As Kev recently wrote here on LeftBrainRightBrain, the main defense of Andrew Wakefield is not a defense at all, but an attack on Brian Deer. Rather than look at the facts laid out in the BMJ article, people are claiming that Andrew Wakefield couldn’t possibly have “fixed” the data (lead authors can and have do this, see our recent post). Also, that Andrew Wakefield didn’t have access to the full records of the children, so that he couldn’t have known that there were contradictory data in those records.
It is an odd argument in that it concedes that yes, indeed, the “facts” in the Lancet article do not match the children’s medical records.
It is also an odd argument because it ignores the citations that Brian Deer makes in his article. Mr. Deer cites where he gets the information that contradicts Andrew Wakefield’s reports. Many of which are not hidden in the child’s records but were available to Mr. Wakefield at the time he wrote his article for the Lancet.
Mr. Wakefield has reported in his Lancet article (now retracted) that “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. ”
Emphasis added.
As Brian Deer has noted in his article in the BMJ, this is not the case. Many of the children reported upon were not “previously normal”. We here at LeftBrainRightBrain have the luxury of more space than did Mr. Deer, so let’s check a few of Mr. Deer’s statements, shall we? Let’s look at the children that Mr. Deer commented upon in his article.
Early on in his article, Mr. Deer refers to Child 8. Child 8 was noted as having facial dysmorphisms. Further, the doctors treating Child 8 “…had significant concerns about her development some months before she had her MMR Vaccination”.
Here is a letter sent to Andrew Wakefield on 3 October, 1996. The Lancet article wasn’t published until 1998:
“ Dear Dr Wakefield
[Child 8’s] mother has been into see me and said that you need a referral letter from me in order to accept Child 8 into your investigation programme. I gather this is a specific area of expertise relating to the possible effects of vaccine damage and her ongoing GI Tract symptoms. As far as I am concerned, if [Mrs 8] is happy to proceed with this and it gives her any further information and peace of mind, I am sure it would be beneficial for both her and for [Child 8]. I enclose photocopies of some recent correspondence which gives a fair idea of [Child 8’s] current state. I would simply reiterate Dr Houlsby’s recent comment that both the hospital and members of the Primary Care Team involved with [Child 8] had significant concerns about her development some months before she had her MMR Vaccination. I take Mum’s point that she has video evidence of [Child 8] saying a few words prior to this vaccination being given and her vocal abilities are now nil but I do not think we can be entirely convinced as yet that the vaccine is the central cause of her current difficulties. However, I am quite prepared to support [Mrs 8] in her quest for further information and I hope some useful results come from these tests.
Best wishes.”
emphasis added.
This was presented to the GMC on Day 29 of the hearing. Mr. Wakefield knew Child 8’s physicians questioned whether child 8 was “previously normal” when he wrote the article in the Lancet. It is unclear if Mr. Wakefield sought out those physicians, or if the “recent correspondence” also noted those early signs. But we do know that Andrew Wakefield had more than just the parent’s report on the child’s history and that the physicians disagreed with the parent’s impression. Given the contradiction between the two sources, at the very least, Mr. Wakefield should have sought out the child’s records.
As an aside here, Child 8 was already funded by legal aid at the time of referral. Mr. Wakefield has claimed that children were not already a part of litigation when they were seen by him at the Royal Free. This is also noted in an doctor’s note in the transcripts:
“Mum taking her to Dr Wakefield, Royal Free hospital for CT scan and gut biopsies.
? Crohn’s – will need a letter.
Dr Wakefield to phone me.
Funded through legal aid.”
Again, the child was “funded through legal aide” before referral to Mr. Wakefield.
Here is how Child 4 is reported in The Lancet paper:
One child (child four) had received monovalent measles vaccine at 15 months, after which his development slowed (confirmed by professional assessors). No association was made with the vaccine at this time. He received a dose of measles, mumps, and rubella vaccine at age 4·5 years, the day after which his mother described a striking deterioration in his behaviour that she did link with the immunisation.
“Confirmed by professional assessors”. I find this interesting. One of the defenses of Mr. Wakefield is that “he was just reporting what parents told him”. But, there it is, “confirmed by professional assessors”. Andrew Wakfield had “professional assessors” check the validity of the claims. Have Andrew Wakefield’s supporters actually read the paper?
Was there anything in this child’s records that a “professional assessor” might flag as possibly showing signs of delay before vaccination? Here is the letter from Child 4’s doctor to Mr. Wakefield dated 1 July 1996.
“Following our recent telephone conversation I would be grateful if you could arrange an appropriate ECR appointment for [4] to undergo assessment regarding his possible autism and his bowel problems.
[Child 4] has had long standing difficulties and shows severe learning difficulties and also bowel disturbance and his mother has always found it difficult to accept that there was no known cause for [Child 4]’s disorder. A few years ago she was chasing the idea that he might have a metabolic disorder and I enclose a copy of a letter I wrote to Dr Wraith in Manchester at that time although his reply was he did not see any value in further tests along these lines. I’m aware that you are looking at the possible links between measles vaccine and various difficulties and [Child 4] certainly had MMR in 1988. In general [Child 4]’s mother thinks that he developed normally initially and then subsequently his problems worsened and he lost some of the milestones he had achieved but that he has subsequently improved on something of a restrictive exclusion diet. The professionals who have known [Child 4] since birth do not entirely agree with this however and there is a suggestion that some of [Child 4]’s problems may have started before vaccination.
Since 1994 4 has continued to have intermittent problems with his bowels and diarrhoea that [Mrs 4] relates to food intake; he has had a negative test for celiac disease and has on at least 2 occasions had giardia but he has had no further investigations regarding the cause of these symptoms.
As I say, [Mrs 4] is convinced that both [Child 4]’s behaviour and his diarrhoea are triggered by his diet and she has him on something of a restrictive exclusion diet. He has not gained weight and we have been very concerned about this and [Mrs 4] feels that this is despite him being on a more normal diet. We have therefore not made any assessment as to whether his failure to gain weight might be due to an inadequate diet or to possible malabsorption.
I would be grateful if you could arrange an appropriate appointment and would be very interested if you feel [Child 4] fits into the sort of category of patient that you are interested in looking at further”.
From Day 6 of the GMC hearing. Note that the “…had MMR in 1988” is likely incorrect and that it was the monovalent measles vaccine in 1988.
