Journal of Health Psychology Publishes Hughes-Tuller Critique of Wessely-Chalder CBT Claims

By David Tuller, DrPH

What kind of researchers would publish obviously misleading figures about their favorite intervention in a study abstract? And who would make causal claims in a paper while simultaneously pointing out that the study design does not allow for causal claims? Well, it seems Professor Sir Wessely and Professor Trudie Chalder, along with three of their colleagues from King’s College London, would do both of those things.

Another question is why would the purportedly rigorous Journal of the Royal Society of Medicine publish a paper that included misleading figures in a study abstract and made unwarranted causal claims? What happened with the peer review process that such obvious failings were not noticed, or not revised if they were? Did the journal recognize that it would need to be especially rigorous when reviewing a paper co-authored by the sponsoring society’s immediate past president, and that any weaknesses exposed later on would reflect especially badly on all involved?

And beyond all those questions is this one: Why would the investigators, the journal or anyone put themselves in the embarrassing position of publishing a study as bad and misleading as “Cognitive behavioural therapy for chronic fatigue and chronic fatigue syndrome: Outcomes from a specialist clinic in the UK” in the first place? My epidemiology colleagues on the public health faculty at UC Berkeley would be horrified and wonder where they went wrong if their students turned in homework as abysmal as this Wessely-Chalder co-venture.

This paper was spectacularly easy to critique–it almost read like a parody. Once again, as with the PACE trial, core members of the biopsychosocial ideological brigades have produced something that seems designed for use as a case study of how NOT to conduct research. Why are they still foisting nonsense like this upon the public and seeking to influence medical practice with such flawed argumentation?

When the bogus Wessely-Chalder study first appeared last year, I gave it a tough critique in a blog post. After that, my friend and colleague Brian Hughes, a psychology professor at National Ireland University Galway, and I wrote what started off as a letter but ended up as a full-fledged commentary. We submitted it to the Journal of the Royal Society of Medicine, but it was politely declined. I don’t think either of us was surprised by the rejection, although it was nonetheless dispiriting–a sign that the journal, its editor, and presumably the investigators had no intention of taking responsibility for the problems we had documented. That failure to take responsibility represents a violation of the norms of proper scientific inquiry.

We were delighted that the Journal of Health Psychology was interested in reviewing our critique, and ultimately publishing it. As can be seen by comparing the version we posted on a pre-print server with the one released by the journal, we have added a strong critique of the deficient peer review process to which the Wessely-Chalder study was subjected. The authors have done themselves a real disservice by publishing their findings in a journal with such close ties to one of them, if that association was a factor in the inadequacy of the review process. As a result, the good professors and the journal have all scored an own goal.

Brian has written about the whole thing on his blog, The Science Bit. You can read our paper itself here.




4 responses to “Journal of Health Psychology Publishes Hughes-Tuller Critique of Wessely-Chalder CBT Claims”

  1. CT Avatar

    This really looks like bottom of the barrel stuff, and how awful for any trainee to be put in the position of having to peer review their seniors’ paper.

    What has happened to UK science integrity? The UK Parliament surely needs to re-examine the topic in the light of things like this. I seem to remember that, the last time around, leading members of the scientific community made out to the Science and Technology Select Committee that the community could regulate itself. The publication of this Adamson et al. (2020) paper strongly suggests to me that it can’t.

  2. CT Avatar

    I said above- “The publication of this Adamson et al. (2020) paper strongly suggests to me that it can’t” (i.e. that the scientific community can’t regulate itself).

    Of course, it was not just the publication of this paper that throws doubt on UK science integrity and on the peer review process but the Journal of the Royal Society of Medicine’s decision not to allow the flaws in the paper to be debated by declining to publish Hughes and Tuller’s commentary. Where is UK science if critical debate is blocked? And how can medicine possibly be safeguarded if it is?

  3. SusanC Avatar

    Hi David,

    Glad to see your critique got published somewhere.

    As you say, the way Chalder, Wessely et al deal with patient drop-out has serious potential to bias the result. The conservative way to treat drop outs is to assume they weren’t satisfied with the treatment (for calculating patient satisfaction ratio). Drop-out is trickier to deal with in assessing treatment effectiveness, but, basically, the conservative assumption is that they didn’t get better. (Cf. Intention to treat analysis, last observation carried forward, etc)

  4. CT Avatar

    This is the Science and Technology Committee’s 2018 report on research integrity –

    Looking through it I can’t see much mention of how the dissemination of research – the production of the scientific record itself – can provide a vehicle for deception in science, but this now seems to be a major player in spinning the results of research studies. The peer review process is open to bias and corruption and the abstracts of scientific papers often omit or gloss over key findings that authors would rather not have highlighted. If scientific and medical journals allowed and encouraged open scientific debate on their pages then these problems could, to some extent, be mitigated…..but they don’t, instead blocking criticism and reserving the right to edit contributions that are submitted as critiques of their papers. To my mind, this self-regulating science publication setup (especially in relation to the UK’s medical journals) needs to be scrutinized by the Science and Technology Select Committee, because it appears to be enabling serious warping of the scientific record. Far from trying to clean up medical science, medical journals appear to be part of the research integrity problem by acting as both judge and jury in cases of research and/or publication misconduct. In the event that the Science and Technology Committee chooses to revisit the topic of ‘research integrity’ then neither the BMJ’s journals nor journals such as the Journal of the Royal Society of Medicine should be exempted from such scrutiny on the basis that they’re to be trusted as part of the UK’s medical ‘establishment’.