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Traces Of Desperation

11 Jul

A new trend is developing amongst the mercury militia. This new trend might even lead me to have to abandon the term ‘mercury militia’ completely.

What seems to be happening in the last couple of months is the downplaying of the role of thiomersal/mercury in ‘causing’ autism and the fomentation of a more generalist position of ‘somethings’ (including thiomersal) causing autism.

This is easy to sympathise with. In recent days a large-scale study has come out that (yet again) indicates no causative link between thiomersal (or MMR) and autism and the body of ‘science’ accumulated thus far by the miltia’s scientists was utterly demolished in both scientific and legal terms. These are people who’s position is becoming desperate. Essentially, in terms of legal success they have less than six months for a scientific paper to establish the possibility of a causative link between autism and thiomersal. I think its fairly obvious that’s not going to happen. When one examines the CDDS data (data David Kirby refers to as ‘the gold standard’) in the 3 – 5 year old cohort (the cohort Kirby agree’s is the only important one to examine) the rate of autism is not falling. It is still climbing. What we see are quarterly fluctuations (both ways) in the rate of increase (which Kirby agree’s is not the right measure).

Therefore, we have a still climbing autism rate according to CDDS data despite the fact that the amount of thiomersal in vaccines has very dramatically gone down and the amount of vaccines containing thiomersal has drastically reduced.

To look at it another way, in order for the autism rate to continue to be climbing in the way it is and for the thiomersal hypothesis to be correct, the US would need to be maintaining the same amount of thiomersal containing vaccines with the same amount of thiomersal in each.

So for a variety of reasons thiomersal’s role is altering to fit the new agenda.

Thiomersal’s role is subtly altering in the mercury militia’s mindset. It’s now altering from an absolutist ‘autism = mercury poisoning’ role to a more subtle role where thiomersal is one amongst many elements that cause autism. As an interesting aside, one has to wonder what the role of Generation Rescue will be in this brave new world.

Now, lets be kind here and forget that for months, years even, those of us who’ve consistently opposed such an absolutist position have tried to explain just why it couldn’t simply ‘be’ thiomersal. We have to remember that those who believe it _is_ thiomersal and solely thiomersal lack the capacity of rational thought in many cases. John Best Jr is a case in point.

The idea that thiomersal is simply ‘one amongst many’ that may cause autism is more valid from a standpoint of basic (dare I say it?) Common Sense, and yet from a science point of view it brings the group of people we should now refer to as the ex-mercury militia (all alternative aliterations accepted) to a standpoint of working from the ground up about how a whole _multitude_ of elements may cause autism. Good luck with that one.

And yet, the ghost of the thiomersal, much like another unquiet corpse, rests uneasily in its grave. It is now suggested, despite the massive drop in the available amount of thiomersal (from a compulsory 187 ug Hg to an optional 25 ug Hg in the US)and the apparent continued rise in rates of autism that the reason the autism rate may continue to be rising may be the ‘trace’ amounts of thiomersal used in the vaccine manufacturing process. This trace amount is in DTaP-HepB-IPV, DTaP, Hepatitis B and one flu vaccine.

Here’s a commenter on a recent WebMD thread:

First, it must be recognized that thimerosal, although not generally used as a “preservative,” is still used in the manufacturing process, resulting in “trace” amounts remaining in various quantities. Also, thimerosal is still used as a preservative in many, if not most, flu vaccines which are highly recommended for administration to pregnant women and young children. There is no denying that the exposure to thimerosal has been greatly diminished, but it has not disappeared altogether.

So lets examine what the word ‘trace’ might mean. I offer as evidence a bottle of cranberry flavoured water from the Leitch fridge. Look closely at the nutritional list where fat – saturated fat even – is descibed as being in trace amounts (click for bigger picture):

Now, I can’t speak for America but over here we don’t have an epidemic of cranberry flavoured water induced obesity. However, by law, manufacturers are required to state what the _exact_ constituent makeup of their product is. It seems daft and rather nanny-stateish to me but thats besides the point. The trace of saturated fat in bottled water can’t make anyone overweight. The trace of thiomersal levels now in vaccines can’t make anyone autistic.

The commenter on WebMD went on to say:

Finally, it is worth noting that thimerosal’s reduction in most vaccines has coincided with an increase in the use of aluminum. Although I know of no published studies yet bearing on the impact of aluminum one way or the other, I understand that this is a question that we shall see more of in the future. If aluminum has an impact that is similar to mercury, the numbers would remain largely unchanged.

Fascinating bit of strawman logic. And one I take pleasure in saying ‘I told you so’ about.

14 months ago in May 2005 I said

the next big boogeyman (which will apparently be Aluminium)

when referring to a review of Evidence of Harm. This either makes me really smart or the ex-mercury militia very, very predictable.