Again, Mr. Wakefield was alerted to a child having possible problems before MMR administration, but reported the child as “previously normal”. We are left with a question, did Mr. Wakefield just fail to follow up on this possibility or did he know the details and misreport them?
Here is a statement in the child’s records. Whether this was available to Mr. Wakefield at the time of writing the article in The Lancet is unclear:
A delayed development was acknowledged by the health visitor at 1 year of age but at this stage [Mrs 4] did not accept that [Child 4] was slow.
Here is a letter written to Child 4’s physician after his time with the Royal Free team:
“I will write to Dr Wakefield to see if I have any better luck at getting a summary of their investigations and conclusions. [Child 4] had a course of (I think) sulphasalazine after his investigation at the Royal Free Hospital. He became acutely distressed, apparently with abdominal pain and his autism and behaviour did not improve. It was therefore discontinued after a fortnight”.
Apparently, the therapies Mr. Wakefield’s team supplied were not always beneficial.
Let’s move on to Child 1. Mr. Deer reports in the BMJ:
The remaining five children served Wakefield’s claims no better. There was still no convincing MMR syndrome. Child 1, aged 3 years when he was referred to London, lived 100 miles from the Royal Free, and had an older brother who was diagnosed as autistic.76 Child 1’s recorded story began when he was aged 9 months, with a “new patient” note by general practitioner Andrea Barrow. One of the mother’s concerns was that he could not hear properly—which might sound like a hallmark presentation of classical autism, the emergence of which is often insidious. Indeed, a Royal Free history, by neurologist and coauthor Peter Harvey, noted “normal milestones” until “18 months or so.”
Child 1 was vaccinated at 12 months of age, however. Thus neither 9 nor 18 months helped Wakefield’s case. But in the Lancet, the “first behavioural symptom” was reported “1 week” after the injection, holding the evidence for the lawsuit on track.
Here’s the “new patient” note:
“New patient – recently posted from XXXX. Mum worried re hearing/wax in ears/? Discharge left ear … Reassured.” Then “(NB – older brother … ? behaviour probs and ? family dynamics ?)”.
Here’s the statement by Dr. Harvey (of the Royal Free): “after normal milestones a deterioration from 18 months or so”. The referral letter for this child, sent to the Royal Free, states that the child was normal until age 15 months.
Here is a statement from the records at the Royal Free (day 24 of the transcripts):
“Child 1 was admitted for further investigation of his autism and specifically to look into a possible association between his neurological condition and any gastrointestinal disorders. The main problems are a “classical” autism diagnosed a year ago and of diarrhoea.”
On page 50:
“His diarrhoea started approximately 18 months ago. He passes five watery stools a day which contain no blood or mucous. They do contain some undigested food. He appears to have no control over his bowel movements and frequency is increasing. His appetite has always been poor and there has been no obvious change in this. He has only very occasional episodes of vomiting.
He is up-to-date with his immunisations, including his MMR at 12 months of age. There is obvious parental concern that this has some bearing on his subsequent condition.”
Perhaps not consistent, but Andrew Wakefield knew that the child’s records did not place concern until much time had passed since the MMR vaccination.
The “onset of behavioral symptoms” reported in The Lancet does derive from parental report. But not a very strong report. A letter to Andrew Wakefield about child 1 put it like this:
“I saw this interesting child with autism which began some weeks following MMR although there was 7-10 days after the MMR at the age of 1 a brief illness during which he was pale, possibly had fever and his mother said he may have been delirious. [Mrs 1] was keen that you would have a look at a document that she got concerning homeopathic remedies and I am passing this on to you.”
So, Mr. Wakefield reported Child 1 as having first symptom 1 week after MMR. If you include “fever/delirium”. Not exactly an autism symptom. But developmentally the child was noted as being normal until 15 or 18 months? Is that “fixing” data or just something less than accurate?
The Wakefield 1998 Lancet article did not give an accurate picture of these children, based on the records available to Mr. Wakefield at the time. And that is the important fact: Mr. Wakefield had access to information that put his reported findings into question.
Left Brain Right Brain 
I live in Canada, not the US or the UK. Do parents sign off on medical records in those areas? Here we do not. I obtained a copy of my child’s medical records recently and was surprised at what was missing. Many important details were not recorded, and in one case, the exact concern that brought us to the ER was completely omitted (head-to-toe blister-type rash) when they found he also had an ear infection. Records show we were there for an ear infection only. Just one example. My personal experience shows me that medical records are not guaranteed to be 100% accurate. I have since been photographing and documenting everything myself. If it weren’t for video cameras, many doctors would not even believe in the reality of “autistic regression”. Parents have been discredited in many ways, for far too long. But now, technology will help with that.
Children first: You are getting it round the wrong way. Deer doesnt base his case on what is missing, but what is there. For example, diagnoses which preclude regressive autism, parents making allegations against MMR which are not in the paper, and pre-existing delays. What is missing seems mainly to be in the published paper, not in the records.
How does one know what may or may not be missing, if it is not there? My point is, medical records are not guaranteed to be accurate and I doubt I am the only parent to whom this has happened. Where medical errors are known to occur in the physical realm, why would we not expect them to occur on paper? I urge all of my friends to record data for themselves, with witnesses. What we are given as “truth” may not be worth the paper it’s written on.
Children First,
so, if medical records aren’t to be trusted and, if ChildHealthSafety were correct with this statement “Neither the GP nor the mother is competent to provide the specialist assessment of whether the child’s development was in the normal range”, what’s left?
I am amazed that ChildHealthSafety went so far off-script with that one. Claiming that parents aren’t “competent” enough to give an assessment of their own children is 180 degrees opposite of what Mr. Wakefield’s supporters base their views upon.
If were to throw out parental observations, because parents aren’t competent to provide them as ChilHealthSafety asserts, the Lancet article falls as there is no parental recall on timing of symptoms following MMR vaccination.
The challenge is still out for Brian Deer.
Tell us where the fraud is. You can come to our blog here and tell us.
“Wakefield & MMR – BRIAN DEER CANNOT TELL US WHERE THE FRAUD IS”
http://tinyurl.com/5vs8rwt
If Brian Deer is alleging fraud then he must compare the data and results provided to Wakefield by the Royal Free team with what is in the paper.
