Letter to BMJ Editor Seeking Correction in New Review of Interventions for Long Covid
By David Tuller, DrPH
The BMJ recently published a review of interventions for Long Covid that–surprise!–recommended CBT and a rehabilitation program as treatments. The review is full of holes. I have focused on one in particular. The review relies for its rehabilitation recommendation on an earlier BMJ study–even though that study has itself already been corrected for having misrepresented its findings in key sections. This morning, I sent the following letter to Dr Kamran Abbasi, editor-in-chief of The BMJ:
Dear Dr Abbasi—
A recent paper in The BMJ, Interventions for the management of long covid (post-covid condition): living systematic review, from Zeraatkar et al,drew a crucial conclusion from a trial whose findings were seriously misrepresented. That trial report, also published by The BMJ, has already been corrected. The review needs a similar correction.
Zeraatkar et al recommended a mental and physical health rehabilitation program and cognitive behavior therapy as reasonable interventions for people suffering from the prolonged symptoms that characterize Long Covid. Each recommendation was based on a single clinical trial.
The basis for the first recommendation was Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial, from McGregor et al. The paper was published by The BMJ in February of this year and then corrected in May. The initial version failed to note in major sections—such as the conclusion of the abstract—that the sample included only patients who had been hospitalized for acute Covid-19. Given the significant differences between Long Covid patients who have and have not been hospitalized, the trial findings cannot automatically be extrapolated to everyone with prolonged symptoms. The corrected version now makes that clear.
Unfortunately, the review from Zeraatkar et al committed the same error as the pre-corrected version of McGregor et al. The review did not mention in key passages—such as the abstract and conclusion–that its expansive recommendation for mental and physical rehabilitation came from a trial including only patients who had been hospitalized. While the review noted this salient detail deep in the text, it nonetheless suggested that the intervention be offered far more broadly than warranted by the trial itself.
In short, if the trial paper required a correction for not highlighting prominently enough an indisputable limitation of its findings, then the review requires the same.
David Tuller (corresponding author)
Center for Global Public Health
University of California, Berkeley
Berkeley, California, USA
davetuller@berkeley.edu
Nicola Baker
School of Health Sciences
University of Liverpool
Liverpool, England, UK
Svetlana Blitshteyn
Department of Neurology
Jacobs School of Medicine and Biological Sciences
University of Buffalo
Buffalo, New York, USA
Todd Davenport
Department of Physical Therapy
University of the Pacific
Stockton, California, USA
David Davies-Payne
Department of Radiology
Starship Children’s Hospital
Auckland, New Zealand
Andrew Ewing
Department of Chemistry and Molecular Biology
University of Gothenburg
Gothenburg, Sweden
Mark Faghy
Human Sciences Research Centre
University of Derby
Derby, England, UK
Keith Geraghty
Centre for Primary Care and Health Services Research
Faculty of Biology, Medicine and Health
University of Manchester
Manchester, England, UK
Mady Hornig
CORe Community (COVID Recovery through Community)
New York, New York, USA
Brian Hughes
School of Psychology
University of Galway
Galway, Ireland
Leonard Jason
Center for Community Research
DePaul University
Chicago, Illinois, USA
Binita Kane
Respiratory Medicine
Manchester University NHS Foundation Trust
Manchester, England, UK
Douglas Kell
Institute of Systems, Molecular and Integrative Biology
University of Liverpool
Liverpool, England, UK
Asad Khan
North West Lung Centre
Manchester University Hospitals
Manchester, England, UK
Resia Pretorius
Department of Physiological Sciences
Stellenbosch University
Stellenbosch, South Africa
David Putrino
Department of Rehabilitation and Human Performance
Icahn School of Medicine at Mt Sinai
New York, New York, USA
Charles Shepherd
ME Association
Gawcutt, England, UK
John Swartzberg
Division of Infectious Diseases and Vaccinology
School of Public Health
University of California, Berkeley
Berkeley, California, USA
Susan Taylor-Brown
Department of Pediatrics, Developmental & Behavioral Pediatrics
University of Rochester Medical Center
Rochester, New York, USA(View the original post at virology.ws)
#BMJ #LongCovid #REGAIN
David Tuller /
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2024-12-09 19:51:21