Boyd Haley and Mark Geier: Experts?

7 Jul

In case you didn’t know, as well as vaccines, the mercury militia also think that the thiomersal in RhoGAM given to pregnant mothers causes autism. Alongside the ongoing autism/vaccine omnibus hearings, there has been a RhoGAM hearing as well.

An unidentified couple brought a case against Ortho-Clinical Diagnostics Inc’s RhoGAM product as they claimed that their unidentified child’s (referred to as ‘Minor Child Doe 2’) autism was caused by two shots of RhoGAM – one whilst the mother was 28 weeks pregnant and one administered shortly after the child’s birth. They declared three expert witnesses to speak on their behalf, George Lucier, Boyd Haley and Mark Geier.

The defendants (Ortho-Clinical Diagnostics Inc) put forward a motion to exclude these expert witnesses, which after hearing evidence as to why, the court granted. Yesterday, the court discussed its decisions and let it be known exactly why these three expert witnesses were excluded.

The court conducted a ‘Daubert‘ hearing to decide on the quality of these expert witnesses.

Daubert requires a two-part analysis: first, this Court must determine whether an expert’s testimony reflects “scientific knowledge,” whether the findings are “derived by the scientific method,” and whether the work product is “good science.”. Second, this Court must determine whether the expert’s testimony is “relevant to the task at hand.”

Source.

The way that the court reaches judgement in respect of these two points is as follows:

courts may consider whether the theory or technique employed by the expert is generally accepted in the scientific community; whether it has been subjected to peer review and publication; whether it can be and has been tested; whether the known or potential rate of error is acceptable; and the existence and maintenance of standards and controls. These factors are not exclusive nor dispositive. Since Daubert, the U.S. Supreme Court and lower courts have also identified additional factors that may be considered, such as whether an expert has unjustifiably extrapolated from an accepted premise to an unfounded conclusion, whether an expert has adequately accounted for obvious alternative explanations, or whether an expert is proposing to testify about matters “growing naturally and directly out of research they have conducted independent of the litigation, or whether they have developed their opinions expressly for purposes of testifying.”….Trained experts commonly extrapolate from existing data but nothing in either Daubert or the Federal Rules of Evidence requires a district court to admit opinion evidence which is connected to existing data only by the ipse dixit of the expert. A court may conclude that there is simply too great an analytical gap between the data and the opinion proffered.” Finally, a bold statement of the experts’ qualifications, conclusions, and assurances of reliability are not enough to satisfy the Daubert standard.

There were two types of Daubert hearing held. In the first instance, the Daubert principles were applied to the issue of general causation (can the thiomersal in RhoGAM cause autism?) and the issue of specific causation (did the double RhoGAM shots cause Minor Child Doe 2’s autism?). If general causation cannot be established then specific causation does not need to be examined.

Boyd Haley’s Strong Beliefs

Lucier and Haley were not put forward as experts able to address the specific causation issue, but all three (Lucier, Haley and Geier) were put forward to address the general causation issue.

On the issue of general causation the court had the following to say:

The court…finds that *Dr. Haley’s report does not state an expert opinion that thimerosal causes autism, rather just that he has a theory about how such a thing could happen*. At best, he expressed “strong belief” that the cause of “neurodevelopmental disorders in infants” is exposure to an organic-mercury compound such as thimerosal. Additionally, Plaintiffs proffered the report of Dr. Lucier, who is an expert in methylmercury and not ethylmercury, which is the substance in RhoGAM. Dr. Lucier does not offer an opinion that methylmercury causes autism, but rather that it may cause “developmental disorders.” Significantly, the Court notes that neither Dr. Haley nor Dr. Lucier asserts that he is an expert on autism nor are they offered as such. In any event, the Court finds that neither of the proffered reports of Dr. Haley nor Dr. Lucier are sufficiently reliable under Daubert on the general causation issue because neither is relevant to the “task at hand.” It would be an unacceptable scientific leap to suggest that they serve as proof, by a preponderance of the evidence, of Plaintiff’s claim that the thimerosal in RhoGAM can cause autism.

Ouch. Let’s make sure we don’t underestimate the gravity of this. Under the Daubert principle, which is very very thorough in terms of scientific methodology, Boyd Haley’s theories about thiomersal causing autism are not anything other than a theory that discusses how such an event might happen. All he can apparently offer is a ‘strong belief’ that he is right.

This left the court with the thorny problem of Mark Geier.

Mark Geier Takes A Licking

Much of Geier’s testimony was dependant on a review of the scientific literature. Under the Daubert principle, the literature itself must also undergo examination under the Daubert principles.