What he has done instead is compare the wrong information.
So much for being the first journalist to go behind a medical paper and find the ‘truth’.
We are waiting. There are Children 1 to 7, 9 to 10 and 12 yet to go. Still plenty for you to show us where the fraud is.
Let’s see a nice table comparing the data and results the Royal Free specialists provided to Wakefield with what is in the 1998 Lancet paper.
Come on Brian – let’s see it.
CHS – a few of us have already pointed it out to you time and time again. You refuse to see what’s in front of your face. Which is your prerogative of course.
ChildHealth’s argument mainly centres on picking out a single line of child 8’s medical record and then misreading it. No where in the December 94 write up will you find a statement saying that child 8 was developmentally normal. You will however find statements that the pediatrician was unable to complete diagnostic testing, that he was concerned for the development of child 8, and that further consultations where required.
Yes, the pediatricians general impression from the incomplete battery of tests at the December 94 consultation was that the child was at the bottom end of normal, he remained however (as was explicitly made clear to Wakefield) significantly concerned. By no stretch of the imagination is this synonymous with the Pediatrician declaring that child 8 was developmentally “normal” as Wakefield alleges.
Ask yourself how would a lay person, scientist, or doctor would interpret the statement “previously normal”? Does it in anyway remotely resembling the case history of child 8?
No on all three counts.
Bob. I know Clifford Miller and I can assure you you are not only wasting your time trying to debate him, but you are making things worse all round.
He has no interest in autism or vaccines or child health safety. What he needs to do is cause other people distress. He feeds on this. He will revel in your frustration, drink himself into a stupor, guffawing to himself about how upset he has made people.
This is what some of these people do. They do it because they do it. If it was not so poisonous, I would say that is all there is to it.
SB,
thankfully Mr. Miller doesn’t frustrate me. He reminds me of the people who push the idea that Wakefield had approval for his research project because one of his colleagues had permission to take 2 extra mucosal samples. It’s so clearly wrong, but the plan seems to be to raise the noise level so high as to drown out the facts.
@Children First: guess what? Medical records AREN’T complete. If you are seen in a hospital emergency room by an ER doc, your own physician may not even know about the visit until you tell him/her. Your physician is dependent on the documentation of the other physician and what you tell him. An ER discharge summary will have on it the major reason for treatment which may NOT be why you went to the ER.
For example: I went to the ER because I fell off a ladder and thought I’d broken my ankle. The final ER diagnosis on the discharge record was for a wrist fracture….I hadn’t even realized I had injured my wrist. My ankle, which just turned out to be badly bruised, was not mentioned on the discharge summary. (It was documented in the ER notes, but those are not a part of the summary nor are they sent to your private physician – if he/she gets anything at all, it’s only the discharge summary).
And, doctors are human. If your doctor saw you in the ER for a rash and ear infection, he/she may only note the issue he feels was important for follow up in the office notes. Takes less time and writing that way.
Keeping your own documentation is a good idea – IF you write daily. If you have to look back 1 week, 2 weeks, 1 month, you are not accurate. And parents don’t see things dispassionately. I recall a discussion where a mother tried to prove her child was “previously normal” when video tapes showed that the child actually was not normal but the parents mis-interpreted the behaviors.
“Child 8 was developmentally within the normal range as repeatedly stated by the developmental pediatrician.”
First, it appears to have been stated only once, and only in relation to an incomplete or insufficient assessment. Second, the paediatrician appears to have completed a formal assessment as part of a ‘review’ session, based on continuing concerns, and does not appear to have noted any significant changes.
There is no suggestion that the two sessions contained functionally and clinically seperate fully completed and sufficient assessments. As Sullivan has pointed out repeatedly, the second session appears to be a direct continuation of the first.
No statement supporting the view that the post-MMR assessment was clinically seperate from the pre-MMR assessment process has been supplied, despite the extreme importance of such a statement.
However, multiple statements that support the idea that the post-MMR assessment was a direct continuation of pre-MMR concerns exist, and have not been shown to be false.
The only supportable conclusion is that the latter assessment is clinically superior to the first, and should be considered to be the ‘proper’ assessment, and should be considered to be based on concerns that pre-existed the MMR until much stronger evidence is provided. A simplistic before/after comparison does not cut it, for reasons that have been extensively laid out.
No one here has any problem with the idea of a full assessment being superior to an abortive assessment, nor do they have any problem with the idea of a full assessment discovering more than an abortive initial assessment. No one, that is, except CHS.
Had Child 8 not had the MMR, their assessment progression would have been unremarkable, and no one would have had any difficulty in regarding the initial assessment as less valid.
The problem here is, is that CHS’s point is technically correct – as long as you fail to acknowledge the context and later statements – yet a fuller exploration of the assessment process indicates that the second assessment supercedes the first and was based on contemporary concerns – i.e. that it was not a new referral or was not for new concerns.
CHS is treating the assessments as equally valid and clinically seperate, when there are multiple statements that indicate otherwise. ‘Somehow’, CHS repeatedly fails to provide this full context in their arguement, despite it being hugely important to correctly intepreting Deers claims.
It seems we are only supposed to trust developmental paediatricians when they say what CHS wants them to.
Re Sullivan’s comment about advance ethical permission
Eloquently and succinctly put. Much better wording than I’ve used.
Just a thing to note here: In my son’s own doctor’s medical records it is noted that his ‘reaction’ started on a much later date than the first date that we called her with our concerns over his 24 hour fever and screaming. Furthermore, in the notes, there is an entire section where either the Dr or the staff “whited it out”. When I confronted her about the discrepancy, she quickly told us that she could no longer see us as patients and that we should find another doctor.
Doctor’s do make mistakes and try to cover them up. No one is infallible.
Sullivan January 13th, 2011 @ 15:25
“so, if medical records aren’t to be trusted and … “Neither the GP nor the mother is competent to provide the specialist assessment of whether the child’s development was in the normal range”, what’s left?”
The specialist – in Child 8’s case the developmental pediatrician who saw her twice before MMR [a month before] and a few weeks after and who was not part of the Royal Free. Her history was within the normal range.
Is Brian Deer yet ready to come over to CHS to deal with the rest of the children?
