The Faculty Lounge

Can McMaster University Medical School Psychiatrists Be Trusted to Treat ME/CFS Patients?

[Cross-posted on the Virology Blog]

There were many problems with Dr. Jeremy Devine’s disturbing oped in the Wall Street Journal, as I have detailed here. In addition to gaslighting Long Covid patients and disparaging patient advocacy groups, Devine asserted that the PACE trial’s psychogenic theory of ME/CFS is “the prevailing view among medical practitioners.” As readers of this site know, that has not been true since at least 2015, when the U.S. Institute of Medicine (now the National Academy of Medicine) reported its finding that ME/CFS is a “serious, chronic, complex, systemic disease”— not a psychiatric or psychological disorder.

Devine is a 2017 University of Toronto medical school graduate and currently a psychiatry resident at the McMaster University Faculty of Health Sciences in Hamilton, Ontario. As a doctor-in-training, he obviously must have obtained at least some of his misinformation from his supervising senior physicians. This raises the troubling likelihood that McMaster psychiatry residents are still being taught that ME/CFS is, as Devine put it, “an underlying mental-health issue,” presumably treatable with cognitive behavior therapy and graded exercise therapy per the PACE trial (which Devine linked in his oped).

Because prospective ME/CFS patients have a right to know about the quality of care they can expect from McMaster physicians, I sent an inquiry to Drs. Nick Kates and Karen Saperson, respectively the chair and vice chair of McMaster’s Department of Psychiatry and Behavioural Neuroscience, recognizing of course that Devine is entitled to his own opinions about Long Covid:

Dr. Devine also wrote that the “prevailing view among medical practitioners” is that ME/CFS is a symptom of “an underlying mental-health issue,” linking to the UK’s 2011 PACE trial. That was more than a statement of his opinion, and it seriously misrepresented the actual state of current medical practice.

The US Institute of Medicine (now the National Academy of Medicine) issued a report in 2015 finding that ME/CFS is a “serious, chronic, complex, systemic disease”— not a psychiatric or psychological disorder. The PACE trial’s recommended treatments of Graded Exercise Therapy (GET) and Cognitive Behaviour Therapy (CBT) have since been discontinued by the U.S. National Institutes of Health and Centers for Disease Control. Likewise, the UK’s National Institute for Health and Care Excellence (NICE) issued a revised draft of its clinical guidelines, dropping both CBT and GET as treatments for ME/CFS, and strongly advising against the latter. Promising biomedical research on ME/CFS is now underway at major U.S. Universities, including Stanford, Columbia, and Cornell.

It is simply untrue to maintain that the “prevailing view among medical practitioners” is that ME/CFS is mental-health disorder.

Consequently, I am writing to ask whether Dr. Devine’s understanding of the “prevailing view” is taught in the McMaster psychiatry program. Does your department continue to follow the recommendations of the PACE trial (which the NICE draft called a “low quality” study)? Are your patients advised to engage in Graded Exercise Therapy? Are your residents made aware of post-2015 developments in the U.S.?

It appears to me that Dr. Devine’s outdated views of ME/CFS may reflect poorly on the quality of training and care provided by your program. Kindly let me know if I am mistaken.

Bruce Springsteen with the Sessions Band

Pittsburgh Tax Review CFP: "Teaching Tax Law" (abstracts due 5/15)

Pittsburgh Tax Review

Call for Papers:

Teaching Tax Law

Spring 2022 Special Issue

In the second issue of its 19th volume, the Pittsburgh Tax Review will publish a series of contributions addressing the teaching of tax law. The aim of this special issue is to collect in one place the insights of leading tax teachers as a service for all those who are interested in and devoted to educating current law students and future tax lawyers. The Pittsburgh Tax Review has already secured the participation of five distinguished scholar/teachers: Alice Abreu (Temple University Beasley School of Law), Samuel Donaldson (Georgia State University College of Law), Heather Field (UC Hastings College of Law), Deborah Geier (Cleveland State University Cleveland-Marshall College of Law), and Katherine Pratt (Loyola Law School, Los Angeles).

The Pittsburgh Tax Review invites proposals from others for one to two additional contributions to be included in this special issue. Proposals for a contribution of between 8,000 and 10,000 words are welcome from all who teach tax law. Potential contributions to the special issue might take a variety of forms. For example, contributions to the special issue might describe classroom techniques and innovations, innovations in course design or structure, or novel courses. Or contributions might explore the lessons learned during the time we have all now spent teaching during the pandemic and consider how that might impact our teaching once we all return to the classroom. Or contributions might be completely forward looking and propose novel ideas or experiments in teaching that have not yet been implemented. Or contributions might approach the topic of teaching tax law from an entirely different perspective.

