For your own good, don’t use that study!

1 Oct

I just read something interesting on the web.  Someone was telling a petitioner in a Vaccine Court trial that she would have a better chance of winning if her expert witness didn’t use a research report by the Geiers.

Was this a blog?  Was this a yahoo group?  Nope, this was a decision on the Vaccine Court’s website.  This was the opinion of Special Master Vowell.

If that name sounds familiar, it’s because she is one of the three Special Masters working on the Autism Omnibus Proceedings.  What exactly did she say?

“I suggested that, in view of the criticisms leveled at Dr. Geier and his research, petitioner would be better served if her expert could opine favorably at the hearing without relying on the cited articles. “

and

“In attempting to assist this petitioner in presenting the strongest possible case for vaccine causation of her illness, I urged her counsel to caution her expert against relying on the Geier articles he cited.”

Ouch.

In case you were wondering, I wasn’t just reading the Vaccine Court decisions for fun.   I was prompted by something that Mark Geier said on NightLine.  Dr. Geier made a comment about “Wining” in vaccine court.

This struck me as a very odd statement.  Petitioners (plaintiffs) win.  Lawyers win.  Expert witnesses?  They can help someone win, but I don’t see them as “winning”.  Besides, there was something in the way he said it.  Something like when a kid says, “of course I did my homework” and you know you have to go check.  So, check I did.

I looked through the published and unpublished decisions and searched for “Geier” in each.  These go back to 1997 for published decisions.   “Decisions” include actual cases as well as pre- and post-trial actions.  The one quoted above is a good example of “pretrial”.  Post-trial Decisions are often about whether everyone should get paid what they billed.  Or, at least, this seems to be the case in more recent times.

Not all Decisions are trials.  Keep in mind, a single trial could have multiple Decisions.  I haven’t tried to group them together by case, I just made a list of all of the ones I could find involving Dr. Mark Geier.

With all that out of the way, what did I find?  There are 31 Decisions posted that involve Dr. Geier.  Of those, three are cases “won” where Dr. Geier was involved.  A further 3 may be considered “mixed” or “neutral”.  Figure that in 80% of the cases, the Petitioner and/or Dr. Geier loses.  I consider that a generous take.  It really is more like 90%.

Let’s look at those “winners”.

1999: The petitioner won the case.  “The court’s decision in this case is not based on Dr. Geier’s testimony, but neither will the court discard his testimony as unreliable.”  Not the most ringing endorsement.

2000: The petitioner won the case.  Dr. Geier submitted an affadavit which was used to “buttress” the case made by the expert witness who actually testified.

2006: Discussion of fees where Dr. Geier’s fees and use is found to be reasonable. ” In the instant case, $1562.50 in expert witness fees for Dr. Mark Geier’s services is reasonable.”

Yes, in the last 10 years, those are the “good ones”.   Not impressive.

I have seen people post that somehow the Special Masters are trying to discredit Dr. Geier because he is so effective.  People seem to imply that his recent stances on mercury and autism caused the Government to try to neutralize Dr. Geier. 

With that in mind I looked to see if the tone of the rejections has changed with time.  I didn’t really see that.  Keep in mind that some of the well known comments about Dr. Geier predate all these decisions.  For example, he was called “intellectually dishonest” way back in 1993!

Here is a sampling of quotes from other decisions through the past 10 years:

1997: Dr. Geier’s opinion, which is in an area outside his expertise, was not persuasive to the court.

1998: The court is unpersuaded by the opinions of Drs. Kinsbourne and Geier.

1999: This conclusion itself effectively renders the rest of Dr. Geier’s theory useless to petitioner in this case.

2002: “First of all, Dr. Geier is wholly unqualified to testify concerning the two major issues in this case”

2003: “Intellectual rigor is missing from Dr. Tornatore’s testimony and the stealth witness Dr. Geier’s submission after trial. ”

2004: “He is however a professional witness in areas for which he has no training, expertise, and experience”

2005: “The Special Master also noted that Dr. Geier’s opinions have been increasingly criticized in other vaccine cases. See Decision at 5. The Special Master identified seven cases in which Special Masters had rejected the expert opinion offered by Dr. Geier because the opinion related to areas outside Dr. Geier’s areas of education, training and experience.”

2006: This was a question of charges.  Dr. Geier charged $29,350.  In the end, they found $8,520 was reasonable.  It was  found that he was (1) not qualified as an expert, (2) charging for work on his own publications and (3) charging for time spent working in a related civil case.

