Intended for healthcare professionals

Rapid response to:


Pressure grows on Lancet to review “flawed” PACE trial

BMJ 2018; 362 doi: (Published 22 August 2018) Cite this as: BMJ 2018;362:k3621

Rapid Response:

Re: Pressure grows on Lancet to review “flawed” PACE trial

Kewley (previous comment) makes the key point. The reason why I have signed the letter to The Lancet is that the PACE trial is methodologically so poor as to be uninterpretable. Patients may have expressed concern that the trial inappropriately reinforces psychological theories but this seems to have been used as a smoke screen by the PACE authors and associates to obscure the fact that patient scientists have identified the flawed nature of the trial. I have no personal or professional interest in ME but have been greatly impressed by the ability of ME/CFS patients to initiate the sort of critical review that should have been performed by peers.

The reason why the poor quality of this trial is now so important is that this sort of poor methodology, based on unblinded trials with subjective outcome measures, is widespread in the field of therapist-delivered treatments. A house of cards has been built that will ultimately collapse as it emerges that the same results can be obtained with any form of treatment that deliberately aims to influence patients' judgement of their health status.

Competing interests: No competing interests

22 August 2018
Jonathan CW Edwards
Professor in Medicine, Emeritus
Rayne Institute, 5, University Street, London WC1