Treating a complex chronic health problem with an intervention underpinned by an unfalsifiable premise and a biologically implausible mechanism of effect: A self-serving randomised controlled trial

Background & Aim: It has been widely accepted that health problems such as chronic musculoskeletal pain, diabetes, obesity and cardiovascular disease, to name but a few, have complex antecedents in the social, biological and psychological domains. This presents a problem for clinicians with a penchant for narrowly framed treatment regimes that target real or imagined pathology using simplistic lines of causal reasoning and / or magical thinking and / or stupidity. The aim of this study was to produce ostensibly meaningless outcome data for select clinicians to hold up as as an unconvincing substitute for the obvious absence of construct and face validity within the theoretical framework underpinning their preferred assessment and treatment systems.

Method: This was a double blinded, and therefore awesome randomised controlled trial. An impressive sounding number of subjects were divided into control (n= 84) and test (n=82) groups. Treating clinicians were as inadequately blinded as the subjects. The test group received treatment inline with the treating clinician’s favoured clinical processes and contextual arrangements. The control group intervention took place in a danky shed out the back and was comprised of a hearty round of disparaging face slapping. Intervention efficacy was measured by way of the How Awesome Do I Treat (HADI) Questionnaire. Data relating to the subject’s experience of the intervention or impact on meaningful activity capacity was considered obviously irrelevant and was not collected.

Results: The test group subjects’ treating clinicians scored themselves 100% on the HADI, whilst the control group subjects’ treating clinicians also scored themselves 100% on the HADI.

Conclusion: These results prove that clinicians who know they’re awesome highly rate their own clinical competence, regardless of whether favoured clinical processes or a control intervention are utilised. No more research is required to validate the theoretical framework that informs the clinical reasoning of clinicians.