“Since Dr. Geier did not possess the necessary expertise to testify in this case, the Court will reduce his hourly rate from $250.00/hour to $200.00/hour. Petitioner will not be compensated for costs that can be directly attributed to Dr. Geier’s original publications, attorney/lawyer consultations, and physician consultations. Additionally, the work billed for petitioner’s civil cases is not compensable.”

2007: Again Dr. Geier’s payment is cut. 

“For the reasons stated above, the undersigned finds 13.5 hours to be excessive. Dr. Geier  will be compensated for only those hours that are reasonable. Based on the undersigned’s experience with the Vaccine Program, Dr. Geier will be awarded compensation for five hours of  his time which is a reasonable, indeed generous, number of hours for a literature search and review of articles. ”

Again, that is just a sampling,  No attempt was made to be random.  The tone has been increasing against Dr. Geier, though.  As noted in 2005, “The Special Master also noted that Dr. Geier’s opinions have been increasingly criticized in other vaccine cases”.  So it is increasing.  But that is only increasing by going from Bad to Worse. 

You are welcome to go through the decisions and see if I have been quote mining.  One thing you will see is the possible reason why the Special Master has started warning petitioners to avoid Dr. Geier’s studies.  There are statements to the effect of, “If I had known Dr. Geier was useless as an expert witness, I would have hired someone else”.

Sounds like good advice. 

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41 Responses to “For your own good, don’t use that study!”

  1. Ms. Clark October 1, 2007 at 01:30 #

    Thanks, Sullivan. It’s just amazing how bad behavior takes so long to catch up to some people.

  2. Tito Rajarshi Mukhopadhyay October 1, 2007 at 01:49 #

    I can talk about my ‘behaviour’ display. Thought it might give an alternate picture….I wanted to share.

    Mother was embarrassed.
    The limit of embarrassment varies from people to people and situation to situation. Today I was trying to determine the limit of embarrassment, which can be faced. I could not get a very reliable measure yet, although I did some scientific trials to determine and assign a right value to it.
    To find the value I had to choose some kind of action, which can cause embarrassment. So I chose to pick my nose. My previous experience told me that picking nose cannot make any one ignore you for long. Personally I have no problem picking my own nose. After all I would never pick someone else’s nose! And being affected with autism gives me some freedom to perfect my ‘fine motor skills’. Any occupational therapist would aim that for any autistic client.
    I had to do my fine motor skill practice of nose picking first at home when mother was talking over the phone. Mother seemed to get gradually distracted every time she made an eye contact with me. She faintly frowned I think during those ‘every times.’
    Later she gave me a lecture while she sat in her car as we went to the grocery store, warning me to keep my hands inside the pocket…otherwise….
    ‘Otherwise’ happened right when I saw mother turn around to pick some potatoes in the cart. I was quick enough. That is what I call is being ‘alert.’ The moment she turned back to face my side, my hands slid into my pocket. Mother sure suspected something.
    After that, there was a ‘catch me if you can’ game. She deliberately turned around to pretend to look at the carrots and immediately turned back. I was getting good at my alertness too.
    Anyway, a gentleman who was shopping perhaps noticed me and made the funniest face of disgusted rejection. But he was not part of my game.


    Tito Rajarshi Mukhopadhyay

  3. Schwartz October 1, 2007 at 02:32 #

    Sullivan,

    Is Grier still scheduled to testify in the next hearing? I am shocked if that is the case.

  4. Ms. Clark October 1, 2007 at 04:30 #

    Hi, Tito! How are you, besides improving at surreptitious nose picking?

  5. Sullivan October 1, 2007 at 05:43 #

    Schwartz,

    As of July, Dr. Geier was on the list. AutismDiva had a post about it.

    However, I notice that only one “Geier” paper is included in the PSC master list of articles

    That is a Bradstreet First Author paper:
    A Case-Control Study of Mercury Burden in
    Children with Autistic Spectrum Disorders.

    There are three papers dealing with testosterone on the list. Those are Simon Baron-Cohen papers, not Geier papers.

    This begs the question of what Geier is supposed to talk about. It does point out that the PSC must realize that the Geier studies are not worth presenting to the Special Masters.

  6. Sullivan October 1, 2007 at 06:25 #

    It looks like one of the experts (Sander Greenland) is specifically excluding a Geier study due to the criticisms of its scientific merit.

    As an aside–his (Prof. Greenland’s) argument appears to be based on the idea that the regressive autism kids could be “under the radar” (my term) of the epidemological studies. Since they represent a small fraction of the total, they could happen without changing the results of those studies. He also notes the large confidence intervals cited in many studies.

