Wakefield autism studies slammed as fraud by BMJ

By Grant Jacobs 06/01/2011 111


The editorial team at the British Medical Journal, better known as BMJ, have presented an editorial titled ‘Wakefield’s article linking MMR vaccine and autism was fraudulent’, writing that ‘Clear evidence of falsification of data should now close the door on this damaging vaccine scare’.

Their editorial (open access) points to the ‘diligent scepticism of one man [journalist Brian Deer], standing outside medicine and science, to show that the paper was in fact an elaborate fraud’ in introducing the first of a series of articles by Brian Deer (open access) detailing his case against Wakefield. (See their footnotes: this series appears to have been commissioned by the journal.)

Tellingly, the editorial team write

Is it possible that he [Wakefield] was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross.

I encourage readers to read the editorial and Deer’s series for themselves.

I have little doubt there will be many more ‘short takes’ in no time at all: shorter accounts of the articles can be found at Left Brain, Right Brain (includes the bullet-point summary from Deer’s article) and CNN.

Although these articles rightfully point the finger at Wakefield’s paper, and provide excellent background to the story (saga?), I worry that they let the media involved off too lightly.

H/T @OpenParachute and many others on twitter.

Update

You know how it goes. You write a short article bringing a ‘hot’ topic to readers attention, come back an hour later to look around to see what has been written on the subject and there are (literally) dozens (if not hundreds) of articles out there…

Most re-iterate the message of the BMJ, but John Stone, UK editor of Age of Autism (advocates for a vaccine-autism link), writes under the title ’Fiona Godlee: Editor with an Agenda?’ Two quick thoughts. There are three editors present as authors of the editorial, yet Stone’s polemic only points at Godlee. Leaving aside that his arguments at first blush strike me as reiterating basic (if common) fallacies, his closing shot refers to a ‘dogma of vaccine infallibility’, something I don’t believe even exists. Where vaccine concerns are genuine, they are acknowledged and met with action so how can he talk of a ‘dogma of vaccine infallibility’?

There are numerous studies testing a link between vaccination and autism and reporting finding none (and between mercury and autism, too). To my mind it is a pity that advocacy groups don’t move on. I for one am looking forward to further studies on the genetics of autism. They are at least positively getting on with finding out actual causes of autism, rather than all this negativity and polarised ’debate’.

6-Jan-2011, mid-afternoon:

John Whelan of Forbes is suggesting that the USA extradite Wakefield if fraud charges follow.

Left Brain / Right Brain has a further blog post looking at the defence by the USA National Autism Association. The NAA’s press release in response the BMJ’s articles is available on-line.

Orac is his usual long-format approach has added his take: “Piltdown” medicine: Andrew Wakefield’s scientific fraud was worse than previously thought

6-Jan-2011, 10:30pm:

A CNN report includes brief statements from Wakefield, defending himself and pointing fingers in reply.

10-Jan-2011, 11:45am:

Readers should read fellow sciblogger’s in-depth coverage of other work by Wakefield.


Other related articles on Code for life:

Brevia — Wakefield saga continues… struck off

Immunisation, then and now

Has Andrew Wakefield resigned from Thoughtful House? (Updated)

Another Wakefield paper pulled?

Conspiring against science


111 Responses to “Wakefield autism studies slammed as fraud by BMJ”

  • For those following this on RSS, I have added a few updates, in particular linking to rebuttals by Wakefield and his supporters.

    Reading the international media reports I note little if any mention of the role of media in creating the Wakefield debacle, which I find very disappointing.

    I’d like to think most would agree that Wakefield’s study was always too small and informal to have the meaning ascribed to it. While statements Wakefield may have made to press conferences or interviews may not have helped, neither did uncritical early reporting.

  • Having looked at the coverage of this issue on CNN and elsewhere and also read the postings by A of A and Cry Shame I am personally convinced this is an escalation of an orchestrated campaign against Wakefield. CNN were clearly out to nail Wakefield. The interviewing of Wakefield was more aggressive than that of Brian Deer. And the lighting where Wakefield was filmed was clearly designed to add to the portrayal of a shady character. I laughed when Brian Deer suggested that Autism parents were somehow being ignorant of the real issues and somehow being taken in by Andrew Wakefield.. The experiences of seeing their children’s development regress after vaccination are widespread in the Autism/ Aspergers Syndrome Community. Many of them are well educated and are are quite capable of researching and evaluating the issues for themselves. Of course not all are but they are a tightnit community and share information.. The ones I feel sorry for are those who have been convinced by their health professionals to only believe the official line and ignore websites like Age of Autism.
    UPDATE. Age of Autism has posted a video showing a CNN interview of J B Handley which redresses the balance somewhat.
    http://ageofautism.com/2011/01/jb-handley-talks-to-cnns-ali-velshi-on-vaccine-safety.html

  • The experiences of seeing their children’s development regress after vaccination are widespread in the Autism/ Aspergers Syndrome Community.
    They may well be, since the early symptoms of autism tend to arise at much the same time that particular demonised vaccines are given. One of the problems with Wakefield’s ‘study’ is that he misrepresented parental information on this timing: at least one parent had noted typical autism symptoms in their son before the child was vaccinated. (There are also issues with recall bias in studies of this nature.) It’s also clearly documented that Wakefield progressively dropped children from his analysis (which had a risibly small sample size anyway) to give the impression of a very short time period – about 6 days – between vaccination and onset. His original data set had a much longer time gap & would not have supported his claim about correlation.

    The whole study was flawed even before the evidence of outright fraud came to light. One example: the ethics approval for this bit of work had participants being enlisted randomly, as they presented at the hospital. Wakefield went out of his way to enlist participants by approaching them directly. This is in no way good practice & he should have been pinged for that at the start.

  • At least someone is looking at the media issues:

    http://andersoncooper360review.blogspot.com/2011/01/haiti-one-year-later-interview-with.html

    (Several videos to watch, too.)

    This isn’t quite what I would like to have seen people look at regards the media. I wouldn’t mind seeing a study of the initial week or so of reporting. Who, what, how, etc. Such a small & weak case series study should have stayed fairly obscure. But still something is better than nothing!

    FBB & Alison: I’ll try get back to you tonight – bit rushed at present time.

  • > I am personally convinced this is an escalation of an orchestrated campaign against Wakefield

    Well yes, of course it is – Wakefield is apparently a crook and a liar and still hasn’t been brought before a court. A lot of people would like to see orchestrated campaigns against some of the people involved with finance company failures in NZ too.

  • “I am personally convinced this is an escalation of an orchestrated campaign against Wakefield. CNN were clearly out to nail Wakefield.”
    Wakefield and other anti-vaccine proponents quite happily used the media to circulate misleading arguments so perhaps the media are “getting their own back” for being used to circulate misinformation?

    The expression “he who lives by the sword, dies by the sword” springs to mind.

    Alison makes an excellent point about the unethical nature of some of Wakefield’s research. How this got past an ethics committee I have no idea.

  • I suspect it didn’t; what the ethics committee approved was different from what actually went on.

  • It is unlikely we will ever know the truth behind Wakefield’s ‘study’. Was money involved? Isn’t there always. Let’s face it, vaccines are a license to print money both on the research front (financed by companies wishing to patent the result) and through sales. Plenty of studies in Africa, the results of which are rarely published… but let’s not delve into the murkier waters of drug testing.

    My personal example? I had my child fully vaccinated as a baby 16 years ago but I delayed the first set until 16 weeks. However I refused to consent to my child getting the meningococcal vaccine after the minister of health could not:
    a) tell me the length of protection it would provide -not even an approximation (Norwegian trials were inconclusive).
    b) assure me my child would not be adversely affected by the preservatives of the multidose vial.

    So, no guarantee of any length of protection, if any, to only one of the three deadly strains. I was pretty stunned and glad I asked.

    The facts is that in New Zealand and overseas there have been large sums of compensation paid to parents who’s children have been neurologically disabled by vaccines. But these have strict confidentiality clauses attached to them.

    Not reporting adverse effects data on vaccines simply because of fear of adverse publicity gives a whole new meaning to ‘informed consent’. And is it ethical?

  • >It is unlikely we will ever know the truth behind Wakefield’s ’study’. Was money involved?

    Yes. Wakefield himself had a patent for an alternative vaccination shot.

  • Continue on without me, as I’m still flat out :-)

    “Reason”,

    One quick note, re:

    It is unlikely we will ever know the truth behind Wakefield’s ’study’.

    While it’d be hard to determine his personal motivations—you’d have to read his mind—you can look at his actions. I’d like to think that’s the point of the investigative journalism, etc.

    Your comment has quite a number of points that need correcting/clarifying – I’ll try get back on that. If others don’t beat me to it :-)

  • “It is unlikely we will ever know the truth behind Wakefield’s ’study’.”
    I disagree. It is quite clear that Wakefield’s “conclusions” do not match the research and that the research he did do was unethical and flawed. And as possum points out Wakefield had a vested interest in an alternative vaccine. Wakefield was also paid by lawyers in order to find “evidence” to “prove” that vaccines cause harm. Hardly an objective start for medical research.
    I’m not quite sure what truth you are looking for, Reason, but Wakefield’s claims are invalid and immoral from every angle.

    “However I refused to consent to my child getting the meningococcal vaccine after the minister of health could not:
    a) tell me the length of protection it would provide -not even an approximation (Norwegian trials were inconclusive).
    b) assure me my child would not be adversely affected by the preservatives of the multidose vial.”

    I would be surprised if the Minister of Health had the medical expertise to provide advice so I will assume you mean medical experts at the Ministry of Health. If they are good scientists they wouldn’t tell you that there is no possibility of adverse effects from a vaccine – only that in a minority of cases there are minor reactions to vaccines, and that such reactions are strongly outweighed by the devastating effects of meningitis. Severe reactions to vaccines are very rare.
    As for not knowing how long it would last for, does this negate the effectiveness of it? It only makes it uncertain when one might require a booster shot.
    You have chosen not to vaccinate because of the small chance of side effects, as is your right as a parent. However, have you considered the benefits of vaccination. It reduces the likelihood of contracting the disease by a factor of 3x compared to unvaccinated children. Bearing in mind that 1 in 20 children infected with disease die while, between 1in 5 and 1 in 20 suffer brain and other injury, while 1 in 4 suffer behavioural/learning difficulties.

  • “However, have you considered the benefits of vaccination. It reduces the likelihood of contracting the disease by a factor of 3x compared to unvaccinated children. Bearing in mind that 1 in 20 children infected with disease die while, between 1in 5 and 1 in 20 suffer brain and other injury, while 1 in 4 suffer behavioural/learning difficulties.”
    Yes, Michael, I considered the benefits of vaccinations, hence the vaccinations for MMR etc during my child’s early years. However I find your blanket statistics a bit a bit broad and optimistic.

    My decision on Prevenaar was because I was appalled at the lack of information available from the MOH or the Minister’s office. For example, the trials in Auckland (in a very small group before going NZ wide) were only conducted for a few months. Some people did not develop immunity at all. Then I asked for the overseas results and was told these had been inconclusive, ?. The immune response varied from nil to 2 years and everything in between. So then I asked if there would be any follow up shots required later on- no answer.
    Is there a study being conducted to check:
    a) the protection period of vaccine?
    b) the efficacy in lowering the rate of infection of that one particular strand? (or as you say, the magic 3x factor?)

