Fact checking Brian Deer on Andrew Wakefield

11 Jan

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.

593 Responses to “Fact checking Brian Deer on Andrew Wakefield”

  1. sheldon101 January 27, 2011 at 04:27 #

    January 26th, 2011
    23:36:49
    Did Brian Deer say the following?

    “Dr Wakefield was, as you know, a senior author of the Lancet paper, and publication of the paper, together with the commentary and the observations that he made at the press briefing…

    Everyone who thought it was Wakefield’s barrister gets a point.

  2. Rosemary Cousins January 27, 2011 at 10:03 #

    SCIENTISTS ARE THE KING OF THE BEASTS

    It is my genuine understanding, from the information which I have before me (details of which I cannot go into because of my up and coming court case) that a team of British neuroscientists/geneticists have made a major discovery in our genes and as a consequence now have a massive understanding of the shift in the human gene pool.

    The Government must make a statement.

  3. John Stone January 27, 2011 at 10:19 #

    Balzola abstract here:-

    http://justthevax.blogspot.com/2010/05/wakefield-drops-bomb.html

    Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients.
    Federico Balzola, Clauser Daniela*, Alessandro Repici, Valeria Barbon, Anna Sapino***, Cristiana Barbera**, Pier Luigi Calvo**, Marina Gandione*, Roberto Rigardetto*, Mario Rizzetto.

    Dept of Gastroenterology. University of Turin. Molinette Hospital Turin, Italy

    *Dept of Neuropsychiatry for Children. University of Turin Regina Margherita Pediatric Hospital, Turin, Italy ** Dept of Pediatric Gastroenterology. University of Turin Regina Margherita Pediatric Hospital, Turin, Italy *** Dept of Biomedical Science and Human Oncology University of Turin

    Although the causes of autism are largely unknown, this long-life developmental disorder is now recognised to affect as many as 1 to 500 children. An upper and lower intestinal disease has been recently described in these patients (pts) in spite of gastrointestinal symptoms have been reported by the parents back more many years. This disorder comprising ileo-colonic lymphoid nodular hyperplasia (LNH) and chronic inflammatory colonic disease was called autistic enterocolitis: an association between autism and bowel disease was then proposed.

    Nine consecutive male pts (mean age 18 years, range 7-30 years) with a diagnosis of autism according to ICD-10 criteria that showed chronic intestinal symptoms (abdominal pain, bloating, constipation and/or diarrhoea) were enrolled. After routinely blood and stool tests, gastroscopy and colonoscopy with multiple biopsies were performed under sedation. A wireless enteroscopy capsule was also performed in 3 adult pts.

    Anemia and fecal blood positive test were found in 2 pts and 3 pts, respectively. Gastroscopy revealed mucosal gastritis in 4 pts, esophagitis in 1 and duodenitis in 1 pts. Histological findings showed a chronic inflammation of the stomach and duodenum in 6 pts (66%) but inconsistent with celiac disease. Macroscopic mucosal abnormalities (aphtoid ulcerations and loss of vascular pattern) were found in 1 pts (11%) at colonoscopy and a LNH in the terminal ileum in 4 pts. (44%) Microscopic colitis with intraepithelial lymphocytes and eosinophils infiltrations, mucosal atrophy and follicular hyperplasia was histologically present in all the pts (100%) whereas a chronic inflammation with iperemia and villous shortening of the terminal ileum was shown in 6 (66%) pts. The wireless capsule revealed areas of bleeding or patchy erythema, mucosal erosions and ulcers in both jejunum and ileum in 1 patients whereas a particular chronic jejunum and ileal erosive pattern was evident in the other two.

    These preliminary data are strongly consistent with previous descriptions of autistic enterocolitis and supported a not-coincidental occurrence. Moreover, they showed for the first time a small intestinal involvement, suggesting a panenteric localisation of this new IBD. The treatment to gain clinical remission has still to be tried and it will be extremely important to ameliorate the quality of life of such pts who are likely to be overlooked because of their long-life problems in the communication of symptoms.