    A second part of the report from the PSC:
    Dr. Deth’s report has a section on treatments:

    If thimerosal does indeed contribute to autism via its ability to cause oxidative stress and impaired methylation, then treatment approaches that reverse these conditions would be clinically beneficial. Indeed, the administration of agents that support methionine synthase activity (e.g. methylcobalamin, betaine or folinic acid) have been reported to reduce bnormal levels of sulfur metabolites in autistic children, in conjunction with improved clinical status (9). Similarly, measures that reduce oxidative stress or remove heavy metals are reported to bring clinical improvement in autism (7,49). Notably, our lab studies show that thimerosal-induced inhibition of methionine synthase activity can be reversed by supplying either methylcobalamin or GSH. While more extensive clinical testing is needed to confirm and extend these early reports, my personal contact with autism families has convinced me that therapies which improve methylation and decrease oxidative stress can benefit a substantial proportion of children with autism. The fact that improvements in an otherwise “untreatable” disorder occur when antidotes to thimerosal are administered is perhaps the most important evidence for its role in causing autism.

    To me the slide from “my personal contact…” to “The fact that…” was not connected well, in my opinion.

    Also, he has left open the idea of chelation as a “successful” treatment.

    Bring on those recovered kids. There’s the proof. No sarcasm here–I’d love to see them.

  7. Tito Rajarshi Mukhopadhyay October 1, 2007 at 12:40 #

    Madam Clark,
    I am glad that you could read. I know that my paragraph is something ‘out of the blue’.
    This site has such heavy information that it becomes difficult for me to communicate here. I feel amused about my autistic state and want to make the most of it. I am a man of a different perspective, you see.
    But sure I learn a whole lot from here.
    Regards
    Tito Rajarshi Mukhopadhyay

  8. Sullivan October 1, 2007 at 16:34 #

    Tito,

    I’m fairly new around here so I haven’t had the chance to “meet” you.

    Thanks for chosing my entry to post your story to.

  9. Kev October 1, 2007 at 16:44 #

    Hi Tito,

    Good to hear from you again – please know you are always welcome here in whichever topic you feel you want to appear.

  10. Joseph October 1, 2007 at 17:07 #

    Sullivan: Tito is one of the autistic children from the book “Strange Son” by Cure Autism Now founder Portia Iversen. I guess he’s all grown up now. It’s cool to have you here, Tito.

  11. Tito Rajarshi Mukhopadhyay October 1, 2007 at 22:18 #

    Thank you so much. I feel honoured.
    I sort of get amused about the researches perhaps because I had gone through some of them and saw how tangentially researches go. And then I realized that its more about publishing a paper than a cause.
    But its really worth reading things which are discussed here because there is so much to learn specially after I have boycotted the scientists ever since. They seem to be so childish in their own levels.
    Science is necessary.
    Scientists (most) are accessories.
    When they cannot find anything,
    They begin claiming.

    Regards,
    Tito Rajarshi Mukhopadhyay

  12. Anne October 2, 2007 at 00:55 #

    Sullivan, thanks for the review. That led me to look at the omnibus docket again, and I see that the petitioners have filed the expert reports that they rely on. It includes one Geier article (the one in JAP(and)S), and Dr. Hornig’s autistic mouse study, too. And Blaxil, Redwood and Bernard’s article in “Medical Hypotheses.” The whole list is here:
    http://www.uscfc.uscourts.gov/OSM/Autism/PSC%20exhibits%20not%20filed.pdf

  13. Anne October 2, 2007 at 00:57 #

    Hi, Tito, you brat. I think that those grad students you were messing with are scratching their heads, wondering “what just happened?”

    You can pick your friends and you can pick your nose …

  14. Ms. Clark October 2, 2007 at 01:34 #

    Anne,

    Which grad students? Is there more to the story?

    Tito! Yes, you are welcome here. 🙂

  15. Sullivan October 2, 2007 at 01:39 #

    Science is necessary.
    Scientists (most) are accessories.

    what a great phrase!

  16. Tito Rajarshi Mukhopadhyay October 2, 2007 at 12:34 #

    Phew! I was wondering whether I said the wrong statement or not.
    About those students! I had to remind them not to own science. Sometimes non-scientists can know more science than scientists.
    Thank you.

    Tito Rajarshi Mukhopadhyay

  17. Anne October 2, 2007 at 14:19 #

    That was an interesting report by Sander Greenland. It’s based on the premise that there are different types of autism, and that a small number of cases are regressive, and a small number of the regressive cases are “clearly regressive,” without earlier developmental abnormalities (citing Werner & Dawson, “Validation of the phenomenon of autistic regression using home videotapes,” Arch Gen Psychiatry 2005; 62:889-95, which I have not read).

