Brian Deer discusses Andrew Wakefield’s “autistic enterocolitis” in the BMJ

15 Apr

Before the General Medical Council reached a verdict on Dr. Wakefield, Brian Deer was promising that he was going to report on the data Dr. Wakefield used for his now retracted Lancet paper. We were told that he would give a first time ever view of a journalist allowed to check the facts on a scientific research paper.

After the GMC verdict was handed down, I watched the Sunday Times for such an article. I waited. Well, the wait is over. And it isn’t in the Times. Mr. Deer reports his findings in the British Medical Journal (BMJ).

Although much of the attention on Dr. Wakefield’s work has centered on the possible MMR connection, the topic of a “new syndrome” called “autistic enterocolitis” was proposed in that paper. In Wakefield’s “autistic enterocolitis” under the microscope, Mr. Deer takes a closer look at that claim. He does what is very rarely done: he obtained original data used for the study and obtains expert opinions on that data.

In his introduction, he notes the “new syndrome” and the MMR angles of the Lancet paper. Citing the press release from the Lancet paper:

“Researchers at the Royal Free Hospital School of Medicine may have discovered a new syndrome in children involving a new inflammatory bowel disease and autism,” the institution announced in a press release in February 1998. “Their paper . . . also suggests that in a number of cases the onset of behavioural symptoms was associated with MMR vaccination.”

Mr. Deer notes that before any patients were investigated, Dr. Wakefield was already proposing in a submission to the Legal Aid Board that such a new syndrome exists and it is linked to regression in children.

“In contrast to the IBD cases, which have a prima face [sic] gastrointestinal pathology, children with enteritis/disintegrative disorder form part of a new syndrome,” said Wakefield and the lawyer in a confidential submission for legal aid funding for the project in June 1996, before any of the 12 children in the paper had been investigated. “Nonetheless, the evidence is undeniably in favour of a specific vaccine induced pathology.”

For emphasis:

The evidence was “undeniably in favour of a specific vaccine induced pathology”.

Before children were investigated.

That on its own is huge. And, from what I can tell, not consistent with the image Dr. Wakefield is portraying in the alternative media.

That said, was there evidence of this “new syndrome”?

But when the children were brought in to the Royal Free for ileocolonoscopy, between July 1996 and February 1997, a snag in Wakefield’s project emerged. The hospital’s pathology service repeatedly judged colonic biopsy samples to be unexceptional, and thought bowel disease was a possibility in only one child.

The Royal Free’s own pathology service thought that the biopsy samples were unexceptional.

How can Mr. Deer make such a claim? He obtained data from the children’s records from their investigations at the Royal Free. Unfortunately, the actual samples are no longer available, but the reports are, and Mr. Deer submitted these to experts to review:

The biopsy slides are no longer available, according to one of the paper’s authors, Professor Amar Dhillon, but the GMC obtained all but one of the hospital pathology reports, and for the missing case I obtained the discharge summary. I passed the summary and reports to specialists for their reaction. They concluded that most of the 11 children reported as having non-specific colitis in the Lancet paper had been reported by the Royal Free as having normal pathology.

One expert reviewer stated:

“In the present reports and patients, overall, it is my impression that 8 of the 11 [for whom pathology reports were available] were normal,” Karel Geboes, a professor in the gastrointestinal pathology unit of the Catholic University of Leuven, Belgium, told me.

How does this compare to what was reported in the Lancet?

Eleven of the 12 children were said to have “non-specific colitis”: a clinically significant inflammation of the large bowel. In all 11, it was said to be “chronic,” while in four it was reported as both “acute and chronic.”

In other words, the report in the Lancet is not consistent with how experts interpret the pathology reports.

Mr. Deer further notes:

In fact the [Royal Free’s pathology] service identified findings suggestive of possible inflammatory bowel disease in only one of the 12 children. “The mild patchy generalised increase in inflammatory cells with lymphoid aggregates and follicles is not very specific but could be in keeping with low grade quiescent inflammatory bowel disease,” it reported for child 2. But this inflammation resolved after two months’ enteral feeding with a product now marketed as Modulen. A repeat ileocolonoscopy found no abnormality, and a food intolerance was diagnosed.

Yes, it appears that the pathology service, at Dr. Wakefield’s own hospital, at the time of the investigation, didn’t find evidence of abnormalities reported by Dr. Wakefied’s team.