Interested individuals should send an abstract outlining the topic and substance of their proposed contribution to the Pittsburgh Tax Review by email at taxrev@pitt.edu. Abstracts should be no longer than 250 words and should be submitted by May 15, 2021. Proposals will be reviewed and invitations will be issued by June 15, 2021. Those invited to participate will be required to submit tentative drafts by October 15, 2021 (to be shared among all of the contributors to the special issue) and final drafts ready for editing by the Pittsburgh Tax Review’s staff of student editors by December 31, 2021.

Hari Osofsky Named Finalist in Iowa President Search

The University of Iowa has named Dean Hari Osofsky, of Penn State Law - University Park, as one of four finalists in its search for a new president.   A report on her presentation is here.  Iowa President Bruce Herreld announced his retirement last fall.  Osofsky joined Penn State as dean in 2017.

Darby Dickerson Named New Dean of Southwestern Law

Southwestern Law School has announced that its new dean will be Dean Darby Dickerson of UIC - John Marshall Law School.  Dickerson, who holds a JD from Vanderbilt, is the Immediate Past President of the AALS.  Dickerson takes over from Dean Susan Prager on July 1.  

Finding Fault with Faux Facts

I have this new essay up today on Social Science Space:

Finding Fault with Faux Facts

Published on 04/14/2021  by Steven Lubet

As I teach the students in my litigation courses, the use of vivid details will always make a case more convincing. Can the witness to an accident describe the dark color of an automobile or the screech of its brakes as it wheeled around a corner?  “Screech” and “wheeled” – rather than “sound” and “turned” – are small examples of using vivid details to dramatize events; the more precise verbs underscore the accuracy of the witness’s perceptions, while allowing the fact finder to re-imagine the sequence of events. It would be even better if the witness could identify the car’s particular shade, rather than a generic color, especially if it is unusual.

My coauthor and I explain this in Modern Trial Advocacy (2020, p. 32): “Using details can turn a bald claim into a reasoned, logical, well-founded proposition.” Here is an example of how that can work, taken from a Wikipedia entry:

Shotgun Man was an assassin and spree killer in Chicago, Illinois in the 1910s, to whom murders by Black Hand extortionists were attributed.^[1] Most notably, Shotgun Man killed 15 Italian immigrants from January 1, 1910 to March 26, 1911 at “Death Corner,” the intersection of Oak Street and Milton Avenue (now Cleveland Avenue) in what was then Chicago’s Little Sicily.^[2] In March 1911, he reportedly murdered four people within 72 hours.^[3]

The first sentence is a general claim, if not quite a bald one, about a mysterious assassin known as “Shotgun Man,” active in the 1910s, whose scary story might ordinarily be in doubt. His existence is more firmly established – especially in the context of Chicago’s well-known history of gangland murders – by the addition of the successive details. We have his motive, which was to facilitate “Black Hand” extortion of Italian immigrants. We have the duration of the murder spree, including the number of victims, right down to specific beginning and end dates. We have not only the neighborhood, with its origin embedded in the evocative designation “Little Sicily,” but also the exact intersection where the crimes took place, identified by its own macabre epithet. We even have the renaming of Milton Avenue as Cleveland Avenue, a verifiable historical fact. Finally, there are footnotes with links to reliable sources: Griffith, American Mafia: Chicago: True Stories of Families Who Made Windy City History and Sifakis, The Mafia Encyclopedia.

The only problem is that the story is untrue. According to the better-researched Wikipedia entry for Urban Legends,

Shotgun Man is an urban legend of organized Crime: as an assassin and spree killer in Chicago, Illinois in the 1910s, to whom murders by Black Hand extortionists were attributed. . . .^[17]  However, a check of the Northwestern University website on “Homicide in Chicago” shows shotgun killings in Chicago – but none in Jan-March 1911-and only one killing at Oak and one at Milton Streets between 1900 and 1920.

The “Homicide in Chicago, 1870-1930 “website was created by Northwestern’s Chicago Historical Homicide Project, under the direction of my colleague Leigh Bienen (I had no involvement). The comprehensive list of over 11,000 homicides in Chicago was compiled through a painstaking search of sixty years of handwritten records. The project then transcribed the original police and coroner’s reports into Word documents, resulting in a searchable data base that allows fact-checking of the Wikipedia entry on Shotgun Man.

"Dear Tax People": The Despacito Parody, Federal Income Tax Style

If you are a fan of reggaeton/Latin pop or Federal Income Taxation or both, you will love "Dear Tax People," a hilarious parody video of Despacito, the song originally recorded by Luís Fonsi (featuring Daddy Yankee) and later remixed by Justin Bieber. The video was made by a student at the University of Florida Levin College of Law, currently taking Income Taxation (posted with the student's permission). It is very, very clever!

