Journal of IiME Volume 5 Issue 1 (May 2011) PACE is dead, long live PACE? by Kevin Short In my view, in relation to the PACE trial into 'Chronic Fatigue Syndrome/Myalgic Encephalomyelitis'[1] (published by The Lancet) and some subsequent supportive publications, it is timely for the scientific community and interested observers to consider three questions and revisit some previously published material for possible answers. The first question is, just why do certain UK psychiatrists apparently refuse to adhere to WHO disease taxonomy, as per ICD-10-G93.3 neurological ME/PVFS and ICD-10-F.48.0 psychiatric FATIGUE SYNDROME respectively, by erroneously conflating what the WHO and an increasing body of biomedical evidence rightly separate? (That, according to some such psychiatrists, 'CFS/ME' is allegedly and primarily both physical and psychiatric and that most illnesses are comprised of both such primary components is often cited as justification: an unlikely assertion if, for example, applied to lungcancer or HIV/AIDS. Like cancer and AIDS patients, ME sufferers do not object to secondary/co-morbid psychiatric complications being addressed for what they are. They do however object to primary physical illness being misrepresented and mistreated as psychiatric. Such misrepresentation of primary physical illness in the case of cancer and AIDS would rightly be dismissed as ludicrous by most informed people and ditto should be the case for neurological ME/Postviral Fatigue Syndrome categorised by the WHO in ICD 10, G93.3.). Perhaps in no small part the answer is to be found in earlier published comment. In this case the 2006 UK Parliamentarian Group on the Scientific Research into ME (GSRME) which, in connection with such psychiatrists' role in advising the UK Department of Work and Pensions (the DWP was one of the major funders of the PACE study) on ME/CFS, cautioned: “There have been numerous cases where advisors to the DWP have also had consultancy roles in medical insurance companies. Particularly the Company UNUM Provident. Given the vested interest private medical Invest in ME (Charity Nr. 1114035) Kevin Short Kevin Short is a long-time patient advocate who was instrumental in bringing better education and information to the ME community, including key meetings and research which led to the Gibson Inquiry into ME of 2006 . His work has influenced many activities in raising awareness and led indirectly to the IiME conferences being initiated, Short, along with Douglas Frazer, forced NICE to a Judicial Review regarding the NICE Clinical Guidelines for ME. Kevin Short Anglia ME Action April 2011. insurance companies have in ensuring CFS/ME remain classified as a psychosocial illness there is blatant conflict of interest here. The Group find this to be an area for serious concern and recommends a full investigation of this possibility by the appropriate standards body. It may even be that assessment by a medical „expert‟ in a field of high controversy requires a different methodology of benefit assessment.” - GSRME Report, Page 30. www.erythos.com/gibsoninquiry/index.html The second question is, how on earth does so much psychiatric 'research' that is poorlyconceived, of questionable-quality and undertaken by investigators with demonstrable conflicts of interest receive so much funding and peer-reviewed journal exposure? Again, in no small part, perhaps the explanation is to be found in earlier published comment. In this case taken from the introductory summary of Professor Bruce Charlton's 2008 peerreviewed paper entitled 'Zombie Science – a sinister consequence of evaluating scientific theories purely on the basis of enlightened selfinterest': "Although the classical ideal is that scientific theories are evaluated by a careful teasing-out of their internal logic and external implications, and checking whether these deductions and predictions are in-line-with old and new www.investinme.org Continued page 43 Page 42/58
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