MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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Mark Seddon, a member of Labour’s National Executive, told the BBC of his concern about the influence of
Lord Sainsbury: “In any other country, I think a government minister donating such vast amounts of money and
effectively buying a political party would be seen for what it is – a form of corruption of the political process”
(www.gmwatch.org).
For some, the choice of an unelected biotech investor to be Science Minister was emblematic of the UK’s
corporate science culture. Not only was Lord Sainsbury in charge of the MRC, but he is also known to be a
keen supporter of the Science Media Centre .
The Linbury Trust has published two portfolios on “Chronic Fatigue” (into which they subsume ME/CFS).
Both were published by the Royal Society of Medicine (1998 and 2000). The Wessely School is well‐
represented and contributors include Simon Wessely, Trudie Chalder, Anthony David, Helen Cope,
Anthony Cleare, Peter White, Michael Sharpe, Alison Wearden, Louis Appleby and Philip Cowen.
These two portfolios make disquieting reading. Suffice it to say that Anthony David and Helen Cope
dismiss the neuroimaging findings, describing them as “ ’abnormalities‘ of debatable significance”, and that
Philip Cowen thinks that up to 30% of “CFS” patients meet the criteria for major depression; his
contribution is entitled “Abnormalities of Mood”.
For the avoidance of doubt, Professor Cowen (a psychopharmacologist from Oxford who has co‐authored
on “CFS” with Michael Sharpe) is a member of the newly‐convened MRC “CFS/ME Expert Group” chaired
by Professor Stephen Holgate, as is Dr Esther Crawley, Professor Anthony Pinching and Professor Peter
White.
Perhaps this explains why at the RSM meeting on 11 th July 2009 Professor Holgate indicated that the MRC
favours the status quo and that he wondered if change in relation to ME/CFS would in fact happen.
The amount of what appears to be frank misrepresentation in the PACE Trial by those professionals
involved with it seems to call into question the validity of the whole PACE Trial and indeed, the scientific
integrity of the MRC itself.
Unblinding / blinding
Page 59 of the Trial Protocol states: “all research and therapy staff…are unblinded to therapy allocation”, meaning
that the PACE Trial could suffer from “assessor bias” described by Lynch, Laws et al (Cognitive behavioural
therapy for major psychiatric disorder: does it really work? A meta‐analytical review of well‐controlled
trials. Psychological Medicine 2009:1: DOI:10.1017/S003329170900590X). Lynch et al focused particularly on
methodologically rigorous trials that compared CBT with a “psychological placebo” and also investigated
the impact of blinding, ie. whether or not the people who assessed the patients knew if they were receiving
active treatment or not. The authors noted that not a single trial employing both blinding and placebo has
found CBT to be effective in schizophrenia and surprisingly few well‐controlled studies of CBT in
depression: “‘The results of this review are important because in March NICE re‐approved CBT for use in all people
with schizophrenia. The Government is also investing millions of pounds to provide CBT for depression and anxiety in
250 dedicated therapy centres across England’ said Professor Laws. ‘Yet the evidence here is that the effectiveness of
this form of therapy may be less than previously thought, to the point of being non‐existent in schizophrenia’ ”
(ScienceDaily, 26 th June 2009).
Even blinding at the PACE Clinical Trial Unit might not prevent inaccurate results because the data is
known to be unreliable in any event.
One PACE Trial participant has openly said on the internet that it is very easy to lie to the Investigators to
offset their coerciveness and their bullying tactics: in one particular case, the therapist insisted that the