📝 Plot:
In a nearly abandoned Provençal village, a solitary farmer refuses to let his land and way of life disappear. When a woman seeking refuge arrives, their fragile bond rekindles hope and restores meaning to the deserted fields. Through hard work, trust, and quiet determination, the community slowly revives. A poetic rural drama about rebirth, attachment to the land, and the enduring strength of human connection.

#Regain
#Drama
#FrenchCinema
#RuralDrama
#ClassicFilm

🎭 Cast:
Fernandel, Orane Demazis, Marguerite Moreno, Édouard Delmont, Henri Poupon, Marguerite Chabert, Odette Roger, Charles Blavette, Milly Mathis, Louis Chaix, Gabriel Gabrio, Paul Dullac, Robert Le Vigan, Henri Rollan, Albert Spanna

#Regain
#FrenchCast
#ClassicFilm

🎬 Regain [Harvest] (1937)

Subtitles available:
🇬🇧 English
🇫🇷 French
🇩🇪 German
🇪🇸 Spanish

⬇️ Download
https://app.box.com/s/kq6i76qg7ga0a84bvoorpq34tp0o0vzu

🎞 IMDb
https://www.imdb.com/title/tt0028980/

▶️ Watch the video here 👇
https://darkiworld15.com/titles/17572/regain

#Regain
#Drama
#RuralLife
#FrenchClassic
#LiteraryAdaptation
#Provence
#HumanResilience

#Regain : "obtain possession or use of (something) again after losing it."

We have regained the Ronald Reagan 1985 problem, described by teacher Neil Postman in his 1985 book "Amusing Ourselves To Death" - about 1985 - which applies to Donald Trump 2025 second term in office.

https://www.northjersey.com/story/opinion/columnists/2024/03/27/us-politics-2024-predicted-media-expert-neil-postman/73022583007/

#Regain de popularité du #catholicisme chez les #jeunes français, de toutes origines. Multiplication des #baptêmes chez eux, mineurs et jeunes adultes. Je trouve cela génial ! #Jeunesse.

Eric Dubois

BMJ’s Strange Response to Our Letter of Concern Regarding “Living Systematic Review” of Long Covid Interventions

By David Tuller, DrPH

In December, I sent a letter, co-signed by 18 colleagues, to The BMJ‘s editor in chief, Dr Kamran Abbasi. The letter requested a correction to a problematic study called “Interventions for the management of long covid (post-covid condition): living systematic review.” According to this review, there is “moderate certainty evidence” that a physical and mental health rehabilitation program can “probably improve symptoms of long covid.”

This assertion was based on a paper called “Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial,” which The BMJ published in February of last year. The REGAIN trial included only participants who had been hospitalized for COVID-19, but this information was not mentioned in key sections of the paper.

In May, the REGAIN paper was corrected. The correction involved adding a phrase to the conclusion of the abstract and a boxed highlights section to clarify that the findings can only be extrapolated to Long Covid patients who had been hospitalized for COVID-19. That group represents a very small percentage of the population of people who have suffered from Long Covid.

The review of interventions, published last November, committed the same error. While the discussion section noted that the participants had been hospitalized, this important detail was not included in the most prominent parts of the paper—namely, the abstract, the conclusion, and a boxed highlights section. Our letter expressed the view that the review required the same correction as the REGAIN paper. (I posted an initial critique of the review here.)

In a rapid response posted in January, the review authors rejected our request, citing both my initial blog post and the post including our letter to Dr Abbasi. So I was surprised this week when I received the following letter from a research editor at The BMJ. (I am redacting their name.)

**********

Dear Dr Tuller

I am one of the research editors at The BMJ and I am following up on your email below as I believe it may have been overlooked among other responses we received about this research paper.

Plese [sic] could you post your email as a rapid response to the article itself? If you go to the article page (https://www.bmj.com/content/387/bmj-2024-081318) and follow the link to “respond to this paper” in the menu on the left of the paper, you should be able to complete the form to submit a response. 

We can then ask the authors to reply, and the journal can make a decision about a correction.

