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With the facts against them Dr. Wakefield’s supporters appeal to emotion

3 Feb

I should stop being shocked and amazed at how little groups like the Age of Autism blog think of their readership. Sorry to put it so bluntly, but it is pretty clear that they expect us all to just read what they have to say and never go to the original sources and think for ourselves.

Case in point, the GMC hearing on Dr. Andrew Wakefield. Dr. Wakefield was guilty of ethical violations in the treatment of his disabled patients. Not once, not twice but many many times. But you wouldn’t know that to read some of the reports on the blogs and even a couple in newspapers.

We have the NAA SafeMinds and TACA telling us all about how bad this ruling is. We have been told that there was “false testimony”.

OK, take a look at the actual charges. Just for a moment. Here are a few examples

1) Dr. Wakefield took money from the Legal Aid Board (LAB) for procedures paid by the NHS. He then diverted some of the LAB money to other projects.

2) Dr. Wakefield got ethical permission to do his study in December 1996, only on patients enrolled after that date. However, he had already started research on children. Here are two examples:

Child 2 had an MRI, colonoscopy and lumbar puncture in September of 1996.

Child 1 was also a research subject without ethical approval. Tests were performed which were not in the clinical interests of the child.

3) For people who promote the myth that “the only thing he did was start early”, note that Dr. Wakefield’s team did invasive tests that were not called for. For example:

Child 3 was also a research subject without ethical approval, having started before the approval. He underwent a lumbar puncture even though: “The Panel has taken into account the fact that there is no evidence in Child 3’s clinical notes to indicate that a lumbar puncture was required.”

Was this the result of some “false testimony? According to the GMC ruling, experts on both sides stated that the lumbar puncture was not clinically indicated.

Experts on both sides, Professor Rutter and Dr Thomas both considered that such a test was not clinically indicated.

Dr. Thomas is not accused by the defenders of Wakefield as “giving false testimony”.

The above are only a few of the examples of clear misconduct on the part of Dr. Wakefield.

How many times must a man be found guilty of not doing what was in his patients’ clinical interests before we are allowed to consider him as, well, someone who doesn’t always put his patient’s clinical interests first?

Kim Stagliano has taken to the Huffington Post with “The Censorship of Autism Treatment“. No mention of the actual charges. No mention of the fact that Andrew Wakefield was guilty. No mention of the fact that Andrew Wakefield’s research efforts for the past 12 years have centered on repairing his own damaged reputation, not on autism treatment.

Can you find a single mention of the word “ethics” in her post? How about any comment about the actual charges levied against Dr. Wakefield?

You know you are in trouble just with the title from this story: MMR doc’s just guilty of caring . At least that article makes one clear statement:

It [the GMC ruling] focused on the methods of research used, some of which were undoubtedly questionable, but which were performed in the name of finding solace for desperate parents convinced their children had changed for ever following their one-size-fits-all MMR injection.

Yes, you can be unethical if you are “finding solace for desperate parents”.

A blog post by the National Autism Association stated:

“Many parents of children with autism view the GMC investigation as little more than character assassination of a physician brave enough to investigate controversial issues”

Well, not this parent. Anyone who paints the GMC investigation as “character assassination” didn’t read the ruling. Seriously, trying to dismiss this fact-filled ruling as “character assassination” is just plain bizarre.

another post comments, discussing the work Dr. Wakefield’s team performed on his study subjects:

the procedures involved were routine

and

No children were harmed and no parent or guardian has complained about the care these three men provided.

Lumbar punctures are hardly “routine”. Further, there is no reason to do them if not clinically indicated. Colonoscopies are not routine, especially in patients whose symptoms don’t warrant them. Say, as in Child 1.

One child suffered a perforated bowel (in 12 places!). His family won a lawsuit against the Royal Free hospital.

High Court papers alleged that the colonoscopy procedure performed on Jack in 1998 was ‘not clinically indicated or justified’. They also claimed the ‘principal reason’ for the surgery was to further research into links between autism and bowel conditions rather than Jack’s clinical needs.