 

 

Panel: The Law and Politics of the 2020 Election and its Aftermath

Panel: The Law and Politics of the 2020 Election and its Aftermath

FIU College of Law will host a panel, The Law and Politics of the 2020 Election and its Aftermath, from 1-2:15 EDT on Tuesday, April 13 (tomorrow). Panelists are Carissa Byrne Hessick (UNC and PrawfsBlawg), Ellen Katz (Michigan), Brian Kalt (Michigan State), Genevieve Lakier (Chicago), and Steve Vladeck (Texas and formerly PrawfsBlawg). It should be a great discussion.

Click here to join us.

Hiring Announcement: California Western School of Law (updated)

From an email message that I received in recent days:

California Western School of Law (CWSL) is seeking applications from lateral candidates for one tenure or tenure-track position to begin on or about August 1, 2021.  We are looking for candidates with strong academic backgrounds, a commitment to excellence in teaching, and demonstrated potential to be productive scholars.  We specifically are interested in an experienced instructor to teach Torts beginning in Academic Year 2021-22, and particularly welcome applications from individuals who would contribute to the vibrancy and diversity of our faculty.

Established in 1924, CWSL is an ABA accredited and AALS member, non-profit law school, and has the distinction of being San Diego’s oldest law school. At CWSL we pride ourselves on the diversity of our student body.  This year, around 50% of our incoming students are from diverse cultural and ethnic backgrounds.  We are committed to having a faculty that reflects our student body and our community.  CWSL continues to rethink the status quo in legal education – balancing a rigorous practical education with cutting edge scholarship and community service.  As a result, our graduates have a reputation for being uniquely practice-ready. 

CWSL is located in downtown San Diego, literally overlooking the Pacific Ocean.  A city of breathtaking beauty, we have perfect weather, miles of beaches, and nearby mountains.  We are a family-friendly, diverse city with small city traffic and walkable neighborhoods. 

Application materials should include a cover letter, C.V., research agenda, and a diversity statement that addresses how you will contribute to CWSL’s goal of creating a diverse faculty. Please direct application materials and questions to the chair of the Appointments Committee, Professor Ken Klein, at the following email address:  appointments@cwsl.edu.  INTERESTED APPLICANTS SHOULD SUBMIT THEIR MATERIALS AND AN EXPRESSION OF INTEREST NO LATER THAN APRIL 16, 2021.

 

What's Going on at the Journal of the Royal Society of Medicine?

My occasional coauthors David Tuller (UC Berkeley) and Brian Hughes (National University of Ireland) have an important new article in the Journal of Health Psychology. They provide a devastating critique of an ME/CFS study recently published in the Journal of the Royal Society of Medicine. As Tuller and Hughes explain, the underlying study suffered from “serious methodological flaws and the highly misleading way in which its results had been presented,” and “key statistical statements in the paper’s Abstract were factually inaccurate.” But that is not why I am posting about it.

Most alarming, from an academic perspective, was the way in which the Royal Society of Medicine first accepted a deeply problematic paper, and then refused to publish a subsequent critique. Here is how David Tuller described it on the Virology Blog, noting that one of the coauthors of the dubious paper was Prof Simon Wessely, the immediate past president of the Royal Society:

Another question is why would the purportedly rigorous Journal of the Royal Society of Medicine publish a paper that included misleading figures in a study abstract and made unwarranted causal claims? What happened with the peer review process that such obvious failings were not noticed, or not revised if they were? Did the journal recognize that it would need to be especially rigorous when reviewing a paper co-authored by the sponsoring society’s immediate past president, and that any weaknesses exposed later on would reflect especially badly on all involved?

If the initial publication may have reflected some in-group favoritism, the Royal Society certainly reinforced that impression by its subsequent decision. Here is how Tuller and Hughes summarized the critique they submitted to the Journal of the Royal Society of Medicine:

Their research is undermined by several methodological limitations, including: (a) sampling ambiguity; (b) weak measurement; (c) survivor bias; (d) missing data and (e) lack of a control group. Unacknowledged sample attrition renders statements in the published Abstract misleading with regard to points of fact. That the paper was approved by peer reviewers and editors illustrates how non-rigorous editorial processes contribute to systematic publication bias.

Even so, as Hughes explained on The Science Bit:

Despite this, the Journal of the Royal Society of Medicine saw fit to reject our submission without providing any reason. Even though our manuscript met all the journal’s guidelines, the editor chose to not even allow it be reviewed for publication.