  4. Rosemary Cousins January 27, 2011 at 11:11 #

    JOURNALISTS TAKE NOTE:

    I draw the attention of journalists and members of the Government to the comments of some individuals on this autism blog. A blog which was set up as a platform by a denomination of The State itself.

    The relentless persecution parents of the disabled have endured at the hands of The State is there for all the world to see.

    • Kev January 27, 2011 at 13:35 #

      A blog which was set up as a platform by a denomination of The State itself.

      Careful Ms Cousins, you’re at best, wrong and at worst, lying. This blog was set up by me at the behest of no one at all.

  5. Rosemary Cousins January 27, 2011 at 12:45 #

    A FISH ROTS FROM THE HEAD

  6. Catherina January 27, 2011 at 13:00 #

    Good morning, Mr Stone.

    The abstract you have posted from Federico Balzola is just that, a conference abstract. It was presented in 2005, so over 5 years ago and has not seen the light of day as a proper, peer reviewed study yet. My guess is, that it won’t (although Dr. Balzola showed some motivation on tour with *that* circus).

    What we would really be after is an independent verification of Andrew Wakefield’s (fraudulent, it has been alleged) claims. I am not sure that a conference abstract by a gastrointestinal surgeon, who was “awarded training from 1994 to 1995 at Royal Free Hospital in London on measles implication in inflammatory bowel disease”, described as “an ex research fellow in AJW’s lab” and by Wakefield as “my ex student” (PMID: 8961895, PMID: 9789132) is totally independent.

  7. Joseph January 27, 2011 at 13:34 #

    What does the Bazola abstract show exactly? It appears that they enrolled 9 autistic children who had “chronic intestinal symptoms (abdominal pain, bloating, constipation and/or diarrhoea).” Then they find that (surprise, surprise) these children have a number of clinical GI anomalies.

    That’s hardly a replication. There’s no mention of MMR, when they had it, regression, etc.

    To actually put forth the existence of a new syndrome, they would’ve had to enroll N matched non-autistic children with the same GI complaints (abdominal pain, bloating, constipation and/or diarrhoea) and then compare clinical findings. They didn’t do this, so it’s not surprising the paper remained an abstract and never got to a journal.

  8. Drive-by comment January 27, 2011 at 13:36 #

    The trainees under Wakefield were generally qrateful since he was often able to get them money from drug companies. Having said that, a number were not, and have subsequently made complaints about him to Deer: Nick Chadwick being the most publicised example.

  9. Rosemary Cousins January 27, 2011 at 13:51 #

    Kev

    A denomination of The State means exactly that and not The State in essence.

    By using the descriptive term ‘denomination’ I mean by association.

  10. Joseph January 27, 2011 at 14:48 #

    A denomination of The State means exactly that and not The State in essence. By using the descriptive term ‘denomination’ I mean by association.

    @Rosemary: Could you translate this gibberish into English?

  11. sheldon101 January 27, 2011 at 16:02 #

    Kev: Consider banning Rosemary. Her comment:
    “JOURNALISTS TAKE NOTE:

    I draw the attention of journalists and members of the Government to the comments of some individuals on this autism blog. A blog which was set up as a platform by a denomination of The State itself.

    The relentless persecution parents of the disabled have endured at the hands of The State is there for all the world to see.”

    is intended to chill free discussion at this website.

  12. Brian Morgan January 27, 2011 at 16:27 #

    Well I’m a journalist, and I don’t think these comments are taken seriously. In my opinion they certainly don’t “chill free discussion”. They’re just ignored. Yes they take up space and slow down reading of other posts. Any decision as to banning must be carefully considered though because inevitably some will condemn this as restricting free discussion about vaccine and autism issues.

    Is this person the same as Bowrain who contributed to the Guardian? There was a fair amount of deleted comments from him/her.