At the close of Plaintiffs’ presentation at the Daubert hearing, Plaintiffs argued that their evidence would support such a conclusion. In response to Plaintiffs’ position, Defendant challenged Plaintiffs’ proffer by way of a cross examination of Plaintiffs’ expert Dr. Geier and by offering its own experts to *demonstrate that Plaintiffs’ experts used unsound methodology or otherwise failed to follow sound protocol*. Having closely considered the evidence and arguments both by Plaintiffs and Defendant, the Court has made a number of findings with respect to the testimony by Plaintiffs’ primary expert Dr. Geier. These findings form the basis of the Court’s ultimate conclusion that *Plaintiffs have not met their burden under the Daubert analysis*.

Oh dear. So Geier and the evidence he presented did not meet the Daubert principles. Lets discuss this further.

The Court has taken into account…..the fact that Dr. Geier has testified as an expert witness in about one hundred cases before the National Vaccine Injury Compensation Program of the United States Court of Federal Claims. It is noteworthy that in more than ten of these cases, particularly in some of the more recent cases, Dr. Geier’s opinion testimony has either been excluded or accorded little or no weight based upon a determination that he was testifying beyond his expertise.In this case, subject to the Court’s Daubert analysis, Dr. Geier’s testimony is being offered by Plaintiffs for presentation at trial to support Dr. Geier’s ultimate conclusion that the thimerosal in RhoGAM caused Minor Child Doe’s autism.

Let’s remind ourselves that in those cases, Geier’s testimony has been described as, ‘speculation that is directly contrary to the conclusions reached
in well-respected and numerous epidemiologic and medical studies ranging over two decades’, ‘did not reach “the level of evidentiary reliability that Daubert requires because it is not based upon scientific validity, valid methodology, peer review or testing, and more than minimal support within the scientific community’, ‘intellectually dishonest’, ‘nothing more than an egregious example of blatant, result-oriented testimony’ and that he himself was a ‘”professional witness in areas for which he has no training, expertise, and experience’.

What else did the court have to say?

…the Court notes that, in fact, a literature review can be an appropriate part of a method of determining general causation. However, a literature review must still be performed appropriately. As revealed by his testimony at the Daubert hearing, Dr. Geier, however, relied upon a number of disparate and unconnected studies, including the findings of Dr. Haley and Dr. Lucier, to reach a piecemeal conclusion with respect to general causation.

The court went on to admit that, in common with a couple of journalists I can think of, when one hears Geier speak and hears his testimony it sounds persuasive on the face of it. However, it soon became clear that when one looked past the thin veneer of ‘disparate and unconnected’ studies, the threadbare nature of the ‘association’ became very very clear.

However, upon being subjected to extensive cross examination, much of Dr. Geier’s analysis, based upon his collective review of a motley assortment of diverse literature, proved, in the Court’s view, to be overstated. For example, in examining Dr. Geier’s methodology, the Court notes that Dr. Geier could not point to a single study, including anything that he had published, that conclusively determined that the amount of thimerosal in RhoGAM when given not to the fetus but to the mother, as in this case, could cause autism. *It is also significant in the review of his methodology that Dr. Geier could not point to a single study that conclusively determined that any amount of mercury could cause the specific neurological disorder of autism.*

The court closed its look at the literature review with the following:

This Court must find more than the “hypothesis and speculation,” engaged in by Dr. Geier in this instance….

Double ouch. Most of Geier’s testimony revolved around this literature review. Not only was court already looking at him with extreme skepticism, it also – quite rightly – dismissed his presentation of the review _including the review materials themselves_ as resulting in nothing more than ‘hypothesis and speculation’. The court further noted that not even this (his own!) literature review can support Geier’s general causation testimony.

Thus, while Dr. Geier’s presentation of the literature as part of his methodology might at first glance appear convincing, the disconnected literature he presents does not add up to the opinion and conclusion that Dr. Geier is offering. Accordingly, the Court finds that *Dr. Geier’s literature review, in this instance, does not meet the Daubert standard of being both derived by the scientific method* and relevant to the “task at hand.

Again, this is important stuff. This was the first real courtroom test of the scientific literature that the mercury militia have built to support the thiomersal/autism hypothesis. Have a look at the references – the Holmes baby study was presented, as was the Hornig mouse study amongst others. It was collectively adjudged not to meet Daubert standards in that it was not possible to say it was derived using scientific method.

To put it less politely, its a bunch of crap.

The court also discussed the other part of Geier’s testimony relating to general causation – his examination of VAERS. In this it concluded that:

the Court finds that Dr. Geier’s published VAERS studies have been severely criticized by The Institute of Medicine as having “serious methodological flaws,” analytic
methods that were “non-transparent,” and generally “non-contributory with respect to causality. More specifically, one of the particular criticisms leveled at Dr. Geier’s study was that, as a passive reporting system, it would be inappropriate to calculate incidence rates based upon the data in V AERS because it “does not have complete reporting of all adverse events and because many report events lack a confirmed diagnosis or confirmed attribution to vaccine.”

