Trial By Error: Why is Professor Crawley Still on the COFFI Steering Committee?

By David Tuller, DrPH

Several years ago, the leaders of the biopsychosocial ideological brigades decided to create the Collaborative On Fatigue and related symptoms Following Infection, or COFFI. According to its website, COFFI’s “overarching aim” is “to investigate factors influencing the development of long-term symptoms (in particular fatigue) following certain infectious diseases.” Akershus University Hospital (AHUS) in Norway is COFFI’s host institution.

The seeds for the organization were first sewn in 2015, and the formal structure was established in 2020. That is, of course, the year the coronavirus pandemic triggered widespread reports of prolonged illness that became known as Long COVID. A central concern about COFFI is its core focus on “fatigue”–as if all fatigue were exactly the same. While the organization’s website makes references to other major post-infectious symptoms, they are clearly relegated to secondary status.

COFFI is an international who’s who of prominent investigators, some or many of whom have engaged in exceedingly questionable research strategies. The steering committee includes the principal investigators whose cohorts are considered to be COFFI-affiliated. The chair of the steering committee is Professor Vegard Wyller, who holds a position at AHUS.

The steering committee also includes, among others, Professor Andrew Lloyd at the University of New South Wales in Australia, Professor Hans Knoop of the University of Amsterdam in the Netherlands, and Professor Rona Moss-Morris of King’s College London in the U.K. I have criticized all three of these investigators for serious methodological and ethical lapses in their research or, in some cases, in their public statements. 

In reviewing the COFFI website recently, I noticed something odd. Professor Esther Crawley, the former pediatrician and grant magnet at the University of Bristol, is listed as a current member of the steering committee. However, Professor Crawley is no longer at the university or practicing medicine—for reasons that remain obscure. So why is she still listed as an active participant in COFFI? 

It is troubling when an organization like COFFI cannot keep its website current. Professor Crawley departed from the scene years ago. COFFI has had plenty of time to correct the information. How is anyone supposed to take an organization seriously when it can’t be bothered to update crucial facts on its website? I mean, if a U.S. website still listed Joe Biden as president, would anyone take any information from the page seriously?

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To clarify the situation, I have sent the following e-mail to COFFI and Professor Wyller, with the following subject line: “Is Professor Esther Crawley still involved with COFFI?”

Dear COFFI and Professor Wyller—

A quick review of the COFFI website reveals that Professor Esther Crawley is listed as a member of the steering committee. According to the website, she is at the University of Bristol.

The website notes: “The Steering Committee comprises all Principal Investigators (PIs) in included cohorts, labelled COFFI partners. The Steering Comitteee (sic) is chaired by the leader of the COFFI collaborative.”

First, whoever is responsible for the COFFI website appears to have spelling issues, given the rendering of “committee” as “comitteee.” Second, I am curious as to why COFFI still lists Professor Crawley as being involved with the organization and as having an affiliation at the University of Bristol. Professor Crawley retired from both the university and medical practice within the last few years. She is also no longer known to be active in research.

It should be pointed out that, at the time of her departure, Professor Crawley’s research output had been formally exposed as fraught with methodological and ethical lapses. 

In a pediatric trial of the Lightning Process in Archives of Disease in Childhood, more than half of the participants were enrolled before trial registration, with primary and secondary outcomes swapped at that time. These factors were not disclosed in the paper, which reported the results as if the trial were fully prospective. Such actions violated core principles of scientific inquiry. The trial now carries a 3,000-word correction and a 1,000-word editor’s note explaining, in tortured language, why the paper was not retracted.   

Besides that glaring episode, Professor Crawley was ordered to correct the ethics statements in almost a dozen other papers after it was revealed she exempted multiple studies from ethical review without any oversight. She did this based on a single research ethics committee letter for a study unrelated to any of the others. Every researcher knows that this sort of behavior is unacceptable.

It was always concerning that someone with this sort of problematic record would be granted such prominence in an international research consortium like COFFI. Was COFFI aware of these major lapses before inviting Professor Crawley to join the organization? Was COFFI concerned that Professor Crawley’s reputation for error would reflect badly on other researchers affiliated with the group?

At this point, can you please explain what current role Professor Crawley has with COFFI? If she has no current role, can you explain why she is still listed on the website as a member of the COFFI steering committee? There has been plenty of time since her retirement for COFFI to have figured out how to fix the website. 

If, as seems to be the case, COFFI can’t be bothered to update its information to accommodate changes in its governance, not to mention proof-reading the website to make sure it does not contain obvious spelling errors, how can readers take the organization and its claims seriously? These missteps indicate not just sloppy execution but sloppy follow-up as well.

Are the other members of the steering committee still active? I assume so, but who knows?

I would appreciate some clarification. Thank you. 

Best–David

David Tuller, DrPH
Senior Fellow in Public Health and Journalism
Center for Global Public Health
School of Public Health
University of California, Berkeley
Berkeley, California, U.S.