In the GMC hearing, one of the co-authors on the Lancet paper, Dr. Susan Davies, discussed her concerns about the changes in the findings from normal to abnormal at the time of the investigation.

These changes—from normal to abnormal, or from healthy to diseased—had also raised concern in the mind of at least one of the paper’s authors. In September 2007, Davies, the lead histopathologist for the Wakefield project, was examined at length before the panel. “When you were given a draft of the Lancet paper, did you read it?” she was asked by Sally Smith QC, for the doctors’ regulator.
“Yes,” Davies replied.
“What was your overall view of the terminology used in relation to the histology findings in the Lancet paper, just when you read the paper?”
“I was somewhat concerned with the use of the word colitis.”
“First of all, what did you understand that word to mean?”
“I personally use that terminology, ‘colitis,’ when I see active inflammation, or a pattern of changes which suggest a specific diagnosis, and it was not my impression that the children coming through in the spasmodic way that they had, I [sic] had formulated some distinct pattern warranting that terminology.”

If even a co-author was concerned, and the hospital’s pathology reports don’t support the diagnosis of colitis, the obvious question would be: how did the paper reach it’s conclusions?

The answer appears to be that the results underwent a second review. This second review is discussed in the Lancet paper, but there is no mention of the review changing the interpretation of the data,

Mr. Deer poses an important question:

[H]ow many peer reviewers would have felt comfortable approving the paper if they had known that the hospital pathology service reported biopsy specimens as largely normal, but they were then subjected to an unplanned second look and reinterpreted?

Which we are fortunate enough to have answered. Mr. Deer was able to obtain an answer from one of the peer reviewers:

“I’m surprised the GMC didn’t make more of this,” said David Candy, paediatric gastroenterologist at St Richard’s Hospital, Chichester, who reviewed the paper in 1997. “That’s an example of really naughty doing—to exclude the original pathology findings.”

“Really naughty doing”. Not very clinical but I think it tells the story well.

Is it possible that the hospital’s pathology service missed the condition? Apparently at least one author (Dr. Walker-Smith, a co-defendant with Dr. Wakefield in the GMC hearings) noted this in his GMC testimony:

And how bad was this “colitis,” such that the hospital’s pathology service didn’t spot it as the children came through? Walker-Smith told the GMC panel that he had “concerns” about the service and its ability to detect inflammation.

In his report, Mr. Deer counters with:

Yet inflammatory indices that were not reported in the Lancet paper, including serum C reactive protein concentrations and other blood tests, were almost all within normal ranges for the 12 children.6 And as an alternative explanation for any inflammation that was present, nearly all of the children had constipation with megarectum16 (unreported in the paper), which specialists say can cause cellular changes.

Mr. Deer attempted to speak with Dr. Dillhon, a co-author on the Lancet paper. Dr. Dillhon viewed the slides made from the samples taken from the children, and he graded them with Roman numerals to rank the degree of inflammation. At some point, those Roman numerals were translated into “non-specific colitis”.

So who translated these scores on the grading sheet into findings of “non-specific colitis” in the paper? Dhillon says it wasn’t him. He says he would like to see the slides again, but they are missing from the Royal Free laboratory. “He [Dhillon], Andrew Anthony, and Wakefield all looked at them,” I was told, on Dhillon’s behalf, by a senior member of staff at the Royal Free. “Andy [Wakefield] then synthesised their results into what appeared in the paper.”

But still, according to Mr. Deer, “…how the Roman numerical scores, histopathological gradings for a variety of sites in the colon, became the “colitis” findings might, under such circumstances, be anybody’s guess.”

Mr. Deer posits a possible scenario, based on Dr. Wakefield’s complaint to the press complaints commission:

Wakefield wrote: “When the biopsies were reviewed and scored by experts in bowel pathology—namely, Drs Dhillon and Anthony—these doctors determined that there was mild inflammation in the caecum, ascending colon, and rectum,” he said. “This was correctly reported as non-specific colitis in the Lancet.” In other words, it looks like it was Wakefield who translated the scores.

A companion editorial was published in the BMJ by Prof. Sir Nicholas Wright, warden, of Barts and the London School of Medicine and Dentistry, Queen Mary University of London. He lists in his conflict of interest statement: “He has provided expert opinion in the case of Wakefield v GMC and acted as a character witness for Professor John Walker-Smith.”