Many thanks for raising this concern.

Yours sincerely
[Name redacted]

**********

Today I sent the following response, and cc’d the co-signatories:

Dear [Name redacted]–

I appreciate your suggestion, but I have to say I’m perplexed. I sent the letter of concern about the “living systematic review,” co-signed by 18 of my colleagues, in early December, and then posted it on Virology Blog. I had previously posted a similar critique of the review, also on Virology Blog.

In that first blog post, I wrote the following:

“The review’s abstract claims that, based on ‘moderate certainty evidence,’ the REGAIN intervention ‘probably’ improves Long Covid symptoms–without noting that the trial participants had been hospitalized. The review mentions this highly salient fact only deep in the text of the paper. But the broad statements in the abstract and elsewhere, which essentially extrapolate the purported benefits to all Long Covid patients, seem to have raised no questions among peer reviewers. Nor did this excessively expansive interpretation of the REGAIN results lead to any apparent concern among editors at The BMJ, who presumably should have known that the referenced trial, published by their own journal earlier this [i.e.last] year, already bore an embarrassing correction for having misrepresented its findings.”

The letter we sent to The BMJ raised the same concern.

The REGAIN correction seems to have occurred at the direction of journal editors, since the authors themselves had rejected the need for such a step in a rapid response. The authors argued that the REGAIN paper had included information about the study population in multiple places, and that this limitation therefore didn’t need to be mentioned in some prominent sections of the paper. Nonetheless, the correction appeared weeks after the authors had rejected the need for one, and new language was added to both the conclusion of the abstract and a box highlighting the study’s main points. Presumably, someone with integrity and scientific acumen at The BMJ determined that the authors’ decision was inadequate, and overruled it.

In the case of the review, the authors have already posted a rapid response in which—like the REGAIN authors–they have rejected the need for a correction. Why? Because the review included a sentence in the discussion section pointing out that the REGAIN patients had been hospitalized and that “it is possible that effects may be different in patients with mild to moderate covid-19 infection.” In their rapid response, the authors cited both of my blog posts–the initial critique quoted above, and the post that included the letter from us to The BMJ. 

From our perspective, the review authors’ rapid response, like the rapid response from the REGAIN authors, is non-responsive to the concerns raised. Our letter acknowledged that the review referenced details about the study population in passing. That incidental mention is beside the point.

The REGAIN correction made it clear that the trial’s findings should not be extrapolated to all Long Covid patients, and that this important point needed to be noted in all prominent sections of the paper. Yet the review fails to do just that in the places where it counts most–the abstract, a box highlighting the findings, and the conclusion. It is hard to understand why the editorial team at The BMJ required a correction to key parts of the REGAIN paper while allowing a review published many months later to engage in the same misrepresentation in its most high-profile sections. If the REGAIN paper needed correcting to ensure that the findings were appropriately framed and not misunderstood, so does the review.

Since the authors have already rejected the need for such a correction, it seems like a waste of time for us to post our letter as a rapid response. It also seems odd to suggest that a rapid response would trigger yet another statement from the authors, as well as a determination from The BMJ as to whether a correction is necessary. The BMJ already has all the information that editors need to assess the situation. It is self-evidently inconsistent—and, I would say, rather bizarre–for The BMJ to correct the REGAIN paper and then, months later, to publish a review that compounds the original error.

This entire series of events does not reflect well on the The BMJ. Requesting us to submit a rapid response in order to make a point we have already made, and that the review authors have already addressed—albeit in a manner antithetical to basic scientific principles—suggests that the journal’s editorial team is not operating at full speed and suffers from a shortage of common sense and/or competence.

We still believe it is incumbent upon The BMJ to correct the review, and that the failure to do so represents a serious breach of the journal’s obligations to publish accurate and unbiased information. However, we see no point in submitting a rapid response at this time.

In a related matter, the peer reviews for the review have not yet been posted. Policy at The BMJ is to post them within five days. As far as I know, no reason for this lapse has been offered. Does The BMJ plan to post the peer reviews? If so, when? And if not, why not? This lapse undermines the claim that “The BMJ has fully open peer review.”

