I just watched a remarkable video. It’s a CME video posted today on psychiatrist.com forwarded by someone who knew I’d enjoy it – and I did. It’s really quite remarkable. Madhukar Trivedi combines TMAP, CompTMAP, IMPACT, and STAR*D into a presentation extolling the virtues of his version of measurement based care using his program. Watching it, one would never know that TMAP is defunct and headed for a jury trial for fraud; that his IMPACT study using his CompTMAP program was never actually completed; or that after hundreds of papers, STAR*D never got around to publishing its final advertised results. Yet there they are, slide after slide with all our old friends [TMAP, STAR*D, QIDS-SR] showing various results from here and there purported to demonstrate this wondrous system.
They’ve landed on a new version of spin to report these studies. CO-MED was a bust. Were two antidepressants better that one as they hoped? The answer, "No":
But in interviews after the fact, it was a positive "now we finally know" study. This current CME is the same thing. The abject failures of TMAP, CO-MED, STAR*D, CompTMAP, IMPACT are the reason we need algorithms and computers – because the results are so dismal. The very algorithms that have let us down are the reason we need them?? Here are the results from Trivedi’s only completed computerized algorithm study [algorithmic psychiatry – the fall…]:
My sister gave me a copy of The Big Short by Michael Lewis. I started reading it this morning. Then I viewed the CME presentation by Shelton and Trivedi. Trivedi reminded me of the “intelligent man” described in the epigraph I had just read in The Big Short…
“…the simplest thing cannot be made clear to the most intelligent man if he is firmly persuaded that he knows already, without a shadow of doubt, what is laid before him [Leo Tolstoy, 1897].â€
Great quote! Did you work with Madhukar?
This is education? This clip featuring Trivedi is pabulum – a succession of bland platitudes with no educational content. And why, pray, is Shelton lending his weight to this gig?
Mickey, I tried to work with Madhukar Trivedi in 2005. At that time, he held the same position he holds now at UT Southwestern Medical School. Frankly, I was surprised when he did not follow his mentor, A. John Rush, to Singapore.
To be clear, I worked for several months as a research study coordinator for Madhukar Trivedi. It was a trying experience.
This is religious belief masquerading science.
Rush, Trivedi, & others recently published “Measurement-Based Care in Psychiatric Practice: A Policy Framework for Implementation†(http://www.ncbi.nlm.nih.gov/pubmed/21295000) that “provides a policy top-10 list for implementing MBC into standard practice.â€
Here is another poorly done study by Trivedi and friends, done on the taxpayers’ dime:
Exercise as an augmentation treatment for nonremitted major depressive disorder: a randomized, parallel dose comparison. J Clin Psychiatry. 2011 May; 72(5):677-84.
I’d say Thomas Insel has some explaining to do.