His editorial:

Does autistic enterocolitis exist?
Despite the retracted Wakefield study, questions remain

His conclusion:

Is autistic enterocolitis a histopathological entity or even an entity at all? In view of the lack of data and the entrenched position of many of the protagonists and antagonists, any firm conclusion would be inadvisable. The expert review, referenced by Deer, concludes that key areas such as the prevalence and best treatment of gastrointestinal disorders in people with autistic spectrum disorders are incompletely understood, and that evidence based recommendations are not yet available. We should remember, as recent experience in several fields has shown, that although science has its defects, it is a self correcting process. Time is, perhaps, the wisest counsellor of all. In the meantime, this case offers a salutary reminder for researchers and journal editors alike that coauthorship means bearing responsibility for what is written.

First, I would submit that Dr. Wright is not being clear on the subject. It is not whether autistics have a greater prevalence of GI issues, or whether there is a difference in the treatment for autistics. The question is whether there is a specific entity which is unique to autistics: autistic enterocolitis. Further, it is also a primary question whether “autistic enterocolitis” is causal in autism. While one can hide behind the “you can’t prove a negative” shield, the answers at present appear to be no to both questions.

Second, the idea that science is a self correcting process is often times true. In this case, it clearly is not. The science, the Lancet paper, was not corrected through science but through investigative journalism. Without the stories in The Sunday Times, Dr. Wakefield’s “science” would likely still be in the official record of The Lancet. Much more, the Lancet study and the presumed expertise of Dr. Wakefield would have likely been key in litigation in the UK and the US. Without Mr. Deer’s continued scrutiny, the facts behind the research into the Lancet paper, specifically that the pathology reports on those children were not consistent with the findings of the paper, would almost certainly not have come to light.

Returning to Mr. Deer’s article, he concludes:

So what should we make of all this? Now the Lancet paper is retracted, its findings don’t officially exist. And, if Dhillon is right in saying the slides can’t be found, the ultimate proof is missing. All we have are the pathology reports, which independent specialists seem to agree are largely unremarkable. “They wanted this bad,” commented Tom MacDonald, dean of research at Barts and the London School of Medicine and coauthor of Immunology and Diseases of the Gut. “If I was the referee and the routine pathologists reported that 8/11 were within normal limits, or had trivial changes, but this was then revised by other people to 11/12 having non-specific colitis, then I would just tell the editor to reject the paper.”

Clearly the Lancet paper should have been rejected. But this isn’t just a scientific paper that made a bad conclusion. This paper impacted multiple families inside the autism communities to believe that their child’s autism was caused by MMR. This paper led many families in the autism communities to apply poorly researched “therapies” to their disabled children. This paper led many families to stop vaccinating their children, leading to outbreaks of measles in the UK and elsewhere.

It is easy to go through Mr. Deer’s paper in the BMJ point by point in a clinical fashion, noting how the research went awry, showing that “autistic enterocolitis” has what appears to be no founding in science. But how does one express the reaction to so much damage caused by Dr. Wakefield’s investigation?

Of course, a further question I have and I bet I share with Dr. Wakefield’s supporters is this: is Brian Deer finished or is there even more yet to be unearthed in this sad tale of research gone awry?

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36 Responses to “Brian Deer discusses Andrew Wakefield’s “autistic enterocolitis” in the BMJ”

  1. FreeSpeaker April 15, 2010 at 23:00 #

    The Wakefield defenders will claim that Brian Deer is “only a journalist”. OOPS! Kirby was “only a journaist.” OOPS!squared. Olmsted was only a journalist.

    There goes that argument. Next!

    • Sullivan April 15, 2010 at 23:17 #

      FreeSpeaker,

      I bet the Wakefield defenders will do just about anything rather than address this one paragraph:

      “In contrast to the IBD cases, which have a prima face [sic] gastrointestinal pathology, children with enteritis/disintegrative disorder form part of a new syndrome,” said Wakefield and the lawyer in a confidential submission for legal aid funding for the project in June 1996, before any of the 12 children in the paper had been investigated. “Nonetheless, the evidence is undeniably in favour of a specific vaccine induced pathology.”

      Before seeing children, he was already convinced that vaccines caused regression with GI conditions?

  2. FreeSpeaker April 15, 2010 at 23:02 #

    Anyone see Wakefield recently? Any job fairs around? Please post any sightings to http://www.wakefieldwatch.blogspot.com. It seems that Thoughtfull House is also looking for him.