How does that not count as not “harmed”? Is it because he wasn’t one of the original 12 from the study in The Lancet?

The behavior of the Wakefield supporters is totally predictable. They have no science. They have no first (or second) tier researchers. They rely heavily on Dr. Wakefield. Who else has the perceived stature of Dr. Wakefield for them? When Brian Deer broke the story that Dr. Wakefield may have “fixed” data in his study last year, there was an immediate reaction from the Wakefield supporters: give him faux awards! Make him the keynote speaker at their conventions!

For the past year the message has been “Dr. Wakefield has not been discredited”. They’ve lost that now.

We’ve been warned that they are bringing out their big guns. Yes, David Kirby will blog about this on the Huffington Post. With apologies to Mr. Kirby, but when he’s their “ace in the hole”, you know they don’t have much.

As I finished this, David Kirby came up with his post: “The Lancet Retraction Changes Nothing”. Joining in the style of the times, Mr. Kirby also ignores the actual GMC ruling. Nothing that actually defends Dr. Wakefield against the real charges.

Seriously, go read for yourself. It’s David Kirby with his usual talking points and straw men.

I hope David Kirby is wrong. I hope that things have changed. I hope that the future is a world where the loudest voices in the autism communities fight for a better life for autistics, rather than for a political goal of recognition for bad science, badly done.

I hope.

Lancet retracts Wakefield paper

2 Feb

Following the judgment of the UK General Medical Council’s Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al1 are incorrect, contrary to the findings of an earlier investigation.2 In particular, the claims in the original paper that children were “consecutively referred” and that investigations were “approved” by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.

Source.

Andrew Wakefield – What happens next?

31 Jan

So Andrew Wakefield has been found proved guilty of the vast majority of the accusations against him and been found dishonest and acting irresponsibly with both the children under his ‘care’ and the not inconsiderable sums of public money he had occassion to recieve and ‘manage’.

None of this would have come as a surprise to anyone who had taken the time to carefully read Brian Deer’s thorough works on the subject. That it was a major shock to the John Stone’s and Martin Walker’s of this world tells you more about their capacity for self delusion than how shocking the findings regarding Wakefield were.

So whats next for Andrew Wakefield? Now that the official findings have been made public, the GMC must consider:

…whether those facts found proved or admitted, were insufficient to amount to a finding of serious professional misconduct. The Panel concluded that these findings, which include those of dishonesty and misleading conduct, would not be insufficient to support a finding of serious professional misconduct.

Yeah, pointless double speak aside (would not be insufficient??) the panel are basically saying that Andrew Wakefield’s behaviour could easily constitute serious professional misconduct.

So what can result from that? Brian Deer, writing in the Times Online provides a possible answer:

Lawyers have told me that any one of the more than 30 charges that were proved against Wakefield would typically lead to his being struck off. His days as a medical practitioner will soon be history…

And so what is the next step?

In the next session, commencing 7 April 2010, the Panel, under Rule 28, will hear evidence to be adduced and submissions from prosecution counsel then Dr Wakefield’s own counsel as to whether the facts as found proved do amount to
serious professional misconduct, and if so, what sanction, if any, should be imposed on his registration.

From April 7th then Andrew Wakefield will be fighting for the right to refer to himself and be referred to by others as ‘Doctor’. That will be a victory for anyone concerned with patient care in the UK.

Oh Deer…

31 Jan

Apart from people who have boosted Andrew Wakefield’s discredited and dishonest wild theories about MMR vaccine over the years (Lucy Johnston, Melanie Phillips, Fiona Phillips et al), one journalist will forever be associated with Wakefield: Brian Deer.

Brian Deer is no shill for the pharmaceutical industry. Back in the 90s he tackled the harms of Septrin (a widely prescribed antibiotic), and later went on to tackle Merck over Vioxx. Brian has pursued Wakefield in the same way as he carried out his investigations of “big pharma”. Not that this has protected him from allegations about his motivations, his detractors being unable to accept that a journalist might investigate the Wakefield hoax without help from “big pharma” or a conspiring UK government. Melanie Phillips alleged he was part of a witch hunt, although she was incorrect. Last year, the increasing lunatic fringe of the UK’s anti-vaccine movement alleged Brian’s sexuality was the reason for his investigative reporting:

By all accounts a gay man and therefore unlikely ever to have to face the multiple vaccine risk agonised over by parents from around the world in relation to their children, Brian Deer has made it his business to portray the parents of these autistic vaccine damaged children as deluded mendacious chancers.

