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Trial By Error: NICE's Consideration Of The Lightning Process

Tuesday 29 May 2018


From Virology Blog:


David Tuller
David Tuller

Trial By Error: NICE’s Consideration of the Lightning Process

By David Tuller, DrPH
28 May 2018
Content on this site is licensed under a Creative Commons Attribution 3.0 License

Earlier this month, in advance of a stakeholder meeting, the U.K.’s National Institute for Health and Care Excellence released a draft scoping report. The document outlined the issues slated to be addressed by the committee selected to develop the new guidance for the illness NICE now calls ME/CFS. (The 2007 guidance referred to it as CFS/ME; the name switch represents, at least to me, a potentially positive albeit modest sign of shifting attitudes at NICE.)

According to follow-up reports from the Friday meeting, the discussion appeared to go reasonably well. A formal consultation period from June 21st to July 19th will provide an opportunity for people to submit further comments before the scoping report is finalized.

Smart stakeholders will hopefully be able to hold NICE to account on this matter. When I skimmed the draft scoping document, I wasn’t surprised to see graded exercise therapy and cognitive behavior therapy listed among the non-pharmaceutical interventions up for discussion. But the presence of the Lightning Process in the list caught my eye.

The Lightning Process is the woo-woo pseudo-nonsense that trains people to reject their illness and engage in positive affirmations, among other strategies. Professor Esther Crawley, the University of Bristol pediatrician whose work is fraught with ethical and methodological missteps, published a study last year that purported to document its effectiveness in treating kids. But the study violated core scientific principles, as I have documented on Virology Blog and in correspondence with the editor of the journal that published it, Archives of Disease in Childhood.

The editor has failed to take any action. So has BMJ, which publishes Archives of Disease in Childhood. This dereliction of editorial responsibility is certainly disturbing, since the facts of the case are incontrovertible: 56 out of the 100 trial participants were recruited before registration as part of a feasibility study, and the outcome measures for the final paper were swapped based on the results of these early enrolled patients. These maneuvers are clearly guaranteed to induce bias and are unacceptable from any scientific perspective.


Full article…



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