  3. Julian Frost April 16, 2010 at 06:20 #

    So to recap the flaws:
    1. Wakefield was approached by lawyers looking to make a connection between MMR and Autism and failed to disclose that to the Lancet;

    2. Wakefield used children referred to him by the lawyers above, and used a control group that wasn’t really randomised, and;

    3. Despite this, the data argued against his hypothesis so it was altered to conform to the preselected conclusion.

    Dishonest is not the word.

  4. Journal Checker April 16, 2010 at 13:36 #

    Message from Angus Files to:

    http://health.groups.yahoo.com/group/thoughtfulhousecenterforchildren/message/16728

    One simple question!!!!! Did your child regress into Autism and suffer with painful bowel disease and gut problems after vaccination with the MR or MMR especially.

    Brian Deer the Sunday Times journalist and the GMC think that our children are not sick and we need to let them know. Please comment here with your child’s… Name if they did
    Or send an e-mail to Kate@maxclifford.com

    Comments welcome about his article at
    http://www.bmj.com/cgi/doi/10.1136/bmj.c1127

    So will the BMJ be inundated with messages? Or maybe thoughtfulhousecenter readers will actually look at the BMJ article first – it does not say what Angus Files suggests.

  5. Journal Checker April 16, 2010 at 19:09 #

    The new AJW press release:

    http://health.groups.yahoo.com/group/thoughtfulhousecenterforchildren/message/16732

    • Sullivan April 16, 2010 at 19:14 #

      Journal Checker,

      I’m not on that list. Care to quote the press release?

      • Sullivan April 16, 2010 at 19:38 #

        Journal Checker,

        someone emailed it to me. Interesting stuff. Why Wakefield chose to take on the press release rather than the actual papers is an interesting question.

        “Journalist Brian Deer’s Allegations about Dr. Andrew Wakefield fails to disclose press complaint”

        I find it not a little hypocritical of Dr. Wakefield to use his own PCC complaint as a method to try to discredit Mr. Deer. Dr. Wakefield filed the complaint himself and it has not been acted upon. The parallel to the (false) complaints that Mr. Deer has a conflict of interest because of the (false) idea that he was the complainant to the GMC is pretty striking.

        Beyond that, what is Dr. Wakefield saying? His press release isn’t responding to Brian Deer’s BMJ article, which not only notes the PCC complaint, it relies upon it.

        “It was decided that the senior consultant histopathologist with expertise in intestinal disease (Dr Dhillon) should review all biopsies from autistic children, and that pathology should be graded on a pro forma (or grading sheet) designed by him,” Wakefield said last March, in a now suspended complaint12 to the UK Press Complaints Commission about one of my Sunday Times reports.

        and

        However, in his complaint against me to the Press Complaints Commission, Wakefield last year offered a glimpse into how this happened.

      • Sullivan April 16, 2010 at 19:41 #

        I’ll post the press release soon. Maybe even blog it.

        But here is the first paragraph:

        LONDON, ENGLAND, April 16, 2010 — Today the British Medical Journal (BMJ) has published an
        online commentary authored by journalist Brian Deer in which he makes further allegations against Dr.
        Andrew Wakefield and the doctors involved in the 1998 Lancet study that first reported possible links
        between MMR and autism, without affording Dr. Wakefield an opportunity to respond simultaneously to
        these serious allegations online. Deer’s latest claims follow his February 2009 Sunday Times article
        accusing Dr. Wakefield of “fixing data” for which there is a pending complaint to the UK’s Press
        Complaints Commission (PCC). The BMJ’s press release regarding this latest published “special report”
        by Brian Deer, along with Dr. Wakefield’s point-by-point response, is below:

        “for which there is a pending complaint to the UK’s Press Complaints Commission (PCC)”

        That is far to vague given the circumstances. From this observer’s standpoint, Dr. Wakefield needed to make it clear that it was he himself who brought the complaint. To do so would blunt his message rather severely, though.

  6. Journal Checker April 16, 2010 at 20:05 #

    There is an interim response from Brian Deer to the PCC:

    http://www.pcc.org.uk/assets/441/Brian_Deer.pdf

  7. Journal Checker April 16, 2010 at 20:22 #

    Sullivan and others.

