“Can I get the taxpayers to pay me for this advice?”

Maybe you should apply? :)

They have ‘expert’ witnesses paid by the taxpayers to compile reports and lists of papers.

‘Look, there’s a paper in Prof. XX expert report. Let’s add it to the list.’

Not really hard.

‘look, Dr. YY, we have kid(s) with mitochondrial disfunction who are going to be potential test cases. Do you think you could include that in your report?’

Can I get the taxpayers to pay me for this advice?

“Since Dr. Poling will likely now not be on the stand, who is going to defend his conflict of interest on this paper?”

I already stated I agree with you that from a non-trial perspective, the journal article should list the COI. No debate from me on that point. However, who we blame for this depends entirely on the COI rules for that journal at the time of publication.

Again, I can’t speak for the PSC. However, I can speak from experience, that in a single case alone, finding, correlating and organizing papers is extremely difficult. I can’t imagine the difficulties in reviewing 5000 cases and all sorts of possible variants. How many staff did they have?

Since Dr. Poling will likely now not be on the stand, who is going to defend his conflict of interest on this paper?

The fact that Dr. Poling was actively seeking a claim in Vaccine Court at the time of this paper severely weakens it as evidence, in my view.

The fact that the PSC repeatedly made mistakes in the entry of this paper in their literature list raises a few questions as well. Were they that disinterested in it or were they trying to somehow hide it? The latter seems even less likely than the former.

Do you know the COI guidelines for that journal (at that time)?

WRT to the legal proceeding, I don’t think that’s as big an issue. There is no chance for misunderstanding as almost all cross examinations begin with questions about conflict of interest. The Special masters and defense would have had full access to question him, and they could judge his level of bias. Additionally, everyone in the trial would know the name.

Published in the journal however, it was not obvious at all that he was the father. I certainly didn’t know until I later found out his name.

“Schwartz, first of all, that would be a stated opinion, as opposed to “written definitively”.

Secondly, not to get caught up in semantics, but there is a substantive difference between “There is no evidence of disease…” and “There is evidence of no disease…”. You’re initial comment assumes the latter.”

Fair comments.

“You’ve declared your COI’s in this post. Why didn’t you declare your COI’s in your article in the Journal of Child Neurology — most notably, the fact that you were father to the the subject of the case-study, and party to a pending legal claim involving precisely the issues described in it?”

He hasn’t responded, and I don’t expect he will. He stated in his reply that he did not intend to answer any questions. To my knowledge, he has not addressed this matter publicly. I wonder if he has addressed it with his co-authors.

BTW, I didn’t see any IRB statement either, though I’m not sure to what extent IRB review is required for the sort of retrospective chart review that was described in the paper.

I don’t begrudge the Poling family the award; it was obviously recommended after careful consideration of the facts of the case, and in accordance with the Congressional intent of generosity. I hope it will make their lives a little easier.

Still, scientific and publishing ethics matter, especially when it comes to studies on disabled kids, and material presented as evidence in legal proceedings.

there are a few “hits” in the biomed community on mitochondria. There was a recent paper by Rossingal and Bradstreet on mitochondria. Jill James mentioned mitochondria in passing at the IOM environment and autism conference.

Schwartz—at some level we may be discussing two different things. If Hannah Poling had gone forward as a test case, they certainly would have had to bring up the mitochondrial issue. However, this was not the general strategy of the PSC based on their preparation. How much the mito issue would have been stressed—for Hannah Poling—is anyone’s guess. It certainly would not have helped (as in likely would have hurt) the other two test cases, making one wonder why they would have grouped them together.

Also, there is no evidence that the concession was negotiated. The PSC submitted their initial report on her last fall. The HHS came back with their report, with recommendations for how the case should proceed (as required by law). That was mid Nov. 2007. That was the concession. The PSC had no ability to “negotiate” the concession. The HHS had admitted liability, what was there to negotiate?

Negotiations would be likely in the damages and in the inclusion of the seizure disorder. “Negotiations” might mean different things to different people—I do not imply smoke filled rooms filled with lawyers. Instead, Mr. Shoemaker would have submitted report(s) of what supports Miss Poling would need throughout her life. Issues like what is her life expectancy? At what age does she leave her parent’s medical insurance? Would have been addressed.

Look at all the press releases, DAN! conferences, and interviews, presentations and testimony of plaintiffs and their experts going back to 1999-2000(ACIP, IMFAR, Autism One, DAN!, IACC, CDC hearings, to name a few). Lump ALL those presentations, speeches, public comments, power points together, and someone tell me how many of them even mentioned mito disorder…someone…please.

This fell into Shoemaker’s lap, and now he’s running with it.

Schwartz, first of all, that would be a stated opinion, as opposed to “written definitively”.

Secondly, not to get caught up in semantics, but there is a substantive difference between “There is no evidence of disease…” and “There is evidence of no disease…”. You’re initial comment assumes the latter.

If the mito disfunction is a tranistory problem (as it appears to have been in Hannah) then there would no longer be any evidence of it.

Unless the tests were done at the time of injury, or shortly thereafter, it may be long past any opportunity to gather any evidence of the problem. Additionally, my understanding is that muscle biopsies are quite painful so there has to be good clinical reasons to do them at any point in time.

Do we know when they started negotiating a concession?