Wednesday, June 22, 2011

Review by The Cochrane Collaboration cautions about vested interests as possible source of bias in McGorry studies

"However, as with the Australian studies, many of the trials were undertaken by leading figures in the world of early intervention who could have a vested interest in the findings - just as industry has in the outcomes for the drugs they manufacture."

All but one of the many "Australian studies" referred to here have Professor Patrick McGorry as a co-author. It seems clear that former Australian of the Year Prof. McGorry is one of the "leading figures" referred to here as having a potential conflict of interest. I'd say that is an understatement.

If you are going to click on one of the links and have a look at the review, you might wish to check the summary of the main results in the abstract of the systematic review. You'll see that there is very little to get excited about among the results of trials of various early or preemptive interventions for psychosis. The whole idea of preventively treating people who appear to be at risk of developing schizophrenia/psychosis, people with "prodromal symptoms", is not supported by this systematic review:

"At the moment it is not clear whether treating people presenting with prodromal symptoms of schizophrenia provides benefits. There is inconclusive evidence on the personal and social consequences of providing treatment to people who will not necessarily become unwell. Further evidence is needed before recommendations can be given."

This is one type of mental health service that has been most assertively advocated by Professor McGorry. It appears that there is no reason to believe that it is effective, or more beneficial than harmful, but the Gillard Government has committed to spending hundreds of millions of dollars on McGorry's new EPPIC centres that have been promoted as having psychosis prevention and treatment of "prodromal" youth as a major element of their services.

Perhaps you are not familiar with the Cochrane Collaboration, the organization that is behind these systematic reviews. It is probably the world's most respected source of information in medicine. It is my understanding that it doesn't do medical research, but it judges the worth of medical research trials (published or not) and compiles systematic reviews of studies of various medical interventions and drugs, based on only studies that meet certain standards, and if this evidence is searched for but simply doesn't exist, the Cochrane Collaboration makes it clear that no conclusions can be made. The Cochrane Collaboration are like the great big rubbish filter of medical science, and my oh my, there is so much rubbish research published in medical journals.

Sources:

Marshall, M. and Rathbone, J. Early intervention for psychosis. The Cochrane Library. Cochrane Database of Systematic Reviews. 2011 Issue 6. page 24.
Art. No.: CD004718. DOI: 10.1002/14651858.CD004718.pub3.

http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/pdf_fs.html

http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/frame.html

Schism opens over ills of the mind.
Sue Dunlevy
The Australian.
June 16, 2011.
http://www.theaustralian.com.au/news/features/schism-opens-over-ills-of-the-mind/story-e6frg6z6-1226075910650

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