    Can you access this one?

    http://health.groups.yahoo.com/group/Autism-Mercury/message/279087?o=0&var=1

    • Sullivan April 16, 2010 at 20:26 #

      Journal Checker,

      is that link the same info as here?

  8. Journal Checker April 16, 2010 at 20:31 #

    No, sadly, it’s truncated.

    Here’s the full release:

    BRITISH MEDICAL JOURNAL PUBLISHES FALSE CLAIMS ABOUT
    MMR DOCTOR
    Journalist Brian Deer’s Allegations about Dr. Andrew Wakefield fails to
    disclose press complaint
    LONDON, ENGLAND, April 16, 2010 — Today the British Medical Journal (BMJ) has published an
    online commentary authored by journalist Brian Deer in which he makes further allegations against Dr.
    Andrew Wakefield and the doctors involved in the 1998 Lancet study that first reported possible links
    between MMR and autism, without affording Dr. Wakefield an opportunity to respond simultaneously to
    these serious allegations online. Deer’s latest claims follow his February 2009 Sunday Times article
    accusing Dr. Wakefield of “fixing data” for which there is a pending complaint to the UK’s Press
    Complaints Commission (PCC). The BMJ’s press release regarding this latest published “special report”
    by Brian Deer, along with Dr. Wakefield’s point-by-point response, is below:
    This week, the BMJ questions the existence of a new bowel condition in autistic children dubbed “autistic
    enterocolitis” by Dr Andrew Wakefield and colleagues in a now infamous and recently retracted paper
    published by the Lancet in 1998.
    In a special report, journalist Brian Deer tries to unravel the journey
    of the biopsy reports that formed the basis of the study, while an accompanying editorial asks does
    autistic enterocolitis exist at all?
    In 1996, Dr Andrew Wakefield was hired by a solicitor to help launch
    a speculative lawsuit against drug companies that manufactured MMR vaccine to find what he called at
    the time “a new syndrome” of bowel and brain disease caused by vaccines.
    FALSE. I was not hired by a solicitor to find a new syndrome of bowel and brain disease caused by
    vaccines. I acted as a medical expert in respect of two matters: first, to provide a report on safety
    studies of measles-containing vaccines; and second, to look for evidence of measles virus in
    intestinal tissues of children with Crohn’s disease, and children with regressive developmental
    disorder and intestinal symptoms who were undergoing investigation for possible bowel disease.
    The proposed “new syndrome” was not what Deer claims. At the material time, the “new
    syndrome” consisted of gastrointestinal symptoms (not disease) in children with developmental
    regression. Prior to the clinical investigation of these children, the presence of intestinal disease had
    not been determined.
    Deer reveals that biopsy reports from the Royal Free Hospital’s pathology service on 11 children
    included in the Lancet study showed that eight out of 11 were interpreted as being largely normal. But in
    the paper, 11 of the 12 children were said to have “non-specific colitis”: a clinically significant
    inflammation of the large bowel.
    FALSE. The findings were correctly reported in The Lancet paper. The meticulous process by
    which the diagnoses were made in the children reported in that paper has been described on
    numerous occasions, including in published papers, in Mr. Deer’s presence at the GMC, in the
    complaint filed against him to the PCC that is published online1. For the avoidance of doubt, the
    1 http://www.cryshame.co.uk//images/stories/complaint_to_uk_pcc.pdf
    clinical process involved two stages: routine reporting of the pathology by the duty pathologist,
    followed by a combined review by Professor Walker-Smith’s team and Dr. Sue Davies. During this
    clinical review, it was recognized that significant disease was being overlooked. It was decided to
    have all biopsies reviewed by the senior pathologist with greatest experience in bowel disease, Dr.
    Paul Dhillon. This research review was undertaken in a blinded, unbiased manner such that Dr.
    Dhillon was not aware of the diagnosis in any child. Dr. Dhillon’s diagnosis formed the basis for the
    findings reported in The Lancet. Dr. Dhillon’s review is referred to in The Lancet and is described
    in detail in subsequent papers that confirmed the presence of bowel disease in many more children
    with autism. Mr. Deer was aware of these facts when making his false allegations but does not
    appear to have disclosed this to the BMJ..
    So how did the mismatches occur?
    Apparently, the biopsies were first reported on by Dr Susan Davies, a