    Greenland says that the number for “clearly regressive” autism is so small that it would have been undetectable in existing epidemiological autism studies due to dilution bias. His conclusion is that existing studies therefore have not “ruled out” an association between mercury containing vaccines and the very small number of cases of “clearly regressive” autism. And that is how the PSC is going to demolish Fombonne, et al.

    Hi, Ms. Clark, I was joking with Tito about his posts over on Dr. Merzenich’s blog, where he added to the confusion of some science students who were trying to make him admit that they know more about him than he does.

  18. jypsy October 2, 2007 at 18:01 #

    one of those science students stated:

    “Children aren’t born with it. The age of the start or onset is about 3 years old. Before this, there is normal or typical or full functioning. At the onset, there is an abrupt and profound change.”

    This is one of the most bizarre things I’ve ever heard. Where on earth did they get that “fact”?!

  19. Anne October 3, 2007 at 16:34 #

    Oh, jypsy, don’t even get me started. Anyway, apropos Kev’s outstanding video response to Dr. Kartzinel, the view expressed by these science students is that it doesn’t matter what autistic people think and feel about the way they’re described — if they don’t like it, it’s denial. The arrogance is stunning.

  20. Ms. Clark October 4, 2007 at 04:03 #

    OK, I posted a comment on the Merzenich blog. I bet it doesn’t get past the moderator. I asked if the research done on Tito had had IRB approval. I asked before and as I remember the comment didn’t get past the moderator.

    The level of ignorance about autism the “students” showed was stunning, and after insulting Tito’s intelligence a few times, then they wanted “free samples”. Oh, yeah.

    Well, chuckleheads, get an IRB!

  21. Brian Deer October 4, 2007 at 16:27 #

    Is it just me who, in the literature lists and references (eg Greenland’s) on measles-containing-vaccines, for the next round of US litigation, there is a striking absence of the papers of one Andrew Wakefield?

  22. Matt October 4, 2007 at 16:48 #

    Good point on absence of Wakefield.

    Bringing Wakefield back in would kill the PSC’s attempt to quash Bustin’s testimony.

    That was pretty damning testimony from Bustin. There’s no way to bring Wakefield’s papers back from the grave, so why shoot themselves in the foot?

    At the same time, how do you make the MMR/autism connection without Wakefield?

  23. century October 5, 2007 at 07:40 #

    Good to see Brian Deer is back.

    How’s your personal crusade at the GMC going?

  24. Kev October 5, 2007 at 07:57 #

    Better than Wakefield’s I suspect.

  25. century October 5, 2007 at 08:03 #

    “Better than Wakefield’s I suspect.”

    Can you expand on this?

  26. Kev October 5, 2007 at 08:38 #

    Sure. It means I suspect that whether or not Wakefield gets struck off, the press attention he is getting is merely serving to expose him as knowingly wrong.

    As Brian points out, he has been dropped quicker than a hot potato from the PSC experts. The Bustin testimony during Cedillo basically destroyed the MMR/autism hypothesis and the Chadwick testimony revealed the man himself as dishonest.

    QED: Wakefield’s time in front of a GMC hearing is irrelevant in the context of his scientific accuracy and personal honesty. Both have been neatly established during Cedillo. The only thing left for the GMC to do is either strip him of his right to practice medicine in this country or take pity on him.

  27. culvercitycynic October 5, 2007 at 10:12 #

    Oh, no, not Merzenich the neuro-bigot again. Shoddy scientist, sloppy writer (stop blogging!) and speaks appallingly about those on the spectrum.

  28. Jon October 5, 2007 at 16:09 #

    that thread on Merzenich’s blog is wonderful – non-linear, non-zero sum games and fun 🙂 they know not what they are vs they know not what they do

  29. Brian Deer October 5, 2007 at 18:03 #

    Century: I don’t have a personal crusade. I do a job. Period.

    As for the GMC, I’d be surprised if he wasn’t struck off. The only conceivable basis of how I could imagine him escaping this is if, due to the medical establishment’s protection of doctors in general, and Wakefield (yes, the medical establishment has been protecting Wakefield) in particular, his legal team can wriggle him through some technical loophole.

    You may or may not know, but in the UK, doctors, uniquely, are disciplined against the criminal standard of proof. Unlike with crimes, however, the prosecuting authorities have no powers to seize evidence, or draw inferences from the accused person’s silence. And Wakefield has remained silent, even to the extent of his lawyers asking no questions of key prosecution witnesses, such as Profs David Salisbury and Sir Michael Rutter.

    This has meant that many incriminating documents (including some that I have) are not in evidence.

