James Coyne gives a public talk on PACE Trial
In a public talk in Edinburgh on Monday, psychologist Professor James Coyne declared the “moral equivalent of war” on the practices and assumptions that, he said, have allowed the “bad science” of the PACE trial to go unchallenged by scientists and the media.
The authors of the UK’s £5 million PACE trial have claimed that it showed that cognitive behavioural therapy and graded exercise therapy were beneficial for patients with chronic fatigue syndrome. Patients have criticised the trial’s methodology since its publication but criticisms have been dismissed by the study authors as reflecting “the apparent campaign to bring the robust findings of the trial into question.”
Professor Coyne’s attention was drawn to PACE by the authors’ latest claims, made in a recent Lancet Psychiatry paper, that long-term follow-up of patients confirmed these benefits. Coyne published a detailed blog post condemning the paper as “uninterpretable” and as having used “voodoo statistics” in a failed attempt to correct for “fatal flaws.”
The problems, Professor Coyne said, are “obvious to anyone who looks carefully. That virtually no one else picked them up reflects badly on the editing and peer review at Lancet Psychiatry… and media portrayals of this trial.”
PACE’s results were, Professor Coyne said, “being badly mispresented by the investigators,” “going unchallenged” and being “uncritically passed on by journalists and the media, with clear harm to patients.” There were, he said, “murky politics about who can speak and who is silenced.”
In a move that will delight many patients, Professor Coyne stated that he was now refocusing his existing goals and activities on exposing more of the “questionable research practices” of PACE; establishing the culpability of journal editors and reviewers; and educating the media and journalists on “responsibilities they have not exercised” in reporting the trial.
He would also, he said, expand his focus to include questionable research and publication practices that “have maintained [the] illusion that there is validity to [the] psychosomatic model for [the] treatment of ME, CFS, and [post-viral syndrome]”. He added that he would “validate and legitimize what patients have been saying all along and bring them into [the] conversation as credible citizen-scientists” and would “identify and dismantle [the] structure by which PACE investigators bullied and neutralized critics.”
Professor Coyne, of Pennsylvania University, is one of the world’s most cited psychologists and is well known for his work in debunking false scientific claims, including that having a positive attitude can help cancer survival. He said in his talk that “the story of PACE will be rewritten to underscore [the] necessity of [a] strong patient voice in [the] design and conduct of clinical trials” and that it would mark a “turning point in [the] use of language indicating greater respect for patient activism, healthy assertiveness, and self-determination.”