    consultant histopathologist and co-author on the study, but they were also seen and interpreted by three
    other co-authors before final publication. When Dr Davies was cross examined before the General
    Medical Council she said that she had initially been concerned about the use of the term “colitis” in the
    Lancet paper because she herself had found nothing abnormal in the biopsy sections. But she was
    reassured, she said, by the “formalised review” of the biopsies by her three colleagues.
    FALSE. This is not what Dr Davies said. Mr Deer fails to mention that Dr. Davies was referring, in
    her evidence, to her use of the term colitis only in terms of active colitis (involving an increase in
    pus-forming cells) rather than chronic colitis which was present in many children, In his selective
    misrepresentation of the evidence he also fails to mention that, later in her evidence, Dr Davies
    clarified how, as a distinct pattern of disease emerged in the autistic children (particularly following
    an unbiased review she undertook with Dr. Murch) this disease came to be termed ‘autistic
    enterocolitis’.
    This apparent concurrence of four pathologists gave strength to the finding of a new bowel disease,
    writes Deer. But there is no suggestion in the paper that the second assessment caused findings to be
    substituted or changed.
    How many peer reviewers would have felt comfortable approving the paper if
    they had known that the hospital pathology service reported biopsy specimens as largely normal, but they
    were then subjected to an unplanned second look and reinterpreted, he asks?
    FALSE. A planned “second look” was undertaken routinely by Professor Walker-Smith and his
    team at the weekly clinical meeting he held with Dr. Davies for this purpose. This planned review
    has Is been part of Professor Walker-Smith’s clinical practice, and is essential for quality control. It
    was at this point that discrepancies were found, and it was these discrepancies that led to a further
    planned review by Dr. Dhillon.
    Professor David Candy, paediatric gastroenterologist at St Richard’s Hospital, Chichester, who reviewed
    the paper in 1997, said “no”: he wouldn’t have felt comfortable. “That’s an example of really naughty
    doing – to exclude the original pathology findings.”
    It is highly unlikely that Deer informed Dr. Candy of the extensive evidence refuting his false
    claims, or that on the basis of these false claims, Mr. Deer is the subject of a formal complaint to the
    PCC.
    So what should we make of all this, asks Deer? The biopsy slides are no longer available, and cannot be
    re-assessed. All we have are Dr Davies’ pathology reports, and independent specialists seem to agree that
    she regarded what they showed as largely unremarkable.
    FALSE. Contemporaneous reports based upon Dr Dhillon’s formal assessments are available that
    confirm the findings described in The Lancet.
    Professor Tom MacDonald, dean of research at Barts and the London School of Medicine and co-author
    of Immunology and Diseases of the Gut said: “If I was the referee and the routine pathologists reported
    that 8/11 were within normal limits, or had trivial changes, but this was then revised by other people to
    11/12 having non-specific colitis, then I would just tell the editor to reject the paper.”
    In an
    accompanying editorial, Sir Nicholas Wright also from Barts and the London points out that all
    histopathological interpretation is a matter of opinion, but we should always ask how reliable that
    opinion is.
    CORRECT. It was precisely for this reason that the final diagnosis was left to the most senior
    pathologist with the most experience in bowel disease who assessed the tissues in an unbiased
    fashion.
    In terms of whether autistic enterocolitis exists, several studies have shown an association between
    inflammatory pathology and autistic spectrum disorder, but he believes that, in view of the limited data,
    any firm conclusion would be inadvisable.
    CORRECT. The finding of inflammatory disease of the intestine of autistic children has now been
    confirmed in 5 different countries.
    Dr Wakefield said “It is extraordinary that a journal like the BMJ should have reduced itself to
    this sort of tabloid medicine from an entirely unqualified and biased source. The egregious errors
    in Deer’s report should cause embarrassment to the BMJ’s editors. In a relentless and misguided
    effort to distract attention from vaccine safety issues, agenda-driven journalism has once again
    made a mockery of medicine.”
    *********