    Over to you Kev.

  13. Chris January 27, 2011 at 16:34 #

    Ms. Cousins, you are making absolutely no sense. Could you please show evidence for the claims you have made on this thread:

    1) Exactly which of those studies you claim have independently (means neither Wakefield nor Krigsman can be an author) replicated Wakefield’s Lancet findings. Please include the number of children (this means no adults) and which version of the MMR vaccine they received (this means that measles vaccination must be at least mentioned, and would be either of the two used in the UK between 1988 and 1998).

    2) How exactly does this paper replicate Wakefield’s findings?

    3) Explain exactly what evidence you have to call the GMC corrupt. You made a very libelous statement as a citizen of a country with very expensive libel laws. I assume you have iron-clad documentation to defend yourself.

    And just out of curiosity, why did you ask Steve Barclay MP to help you? Why are you calling a Member of Parliament “Prime Minister”? It makes me wonder about your statements like “A denomination of The State means exactly that and not The State in essence”, when you cannot even keep straight the hierarchy of your own government.

  14. John Stone January 27, 2011 at 17:28 #

    Catherina

    Of course, if something becomes a heresy then it might be difficult to publish, but so what?

  15. Gina January 27, 2011 at 17:30 #

    @Rosemary: seriously, buy a dictionary. You say:”Kev

    A denomination of The State means exactly that and not The State in essence.

    By using the descriptive term ‘denomination’ I mean by association.”

    If you mean association, then use association and not denomination. But it doesn’t matter, because they are both contextually wrong for the point you are trying to make. Association or denomination, neither is true. You were, at one point in this discussion, acting civil and reasonable. Now, you’re completely incomprehensible.

    In all your demands of evidence from Mr. Deer, you’ve not had the courtesy to support any of your own assertions yourself. You’re a hypocrite.

  16. Catherina January 27, 2011 at 17:55 #

    John,

    what a poor excuse, really. If someone had the appropriate study with appropriate design and controls, then we would see it published (and you’d really need a full paper to judge on the data). But of course, if the premise of the study was totally made up, then it will be difficult to reproduce it.

    I am not saying that there is no dogma and that dogma can be a significant hurdle to publish new and different findings (or new interpretations of old findings). However, dogma will most effectively be challenged from within the system, not by press releases, anti-dogma conferences etc. The high quality science to support Andrew Wakefield is just not there, and not every “heretic” is a Gallileo. Some are just plain wrong.

  17. Science Mom January 27, 2011 at 19:10 #

    Of course, if something becomes a heresy then it might be difficult to publish, but so what?

    Ditto to Catherina. You’re making excuses. It didn’t stop Wakefield from publishing numerous methodologically-poor papers, didn’t stop Hewitson from the same and didn’t stop Goodman and Gallagher. You put the information out there and let the scientific/medical communities judge the validity of the methods and results. We aren’t swayed by introductions and discussions like you.

    • Sullivan January 27, 2011 at 19:28 #

      If something is wrong, it should be difficult to publish. Didn’t work out that way in 1998, did it?

  18. Catherina January 27, 2011 at 19:55 #

    didn’t 4 out of 6 reviewers catch it even back then?

    • Sullivan January 27, 2011 at 21:34 #

      didn’t 4 out of 6 reviewers catch it even back then?

      Yes. I don’t know what is standard for The Lancet, but 6 reviewers is high for most journals. This tells me that the editor probably got the rejections first, and then sent the manuscript out for a second set of referee reports.

      In other words, it should have been rejected. Either the authors asked for reconsideration or the editor decided on his own to get more referees in order to justify publishing.

  19. Brian Morgan January 27, 2011 at 22:16 #

    Sullivan said: “This tells me that the editor probably got the rejections first, and then sent the manuscript out for a second set of referee reports.”

    Can you direct me to a good source for this? I’ve tried a Google search and nothing comes up near the top.