Geier has also written two papers regarding RhoGAM and had the cheek to submit them as part of his literature review. However, as they had not been accepted for publication, nor peer reviewed and as the court expressed doubts over both the methodology utilised in these papers and the odd ‘coincidence’ that these papers were embarked on shortly after the instigation of the case being heard, they threw them out too.

And so, that’s the issues of general causation stone dead. At this point, the court would be fully justified in not proceeding further. However, they did move on to address Geier’s testimony is respect of specific causation.

Mark Geier Takes A Kicking

The court accepted that a differential diagnosis was a sound method of establishing a basis for allowing _expert opinion_ with regard to specific causation and this indeed, was the method Mark Geier used to attempt to illustrate specific causation in Minor Child Doe 2’s case. However, we need to make sure we understand this. The court is _not_ saying that a differential diagnosis is automatically good enough to illustrate specific causation. It is saying that *if* the person offering the differential diagnosis is a recognised expert, that that differential diagnosis stands a better chance of being accepted as ‘good enough’ to establish specific causation.

…even if the Court were to assume that general causation had been shown in this instance, the Court finds that Dr. Geier’s application of the differential diagnosis technique suffers from its own irregularities.

Bad enough, but then the real humiliation follows:

First, the Court notes that Dr. Geier is not a pediatrician or a pediatric neurologist. In fact, *testimony was presented to the Court that Dr. Geier was not even successful in sitting for his Medical Board examination in the specific field of pediatric genetics*.

Triple Ouch. That one had to hurt. They’re essentially questioning if Mark Geier is even qualified to undertake a differential diagnosis _at all_. Let alone qualified to offer an expert opinion on one. _Let alone_ qualified to offer an expert one on a question of specific causation.

The court also took Geier to task for his failure to include the most widely accepted scientific theory regarding autism causation – genetics. It beggars belief that he would attempt to offer a *differential* diagnosis without even mentioning this possibility.

Although Dr. Geier apparently has considered a number of specific genetic disorders in performing his differential diagnosis, the Court finds that his failure to take
into account the existence of such a strong likelihood of a currently unknown genetic cause of autism *serves to negate Dr. Geier’s use of the differential diagnosis technique as being proper in this instance*

and that therefore…

….the Court finds that Dr. Geier was not specifically qualified to perform a differential diagnosis of a pediatric neurological disorder, and, that he did not properly perform the differential diagnosis

Oops. I hope John and Jane Doe feel suitably recompensed for their ‘experts’ testimony.

The court goes on to make a few interesting comments and comparisons regarding the Omnibus vaccine proceedings, noting that those proceedings have until the end of this year to submit papers to establish causation and that the defendants in this case were also defendants in those proceedings. They then wrap up with:

Accordingly, notwithstanding the valiant effort by Plaintiffs in this case, Defendant’s Motion for Summary Judgment must be allowed and this case must be dismissed with prejudice.

And that’s that.

Significant Conclusions

Awhile ago, I posted regarding a series of comments from Lenny Schafer in which he discussed his hopes that the thiomersal court cases would be easier to prove in a court of law than they would in the scientific realm. I think after this ruling its clear to see why they will not.

This is a significant turn of events for numerous reasons. Firstly, it was the first time that autism had been attempted to be directly linked to thiomersal. That gambit failed. Secondly, it was the first time the body of evidence the mercury militia has accumulated thus far was tested in court. It failed to be recognised as scientifically valid. Thirdly, it was the first time that Geier or Haley had stood as expert witnesses in a court case relating directly to the thiomersal/autism hypothesis. They were both found severely wanting in that respect.

Let’s remember that the vaccine Omnibus hearings have until the end of _this_ year – less than six months away now – to augment the evidence found wanting in these hearings.

For the mercury militia, times is just about up.

Full court listing and decision document.

Further discussions here: Autism Diva, Orac, Prometheus and Kathleen provides a HTML version of the decision on neurodiversity.com

Canada Speaks: No, It’s Not Vaccines

6 Jul

Pediatrics have published a new paper, *Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations* authored by Fombonne et al.

Pre-empting an NAA style ad hominem attack, the authors declare their conflicts early.

In the United Kingdom, Dr Fombonne has provided advice on the epidemiology and clinical aspects of autism to scientists advising parents, to vaccine manufacturers, and to several government committees between 1998 and 2001. Since June 2004, Dr Fombonne has been an expert witness for vaccine manufacturers in US thimerosal litigation. None of his research has ever been funded by the industry.

As they don’t agree with the paper this has caused the usual suspects, notably Safe Minds and FAIR Autism Media to highlight these aspects of the paper in an attempt to claim these invalidate the papers findings. Mark Blaxill of Safe Minds says that:

According to an analysis by SafeMinds, however, the study […] should be treated with skepticism, for a number of reasons.