Best–David

David Tuller, DrPH
Senior Fellow in Public Health and Journalism
Center for Global Public Health
School of Public Health
University of California, Berkeley

(View the original post at virology.ws)

#BMJ #letter #LongCovid #REGAIN

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BMJ Has Corrected the REGAIN Trial Paper–But Not the Editorial or Systematic Review Touting REGAIN’s Findings

By David Tuller, DrPH

Last February, The BMJ published a paper called “Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial,” from McGregor et al. The study purported to have proven that this multi-disciplinary intervention was “clinically effective” in reducing symptoms associated with Long Covid. Unfortunately, the claim was fraught with problems that rendered it bogus. (I have written about the trial several times, including here and here.)

First and foremost, the study was unblinded and relied solely on subjective, self-reported outcomes—a combination of traits that inevitably leads to unknown amounts of bias. In such instances, modestly positive results would be expected as an artifact of the study design and are essentially meaningless.

Beyond that, the study included some untenable flaws. Specifically:

*In prominent sections of the paper, including the conclusion of the abstract and a highlights box called “What this study adds,” the investigators presented their findings as if they could be extrapolated to all Long Covid patients. This was completely unwarranted because it omitted a highly salient point. The study participants had all been hospitalized for acute Covid-19, while the great majority of Long Covid patients have not been hospitalized. Given the major differences between these two populations, it is scientifically unjustified to automatically assume that findings in one group apply to those in the other.

*The reported benefit on the primary outcome fell below the recommended threshold for what is called the “minimal clinically important difference” (MCID) for that measure, as determined by those who developed it. If a trial’s results do not meet the MCID recommended by the creators of an outcome measure, it is hard to take seriously the investigators’ claim that the intervention is “clinically effective.”

Given these and other issues, multiple complaints ensued. Some people filed rapid responses. I organized a letter to the journal’s editor-in-chief, Kamran Abbasi, signed by a dozen other colleagues. For their part, the investigators rejected all the criticisms in their own rapid response, posted last April. However, apparently someone at the BMJ disagreed with the investigators’ decision-making, because by May the paper bore a correction, although it addressed only the issue of the expansive extrapolation of the findings to all Long Covid patients. As the correction noted, the phrase “at least three months after hospital discharge for covid-19” was added to the key sections from which it had been omitted.

The correction did not include an explanation for why or how the journal overruled the investigators’ position that no such correction was needed. It was nonetheless an acknowledgement that the investigators, whether intentionally or not, had conveyed inaccurate or untrue information to the public. Unfortunately, media outlets had already disseminated this widely right after the study’s initial publication. No media outlets seemed to cover the correction.

Unfortunately for The BMJ, that is not the end of its responsibilities here. The claims from the trial have figured prominently in at least two other BMJ publications. An invited editorial accompanied the initial trial report last February. Like the trial itself, the editorial misrepresented the findings by not mentioning the limitations imposed by the study population until the very end.  No one who reads it would necessarily be aware that a correction to the trial has severely restricted the relevance of the findings to the larger Long Covid population.

Even more troubling, The BMJ in November published an article called “Interventions for the management of long covid (post-covid condition): living systematic review,” from Zeraatkar et al. The review relies solely on McGregor et al to claim “moderate certainty evidence” in favor of a program of physical and mental health rehabilitation for Long Covid patients. The investigators rejected the notion that the recommendation should be limited to patients who were hospitalized, even though the review was accepted for publication months after REGAIN was corrected to reinforce that specific point.

Did anyone notice or care about this discrepancy? Hard to tell. The policy at The BMJ is to post peer reviews. In this case, no peer reviews of this systematic review have yet appeared, with no explanation offered for the delay. It goes without staying that if a study is corrected and its findings dramatically limited to a much smaller population, other articles that relied on the initial error should also be fixed—whatever the authors of those other articles think. Even the biopsychosocial fanatics apparently in charge at BMJ should be able to understand this basic principle.