    • Sullivan January 27, 2011 at 23:05 #

      Brian Morgan,

      Sullivan said: “This tells me that the editor probably got the rejections first, and then sent the manuscript out for a second set of referee reports.”

      Can you direct me to a good source for this? I’ve tried a Google search and nothing comes up near the top.

      that is my suspicion based on the fact that they had 6 referees. As Catherina comments, 2 or 3 referees is normal for a journal. Assuming that, the editor must have sent the Wakefield Lancet paper out for the first set of referees and had rejections come back. Otherwise, no reason to send out for more.

      An author can challenge referee reports and ask for a review. It is the editor’s discretion as to how to handle such a request. He/she can either (a) make an editorial decision to reject or accept the paper based on the existing reports, (b) send back to the original referees, or (c) find new referees.

      Assuming that the paper went through more than one referee cycle (and I consider that a pretty good bet given 6 referees), the question then becomes whether the request for extra review came from Mr. Wakefield or was solely the decision of the Lancet editor.

  20. Catherina January 27, 2011 at 22:17 #

    I have NEVER heard of 6 for a paper. For grants this happens, but papers you are usually looking at 2 or 3. Interesting thought with a whole second set of reviewers.

    Well, if Horton’s idea was to be controversial, he has certainly achieved that…

  21. John Fryer Chemist January 27, 2011 at 22:52 #

    The worth of any single paper is very limited and the 12 year taking down of this paper is unparalled in the history of research papers and it seems the taking down of just one of 13 authors will go on for the next 12 years.

    Any criticism of any paper in this depth is bound to bring up problems and the biggest problem as mentioned is that a single paper is a speck in the knowledge of man.

    Most of what is in this paper has been published both before and after and of course denied in papers as well.

    As a chemist it seems implausible that a vaccine given so long after many other more toxic vaccines would be the main culprit for gut problems or autism and I suspect that it has taken discussion away from mercury vaccines administered in much greater amounts from 1990 or so.

    If a non toxic vaccine is arguably bad at 18 months than how about highly toxic vaccines with brain destroying mercury compounds at the age of 2 months, one day or while the baby is in the womb?

    Further other non toxic proteins in DTP can explain why we get so much food intolerance.

    Harm from vaccines was established more than a hundred years ago.

    Natural immunity from breast feeding has been rode rough shod over and exposes little infants to harm when fed on material from unrelated animals and more often today GMO altered as well.

    Gut problems and autism have been linked since 1971 at least.

    Problems from specifically the measles component were also suggested before this publication.

    Some people even accuse Andrew Wakefield of plagiarism rather than reinforcing knowledge.

    There are still die hards that think autism is some rain-man syndrome where genius is the syndrome of autism.

    It is in fact so wide in its repercussions that it cannot be solely genetic or just a simple disorder of neuron wiring.

    Andrew Wakefield links autism to gut problems and the incidence of just under half shows it is important.

    Also there are links to epilepsy, links to poor hearing et al.

    We need to move forward and think of the injury caused and increasing that needs addressing today.

    This paper is important to many people on both sides of the argument.

    How about an independent re-write taking into account the limitations put forward?

    How about studying these people now at age 14 or so?

    Before this paper came out I had the view that 95 per cent of published papers were of low quality and if the rules of thumb here are used I would think my view was not far from the truth.

    Andrew Wakefield was very young when he published this paper with others and it is clear his knowledge and expertise in this field has increased to the point where even he must be embarrassed by errors he made while preparing or publishing this paper.

    The destruction of the worth of any person who produces research questioning established common sense will only mean the true cause of how ever many cases of autism people cannot agree on in todays world will forever largely remain a mystery.

    This area of modern health or ill-health is just one more complete unknown to go with a dozen or more other modern medical catastrophes.