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"content": "Letter to BMJ Editor Seeking Correction in New Review of Interventions for Long Covid\n\nBy David Tuller, DrPH\n\nThe BMJ recently published a review of interventions for Long Covid that–surprise!–recommended CBT and a rehabilitation program as treatments. The review is full of holes. I have focused on one in particular. The review relies for its rehabilitation recommendation on an earlier BMJ study–even though that study has itself already been corrected for having misrepresented its findings in key sections. This morning, I sent the following letter to Dr Kamran Abbasi, editor-in-chief of The BMJ:\n\nDear Dr Abbasi—\n\nA recent paper in The BMJ, Interventions for the management of long covid (post-covid condition): living systematic review, from Zeraatkar et al,drew a crucial conclusion from a trial whose findings were seriously misrepresented. That trial report, also published by The BMJ, has already been corrected. The review needs a similar correction.\n\nZeraatkar et al recommended a mental and physical health rehabilitation program and cognitive behavior therapy as reasonable interventions for people suffering from the prolonged symptoms that characterize Long Covid. Each recommendation was based on a single clinical trial.\n\nThe basis for the first recommendation was Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial, from McGregor et al. The paper was published by The BMJ in February of this year and then corrected in May. The initial version failed to note in major sections—such as the conclusion of the abstract—that the sample included only patients who had been hospitalized for acute Covid-19. Given the significant differences between Long Covid patients who have and have not been hospitalized, the trial findings cannot automatically be extrapolated to everyone with prolonged symptoms. The corrected version now makes that clear.\n\nUnfortunately, the review from Zeraatkar et al committed the same error as the pre-corrected version of McGregor et al. The review did not mention in key passages—such as the abstract and conclusion–that its expansive recommendation for mental and physical rehabilitation came from a trial including only patients who had been hospitalized. While the review noted this salient detail deep in the text, it nonetheless suggested that the intervention be offered far more broadly than warranted by the trial itself.\n\nIn short, if the trial paper required a correction for not highlighting prominently enough an indisputable limitation of its findings, then the review requires the same.\n\nDavid Tuller (corresponding author)\nCenter for Global Public Health\nUniversity of California, Berkeley\nBerkeley, California, USA\ndavetuller@berkeley.edu\n\nNicola Baker\nSchool of Health Sciences\nUniversity of Liverpool\nLiverpool, England, UK\n\nSvetlana Blitshteyn\nDepartment of Neurology\nJacobs School of Medicine and Biological Sciences\nUniversity of Buffalo\nBuffalo, New York, USA\n\nTodd Davenport\nDepartment of Physical Therapy\nUniversity of the Pacific\nStockton, California, USA\n\nDavid Davies-Payne\nDepartment of Radiology\nStarship Children’s Hospital\nAuckland, New Zealand\n\nAndrew Ewing\nDepartment of Chemistry and Molecular Biology\nUniversity of Gothenburg\nGothenburg, Sweden\n\nMark Faghy\nHuman Sciences Research Centre\nUniversity of Derby\nDerby, England, UK\n\nKeith Geraghty\nCentre for Primary Care and Health Services Research\nFaculty of Biology, Medicine and Health\nUniversity of Manchester\nManchester, England, UK\n\nMady Hornig\nCORe Community (COVID Recovery through Community)\nNew York, New York, USA\n\nBrian Hughes\nSchool of Psychology\nUniversity of Galway\nGalway, Ireland\n\nLeonard Jason\nCenter for Community Research\nDePaul University\nChicago, Illinois, USA\n\nBinita Kane\nRespiratory Medicine\nManchester University NHS Foundation Trust\nManchester, England, UK\n\nDouglas Kell\nInstitute of Systems, Molecular and Integrative Biology\nUniversity of Liverpool\nLiverpool, England, UK\n\nAsad Khan\nNorth West Lung Centre\nManchester University Hospitals\nManchester, England, UK\n\nResia Pretorius\nDepartment of Physiological Sciences\nStellenbosch University\nStellenbosch, South Africa\n\nDavid Putrino\nDepartment of Rehabilitation and Human Performance\nIcahn School of Medicine at Mt Sinai\nNew York, New York, USA\n\nCharles Shepherd\nME Association\nGawcutt, England, UK\n\nJohn Swartzberg\nDivision of Infectious Diseases and Vaccinology\nSchool of Public Health\nUniversity of California, Berkeley\nBerkeley, California, USA\n\nSusan Taylor-Brown\nDepartment of Pediatrics, Developmental \u0026 Behavioral Pediatrics\nUniversity of Rochester Medical Center\nRochester, New York, USA(View the original post at virology.ws)\n\n#BMJ #LongCovid #REGAIN",
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