Prof. Walker Smith’s memories perhaps not so enduring

12 Nov

Prof. John Walker-Smith was a pediatric gastronterologist  (now retired) who worked with Andrew Wakefield on the research that formed the basis for the now retracted 1998 article in The Lancet that sparked the public fear over a possible link between the MMR vaccine and autism. Multiple studies since have demonstrated that the MMR does not increase autism risk and even Prof. Walker-Smith has stated through his attorney that the Wakefield autism/MMR hypothesis is without merit.

Prof. Walker-Smith was found guilty of misconduct and stripped of his medical license by the General Medical Council (GMC), but that ruling was quashed on appeal. In the appeal decision the judge ruled:

It had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician.

Prof. Walker-Smith and Andrew Wakefield took the position that the work they performed was not research driven, but was clinically indicated tests on children later collected as a case series. That the study for which they received ethical approval was not performed. So there was no problem in that children were seen before the approval was granted.

Prof. Walker-Smith wrote an autobiography (Enduring Memories). Two autobiographies, really. One in 2003 (before Brian Deer exposed the ethical lapses involved in the Royal Free Hospital’s research program) and another in 2012 (after the GMC hearings).

Mr. Deer has contrasted some excerpts from the two versions. Here is a snippet fro the 2002 edition:

The centre piece of the research however would be first a study to see if there was significant bowel inflammation in these children which could be treated. A secondary but important question would be whether measles virus, especially the vaccine virus strain, was present in any inflamed tissue which might be found. ”

The inflammation study-the Lancet work-was the center piece of the research with the measles virus work as a secondary project. The first measles virus effort was unpublished.

According to Prof. Walker-Smith in 2003, ethical approval was obtained and a pilot study went ahead:

My own role in all this was permissive as Andy Wakefield was the research leader, the conductor of the orchestra, a classical role in research for a gastroenterologist. A team was assembled, an ethical committee application was obtained and a pilot study went ahead.

The 2012 version differs notably from the above. The center piece is no longer the inflammation study, but the measles virus study and the work was not part of an ethics board approved study, but as a byproduct of routine investigation:

The centre piece of the research per se would be to determine whether measles virus, especially the vaccine virus strain, was resent in any inflamed tissue which might be found in these children and to investigate a pathogenetic hypothesis. This research could only be contemplated as a by-product of routine investigation.

Where the ethical approval statement from 2003 says a study went ahead, in 2012 the statement indicates that the project “was not implemented”.

A team was assembled, an ethical committee application was developed to investigate an hypothesis and was submitted by Andy Wakefield but based upon our clinically indicated diagnostic approach. The Ethical Committee approved the application but in the event the study was not implemented.

More modest studies based upon ethically approved research biopsies went ahead

The 2003 version is basically consistent with the GMC charges and the story unearthed by Brian Deer. The 2012 version is consistent with the failed defense Prof. Walker-Smith and Andrew Wakefield gave to the GMC. The decision against Prof. Walker-Smith was quashed.

For many reasons the argument that the quash of the GMC decision somehow exonerated Andrew Wakefield was not convincing from the start. From where I sit, it is even less so in light of a 2003 account clearly setting out the work as a research project.

8 Responses to “Prof. Walker Smith’s memories perhaps not so enduring”

  1. autismjungle November 12, 2012 at 06:44 #

    For many reasons the argument that the quash of the GMC decision somehow exonerated Andrew Wakefield was not convincing from the start.

    Totally agree. In fact, I think it makes it worse for Wakefield.

  2. Lawrence November 12, 2012 at 11:13 #

    @Sullivan – wasn’t part of the appeal / trial where Walker-Smith’s attorney, in response to a question from the Judge, stating that the vaccine-autism link was dis proven & “settled science?” I just want to make sure I get that part right, since the AoA people seem to overlook that particular statement.

    • Andrew November 12, 2012 at 23:58 #

      Lawrence: Judge Mitting wrote:

      “There is now no respectable body of opinion which supports his hypothesis, that MMR vaccine and autism/enterocolitis are causally linked. ”

      But I don’t know what the lawyer for Walker-Smith wrote (if anything)

      • Sullivan (Matt Carey) November 13, 2012 at 00:05 #

        Per a news article:

        ” Miller said it had been important that the disciplinary panel “separate out research from the clinical medicine – but that was a task that appeared to be beyond them”.

        The judge asked Miller whether the alleged link between MMR and the vaccine “has now been utterly disproved” in the opinion of “respectable medical opinion”.

        Miller said that was “exactly” the position.”

        Miller being Prof. Walker-Smith’s attorney

  3. Science Mom November 12, 2012 at 19:33 #

    Justice Mittings appeal decisions and statements never sat quite right with me but of course had to accept the decision. I wonder now if Walker-Smith had wanted to see the closure of his career with a big bang (in a good way though), let Wakefield lead him down the primrose path and essentially get away with it based on some far-reaching technicalities. I certainly don’t think he’s some doddering dupe he’d have us believe.

    All in all, I still can’t understand how Wakefield disciples can extrapolate Walker-Smith’s appeal to Wakefield as if by proxy. It’s really outstanding delusion. That and the fact that Wakefield didn’t appeal and opted to sue Deer et al. in Texas rather than the UK should send up some some big giant red flags. But alas, the delusion is maintained and Wakefield got a fresh round of “funding” out of it.

    • Sullivan (Matt Carey) November 13, 2012 at 00:10 #

      Sometimes it is hard to see the “red flags” because the warning sirens are so loud that you have to duck and cover. I don’t think that’s the case here, though.

    • mikemawords November 13, 2012 at 08:23 #

      St Andy marches slowly on but his destination remains unclear.

  4. Neuroskeptic (@Neuro_Skeptic) November 13, 2012 at 08:41 #

    Hmm. I smell something that comes from bowels, yes. Bull’s bowels.

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