Whilst David Ayoub states that:

“This is just another heavily biased study by an author with a long track record of financial ties to the drug industry, and whose previous views on the epidemiology of autism have been discredited,” wrote Ayoub

So, as far as the mercury militia are concerned, the following points are an issue.

1) Fombonne’s alleged financial ties to the drug industry. One assumes he is referring to Fombonne’s pre-stated offering of advice on the epidemiology and clinical aspects of autism and the fact that he’s an expert witness for vaccine manufacturers.

Let’s cut the shit here shall we? Richard Deth is a petitioners’ expert witness in major vaccine litigation. So are the Geier’s. So are various others. They have an equal ‘special interest’. Should we dismiss their papers out of hand? Either we allow *all* or allow *none*.

2) Fombonne’s previous views on the epidemiology of autism have been discredited.

Really? They have? By who? In what journal was this ‘discrediting’ published? Lets be clear here. Ayoub uses the word ‘discredited’. He didn’t say, ‘challenged’. He didn’t say ‘contraversial’ he said ‘discredited’.

David Ayoub by contrast, thinks that Rashid Buttar – a man who’s own patients think he’s a money grabbing quack – is an industry expert:

The 2 top chelation people in the world are Gary Gordon, MD, and Rashid Buttar, MD, he adds.

It’s my opinion that anyone who thinks Rashid Buttar is ‘top’ of anything autism related needs get his head back to reality pretty quickly.

3) Mark Blaxill at least takes a stab at something substantive. He questions the study methodology on two points. Firstly, he tries to insinuate that what might be true for Canada might not be for the US. Secondly he states that some of the study subjects may have received thiomersal from other vaccine sources than those noted in the study.

Fombonne et al write that:

The findings ruled out an association between pervasive developmental disorder and either high levels of ethylmercury exposure comparable with those experienced in the United States in the 1990s or 1- or 2-dose measles-mumps-rubella vaccinations.

So the word ‘comparable’ is used. Fombonne et al never attempt to state that it is a fact that what’s true for Canada is true for the US. However, its also true that there wouldn’t seem to be any good reason for _not_ thinking that. Why would the US and Canada be different? Surely thiomersal is thiomersal?

After that weak stab at something relevant, Blaxill retreats to Ayoub’s tactics of smear and spin.

Dr. Fombonne wrongfully claims that large-population studies in the United States, England and Denmark also disprove a link between mercury and autism, and he states that “there is no autism epidemic.”

The one mention of the word ‘Denmark’ in the entire paper is this one:

Our results are entirely consistent with cohort, case-control, and other ecological studies performed in Denmark and Sweden.

Fombonne et al never claim that these studies disprove anything. They merely note that consistency between those studies and their own. I can’t locate the use of the word ‘England’, ‘UK’, ‘united kingdom’ or ‘Britian’ anywhere in this paper so I fail to see why Blaxill mentions them.

Blaxill is guilty of intellectual dishonesty many times in his ‘rebuttal’. None more so than when he states that:

He conveniently ignores the vast body of scientific evidence that has shown that environmental factors such as mercury may have caused the increased number of autism diagnoses in the US and other countries.

Fombonne et al do not at any point discuss generalised ‘environmental factors such as mercury’. They discuss the key question regarding thiomersal and MMR. It raises questions about Blaxill’s integrity that he would try and switch the focus onto something he and his group explicitly have targeted to something much more general and which Fombonne et al does not address. This is a pattern becoming more and more apparent from key members of the mercury militia. As science continues to fail to support any causative link between thiomersal, MMR and autism, these groups are becoming much more generalised in their terminology. Expect to see more of this as 2006 draws to a close.

Blaxill also claims there is an increased number of autism diagnoses yet he fails to point to evidence for this. Fombonne’s own research on this point indicates a high but stable prevalence.

Blaxill continues:

Dr. Fombonne’s actions have not historically been in the best interest of families with autism—he has declared himself an expert witness on behalf of various pharmaceutical companies in thimerosal-related litigation.

By contrast, the Geier’s actions have not been in the interests of autistic peoples. And in fact this whole point about ‘best interests’ is childish in the extreme. The _only_ interest that science should adhere to is that of honest science. To suggest otherwise leaves a question mark over the objectives of Blaxill’s actions.

Several independent federal agencies and respected scientists and researchers have received federal funds to investigate the autism epidemic and the biological
plausibility of a link between mercury and ASDs.

Why is this even mentioned? Why not wait for them to be completed? Like this one already is.

Multiple studies have indicated that there is a connection between childhood vaccines containing thimerosal and the incidence of autism.

