UK study refuses to release data: PACE trial

Large controversial UK study refusing to release data: PACE trial

The authors of a £5 million trial into cognitive behavior therapy and graded exercise therapy again refused to release the data to scientists who wanted to examine it. The Queen Mary University of London believe it to be exempt from Freedom of Information (FOI) laws; here is the full letter of refusal.
To refresh your memory, the authors of the PACE trial said:

“We did a randomised controlled trial (n=640) and found two rehabilitative treatments, graded exercise therapy (GET) and cognitive behaviour therapy (CBT), added to specialist medical care to be superior to adaptive pacing therapy added to specialist medical care and specialist medical care alone in improving fatigue and physical functioning for patients with chronic fatigue syndrome.”

The PACE trial was published in The Lancet in 2011 and since then many patient groups and scientists have criticised the study, most notably the UK’s ME Association, James Coyne and David Tuller, who is a lecturer at Berkeley school of journalism (University of California) and has a master’s degree in public health. Tuller pointed out flaws in the trial and quoted expert doctors:

“Dr. Bruce Levin, Columbia University: “To let participants know that interventions have been selected by a government committee ‘based on the best available evidence’ strikes me as the height of clinical trial amateurism.”

Dr. Ronald Davis, Stanford University: “I’m shocked that the Lancet published it…The PACE study has so many flaws and there are so many questions you’d want to ask about it that I don’t understand how it got through any kind of peer review.”

Dr. Arthur Reingold, University of California, Berkeley: “Under the circumstances, an independent review of the trial conducted by experts not involved in the design or conduct of the study would seem to be very much in order.”

Dr. Jonathan Edwards, University College London: “It’s a mass of un-interpretability to me…All the issues with the trial are extremely worrying, making interpretation of the clinical significance of the findings more or less impossible.”

Dr. Leonard Jason, DePaul University: “The PACE authors should have reduced the kind of blatant methodological lapses that can impugn the credibility of the research, such as having overlapping recovery and entry/disability criteria.””

The main criticisms of the trial were summarised by Tuller:

  • the study included a bizarre paradox: participants’ baseline scores for the two primary outcomes of physical function and fatigue could qualify them simultaneously as disabled enough to get into the trial but already “recovered” on those indicators–even before any treatment. In fact, 13 percent of the study sample was already “recovered” on one of these two measures at the start of the study.
  • there was very little difference in outcomes at long-term follow-up between any of the four interventions.
  • The PACE claims of successful treatment and “recovery” were based solely on subjective outcomes. All the objective measures from the trial—a walking test, a step test, and data on employment and the receipt of financial information—failed to provide any evidence to support such claims. Afterwards, the PACE authors dismissed their own main objective measures as non-objective, irrelevant, or unreliable.
  • In the middle of the study, the PACE team published a newsletter for participants that included glowing testimonials from earlier trial subjects about how much the “therapy” and “treatment” helped them.
  • More here.

The PACE trial authors are also in breach of orders to share the data. The UK’s Information Commissioner’s Office ordered Queen Mary University of London to release the data. The UK Medical Research Council 2011 policy on data sharing has endorsed principles laid out by the Research Councils UK including:

Publicly funded research data are a public good, produced in the public interest, which should be made openly available with as few restrictions as possible in a timely and responsible manner. To enable research data to be discoverable and effectively re-used by others, sufficient metadata should be recorded and made openly available to enable other researchers to understand the research and re-use potential of the data. Published results should always include information on how to access the supporting data.

More than 11,700 people and organisations have signed a petition to call upon The Lancet to retract claims of recovery, to give independent researchers access to the data and call upon all parties to reject the view that being as disabled as patients with congestive heart failure is a good recovery of physical function in CFS.
More reading: 
As well as the links above, three letters recently published in The Lancet are worth reading:
Results of the PACE follow-up study are uninterpretable”, from James Coyne and Keith Laws
PACE: CBT and GET are not rehabilitative therapies”, from Frank Twisk
The ME Association’s letter

Facebook
Twitter
WhatsApp
Email

2 thoughts on “UK study refuses to release data: PACE trial”

  1. Sasha,
    The institutions involved in the PACE trial have had a lot of experience dealing with information requests over the years.
    The authors are coming towards the end of their carrees & their main pre-occupation is probably to save their reputations. Guessing a few more will move onto other fields once more information on biomarkers & treatments comes out.

  2. Thanks for reading and commenting, Sean.
    I’m sure I’m not the only one who can’t wait for them to retire, the ramifications of PACE are felt around the globe.

Comments are closed.

Latest News

Happy Pride Month 2022 with rainbow ribbon in a heart

#MEAction Recognizes & Celebrates Pride Month 2022!

#MEAction recognizes and celebrates Pride Month! As a community that welcomes and encompasses all, this Pride Month, we asked members of our LGBTQIA+ community to share what Pride means to them and what they have learned from this movement that they bring with them to the ME movement. Here are a few responses: Kristina Osobka-Stier

Read More »
Severe ME Artist Project 2022 over swatches of gold paint

Severe ME Artists Project 2022!

#MEAction is once again excited to announce our Severe ME Artists Project 2022 that will feature work from those within the severe ME community and will be in recognition of Severe ME Day on August 8th! This project will be an opportunity for those with severe ME to showcase their art work (whether it be

Read More »

Help keep our work going

We rely on donations from people like you to keep fighting for equality for people with ME.

Donate

Get actions alerts and news direct to your inbox

You can choose what you want to be kept up to date on.

Subscribe
Scroll to Top