Autism Omnibus and shrinking hypotheses

13 May

The number of people who have made confident assertions about thiomersal causing autism over the last four years or so is astounding.

It’s now 2005…..[W]e should see fewer cases entering the system this year than we did last year.

– David Kirby

if the total number of 3-5 year olds in the California DDS system has not declined by 2007, that would deal a severe blow to the autism-thimerosal hypothesis… cases among 3-5 year olds, not changes in the rate of increase is the right measure.

– David Kirby

“Late 2006 should be the first time that rates go down” said Handley. “If they don’t, our. hypothesis will need to be reexamined.”

– JB Handley

…I would like to make a virtual wager that within the next 18-24 months scientific evidence will make the thimerosal-autism link a near certainty.

Richard Deth, March 22, 2006.

All these statements have one thing in common, they promote the idea that mercury (thiomersal in particular) causes autism in either all, or the vast majority of cases.

However, listening to the Autism Omnibus yesterday provided a very interesting change from this perspective:

In some kids, there’s enough of it that it sets off this chronic neuroinflammatory pattern that can lead to regressive autism,” said attorney Mike Williams.


Note the new language: ‘some kids’….’regressive autism’…..’can lead’.

It seems the days of ‘all autism is mercury poisoning’ are long gone.

Petitioners presented a very interesting expert witness yesterday – a Dr Sander Greenland from UCLA who is a Professor of Epidemiology.

Dr Greenland argued some strange facts for the PSC but completely in line with this new tack that I can’t even remember being argued in the Cedillo hearing (thiomersal may cause regressive autism in some kids).

Greenland essentially argued that all the current epidemiology regarding autism and thiomersal was not good enough to detect thiomersal causation in regressive autism – this is from his submitted report:

A simple example may clarify this point. If a vaccine is not associated with any type of disorder in the category, we should expect to see the same risk when comparing vaccinated to the unvaccinated. Suppose, however, that in reality the vaccine is associated with a two-fold increase in the risk of a type of disorder in the category, but not associated with any other type. Suppose also that, without the vaccine, the associated type represents only one-tenth (10%) of the disease category, and that the total number of cases in the category would be 100. Then, without the vaccine, the number of cases with the associated type would be 100/10 = 10. With the vaccine, however, the number of cases with the associated type would double, to 20, an excess of 10 cases over the original 10 with the associated type. This excess produced by the vaccine would result in a total of 100+10 = 110 cases over the full category, which is only a 10% increase in the risk of any type in the category. Thus, the risk ratio for getting any type in the category would be only 110/100 = 1.1. Such a small risk ratio cannot be reliably distinguished from 1 by ordinary epidemiologic studies.

In other words, the amount of autism caused by vaccines is in fact too small to be detected by epidemiology. If, of course, it is associated with it at all – a point made later by Dr Greenland:

The brief overview given above supports the idea that the association of MCV (mercury containing vaccine) with autism is small or nonexistent.

But really his point is that if thiomersal does cause autism (and whilst he professes to have ‘no opinion’ on the matter it may be telling that he refers to the idea as a hypothesis throughout his report, not a theory) it causes it in very, very small numbers indeed.

Dr Greenland passed no opinion the validity of the hypothesis itself. Rather, he was there to study epidemiology. We have to respect his opinion even if we disagree with it.

The more telling aspect for me was this sudden conversion from ‘vaccines cause autism’ to this suddenly tiny percentage – so small to be undetectable by epidemiology up to this point. That’s quite a step back. What will become of the Omnibus cases that are not considered’ regressive’? Or the ones (like Michelle Cedillo) who were claimed to be regressive but were, upon viewing the video evidence, clearly not. Are the PSC really throwing cases away?

13 Responses to “Autism Omnibus and shrinking hypotheses”

  1. Joseph May 13, 2008 at 18:40 #

    That’s an interesting change in strategy. It could even work.

    I’d say that even if only 10% of autism can be accounted for by thimerosal, a drop should’ve been noticed in the 3-5 caseload of autism in California. But the trend is completely flat. Why? Probably because there’s no association whatsoever.

    We could even run some numbers on that.

    Similarly, Thompson et al. (2007) should’ve found *some* neurological effects due to thimerosal, I would think.

    There is, however, considerable evidence on a lack of association of regressive autism and the MMR.

  2. _Arthur May 13, 2008 at 21:02 #

    The Petitioners claim to represent 5000-odd autistic kids (families).

    And now, one of their key argument is that the damage allegedly caused by Thimerosal is too small or too subtle to be detected by epidemiology ? (Or by any other known test, for that matter) ?

    Maybe they aren’t trying to win their own case, as Kathleen establish, they get paid in full (from the Vaccines Fund) just to go thru the motions.

  3. Matt May 13, 2008 at 21:15 #

    The DOJ lawyer asked if Dr. Aposhian (witness for the petitioners” if “..the epidemiological literature does not support the hypothesis that an epidemic is caused by thimerosal containing vaccines.”

    Aposhian “I agree”.

    He also states that in his calculations that he assumes no elevated risk for others than “clearly regressive” autism.

    However, he can’t state that there is no elevated risk factors for other types of autism.

    The ‘clearly regressive subgroup” is rare enough that it doesn’t show up in epidemiological studies.

    Where did the ‘epidemic’ go? What is causing the rise in the rest of the types of autism?

    This is a BIG shift. It will be interesting to see how the ‘vaccine-injury-autism-epidemic’ group works with this.

  4. Matt May 13, 2008 at 21:19 #

    I’m sorry–the comments above were Dr. Greenland, not Dr. Aposhian.