  9. Science Mom April 16, 2010 at 22:06 #

    So if Mr. Deer is so libellous, why another PCC complaint instead of legal action?

    The finding of inflammatory disease of the intestine of autistic children has now been confirmed in 5 different countries.

    No it hasn’t; that is just the same, tired rant that Wakers and his supporters keep insisting but those ‘studies’ do nothing of the kind:

    http://justthevax.blogspot.com/2010/02/independent-wakefield-way-really.html

    • Sullivan April 16, 2010 at 22:22 #

      That’s a great writeup, Science Mom. I’m tempted to “abscond” with it.

      In fact….may I? With attribution, of course.

  10. Chris April 16, 2010 at 22:07 #

    CORRECT. The finding of inflammatory disease of the intestine of autistic children has now been confirmed in 5 different countries.

    Does he provide any evidence of that?

  11. Sullivan April 16, 2010 at 22:08 #

    While not directly related to Mr. Deer’s report, I wonder where the Telegraph got the information to make this statement in 2001:

    The finding that these children had real and severe bowel disease was a groundbreaking discovery. Had the paper stuck to these facts alone Dr Wakefield might still be in a job. Against the advice of others in the team, however, he insisted that their joint paper record that eight parents said their previously normal child had fallen ill after receiving the MMR inoculation – a mixture of weakened but live measles, mumps and rubella virus given to a 1.5 million children a year.

    http://www.telegraph.co.uk/news/uknews/1364081/Parents-left-stunned-as-MMR-doctor-is-forced-out.html

    Why would Dr. Wakefield be going against the advice of others on his team at the time? Did the team know at the time that he was working as an expert for the litigation?

  12. FreeSpeaker April 16, 2010 at 22:35 #

    If I read between the lines of Brian’s response correctly, it is time to get rid of the PCC. With the UK’s libel laws so plaintiff friendly, and the PCC looking over the back of every journalist, it is a reasonable conclusion to say that there is no such thing as free speech in the UK. The combination of those two factors leads to a chilling effect that our First Amendment was designed to prohibit.

  13. Journal Checker April 16, 2010 at 22:51 #

    The BMJ published its Brian Deer report and commentary on-line at midnight BST Thursday 15th April. By mid-afternoon Friday the AJW counter press release was being circulated. The PDF version held on the Thoughtful House message board was created at 13.23 on 16th April (doesn’t say what time zone) by someone named Cazza – we’ll have to reflect on who that might be.

    There’s one little bit of information circulating at the moment – can’t confirm yet – but apparently Max Clifford, the respected media publicist – may have reversed his position and agreed to act for Wakefield.

    There was a clue to this on Wakefield’s Twitter http://twitter.com/DrWakefield on April 7th.

    BTW there’s someone called DrCaz who’s listed there as one of 7 ‘following’ whatever that means.
    Is DrCaz also Cazza?

    There’s no mention at the time of writing in any Google News search results of a counter release by AJW – so let’s see what comes up tomorrow, Saturday. AoA is very silent so far on the matter.

    • Sullivan April 16, 2010 at 23:07 #

      Officially the report went online at midnight. Actually, I think officially at 11:01 pm.

      I saw the report on the BMJ website before that time. I saw the link live at what was about 7:30 GMT on Thursday.

      edit to add–also, there is nothing to say that Dr. Wakefield didn’t get a preprint of the articles. One must assume it likely that the gentleman who wrote the editorial supporting Dr. Wakefield would have shared his editorial. Also, since the editorial was based on the Deer BMJ article, it would seem very possible that Dr. Wakefield saw the BMJ article in advance.

      This raises the obvious question: why respond to the BMJ press release and not the Brian Deer report?

  14. Journal Checker April 16, 2010 at 22:58 #

    @FreeSpeaker – getting the balance right is the thing – publishers in the US can get away with frightful defamation – using the First Amendment. So what did some affected by this do, those who had resources? Turn to UK courts for redress.

  15. Journal Checker April 16, 2010 at 23:33 #

    I was working on historical release times when midnight plus one minute used to be rigidly adhered to. Of course this was in the days before on-line publication happened in the 7 days running up to print issue appearing.

    Does AJW mention suing and withdrawing the action? Does he mention trying to keep the action going just to keep a rein on the media firms and journalist involved and being told to get stuffed by the judge?

    • Sullivan April 17, 2010 at 00:45 #

      Here is a very strange response by Dr. Wakefield:

      Responding to this in the BMJ press release:

      Professor David Candy, paediatric gastroenterologist at St Richard’s Hospital, Chichester, who reviewed the paper in 1997, said “no”: he wouldn’t have felt comfortable. “That’s an example of really naughty doing – to exclude the original pathology findings.”

      with Dr. Wakefield’s response:

      It is highly unlikely that Deer informed Dr. Candy of the extensive evidence refuting his false claims, or that on the basis of these false claims, Mr. Deer is the subject of a formal complaint to the PCC.