Waiting for him here:-
“Wakefield & MMR – BRIAN DEER CANNOT TELL US WHERE THE FRAUD IS”
http://tinyurl.com/5vs8rwt
Children First,
could you defend what appears to be your personal conclusions? I have presented information to support my conclusions and have pulled more and more as the discussion has gone on. It is very easy to dismiss data and interpretation with a pronouncement like “closed minds” and “defend personal conclusions”. Or, has ChildHealthSafety has done, try to keep score like this is some sort of debate club rather than a reasoned discussion.
The facts are there–Wakefield’s paper doesn’t accurately represent the data he had in hand. The discussion above shows that repeatedly and in multiple instances. The discussion has shown that Mr. Wakefield misrepresented the facts in his own defense attempt (Callous Disregard). His claim of child 8 having a reaction within 24 hours is not supported by any available data.
ChildHealthSafety shows that by carefully editing out key passages in doctor’s notes, he can create the appearance that Mr. Wakefield was correct. It is a circular argument: misrepresenting the data now doesn’t defend Mr. Wakefield misrepresenting the data 13 years ago.
Thanks Kevin. It’s nice to see some purity here. It’s troublesome that many above are here only to defend their personal conclusions, with closed minds. This is going nowhere.
Children First,
do you agree with ChildHealthSafety’s claim that parents are not competent to report their own children’s developmental status? This seems key to his argument and would fall into the realm of an attempt to try to defend his own personal conclusion.
ChildHealthSafety is entitled to his/her own opinions, as are you, and it matters not who agrees or disagrees with him/her or others. My personal issue is with defending already made-up minds. Few are here in pursuit of answers, and only to defend views. And to answer your previous question, no I will not share my child’s private medical records online (or even privately with you). My child’s medical records are private.
My apologies upfront, but please refrain from asking further questions directly of me. I was just visiting the site briefly, and won’t see further posts. Good luck with your debate.
Children First,
Good luck in your endeavors. I will note that you had an opportunity to respond before leaving and you declined that opportunity.
Children First,
It is unfortunate that you have left us as I don’t understand who you believe asked for access to your child’s medical records. It certainly wasn’t me.
I am certainly interested in pursuing answers. Where we diverge is that the answers I find are clearly at odds with the assertions made by Mr. Wakefield and ChildHealthSafety.
If we can’t trust the parents and their were huge problems with the medical records and what Wakefield saw and didn’t see, then how did Wakefield know what to write about the medical history of each child. Perhaps an Ouija board?
Not anxious to wade too deep into this already aging thread, but have to say I’m interested in the debate over what/when and Child 8 in no small part because his/her assessment history mirror’s my son’s.
When we first voiced concerns to our pediatrician, she disagreed, but sent us for an eval by a developmental pediatrician, who noted mostly normal (but slow-end) development, but difficulty in doing the assessment. No diagnosis. Recommended re-eval after a year. 18 months later, autism diagnosis by the same devel. ped.
Squillo so sorry to read that, it took us the same 18months for diagnosis(even without it you know) .Thanks to Deer thousands are appearing now with severe Autism .When Dr Wakefield et-al were preparing court material they could have, and would have been treating our kids…SHAME ON DEER…SHAME ON ALL WHO SUPPORT HIM ON HERE AS WELL.
AWOL,
Are you suggesting that wakefield should have been treating children instead of being in the GM C hearings?
Are you aware that he is legally unable to treat in the US? He has no license. One of the problems he got himself into was participating in the clinical aspects of the children at the royal free hospital, as his post expressly forbade that. He was a researcher with no treatment privileges.
There seems to be some confusion about scientific ethics. It is considered fraud to omit information that might cast doubt on your hypothesis, even if you personally feel that information is incorrect or misleading.
Let us suppose, for the sake of the argument, that Wakefield had two conflicting reports from physicians, Physician 1, a GP, reports concerns that the child has not been developing normally from an early age, but Physician 2, a specialist in neurological disease, felt that the child’s pre-vaccination development was within normal limits.
If Wakefield were to report, “Although the child’s GP reported concerns about early development pre-vaccination, a specialist in neurological disease disagreed and considered early development to be within normal limits. Because of the GP’s lack of certification in diagnosis of developmental delays, we rank the child’s early development as normal,” that would be scientifically legitimate, as it provides full information to the reader, who can then decide whether he agrees or disagrees with the authors’ criteria for weighting developmental assessments.
On the other hand, to completely omit any mention of a discrepancy in diagnosis between the two physicians would constitute scientific fraud.
The rules of science are quite clear: you don’t get to pick and choose which information to report. You have to report all of it. If you choose to discount some of it, you have to specify what you are discounting and why.
Sulliavan and trrll
Yes trrll only when its Dr Wakefield and the Royal Free are the rules cast in stone,I ask you is Deer now going to after all the memmbers of staff at the Royal Free possibly including the cleaners and kitchen staff,not many left now that he can go after..
Most of Deer’s spurious “evidence” is not permissible in The High Court I believe Dr Wakefield has lodged an appeal on the verdict of the GMC hearing ,so its early days to throw away the key,. If Deer and the GMC , are so cock sure, of the stance and the “evidence” why is it Deer and the GMC wont answer any, of the many questions being asked of them concerning Deers ,wonderland stories ,why?
First, let me say if Kevin reported truly and there are “whited out” sections in his child’s medical records, he should report that physician to the medical board. Records should NEVER be whited out. In case of an error (i.e. medical information for one patient got written on another patient’s chart – yes, it does happen) the data should be stricken out with one or two lines through it and the word “error” with initials and date written next to it. I can’t speak for any other place but the US, but a medical record in the US with that sort of issue would be highly suspect legally.
Second: I don’t see where anyone asked Children for her child’s medical records. But, since she ran away, I don’t think we will ever know who she is implying would do so.
Lastly: Anyone with medical knowledge who reads a record such as Child 8 knows that the doctor has concerns. Doctors don’t keep patients who don’t need them. The fact that the Developmental specialist saw child 8 several times means that there was something to be concerned about. You don’t need to do developmental testing on a child who is developmentally normal; you can look at that child, even coryzal and miserable, and see they are developing normally. You do (or plan to do in the future when the child is healthy and can perform to the best of their ability) full testing on a child who does not appear to be developing normally.
AWOL:
Wakefield has claimed he would appeal and had 28 days from the GMC ruling last May to do so but I don’t see that he has. And so what if he has? It’s not as though merely filing an appeal exonerates him.
