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==Criticism & Undisclosed Conflicts of Interest== '''2016''' Professor [[James Coyne]] has criticized Cochrane's work assessing exercise as a treatment for chronic fatigue syndrome, asking it "to consider the implications of having authors conduct a systematic review with the Cochrane collaboration brand attached who have ties to an industry which would benefit from particular conclusions. These same conclusions would personally enrich some of the authors professionally and personally", referring to the involvement of [[Trudie Chalder]], [[Rona Moss-Morris]], [[Michael Sharpe]], [[Alison Wearden]] and [[Peter White]] who are also authors of the [[PACE trial]].<ref name="Coyne20160105">{{citation | last =Coyne | first1 = James | author-link1 = James Coyne | title = Undisclosed conflicts of interest in a systematic review protocol of interventions for medically unexplained symptoms | website=Quick Thoughts blog | date = Jan 5, 2016 | url = https://jcoynester.wordpress.com/2016/01/05/undisclosed-conflicts-of-interest-in-a-systematic-review-protocol-of-interventions-for-medically-unexplained-symptoms/ }}</ref><ref name="Coyne20160320">{{citation | last =Coyne | first1 = James | author-link1 = James Coyne | title = Why the Cochrane Collaboration needs to clean up conflicts of interest | website=Quick Thoughts blog | date = Mar 20, 2016 | url = https://jcoynester.wordpress.com/2016/03/20/why-the-cochrane-collaboration-needs-to-clean-up-conflicts-of-interest/ }}</ref><ref>{{Cite news |url = https://jcoynester.wordpress.com/2016/04/23/probing-an-untrustworthy-cochrane-review-of-exercise-for-chronic-fatigue-syndrome/ | title = Probing an untrustworthy Cochrane review of exercise for “chronic fatigue syndrome” | last = Coyne | first = James | date = 2016-04-23|work=Quick Thoughts|access-date=2018-10-17| archive-url = | archive-date = |url-status = | language=en-US}}</ref> Prof. Coyne also wrote an open letter to Cochrane in March 2016 regarding the upcoming Cochrane review and conflicts of interests.<ref name="Coyne2016a">{{Cite web | url = https://www.coyneoftherealm.com/blogs/news/an-open-letter-to-the-cochrane-collaboration-bill-silverman-lies-a-moldering-in-his-grave | title = An open letter to the Cochrane Collaboration: Bill Silverman lies a-moldering-in his grave – Coyne of the Realm | last = Coyne | first = James | date = Mar 6, 2016 | website = Coyne of the Realm|language=en| archive-url = | archive-date = |url-status = | access-date=2018-10-17}} </ref><ref name="Coyne2016b">{{Cite news |url = https://jcoynester.wordpress.com/2016/04/21/my-response-to-an-invitation-to-improve-the-cochrane-collaboration-by-challenging-its-policies/ | title = My response to an invitation to improve the Cochrane Collaboration by challenging its policies | last = Coyne | first = James | date = 2016-04-21|work=Quick Thoughts|access-date=2018-10-17| archive-url = | archive-date = |url-status = | language=en-US}}</ref> In March 2016, the 2014 Cochrane Intervention Protocol was modified to include previously undisclosed conflicts of interest for Peter White: "PDW has undertaken consultancy work for a re-insurance firm. He has also undertaken voluntary consultancy for the [[Department for Work and Pensions|Departments of Health, Work and Pensions]] and is a member of the Independent Medical Experts Group, a non-Governmental organization which advises the Ministry of Defense regarding their Armed Forces Compensation Fund."<ref name="Coyne20160319">{{citation | last =Coyne | first1 = James | author-link1 = James Coyne | title = Update to: Undisclosed conflicts of interest in a systematic review protocol of interventions for medically unexplained symptoms | website = Quick Thoughts Blog | date = Mar 19, 2016 | url = https://jcoynester.wordpress.com/2016/01/05/undisclosed-conflicts-of-interest-in-a-systematic-review-protocol-of-interventions-for-medically-unexplained-symptoms/ }}</ref> It was admitted in the information tribunal of April 2016 on page 31 that "Professor Chalder states that disclosure to the Cochrane review does not count as disclosure to independent scientists as all three of the [[PACE Trial Management Group|PACE]] principal investigators sat on the review panel."