I organized letters to The BMJ editor on both counts. (They can be read here and here.) In both cases, I received responses from BMJ’s “research integrity” department assuring me that the questions I had raised were being reviewed. I have not yet received any information about resolutions.

********

Meanwhile, there are now eight rapid responses appended to Zeraatker et al. (Embarrassingly, one is from the REGAIN investigators themselves, questioning the review’s statistical analysis.) Several raise concerns about the review’s over-broad claims regarding the REGAIN findings, among other problematic issues. Of particular note are smart, well-argued responses from two patient advocates, Michiel Tack and Dominic Salisbury.

Perhaps at some point The BMJ and the team that produced this problematic “living systematic review” will decide to provide some answers.

(View the original post at virology.ws)

#BMJ #REGAIN

Letter to BMJ Editor Seeking Correction in New Review of Interventions for Long Covid

By David Tuller, DrPH

The BMJ recently published a review of interventions for Long Covid that–surprise!–recommended CBT and a rehabilitation program as treatments. The review is full of holes. I have focused on one in particular. The review relies for its rehabilitation recommendation on an earlier BMJ study–even though that study has itself already been corrected for having misrepresented its findings in key sections. This morning, I sent the following letter to Dr Kamran Abbasi, editor-in-chief of The BMJ:

Dear Dr Abbasi—

A recent paper in The BMJ, Interventions for the management of long covid (post-covid condition): living systematic review, from Zeraatkar et al,drew a crucial conclusion from a trial whose findings were seriously misrepresented. That trial report, also published by The BMJ, has already been corrected. The review needs a similar correction.

Zeraatkar et al recommended a mental and physical health rehabilitation program and cognitive behavior therapy as reasonable interventions for people suffering from the prolonged symptoms that characterize Long Covid. Each recommendation was based on a single clinical trial.

The basis for the first recommendation was Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial, from McGregor et al. The paper was published by The BMJ in February of this year and then corrected in May.  The initial version failed to note in major sections—such as the conclusion of the abstract—that the sample included only patients who had been hospitalized for acute Covid-19. Given the significant differences between Long Covid patients who have and have not been hospitalized, the trial findings cannot automatically be extrapolated to everyone with prolonged symptoms. The corrected version now makes that clear.

Unfortunately, the review from Zeraatkar et al committed the same error as the pre-corrected version of McGregor et al. The review did not mention in key passages—such as the abstract and conclusion–that its expansive recommendation for mental and physical rehabilitation came from a trial including only patients who had been hospitalized.  While the review noted this salient detail deep in the text, it nonetheless suggested that the intervention be offered far more broadly than warranted by the trial itself.

In short, if the trial paper required a correction for not highlighting prominently enough an indisputable limitation of its findings, then the review requires the same.

David Tuller (corresponding author)
Center for Global Public Health
University of California, Berkeley
Berkeley, California, USA
davetuller@berkeley.edu

Nicola Baker
School of Health Sciences
University of Liverpool
Liverpool, England, UK

Svetlana Blitshteyn
Department of Neurology
Jacobs School of Medicine and Biological Sciences
University of Buffalo
Buffalo, New York, USA

Todd Davenport
Department of Physical Therapy
University of the Pacific
Stockton, California, USA

David Davies-Payne
Department of Radiology
Starship Children’s Hospital
Auckland, New Zealand

Andrew Ewing
Department of Chemistry and Molecular Biology
University of Gothenburg
Gothenburg, Sweden

Mark Faghy
Human Sciences Research Centre
University of Derby
Derby, England, UK

Keith Geraghty
Centre for Primary Care and Health Services Research
Faculty of Biology, Medicine and Health
University of Manchester
Manchester, England, UK

Mady Hornig
CORe Community (COVID Recovery through Community)
New York, New York, USA

Brian Hughes
School of Psychology
University of Galway
Galway, Ireland

Leonard Jason
Center for Community Research
DePaul University
Chicago, Illinois, USA

Binita Kane
Respiratory Medicine
Manchester University NHS Foundation Trust
Manchester, England, UK