Mr. Deer has put forth his evidence in the form of easy-to-read features in the BMJ; he is under no obligation to answer to internet whiners, even though he has made numerous comments here and on Respectful Insolence. This is all rather elementary, if Wakefield has been libelled, he can seek relief in the UK court system, which is very plaintiff-friendly. He hasn’t done so, nor have any of his half-brained sycophants, even those with law degrees done so. Instead they are taking their case to the internet. Pretty weaksauce if you ask me.
AWOL wrote:
Most of Deer’s spurious “evidence” is not permissible in The High Court I believe Dr Wakefield has lodged an appeal on the verdict of the GMC hearing ,so its early days to throw away the key,. If Deer and the GMC , are so cock sure, of the stance and the “evidence” why is it Deer and the GMC wont answer any, of the many questions being asked of them concerning Deers ,wonderland stories ,why?
Um… Brian Deer wasn’t a witness at the GMC. I don’t think his stories were introduced as witnesses.
Brian Deer supplied his stories and other information to the ‘prosecutors’ and they used it as they chose.
Wakefield is shown as appealing on the GMC site, inasmuch as his erasure is not yet in force.
The information used in the appeal will be the transcipts, evidence and decision of the GMC. I can’t see any reason for either side to even try to introduce new evidence.
@sheldon
When and where did I say Deer was a witness?
When and where did I say his stories were witnesses?
My point is most of the conjecture Deer put forward has not a grain of truth in it and would have been thrown out before reaching The High Court.
Yes,,, I have just pointed out above that Brian Deer grudgingly posted on ORACS blog Dr Wakefield has appealed Deer only admitted and posted this after being hectored by a poster “One Queer Fish” into a reply as obviously ORAC et-al pleaded with Deer to clarify to stop the forum pharma bloggers from making a bigger arse of themselves.
Deer hadn’t even informed his supporters and friends that Dr Wakefield had raised an appeal…with friends like Deer who needs enemies…
I am 100% sure new evidence shall be introduced 100% sure of that…
In the meantime, Mr Deer and the BMJ could reply to the many questions circulating but they aren’t –cant because it seems they cannot defend Deer’s conjecture in wonderland ..time for bed Alice
this should have gone up first
Science Mom
Ill be brief do your research a bit more before putting pen to paper.Here is Brian Deer on ORACS blog
http://scienceblogs.com/insolence/2011/01/as_andrew_wakefields_defenders_circle_th.php#comment-3093837
“311 With regard to Wakefield’s purported appeal, I’m afraid it’s the same old story. He has filed a document, but has done so “in person” (meaning without representation) because, on advice from his GMC defence legal team, the Medical Protection Society has declined to fund an appeal.
I guess they figure they’ve thrown enough of their members’ money down the toilet.
So, he has a document filed, so he can say he is appealing, but he doesn’t actually do anything to progress it – as he tried to do with his libel action, and which he did with a complaint two years ago to the Press Complaints Commission.
I’m not sure what the GMC does in this situation.
Posted by: Brian Deer | January 14, 2011 3:34 PM”
Fine since Deer writes it ,it has to be right for you to believe it.28 days to raise and however long the GMC want to take before responding…
The rest of your abuse doesn’t merit a polite reply just to say as Deer has proved you wrong above complain to him for not informing you, not whoever it is your referring to above.
No replies have been sent by the GMC r.e. Deer’s latest adventures in wonderland, and Deer has gone quiet remarkable for someone who seeks attention so much…ADHD possibly…
AWOL:
As I stated, it doesn’t matter if Wakefield has filed an appeal to the GMC ruling. If it was that important, I would have done my due diligence by investigating that. But thanks for supplying Mr. Deer’s report of Wakefield’s appeal application, it looks as though he is swinging in the wind solo on this. Come back when and if he actually pursues it and prevails.
Mr. Deer isn’t required to keep me personally informed of the Wakefield issue. He has published his results of his investigation in BMJ; he is also not obligated to make personal appearances to answer the vapid charges by Wakefield’s deluded supporters either. You haven’t provided a single shred of evidence to the contrary to Mr. Deer’s reports, just the predictable, “He’s a lying poopie-head”. So tell Wakefield to file a libel suit against Deer, BMJ and the Sunday Times if Deer is wrong. Why hasn’t Wakefield vowed to do this instead of whining about Deer in the press?
You simply can’t answer that can you?
@Science Mom
To cut to the chase ,if Dr Wakefield raised libel ,Dr Wakefield would have to disclose information to Deer while his appeal is being considered by the Kangeroo GMC Board (K.G.B.) .Think hard now, who would benefit from that scenario remembering Deer has broken his Oath and used the evidence he obtained from Judge Eady in the previous libel when he was only meant to use it for his defence(the material you see in his latest wonderland pieces came from Eady).
I ask you,is it any coincidence Deer knows he can bait Dr Wakefield to proceed with libel as he knows Dr Wakefield once bitten twice shy…was that simple enough for you??
So, Mr. Deer somehow tricked Mr. Wakefield into bringing complaints…twice? It’s Brian Deer’s fault that Mr. Wakefield put forth complaints that he (Dr. Wakefield) couldn’t support?
The term here is Blameshifting.
If thats cutting to the chase AWOL I’d hate to see you being verbose lol…what a pile of shite.
Kev
It was cutting to the chase I just answered her last three and a half lines and ignored the othe ,mumbo..
Sullivan
You know very well that Dr Wakefield stopped the libel because of the GMC complaint and the disclosure by Judge Eady of medical notes which Deer is using now and breaking his Oath to Judge Eady and the Uk Justice system. Just as well Dr Wakefield stopped the libel, before Deer got the name of the kitchen staff and the cleaners and everyone else at the Royal Free as they would have been,fingered by Deer in his Wonderland allegations as well.. Just like s a used condom Deer will be dumped when the deed is done ..
AWOL:
Are you daft? If Wakers had evidence that would have exonerated him during the GMC hearing, he would have presented it. As it stood; he made no attempt to defend himself. If he possessed some super secret information that would exonerate him in an appeal, it would be the same that could prove Deer was in error.