    If so, I’ll happily await the research results and march my offspring to get the jab once the effectiveness are clearly shown by data.

    I’m not against vaccines, though I don’t feel they are the magic bullet to cure all ills (MMS does that apparently ; ). My children got the full early childhood shots (back in the day before Hep B, H1N1 and MiB were added to the cocktail). I did wait until there was at least some brain myelation though, 16 weeks – just in case.

    Knowing what I know about neural development, it concerns me that 6 week old neurons are being bombarded with 6 different immune responses at once. And I haven’t read any studies to put my mind at ease.

    But those of you out there who might know of some studies of how 6 weeks old brain neurons with basically no protection from 6 different immune responses can survive unscathed please let me know. Neurological impairment can take years to show up.

  • “Knowing what I know about neural development, it concerns me that 6-week-old neurons are being bombarded with 6 different immune responses at once.”

    Given that from birth we are exposed to at least thousands of antigens every day, the 6 antigens from the early vaccinations aren’t even a drop in the bucket.

  • Reasons, thanks for elaborating further on your investigation of the prevenaar vaccine. Hopefully studies are under way which may provide more clear data for you. I’m not sure who considers vaccines “the magic bullet to cure all ills”, as I don’t think any fully informed person would, but they certainly have been a significant medical advance/reducer of mortality.
    Perhaps one of the bloggers who works in a vaccine related area will be able to tell you about ongoing research?
    You mention that there are no studies that you are aware of that show that 6 week old brain neurons will remain unaffected by vaccination. Is there any research to show that 6 week old brain neurons are affected by vaccines? Or are you extrapolating that such damage might be possible based on your knowledge of neural development?

  • “Reason”, I will get back to you – I promise! It looks to be the making of a stunning day in these parts, so don’t expect anything before evening!

  • OK. Many things to remark about, too little time; excuse me if my thoughts are very brief and not backed with citations, etc.

    “Farmer Baby Boomer”

    an orchestrated campaign against Wakefield

    While I can understand that some individuals or individual groups might wish to target Wakefield, I would be very skeptical of a larger, wider “campaign”. For example, without taking sides, it’s pretty understandable that individuals or individual organisations might wish an end to the “vaccine scare” subsequent to the fuss about his work, but it’s (very) hard to see them deliberately working together on a larger scale.

    Media can “colour” interviews, but that plays both ways. Wakefield has been in some what I would view as self-promotional interviews; these these are certainly “coloured”–just in his favour.

    The experiences of seeing their children’s development regress after vaccination are widespread in the Autism/ Aspergers Syndrome Community.

    As Alison pointed out earlier, the timing itself may not mean a lot. Some disorders become apparent at particular ages regardless of whatever else might be happening. The trick is to establish causes rather than timing in itself.

    For what it’s worth, I recall studies suggesting that autism occurs earlier than the vaccines are administered; my recollection is one study showed that specialists examining first birthday videos were able to call (to whatever level of accuracy it was) autistic children from non-autistic using behavioural patterns. I’ve seen some remarks to the effect that the a common origin is likely to be very early in development, or pre-natal. I’m not an autism specialist (and to my reading, neither are you): the point here is that a disorder can first occur or be initiated well before it becomes obvious.

    Of course not all are but they are a tightnit community and share information.

    That plays both ways, as I’m sure you realise! (The usual: peer-pressure can encourage people to dismiss things they should have an open mind to, etc. History is full of this!)

  • There is science and then there is journalism. There are a lot of opinions and impressions.

    What did Wakefield do wrong?

    He published a case series and stated he did not establish a connection between autism and MMR vaccinations.

    Why is the BMJ publishing what looks to be to be poor quality newspaper journalism as part of their journal? What’s that got to do with science? Should not every scientist be offended?

    I don’t advocate for or against Wakefield. I advocate for using science to get the best idea of reality.

    My reading is that Wakefield did little if anything fraudulent. I could be wrong in this opinion.

    I have not heard any evidence of anything that would be considered fraud — only that I should uncritically accept the opinions of the medical council and writers in medical journals.

    Has the basic comparison been made of subjects receiving the complete vaccine regimen on the typical schedule to subjects not receiving vaccines? How do autism rates compare?

    Comparing vaccine treated subjects to vaccine treated subjects not receiving an MMR vaccine is not convincing. I don’t think it should be for anyone else.

    I do not know much about this subject, so I would be happy to be enlightened.

  • What did Wakefield do wrong?
    – he ignored the boundaries of the ethics approval for his original study, which clearly stated that patients were to be recruited in the order in which they presented at a hospital clinic: Wakefield instead made direct approaches to potential enrollees away from the hospital context;
    – he then went on to pay children attending a child’s birthday party if he was allowed to draw a blood sample – unethical in the extreme;
    – he also carried out gut biopsies for which there were no good clinical indications on several of these children, which suggests he was desperately searching for data to support an a priori conclusion;
    – he cherry-picked his original data (which came from a very small pool of patients) so that those with a long time interval between vaccination & onset of symptoms were excluded from his final analysis;
    – he misrepresented information given to him by some parents;
    – as Siouxsie noted in her recent post, he published a paper claiming that vaccine-strain measles was found in patients with autism & various gut problems when in fact the data showed no such thing, & I have to say I agree with her on whether that was misconduct or incompetence…

    Interesting that Wakefield should say that “he did not establish a connection between autism & MMR vaccinations”, considering that since then he’s been pushing this ‘link’ for all he’s worth.

    And yes, there has been a retrospective study of vaccinated vs unvaccinated (in Denmark/Finland, I think from memory). Result: no correlation between vaccination and autism. It would not be possible – for ethical reasons – to set up a prospective study on this: no ethics committee is going to approve a study where one ‘treatment’ arm would be exposed to vaccine-preventable diseases.

    In the post attached to this comment thread Grant’s given a link to the work of Brian Deer, who’s provided a lot more detail than I have time to write in between student appointments :)

    I agree, scientists should have been – & probably were! – offended that the BMJ published such a poor-quality paper in the first place. As a scienti

  • Oh drat! Too many distractions!!
    As a scientist… I consider the BMJ’s latest publications and commentary on the Wakefield issue quite appropriate & the least they could do, considering the damage done by that original paper.

  • It would seem from reading Brian Deer that there is sufficient evidence to take Wakefield to court for fraud. It will probably never happen, but it’s nice to imagine the headlines that such an event would generate worldwide.

    Considering the number of children worldwide who have suffered, been maimed, or died from vaccine preventable diseases since Wakefield made his first unsubstantiated statement, maybe such headlines would help limit future damage.

  • I suspect the vast majority of scientists who do their research ethically and honestly would be quite relieved that someone has carefully gone through Wakefield’s work and outlined all the flaws and failings.
    The article written by Brian Deer looks good to me – very thorough and not overly emotive (for a science based article)

  • Many of the comments on this site misrepresent facts. When we are talking about matters that affect human life, we should be quite careful. Commentators on this site are sloppy and propogate falsehoods. Many comments confuse the BMJ with the Lancet indicating profound ignorance.

    I have no involvement with autism, Dr. Wakefield, or any drug manufacturer. I object to science being misused. All evidence indictes that Dr. Wakefield is an good scientist who is being villified for political reasons.

    We will leave aside that which should be offensive to any scientist, that the BMJ is using a freelance popular writer and printing his work in their medical journal. I find the intermixing of popular press and science offensive. I find Brian Deer’s work amateurish and self-promoting. That is just an opinion.

    Now here is where it seems some of commenters statements are false:

    CAMPBELL: he ignored the boundaries of the ethics approval for his original study, which clearly stated that patients were to be recruited in the order in which they presented at a hospital clinic: Wakefield instead made direct approaches to potential enrollees away from the hospital context;

    ME: The original paper was in The Lancet in 1998. It was a case series report signed by twelve or more qualified specialist and peer reviewed. Dr. Wakefield’s specialty was gastroenterology. He did not recruit anyone. The Lancet paper was not a clinical trial. Patients came to the Royal Free Hospital for treatment for GI problems. It was entirely responsible for the twelve specialists to report an observed correlation with autism.

    CAMPBELL: he then went on to pay children attending a child’s birthday party if he was allowed to draw a blood sample – unethical in the extreme;

    ME: I do not know if this story is true. If it is, it sounds unprofessional. Medical subjects are paid regularly. I do not know why you call this unethical. It is certainly not fraud. If this is the worst or near worst thing he is accused of after twelve years of intense villification, Wakfield sounds quite ethical.

    CAMPBELL: he also carried out gut biopsies for which there were no good clinical indications on several of these children, which suggests he was desperately searching for data to support an a priori conclusion;

    ME: This is false. Why use the word “desperately”? Dr. Wakefield was a working gastroenterologist working at Royal Free Hospital collaborating with respected specialists. Your a priori conclusion statement makes no sense. Remember that the conclusion was that the authors had not established a connection between MMR and autism. That was a theory advanced by the parents of the sick children.

    CAMPBELL: he cherry-picked his original data (which came from a very small pool of patients) so that those with a long time interval between vaccination & onset of symptoms were excluded from his final analysis;

    ME: The 1998 Lancet report was a case series. If you do not know what that is, it is a report of individual cases with an interesting set of similarities. Your statement is illogical.

    CAMPBELL: he misrepresented information given to him by some parents;

    ME: I have no idea what you are talking about.

    CAMPBELL: as Siouxsie noted in her recent post, he published a paper claiming that vaccine-strain measles was found in patients with autism & various gut problems when in fact the data showed no such thing,

    ME: I have no idea why you or SIOUXSIE would say this.

    Interesting that Wakefield should say that “he did not establish a connection between autism & MMR vaccinations”, considering that since then he’s been pushing this ‘link’ for all he’s worth.

    ME: Your quote is from the original 1998 report. It is entirely appropriate. It is only the popular press and falsehoods promoted by the ignorant that claim otherwise.

    ME: All evidence I have seen indicates that Dr. Wakefield is a responsible scientist using science appropriately. He seems to have been villified for political reasons. I have yet to here a credible reason as to anything he did that was fraudulent.

    I would like a reference to the paper you quote. If there are populations that are unvaccinated, epidemiological studies could be conducted. Do not claim the comparison would have to be an unethical prospective study so the comparison cannot be made.

    Here is my opinion: The discussion here seems to be at the level of playground bullies. If this site is about science, this is unbecoming.

  • Joel,

    “Commentators on this site are sloppy and propogate falsehoods.”

    With all respect, two points:

    1. Take care with the tone. Direct personal accusation upon commenters generally reads badly and starts to twitch my moderation finger 😉 Ditto for “definite” statements that are better and more accurately presented as tentative or opinion.

    2. You might be wise to realise that you’ll look bad if it proves that you are doing what you accuse others of.

    I’d also point out, that most of the points others are making are not their own, but from other sources, e.g. the research literature, etc.

    I object to science being misused.

    Are you quite sure you object to science being misused or to views that don’t match your own? My initial impression favours the latter. While I’m no this topic, one of the problems I see with advocacy groups is that they often don’t appear to realise that their pushing one side over the other in the fashion that they do is not how science works at all, but (advocacy group) politics.