Douglas Kell
Institute of Systems, Molecular and Integrative Biology
University of Liverpool
Liverpool, England, UK

Asad Khan
North West Lung Centre
Manchester University Hospitals
Manchester, England, UK

Resia Pretorius
Department of Physiological Sciences
Stellenbosch University
Stellenbosch, South Africa

David Putrino
Department of Rehabilitation and Human Performance
Icahn School of Medicine at Mt Sinai
New York, New York, USA

Charles Shepherd
ME Association
Gawcutt, England, UK

John Swartzberg
Division of Infectious Diseases and Vaccinology
School of Public Health
University of California, Berkeley
Berkeley, California, USA

Susan Taylor-Brown
Department of Pediatrics, Developmental & Behavioral Pediatrics
University of Rochester Medical Center
Rochester, New York, USA

(View the original post at virology.ws)

#BMJ #LongCovid #REGAIN

My Letter to BMJ Seeking Correction to Editorial on REGAIN Trial of Mental-and-Physical-Health Rehab for Long Covid

By David Tuller, DrPH

I have recovered sufficiently from my post-election coma to send off another of my irritating letters to journals–this one to The BMJ.

As I mentioned in a post earlier this week, The BMJ has corrected a major paper: “Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial.” (Post-Covid-19 condition, or PCC, designates a specific definition for Long Covid.) The correction, published in May, involved adding to key sections of the REGAIN paper the salient detail that the study sample included only patients who had been hospitalized for Covid-19. As a matter of scientific interpretation, the findings cannot automatically be generalized to include all PCC patients–the great majority of whom have not been hospitalized. Yet in the conclusion of the abstract, as well as in a prominent section called “What This Study Adds,” the investigators omitted any mention of this caveat, leaving the impression that the findings could be broadly extrapolated.

It’s all well and good that The BMJ corrected the paper. But as I pointed out in the earlier post, an accompanying editorial, which had been commissioned by the journal and was not externally peer-reviewed, did the exact same thing. And that editorial has not been corrected. So today I sent the following e-mail to Dr Kamran Abbasi, editor in chief of The BMJ.

**********

Subject: Request for correction to editorial accompanying REGAIN study

Dear Dr Abbasi—

In February, The BMJ published “Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial,” from McGregor et al. A dozen colleagues and I sent the journal a letter expressing concerns about several aspects of the REGAIN paper—including the apparent extrapolation of the findings to everyone with post-Covid-19 condition (PCC) rather than just to the small percentage of patients who, like the study participants, had been hospitalized. Other observers raised similar objections.

In April, the investigators posted a rapid response rejecting the various criticisms. In May, however, The BMJ published a correction. The correction addressed the charge that the REGAIN paper misrepresented the findings by omitting from key sections the salient detail that all the participants had been hospitalized. 

The correction is an important and welcome update of the public record, since it clearly limits the presumed applicability of the  REGAIN findings to a narrow sub-group of PCC patients. Unfortunately, it was issued long after the media had already touted the study results without making any such distinctions.

The correction raises some new questions:

1. Given that the rapid response from the investigators rejected the need for corrections, why did The BMJ decide to publish one anyway, and did the investigators agree with that decision?

2. Has The BMJ issued a press advisory about the REGAIN correction, or made any efforts to reach out to news organizations that covered the initial publication?

3. Alongside the REGAIN paper, The BMJ published a commissioned editorial called “Rehabilitation for post-covid-19 condition.” As with the paper itself, the editorial’s most prominent sections presented the intervention’s reported benefits without mentioning that this cohort of patients had been hospitalized. 

    Only in the very last paragraph did the editorial cite the caveat about the study population, noting in passing that “inclusion criteria required a history of hospital admission for covid-19, and it is unknown if findings can be generalised to patients…who do not require admission.” And yet, for all intents and purposes, the editorial’s preceding paragraphs did just that—generalize the REGAIN findings.