No hard thinking required, you’re lobbing softballs. Deer didn’t break his oath; he was constrained from using the discovery materials from Waker’s libel suit against him since the suit was dropped. And he did so until after the GMC hearing, during which, all of the same materials were presented and made public. The only ‘Wonderland’ is the one you seem to exist in.
Simple, yes but also a big load of bollocks. Do you honestly believe that he, the Sunday Times and BMJ would be banking on Wakers being reluctant to proceed with a libel suit rather than, oh say, fact-checking the hell out of Deer’s investigations so that it would withstand scrutiny by any standard of evidence? That was a rhetorical question since it is clear that you are incapable of reporting any factual information.
Science Mom When did you ever hear of an appeal while your case is still running?Appeals are after the hearing Dr Wakefield is waiting for guidance from the GMC concerning his appeal….so whatever material he has just now for his appeal he would have to provide that to any hypothetical appeal..Get it??
Wrong Deer was only permitted to use any documentation for his defence ..end of period Deer has broken his oath … since you only listen to Deer see for yourself
http://briandeer.com/wakefield/eady-gmc.htm
Hey, your not often right, but your wrong again..the fact checking has been done and a multitude of answers are waiting to be answered this is on Kevs blog so you should pay attention..
https://leftbrainrightbrain.co.uk/2011/01/the-big-lie-what-andrew-wakefield-did-was-possible-and-fraudulent/#comment-127533
Beggar’s belief why the GMC and rapid fire Deer don’t reply??
Factual enough for you??heaps more if you can take it in..
corrected meant to read
material he has just now for his appeal he would have to provide that to any hypothetical LIBEL CASE..Get it??
Rather than just spout nonsense, ask questions.
To help with Wakefield’s defense, the GMC supplied Wakefield with medical records.
At the same time, Wakefield was suing Deer. As part of the discovery process, Wakefield had to supply the information he had, which included the records the GMC sent him.
Deer wanted to use the GMC information, but the GMC objected. So a motion was held before a judge. The judge held that Deer could use the information in the lawsuit. He used them under supervision.
Wakefield dropped the lawsuit. So Deer couldn’t use the information in the records.
At the GMC hearing, the GMC made public the medical records of the kids. And that’s how Deer got legal access to the records.
There’s no advice from the GMC. The GMC decided to erase Wakefield. Wakefield has filed a notice of appeal, acting for himself. The usual way insincere appeals are eliminated is because the appealing party doesn’t order the transcripts. A court reporter take notes or uses a steno during a hearing or trial. But they are only transcribed if somoeone is going to order and pay for them. And the cost of transcripts can be huge. In Wakefield, the GMC did transcripts. So aside from filing fees, there’s no cost to Wakefield of appealing.
Sheldon
A number of vaccine “safety” orgs stepped forward to pay Mr. Wakefield after Thoughtful House let him go.
I have no doubt that if they felt that Mr. Wakefield could prevail against Mr. Deer, the financial backing would appear quickly.
Mr. Wakefield is now a spokesman for those orgs. His previous salary was $270,000 per year. If the can support Mr. Wakefield, they can pay his legal fees.
sheldon101 January 16th, 2011 23:26
Ha, ha, ha, ha, ha ….
An appeal just involves filing transcripts. Tooo funny.
You seem know just as much about vaccine safety.
@sheldon
Swat up time the longer the questions remain unanswered the more dispondent your side is going to get
“if you look at Deer’s report, in most cases he is comparing the Royal Free’s own records with the Lancet paper”
Mr Deer has done it a tad shoddily it seems. How that got past the “peer reviewers” raises questions about what “peer review” means at the BMJ.
Unfortunately Mr Deer appears to have gone to ground and is not even answering basic questions put to him on his new Guardian blog.
Instead his “big sis” ploy is to get the BMJ Deputy Editor to post instead – she says “if you don’t like what we say sue us”. Which is a remarkable position for a supposedly peer reviewed journal to take.
“In most cases” takes on a new meaning regarding Child 11 – remember these are allegations of fraud being made – see below.
And we see you, like the usual suspects on a Kev Leitch blog. engage in the usual personal attacks on people who are not around to defend themselves. Nice. The usual bully tactics.
Regrettably “visitor” it is the answers from Mr Deer himself which are needed – the horse’s mouth so-to-speak and not the go-betweens on Kevin Leitch’s blog.
Can we have answers from Mr Deer please or is he continuing to hide?
______________________________
Examples Mr Deer refuses to answer. Perhaps he might step out of the shadows now and deal with them?:-
Child 1, 8, 11
In order to “go behind” the 1998 Lancet paper, Mr Deer needed the original data and records provided to Mr Andrew Wakefield by his 12 other professional specialist colleagues at The Royal Free Hospital, London.
Does Mr Deer have exactly that data and those records? Or has Mr Deer instead relied on such of the NHS records of children either disclosed to him under Court rules [CPR 31.22] in the Wakefield v Channel 4 & Deer libel litigation and/or information contained in the transcripts of the General Medical Council proceedings.
Child 11’s medical records were not available for the GMC hearings. Very little mention was made of Child 11. Can Mr Deer explain upon what particular medical records for Child 11 he relies?
DEVELOPMENTAL HISTORIES
This is what the 1998 Royal Free Lancet paper said about all the Lancet 12 children:-
they had “a history of normal development followed by loss of acquired skills”.
That was a main issue the 1998 Royal Free Lancet paper was reporting on scientifically and medically. It also states clearly it was an “early report” and called for further investigation.
CHILD 8
Mr Deer says about Child 8:-
“But although the paper specified that all 12 children were “previously normal,” [Child 8] had developmental delays, and also facial dysmorphisms, noted before MMR vaccination.
For Child 8 specifically the Lancet paper stated:-
“Prospective developmental records showed satisfactory achievement of early milestones in all children. The only girl (child number eight) was noted to be a slow developer compared to her older sister.”
Let us now compare what The General Medical Council hearing transcripts show regarding Child 8’s specialist developmental pediatrician’s opinions. This specialist was not any part of the Royal Free team and was part of the normal UK NHS health service.
May 1994 age 10.5 months:
“There were no neurological abnormalities and I felt that her development was within normal limits”
23 December 1994 (approx 18 months) – developmental pediatrician wrote:
“I felt that her abilities, although delayed on the average age of attainment were not outside the range of normal. Her growth has been satisfactory.”
