Trial By Error: MEGA’s Latest Failure

By David Tuller, DrPH

In his welcome talk at last week’s annual conference of the CFS/ME Research Collaborative (CMRC), the chair, Professor Stephen Holgate, praised his colleague and second-in-command, Professor Esther Crawley, for her stunning and amazing work on the group’s main research initiative. There was just one problem: That initiative, the ME/CFS Epidemiology and Genomics Alliance (MEGA), had recently failed in its second high-profile bid for major funding.

Earlier this year, of course, MEGA announced that it had failed in its first big effort, a submission to the Wellcome Trust. This second unsuccessful bid was to the Medical Research Council (MRC). Professor Holgate tried to put a positive gloss on things by vowing that MEGA would learn from this defeat and press forward. Yet he undoubtedly knows that applicants who repeatedly get turned down for top grants can start to smell like losers. Funders prefer to shower money on those perceived as winners. Notwithstanding Professor Crawley’s stunning and amazing work, MEGA so far has proven itself more loser than winner.

Before sharing the unfortunate news about MEGA’s bid, Professor Holgate appeared to be trying to soften the blow and rationalize the rejection by praising proposals in this emerging research field that get to the edge of being funded, even if they ultimately fail.

As we start to ramp up the quality of research, you won’t just see a switch and suddenly money pouring in, Professor Holgate explained to those assembled for the two-day conference. You see people almost getting there but not quite, reconfiguring their applications and then coming back in again and getting it right. So this is the right direction of travel and I think it’s absolutely wonderful that we’re seeing this happening now.

As I interpret his remarks, Professor Holgate’s optimistic view is that MEGA, after two failed bids, is now traveling in the right direction on its wonderful journey. As he explained, the MEGA proposal survived the first round at the MRC and made it to the interview stage, along with several other candidates. Then the bid lost momentum, for reasons he did not share.

We got down to the short list, which was great, said Professor Holgate. We were interviewed but at the interview we didn’t quite make the cut. That doesn’t mean this whole thing is just going to wither on the vine, it means we need to take the feedback from the Medical Research Council committee, sit down, get serious about what they said, and think about where we’re going next with this. But I can tell you this is not the end by any means, we are definitely going to move forward. We just have to make sure that when we do move forward we learn from the experience and then we look for opportunities for funding elsewhere.

Whatever. Perhaps this is not the end for MEGA, and next year will be more productive. But apparently the reviewers for two major funders have not agreed with Professor Holgate’s assessment of Professor Crawley’s work. I presume she and her team put great effort into pulling together the proposal rejected by Wellcome. Putting on a brave front after that failure, MEGA appeared determined to regroup for the MRC bid. Now the MRC has also turned thumbs down on whatever it was that MEGA proposed. Hm. Professor Crawley must feel deeply disappointed and even embarrassed, an understandable reaction, of course, after such a humiliating public defeat.

It’s no secret that Professor Crawley and I are not the best of friends. I have accused her of problematic research practices, and she has accused me of writing libellous blogs. I have documented my charges and backed up every claim. Professor Crawley has failed to respond to my repeated requests for evidence that anything I’ve written about her work is inaccurate. I take her silence as acknowledgement that her libel claim is false.

I wrote several blog posts about this situation. I sent an open letter to the CMRC board, chastising Professor Holgate and the other members for failing to address their colleague’s unprofessional behavior. I complained to Bristol University, since Professor Crawley made her defamatory statement about my work at her inaugural lecture there this past spring. And I recently wrote about her curious failure to seek ethical review for a 2011 study of children, using the questionable claim that it was a service evaluation project and therefore exempt from such a review.

Have these and other developments begun to be noticed by the kinds of people who would serve on MRC and Wellcome review committees? Would these reviewers have heard by now of the mushrooming scandal around the conduct and findings of PACE, which Professor Crawley has declared to be a great, great trial? Would these reviewers know that large segments of the international scientific and public health communities, including the U.S. Centers for Disease Control, have rejected the GET/CBT ideological movement, for which Professor Crawley is an ardent advocate?

It is certainly possible that awareness of these developments is slowly spreading beyond the narrow confines of those actively engaged in the debate, that is, beyond the communities of patients, advocates and ME/CFS investigators. It is even possible that these developments are starting to impact Professor Crawley’s prospects for obtaining research funding. These two recent rejections suggest that could be the case. On the other hand, she has received support for her problematic FITNET-NHS trial, so perhaps the rejections had nothing to do with the debate around PACE/CBT/GET.

In any event, the issues are not going away. Given Professor Crawley’s apparent inability or unwillingness to provide satisfactory answers to legitimate concerns raised about some of her ethical and methodological choices, she is likely to face continued scrutiny.

As I have previously pointed out, Professor Holgate and the CMRC have enabled Professor Crawley’s bad behavior by endorsing her leadership despite her high-profile public campaign to discredit critics as vexatious and libelous. However, no matter what the CMRC does or does not do at this point, the CBT/GET approach to ME/CFS is collapsing under the weight of its own absurdity and the accumulating scientific evidence. In the face of this ongoing paradigm shift, Professor Holgate’s fulsome praise of Professor Crawley’s unsuccessful efforts to seek support for MEGA seemed like a desperate effort to forestall the inevitable reckoning.

On Saturday morning, I wrote to Professor Holgate and others on the CMRC leadership team, seeking comment about MEGA. I haven’t heard back, not that I expected to. Here’s what I wrote:

I’m writing a post for Virology Blog about some of the news coming out of the conference. So I am wondering if you [i.e Professor Holgate]–or any other members of the CMRC executive committee–want to comment on the failure of MEGA at the interview stage in the MRC funding cycle. My blog will be posted on Monday or Tuesday, so please send me back any comments by Sunday evening, California time.

Here are my questions: Are there specific shortcomings in the proposal that the MRC reviewers highlighted? Or was the interview itself problematic, in terms of how the MEGA team presented its ideas? Given that the MEGA team presumably gave this proposal its all, especially after the previous rejection from Wellcome, what grounds do you have to expect better results in the future? Do you think other funders will perceive similar issues to those that apparently proved to be a stumbling block for the Wellcome and MRC reviewers?

Do you think it is possible that Wellcome and MRC reviewers have started to notice the mushrooming international concerns around the conduct and reporting of the PACE trial? Do you think there might be growing reluctance to fund people and projects perceived to be associated with the PACE/GET/CBT school, including investigators who have declared this self-evidently flawed piece of research to be a “great, great trial”? 

I have not included Professor Crawley on this e-mail; it is my understanding that she considers contact from me to be unwelcome. But I of course would include a statement from her about MEGA in my post. I am also still interested in a statement from her about her false accusation that I have written “libelous blogs,” since she has never bothered to clear up that issue or explain her charge. So please feel free to forward this e-mail to her!

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