Blaxill (maybe purposefully) doesn’t mention _who_ might’ve conducted those studies, or where they were published. I’m guessing that he means the Geier’s but that recent revalations regarding their integrity and the quality of their work, made him think twice about saying their names for the record. Can’t say I blame him.

Skeptico, Orac and Autism Diva also comment on this study.

The National Autism Association: You’re Not Helping

21 Jun

Its no secret that there are big questions over the legitimacy of the science behind the spurious claims that thiomersal causes autism. What’s not often discussed in the mainstream media is the extent to which blatant fallacy and misrepresenting occurs within so called advocacy groups.

The self-styled ‘autism community’ especially in the West are blatant hypocrites when it comes to promotong their own agenda. I aim to start highlighting some of the hypcricy and outright lies perpetuated by some.

The National Autism Association

The NAA first came to my attention when I discovered that Wendy Fournier, their President, was the web designer who designed (and I use that word in its loosest possible sense) David Kirby’s Evidence of Harm website. On this website there are claims from reviewers that Kirby:

explores both sides of this controversy

and that his book:

Walk[s] the middle line

It’s quite difficult how any book that has a supporting website designed by the President of an organisation that believes thiomersal cuases autism can be thought of as exploring both sides or walks the middle line. Its also difficult to see how the NAA gets so irate about what they percieve as non-impartiality.

On April 3rd of this year, Wendy Fournier and Rita Shreffler of the NAA put their names to an NAA press release regarding researcher Paul Shattuck’s study that said it was impossible to confirm or disprove the idea of an autism epidemic based on current knowledge. As this didn’t fit with the NAA’s agenda, they decided to play nasty:

In addition to the study’s weak methods and erroneous conclusions, questions have now arisen over possible failure to disclose conflicts of interest

So its interesting that the NAA are concerned about conflicts of interest only when they’re not their conflicts of interest.

So what about Shattuck’s conflict of interest? What was it exactly?

Although the article states that Dr. Shattuck has indicated he has no financial relationships relevant to the article, NAA has learned that he was a Merck Scholar Pre-doctoral Trainee from 1999-2003, and in 2003-2004 he successfully applied for $530,000 from the Centers for Disease Control and Prevention (CDC).

Neither of things are true. As Orac commented at the time:

Oooh, Shattuck received money from the evil Merck to support his training! Except that the Merck we’re talking about seems to be not the evil drug company but rather a nonprofit organization, the John Merck Fund, which supports research into a variety of areas, particularly developmental disabilities

and as regards the half a million plus dollars, Paul Shattuck himself had this to say:

As for the $540,000 from the CDC…it’s not entirely clear what they are talking about. I certainly don’t have a grant that big from anyone. They are probably talking about the autism surveillance grant that our center received from the CDC…a proposal which I helped prepare but am not listed as a co-investigator and am not funded from. Our University is one of several sites around the country funded to do prospective monitoring of the prevalence of autism and other disorders…am not sure why that is so horrible in the eyes of some advocates. I do have a small grant for about $12,000 from the CDC to investigate racial and socioeconomic disparities in the timing of autism diagnosis and service utilization. Prior research has indicated that the timing of identification and the level of service receipt can vary as a function of race and class. This is not a good thing in my opinion. So, I’m trying to find ways to do something constructive about it. I cannot imagine why some people would think that’s such an awful thing.

So, not only are the NAA hypocrites that only abhor conflicts of interests that don’t suit them, they’re also at best, wrong and at worst, knowingly lying.

Just as a follow up to this, I had a brief email exchange with Lenny Schafer where he said he was going to ask the NAA about this:

*Schafer to Leitch (Apr 27th 2006):*
I have forwarded Shattuck’s response to NAA and await their response. Thank you for making me aware of it.

*Leitch to Schafer (Apr 28th 2006)*
The NAA are already aware of these issues. I know of at least one person who has mailed them directly. They elected to ignore it and not to issue a correction or apology.

*Schafer to Leitch (Apr 28th 2006)*
I communicated today with the person who did the research for NAA. I am told a response is being prepared.

That was almost two months ago. The press release is still in place on the NAA website, along with the following quote from Claire Bothwell who it should be noted, given the NAA’s distate for conflicts of interest is either employed or at one time was employed by Waters and Krauss who are thiomersal litigant lawyers.:

Given the rocky history of the CDC and the autism community, failing to mention the author’s ties to this agency is a glaring omission that requires an explanation

I would suggest that given the obvious propensity of the NAA to be economical with the facts, their inability to research a subject properly and their failure to put the record straight is both irresponsible in its implications for autism research and its implications for people like Paul Shattuck who now finds himself grossly unfairly painted in a very negative light.

