By David Tuller, DrPH
Added Feb 12:
I realized today that I wanted to add a couple of details. The new version of the BMJ article about the Health Research Authority analysis of PACE includes this sentence at the bottom: “Correction notice: On 8 February 2019 a new version of this article was posted with clarifications added.”
For unexplained reasons, no further details are provided about what was corrected or clarified. Readers would therefore not know that the initial description of my role omitted my academic credentials altogether and referred to me solely as “a US activist.” Nor would they know that the BMJ article originally referenced only “activists” as being opposed to PACE–and that it did not cite Virology Blog’s open letter to The Lancet, which was signed by more than 100 academics and other experts and slammed the study’s “unacceptable methodological lapses.”
I empathize with BMJ’s position. For a leading medical journal to have disseminated this kind of misleading information is embarrassing, and rightly so. But omitting details of corrections and/or clarifications is not the most transparent way to correct or clarify the published record. Just saying.
Last Wednesday, the UK Health Research Authority released a letter reviewing its analysis of the PACE trial. Members and supporters of the GET/CBT ideological brigades have misrepresented the HRA letter as a vindication of the study. On Thursday, BMJ posted an article about the HRA letter by science journalist Nigel Hawkes.
The BMJ article quoted from a Virology Blog post. After my byline on that post, I had included as always the initials for my public health doctoral degree–DrPH. Yet BMJ identified me as â€œa US activistâ€ without mentioning my academic credentials and my position at one of the worldâ€™s leading research universities.
The pro-PACE experts quoted in the BMJ article were appropriately recognized for their professional roles at prestigious British institutions. The article also attributed opposition to the trial solely to â€œactivists,â€ as if no epidemiologists, biostatisticians, infectious disease experts, physicians and specialists from other relevant disciplines have lambasted PACE for its unacceptable methodological lapses.
The day the article appeared, I sent an e-mail to Dr Fiona Godlee, editorial director of BMJ, alerting her to the problem with how I was identified and requesting a prompt fix. (See end for the text of this message; I posted it last week on Facebook.) I know I was not the only one to express concerns.
On Monday morning I received a response from Dr Godlee. She noted that BMJ had added a reference to my academic position as well as a mention that other academics have criticized PACE. All good. The changes are helpful. I appreciate Dr Godlee’s willingness to make them without delay.
However…the revised version continues to describe me as â€œa US activist,â€ and that phrase precedes the new reference to my Berkeley title. To be clear, I view â€œactivismâ€ as an essential ingredient in effecting critical social change, including in the health and medical spheres.Â In the current debate, I am happy to be regarded as an â€œactivistâ€ on behalf of science that meets minimal standards of integrity and logic–which PACE does not, in my professional opinion as a public health academic from the University of California, Berkeley.
In contrast, the use of the word â€œactivistsâ€ in the BMJ article appeared intended as dismissive. The story positioned the â€œactivistsâ€ questioning PACE against impeccably credentialed pro-PACE professors. Given that, the decision in the current version to single me out among the quoted experts as also being an â€œactivistâ€ seems like a signal to readers that my opinions might not warrant much consideration.
As a public health academic and professional, I am advocating for what I perceive to be in the best interests of patients. The esteemed professors applauding the HRA letter in the BMJ article are also advocating for what they presumably perceive to be in the best interests of patients. They are no less â€œactivistsâ€ on behalf of their perspectives than I am on behalf of mine.
Here’s my Thursday e-mail to Dr Godlee:
Last time I checked, I was an academic appointee at the University of California, Berkeley, with a doctorate in public health. I have included my official title in my sign-off in every letter I have sent you.
Can you please then explain why BMJ has described me in its article on the Health Research Authority report as “a US activist”? This isn’t surprising, of course, given the mass delusion in the UK medical and academic establishments that PACE is a quality piece of work. Since I am willing to state openly that it is “a piece of crap,” I guess that automatically signals to people like Nigel Hawkes that I must be an “activist.”Â
Now, there’s nothing wrong with being an “activist,” and I don’t deny that my work involves public health advocacy. But it is inaccurate and unacceptable to describe me as an “activist” while omitting my academic credentials and the fact that I have a position at one of the world’s leading universities. Of course, the article did include the academic affiliations of the other experts quoted–but they happened to be saying nice things about PACE.Â
Hm. Do you think BMJ might have a bit of a blind spot on this issue? Â
A correction or clarification is obviously in order. I appreciate your prompt attention to this issue.
David Tuller, DrPH
Senior Fellow in Public Health and Journalism
Center for Global Public Health
School of Public Health
University of California, Berkeley