    The REGAIN paper was corrected for having failed to highlight an obviously pertinent point in a sufficiently prominent manner, so it is perplexing that the editorial, which has a similar flaw, has not also been corrected. The critical information about the study sample, which indisputably impacts the interpretation of the findings, should have been provided to readers at the beginning of the editorial–not tucked away at the end like an afterthought. Under the circumstances, does The BMJ plan to correct the editorial as well? 

Thank you for your attention to this matter.

Thank you for your attention to this matter.

Best–David

David Tuller, DrPH
Senior Fellow in Public Health and Journalism
Center for Global Public Health
School of Public Health
University of California, Berkeley

#REGAIN

The BMJ Corrects REGAIN Study’s Expansive Claims; Results Only Applicable to Post-Hospitalized Long Covid Patients

By David Tuller, DrPH

In February, The BMJ published a study called Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial.” (Post-Covid-19 Condition, or PCC, is one of many current definitions for Long Covid.)The study, led by a team from the University of Warwick, suffered from some serious flaws. Its claims cannot be taken at face value—as many observers noted and as I outlined here. I also organized a letter of concern to the journal’s editor, co-signed by a dozen other experts.

 A key issue was that the trial was unblinded and relied solely for its claims of success on subjective outcomes—a combination of elements that is guaranteed to generate an unknown amount of bias. Beyond that, the authors misrepresented the findings by declaring that the intervention was “clinically effective.”  In fact, the results for the primary outcome fell below the currently recommended level for the “minimal clinically important difference” (MCID) for their primary outcome, so the intervention should not be framed as having demonstrated “clinical effectiveness.” The investigators essentially lied about the MCID issue in the Methods section of the paper, and then contradicted themselves deeper in the text.

Another major issue involved a different kind of misrepresentation of the findings—in this case, how broadly the results could be applied.  This was a trial of patients who had been hospitalized for Covid-19. However, the vast majority of PCC, or Long Covid, patients have not been hospitalized—rendering the study of questionable relevance for them. And yet, the investigators omitted this key detail in prominent sections of the paper that readers are most likely to see. The detail was not mentioned in the paper’s title. And in the conclusion of the abstract as well as in the “What This Study Adds” box, which accompanied the text and highlighted key messages, the findings were extrapolated to all PCC patients. (To reiterate, any claim of clinical effectiveness or benefit is itself an over-statement, given that the primary outcome results did not meet the currently recommended MCID threshold for that measure.)

Hospitalized patients often have a different set of subsequent medical issues from those who have not been hospitalized, perhaps because their cases were more severe in the first place, or because of the impacts of the hospitalization itself, or other reasons. In this case, therefore, findings from hospitalized patients cannot be easily or automatically extrapolated to those who were not hospitalized. Whether the findings apply to non-hospitalized populations with PCC is a question that might be explored in future research. But it is certainly not appropriate to assume that the answer is positive—nor is it appropriate to disseminate this assertion as if it were an accurate interpretation of the research.

The mismatch between the study sample and the larger PCC population is self-evident, so it is hard to understand how the investigators could have misrepresented their findings so dramatically. This oversight could have been either a deliberate effort to hype and bolster the apparent relevance of the findings or a sign of incompetence and cluelessness about the proper reporting of science.

The letter I organized and sent to the journal editor noted, among our other concerns, that “it is inappropriate for the authors to extrapolate findings from patients who were hospitalized with covid-19 to the much larger number of patients with prolonged symptoms who were not hospitalized.” Similar criticism also appeared in online comments about the article.

In a rapid response posted on The BMJ’s website on April 11th, the investigators rebutted the criticism that they had inappropriately extrapolated their findings by noting that they had provided the correct information in various sections, including the paper’s conclusion–which is not the same as the conclusion of the abstract. Their defense, while technically correct, missed the point. As far as I know, no one argued that the text of the study did not include the necessary information. The substance of the criticism was that, by omitting the detail in very prominent locations–such as the conclusion of the abstract–the paper had misled readers about the significance of the findings.