In a more recent Press Release, the NAA quote Wendy Fournier as saying:

In understanding that the court of public opinion sits in the driver’s seat, entities such as the General Medical Council discredit sound research in the name of a supposedly well-perceived vaccination program. Yet, this is a compromise. Compromise has no place in science, even science surrounding vaccinations.

Dr. Wakefield is one of the few that conducted research in truth, and yet the leaders in medical authority continue to compromise the health of subsets of the population that have negative reactions to shots like the MMR. Are we supposed to view these children as acceptable losses?” asks Fournier. “Dr. Wakefield’s willingness to find answers for these subsets is a testament to his scientific integrity.

Yet again, the NAA seems more than willing to bend the known truth and be incredibly hypocritical into the bargain. Certainly compromise has no place in science, which is why we should never compromise knowledge with bad science such as the original Lancet study or seek to bolster bad science with unpublished and unverifiable science such as that performed by Krigsman – a partner of Wakefields at Thoughtful House and thus someone who one would assume that the NAA, given their dislike of conflcits of interest, would be highlighting in as equally negative a light as they did Paul Shattuck. They also state unequivocally the Wakefield condicted research ‘in truth’ – which is an eyebrow raising statement given the fact that he gained his studies participants via vaccine litigants.

Good science does not require ‘assists’ such as skewing the population. And advocates like the NAA have no place in placing themselves at the center of a debate they obviously have little understanding of and which they are patently prepared to misrepresent.

This post has been sent as an email to Wendy Fournier, Claire Bothwell and Rita Shreffler. I’ll be asking them for a response either via email or via this blog.

Mark Geier and David Geier: Carry On Misrepresenting

20 Jun

Less than a fortnight ago, Kathleen provided evidence that Geier and Geier were guilty of fallaciously misrepresenting themselves by claiming a false affiliation with George Washington University. She promised at the time that this was far from the end of the matter and now she reveals the second (but far from the last) of her evidence against the integrity and honesty of the Geier’s.

Both the abstract and text of Dr. Mark Geier and David Geier’s article in Hormone Research, A Clinical and Laboratory Evaluation of Methionine Cycle-Transsulfuration and Androgen Pathway Markers in Children with Autistic Disorders, indicated that, The Institutional Review Board of the Institute for Chronic Illnesses (Office for Human Research Protections, US Department of Health and Human Services IRB number: IRB00005375) approved the present study.

After a search for the IRB of the Institute for Chronic Illnesses, Kathleen found that the following people were memebrs of the IRB panel:

Mark Geier, David Geier, Lisa Sykes, Kelly Kerns, John Young, Anne Geier, Clifford Shoemaker

The two Geier’s are obvious. Anne Geier is Mark Geier’s wife. Lisa Sykes is parent to a child on the Lupron protocol. Dr Young is Mark Geier’s business partner, Kelly Kerns is a petitioner in the vaccine/autism lawsuit and Clifford Shoemaker is a vaccine injury lawyer. How very convenient. Go to Kathleen’s site to read the rest of this debacle.

UPDATE (24-06-06): Kathleen made another discovery about one of the above – John Young: It has just been called to my attention that John L. Young is not only an OB-GYN; his name appears on the Autism Research Institute’s list of DAN! practitioners. According to his ARI listing, Young completed an eight hour Intensive Training by the DAN! Physician Training Team at the 2006 DAN! conference in Washington, DC. He offers vitamin/mineral supplementation, essential fatty acids, gluten and casein-free diet, antifungal pharmaceuticals and nutriceuticals, heavy metal detoxification (i.e., chelation), antiviral medications, and last but not least, Lupron injections to autistic children.

Rashid Buttar And the Autism Industry

17 Jun

Its a few days short of a year since I wrote my original piece on Rashid Buttar – a piece that drew equal amounts of amusement and hostility depending on one’s viewpoint. I received many comments regarding how nasty I was to a poor, dedicated doctor and so I thought it fit to take another look at Dr Buttar and re-examine some of my comments and look at some things I didn’t previously look closely at.

TDDMPS Revisited

In my previous posts I was skeptical of the efficacy of Buttar’s TD-DMPS product, however I noted that Buttar had stated that:

In a study due to be released by the winter of 2004, conclusive data was accumulated regarding the efficacy of a specifically formulated transdermally applied combination of DMPS conjugated with a number of peptides, called TD-DMPS

And yet, a search of PubMed still – 18 months after the stated release date – reveals _no_ such study. If anyone has a copy of this elusive study I would love to see it.

Interestingly, as I (and Orac) also reported, Dr Buttar seems to be moving away from TD-DMPS, once lauded as the holy grail of autism treatments, in favour of an IV EDTA protocol. The reader can make up his or her own mind about why that might be.

Rashid Buttar: Man Of Letters

Rashid Buttar has an impressive amount of letters after his name and an equally impressive amount of fellowships and board certifications on his CV.