    That being said, if he gets away with what he did, then something is more seriously wrong with the system than I thought. I don’t think he will, however. And, indeed, the outlook for his two co-accused also looks bleak.

    Their problem will come when they give evidence next year (as their counsel say they will). In this event, I can’t see how, under cross-examination, they can avoid lying on oath. At the core of their case are the claims that they never carried out any research in the first place, the Lancet paper wasn’t about MMR, they didn’t need ethical approval to stick tubes and needles into autistic children, and the children weren’t under their care anyway.

    Sadly, the problems of scheduling so many doctors and lawyers to appear in the same room at the same time means we’ll have to wait till next spring to see how this variant of the Vicky Pollard defence plays out.

  30. century October 5, 2007 at 18:48 #

    Brian

    Will you give every reader here your synopsis (brevity please) of the GMC hearings to date – we know what Martin Walker has said and would like your slant on it.

    Thanx in advance

  31. HN October 6, 2007 at 05:38 #

    Hey, century…

    The GMC has not made the testimonies public. The only information is through admittedly biased sources.

    So if you are so concerned about testimony about Wakefield, how about you going through the already publicly available testimony of Bustin and Chadwick from here:
    ftp://autism.uscfc.uscourts.gov/autism/index.html

    Now, please hold your questions on our opinons on the GMC hearings until the transcripts are made public. Not filtered through some orgainization or even through Mr. Deer.

    Can you try to be patient?

  32. century October 7, 2007 at 08:02 #

    Brian doesn’t need you to answer for him. And no, I can’t be patient – it’s too much fun because Brian just won’t do it.

    The reason Wakefield et al are before the GMC is totally due to Brian’s personal crusade – not one parent/autistic child has made a complaint about the 3 in question.

    Only 2 observers have been at the hearings practically every day – Brian and Martin Walker, and 1 has written an account and the other hasn’t. Is there no positive spin Brian can put on it?

    Brian continues on certain blogs with insinuendo.

    “This has meant that many incriminating documents (including some that I have) are not in evidence.”

    Publish them Brian – after all you obtained them under the FOI, so they are in the public domain.

    “Sadly, the problems of scheduling so many doctors and lawyers to appear in the same room at the same time means we’ll have to wait till next spring to see how this variant of the Vicky Pollard defence plays out.”

    Prosecution ploy? Who knows?

  33. Kev October 7, 2007 at 08:17 #

    The reason Wakefield et al are before the GMC is because they have a case to answer. And when the transcripts/judgements are released we’ll all know how it went. Until then you’re just sounding off. Feel free to carry on, but please don’t think that means anyone owes you anything.

  34. century October 7, 2007 at 16:52 #

    Does Brian need you to answer for him?

    Go on Brian, tell us your take on the hearings so far.

    You might even find it cathartic 😉

  35. Kev October 7, 2007 at 17:05 #

    Century, why do you continually do this? If you have a point to make, make it. If you don’t then stop carrying on like a giggly pre-teen in a playground.

  36. century October 7, 2007 at 17:12 #

    My point has been made – you know it, Brian knows it.

  37. Kev October 7, 2007 at 19:24 #

    No century, I don’t know it. If I knew it I wouldn’t be asking. What you’ve done so far is asked if someone will answer a question and then pretended the lack of an answer is significant. You do this every single time you turn up here. Its getting really, really old. I want people to contribute something of substance Century, not try and force meaning into silence.

  38. century October 7, 2007 at 20:45 #

    What-ever or

    Ho-hum

  39. Brian Deer October 8, 2007 at 12:47 #

    Kev,

    The fault is mine. I didn’t realize that “century” was one of the cranks who lurk around this topic. They emptionally feed off these kind of interactions because they have nothing else. Therefore, I wouldn’t knowingly address anything from them whatseoever.

    Nevertheless, if he makes a £500 donation via paypal to your website, I’ll take a day out of my schedule to write an overview of the GMC hearing. Otherwise, I don’t have the time.

    For free, I’ll say that, among other things, the GMC’s lawyers have done a good job in proving my investigation to the criminal standard of evidence, bizarrely still required for doctors’ disciplinary purposes. This is more than I ever needed, or will ever need, to do.

    The summary to date, as always, is at http://briandeer.com/lancet-summary.htm

  40. century October 8, 2007 at 19:57 #

    “The summary to date, as always, is at http://briandeer.com/lancet-summary.htm

    404 error – file not found

    Broken link – broken journalist?

  41. original cali biomed xprt October 8, 2007 at 20:09 #

    this one, perhaps?

    http://briandeer.com/mmr/lancet-summary.htm

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