    All evidence indictes that Dr. Wakefield is an good scientist who is being villified for political reasons.

    It might help to remember that the objections from scientists are to his sloppy science (at best; fraud at worst). Note this is irrespective of wider vaccine issues.

    He did not recruit anyone.

    This doesn’t fit with the medical body’s ruling from memory. You may want to back this up by checking their ruling.

    for the twelve specialists to report an observed correlation with autism

    A small case series cannot report a correlation—here meaning a statistically significant correlation—it would lack statistical power to do so. They can report observations, which are the essence of case studies. To me, your word ‘correlation’ overstates what the Lancelet could have reported, assuming it had no other flaws.

    I’ll have to leave this here for the moment as I have work to get on to. More later, if I find time. Still haven’t replied to others as I’d promised to! (My apologies.)

  • CAMPBELL: he cherry-picked his original data (which came from a very small pool of patients) so that those with a long time interval between vaccination & onset of symptoms were excluded from his final analysis;

    ME: The 1998 Lancet report was a case series. If you do not know what that is, it is a report of individual cases with an interesting set of similarities. Your statement is illogical.

    I am very well aware of what a case series is. Wakefield presented data from parents where there was a short period between vaccination & the apparent development of ASD symptoms. Cases with a longer period (eg 46 days in one case) were omitted. If that ain’t cherry-picking I don’t know what is.

    The payment-for-blood case was brought up at the BMC hearing for misconduct, which found him guilty of a number of wrongdoings, including that he published inadequately founded research, failed to obtain ethical committee approval for the work, obtained funding for it improperly, and subjected children to “unnecessary and invasive investigations”.

    CAMPBELL: as Siouxsie noted in her recent post, he published a paper claiming that vaccine-strain measles was found in patients with autism & various gut problems when in fact the data showed no such thing,

    ME: I have no idea why you or SIOUXSIE would say this.

    This is a little disingenous. The point Siouxsie & I are making is that it is a clear example of Wakefield’s misrepresentation of the facts – & of his claims that MMR & autism are causally linked – & entirely relevant to any discussion of whether or not he is guilty of scientific fraud.

    CAMPBELL: he misrepresented information given to him by some parents;

    ME: I have no idea what you are talking about.

    At least one parent has said that Wakefield has misrepresented his statements – this is detailed in Brian Deer’s reports.

    I would like a reference to the paper you quote.

    The paper I referred to is:
    PEDIATRICS Vol. 110 No. 5 November 2002, pp. 957-963, “Neurologic Disorders After Measles-Mumps-Rubella Vaccination”, authors: Annamari Mäkelä, MD, J. Pekka Nuorti, MD, Heikki Peltola, MD: http://pediatrics.aappublications.org/cgi/content/abstract/110/5/957

    If there are populations that are unvaccinated, epidemiological studies could be conducted. Do not claim the comparison would have to be an unethical prospective study so the comparison cannot be made.

    Why not? It would be unethical in the extreme to expose children to vaccine-preventable diseases & this is the reason that such a study would not get past any human ethics committee (google ‘Helsinki accord’).

    The discussion here seems to be at the level of playground bullies. If this site is about science, this is unbecoming.

    I fail to see where anyone has made statements that could be construed as bullying (of Wakefield or of yourself). The information about Wakefield’s ‘research’ & the various claims he has been making since then are readily available on line & comments here are based on that evidence. We’ve attempted to answer the points in your original post on the basis of that evidence & I’m sorry if you perceive this as ‘bullying’.

  • Joel, did you actually read my post? To clarify, I am a trained scientist and the first lesson I learned as a PhD student was that controls are the most important part of research. If you still think Wakefield is a good scientist* then I don’t think anything we say is going to change your mind.

    *In actual fact, he was never a trained scientist but a medical doctor doing some science. Very different things in my experience.

  • “Many of the comments on this site misrepresent facts.”

    I disagree. On the contrary I find your postings seem to be ignoring a lot of facts. Most of the commentators here are strong advocates for good science and have pointed out valid flaws in Wakefield’s work.
    In many of your critiques of comments made on here you do not actually provide any information to prove they are wrong. You simply state they are wrong, add additional, irrelevant information or make statements such as “I don’t know what you are talking about”

    If you are going to state that “commentators on this site are sloppy and propagate falsehoods” I would appreciate it if you would provide evidence to show this, rather than just reiterating your opinion.

  • I am not an advocate for anything related to MMR or autism. I do not want anyone implying that. I don’t even know anyone with autism. Everything I have heard so far about Dr. Wakefield gives me the impression that he is the victim of a political campaign.

    The more I hear about Deer, who is an uninformed layman, the more convinced I am that he is not reliable. For anyone to quote him is sloppy. He is not a scientist. He is not peer reviewed. Deer’s writing has nothing to do with science. But let’s leave Deer aside. Let’s not quote him as a reliable source.

    I want to thank Grant for pointing out my error in saying that a case series can indicate a correlation. I should have said similariities. I am sorry I made this mistake.

    I think it is a complete falsehood that Deer approached subjects and recruited them for the 1998 Lancet paper.

  • For those that asked, here is a earlier comment that seems to misrepresent facts:

    ” he [Wakefield] cherry-picked his original data”

    What does this refer to?

    Here is something that sounds like bullying:

    “If you still think Wakefield is a good scientist* then I don’t think anything we say is going to change your mind.”

    I see words used like “crook and liar”. This sounds like bullying also.

  • Both Siouxsie Wiles and Allison Campbell imply that Wakefield’s orignial case series was published in BMJ:

    CAMPBELL: As a scientist… I consider the BMJ’s latest publications and commentary on the Wakefield issue quite appropriate & the least they could do, considering the damage done by that original paper.

    SIOUXSIE WILES: I was recently told that the BMJ originally rejected Wakefield’s paper. I wonder if they sent it out for peer review?

    Wakefield’s 1998 case series was published in The Lancet.

    If commentators have the two journals confused, this is sloppy, to say the least. It also indicates they have not read Wakefield’s 1998 paper of which they seem to have much to say.

  • Joel, you are correct that Alison and Siouxsie made a slight error when they implied that Wakefield’s original work was in the BMJ. Mistakes happen, in the same way that you made a mistake in stating that “I think it is a complete falsehood that Deer approached subjects and recruited them for the 1998 Lancet paper.” I think you have confused Deer with Wakefield? A simple and forgiveable error, much the same a Siouxsie’s and Alison’s.
    You seem very focused on denouncing Deer’s article on the basis that he is, in your terms a layman. The assumption that a layperson cannot possibly understand science is an arrogance. Perhaps you should focus on the actual points that Deer makes in his article – can you prove they are inaccurate. In science one focuses on the verifiable facts, not on who provides them. So long as the facts can be verified they stand on their own.
    If you intend on dismissing someone’s opinion because they are a “layman” with regards to their scientific training perhaps you should state your own scientific background?
    Your arguments are quite extraordinary in that they largely consist of attacking Deer and ignore the facts, while this is exactly what you claim is happening to Wakefield.
    You might want to take a step back and check the consistency of your own arguments first.

  • Joel, you and I obviously have a different definition of bullying. Bullying is defined by wikipedia as involving “repeated acts over time attempting to create or enforce one person’s (or group’s) power over another person (or group).”
    Thus far, while commenters have disagreed with your position citing factual information, I cannot see anyone acting towards you in a threatening way. Your posts have not been censored, you have not been called names.
    The accusation of bullying is a serious one for me, having put up with a lot of it during my school years. I find the flippant use of the term bullying by those who wish dismiss people who do not share their opinion and those who want to shut down rational debate frustrating as it trivialised the experiences of those who have truly experienced bullying.

  • Michael, thank you for your thoughtful reply. Yes, I made a mistake, I meant to say “Wakefield recruit,…”

    I am sorry for the mistake and apologize for any confusion I may have caused.

    I do not equate Souxsie and Campbell’s errors with mine. They seem to systematically know very little about the original 1998 Lancet paper, just quoting others, and repeated confused the journals, never self-correcting nor being corrected by others. But, I would like their explanation.

    The paradox I find interesting is the whole-hearted support and acceptance of Deer in some portions of the scientific community when the same community has long dismissed the assertions of laymen and those not subject to peer review.

    I have no problem with laymen doing scientific work. I specifically do not find Deer reliable or knowledgeable. I am not a scientist. I am a citizen expressing my concerns that science is not doing its job. I came to this site looking for science about Dr. Wakefield’s purported fraud. I am still not impressed by what I see here.

    Commenters and the original post refer me to sites that impress me as amateur and bombastic. I have serious concerns about Deer. I have been told that he was hired to attack Dr. Wakefield and amplify Wakefield’s slightest errors and omissions. I have been told that Deer says many things that are false. I do not think his writing has any place in a medical journal and is more appropriate to the Sunday paper. In fact, I started to read his piece in the BMJ knowing nothing about hime and my first though was that this sounds like something from a Sunday paper. Some time later I find that is where he usually is published. By the way, Deer misrepresents himself. He has never been an employee of the Sunday Times. They just buy his freelance work, just as the BMJ does.

    Many people on this site write a lot about Dr. Wakefield and state he committed fraud. I do not defer to the opinion of the GMC. I have heard of good scientists persecuted by medical boards for political reasons. My impression is that this is what happened to Dr. Wakefield.

    The preponderance of the evidence I have seen supports Dr. Wakefield. Many people seem to not like him. So what? I was hoping someone could give good evidence on this site as to something Dr. Wakefield did fraudulent. The blog owner, Grant Jacobs, brought up the subject and states that Dr. Wakefield committed fraud. I see distressing little evidence to support this.

    So, can any one here on this site provide me with even one offense of Dr. Wakefield that could be considered fraud? Actually, you can all get together and decide on your best, most damning piece of evidence if you want. I am still not convinced Dr. Wakefield did anything fraudulent. Then, maybe we could start to look at the entire picture of the allegations against Dr. Wakefield.

  • Joel, I did not imply the case study was published in the BMJ. What I said was, it was originally rejected from the BMJ. What this means is that I was told by a reliable source that Wakefield first sent his paper to the BMJ. They rejected it, and so he sent it to the Lancet. The Lancet accepted it and hence it was published. What I want to know is, on what grounds did the BMJ reject it?

  • Thanks, Michael – we did indeed conflate the BMJ & the Lancet; the BMJ has recently published a considerable amount of material critiquing Wakefield’s original study, which itself was published in the Lancet. As I said previously, as a scientist I value the role of the BMJ in making this information publicly available. And Joel, please note that things like the patient records, published in the BMJ series, have been checked & peer reviewed independently of anything Brian Deer has written, as a result of these data being presented in the GMC hearings that saw Wakefield found guily of professional misconduct. The BMJ has also made it clear that Deer’s articles for them were peer-reviewed prior to publication.

    On the issue of what Wakefield did & didn’t say about the ‘link’ between MMR & autism, here are a couple of quotes from that original paper:

    We identified associated gastrointestinal disease and developmental regression in a group of previously normal children**, which was generally associated in time with possible environmental triggers. ** by ‘previously normal’ the authors are referring to children they now regarded as autistic.