      The response doesn’t really have anything to do with the press release statement. Let’s assume that Brian Deer made false claims and that he is the subject of a formal complaint–would that have any bearing on whether it was “naughty” that the paper didn’t mention that the initial pathology reports were inconsistent with the final conclusion?

      It’s a smoke screen by Dr. Wakefield.

  16. Journal Checker April 16, 2010 at 23:35 #

    Autism File Magazine have bandwaggoned – http://www.box.net/shared/zks6g0ekub

  17. brian April 17, 2010 at 01:32 #

    Hi, Science Mom–

    I posted a brief quote from your blog and a link in response to an article titled “More challenges to Wakefield’s autism research” in the “Paging Doctor Gupta” blog on CNN. I agree with Sullivan: nice write up.

  18. FreeSpeaker April 17, 2010 at 01:37 #

    Journal Checker, in the US, we had a fellow named Oliver Wendell Holmes. In fact, he was so good, we had two. One became a justice of our Supreme Court and came up with the idea that the best check on offensive speech is not by govenrment action, but by more speech. He called it the Free Market Place of Ideas, and, in my opinion, ideas flourish in such a setting. He would love the internet.

  19. FreeSpeaker April 17, 2010 at 01:39 #

    My dittos on Science Mom. I’ll have to become a regular reader. Remember, any Wakefield sightings are to be posted on WakefieldWatch at http://www.wakefieldwatch.blogspot.com. My regular visitor from ThoughtFull House seems to be looking for him, too. 😉

  20. Joseph April 17, 2010 at 02:43 #

    So to fully bring this matter to a close, I think the PCC needs to issue a ruling. Why does it appear that they dragging their feet?

  21. Journal Checker April 17, 2010 at 06:22 #

    It seems to me the AJW team writing the response were only looking at the BMJ press release and not the actual articles. Some of the rebuttals don’t actually match what Deer actually wrote.

  22. Orange Lantern April 17, 2010 at 07:17 #

    Freespeaker, you’re no doubt aware of Wakefield’s recent interview with Mercola. An update to the blog would be nice to see. I love your sense of humor.

  23. Catherina April 17, 2010 at 12:05 #

    Sullivan – my blog post on Wakefield’s “independent” supporters – thanks for the praise and of course you may use it. I might amend the Balzola meeting abstract, because I got the full text now.

  24. FreeSpeaker April 18, 2010 at 01:42 #

    Orange Latern, I have an article in the works, but, have had scant time to finish it off. We have been dealing with dracvonian cutbacks in paratransit here, and it turns out that my son with CP has become a major lobbyist and advocate. He compiled a 7-page talking points, and he nails the naysayers in the government agencies involved. We had meeting all day and I hope to get some time tonight or tomorrow. Just to let you know, the visits from Thoughtful House use a State of texas domain, and I am still trying to find out how they swing that.

  25. Orange Lantern April 21, 2010 at 02:43 #

    Understandable. Good luck with your son!

  26. Noodlemaz May 11, 2010 at 15:57 #

    Hi, I read your article with interest, very nicely written.
    I saw Deer speak last night and had a chat with him at the bar afterwards.

    http://noodlemaz.wordpress.com/2010/05/11/research-fraud-for-dummies/

    Here is my account of the evening; I recommend a read of Deer’s own website (which I’ve linked to at the start of the article) as he goes over some more of the conflicts of interest; mainly that Wakefield was hired by lawyers with the clearly-defined goal of discrediting MMR. He was paid to do it and paid a lot.
    This is undoubtedly one of the most disgraceful cases of medical fraud ever; the lives cost are probably uncountable (thanks to idiots like Jenny McCarthy spreading the infectious panic even further).

    • Sullivan May 11, 2010 at 18:59 #

      Thanks Noodlemaz,

      I would point out that I find the term “idiot” to be inappropriate, especially on a disability blog. Idiot, like moron and imbecile, are former diagnostic terms for intellectual disability severity. It is similar to “gimp” or “spaz” or other derogatory terms derived from disability.

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  1. Research Fraud for Dummies « Purely a figment of your imagination - May 11, 2010

    […] of the 12 children fits his bill (the details of the pathology are expanded on very well in this autism blog), yet he still denies […]

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