  22. Brian Morgan January 27, 2011 at 23:20 #

    I’ve got a lot of catching up to do, and whilst I have myself exposed unethical research and mis-reporting in papers, and been exposed with others to very serious ad-hominem attacks as a result, I’ve yet to see any of the research papers withdrawn. Maybe now’s the time to press for this.

    Where will I see a reference to the 6 referees in the Lancet paper?

    • Sullivan January 28, 2011 at 00:43 #

      “Where will I see a reference to the 6 referees in the Lancet paper?”

      I know that Paul Offit mentions this in Autism’s False Prophets.

      Here is a section of the transcript, day 16. They are questioning Richard Horton, editor of The Lancet:

      Q If he decides that it is appropriate to send it out for peer review, at that stage, how many reviewers would it go to?
      A The paper would be sent to three external reviewers plus a statistician. It is very important to have a statistical adviser take a look at the design of the study.

      So, the paper was sent to 3 referees initially.

      Dr. Horton discusses the process further:

      Q Once that process is complete, they have seen the paper and written reports on it, what happens next?
      A Those reports back in 1997 would have been sent in my mail, collated by the editor and, when all the reports were available, then he or she would present the paper plus the peer review comments at the Thursday afternoon editorial meeting and the debate would ensue.

      Q Is it customary for people who have reviewed the paper to say critical things as well as positive things?
      A Extremely, yes, very much so.

      Q How do you handle those as far as the authors of the paper are concerned?
      A We have two separate components. They say things that they are happy to be transmitted to the authors and they also provide confidential comments that they say they report to the editors, which often presents us with a tricky situation because they are frequently very polite to authors and somewhat less polite when they are discussing a paper in front of us privately.

      Q On those parts that they are happy to have relayed to the authors, do you discuss any criticisms that have been made?
      A On the Thursday afternoon meetings?

      Q Or at all?
      A We certainly debate all the pros and cons of the paper at the manuscript meeting and make a decision then whether we are going to reject the paper, seek further opinion or open negotiations with the authors.

      Q Will there be, at that state, any general discussion about other matters which might be relevant to publication?
      A Certainly we will be discussing whether the paper has aspects of it that might cause controversy and should be considered in judging a paper, whether there are any conflicts of interest that should be taken into account in considering the paper or any other aspects of the work that might have cause for concern.

      Q At the end of that meeting, do you then make a final decision as to whether you are going to reject the paper or admit it for publication?
      A Three options: either to reject, to open negotiations or to seek further opinion.

      Q Can you tell us what open negotiations means?
      A That means that if there are questions raised by one or more of the peer reviewers that we think require explanation or further elucidation in a revised manuscript by the authors, then we will go back to the authors and say please can you take a look at your paper, in the light of these reviewers’ comments, and make the necessary adjustments. They hopefully will take account of those questions, submit a revised version of the paper and then we go back into a Thursday afternoon discussion to decide whether that is acceptable or not.

      Q The third option you said was to seek a further opinion. Is that over and above the peer reviews you have already had done?
      A Yes, that is right. Particularly I would say now that is quite a common option but back in 1997 it was less common.

  23. AWOL January 28, 2011 at 00:07 #

    Need answers to your questions?live today, Dr Wakefield on the Gary Null Show

    http://www.progressiveradionetwork.com/the-gary-null-show-wnye/

  24. Gray Falcon January 28, 2011 at 00:16 #

    Here’s my question: “Dr. Wakefield, have you no sense of human decency?”

  25. AWOL January 28, 2011 at 00:30 #

    Maurice Hilleman,(55mins in) is on it as well..your hero..go listen..now!!

  26. Gray Falcon January 28, 2011 at 00:36 #

    They have a man dead six years on a live radio show? That’s pretty impressive.

  27. AWOL January 28, 2011 at 00:48 #

    Yes! Hilleman was an atheist.

    Hilleman is on it for sure. He`s all dressed up and no place to go.

