Sunday, September 27, 2015

Cochrane Distances Self from Critic

The Cochrane Collaboration came out with this press release to point out that one of their collaborators was posting his psychiatric criticism outside of his role in that organization.  The critic mentioned in this release has written this blogger in response to my critique of his criticism of psychiatry.  My response elicited a significant amount of derision directed at me from his apparent supporters.  That led me to modify my policy on posting comments. I believe that he posted a response to my response on another blog or blogs that I never read.

While I am no great supporter of Cochrane and consider their site to be somewhat redundant, non-productive, and lacking creativity and innovation, it is obviously in their interest to distance themselves from statements that they do not consider to be in their best interest.  For links to the exchanges on this blog with this critic, they are included in these two posts:

Apart from the obvious, the more I thought about the last sentence in this release, the more it bothered me:

"There is a wide range of views within Cochrane on the benefits and harms of psychiatric drugs...."

That is an interesting perspective from an organization that is supposed to objectively interpret the evidence.  Are there an equally number of "wide range of views" on other types of medication or just the ones used by psychiatrists?  It leads to questions about whether there are psychiatric experts and people who actually prescribe the medications writing these reviews or if anyone can do it?  I could make the argument that many if not most of the summary statements seem like they are written by the same person or committee.  It also leads to the question about the political nature of these documents.  Could the specified critic for example reformulate his criticism according to the Cochrane format and publish it in their library?  Are Cochrane documents ever a compromise of a "wide range of views"?  Is there anyone at Cochrane who is aware of the additional levels of criticism that psychiatric practice is subject to and the rhetorical nature of that criticism?  I think that these are all important questions if you are concerned about being perceived as having a partisan position.  Of course most critics of psychiatry could care less about being partisan or even the appearance of being partisan, but they are generally not selling objective analysis.

Just this year, I lost access to a library database that I had previously accessed for years. I had to try to access Cochrane Reviews directly through a large publisher's web site. I was confronted with the prospect of purchasing the individual articles or an entire year long subscription through that publisher. They also have an open access model where authors can pay significant fees to have their articles published in an open access mode.   The Cochrane Library is a published product just like anything else, subject to all of the conflicts of interest of a published product.

That is an additional perspective to have when reading the release.

George Dawson, MD, DFAPA

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