    We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunisation. Further investigations are needed to examine this syndrome and its possible relation to this vaccine.

    This is not directly stating a link but it is certainly implying one. However, he subsequently went on to say (in a video promoting his work – the transcript is here: http://briandeer.com/wakefield/royal-video.htm) you would not get consensus from all members of the group on this, but that is my feeling, that the, the risk of this particular syndrome** developing is related to the combined vaccine, the MMR, rather than the single vaccines. ** again, he is referring to autism, as the context of the quote makes clear. If that’s not sufficient to support my original contention that Wakefield has regularly claimed in public that the MMR vaccination is causally linked to the development of autism, he continued: I have to say that there is sufficient anxiety in my own mind of the safety, the long term safety of the polyvalent, that is the MMR vaccination in combination, that I think that it should be suspended in favour of the single vaccines, that is continued use of the individual measles, mumps and rubella components.

    Joel, you also said: For those that asked, here is a earlier comment that seems to misrepresent facts:

    ” he [Wakefield] cherry-picked his original data”

    What does this refer to?
    This suggests that you didn’t actually read my response to your earlier comment. The original series of case reports included children where there was a long time period (>40 days) between vaccincation & the apparent development of ASD symptoms. These cases were omitted from the final report. Hence my statement about cherry-picking data.

    I think it is a complete falsehood that Deer approached subjects and recruited them for the 1998 Lancet paper.

    Yes, well, as Michael has said you’re quite correct as we were in fact talking about Wakefield. Patients were actively recruited rather than being included in the project in the order in which they arrived at hospital clinics (this is from Deer’s report which – remember – was independently reviewed prior to publication):

    The Lancet paper was a case series of 12 child patients; it reported a proposed “new syndrome” of enterocolitis and regressive autism and associated this with MMR as an “apparent precipitating event.” But in fact:
    Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism
    Despite the paper claiming that all 12 children were “previously normal,” five had documented pre-existing developmental concerns
    Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination
    In nine cases, unremarkable colonic histopathology results–noting no or minimal fluctuations in inflammatory cell populations–were changed after a medical school “research review” to “non-specific colitis”
    The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations–all giving times to onset of problems in months–helped to create the appearance of a 14 day temporal link
    Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation

    Joel, like Michael I find your accusations of bullying both rather serious. You have presented no evidence of anyone bullying you or Wakefield & I do have to wonder if use of the term is simply an attempt to shut down a conversation that’s not going the right way.

    When you first posted here you asked a number of questions & said I do not know much about this subject, so I would be happy to be enlightened. Your response to our answers suggests that you did in fact have a predetermined position on the issue and are not really interested in hearing what we have to say.

  • Joel,

    *Places on moderation hat*

    Small suggestion: I’d focus on the message, not the messengers. Much of what you present aims at shooting the messenger.

    Bullying is intimidating others. It’s not bullying to accurately describe someone as they are, nor is expressing an opinion bullying if it is not attempts to (directly) intimidate someone. I doubt very much anything written on this small blog will reach Wakefield’s eyes, nor is directed directly at him 😉

    “I do not equate Souxsie and Campbell’s errors with mine. They seem to systematically know very little about the original 1998 Lancet paper, just quoting others, and repeated confused the journals, never self-correcting nor being corrected by others. But, I would like their explanation.”

    This sort of thing is not helpful, it has you placing yourself on a pedestal looking down addresses others. It is clear to readers that it is you that knows little about the research (you’ve said as much). With that in mind, it is inappropriate for you to write this.

    Please lift your game.

    *Takes moderation hat off*

    For what it’s worth, my reading of Siouxsie at the time was that the article had been submitted to, and rejected by, BMJ prior to been sent to Lancelet. (Incidentally, I could read your replies as you not understanding this, something you may wish to think about.) I’d love to know why they rejected it too.

    My overall impression is that you know relatively little of the details and have come to this story late. Some of us have seen this story unfold from it’s earliest days.

    I specifically do not find Deer reliable or knowledgeable.

    How? Merely saying so doesn’t mean a lot. I have to admit I’d thinking it would be a contradiction in terms for you (Joel) to be unfamiliar with the subject (as you say you are), yet claim to be knowledgeable enough to judge that Deer is unreliable or not knowledgeable. In any event, presenting material, rather making empty claims would help.

    Commenters and the original post refer me to sites that impress me as amateur and bombastic.

    So? This seems a simple attempt to insult, aka trolling. Lift your game, please.

    I have serious concerns about Deer.

    But you won’t say what you concerns are. Be explicit. Present material, rather than attack a messenger. (And, I should add, make the criticism constructive, please.)

    In fact, I started to read his piece in the BMJ knowing nothing about hime

    Ah, this would confirm that you’re new to this story. With all respect, you might want to then bear in mind that this story is very old to the people you are writing to.

    By the way, Deer misrepresents himself. He has never been an employee of the Sunday Times. They just buy his freelance work, just as the BMJ does.

    With all respect, you are misrepresenting, not Deer. The phrase ‘employed by’ does not always mean that the person is an employee, it can mean just that their services were employed. I am scientist who works by offering my services as a consultant. I am employed by my clients, but I am not their employee. Got it?

    I do not defer to the opinion of the GMC. I have heard of good scientists persecuted by medical boards for political reasons.

    Firstly, the GMC rules on doctors, not scientists. I suggest you’re making an error Sixousie pointed out earlier of confusing that Wakefield is not a scientist, per se, but a doctor practising science (badly).

    Secondly, choosing to ignore evidence won’t impress many.

    The preponderance of the evidence I have seen supports Dr. Wakefield. Many people seem to not like him. So what? I was hoping someone could give good evidence on this site as to something Dr. Wakefield did fraudulent. The blog owner, Grant Jacobs, brought up the subject and states that Dr. Wakefield committed fraud. I see distressing little evidence to support this.

    You present no evidence to support any of these statements. What say I suggest you have none? Again, please lift you game. Present substance rather than shoot at messengers.

    So, can any one here on this site provide me with even one offense of Dr. Wakefield that could be considered fraud? Actually, you can all get together and decide on your best, most damning piece of evidence if you want. I am still not convinced Dr. Wakefield did anything fraudulent. Then, maybe we could start to look at the entire picture of the allegations against Dr. Wakefield.

    We’re not obliged to serve you, Joel. If you have something to present, present it. All you have presented to date is empty criticism. I would suggest you present substance and you will be better received.

    As for your first sentence: earlier comments already have.

    Closing aside: I see Alison has presented the quotes I was going to :-) A point to note here is what Wakefield presented to a wider audience; much of the “defence” of Wakefield I see on-line seems to push aside what he said interviews, focusing only the Lancelet paper.

  • I want thank everyone taking the time to reply. I was hoping I did not have to wade through a twelve year history to understand why Dr. Wakefield is being regarded as guilty of fraud.

    I could bring up many side issues such as who pays Deer and whether peer review by the people who commission a piece is legitimate peer review. Or, who gave Deer access to medical records without patient or parental permission. But let’s put all that aside and focus on facts. Let’s not look at Wakefield’s verbal comments outside of his published papers as terribly significant, either.

    I have had a lot of lectures on this site about etiquette and tone. When I come to a web site using words like liar and crook I don’t perceive a gentile atmosphere or much rigor. It gets tedious to precede each statement with, “It is my impression that…”. But, sure, happy to oblige. I expect the same.

    I am surprised that anyone is speculating on a twelve year plus old submission history of a paper. People have papers rejected all the time. I don’t think that means much.

    So let’s get to the heart of this. I will scour Allison’s argument for its content…

    My impression is that there is no definitive test for autism. There is a certain amount of latitude in selecting subjects for a case series. There is no definite objective date that anyone could point to as the date of onset of symptoms unless they were an expert in autism living with the subject. Even then, the diagnosis would be a matter of opinion.

    Everything Wakefield and his cosigners did seems well within the boundaries of typical diagnosis.

    I read Allison’s post over and over. Nothing impresses me as fraud.

    Let’s pick one:

    “In nine cases, unremarkable colonic histopathology results–noting no or minimal fluctuations in inflammatory cell populations–were changed after a medical school “research review” to “non-specific colitis”.

    I have not heard Dr. Wakefield’s detailed explanations nor read his book. I did hear Dr. Wakefield’s explanation in a video clip this week. He stated that this was one of Deer’s misrepresentations that Deer used to imply fraud, one that would only convince an ignorant, untrained observer. Executing science rigorously, Wakefield says researchers sent samples blinded to pathologists for independent assessment after an initial unblinded assessment. That independent blinded assessment was reported in the study. The blinded assessment did not always agree with the initial unblinded histopathology reports. Construing this as fraudulently changing data is despicable. It does not speak well of Deer or those who quote him.

    If in fact this is what Deer said in his report, writers on this site should be outraged.

  • Joel, you made the following comments in your last posting

    “Let’s not look at Wakefield’s verbal comments outside of his published papers as terribly significant, either.”

    and

    “I did hear Dr. Wakefield’s explanation in a video clip this week. He stated that this was one of Deer’s misrepresentations that Deer used to imply fraud, one that would only convince an ignorant, untrained observer.”

    Notice the inconsistency in what you expect from other posters compared to yourself?

    also you wrote

    “I have had a lot of lectures on this site about etiquette and tone. When I come to a web site using words like liar and crook I don’t perceive a gentile atmosphere or much rigor.”

    I don’t remember many lectures just a couple of points made by the author of the blog and some comments about some of the things you have said. Also looking back I think the actually phrase used regarding Wakefield was “apparently a crook and a liar”.
    If there is proof to show that someone is a liar or a crook then such terms would be appropriate, though they are not terms I would be inclined to use myself. There is, as far as I can see, evidence that Wakefield engaged in unethical and flawed research, research that has been since been used by others to promote an anti-vaccine movement. At no time have I seen any evidence that Wakefield has attempted to point out to such anti-vaccine activists that his work does not show a scientifically supported link between autism and the MMR vaccine.

    Your perception that this is not a “gentile” forum intrigues me. Could you perhaps point me in the direction of a forum you consider to be more gentile? Having explored a number of blogs over the past few years, I have not found many as civil as this one.
    To give you an example of less gentile sites to this you might want to visit pharyngula or read the comments below any of the online major “newspapers”, or various political sites.

  • I was hoping I did not have to wade through a twelve year history to understand why Dr. Wakefield is being regarded as guilty of fraud.

    My impression is that you don’t/won’t/can’t read anything! You keep telling us you won’t. You’re not going to be able to determine the truth without some reading, and if that’s what you genuinely want, you’ll just have to do it. It does suggest to me that you are not interested in the truth.

    It’s hyperbolic to write “a twelve year history”: the period being looked at is (much) shorter.

    Let’s not look at Wakefield’s verbal comments outside of his published papers as terribly significant, either.

    Put in their context, they do show something of the wider picture of what he was doing. Besides, aren’t you doing what you say you won’t when you write:

    “I have not heard Dr. Wakefield’s detailed explanations nor read his book. I did hear Dr. Wakefield’s explanation in a video clip this week. He stated that […]”

    Isn’t that a verbal comment outside of his published papers?