  5. Ms. Clark May 14, 2008 at 02:07 #

    Yeah, Dr. Greenland is a reputable (as far as I can tell) epidemiology and statistics expert. He spent a lot of time on the stand explaining exactly how a tiny, beensy, weensy subgroup of the “1 in 150” couldn’t be measured in epidemiology, basically, these are my notes on what he said in during the cross examination by Ms. Ricciardella.

    Greenland: If there is an effect it was concentrated in a small group to have gone undetected.
    Ricciardella: But you have no evidence that such a group exists.
    Greenland: No.

  6. _Arthur May 14, 2008 at 17:13 #

    Right. They have no evidence that their hypothetical subgroup exist, they have no evidence that this subgroup correspond to their clients, they have no causal evidence linking the “damage” to vaccines, except generally fuzzy temporal evidence.

    That’s a long row to hoe.

  7. Ms. Clark May 14, 2008 at 20:19 #

    This hypothetical tiny group that is too small to find with epidemiology reminds me of Bertrand Russell’s quote that is on Brian Deer’s website.

    “If I were to suggest that between the Earth and Mars there is a china teapot revolving about the sun in an elliptical orbit, nobody would be able to disprove my assertion provided I were careful to add that the teapot is too small to be revealed even by our most powerful telescopes.”

  8. Sullivan May 14, 2008 at 20:47 #

    They don’t have to prove the group exists. If they can present a ‘plausible’ description of how they might exist, then it is in the HHS/DOJ’s hands to refute it.

    Given that the vaccine/autism group is now “below the radar”, it becomes more difficult.

    It was a good move for them in this case, as it removes one of the strong arguments against the old theory (that autism is an epidemic of vaccine injury).

    If this is successful, even for a small number in the Omnibus, they can then take the rest to Civil court with the description that “vaccine induced autism is possible”, something they can’t say now.

    If anyone thinks that this is just speculation–well, it is. It was speculated by Mr. Kirby almost a year ago:

    But if even one case of causation is determined, then private lawsuits in civil courts — where the drug makers themselves are on trial — would soon flood the dockets. (Ironically, if families lose in Vaccine Court, they are free to sue in civil court. Having autistic kids appear before sympathetic juries is Big Pharma’s big nightmare, and it’s why a secret rider was attached to the Homeland Security Act of 2002 to bar thimerosal cases from civil court and force them into Vaccine Court).

  9. Ms. Clark May 14, 2008 at 22:36 #

    Speaking of “sympthatic” and parents. The father of one of the test cases testified today. It was Mr. Mead. He is divorced from the boy’s mother. This guy gave a pretty good description of William having a plateau of development (not adding new words but adding a “verbal stim”) some time after he was a year old and then some time around 18 months (if I remember correctly) he had a more obvious regression, where he was losing his balance and stopped speaking (or mostly stopped). The dad puts this down to his having two vaccines 6 or 8 weeks apart. The second of those two, though didn’t show up on William’s vaccine records or in his medical records from the sound of it.

    He was sickly from 3 months of age on and had “bronchiolitis” and lots of ear infections.

    What was most interesting to me is to see how rapidly the parents descended into the abyss of autism quackery. Before he was diagnosed with autism, but after he was referred to an autism clinic for a diagnosis (by an audiologist), they put the boy on the GFCF diet and he immediately felt better. He had been having “explosive diarrhea” and he was very thin, even though he was eating alot. But the GFCF diet didn’t help William be less autistic, except for the eye contact and some other minor issues were resolved. So the mom went to the OASIS conference in Oregon and hear Dr. Green speak (top DAN! doc, been disciplined by the Oregon State Medical board for putting stuff into a kid with IV that later send the kid to an ER where the mom couldn’t tell the docs what had been put into the kid). And then they were off and running into biomed.

    They ended up seeing Green who did his usual battery of tests, including having parents send provoked urine samples to a mail order lab (Doctor Green uses DDI labs, for his provoked urine heavy metals, so maybe the Meads sent the urine there).

    Mr. Mead was utterly shocked to find out that his son’s provoked (note: provoked with a chelator) urine sample was a shocking “7 times the reference level”. Apparently, Mr. Mead wasn’t told or didn’t notice the note at the bottom of the lab test that says, they are using norms are for unprovoked urine samples. So yeah, getting a “high” level of mercury dumped from the kid’s kidneys’ where “high” is compared to non-provoked urine samples is scary for the uninitiated parents, as it is expected to be, one would assume.

    The kid got oral DMSA (which caused yeast to flare up… dad knows this from reading on the Internet), he got IV DMPS, and EDTA (dad then hastened to add that it was “calcium edta”). He got TD-dmsa and TD-glutathione.

    And one very traumatic session of IVIG. After which they said they’d never do that again. I don’t know when they did the IV chelation because the dad described the process of putting an IV into his son as “horrific”. His word.

    Time Buie scoped the boy and they found lymphoid hyperplasia. Buie suspected a problem with the boy’s pancreas and they found that he was missing some pancreatic enzymes and some other enzymes (might explain all that diarrhea, I think). He had 2 or three doses of secretin. He’s been on low-dose naltrexone and the atkins diet. They bought supplements from Green as well as from other sources.

    The dad and mom apparently at one point were thinking it was measles from the MMR because they gave him “vitamin A” for that (a ridiculous quack therapy). I guess it was the boys high level of mercury in that first test that really got them on to thimerosal.

    Dad made a point of saying that his son had 7 times the reference range of “the second most toxic substance on the planet after plutonium.” He said it like he was horrified.

    I couldn’t believe my ears. I wonder if the PSC expected him to say that. It’s classic DAN!-world sciencey-talk.


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