<ref name="QMUL-appeal">{{Cite web | url = http://informationrights.decisions.tribunals.gov.uk//DBFiles/Decision/i1854/Queen%20Mary%20University%20of%20London%20EA-2015-0269%20(12-8-16).PDF | title = Appeal Number: EA/2015/0269, Appellant: Queen Mary University of London, Respondent: The Information Commissioner, Second Respondent: Alem Matthees | last = | first = | date = Apr 22, 2016 | website = tribunals.gov.uk| archive-url = | archive-date = |url-status = | access-date=}}</ref> '''2017''' On April 14, 2017 Prof James Coyne submitted a very early request for the data to Cochrane along with an open letter.<ref name="Coyne2017">{{Cite news |url = https://jcoynester.wordpress.com/2017/04/13/why-i-am-formally-requesting-the-data-set-from-a-cochrane-review/ | title = Why I am formally requesting the data set from a Cochrane review | last = Coyne | first = James | date = 2017-04-13|work=Quick Thoughts|access-date=2018-10-17| archive-url = | archive-date = |url-status = | language=en-US}} </ref> A liaison psychiatrist publishing in the ''British Journal of Psychiatry'' has criticized the '[[Graded exercise therapy|Exercise Therapy]] for CFS' for being heavily influenced by the PACE trial.<ref name="MEA2017Cochrane">{{Cite web | url = http://www.meassociation.org.uk/2017/05/liaison-psychiatrist-suggests-that-cochrane-review-on-exercise-therapy-in-cfs-was-heavily-influenced-by-controversial-pace-trial-6-may-2017/ | title = Liaison psychiatrist says that Cochrane Review on exercise therapy in CFS was heavily influenced by controversial PACE Trial {{!}} 6 May 2017 | last = | first = | date = May 6, 2017 | website = [[The ME Association]]| publisher = The British Journal of Psychology|language=en-US| archive-url = | archive-date = |url-status = | access-date=2018-10-17 | authorlink = }}</ref><ref name="Mitchell2017">{{Cite journal | last = Mitchell|first = Alex J. | authorlink = | date = May 2017 | title = Controversy over exercise therapy for chronic fatigue syndrome: Key lessons for clinicians and academics: Commentary on… Cochrane Corner |url =https://www.cambridge.org/core/journals/bjpsych-advances/article/controversy-over-exercise-therapy-for-chronic-fatigue-syndrome-key-lessons-for-clinicians-and-academics/31FAABA6A2C20FDAA4766C6D37E9614C | journal = BJPsych Advances|language=en | volume = 23 | issue = 3 | pages = 145–148|doi=10.1192/apt.bp.116.016261|issn=2056-4678|pmc=|pmid=|access-date=|quote=|via=}}</ref> According to Coyne, one of the authors of the controversial Cochrane Exercise therapy review, [[Kjetil Brurberg|Kjetil Gundro Brurberg]], misrepresented the conflicts of interest of himself and his reviewers regarding his article '''A PACE-gate or an editorial without perspectives''' after being given a number of opportunities to do so. This was an article he was invited to publish in the [[Journal of Health Psychology]], and Coyne describes Brurberg's actions as "scientific misconduct".<ref name="Brurberg">{{Cite web | url= https://www.coyneoftherealm.com/2017/07/19/misconduct-in-an-authors-nomination-of-reviewers-for-his-manuscript/ | title = Misconduct in an author's nomination of reviewers for his manuscript | last = Coyne | first = James | authorlink = James Coyne | date = Jul 19, 2017 | website = coyneoftherealm.com|archive-url=https://web.archive.org/web/20200602171046/https://www.coyneoftherealm.com/2017/07/19/misconduct-in-an-authors-nomination-of-reviewers-for-his-manuscript/|archive-date=Jun 2, 2020|url-status=|access-date=}}</ref> According to Coyne, Brurberg had been invited to publish about the [[PACE trial]] by the Journal of Health Psychology but his manuscript was rejected after a negative peer review. Coyne states Brurberg appealed he was given opportunity to nominate reviewers without conflicts of interest, but two had clear conflicts of interest and a third reviewer responsed declaring a conflict of interest - that Michael Sharpe (second author of the PACE trial) had previously been his supervisor; Brurberg's article was rejected and then published in the '''Mental Elf''' website.