Trial By Error, by David Tuller

  • CODES Trial Commentary Promotes ‘Eminence-Based Medicine’

    By all accounts, the recently published CODES trial was the most authoritative study to date of whether cognitive behavior therapy (CBT) was an effective treatment for so-called dissociative seizures–a point confirmed in a commentary accompanying the paper in Lancet Psychiatry. Unfortunately, the CODES investigators and the commentary author seem to interpret the null results for…

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  • UK Funds Genetics Project; My Letter to CODES Investigators

    UK Funding for Major Genetics ME Study Two of the UK’s largest public funding agencies announced this week that they would provide £3.2 million (around $4 million at current rates) for a study that will analyze genetic material from as many as 20,000 people to search for underlying causes of myalgic encephalomyelitis. The Medical Research…

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  • More Questions About CODES Trial of CBT for Seizures

    [*In the last paragraph, I mistakenly referred to the CODES protocol rather than the CODES statistical analysis plan. I apologize for the error.] I have recently written about CODES, the high-profile clinical trial investigating whether cognitive behavior therapy (CBT) could reduce the frequency of dissociative seizures, also known as  psychogenic non-epileptic seizures. The trial, published…

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  • BMJ Responds to Appeals About Norway’s CBT-Music Therapy Study

    Earlier this week, I sent a nudge to Professor Imti Choonara, editor-in-chief of BMJ Paediatrics Open, and Fiona Godlee, editorial director of BMJ, about a problematic “feasibility study” published a few months ago. That followed a letter two weeks ago, to which I had not received a response. Previous posts on this issue are here…

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  • Trio of Trials Shows Limits of CBT for Medically Unexplained Symptoms

    Lancet Psychiatry recently published the results of a high-profile trial of cognitive behavior therapy as a treatment for so-called dissociative seizures, also known as psychogenic non-epileptic seizures. The trial, nicknamed CODES, found that CBT had no impact on seizure frequency–the primary outcome. The average number of seizures per month dropped in both the treatment and…

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  • A Letter to KCL, Another Letter to BMJ

    Last week, I wrote about a troubling press release issued by King’s College London regarding a major study of cognitive behavioural therapy as a treatment for so-called dissociative seizures. On Friday, I sent a letter to the two communications people listed on the press release about the study, as well as to the corresponding author.…

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  • A King’s College London Press Release Hides the Bad News

    In teaching courses on covering public health and medical issues, I have often highlighted how university press releases about studies can read like efforts at obfuscating problematic findings rather than providing an accurate account of research. A recent press release from King’s College London, about a high-profile study published by Lancet Psychiatry, is an excellent…

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  • Coupla More Posts Worth Reading

    Ryan Prior is a CNN journalist who told the story of his own ME/CFS diagnosis and illness in the 2015 documentary Forgotten Plague. (I’m interviewed in the film.) On Sunday, he told the story of a friend he met as a result of the film, and the choice she made last year to end her…

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  • A Response from Dagbladet

    The Norwegian tabloid Dagbladet, taking a page from prestigious UK news organizations, has recently published a series of articles portraying ME patients as anti-scientific and belligerent. As I noted in a letter to Dagbladet two weeks ago, the journalist also misrepresented my academic and professional credentials. Since I didn’t hear back, I recently posted both…

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  • A Couple of Blog Posts Worth Reading

    I’ve been writing about so-called “medically unexplained symptoms,” or MUS, for the last couple of years. Much of that has come in the form of critiques of specific studies making excessive claims about the healing powers of cognitive behavior therapy. Recently, a blogger named Goodelf has posted a couple of revealing posts about the overall…

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  • Letter to BMJ Paediatrics Open About that CBT-Music Therapy Study

    UPDATE: I sent the following correction to Dr Choonara shortly after sending the letter of concern. Dear Dr Choonara: I wanted to make a slight correction in point #3 below. The first sentence should have read: “Why was the outcome of recovery not mentioned in the trial registration and statistical analysis plan yet still highlighted…

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  • Two Letters to Dagbladet About Its ME Coverage

    In recent weeks, the Norwegian tabloid Dagbladet has published a series of articles about ME, which it also calls CFS/ME. These articles have promoted the use of the Lightning Process as an intervention, criticized patients and the Norwegian ME Association for expressing opinions about the Lightning Process and cognitive behavior therapy, and engaged in multiple…

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