17 February 1995: The developmental pediatrician writes three weeks after MMR:
“When I reviewed her in clinic recently I confirmed that she is globally developmentally delayed, functioning at about a one year level on Denver Developmental Assessment. …… General examination is unremarkable. There were no neurological abnormalities other than the developmental delay.”
As this is a scientific medical paper specifically focussed on developmental histories, can Mr Deer please explain where he believes the discrepancy is between what is reported in the Lancet paper and what the developmental pediatrician recorded in his clinical opinion.
Can Mr Deer also please confirm that the appropriate opinion to rely on in such a case is that of the specialist developmental pediatrician and not the views of Child 8’s mother nor the view of the referring General Practitioner.
Would Mr Deer like to confirm that in scientific terms in a scientific medical paper reporting on the history of development, Child 8’s clinical history was normal prior to MMR vaccination – or as the specialist developmental pediatrician stated within the “normal range”.
CHILD 11
Assuming Mr Deer did not have Child 11’s full medical records, on what basis can anyone make a serious allegation of fraud?
CHILD 1
Mr Deer implies [but does not say] that Child 1 may have had symptoms of an autistic condition aged 9 months – well before the MMR vaccination:
“One of the mother’s concerns was that he could not hear properly—which might sound like a hallmark presentation of classical autism, the emergence of which is often insidious.”
The additional GP records disclosed in the GMC proceedings (but not available to the Royal Free team) contain an entry documenting in addition to his mother’s concerns about Child 1’s hearing, her additional concern was about a discharge from Child 1’s left ear. Is it not correct that this concern is not suggestive of an incipient developmental disorder but of an ear infection?
BMJ FACT CHECKING
In The Sunday Times last, 9th January, Mr Deer says he insisted the BMJ checked his facts. Did they do so? And if so, what did they do?
INSPECTION OF DATA
Perhaps Mr Deer would be kind enough to confirm where the data relied on in this article can be inspected please?
Mr Deer claims to have gone behind the Royal Free’s 1998 Lancet paper to expose fundamental flaws.
Would Mr Deer perhaps agree that it now seems from this BMJ paper by him that is not what he has done?
It appears Mr Deer has compared the Lancet paper’s findings with the childrens’ GP records instead of with the data and results provided to Mr Andrew Wakefield’s other 12 authors on an interdisciplinary team of medical specialists.
It would be helpful for Mr Deer to explain how on such a basis can an allegation of fraud be sustained?
If Mr Deer wanted to “go behind” the paper then he needed to have the data and results provided for the preparation of the Lancet paper and compare it with the contents of that paper.
The 1998 Lancet paper was written by Mr Andrew Wakefield based on the data and results provided to him by those other 12 specialists.
If there was any falsification as is now being alleged in the British Medical Journal Mr Wakefield’s 12 other authors would have noticed immediately.
Those other authors had the initial referral letter from the GP, the “Red Book” of developmental progress [held by the parents], fresh parental histories taken by Professor Walker-Smith [not Wakefield], test and clinical examination results and any further information in any ensuing correspondence with GPs.
The Royal Free Team did their own examinations, took fresh histories and made their own specialist diagnoses afresh. They did not rely on family doctor [ie. non specialist] GP records. This is standard practice in British NHS hospitals.
GP records are made by non specialists [General Practitioners], taken over years, by more than one person, omit information provided by parents and contain other information unknown to parents.
It is also clear from the transcripts at the GMC that the GP records are riven with fundamental errors like incorrect dates of vaccinations [eg. Child 8 – 7th January instead of 27th January – “I think” said the GP in evidence] and incorrect types of vaccinations being recorded [eg. Child 4 – was it measles vaccine or was it MMR – the records say MMR – the GP said in evidence it was measles].
Additionally the 1998 Lancet paper stated prominently on the first page “Early Report” and it called for further investigation.
Does Mr Deer not agree that an “early report” is an alert to other medical practitioners of a potential problem and not a claim to have found and proven one?
CHS, you’re a UK solicitor. If one is appealing and doesn’t have to ask permission and you’re not meaning to actually sincerely argue it what are the difficult steps beyond filing the appeal with whatever grounds you want, filing the transcipt and writing any garbage in the written argument. As long as Wakefield doesn’t need permission, why can’t he insincerely drag out the process?
Don’t understand how the game is played!
—————————————-
Here and elsewhere Wakefield apologists demonstrate that they don’t know the rules or pretend they don’t.
Here is the rule.
1. Pretend (It is pretend, because it is false) that Wakefield had a random group of kids with GI symptoms who were normal before MMR and developed autism days after MMR.
Kids who aren’t normal before MMR don’t support his case.
There can be differences in opinions of whether a kid is normal or not. Wakefield has to prove his case. So if there’s a difference of opinion, then at a very minimum the paper has to say so. I’d argue that this is sufficient to count as symptoms before MMR. But I might be satisfied with uncertain.
Now that doesn’t apply to Child 8 where a REFERRAL letter is sent to Wakefield. Or child 11 where there is a discharge summary by one of the co-authors. They count as symptoms before MMR.
Sheldon101,
I haven’t checked all the other kids. The one with high lead levels stuck in my mind because of the heavy metal causation hypothesis. Well, that and the fact that Wakefields team chose to not treat.
By the way, AWOL here is also One Queer Fish on Respectful Insolence.
I don’t think you ‘get it’ fish. You are conflating terminology. Nothing is stopping Wakers from instigating a libel suit against Deer ‘while waiting guidance from the GMC’. Nothing is preventing Wakers from filing a PCC complaint and announcing he is suing Deer for libel. The problem is, is that his argument amounts to:
“These allegations are false. Read my book.”
Sheldon covered that, so no need to reiterate. No broken oath and funny, no one else, especially in a position of actual authority thinks so either.
Yes, the fact-checking took place prior to Deer publishing the BMJ features; there is no onus for him to run about answering the caterwauling from Wakefield sycophants on the interwebz. Linking back to one of your own comments is weak gruel.
What part of this don’t you understand? They don’t have to. Your non-acceptance of the evidence against Wakers does not constitute a continued discussion on behalf of anyone else.
Actually, no. Other than confirming that Wakefield filed an appeal, your screeds have been remarkably fact-free.
At this points things are simply getting silly, Wakefield doesn’t want to sue Deer because he has a secret cache of new evidence that he doesn’t want anybody seeing before his appeal?