Fortunately, the peer reviewed Journal of Health Psychology accepted and has now published the Tuller & Hughes article, in which they identify an additional problem with the Royal Society’s peer review:

More notably, the fourth peer reviewer is a psychiatry trainee on the Maudsley Training Programme. This programme is operated in partnership with the Institute of Psychiatry, Psychology and Neuroscience at King’s College London and the South London and Maudsley NHS Foundation Trust. All five co-authors of the Adamson et al. paper list one or both of these institutions as their academic affiliation(s). Two of the co-authors (…) hold senior positions at the Institute of Psychiatry at King’s. Another co-author (…) serves as a College Tutor and Clinical Skills Programme Co-ordinator on the Maudsley Training Programme itself. Ordinarily, being affiliated to the same institution(s) as a manuscript co-author would disqualify a person from serving as peer reviewer. Being affiliated not only to the same institution, but to the same academic units as all five co-authors would certainly appear to present significant issues concerning potential conflicts of interest. That the peer reviewer in question is a trainee of the co-authors’ institutions further compounds the problem. In our view, to ask a student to serve as peer reviewer for a paper produced by senior professors of their own college places them in an impossible position, and is highly inappropriate.

In sum, the Tuller and Hughes experience exposes a major pitfall in academic publishing about ME/CFS, in which old school eminences are able to push weak and contradictory studies, while entrenched journals resist even considering contrary viewpoints.

Vritual Book Launch 4/14: Michelle Drumbl, "Tax Credits for the Working Poor: A Call for Reform"

On Wednesday, April 14, 2021 at 3:00 p.m. eastern, Washington & Lee University School of Law will host a virtual book launch celebration/discussion featuring Professor Michelle Drumbl’s recent book, “Tax Credits for the Working Poor: A Call for Reform.” The event is free and open to the public, but preregistration is required, here.

Here's more info from W&L's webpage:

Drumbl’s book examines the pros and cons of Congress tasking the Internal Revenue Service with the delivery of social benefits. At the core of the book is an examination of the earned income tax credit (EITC), which was introduced in the U.S. in 1975. According to Drumbl, the EITC remains the most significant earnings-based refundable credit in the Internal Revenue Code.

The economic shocks related to the COVID-19 pandemic saw Congress once again turn to the IRS to deliver aid to those in need, as tens of millions of individuals and families received three rounds of Economic Impact Payments. Most recently, Congress enacted a temporary one-year expansion of the Child Tax Credit that transforms the credit in size and scope: parents will receive a higher benefit per child, earned income is no longer a prerequisite to the credit, and part of the credit will be delivered in advance in monthly payments.

During the discussion, Drumbl and her fellow panelists will share their research and perspectives on the future of refundable tax credits. They will explore whether these pandemic-era provisions fundamentally reshape the ways in which the United States delivers social benefits to families.

More info is here.

H/T Francine Lipman.

Just One Look

  

 

Faculty Position – New England Law Teaching Fellow

New England Law | Boston is currently accepting applications for the position of New England Law Teaching Fellow. This fellowship is a two-year appointment beginning August 1, 2021.

Through this fellowship, New England Law seeks to offer an opportunity for aspiring law teachers to gain significant experience teaching law classes and engaging in scholarly activities. New England Law | Boston embraces the AALS Statement on Hiring for Diversity, Equal Opportunity and Affirmative Action. We particularly welcome applications from women, people of color, and others who would enrich the vibrancy and diversity of our  our academic community. 

Fellows will teach three courses each year, one or two of which will be core courses. Fellows will receive mentoring and guidance in teaching, research, and scholarship from New England Law faculty and participate in all aspects of the New England Law community. Fellows are expected to be in residence for both academic years of the fellowship. 

New England Law is seeking applicants with at least three years of significant post-graduate legal experience and strong potential for teaching, research, and scholarship. This year, the law school is particularly interested in applications from candidates interested in teaching civil procedure, contracts, criminal law, or property courses. Compensation for the fellowship is an annual salary of $70,000 and the New England Law employee benefits package. 

Located in downtown Boston, New England Law | Boston is an educational community noted for substantive instruction with a strong foundation in ethics. The New England Law academic program emphasizes extensive preparation in practical skills, including instruction in legal writing and clinical work. Founded in 1908 as Portia Law School, the only law school established exclusively for the education of women, our institution has been coeducational since 1938.  

Individuals interested in applying for the fellowship should submit a letter of application, a résumé or curriculum vitae, a statement of interest including a research proposal, and the names and contact information of three references. These materials may be submitted to Associate Dean Allison Dussias, chair of the Appointments Committee, at adussias@nesl.edu.

The Appointments Committee will begin reviewing applications as they are received, and applications will be accepted until the positions are filled.

It is the policy of New England Law | Boston to provide equal opportunity to obtain employment, without discrimination or segregation on the grounds of race, color, religion, national origin, sex, age, handicap or disability, or sexual orientation.

Lars Smith Named Interim Dean of Louisville Law

The University of Louisville has announced that Professor Lars Smith, the law school's associate dean for faculty affairs, will take over as interim dean on June 1.  The current dean, Colin Crawford, will leave to become the dean of Golden Gate University Law this summer.  Smith holds a JD from New England School of Law; he joined the Louisville faculty in 2000.