Apparently, someone somewhere at The BMJ agreed with this negative assessment. On May 1st–less than three weeks after the investigators’ rapid response–the journal actually published a correction regarding this misrepresentation. The correction did not include an explanation for why the investigators had already rejected the need for such action. Here’s the text of the correction:

“Several sections of this paper by McGregor and colleagues…have been updated for clarity of the study population. The conclusion in the abstract and the first and second points of the ‘What this study adds’ subsection of the box should have made it clear that in adults with post-covid-19 condition ‘at least three months after hospital discharge for covid-19’ the online, home based, supervised, group physical and mental health rehabilitation programme (REGAIN) showed clinical benefits and lack of harm.”

It’s always laudable when journals and investigators agree to correct errors. But they do not deserve much credit for correcting false or obviously bogus statements that never should have been made in the first place. The study largely framed its findings as widely applicable to all PCC patients, so this major correction knocks the stuffing out of any such expansive declarations. But it does not fix the problems created by the initial publication. As far as I know, the media outlets and online influencers who touted the findings in the first place have not corrected the public record. So the false impression created by the study remains—and unfortunately will have an impact on the advice doctors provide and on the care patients receive.

In fact, it seems the journal does not really seem to have taken the correction seriously. What leads me to that conclusion? Because an editorial published alongside the trial, which was commissioned by The BMJ and , features the same omissions that have now been corrected in the paper itself.  The editorial touts the reported findings but only mentions in the last paragraph that the study participants had been hospitalized, with this sentence: “Trial inclusion criteria required a history of hospital admission for covid-19, and it is unknown if findings can be generalised to patients with milder infection who do not require admission.”

As with the paper itself, this salient limitation should have been mentioned in the most prominent parts of the editorial–and especially in the first reference to the study sample. As it is, the detail is presented as something of an afterthought. In other words, the journal is leaving intact in the editorial the same sort of expansive language that has now been corrected in the paper. Shouldn’t the editorial also be corrected, or at least updated, to align with the current version of paper? Perhaps someone should alert the editor to this discrepancy.

#LongCovid #REGAIN

My Tour of Ireland, Through Wind and Rain; Slides of My Talk

By David Tuller, DrPH

Last month, I took a quick speaking tour around Ireland at the invitation of the Irish ME/CFS Association. I first became acquainted with Tom Kindlon, the association’s assistant chairperson, about ten years ago. I was beginning to look into the background of the PACE trial, which purported to have proven the benefits of graded exercise therapy (GET) and cognitive behavior therapy (CBT) in treating what what the investigators called “chronic fatigue syndrome.” I noticed Tom’s name popping up in various journals in the form of correspondence or online comments critiquing the published research. These communications were invariably right on target, cogently argued, and pretty much irrefutable.

They were also excruciatingly polite, absent any hint of snark even when Tom was busy rebutting self-evident methodological failings or unwarranted claims. I admired Tom’s restraint. (In contrast, I generally found it hard to resist temptations to insert some clever-in-the-moment retort to obvious nonsense.) Beyond that, I was amazed, given how sick Tom had been for many years, at his persistence in what appeared to be the Sisyphean effort of pushing back against the propaganda from the GET/CBT ideological brigades. In the PubMed database, a search for his name yields an impressive list of 21 comments and other publications in peer-reviewed journals. Most he authored himself; on six, he was a co-author.

Tom’s input helped me enormously as I navigated the data manipulations behind the reported PACE results, and he served as a key source for my 15,000-word account. (That piece, which appeared on Virology Blog in October, 2015, launched this ongoing Trial By Error project.) Since then, Tom and I have been in regular contact and have met twice over the years in Dublin, when I stopped by the house he shares with his parents for some tea and biscuits and conversation.

With that history, I was really glad to be able to come to Ireland in October at the invitation of the Irish ME/CFS Association to talk to audiences around the country–just as physicians William Weir and Nigel Speight, both ME/CFS specialists, have done in the last couple of years. The talk was called “Bad Science, Bad Medicine: How Flawed Biopsychosocial Studies on ME, Long Covid and Related Illnesses Harm Patients.”

