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Comparing cognitive-behavioural psychotherapy and psychoeducation for non-specific symptoms associated with indoor air: a randomised control trial protocol
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  • Published on:
    In answer to inquiry: Finnish fraud to be finished
    • Sanna I Selinheimo, psychologist, researcher The Finnish Institute of Occupational Health

    Dear Editor,

    We can further clarify T. Tuuminen's suspicions of a conflict of interest.

    Considering researcher AV, his role in the Social Insurance Institute of Finland does not cause any conflict of interest regarding this study. Social Insurance Institute of Finland is an organization where the research unit is administratively separate from the section where AV works as a part-time medical consult for a team which handles social security benefits. Thus, his part-time work (including the cases he handles) and our study do not have any interface. We have now declared all author affiliations with insurance companies, which however have no role in funding or initiating the study.

    We would also like to correct some misunderstandings. First, mindfulness is not a method in our study. The scope of our study is precisely presented in Figure 1 of the article. We study factors which influence the recovery from non-specific symptoms. We do not study immunological mechanisms, nor question or oppose an immuno-toxicological mechanism explanation.

    At the moment in Finland, indoor air related issues raise discussion and emotions. Our study hypothesis is based on a biopsychosocial model for non-specific, persistent symptoms associated with indoor air, which does not exclude the effect of environmental factors (Fig 1). We study whether there is a treatment effect on chronic, nonspecific symptoms. Registered RCT-studies with published protocols are scarce...

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    Conflict of Interest:
    I'm the first author of the manuscript in question.
  • Published on:
    Finnish fraud to be finished

    Finnish fraud to be finished
    Reply to S. Selinheimio

    Dear Editor,
    Thank you for your response in regards to the publication of Selinheimo S. et al. There remain several important issues of concern which I feel obliged despite a short format to explain explicitly.

    In Finland, in 1995 and later in 2015 the §121 paragraph in the Finnish Employment Accident and Occupational Disease Law 459/2015 was added to the legislation. This paragraph grants insurance institute doctors an exceptional right to write out patient statements without complying with Act on Health Care Professionals 23 § adopted for certified medical statements. Putting it simply that means that a medical doctor from an insurance company does not need to sign patient statements through his/her honor and conscience, like any other health care professional. Due to the adoption of this shameful paragraph the social security of those patients who had accidents or got professional diseases has weakened dramatically. This paragraph has now got nearly 12 000 protests (1). In view of the exceptional rights of doctors working in insurance companies it is therefore difficult to assess their honesty and to know when he/she makes any kind of statements that complies with the accepted norms for medical professionals and when not.

    The constitutional rights of Finnish patients suffering from poor indoor air are violated. FIOH exercises a great deal of psycologization and claims that...

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    Conflict of Interest:
    None declared.
  • Published on:
    In answer to inquiry Finnish fraud to be finished

    Dear Editor,

    Tamara Tuuminen has raised concerns that the members of the research team could have had conflicting interests by their affiliations. We did not regard any affiliation to cause conflicts of interest regarding this protocol article. One member of the research group (AV) works part-time as a medical expert in Social Insurance Institute of Finland (KELA) and OP Insurance Ltd, and another (KK) in Varma Mutual Pension Insurance Company. None of these institutions profits financially or non-financially from studying and publishing the methods and results of this intervention study. Moreover, as mentioned in the manuscript, neither the authors' institutions nor the funders have any authority over trial activities or preparing of the manuscript.

    By submitting a protocol paper, our intention was to make our work as transparent as possible. Indoor air associated chronic, non-specific symptoms are perpetuated and exacerbated by various factors. The RCT intervention study compares treatments to reduce symptoms and improve quality of life, regardless of the mechanisms behind the symptoms.

    There is a lack of effective treatments for chronic environment-related symptoms with disability. Thus, our study represents one of the few RCT protocols for these patients. The intention of all stakeholders in Finland is to prevent and reduce disability.

    On behalf of research group,

    Sanna Selinheimo

    Conflict of Interest:
    I´m the first author of the manuscript in question.
  • Published on:
    Note from the Editor

    Please note that BMJ Open has received the above response from Dr Tuuminen. In line with the guidelines of the Committee On Publication Ethics (COPE), we are investigating the issues raised and will follow-up as deemed appropriate.

    Adrian Aldcroft
    Editor
    BMJ Open

    Conflict of Interest:
    I am the Editor of BMJ Open
  • Published on:
    Finnish fraud to be finished

    Dear Editor,

    The reliability of results presented by any scientific paper as a rule is looked through the prism of conflicting interests. Those should be informed by each author of the group without exceptions. ICMJE set the internationally In the recent paper published in this journal by Selinheimo S et al. Comparing cognitive-behavioural psychotherapy and psychoeducation for non-specific symptoms associated wi...

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    Conflict of Interest:
    None declared.