We now know that the man with callous disregard for children’s welfare was the man they have supported; Andrew Wakefield. He had a financial conflict of interest. He treated children unethically. He exposed children to “high-risk” procedures without ethical approval and against their best clinical interests [Here’s an example of what can happen].

Brian was also subjected to a libel action brought against him by Wakefield, the current toy of the rich (Wakefield leads a comfortable life in Texas now, working at a quack treatment centre for £170,000 a year). In an article at the Sunday Times today, Deer talks of the benefits of exposing Wakefield.

Wakefield will probably never admit to his errors. But exposing his methods has been worthwhile, according to medical sources.

“People can’t understand whether a scientific study is valid or invalid,” said a senior doctor who had watched vaccination rates slump, even in the face of endless research on MMR safety. “But they can understand ‘right’ and ‘wrong’, and they can understand ‘honest’ and ‘dishonest’.”

Lawyers have told me that any one of the more than 30 charges that were proved against Wakefield would typically lead to his being struck off. His days as a medical practitioner will soon be history. A further hearing will determine whether “serious professional misconduct” was committed.

Yet more troubling for Wakefield’s future are his prospects for research, or at least of getting it published.

“Any journal to which a researcher shown to be dishonest submitted a paper would reject it,” said Richard Smith, former editor of the British Medical Journal, this weekend. “They would say, ‘This man can’t be trusted’. His career as a researcher is effectively over.”

On the latter point, I’m not so sure. His days as a real researcher are over, but he and his friends already have a plan to tackle that obstacle.

Brian Deer in the Sunday Times on the GMC decisions

31 Jan

I had a strong feeling that an article by Brian Deer would appear in today’s Sunday Times. Brian Deer has followed the story of Dr. Andrew Wakefield closer than anyone, uncovering much of what has now brought the doctor one step away from being struck off the register in the U.K.. So, I was not surprised when I found ‘Callous, unethical and dishonest’: Dr Andrew Wakefield on the Sunday Times’ website.

The article describes the events as the GMC decision was read out. Brian Deer was there, Andrew Wakefield was not.

Dr. Wakefield was found guilty on multiple counts, but the most important from my perspective:

Other proven charges included nine of mistreating developmentally challenged children: causing invasive “high-risk” research to be carried out without ethical approval and against their best clinical interests.

Mr. Deer points out that this ls likely the end of Dr. Wakefield’s career as a researcher. Well, yes and no. I think his career as a mainstream researcher was over years ago. But, as a contributor (and editor) to the world of third-tier research, he appears to be moving ahead.

Based on previous public statements by Mr. Deer, I am hopeful that more articles delving into the details of the research Dr. Wakefield performed at the Royal Free Hospital are forthcoming.

Andrew Wakefield – what were you expecting to happen?

28 Jan

The first of Andrew Wakefield’s days of judgement unfolded today amid hectic scenes of supporters running screaming from the room as the inevitable damning judgements were read out.

Wakefields action was proven to be dishonest and misleading, he was found in breach of managing public finances and that the funds he was in control of were not used for their intended purposes and a whole myriad of others. One of the most shocking is that it was found proved that:

You caused Child 2 to undergo a programme of investigations for research purposed without having Ethics Committee approval for such research.

And thats Andrew Wakefield’s career toasted in the UK. Read the whole thing at your leisure.

I would have gotten this post to you sooner but I was accompnying my two step-daughters to their H1N1 vaccinations as the decisions were being handed down.

