Five professors of science and mathematics, including Professor Ron Davis of Stanford University, have written to PLoS One demanding the correction of an “inaccurate claim” central to a PACE trial paper on cost-effectiveness that was published in the journal in 2012.
Referring to a series of articles by Dr. David Tuller criticizing the PACE trial, the letter states, “Among Dr. Tuller’s findings: the main claim of the PLoS One paper—that cognitive behavior therapy and graded exercise therapy are cost-effective treatments—is wrong… The PACE authors have repeatedly cited this inaccurate claim of cost-effectiveness to justify their continued promotion of these interventions.” Dr. Tuller’s investigation into PACE’s flaws is ongoing.
While there are a number of well-known flaws in the PACE trial, it was ME/CFS patients Simon McGrath and Tom Kindlon who pointed out an aspect of PACE’s presentation of CBT and GET as cost-effective therapies they found troubling: in order to reach this conclusion, the researchers had to value the home care that the patient’s family so often provides at minimum wage – or worse, as being worth nothing at all.
If the home care is estimated to be worth the same as a skilled home care worker might provide, McGrath and Kindlon maintained, the monetary advantage disappears.
Professor Paul McCrone, the paper’s lead author, appeared to concede the point in an online response but failed to correct the paper.
The academics’ letter says that if Professor McCrone cannot account for the discrepancy between the paper’s claims and his own subsequent comments, then either he must correct the paper or PLoS One must do so. The letter notes that PLoS One were notified about the issue by Dr. Tuller in the fall but have failed to act.
In addition to Professor Davis, the open letter was also signed by Professors Rebecca Goldin (mathematician, George Mason University), Bruce Levin and Vincent Racaniello (biostatistician and virologist, respectively, both Columbia University) and Arthur Reingold (epidemiologist, University of California, Berkeley).
Meanwhile, a request made over six months ago by Professor James Coyne of Pennsylvania University for the raw data underlying the same PLoS One paper has still not been met. He has stated, “I am losing patience with PLoS. My confidence in their commitment to data sharing is faltering.”
He added, “It may be too early to act, but is not too early to begin planning an action in which academic editors, the reviewers on whom they depend, and the authors who submit papers avoid involvement with PLOS One for a month.”
For an overview of the PACE trial, consult its MEpedia page.
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