    I’ve seen this angle—dismissing his direct comments—as irrelevant from Wakefield supporters elsewhere. Bear in mind his motivations and actions are wider than the one paper and it‘s invariably better to view things in their full context.

    I have had a lot of lectures on this site about etiquette and tone. When I come to a web site using words like liar and crook I don’t perceive a gentile atmosphere or much rigor. It gets tedious to precede each statement with, “It is my impression that…”. But, sure, happy to oblige. I expect the same.

    Don’t debate moderation decisions, please. Just lift your game without this sort of thing.

    People have papers rejected all the time. I don’t think that means much.

    The reasons why they are rejected always matter.

    Everything Wakefield and his cosigners did seems well within the boundaries of typical diagnosis.

    Based on what? This is just your words. As I tried to suggest: offer substance. I would think you lack the skills to make this judgement and the GMC, say, would have these skills. Likewise, the board of the Royal Free who let Wakefield go would be better-placed to make this call.

  • who gave Deer access to medical records without patient or parental permission.
    The records were placed on record in open court during the GMC hearing. They are thus a matter of public record & anyone (including Brian Deer) is able to access them.

    He stated that this was one of Deer’s misrepresentations that Deer used to imply fraud, one that would only convince an ignorant, untrained observer.
    So we will doubtless be seeing Wakefield suing Deer for libel? And the BMJ, since they have also described Wakefield’s work as fraudulent?

    On the issue of fraud, one of the sections from the BMJ report (which I quoted in my last post) says:
    The Lancet paper was a case series of 12 child patients; it reported a proposed “new syndrome” of enterocolitis and regressive autism and associated this with MMR as an “apparent precipitating event.” But in fact:
    Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism
    Despite the paper claiming that all 12 children were “previously normal,” five had documented pre-existing developmental concerns
    Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination

    Misrepresenting data to match a particular viewpoint is regarded in the scientific community as fraud. So: claiming that children were autistic when they were not = scientific fraud. Stating that all children were normal prior to vaccination when in fact 5 had existing, documented developmental concerns = scientific fraud. Reporting that children developed ASD symptoms days after vaccination when in fact their records show a lapse of some months between the 2 = scientific fraud.

    On the histopathology work:
    hospital’s pathology service repeatedly judged colonic biopsy samples to be unexceptional, and thought bowel disease was a possibility in only one child
    In almost all cases, histopathologists reported a typical mix of cell types and numbers in the biopsy specimens. “Large bowel-type mucosa within normal histological limits,” said, for example, the report for child 3 in the series. “No evidence of architectural distortion or increase in inflammatory cells in the lamina propria,” said child 4’s.

    The lead pathologist for the Wakefield project, and an author of the now retracted paper, was Susan Davies, now at Addenbrooke’s Hospital, Cambridge. At weekly meetings with paediatricians, the unexceptional results were confirmed.

    For four of the 12 she made additional notes recording the position more bluntly: “no abnormality detected.”
    Unfortunately the original slides are no longer available, which is a bit unusual as they’re normally kept for quite some time. However, it seems that the original histo reports for 11 of the 12 children are noted as normal. It appears that Wakefield subsequently had the slides regraded & that those viewing the slides were scoring them for ‘inflammation’, which is definitely not the same thing as colitis. In other words, the reviewers you mention were not looking for the same thing as the people who originally viewed the slides. Thus, to describe slides showing inflammation as being evidence of colitis is also misrepresenting the results (particularly in light of a 1997 ruling on how to record results by the British Society of Gastroenterology: minimal or mild inflammatory changes =/= colitis & should not be recorded as such).

  • Grant, I resent your statement, “My impression is that you don’t/won’t/can’t read anything!”

    I came to this site looking for a scientific summary of what Wakefield did wrong and why any scientist or medical journal would use the work of an non-expert, popular writer. I am told there is a very long history I need to understand.

    I have not seen anything convincing here as to the science, only the repetition of uncritically accepted references to Brian Deer, a popular writer. I ask for science and I am referred to some guy with a scummy looking website who was commissioned to write for the BMJ. I ask to move the conversation away from Deer. Virtually everyone keeps referring back to him.

    By the way, Deer repeatedly implies he is a staff journalist for the Sunday Times. He is just a free-lance writer whose amateurish work occasionally is purchased by them. There is a huge difference. Why do you, Grant, imply the two positions are virtually the same? Why such umbrage that I would question the integrity of Deer?

    I came to this site neutral. You have strongly given me the impression that Dr. Wakefield is the victim of a despicable political campaign. One that many of you support and that has nothing to do with science. Why the continual campaign to discredit a single scientist over a 12 subject case series published twelve years ago, anyway? That does not sound like science, that is politics.

    I have heard little of Dr. Wakefield’s defense. Now I will.

    I read a lot, Grant. I am buying and reading Wakefield’s book. I would like someone’s best recommendation on a book with a differing view, one that is not just nonscientific blathering by a syncophant.

    While i am doing that ponder this, Deer supporters:

    Wakefield’s reporting of history was well within accepted practice:

    “While a clinical gastroenterologist might consider caecal active inflammation with incipient crypt abscess formation to be normal in children , this is a significant finding to be recorded by pathologists“ “Caution in assessing histopathological opinions.” BMJ Rapid Responses 30 April 2010.

    And Brain Deer lied about contacting all the parent as evidenced by this very recent quote from a parent of one of the subjects:

    “I was not interviewed by Brian Deer. I have appeared in the media representing families of vaccine damaged families and talked about my [child] but never gave out any confidential medical information only what reactions he had after the MMR vaccine. Brian Deer knows medical information that he would only have found in his medical notes and long before the start of the GMC so he cannot state that he got the information from the GMC.” source: http://www.ageofautism.com/2011/01/keeping-anderson-cooper-honest-is-brian-deer-the-fraud.html#more

    Who illegally gave Deer those records?

    And this:

    “Central to the latest claims of journalist Brian Deer published in the British Medical Journal 6th January is the allegation that Dr Wakefield “altered numerous facts about the patients’ medical histories in order to support his claim to have identified a new syndrome.“

    What Deer and the BMJ fail to point out is that not only did Wakefield not produce the results, which were the work of a team of 12 other specialists at the Royal Free Hospital, London, England but that it was not possible for Wakefield or anyone else to falsify the prior clinical records of the children because no one at the Royal Free Hospital London had them nor is it normal practice for them to have had them. ” source http://www.ageofautism.com/2011/01/the-big-lie-wakefield-lancet-paper-alleged-fraud-was-not-possible-for-anyone-to-commit.html

  • Who illegally gave Deer those records?
    Joel, I have already answered this one for you on another thread. It would appear that you haven’t read it. The patient files were read into the public record in open court during the GMC hearing that saw Andrew Wakefield struck off. They are thus available to Brian Deer or anyone else who cares to read them. There is no conspiracy here, despite the fact that your question suggests that you are looking for one.

    I would not rely on material ‘published’ on AgeofAutism. You should also refer to my previous comment (other thread) on the differences between readings of the childrens’ histology slides. Wakefield did in fact ‘alter facts’ about the patients’ histories – please note that this is not the same as altering the records – stating, for example, that children were developmentally normal prior to vaccination when in fact their records did not support this statement.

  • Erm, Joel, I followed that with “You keep telling us you won’t.” I feel you’ve quote-mined me here, or at best are missing/reworking the tone of what I wrote. (There is an element of jest in it: lighten up 😉 )

    I ask for science

    You have already been given some.

    I came to this site neutral.

    Your articles and commentary elsewhere show you have a bias, I think 😉

    You have strongly given me the impression that Dr. Wakefield is the victim of a despicable political campaign.

    I pointed out quite early on in this thread that’s very unlikely.

    Why the continual campaign to discredit a single scientist over a 12 subject case series published twelve years ago, anyway?

    You’ve left out what is actually being done – exposing (potential) fraud. As I pointed out earlier, I’ve seen this elsewhere, this trying to make it exclusively “about” the paper, denying looking at the wider context if falls in. It’s also already been pointed out why. (You’re circling here.)

    I have heard little of Dr. Wakefield’s defense.

    Please stand corrected: I did actually provide links to some the updates in the article.

    I would like someone’s best recommendation on a book with a differing view, one that is not just nonscientific blathering by a syncophant.

    Notice how you set up means to dismiss what you don’t like or don’t want to read? For example, if I pointed to Offit or Mnookin’s recent books (not suggesting these, just picking them up as example off the top of my head), I suspect you’ll find some arbitrary excuse to dismiss them, if what you write here is anything to go by.

    If other reader’s aren’t familiar with it, Mnookin’s book is The Panic Virus.

    While i am doing that ponder this, Deer supporters:

    Straw-man, we’re not “Deer supporters”. Like most scientists, we aren’t interested in the message, not the messenger.

    And Brain Deer lied about contacting all the parent

    You might want to substantiate your claim with a quote and link of Deer claiming he contacted all the parents. (I’ve seen him claiming to only have contacted some in interviews, including one I linked in my article.)

    Who illegally gave Deer those records?

    Didn’t Alison already explain this? (And did you read that?)

    You’d do well to bear in mind that Age of Autism is well-known to work from one point of view, so it’s not an unbiased source.

    Your final quote plays word games: I’ll let you have a go at seeing the problem first, as an exercise in the spirit of “teach a man to fish” 😉

    Just to be clear: my winks are not sarcastic, but trying to lighten you up, esp. re your opening of your reply.

  • Wakefield’s reporting of history was well within accepted practice:

    “While a clinical gastroenterologist might consider caecal active inflammation with incipient crypt abscess formation to be normal in children , this is a significant finding to be recorded by pathologists“ “Caution in assessing histopathological opinions.” BMJ Rapid Responses 30 April 2010.

    This is irrelevant given that the original histopathology reports did not identify such features – you may remember that I’ve already provided this information earlier in the comments thread: hospital’s pathology service repeatedly judged colonic biopsy samples to be unexceptional, and thought bowel disease was a possibility in only one child
    In almost all cases, histopathologists reported a typical mix of cell types and numbers in the biopsy specimens. “Large bowel-type mucosa within normal histological limits,” said, for example, the report for child 3 in the series. “No evidence of architectural distortion or increase in inflammatory cells in the lamina propria,” said child 4’s.

  • FBB,

    It’s a bit hard to see, eh? The first time I went past fifty comments, it took me a moment to spot it.

    If you look *immediately* above the ‘Leave a Reply’, in deep red colour, just above the textbox to enter a comment, you will see a link ‘Older Comments’.

    Another trick is to search the contents of the page using the web browser (ctrl-F, or on a Mac command-F) for ‘older comments’. You’ll want to ignore the ‘older comments’ phrase in this comment! :-)

    Hope this helps. If you’re still stuck, let me know.

    [Edited for typo.]

  • I did not come here to debate minute details, but I am glad Allision has focused on one point.

    How do you want it Grant and Allison? Are we we having a light-hearted chat here or are we picking at minutiae with utmost scientific rigor? I can be just as funny as hell. I can call names, bully, use disgusting language, pick your weapons, old buddies. But I refuse do that. I do not think anyone should deal with anything to do with autism or vaccines in anything but the most serious discourse. To do otherwise is repulsive.