    Go listen he can tell you how America won at the Olympics “because the weight from the multiple cancer tumors was weighing them down and the Russians were the first to be tested on with the monkey vaccines.. (no joke) Brian Deer is on it lieing for all he is worth as only he can..

    • Sullivan January 28, 2011 at 01:14 #

      Gary Null falls for Mr. Wakefield’s excuse that he actually had permission to do the work he did. There was approval to take 2 extra mucosal samples from endoscopies. Mr. Wakefield has claimed that this covered him to do all the investigations his team did (barium meals, MRI, lumbar punctures, etc…).

      He discloses that he is “the only journalist anywhere, in the world, other than Brian Deer” to have the approval and claims this wasn’t provided to the GMC.

      Poor Gary. He makes such a dramatic statement. He claims the GMC didn’t have this information and claims that Brian Deer held it back.

      The man really needs to do the least bit of homework to back up his claims. There was a ton of discussion on precisely this issue at the GMC. Over and over and over. The GMC made it clear that Andrew Wakefield’s defense in this regard was unsupported by the facts.

      Makes a good drama, though.

  28. Brian Morgan January 28, 2011 at 01:26 #

    I’m just a little bit concerned about potentially conflicting interests held by Gary Null. http://www.garynull.com/

    And – to my query: “Where will I see a reference to the 6 referees in the Lancet paper?” The response was: “I know that Paul Offit mentions this in Autism’s False Prophets.” Can someone find me the quote?

    • Sullivan January 28, 2011 at 02:19 #

      Brian Morgan,

      If I can find the book at home, I should be able to get the quote shortly.

  29. sheldon101 January 28, 2011 at 02:59 #

    Gary Null’s research on the 162/95 issue is as deep as the research he did for his Ph.D.

  30. Rosemary Cousins January 28, 2011 at 11:59 #

    Dr Andrew Wakefield is fantastic and proves beyond any shadow of a doubt the fraudulent activities of the BMJ and Brian Deer.

    Tick, tock, tick, tock Brian Deer.

  31. Rosemary Cousins January 28, 2011 at 12:04 #

    It’s sink or swim time Brian Deer. What are you going to do?

  32. sharon January 28, 2011 at 12:07 #

    Rosemary you are just embarrassing yourself. Well you have been for a while, but now it’s toe curling.

  33. Rosemary Cousins January 28, 2011 at 12:42 #

    WHEN BRIAN DEER FALLS TO HIS KNEES, THE THUD WILL REVERBERATE AROUND BIG BEN – SO LISTEN CAREFULLY

  34. AWOL January 28, 2011 at 12:43 #

    “Gary Null falls for Mr. Wakefield’s excuse that he actually had permission to do the work he did. There was approval to take 2 extra mucosal samples from endoscopies. Mr. Wakefield has claimed that this covered him to do all the investigations his team did (barium meals, MRI, lumbar punctures, etc…).”

    You have this arse about face. Deer has provided only two approvals, when Gary Null said he was sitting with multiple approvals that Brian Deer also had, which Deer never showed to the GMC.The claim for only two is a fraud Sullivan, and you know it…

    Cherry picking,Fraud, by Deer springs to mind

  35. Rosemary Cousins January 28, 2011 at 13:45 #

    You can’t put the ‘book’ down, though, can you Sharon – absolutely glued to it.

    Sharon claims to be the personification of knowledge on semi intellectualism and narcissism yet fell at the first fence when asked to reveal her hand.

    And you call me an embarrassment Sharon?

  36. Rosemary Cousins January 28, 2011 at 13:48 #

    Sharon – what is your problem with me? Get a life.

  37. Visitor January 28, 2011 at 13:49 #

    “The Panel heard that ethical approval had been sought and granted for other trials and it has been specifically suggested that Project 172-96 was never undertaken and that in fact, the Lancet 12 children’s investigations were clinically indicated and the research parts of those clinically justified investigations were covered by Project 162-95. In the light of all the available evidence, the Panel rejected this proposition.”

