Sunday, January 13, 2013

Countess plays Smackdown again!

As per Rosie Cox, the text below is the original letter sent to the
Independent on Sunday in reply to an earlier piece. The IoS had promised to
print the full version online with the shortened 140 word version in the
paper edition. As of this writing, the full copy (below) is not online.

Sir

Professor Peter White, on behalf of himself and his 26 co-signatories, has
apologized to the three of us following the publication of their letter on
2 December 2012. He made it clear that he did not intend to imply that we
were harassing Professor (now Sir) Simon Wessely. We were not harassing
him. None of us believes that harassment is a means of advancing scientific
debate, and certainly not in promoting a greater understanding of the
causes of ME/CFS.

In the IoS article of 25 November 2012 we were criticizing the award of the
Maddox Prize to Professor Wessely because it is axiomatic that the progress
of scientific understanding depends upon sound evidence. Sir Paul Nurse,
President of the Royal Society, has said: "The John Maddox Prize is an
exciting new initiative to recognize bold scientists who battle to ensure
that sense, reason and evidence base play a role in the most contentious
debates."

We are in complete agreement with Sir Paul. We would wish the scientific
process to prevail, whereby the extensive peer reviewed biomedical evidence
base on ME/CFS is acknowledged and used by all researchers in the field to
advance the understanding of the disorder, and we have been calling for
this for many years.

There can be no doubt that the cause of ME/CFS is a contentious issue and
that there remain many unanswered questions. Both Professor White and Sir
Simon Wessely have promoted an hypothesis that ME/CFS is due to an abnormal
illness belief; that it is perpetuated by dysfunctional beliefs and coping
behaviours, and that cognitive behavior therapy (CBT) and graded exercise
therapy (GET) are effective treatments for the condition. In an attempt to
prove this hypothesis Professor White, principal investigator, and
colleagues, including Sir Simon, conducted what has become known as the
PACE trial, published in February 2011 in The Lancet, at a cost of some £5m
to the taxpayer. No data on recovery rates and positive outcomes have been
released and a FOI request to Queen Mary University of London revealed
that: "The requested data relating to recovery rates and positive outcomes
do not exist. That is to say that such analyses have not been done and
there is no intention to do so.
The reason for this is that the analysis
strategy has changed from the original protocol."

There has been no attempt by Professor White to correct the misapprehension
in respected journals as well as the popular press that the PACE trial
demonstrated recovery rates of between 30% and 40%. The release of all the
data relating to the PACE trial would be the most telling indication of the
efficacy of CBT and GET and would contribute very effectively to the
evidence base that precise scientific enquiry demands.

In our view, the idea that ME/CFS owes its origins to a dysfunctional psyche is an hypothesis that lacks any scientific evidence base. We are therefore at a loss to understand why the Maddox Prize was awarded to the defender of that hypothesis rather than to someone who was upholding the spirit of true scientific enquiry.

Our main interest is in advancing the scientific understanding of the cause
of a frequently devastating and debilitating condition which blights the
lives of many thousands of people. We do not believe that personal attacks
directed against Professor Sir Simon Wessely will advance the cause, but
reserve the right to direct criticism at the hypothesis both he and
Professor White continue to espouse. We believe that a proper scientific
understanding of the cause(s) of ME/CFS will emerge in the fullness of time.

The Countess of Mar
Professor Malcolm Hooper
Dr William Weir
House of Lords
London SW1

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