Journal of Health Psychology Editor responds to misrepresentations by Cochrane author in Mental Elf blog

A Cochrane review author made a number of false claims in his Mental Elf blog post about why his manuscript about PACEgate was rejected by the Journal of Health Psychology.

Andre Tomlin, Editor of Mental Elf should accept responsibility for unfounded attack on integrity of editorial process at JHP.

Brurberg’s misrepresentations defending PACE suggest he is unfit to be a Cochrane reviewer and that he is a source of bias in Cochrane Reviews of graded exercise therapy for chronic fatigue syndrome

This incident lends weight to calls for release of data for independent reanalysis of Cochrane patient level meta analysis conducted by authors including Brurberg and the Principal Investigator of  the PACE trial.

Pacegate altBrurberg’s statements and the responses of David Marks, editor of Journal of Health Psychology

In his post at Mental Elf, Kjetil G. Brurberg claimed:

I was invited by the Journal of Health Psychology to comment on their ongoing PACE debate. Realizing that some people might view my role in a Cochrane review based on individual patient data as a potential conflict of interest (COI), I consulted the editor on these issues before accepting the invitation. Shortly thereafter, the editor confirmed that he did not see my potential COI a big problem.

david marksDavid Marks replies:

What I actually said was: ‘Almost everybody can be accused of ‘bias’ in one way or another. Any potential conflicts can be declared at the end of the article.” In his original submission, Brurberg declared his COIs as follows: “Kjetil G. Brurberg has co-authored a Cochrane Review about exercise for CFS/ME in which the PACE-trial is included. Brurberg is also a member of the steering committee for an Cochrane individual patient data review that is now submitted.”

Contrary to Brurberg’s statement, it is important to note that his declaration of a conflict of interest was not the reason for the rejection of his paper.  The paper was rejected because of several faults and flaws.  The reviewer’s report listed 14 issues with the paper and ended with the recommendation that “this commentary cannot be accepted without a response to cover the issues raised above.”

The rejection letter sent to the authors was in standard format and COI did not enter the equation. The rejection letter was as follows:


Dear Dr. Brurberg:

I write you in regards to manuscript # JHP-17-0133 entitled “A PACE-gate or an editorial without perspectives?” which you submitted to the Journal of Health Psychology.

In view of the criticisms of the reviewer found at the bottom of this letter, your manuscript has been denied publication in the Journal of Health Psychology. However I trust the reviewers’ comments will be helpful in the further development of your research for publication.

Thank you for considering the Journal of Health Psychology for the publication of your research.

With best wishes,

David F Marks PhD
Journal of Health Psychology

David Marks further states:

Brurberg is not telling the truth when he states: “The same COI, however, suddenly became a major issue when I submitted the commentary and my opinions were made known.”

brubergBrurberg also stated in the Mental_Elf  blog:

“all authors who have been supportive to the PACE-trials have been collectively refused.”

David Marks replies.

This statement is manifestly false. The paper by the PACE authors themselves (White, Chalder, Sharpe et al.) and the  paper supportive of PACE paper by Petrie and Weinman were both accepted for publication.  Three papers favorable to PACE were rejected following peer review, in two cases following appeal, because they were of poor  quality. In one case, that of Brurberg et al., the authors misrepresented the Conflict of Interest of the reviewers they had recommended. The attempt by Brurbergb  to deny the reviewers’ COI is futile. Their COI was unambiguously demonstrated and the evidence for it was provided to Brurberg.

Yet, in the thread of comments to his post at Mentsal Elf, Kjetil G. Brurberg compounded his misrepresentations.

The claim that I have nominated reviewers with known conflicts of interest is simply not true…

When asked to nominate reviewers to my own work, I find it important to suggest people who holds the needed distance to me and my work. As the distance increases, it becomes increasingly impossible to have a full overview of peoples’ social life during the last decade. I did not know that one of the suggested reviewers had been sitting next to one of the PACE-authors at a conference dinner, but I would not consider this as a serious conflict of interest.

 Editor Marks replies:

Brurberg fails to mention that the same person (prof x) who sat next to an author of the PACE trial paper at a dinner had also been supervised by another author of the PACE trial paper for 5 years!

When the reviewer recommended by Brurberg was asked to review Brurberg’s manuscript, he declined, stating,

“I might have a personal axe to grind, and having been supervised by Michael Sharpe (who may or may not have anything to do with this manuscript) between 5 and 10 years ago I would probably be regarded as irrevocably conflicted…”

Another reviewer nominated  by Brurberg, Professor Hans Knoop,  another nominated reviewer , wrote the laudatory editorial that accompanied  the original report of the PACE  trial in The Lancet.

The JHP Editor continued:

To bolster his crumbling position, Brurberg states:

“It should not be regarded as dishonest for authors or reviewers to have an opinion on disputed matters as the PACE trial.”

The JHP editor replies:

Nobody, and certainly not this editor, has ever stated that having an opinion is dishonest. What is dishonest is to falsely represent recommended reviewers as having no COI when their conflicts are manifestly strong and long-lasting.

Bruberg states in the blog post itself:

Despite being aware of my “conflicts of interest”, Journal of Health Psychology invited me to write a commentary on Geraghty’s editorial on the PACE trial. You did not declare however that JHP has intellectual conflicts of interests regarding the PACE trial, by only accepting reviewers representing the critics of the PACE trial, and rejecting papers from authors not sharing your views on the PACE trial.

If I had known, I would not have accepted the invitation.”

The Editor replies:

 I think I have already addressed this.