    GMC fitness to practise panel: 28 January 2010.

  38. Broken Link January 28, 2011 at 14:01 #

    I can’t believe I had the impression that Rosemary was “serious”. Delusional, yes. Blathering, yes.

  39. Rosemary Cousins January 28, 2011 at 14:06 #

    What I meant to say, Sharon, was ‘Get a life, preferably on the Sunday Times where they cater for your type of female brain – vacuous.’

    As I have said before, weak women such as ‘Sharon’ and Fiona Godlee don’t ask questions – they merely follow the instructions of even weaker men.

  40. Rosemary Cousins January 28, 2011 at 14:16 #

    Broken link – looking back over your previous comments – you like Brian Deer are disgusting.

  41. Rosemary Cousins January 28, 2011 at 14:17 #

    Filthy disgusting person making comments on a public platform about other peoples children.

  42. AWOL January 28, 2011 at 16:02 #

    Visitor

    Two right don’t make one massive wrong..
    1. “The Panel heard that ethical approval had been sought and granted for other trials and it has been specifically suggested that Project 172-96 was never undertaken and that in fact, the Lancet 12 children’s investigations were clinically indicated and the research parts of those clinically justified investigations were covered by Project 162-95. In the light of all the available evidence, the Panel rejected this proposition.”
    GMC fitness to practise panel: 28 January 2010.

    What does the above say quote?
    “In the light of all the “”AVAILABLE EVIDENCE””, the Panel rejected this proposition.”

    Meaning if Deer never provided the evidence to the GMC,the GMC never went looking. Deer supplied two approvals’ no more depite him sitting with hundreds in his flat and wherever else he looked at the medical files(under supervision HA!HA!)…the GMC wouldn’t accept a request from JWS to have the multitude of other approvals included as evidence.. kangeroo court.. and you have your non-result for Deer and Medico Legal(non).

    And with the GMC and Deer going to ground not defending any of the questions and the most recent articles the problems for Deer and the GMC snowball and gather pace.

  43. Gina January 28, 2011 at 16:43 #

    @Rosemary: “WHEN BRIAN DEER FALLS TO HIS KNEES, THE THUD WILL REVERBERATE AROUND BIG BEN – SO LISTEN CAREFULLY”

    What prompted this?! You’re slipping away from reason, Rosemary. Please join us again for normal conversation.

  44. daedalus2u January 28, 2011 at 16:56 #

    Can someone explain to me why Brian Deer would be the one to have the only copy of the approvals of the IRB to Wakefield to do the invasive research that Wakefield claimed to have approval for?

    It seems to me that keeping track of those approval documents would be an important thing to do.

    Why didn’t Wakefield submit a copy of the approvals to the GMC?

    • Sullivan January 28, 2011 at 19:23 #

      Can someone explain to me why Brian Deer would be the one to have the only copy of the approvals of the IRB to Wakefield to do the invasive research that Wakefield claimed to have approval for?

      It seems to me that keeping track of those approval documents would be an important thing to do.

      Why didn’t Wakefield submit a copy of the approvals to the GMC?

      The GMC did have that approval. That’s part of why this is such a ridiculous claim.

      In addition–Brian Deer would not have been responsible for supplying this to the GMC. The Royal Free would have been. If this was important to Andrew Wakefield, and it wasn’t supplied, then Mr. Wakefield himself could have supplied it.

      They are trying to make a 100+ day hearing look like a deal cut in a backroom between Brian Deer and the GMC. But, as you can see, some people fall for it. Many more are left confused by it. That, I feel, is the point of all these strange defenses proposed. Confuse people so they won’t see the very clear, very damning, proven charges against Andrew Wakefield.