Let us engage our brains for a second 1)Wakefield does not have any substantial new evidence because if he did he would of submitted it to the GMC during his trial. 2)If the BMJ article’s were either inaccurate or unfair in it’s reporting of the publicly available information as Wakefield alleges then he could bring a libel case against Deer without needing to submit anything new to the public record.
My faith in AWOL and ChildHealth has now become so low that I am forced to point out the glaringly obvious. The Dr Houlsby mentioned in Dr. Jelley’s referral letter (above) is the developmental pediatrician that assessed child 8. The information in that letter is crystal clear evidence that 1) Wakefield had sufficient information to know that child 8’s medical history was not “previously normal” and 2)That Wakefield was made aware that Dr Houlsby did not share Wakefield’s view that there was any severe deterioration in child 8 condition following MMR. The fact that Wakefield has the balls to say ten years later that not only was child 8 normal pre-MMR but that it wasn’t him that diagnosed her as such is staggering, even more mind blowing is that people believe him.
BoB January 17th, 2011 07:39
That is not the issue the Lancet paper was addressing.This is what the 1998 Royal Free Lancet paper said about all the Lancet 12 children – they had:-
@CHS: for the last time: Child 8 did NOT have a history of normal development. Being consistently on the “low end” of normal is not normal. Some children DO develop different skills at different paces – They may not walk until 15 months (late), but they are using a pincer grasp at 7 months (early). And again, the developmental specialist was not able to TEST Child 8 until after the MMR because Child 8 was non-cooperative due to illness. His comment that growth was normal after the surgery reflects physical growth.
Go be Wakers solicter, CHS, and sue us all for libel because we are calling you, Wakers and all his defendents liars. Why not? You are in the UK where libel laws are very liberal and pro-plaintiff. Go for it unless you KNOW Deer is right and you are wrong.
(crickets, anyone?)
Science Mom
Your entitled to your opinions but I just feel sorry for anyone not clued up in the Autism debate reading your posts as they are all based on the lies of Deer ,nothing in-between .
Sheldon you get down from whatever your on and smell the rosies.
Brian Deer answer the questions your supporters are becoming weary and running out of logical answers you’ve really got them confused what to say this time even Sullivan seems stumped and short with the replies where in previous arguments he has written reams.
“Being consistently on the “low end” of normal is not normal.”
Especially not if the same assessing clinician later ‘confirms’ that the client is not normal once they get around to performing a full and sufficient assessment.
Under normal circumstance, Child 8’s assessment progression would not attract comment – no-one would seriously suggest that the follow-on assessment was an assessment of entirely new impairments – that is, unless said person was trying to prove a pre-conceived point.
I’m still waiting for the comment from the clinician involved that states the assessment was anything other than a normal follow-on from a previously abortive assessment. Claiming she ‘regressed’ without documented evidence from the person most likely to have spotted and noted it is simply not behaviour that should be tolerated in any discussion of Child 8.
Dedj January 17th, 2011 18:01:31
Dissembling.
It is a sad fact that 50% of the population are below average intelligence – which ones would you say are “not within the normal range” of intelligence or development?
And the Lancet paper noted:
Where is the fraud? Nowhere. You can argue all you like.
Brian Deer remains silent.
If the subject had been buying a used car and Wakefield was the proverbial ‘used car salesman’ then maybe, just maybe, the information on child 8 in the paper maybe, just maybe might be acceptable.
But that’s not the case as far as the GMC is concerned and that’s not the case where a scientific paper is concerned. And especially not when the the selection proces of the kids has been dishonesly described in the paper and elsewhere.
It isn’t a game of gotcha, which is what Wakefield supporters are playing at. What made the paper publication worthy in the paper was tht kids were normal before MMR. Arguing over the precise wording isn’t how scientific papers are evaluated, especially when other failings make it very, very likely that the wording is meant to mislead.
If you don’t like that answer, here’s another. Pretend it was OK for Wakefield to word the information on Child 8 the way he wanted. But at the same time, he has to include clear information from the referral letter sent to him and specify the source as a referral letter. And let the editor and peer reviewers make up their mind as to whether to publish the paper. For some strange reason, Wakefield didn’t do that. Perhaps it was concern that the paper would be round filed.
Dedj January 17th, 2011 18:01:31
Here is it. The General Medical Council hearing transcripts show regarding Child 8’s specialist developmental pediatrician, [who was not any part of the Royal Free team and was part of the normal UK NHS health service] said on 17 February 1995 three weeks after MMR:
Follow the evidence.
Mr Deer remains silent.
sheldon101 January 17th, 2011 18:15:52
Dissembling.
We need Mr Deer’s answer.
“Dedj January 17th, 2011 18:01:31
“Being consistently on the “low end” of normal is not normal.”
Dissembling.
It is a sad fact that 50% of the population are below average intelligence – which ones would you say are “not within the normal range” of intelligence or development?”
First up, you have quoted me quoting someone else, yet have responded as if I was the original authour.
Second, you should be aware of such things as standard deviations and percentiles, as they apply to determining where normal and sub-normal are. Go away and gain this awareness.
Third, any chance of maybe, someday, if someone holds your hand for you, if someone reads out the longer words for you, if you get a good run-up and a good following wind, actually coming around to thinking about addressing the idea that Child 8’s follow-on assessment was a follow-on assessment of the earlier abortive one and not an assessment of new impairments.
Are you, are are you not, going to provide any information that would indicate the follow-on assessment was, in fact, assessing post-MMR damage? A quote saying such from the clinician? A new referral letter? A discharge sheet? Anything at all, that hasn’t been shown to be missing extreme amounts of context by Sullivan?
i.e., are you going to start posting evidence or going to continue in totally missing out the important bits about Child 8 – the bits which (‘coincidentally’ I’m sure) are the most damaging to your case?
“We need Mr Deer’s answer.”
This does not mean he has to supply an answer, especially given that his original article identifies several examples, with references to original documents and later findings.
That you don’t like or understand the answer is not an indication that he has not provided one.
Why the silence Dedj,Deer is someone who blood sucks attention wherever he goes even bating sick children and parents outside the GMC for the sake of attention see the link below .
For Deer, to keep so,so quiet, a bit strange somewhat,is it not??
Deer attention seeking outside the GMC