'friend' would let you make a mistake this public? I just have to conclude that peer review is pretty crap.

    Edited to add:

    I always have to remind myself that there are people who really are okay with lying or cheating if they mean they get ahead. I wonder how many researchers wildly skew their data, knowing that getting caught is vanishingly rare -- and that if they get caught they can always apologize and correct. Meanwhile, they've gotten invitations to speak at conferences, their uni is happy with them, their job is secure -- and everyone remembers what they said first anyway, unless a huge stink is raised, a la PACE.

    I am pretty relentlessly moral, and it's my knee-jerk reflex to think other people see this "but would never do it".

    But, I mean, taking morality out of the equation, why not? They never truly 'get in trouble' for it. PACE and Wakefield are outliers. And clearly there are people in the world to whom the right and wrong means very little, so long as they push their agenda and/or get their money.
     
    Last edited: Feb 23, 2019
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  15. Amw66

    Amw66 Senior Member (Voting Rights)

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    The endocrinologist who " took us on" after age 16 referred to him as " a charlatan".
    Really gave me a lot of confidence ( sarcasm)
     
  16. chrisb

    chrisb Senior Member (Voting Rights)

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    Sorry @JaimeS I know this is off topic but it is an issue worth clearing up, and I do not wish to initiate broader discussion. In the chapter Social History of a 20th Century Illness in the book Chronic Fatigue and its Syndromes by Wessely Hotopf and Sharpe, the authors appear to display their irritation with Macintyre. Her views must have been clear by 1987 and were no doubt those of the MEA, with which there seemed to be perpetual annoyance.

    Another reason for the vehement rejection of psychiatry is because it is perceived as dealing only with the insane: "psychiatrists decided ME is a psychiatric disorder-i.e. we are mad." (Macintyre A , ME Postviral Fatigue Syndrome. How to live with it 1989) Again this too is becoming an increasingly accurate perception of modern psychiatry. Many of the recent trends in psychiatry are consistent with that observation. For those rejected by medicine, and who are clearly not suffering from a major mental disorder such as psychosis, modern psychiatry is not an attractive home. Whilst we bitterly regret this, there is little denying its accuracy.

    One wishes that he gave more frequent reasons, suchas this, to sympathise with his plight.
     
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  17. roller*

    roller* Senior Member (Voting Rights)

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    postviral fatigue - similar to - depression
    concludes: postviral fatigue may be a psychiatric condition

    could have also concluded:
    depression (psychiatric condition) may be postviral disorder
     
  18. Lucibee

    Lucibee Senior Member (Voting Rights)

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    To take this back to where it all started, "who said, 'don't bother testing patients,'" I think it comes down to this...

    There is an expectation nowadays that medicine should have all the answers, and that there should be a test for everything. That there isn't is clear. And I can sort of see the point that endlessly testing for things for which there isn't a *definitive* test might be harmful.

    However, some enterprising characters (who happen to be psychiatrists) have sought to capitalise on this by offering their own "solutions", and by categorising the whole field of conditions that medicine cannot explain (or more importantly, cannot effectively treat) they can ensure that their dying field is rejuvenated, particularly as increasing numbers of psychiatric disorders are explained by biological processes.

    Personally, I think this is a misuse of their "talents", and that they should be focussing their efforts on helping people to live with chronic illnesses (and all the 'psychosocial' issues that entails) until such a time that a viable treatment comes along. They certainly should not be standing in the way of elucidating the causes or developing those treatments - but that's what they have ended up doing. And they need to understand that that's why so many of us are upset with them.
     
  19. ladycatlover

    ladycatlover Senior Member (Voting Rights)

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    But their field isn't dying - there's a crisis in Mental Health care in UK. Children who are suicidal are having to wait 8 weeks for help (I may be wrong on exact time, saw it on TV the other night and can't maintain figures in memory, but it was quite a long time in terms of suicidal child). Adults have to wait for much longer, over a year in some cases I think. So why don't the so and sos FO and deal with REAL mental health problems and leave us alone!
     
  20. Lucibee

    Lucibee Senior Member (Voting Rights)

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    Arguably, that's precisely why there's a crisis. They are struggling to recruit enough professionals into their field, and their profession is inadequately equipped (scientifically and practically) to deal with the problems that folks with mental health conditions face because they refuse to remove their feet, brains and ideology from the 19th century.
     

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