Brian Deer: Truth of the MMR vaccine scandal

24 Jan

The General Medical Counsel (GMC) hearings on doctors Andrew Wakefield, John Walker-Smith and Simon Murch are over and the decision is expected to be made public this week. Brian Deer, the reporter who broke the story exposing the possible misdeeds involved in the MMR-causes-autism research conducted at the Royal Free Hospital by Wakefield et al., has a story out in the Sunday Times:

Truth of the MMR vaccine scandal
After an epic misconduct hearing, the doctors who caused panic over the vaccine are about to learn their fate. A report on the greatest health scare of recent times

The story re-introduces the readers to the story of MMR scare and how it began. I suspect the real story will come out after the GMC decision is handed down and details from the patient records are discussed as in Brian Deer’s recent articles such as MMR doctor Andrew Wakefield fixed data on autism.

Mr. Deer faces a pretty major smear campaign from Dr. Wakefield’s supporters. I can only expect it to get worse after the decision is handed down–whatever that decision may be.

Autism Epidemic Talk

20 Jan

A couple of slap dash blog pieces appeared today both on the same subject – the so called autism epidemic. First off is Harold who writes about a series of interviews with David Kirby. David says:

<blockquote>It’s crazy that in this debate, we’re still debating whether autism numbers are actually going up or not, which is insanity to me. It’s people desperately clinging to this belief that autism is genetic, that it’s always been with us at this rate, that we’re just better at counting it, better at diagnosing it.</blockquote>

Harold claims David has ‘hit the nail on the head’ with this quote. I disagree with Harold and I disagree with David. Its far from insanity to examine a perfectly valid hypothesis. More later.

Anne Dachel at the Age of Autism writes :

<blockquote>Why do I personally know so many young people with severe autism, whose symptoms can’t be ignored?  How could we have just ignored these people in the past?  Where are those misdiagnosed adults with classic autism—those with the same symptoms we see in so many children today?

I’m not talking about [Kristina] Chew’s autistic neighbor who was able to have a conversation with her, or [Paul] Offit’s people who are kind of ‘quirky.’  I mean adults who can’t talk, those in diapers, people who scream for hours and pound hours in walls and who constantly rock back and forth.</blockquote>

Dachel goes on to list several news reports which question the idea of there not being some kind of an epidemic. I disagree with her view and I disagree with the way she has reached her view.

Both Dachel and Harold (and David Kirby come to that) are claiming that epidemiology can be ursurped by individual experience – Dachel’s individual experience with ‘so many young people’ and David’s individual experience with the idea that people are desperately clinging on to some sort of belief in a genetic form of autism.

Now, casting aside the fact that the some of the forms of autism that we know about (Rett Syndrome etc) _are_ solely genetic we have to – as we do with _all_ forms of science, cast aside personal anecdote when making sweeping statements about a very large group of people. What we need to do instead is look at the science. So what does the science say?

Nothing. As far as I can see no firm case has been made that there either is or is not an autism epidemic. Why? Because the science hasn’t been done. It is maybe worth noting that it is the firm opinion of autism experts that a large part of any possible rise is due to:

a) Better diagnostic tools

b) More places at which to recieve a diagnosis

c) More awareness amongst clinicians of autism

d) Earlier diagnosis

e) Diagnostic substitution

f) Widening of diagnostic criteria

Experts such as Eric Fombonne, Roy Richard Grinker and Simon Baron-Cohen have all spoken about these ideas at length. However, that doesn’t make them right. There still seems to be no hard and fast science that says there is an autism epidemic or not.

Forbes on “Stars Vs. Science” once again the autism community looks bad

15 Jan

Forbes Magazine has an article, Stars Vs. Science, From Jenny McCarthy to Tom Cruise, some Hollywood hot shots are leading a war against modern science. The opening paragraph is pretty telling about the tone:

When the medical journal Pediatrics released a consensus report early this year concluding that autistic children do not benefit from special diets, ABC News’ Diane Sawyer knew just whom to call. Jenny McCarthy, former MTV game host, nude model and now mother of an autistic son Evan, enthusiastically denounced the study. “Until doctors start listening to our anecdotal evidence, which is it’s working, it’s going to take so many more years for these kids to get better,” she opined

