David Tuller

Trial By Error: CBT Model of Medically Unexplained Symptoms, Explained; CBT Trial for Q-Fever Fatigue

22 July 2021 by David Tuller

By David Tuller, DrPH

As I have recently written, four major clinical trials of CBT for so-called MUS have documented the opposite of what the investigators hoped to prove. In fact, the evidence from this research suggests that CBT is not an effective treatment for these conditions. That hasn’t stopped these investigators from claiming otherwise, of course. As my earlier post indicated, they have deployed a range of methodological, statistical and rhetorical strategies to obfuscate or downplay their poor results. Three of these studies were based at King’s College London, and one—the now-discredited PACE trial—at Queen Mary University of London.

Trial By Error: Medical Societies and new Komaroff-Lipkin Paper Highlight Long COVID and ME/CFS Links

20 July 2021 by David Tuller

By David Tuller, DrPH

While some medical professionals argue that prolonged non-specific symptoms after acute COVID-19 are psychogenic and that “Long COVID” as a presumed clinical entity was concocted by a cabal of queers and feminists, others are getting on with efforts to disseminate more appropriate information to their colleagues. These efforts often involve drawing parallels with the pathophysiology of ME/CFS.

Trial By Error: Some Lightning Process Updates

13 July 2021 by David Tuller

By David Tuller, DrPH

A Final Round in Norway

Lightning Process supporters got some bad news recently when a Norwegian national research ethics panel rejected a proposed study because it was poorly designed and fraught with conflicts of interest, as I wrote about here. But that wasn’t the end of the drama.

Although the ethics panel’s decision was meant to be final and not subject to appeal, the study team appealed anyway, sending a long letter to the ethics panel defending the trial’s methodology and disputing the charges of conflicts of interest. The ethics panel agreed to take up the issue one more time. After another review, the panel reinforced its initial action by firmly rejecting the proposed study a second time. The ethics panel has made clear that it is not categorically against research into the Lightning Process—just this inadequate effort.

Trial By Error: Professor Steven Lubet on Misogyny, Homophobia and Long COVID Denialism

6 July 2021 by David Tuller

By David Tuller, DrPH

My friend and colleague Steven Lubet is a professor of law at Northwestern University. He and I have collaborated on a number of articles, including a response to Professor Michael Sharpe’s views on so-called “medically unexplained symptoms” in the journal Medical Humanities and a piece on links between ME/CFS and Long COVID for STAT. This spring, along with Professor Brian Hughes, a psychologist at the National University of Ireland, Galway, we wrote an essay for Health Affairs, a public health journal, about the ongoing paradigm shift in this medical domain.

Trial By Error: Professor White & Colleagues “Regret” Ignoring Null Results in GETSET Trial Follow-Up

5 July 2021 by David Tuller

By David Tuller, DrPH

Last week, I wrote about the correction made to the “Highlights” section of the paper reporting the long-term follow-up results for the GETSET trial. (The trial was conducted by Professor Peter White, one of the three lead PACE investigators, and colleagues.) I noted that this correction was not indicated or identified—a fact I attributed to the ambiguous status of “Highlights” sections, which could be viewed as more like news headlines than part of a paper’s core text.

Trial By Error: Quartet of Trials Reveals Limitations of CBT for “Medically Unexplained Symptoms”

3 July 2021 by David Tuller

By David Tuller, DrPH

A year ago, I wrote a post about how the biopsychosocial ideological brigades had completed a trifecta of major studies that investigated cognitive behavior therapy for a variety of so-called “medically unexplained symptoms” (MUS). As a group, the studies demonstrated the overall ineffectiveness of CBT as a treatment for this category of disorders—despite herculean efforts to spin the results the other way. MUS is usually defined to include chronic fatigue syndrome, irritable bowel syndrome, fibromyalgia, functional neurological disorders, and other conditions for which pathophysiological mechanisms have not been identified.

Trial By Error: Journal Corrects “Highlights” of GETSET Paper; A Letter about Prof White’s GET Safety Paper

30 June 2021 by David Tuller

By David Tuller, DrPH

I have pressed the Journal of Psychosomatic Research to correct a recent paper—”Guided graded exercise self-help for chronic fatigue syndrome: Long term follow up and cost-effectiveness following the GETSET trial.” The senior author is Professor Peter White. Now the journal has published a revised “Highlights” section of the paper that accurately presents the study’s null results for the intervention rather than claiming success on an illegitimate basis. But the fact that this laudable change has been made is not indicated.

Trial By Error: Lowenstein’s Guardian Opinion; Eliot Smith’s Post-NICE View; Tack’s Take on Blinding Study

25 June 2021 by David Tuller

By David Tuller, DrPH

The Guardian has published a lot of nonsense about Long COVID and has provided a platform for people who argue that robust manly thoughts are the path to recovery. Of course, it also published George Monbiot’s powerful columns on the topic, including his rebuttal of silly accusations that he was triggering more Long COVID cases by writing about it.

So it can be a mixed bag over there.

Trial By Error: Did the IBS Trial Really Show that Web-Based CBT Offered Significant Clinical Effectiveness?

24 June 2021 by David Tuller

By David Tuller, DrPH

I wrote some posts last year about the ACTIB trial–a major study of telephone-delivered and web-delivered cognitive behavior therapy (TCBT and WCBT) for irritable bowel syndrome (IBS). Contrary to how the results have been framed by those with reputational and financial interests in promoting them, the study demonstrated that WCBT did not provide clinically significant benefits over treatment as usual on its two primary outcomes. At least that’s how I interpret the data.

Trial By Error: Null Outcomes Presented as Success in Yet Another CBT Trial from Prof Trudie Chalder

19 June 2021 by David Tuller

By David Tuller, DrPH

Trudie Chalder, a professor of cognitive behavior therapy (CBT) at King’s College London, has recently published yet another high-profile paper: the main results for “efficacy” from a trial of CBT for patients with so-called “persistent physical symptoms” (PPS) in secondary care. As usual with this group of investigators, things haven’t turned out well. But despite null results for the primary outcome, Professor Chalder and her like-minded colleagues have cast the findings in a positive light in their article, published in Psychological Medicine.

« Previous Page