I arrived in Dublin after a short flight from Paris, on the evening of Saturday, October 19th, amid some air turbulence and reports of major windstorms sweeping across the country. On October 20th, the day of my first talk, the wind whipped so wildly that trees bent half-way over and people gripped by the gusts skittered along the pavement with umbrellas blown inside out. And then it rained heavily on and off throughout the rest of my stay, which ended on Tuesday, October 29th, with an early morning bus from northwest Ireland directly to Dublin airport for a flight to London. Weather notwithstanding, I had a great time. I spent hours wandering around some narrow city lanes, passing through very wet and beautiful countryside, and observing how Ireland parties on Halloween.

After events in Dublin and in Bray, a seaside town south of Dublin, I headed southwest to Cork, and then north from there to Limerick, Galway, and Sligo. In each city, I was greeted warmly by a local host and spoke to a curious and engaged group of attendees, generally a mix of patients and carers.  I appreciated that they braved some raw weather conditions to hear what I had to say! The Dublin talk was recorded, and an edited version should be posted at some point.

In the talk, I highlighted the kinds of problematic research and reporting strategies deployed by investigators of psycho-behavioral interventions, and enabled by like-minded colleagues and journal editors, to gussy up unattractive results and amplify questionable carguments about efficacy. I have blogged about these problematic research and reporting strategies in multiple posts. As listed on Slide #8 of the talk, they include:  

*Outcome-switching

*Claiming success based on secondary outcomes

*Ignoring/dismissing objective findings

*Interpreting associations as causal in their favored direction

*Extrapolating to populations not included in the study

*Statistical significance vs clinical significance (MCID: “Minimal Clinically Important Difference”)

*Pairing article with friendly commentary to amplify bogus claims of success

*Being promoted in a positive light by university public relations departments

*Reliance on inadequate control groups—or no control group at all

*Peer reviewing and publishing each other constantly

*Disclosed or undisclosed conflicts of interest–ie links with disability insurers, govt agencies

In the talk, I then discussed three separate clinical trials as examples of how these strategies have been deployed. These were the PACE trial, the REGAIN study of a multi-disciplinary intervention for Long Covid, and the CODES study of CBT for dissociative seizures, a form of functional neurological disorder. I have previously reported on all of these cases, documenting how poor findings were hyped as evidence of clinical efficacy. (I was surprised that many attendees knew nothing about PACE, or vaguely knew only that its findings couldn’t be trusted without having any idea why.)

You can view all the PowerPoint slides for the talk here. And enormous thanks to all involved in organizing and arranging my visit!

#8 #CODES #MUS #PACE #REGAIN

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#TransPrideBrighton #cofounder #SarahSavage said there is #work to be done by the new #government to make #trans #people feel #supported.

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https://www.standard.co.uk/news/politics/keir-starmer-wes-streeting-people-rishi-sunak-labour-b1171432.html

Nice.

https://www.politico.eu/article/rogue-austria-environment-minister-leonore-gewessler-burns-bridges-save-eu-nature-restoration-law/

#regain

Congress passes a law against machine guns, which Americans want. SCOTUS writes a 19 page technical ruling allowing gun owners to circumvent federal law.
#SCOTUS is bought; corrupted, illegitimate. It must be expanded to be considered legitimate again.
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Everyone will #regain all their #weight when they stop a #GLP1? Nope. Not even close. We have much to learn. New data from EMRs tells a fascinating story.
https://conscienhealth.org/2024/01/real-world-data-say-not-everyone-regains-all-their-weight/

Worldcoin Lands In Singapore After India Hiccup: Can It Regain Momentum?

After a successful launch of World ID 2.0 and the open-sourcing of the Worldcoin iris recognition pipeline in mid-December, the crypto project, co-created by OpenAI CEO Sam Altman, is expanding its reach to Singapore. The project’s custom hardware device, the Orb, is now available in five locations across the city-state for World ID verifications.
#worodcoin #singapore #india #momentum
#regain

https://shadowseeker.online/worldcoin-lands-in-singapore-after-india-hiccup-can-it-regain-momentum/