Or, you can just take a look a the URL–science-jenny-mccarthy-business-healthcare-hollywood-autism.html

Once again, the Autism community takes it on the chin that our representative in the public eye is, well, in a league of her own when it comes to understanding science. Even though the story is about celebrities and science in general, autism plays a big part in the story as a whole. Take a look at the celebrities that were selected for the “slideshow”

Of course, there are Jenny McCarthy and Jim Carrey (click to enlarge and read the caption):

Ms. McCarthy and Mr. Carrey have been trying to shake loose the anti-vaccine image for a while. It doesn’t appear to be working. From the article:

But some of the best-known celebrities use their soap boxes to spread scientifically dubious–and potentially harmful–messages. Jenny McCarthy believes vaccines cause autism, despite numerous studies to the contrary. She campaigns against child vaccines that have been shown to save lives. In 2008, the Centers for Disease Control reported that measles outbreaks had spiked because more parents were deciding to leave their children unvaccinated, thanks to the burgeoning anti-vaccine movement.

Others who made the cut? Arriana Hufffington, of the Huffington Post, (again. click to enlarge):

It is worth reading the caption to that one. Dr. Rahul Parikh is quoted from his Salon.com piece, The Huffington Post is crazy about your health, Why bogus treatments and crackpot medical theories dominate “The Internet Newspaper”.

The quote:

But Huffington has distorted science and facts…fairness and accuracy in health and medicine take a back seat to sensationalism and self-promotion

In his piece, Dr. Parikh had noted the Huffington Post blogs by “David Kirby, Jenny McCarthy’s pediatrician Jay Gordon and detox advocate Dierdre Imus” and also spends a considerable amount of time discussing a piece by Jim Carrey.

The Forbes piece also discusses Oprah Winfrey (click to enlarge):

Once again, autism is prominent in the description given by Forbes.

I’m sure some readers will assume I’m putting this up to embarrass these celbrities. Yeah, like being in Forbes is so low profile that LBRB is going to be the embarrassment for Oprah and company. No, this is just another vent of anger. Anger that the autism community is once again seen by the public as the home to people who are “leading a war against modern science.” Tell me how that helps us advocate.

One notable entry outside of autism is Bill Maher. (click to enlarge)

I bring this up because Forbes notes that Bill Maher has been discussed by “quack busting doctor-blogger David Gorski”. That’s the same guy you can find on Science Based Medicine,

The article does seem to be following a recent trend: they aren’t looking for “balance” by quoting groups from the anti-science side. Instead, qutoes are had by:

William Schaffner, chair of preventive medicine at Vanderbilt School of Medicine:

“These are folks who really don’t have the best information, but because they are vocal and well organized their message has gotten out” [as a result] “around the country pediatricians and their staffs are having to spend more and more time persuading parents to have their kids vaccinated in a timely fashion. It is an enormous problem.”

Stephen Barrett of Quackwatch.org

“Talk shows don’ t pay any attention to whether the advice on their program will kill people. … Producers consider it entertainment,” he says, adding: “Never take health advice from a talk show.”

and

Dr. Paul Offit of the Children’s Hospital of Philadelphia:

Why do celebrities feel the need to spout off on medical or scientific matters? Because they’ve excelled in one field, stars “think they’re an expert in many things,” says the vaccine expert Offit. “That part doesn’t bother me. It’s the part that we listen that bothers me.”

I’m inclined to agree with Dr. Offit. It is the part that we listen to celebrities when they talk about things far outside their expertise that bothers me.

Response to Jake at Age of Autism

14 Jan

Jake Crosby has written a fairly humdrum piece about me which contains a few errors (as do some of the comments), most notably his claim that he’s tried to contact me. I’ve not recieved any contact from him at all either to my personal email nor via the Feedback widget. If Jake wants to contact me to discuss his piece I’m more than happy to do so – you can get me at kevleitchATgmailDOTcom.

The piece itself is a rehash of some of the early comment threads on here – I used to think vaccines caused my child’s autism, then I changed my mind. Jake speculates about why that might be without coming to any firm conclusion.

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