    My words get parsed here. I say we should not use Wakefield’s words from an interview on a general subject. Then when I refer to a verbal comment he made directly on point for the 1998 Lancet paper, I am chastised. We argue about the meaning of bullying. Grant, you endorsed Anderson Cooper’s bullying of Dr. Wakefield in a video clip. Cooper would not even let Dr. Wakefield finish his sentences. My impression was that by the end of that interview, Mr. Cooper had a look on his face like, who fed me all these bad talking points? I look like a jerk here. Same with Sanjay Gupta or whoever that TV doctor is.

    That was just an impression old blokes. Go for it. Hit me. Use sarcasm, a or sudden mathematical logically rigor to defend the estimable Brian Deer. Then go back to your childish bullying. Have it both ways. Fun!

    My motives are speculated upon. I don’t have any except I think professional scientists are not doing their job. I am not impressed with what they did to inform the question of whether MMR increases the chance of the development of autism.

    Somebody asked earlier if I thought Wakefield was being bullied. That is too mild a word. Until convinced otherwise it seems to me he has been abused, persecuted, horribly mistreated.

    Don’t get upset old blokes! Tell me soon, Grant, whether you like the light-hearted thing.

    So give me the name of the book to read, Grant. And, Allison, let’s pick apart the gastroenterology characterization of the Lancet 12 and see if it was fraudulent. Bear in mind I have other things to do. It may take some time.

    i don’t know who either of you are or your background. I guess I prefer to keep it that way so the discourse is not identity-based. No, skip that. Tell me if you are professional scientists.

    If you are, perhaps you understand the paradox. Scientists, who are generally so concerned with credentials and reliable sources are the work of someone who does not have a CV on his website, or even a comment as to whether he has completed grade school. It seems Deer is financially compromised up to his eyeballs. Yet he is the darling of the science crowd. If you support these politics, just remember, any politics used against Wakefield to try to silence him could be used against you.

    Allison, I am more impressed by the level of discourse at Age of Autism than I am at what I see here. I am interested in determining whether Wakefield did anything fraudulent in reporting his gastroenterology result. No, I do not uncritically accept the opinion of Brian Deer.

    Grant, give me a great book to read. You pick.

  • In previous comment change “Scientists, who are generally so concerned with credentials and reliable sources are the work of someone who does not have a CV on his website, or even a comment as to whether he has completed grade school.”

    to

    Scientists, who are generally so concerned with credentials and reliable sources are using the work of someone who does not have a CV on his website, or even a comment as to whether he has completed grade school.

    Sorry for the error. Is there a Preview button anywhere?

  • I have new information. I did not have to read much to find it. Allison you are wrong. Terribly wrong.

    When I quoted BMJ Rapid Responses in an earlier comment, I had no idea who the speaker was. You can believe me or not. Doesn’t matter.

    Now, I find the complete quote at http://childhealthsafety.wordpress.com/2011/01/08/the-big-lie-brian-deer-dr-wakefield-the-british-medical-journal/

    (Grant, use that as my example of a site with a more civil tone than I find here.)

    The writer in BMJ Rapid responses was a direct participant in the Wakefield 1998 Lancet study:

    Additionally, one of the witnesses in the GMC proceedings against Dr Wakefield writing to the British Medical Journal confirmed the validity of the histopathology on which the paper was based and illustrated how Sunday Times journalist Brian Deer had misrepresented her evidence. Dr Susan E Davies, Consultant Histopathologist, Addenbrooke’s Hospital, Cambridge stated in the British Medical Journal regarding a BMJ article by Brian Deer that:

    There is some misrepresentation …. and lack of understanding of the process in studies involving histopathology.” and that there were significant findings “While a clinical gastroenterologist might consider caecal active inflammation with incipient crypt abscess formation to be normal in children (1), this is a significant finding to be recorded by pathologists“ “Caution in assessing histopathological opinions.” BMJ Rapid Responses 30 April 2010.

    I am interested in your reply. I find few people at this site willing to apologize for their mistakes. It reduces your credibility.

  • I tried to use html to set off the quote in an earlier post. Moderator, please delete earlier one, if convenient and possible.

    I have new information. I did not have to read much to find it, Grant. Allison you are wrong. Terribly wrong.

    When I quoted BMJ Rapid Responses in an earlier comment, I had no idea who the speaker was. You can believe me or not. Doesn’t matter.

    Now, I find the complete quote at http://childhealthsafety.wordpress.com/2011/01/08/the-big-lie-brian-deer-dr-wakefield-the-british-medical-journal/

    (Grant, use that as my example of a site with a more civil tone than I find here.)

    QUOTE FROM REFERENCED WEBSITE:

    The writer in BMJ Rapid responses was a direct participant in the Wakefield 1998 Lancet study:

    Additionally, one of the witnesses in the GMC proceedings against Dr Wakefield writing to the British Medical Journal confirmed the validity of the histopathology on which the paper was based and illustrated how Sunday Times journalist Brian Deer had misrepresented her evidence. Dr Susan E Davies, Consultant Histopathologist, Addenbrooke’s Hospital, Cambridge stated in the British Medical Journal regarding a BMJ article by Brian Deer that:

    There is some misrepresentation …. and lack of understanding of the process in studies involving histopathology.” and that there were significant findings “While a clinical gastroenterologist might consider caecal active inflammation with incipient crypt abscess formation to be normal in children (1), this is a significant finding to be recorded by pathologists“ “Caution in assessing histopathological opinions.” BMJ Rapid Responses 30 April 2010.

    ENDQUOTE

    I am interested in your reply, Allison. I find few people at this site willing to apologize for their mistakes. It reduces a writer’s credibility.

  • I am not impressed with what they did to inform the question of whether MMR increases the chance of the development of autism.
    I previously provided you with the details of a research paper that found no evidence of a link between MMR (or any other vaccine) & the development of autism. I notice that you have not made any further reference to this. There are numerous other studies confirming these results.

    Allison, I am more impressed by the level of discourse at Age of Autism than I am at what I see here.
    I need a new irony meter. AoA is extremely heavily moderated; I don’t know anyone with views contrary to theirs who is able to post on that site. You might compare that with the fact that you are able to freely comment here, without being subjected to personal attacks or abuse (this is one example: http://www.ageofautism.com/2009/02/dr-david-gorski-and-his-merry-band-of-idiots-dont-like-full-page-ads.html) before you start accusing commenters here of a lack of civility.

    On the gastroenterology reports – you appear to have avoided answering my previous comment on this.

    And yes, we are all professional scientists; we know how good science is done & how it’s reported. What’s your own background in this area?

  • Allison, I have a B.A. Who cares? I come here as a concerned citizen inquiring as to whether scientists are doing their job. Is Farmer Baby Boomer a professional scientist? Or, just you and Grant? Be specific.

    We may be out of sync here. You said my quote on gastroenterology reports was irrelevant. Then I found I accidentally quote THE pathologist who testified at Dr. Wakefield’s GMC hearing. So, I will assert my quote was relevant. Your reply?

  • am not impressed with what they did to inform the question of whether MMR increases the chance of the development of autism.
    I previously provided you with the details of a research paper that found no evidence of a link between MMR (or any other vaccine) & the development of autism. I notice that you have not made any further reference to this. There are numerous other studies confirming these results.

    Allison, I am more impressed by the level of discourse at Age of Autism than I am at what I see here.
    I need a new irony meter. AoA is extremely heavily moderated; I don’t know anyone with views contrary to theirs who is able to post on that site. You might compare that with the fact that you are able to freely comment here, without being subjected to personal attacks or abuse (this is one example: http://www.ageofautism.com/2009/02/dr-david-gorski-and-his-merry-band-of-idiots-dont-like-full-page-ads.html) before you start accusing commenters here of a lack of civility.

    Before we start moving goalposts around (credentials of commenters as well as writers now), let’s have your responses to those two points.

  • Joel,

    Just present substance, please. Games re “tone”, sniping remarks, etc., are childish.

    I try keep the tone of comments such that those you are less familiar with blogs feel comfortable to join in. This includes discouraging a whole gamut of things. Bullying, rudeness, personal attacks, generally trying to dominate the comments, etc. It’s a subjective call, of course, but it’s my call to make.

    Unlike (say) Age of Autism, I don’t block contrary views or people posting links, etc. I do, however, object when I consider the tone or manner people act poisons the atmosphere for others.

    I’ll tolerate a certain amount of nonsense, particularly on more controversial subjects, but not persistent efforts after the person has been asked by me to lift their game.

    Given that, strike one. Three strikes and I’ll delete further comments from you on this comment thread.

    You’re welcome to comment, just present substance without the childish (IMO) gamesmanship and you’ll be fine. Most people seem to be able to 😉

    “i don’t know who either of you are or your background. I guess I prefer to keep it that way so the discourse is not identity-based. No, skip that. Tell me if you are professional scientists.”

    Blogs have ‘About’ sections, as I am sure you know.

    Putting all this aside:
    – Offering a link is not endorsing the content.
    – It is not the credentials that manner in the end, it is the soundness of the evidence. As I pointed out earlier scientists deal with the message (evidence), not the messenger (who presented it). When considered that way, pointing at titles (‘scientists’, etc.) is just a variant of your previous pointing at Deer for being a journalist. It’s focusing on the messenger, not the message.

  • “Allison, I have a B.A. Who cares? I come here as a concerned citizen inquiring as to whether scientists are doing their job. Is Farmer Baby Boomer a professional scientist? Or, just you and Grant? Be specific.”

    My experience of sciblogs is that all of the bloggers are happy for comments from anyone, scientist or layperson, so long as they are are of a scientific nature.
    Given that you keep ragging on Brian Deer because you consider him to be a layman with regards to science strikes me as hypocritical.
    Most of the contributors here have pointed out repeatedly the flaws and unethical methods in Wakefields research, yet you ignore this. You do not attempt to debate these facts, instead you completely ignore them, typically raising your “concerns” a day later, as if they are new. Rather than debate the facts you make spurious complaints about people being using researchers first names and complaining about the tone. You then suggest that you are “more impressed by the level of discourse at Age of Autism than I am at what I see here”, a site which almost immediately blocks views contrary to it’s beliefs and where quite venomous comments are made regarding its opponents – far ruder than the “apparently a crook and a liar” comment with which complained about.
    You say that you “did not come here to debate minute details”, however it is my observation that this is all you do. You ignore the substantial evidence against Wakefield while hovering around the periphery of the argument looking for minor errors and irrelevancies.
    These are the sort of tactics I have seen utiliised again and again by those who have a firm anti-science agenda.
    If you do have an interest in science as you have previously claimed might I suggest that you:
    1) Actually read the comments of other posters and respond to their questions. Others have afforded you the same courtesy.
    2) Read a bit more about the basic science behind vaccines and the MMR vaccines.

  • I have written nothing here I consider a game. Nothing intended as sniping. Nothing I feel has an objectional tone. I am quite sorry that Grant perceives anything that way. I will keep all comments serious and factual. I expect all commenters to do likewise.

  • “That was just an impression old blokes. Go for it. Hit me. Use sarcasm, a or sudden mathematical logically rigor to defend the estimable Brian Deer. Then go back to your childish bullying. Have it both ways. Fun!”