  45. Brian Morgan January 28, 2011 at 17:12 #

    There is a route for at least partial accountability to Dr Andrew Wakefield, for any alleged errors in reporting by the BMJ, which is through the Press Complaints Commission. The BMJ explains this on their own website.

    http://resources.bmj.com/bmj/about-bmj/bmj-complaints-procedure

  46. sheldon101 January 28, 2011 at 17:53 #

    Re 162/95 and 172/96 and visitor:

    Whether one believes the fairy tales of Wakefield, Walker-Smith and Murch or not, you don’t understand the issue. Which is whether the work for the 1998 paper had advance ethical approval by the ethics committee?

    • Sullivan January 28, 2011 at 19:20 #

      Re 162/95 and 172/96 and visitor:

      Whether one believes the fairy tales of Wakefield, Walker-Smith and Murch or not, you don’t understand the issue. Which is whether the work for the 1998 paper had advance ethical approval by the ethics committee?

      No, they did not. They had permission to take two extra mucosal samples during endoscopies which were clinically indicated. That’s it. Here are a few of the examples of what they did not have ethics approval to do:

      1) Subject children to endoscopies which were not clinically indicated
      1b) take samples form the children in (1) for research purposes

      2) subject children to lumbar punctures when they were not clinically indicated.
      2b) use the data from the children in (2) for research purposes.

      We can go on and on, but those are very clear violations.

  47. Visitor January 28, 2011 at 18:03 #

    Here is one of countless references to the document being presented and discussed at the GMC:

    COONAN: I want to turn, please, to another aspect of this early period and we can see that in relation to Child 1 it is the first child who was admitted on 21 July 1996. We see also a few days later that Child 1 was investigated and we have just put down the colonoscopy and the EEG investigations; there may have been others but those are the two important ones for present purposes. In relation to Child 1 did you carry out any specific research activity?

    WAKEFIELD: Yes, I did. His biopsies were examined for evidence of measles virus and for various characteristics of the disease process which he turned out to have, a focal, active inflammation of the intestine. This was done under the ethical approval 162-95 which was awarded to Professor Walker-Smith when he arrived at the Royal Free.

    COONAN: Can we look at that, please, it is volume 1, page 86A to C. I want to pick it up first of all at 86C, from Maureen Carroll, the secretary at the Ethical Practice Sub-Committee at the Royal Free. It is dated 5 September 1995:

    “I am pleased to be able to inform you that your recent submission to the EP Sub-Committee has now received approval by Chairman’s Action.”

    Code number 162-95 has been given and then at 86A Professor Walker-Smith had written to Baroness Gardner who was then the chair of the Ethics Committee, setting out what had been happening at Barts during his time there.

    “As you know my department transfer to the Royal Free on 1 September. For some years at Barts during the course of colonoscopy in children we have had ethical permission to take two extra mucosal biopsies for research purposes. During colonoscopy children routinely have multiple biopsies taken for diagnostic purposes. The parents have signed a form as attached granting permission. These biopsies are used for a variety of ‘research’ investigations such as cytokine production where on occasion information of direct and immediate importance to the child’s illness has been obtained as well as of research importance.

    I would be grateful if you would grant permission for this to continue after our move to the Royal Free.”

  48. AWOL January 28, 2011 at 18:37 #

    Visitor ,daedalus2u

    Need answers to your questions?, Dr Wakefield on the Gary Null Show

    http://www.progressiveradionet…..show-wnye/

  49. Rosemary Cousins January 28, 2011 at 19:25 #

    Gina if you think the bigotry you direct to parents and their disabled children is normal – God help you.

    To quote your own ill manners – ‘Go scratch.’

    • Sullivan January 28, 2011 at 19:35 #

      Rosemary Cousins,

      I should do your cause a favor and start editing your comments. Your responses are really most telling about you, not the people you are attacking.

  50. Rosemary Cousins January 28, 2011 at 19:31 #

    Sullivan

    It is said that one judges a man by the company he keeps.

    Brian Deer is a filthy corrupt liar. Take a long swim, Deer, preferably in the Thames.

    And take your inadequate friends with you.

    With weights on.

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