<ref name="Brurberg" /> '''2018''' On September 3, 2018, Dr [[David Tuller]] examined in 'The Cochrane Controversy' the systematic reviews which relied upon the flawed PACE trial and associated [[Cognitive behavioral therapy|CBT]]/[[Graded exercise therapy|GET]] studies and even its wrongful categorization in the Common Mental Disorders group.<ref>{{Cite web | url = http://www.virology.ws/2018/09/03/trial-by-error-the-cochrane-controversy/ | title = Trial By Error: The Cochrane Controversy | last = Tuller | first = David | date = Sep 3, 2018 | website = [[Virology blog]]|language=en-US| archive-url = | archive-date = |url-status = | access-date=2018-10-17 | authorlink = David Tuller}}</ref> On September 14, 2018 the Cochrane Collaboration had a mass resignation of its board after it decided to expel a founding member who had written a review which stated that "‘The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias’ and published in the BMJ Evidence-Based Medicine".<ref>{{Cite news |url = https://davidfmarks.com/2018/09/27/is-cochrane-sunk/ | title = Cochrane Catastrophe | date = 2018-09-27|work=davidfmarks.com|access-date=2018-10-18|language=en-US | last = Marks | first = David F.|quote= | authorlink = David Marks| archive-url = | archive-date = |url-status = | publisher=}}</ref> October 8, 2018, [[Mark Vink]] and Alexandra Vink-Niese reanalyzed the Cochrane's review of GET for ME/CFS concluding there is no evidence GET is effective and "failure to report harms adequately in the trials covered by the review, it cannot be said that graded exercise therapy is safe."<ref name="Vink2018">{{Cite journal | last = Vink|first = Mark | last2 = Vink-Niese | first2 = Alexandra | date = 2018 | title = Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review | url = http://journals.sagepub.com/doi/full/10.1177/2055102918805187 | journal = Health Psychology Open|language=en | volume = 5 | issue = 2 | pages = 205510291880518|doi=10.1177/2055102918805187|issn=2055-1029|pmc=|pmid=30305916|via=}}</ref> Their reanalysis also stated that all four Cochrane reviewers were proponents of the [[Biopsychosocial model|biopsychosocial]] model.<ref name="Vink2018" /> On October 17, 2018 it was announced that Cochrane would be temporarily withdrawing its exercise therapy for CFS review from the Cochrane Library.<ref name="reuters2018" /> The Cochrane Editor said that the review had several issues which needed to be addressed and “This not about patient pressure”. Dr Tuller reported on the withdrawal decision and the background to the Cochrane review.<ref>{{Cite web | url = http://www.virology.ws/2018/10/19/trial-by-error-cochrane-withdraws-flawed-exercise-review/ | title = Trial By Error: Cochrane Withdraws Flawed Exercise Review | website = [[Virology blog]]|language=en-US|access-date=2018-10-19 | last = Tuller | first =David | authorlink = David Tuller}}</ref> Forty-one international scientists signed a declaration supporting Cochrane's decision.<ref>{{Cite web | url = http://www.virology.ws/2018/10/23/a-statement-in-support-of-cochrane/ | title = A Statement in Support of Cochrane | website = [[Virology blog]]|language=en-US|access-date=2018-10-24}}</ref> <span id="2019">'''2019'''</span> A new revision and editorial note were published in October 2019, with significant alterations to the conclusions.<ref name="exercisetherapy2Oct2019" /> In May 2020, Cochrane published a note stating that they were committing to a new review and protocol. Concerning the old review, it said: :"It now places more emphasis on the limited applicability of the evidence to definitions of myalgic encephalomyelitis/<wbr>chronic fatigue syndrome (ME/CFS) used in the included studies, the long-term effects of exercise on symptoms of fatigue, and acknowledges the limitations of the evidence about harms that may occur."<ref name="ednote2Oct2019"/> <span id="2020">'''2020'''</span> In March 2020, Cochrane announced a new conflict of interest policy, due to take effect later in the year.<ref name="newconflictofinterest">https://www.cochrane.org/news/cochrane-announces-revised-conflict-interest-policy-cochrane-library-content</ref >
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