Professor Esther Crawley, Bristol University’s Methodologically and Ethically Challenged Pediatrician, Has Retired From Medicine

By David Tuller, DrPH

Professor Esther Crawley, Bristol University’s methodologically and ethically challenged pediatrician and long-time grant magnet, gave up her right to practice medicine last September, according to her current entry at the UK’s General Medical Council, which oversees the registration of physicians. The entry does not offer an explanation for why Professor Crawley decided to relinquish her registration and stop treating patients at a much younger age than is standard for retirement.

Professor Crawley qualified as a physician at Oxford University in 1991. She is apparently in her 50s, likely her mid-50s.

Her departure from clinical practice is great news for families with kids suffering from ME/CFS–and now Long Covid. Professor Crawley has been the most influential pediatrician in the field of what she long called “chronic fatigue syndrome,” or more recently “CFS/ME.” She was a gusher of misinformation, publishing seriously flawed and sometimes fraudulent research at a prolific rate. She called PACE a “great, great” trial.

Both publicly and behind the scenes, she wielded her significant power to aggressively push the notion that children with ME/CFS needed graded exercise therapy (GET) and/or cognitive behavior therapy. She failed to change her views even in the face of widespread protests from parents that forcing their kids to do more made them worse. As news of her retirement sinks in, I hope that those who once whispered her name with fear will feel able to openly discuss the clinical reign of terror she appeared to impose on vulnerable families and children.

Is she still at the University of Bristol? That’s not clear. It appears that she might have retired from there as well. She does not appear in the current staff directory at the university’s Centre for Academic Child Health, with which she had a longtime affiliation. On the centre’s site for the MAGENTA study, a major trial of GET compared to activity management in kids with “CFS/ME,” Professor Crawley is still listed as the “chief investigator.” But clicking the link on her name yields a screen with this advisory: “Page not found.”

The MAGENTA results were published in March and were a disaster for Professor Crawley’s longtime assertion that GET was an effective treatment. She was listed as the second-to-last author, not the senior and corresponding author—an apparent indication of the change in her status. Here is the blunt conclusion from the abstract: “There was no evidence that GET was more effective or cost-effective than AM [activity management] in this setting, with very limited improvement in either study group evident by the 6-month or 12-month assessment points.” Oops!!!

The MAGENTA paper was submitted to the European Journal of Pediatrics on October 5, 2023, which was shortly after Professor Crawley relinquished her right to practice medicine. She presumably had known for a while of these humiliating findings. Whether or not these events are conneted, the MAGENTA conclusions pretty much upend much of what Professor Crawley has claimed for years.

Another recently published paper from investigators at Bristol’s Centre for Academic Child Health, a protocol for a study of children with rare genetic disorders, included the following statement in its acknowledgments section: “The…study was originally conceptualised with significant mentorship and guidance from Professor Esther Crawley who has now retired. We thank her for her significant contribution to the concept of the GenROC study.”

That certainly sounds like it is referring to retirement from the university, not retirement from medical practice. It has been noted in the last year or so that Professor Crawley has been unusually quiet and absent from the public debate. Now it seems that she’s…gone. Really. Just gone. Perhaps at some point we will find out why.

Professor Crawley’s scholarly record carries some big black marks. I pride myself on those, since they were the result of my investigations into her work. (These were themselves prompted by insights from an observant source.)

Professor Crawley’s clinical trial of the woo-woo mind-body intervention known as the Lightning Process was clearly fraudulent. Archives of Disease in Childhood, a BMJ journal, should never have published it. And once I presented the journal with the facts, the study should have been retracted. Professor Crawley’s paper described the research as fully prospective when, as it turned out, 56% of the participants were recruited before trial registration, and primary and secondary outcome measures were swapped mid-way through. The article now carries a 3,000-word correction, along with a 1,000-word editor’s note defending the journal’s indefensible decision to republish the original findings.

My complaints to the UK’s Health Research Authority, a branch of the National Health Service, about a set of Professor Crawley’s studies led to an investigation of her work conducted jointly by the agency and Bristol University. Professor Crawley had unilaterally exempted all these studies from ethical review based on a letter from a research ethics committee that had nothing to do with any of them. Every experienced researcher knows–or should know–that this is not allowed. As a result of the investigation, Professor Crawley was ordered to make corrections in the ethics statements of 11 papers. Although the report–absurdly in my view–held her blameless for these errors, it was nonetheless an embarassing public rebuke of her approach to research.

Then there was Professor Crawley’s public claim that I had written “libellous blogs” and Bristol University’s multiple complaints to UC Berkeley’s chancellor about my “behaviour.” My “behaviour” basically consisted of writing harsh (and sometimes flamboyantly harsh) comments about Professor Crawley’s sub-standard and ultimately harmful work. The UC Berkeley chancellor’s office could not really understand the complaints or figure out what Bristol expected them to do.

But more on that later. It’s enough for now to appreciate the moment. I hope and assume many people will have a lot to say about Professor Crawley and her impact on their lives now that she seems to be out of the picture.