    Talk about the pot calling the refrigerator black! That has got to be the biggest strawman I have seen of late. The discourse so far has been fairly free of sarcasm or childish bullying. At least, that is, until you wrote this sarcastic post.

    Also, just in case you are unfamiliar with the term “bloke”, it is typically used to refer to men. Using it does a disservice to Alison and Siouxsie and any other female commenters.
    And, as someone concerned about the proper use of peoples names you might observe that Alison spells her name with one l not two.

  • Joel, instead of answering back, just get on with. (I did ask you before not to answer back on moderation decisions and you certainly don’t get to dictate terms.)

    You’re sitting on strike two.

    If you honestly want to comment, then fine, but I suggest you just get on with it. If you have no substance to offer, then I suggest you move along as you’re not contributing much to the topic.

  • Michael, I entirely reject any and all accusations and assumptions you make. This debate is not about me, in any case.

    Now, to the matter at hand:

    1. I was asked to be specific.
    2. I found a quote that seemed spot on about the vagaries of gastrointestinal evaluation.
    3. Allison tells me it is irrelevant.
    4. In subsequent reading I find the quote I provided came from the pathologist testifying at Dr. Wakefield’s GMC hearing, so it does appear quite relevant.

    This may sound like a trick, but it is not. You do not need to believe me when I say I did not know the ultimate source of my first quote, my basic concern still needs to be addressed.

    I would greatly appreciate anything anyone could contribute to this discussion. For the aid of the new reader, note that I have yet to see any evidence I find convincing that Dr. Wakefield did anything fraudulent.

  • Grant, I am sorry. The posts got out of sync. I did not see your intervening message. If my response to Michael is inappropriate, I apologize to everyone concerned.

  • I have read the paper that Alison referred me to:

    PEDIATRICS Vol. 110 No. 5 November 2002, pp. 957-963

    Neurologic Disorders After Measles-Mumps-Rubella Vaccination
    Annamari Mäkelä, MD*, J. Pekka Nuorti, MD{ddagger}, Heikki Peltola, MD*

    It seems that paper has a striking flaw. Autism is a condition that typically does nor require hospitalization. Would this study have measured resulting cases of autism with sufficient sensitivity?

  • Allison tells me it is irrelevant

    She explained to you the science of why it’s irrelevant, she didn’t just dismiss it out of hand as you’re making out here.

    A deeper point here is to approach this with on a “who said” basis, as you (Joel) do, is to commit the same “he said, she said” debate fallacy that main-stream media so often commits.

    I keep making this point to you. It’s not about “who said” (or on what platform), it’s about the scientific evidence backing what was said (or lack of it, or evidence against it).

    That is came from a pathologist Wakefield’s lawyers dragged up itself isn’t much either way. The point is if what was said stacks up. Which you haven’t addressed, and have avoided Alison’s explanation…

    I would greatly appreciate anything anyone could contribute to this discussion. For the aid of the new reader, note that I have yet to see any evidence I find convincing that Dr. Wakefield did anything fraudulent.

    Stop trying to rule over the discussion please. Just contribute your part. Others are quite capable of doing their own thing and reading for themselves.

    The posts got out of sync.

    My previous comments were over an hour ago. More likely you are not reading before writing.

  • It seems that paper has a striking flaw. Autism is a condition that typically does nor require hospitalization. Would this study have measured resulting cases of autism with sufficient sensitivity?

    Wasn’t Wakefield’s study (supposed to) collect patients who were referred to hospital? I guess that means you think Wakesfield’s study has a striking flaw… etc.

    Yes, a gentle poke, but because you’re not making sense.

    (To add to that, wasn’t it you that brought up that Wakefield was (supposed to) examine hospital patients?)

  • > I have yet to see any evidence I find convincing

    Joel. You wanted evidence and you were given evidence. NOW you want evidence that you will find convincing. You keep changing the goalposts.

    You have written in a recent post that it is not all about you, but that is what you are making it. You don’t want evidence that has been through a peer-review process by scientists. You don’t want evidence given in court. You appear to want evidence on scientific issues that you can understand and be convinced by. This approach of yours appears to mean that you feel you have licence to reject any evidence from any source that you don’t like the look of, and perpetuate the debate endlessly.

    That is not how science works. What you need to do, broadly, is take the known facts, list them, and build on them to come up with a theory that not only explains all these facts, but is better at doing so than the existing explanation, and ideally enables you to make more accurate predictions of future events than the other scientists can. For example, Einstein theorised that light rays could be bent by gravity. Fourteen years later Eddington proved that Einstein was correct. This convinced scientific doubters that the theory of relativity gave a better explanation of the facts than Newton’s theories.

  • I appreciate everyone who has provided information that has proved useful.

    I am sorry for any confusion I have caused. Grant, my earlier comment was about the paper Allison referred me to:

    Neurologic disorders after measles-mumps-rubella vaccination.
    Mäkelä A, Nuorti JP, Peltola H.
    Pediatrics. 2002 Nov;110(5):957-63.PMID: 12415036

    It seems this paper used as its primary measure of autism, the sum of hospital admissions coded as due to autism.

    My impression is that autism rarely results in autism so the sensitivity of this measure would be severely lacking.

    Is that correct?

    Allison, I wish to understand about Wakefield’s reporting of gastroenterolgy status. Are you saying, that because local hospital evaluations were negative, it was fraudulent for Wakefield to send samples to an independent pathologist?

  • Sorry, please replace earlier post with this: (I am used to comment boxes with a Preview button. I will be more careful in the future.

    I appreciate everyone who has provided information that has proved useful.

    I am sorry for any confusion I have caused. Grant, my earlier comment was about the paper Allison referred me to:

    Neurologic disorders after measles-mumps-rubella vaccination.
    Mäkelä A, Nuorti JP, Peltola H.
    Pediatrics. 2002 Nov;110(5):957-63.PMID: 12415036

    It seems this paper used as its primary measure of autism rate the sum of hospital admissions coded as due to autism.

    My impression is that autism rarely results in hospitalization so the sensitivity of this measure would be severely lacking.

    Is that correct?

    Allison, I wish to understand about Wakefield’s reporting of gastroenterolgy status. Are you saying, that because local hospital evaluations were negative, it was fraudulent for Wakefield to send samples to an independent pathologist?

  • Joel, I’ve already outlined some of the fraudulent aspects of Wakefield’s work in a previous comment in this thread. Of course it is not wrong to ask another set of reviewers to examine slides – provided these reviewers use the same set of criteria as those who first examined the slides. This is not what happened; Wakefield moved the goalposts between reviews.

  • Alison,

    Thank you. As you know I am very new to the 1998 Lancet paper and the controversies.

    May I focus on just one issue? I may have this quite wrong.
    Here is what I understand you to say:

    1. Gastroenterology history was fraudulently reported in the 1998 paper.

    2. Wakfield’s local pathologists or other specialists produced negative evaluations as to gastroenterological diseasse.

    3. Wakefield sent samples, perhaps blinded, to an independent pathologist who found some positive pathologies.

    4. Wakefield only reported the results of the independent pathologist.

    Do I have this right?

  • Grant, my earlier comment was about the paper Allison referred me to

    Obviously: you stated that explicitly the first time around. I replied to you earlier.

    In your latest reply you’ve left out that Wakefield shifted the goalposts as Alison explained earlier.

  • Off-topic, but…

    Picked up this news from the tail-end of the #scio11 (ScienceOnline2011 meeting) twitter stream:

    @ivanoransky (Ivan Oransky)
    Salon retracts 2005 Robert F. Kennedy Jr. piece on alleged autism-vaccine link http://bit.ly/hEJgO2 #scio11

    Long time coming, but interesting news all the same. Lancet did a retraction, now Salon a retraction too.

  • Grant,

    I reread your earlier post where you said:
    QUOTE
    Wasn’t Wakefield’s study (supposed to) collect patients who were referred to hospital? I guess that means you think Wakesfield’s study has a striking flaw… etc.

    Yes, a gentle poke, but because you’re not making sense.
    ENDQUOTE

    I see the point you are trying to make. Why do say I do not make sense?

    It seems we are comparing Wakefield’s 12 subject case study to a 500,000 subject digital record epidemiological study in Finland, right?

    Do you (or any other reader) know this: if the Lancet twelve were admitted to a Finish hospital, how would they have been coded? How consistent was the coding in Finish hospitals for autism when a subject was admitted for another condition?

    Are you, Grant, convinced the Finish study used a measure of autism cases that was sufficiently sensitive?

    I am very new to this. You seem to have been following the MMR autism story for a long time. I would not like to rehash covered ground. Where is the best summary of the science as to why you think typical vaccine schedules are unlikely to be a significant cause of autism? (I hope I do not mischaracterize your position.)

    Also, why do you say Wakefield “dug up” Dr Susan E Davies, Consultant Histopathologist, Addenbrooke’s Hospital, Cambridge? Is she not a valid expert? Was he not expected to present a defense?

    If Wakefield sent blinded samples to a pathologist who found pathology was it wrong to report this? Did we not learn more from this fact? I guess it would be better if he had reported earlier negative evaluations. But, it is hardly fraud to leave this out of 12 subject case series reported on 5 pages. Were not the authors just trying to establish a possibility of a linkage that may deserve further study? I am having trouble understanding how fraud could even be possible in a case series.

    Fraud, to me in a case series would be to invent a subject whole cloth. I guess if Wakefield received some numerical data and changed it, I would consider that fraud, too.

    Is it correct when I read that Wakefield’s coauthors only retracted the Interpretation section of the 1998 Lancet paper? And, to this day, coauthors still completely support all other sections of the paper?

    In the U.S. Justin Radolf blatantily falsified data to get a grant and admitted it, then he repeatedly sued the university (unsuccessfully )to force it to allow him to continue research. Yet he is still allowed to publish, quoted as an authority by newspapers where he criticizes other doctors, and regarded as a reliable researcher. Do you perhaps understand why I am not impressed by the misdeeds of Dr. Wakefield?

    As the Lancet 12 were simply a case series. I would not care if Wakefield picked them out of 100 subjects. I would like to know everything I could about the 12 cases and their similarities. Is there something wrong with that?

  • I would like to know everything I could about the 12 cases and their similarities. Is there something wrong with that?

    No, there isn’t, so let’s have a look at the 12 cases & their similarities, as reported by Wakefield in the Lancet paper and as described in the clinical notes associated with their NHS records. I’d copy-&-paste the actual BMJ table but haven’t the computer skills to do this, so here are the relevant data.

    For each of the 12 individuals, there is information on: a) whether they were diagnosed with ‘regressive autism’; b) whether they were diagnosed with ‘non-specific colitis’; and c) whether the first symptoms occured days after the MMR vaccine (rather than weeks or months).

    For regressive autism, the Lancet paper says that 9 of the 12 had a positive diagnosis. However, the actual NHS records have 6 with ‘no’ on their files & only one with a firm ‘yes’, plus 5 with a ‘?’. If we allow a ‘yes’ for each ‘?’ this gives 6/12 positive for regressive autism, which is being somewhat generous since they could equally well have been negative.

    For non-specific colitis, while the Lancet paper has 11/12 children with this symptom, the actual clinical records say that only 3 of the 12 had this form of bowel inflammation. That’s a big difference.

    As for c), days between vaccination & diagnosis, the Lancet paper tells us that this was the case for 8/12 patients. The clinical records have 10 ‘noes’ ie the intervening time was more than a few days, and two ‘?’, which if you’re being charitable could be scored as ‘yes’. So, 8 ‘positives’ in the paper, but just a possible 2 in the original data. An even bigger difference.

    And, tellingly, a comparison across individuals to see how many had all three symptoms saw the Wakefield paper claiming that this was the case for 6 of the 12 children – but the original clinical records show quite clearly that in fact none of the youngsters had all three.

    It’s hard to see how this could be the result of anything else other than a deliberate attempt to inflate the data in order to support a particular a priori view.

  • “I see the point you are trying to make.”

    Doubt it, or you wouldn’t have to ask:

    “Why do say I do not make sense?”

    given the answer you claim to “see the point” of is that you’ve contradicted yourself.

    Are you, Grant, convinced the Finish study used a measure of autism cases that was sufficiently sensitive?

    I’m not the person who wrote about the Finnish study.

    I am very new to this.

    Anyone with a little effort can learn that you have written anti-medical science statements from quite some time ago and that you claim to be the president of a company “researching and analyzing health care issues”.

    [Aside to readers: His company claims to be “[…] especially concerned with the misuse of scientific method to promote biased and inaccurate views supporting dogmatic views.” Readers can draw their own conclusions, but in my experience this is usually a self-justification to push a position that runs contrary to research findings. (Note the contradiction in the quoted statement.)]

    Where is the best summary of the science as to why you think typical vaccine schedules are unlikely to be a significant cause of autism?

    In many places on internet there are lists of the more than 20 key papers that have investigated this and found no vaccine–autism link. I’m sure a simple search finding these wouldn’t be past someone whose business is—in your own words—“researching and analyzing health care issues”. Ditto for finding a summary that suits your needs. There are the obvious sources any health researcher is familiar with, right? 😉

    (While I’m on this topic, for the sake of readers, I’ve written a blog article listing some of better-known sources of information that might suit readers.)

    [His including the word ‘schedule’ is telling, though, as it’s begging a question. Furthermore it shifts from the particular vaccines in question to schedules. Anyway: research from different countries with different schedules show no autism-vaccine link. (Anti-vaccine proponents often push a “too many vaccines in the schedule” argument or a variant.)]

    If Wakefield sent blinded samples to a pathologist who found pathology was it wrong to report this?

    You’re avoiding the point Alison made earlier. It’s not what the pathologist found per se, it’s what Wakefield asked of the pathologist and how he represented it later. You’ve done this several times.

    If you read Deer’s supplementary data you’d see tables that show what Alison is referring to.

    But, it is hardly fraud to leave this out of 12 subject case series reported on 5 pages.

    That the paper has 12 subject cases or is 5 pages long has nothing to do whether this was a valid thing to do or not. You don’t have to be a health researcher to know that. If he had just one subject and he intentionally misrepresented that subject details, it’d be fraudulent.

    I would suggest you offer reasons why people should consider Wakesfield’s work creditable in the light of what is offered against it. (i.e. constructive discussion, etc.)

  • I would like to thank Allison for her thoughtful reply. Grant, I would not like to turn this into a discussion about me. If I were trying to do anything nefarious, I probably would not use my real name. I really am quite new to questions about anything to do with vaccines, autism, and Andrew Wakefield. I came here to ask questions and learn.

    Would you prefer that I ask questions of Allison only on her blog?

  • Joel,

    My previous reply was to point out some of the logical inconsistencies I see in your statements. (There are more.) That’s not making this “about you”.

    People have responded to you, but you continue to write as if their points hadn’t been made. That’s not discussing a topic.

    I pointed to some logical inconsistencies in what you’ve written. You could address them.

    Alison has repeatedly pointed out to you issues about Wakefield’s presenting of the patient’s status, yet you are still asking after them as if she had not said anything. That’s not discussing the subject.

    No-one is keeping you here. If you don’t like people pointing at your logical inconsistencies, or you don’t want to interact with the points people make to you, or you have nothing positive to contribute supporting your position, then by all means leave: no-one is stopping you.

  • Would you prefer that I ask questions of Allison only on her blog?
    No, because I haven’t written a post on this particular issue & I don’t want to see other threads derailed by you doing so.

  • Grant, When I said “New to this”, I meant the subject of vaccines, autism, and Dr. Wakefield.

    Allison, does “NHS records” refer to other practitioners’ records dated before hospital admission? Did Wakefield or coauthors ever see these records?

    Allision, in the paper you refered me to:

    Neurologic disorders after measles-mumps-rubella vaccination.
    Mäkelä A, Nuorti JP, Peltola H.
    Pediatrics. 2002 Nov;110(5):957-63.PMID: 12415036

    Do you think examining electronic hospital records diagnostic codes indicating autism is a sufficiently sensitive measure for detection of new autism cases subsequent to MMR vaccination?

  • Grant, your original post indicates you would like resources currently applied to studying the question of a possible MMR -autism connection applied instead to studying the genome of those diagnosed with autism.

    I would be interested in a new post explaining how studying autistic individuals’ genomes could prevent future cases or provide treatment for current cases.

    If you are concerned with something I wrote here that is a logical inconsistency, I will try to reply. Just one, please.

  • Do you think examining electronic hospital records diagnostic codes indicating autism is a sufficiently sensitive measure for detection of new autism cases subsequent to MMR vaccination?

    You’ve shifted your position here several times, but have ignored other’s responses to earlier variants.

    More relevant is your larger shifting of goalposts. All of this is immaterial to your original complaint that Wakefield was being targeted, that he might be right, etc. You can’t right his wrongs by trying (badly) to criticise others’ work.

    your original post indicates you would like resources currently applied to studying the question of a possible MMR -autism connection applied instead to studying the genome of those diagnosed with autism.

    I didn’t write or ‘indicate’ quite that. (I am not going to elaborate.) I do think that it’s a waste of funds and time looking further at a MMR vaccine-autism link as I did write: it’s been examined throughly and shown no link.

    I would be interested in a new post explaining how studying autistic individuals’ genomes could prevent future cases or provide treatment for current cases.

    I won’t be writing for you. (For other readers—assuming anyone else is still reading this!—I’m open to writing to other’s enquiries.)

    I’ve previously written on the non-association of “mercury” and autism and one of the many genomic studies on autism (looking in this case at parent of origin effects). You can find them in the archives.

    If you are concerned with something I wrote here that is a logical inconsistency, I will try to reply. Just one, please.

    Trolling won’t lead me. I’ve already shown you quite a few and you haven’t acknowledged them.

    As this is clearly not a discussion, I have no interest in taking further questions or replies from you addressed to me. You may wish to read Alison’s latest post and compare your approach with what’s on the flowchart:

    http://sciblogs.co.nz/bioblog/2011/01/20/rules-of-rational-debate/

  • I’ll jump in for Grant (just passing by between student appointments): there are now a large number of good-quality studies that show no relatiionship between the MMR vaccine & autism. The ‘study’ on which claims of a link were based has now been thoroughly discredited, as has been explained at some length in this thread. There seems very little point in continuing to throw money into this particular bucket.

    There is, however, some evidence that genetics plays a role in the development of ASD. It’s a red herring to suggest that this will prevent future cases but data coming out of these studies could well make it easier to predict the likelihood of autism in particular families, for example.

    Wakefield, as a hospital consultant, would have seen the children’s records. They would have been provided to him when the cases were referred to him & there would be absolutely no excuse for someone in his position not to have read them prior to seeing the children for the first time.

    Do you think examining electronic hospital records diagnostic codes indicating autism is a sufficiently sensitive measure for detection of new autism cases subsequent to MMR vaccination?
    The ‘codes’ are electronic; the diagnoses must still be made by an individual, who then does the coding. And why ‘subsequent to MMR vaccination’? This suggests an attempt to continue to infer a link when all the evidence shows that none exists.

    Joel, you might like to read my own latest post on rules for debating a particular issue :)

  • ooops, I see Grant got in ahead of me while I was distracted…

    I’m sneaky 😉 (JK)

    [While] The ‘codes’ are electronic; the diagnoses must still be made by an individual

    Agreed—I originally wrote something very similar then decided I’m tired of this not-a-discussion.

    There is, however, some evidence that genetics plays a role in the development of ASD. It’s a red herring to suggest that this will prevent future cases but data coming out of these studies could well make it easier to predict the likelihood of autism in particular families, for example.

    Autism has one of the highest heritability scores of common neurological disorders (~0.9), indicating there should to be a strong genetic component. Genetic studies may not directly lead to treatments, but they can point the way to treatments. Another use is to determine the precise underlying cause and use this to guide treatment. Just for fun: there is in fact some work exploring directly treating some disorders by shutting specific genes down, etc. I might write about this at some point as this work relates with some of my own research interests. (In a small way my Ph.D. work is a player in early stages of this line of work, I still (try!) follow where this is going, and it relates to my broader interests in chromatin & epigenetics.)

  • BMJ continues to publish more. In fact there’s several articles on the Wakesfield saga released last week, covering a variety of aspects. (I may present these more fully as a new blog post; I’m just quickly putting the links on the off-hand that someone is still following this thread.) All articles are open-access.

    Brian Deer’s latest feature (18th Jan):

    Secrets of the MMR scare: The Lancet’s two days to bury bad news

    An editorial (18th Jan):

    Assuring research integrity in the wake of Wakefield

    A Views & Reviews article (18th Jan):

    Personal View : How campaigners and the media push bad science

    And more commentary on 19th Jan:

    Institutional and editorial misconduct in the MMR scare (By BMJ editor Fiona Godlee)

    MMR and scientific fraud: Is research safe in their hands?

  • In the estimable company of Richard Gage (9/11 conspiracy nutjob) and Lord Monckton (batty scientifically illiterate toff). Say no more!

  • I will have to admit to grudging admiration for the Irish antifluoridation lobby’s slogan: ‘Get the F out’. Not bad.

  • It would be ever so polite to say that lot aren’t exactly the finest scientific minds… Hot Topic—one of the other blogs hosted on sciblogs—has written a fair bit about Monckton.

    That antifluoridation slogan has a ring to it, even if the cause it promotes doesn’t. Mind you, you’d think they’d worry some might be tempted to play it back at them with retorts that flesh out the ‘F’ like “yeah, why don’t you?” or “take your own advice”, etc.

  • Yes, I’ve read many of Gareth’s takedowns of Monckton. Heh.
    On the subject of antifluoridation, I went to a talk by their guru Paul Connett at Auckland University a few years back. As far as I remember he had a different cause celebre in those days – dioxins, I think it was. He seemed like a lot of hot air to me. It is not usually a good thing when scientists get estranged from the scientific community and go out on their own as activists. In fact I’m struggling to think of an example when it has been a good thing.

  • Carol,

    “It is not usually a good thing when scientists get estranged from the scientific community and go out on their own as activists.”

    I would suggest that most activists engage in propaganda of one sort or another. In my opinion the moment a scientist uses propaganda rather than facts in her or his arguments she/he no longer deserves the be called a scientist.
    But then perhaps after a long tiring day, I’m being a bit harsh :-)

Site Meter