Fellow – American Academy of Preventative Medicine
Fellow – American College for Advancement in Medicine
Diplomat – American Academy of Preventative Medicine
Diplomat – American Board of Chelation Therapy
Board Eligib – Board Certification in Emergency Medicine
Diplomat – American Board of Clinical Metal Toxicology
Diplomat – American Association of Integrative Medicine
Diplomay Candidate – Board Certification in Emergency Medicine
Diplomat Candidate – American Board of Anti-Aging Medicine
Member – National Metals Task Force
Member – American Association of Physician Specialists
Member – International College of Integrative Medicine
Member – International Hyperbaric Medical Association
Member – International Hyperbaric Medical Association Foundation

Wow! Thats pretty impressive. Until we actually look a little closer.

In the US, its the American Board of Medical Specialities who oversee which boards are legitimate and which are not. They have a full list of accepted board certifications online. Of the ten individual associations listed as being ‘American’ or ‘national’ above, *only one – the American Board of Emergency Medicine – is recognised* and this is one that Buttar lists himself as simply being eligible for, not a member, diplomat or fellow of.

So the ‘veneer of respectability’ Rashid Buttar has constructed for himself reveals itself as not in anyway officially recognised. Is such official recognition important? I guess that would depend on who you asked. If you asked autism/thiomersal believers then its not important at all. they would say that such omissions reflect the ongoing conspiracy to ensure only mainstream medicine keeps itself in business by excluding pioneering mavericks like Rashid Buttar. If you asked everyone else they’d probably say it was important because recognised board certification reflects the fact that a member, diplomat or fellow has a certain, scientifically valid level of expertise within a given subject. Or that a given subject is recognised to have a beneficial effect. There is a lengthy document explaining what a medical specialty has to do to gain ABMS approval.

Boards not recognised by ABMS are self appointed and thus free to offer membership based on whatever criteria they see fit.

I did note that there were a few certifications Dr Buttar has missed out on – however he can easily rectify that situation with certification that is as equally – if not more – credible as his current certification.

Rashid Buttar: Man of Science

One of the most intriguing statements on Rashid Buttar’s CV is this:

Visiting Scientist, North Carolina State University

So I popped along to NCSU to have a look and sure enough, Rashid Buttar is listed in his role as ‘visiting scientist. However, what his CV fails to mention is that his chosen specialty is ‘Food Science’, a science that up until now I’d never heard of. Luckily, NCSU have a handy page that defines it for me:

Food Science is what happens to food from the time it’s harvested (or from it’s beginning in a lab) until you swallow it

I think we can all see just how vital this sort of science would be in autism research. Why do I get the feeling that at some point we’ll be seeing the emergence of Buttar Bread? Tasty and Gluten Free!!

Rashid Buttar: Crusading Maverick

In an amusing piece of one-sided propaganda, Rashid Buttar is portrayed as a poor, hard done by hero:

Buttar and eight other integrative doctors from across the state decided they’d had enough. They formed the North Carolina Integrative Medical Society and hired their own lobbyist to work on changing state law. At an April press conference attended by a mere three members of the media, plus lawyers for the medical board and members of the medical society, Buttar’s hand shook as he blistered the medical board for the way it treated integrative doctors.

Two weeks after Buttar’s blistering testimony at the legislature, a letter arrived in the mail from the medical board inviting him and his attorney to appear before the board to answer questions about his practice of medicine and advising him that his rights would be read to him when he appeared. When Buttar declined the invitation, the board subpoenaed him to appear before them.

After two years of harassment and $20,000 in legal fees, Buttar emerged from the hearing poorer but with his clean record intact.

Poor Rashid couldn’t quite seem to grasp why he and his fellow ‘integrative practitioners’ should have to answer to medical authorities like everyone else. And how about that $20,000 legal fee? Ouch.

Rashid Buttar: Fairly Recompensed?

So there’s our hero, 20 grand out of pocket. What does a crusading maverick with an interest in picking food and invented board certifications do? Why he starts getting some money of course! He either set up or joined V-SAB medical labs, which is again listed on his ‘autism buster’ CV….except that just like his ‘visiting scientist’ status, this position doesn’t seem to have much to do with autism. Chemidex lists V-SAB under _’Personal Care & Cosmetics’_ . Go figure.

He has also established ‘Advanced Medical Education & Services Physician Association’ (AMESPA), which is essentially a training facility to allow other practitioners to learn at the feet of Rashid Buttar all the secrets he knows to cure autism, cancer and reverse old age. For this service he charges $20,000 for a five day course. Coincidentally the same amount as two years worth of legal fees when being investigated by North Carolina health authorities. Dr Buttar has no less than 15 testimonials on his site from satisfied practitioners. Thats a cool $300,000 – but not to worry, I’m sure those practitioners will easily recoup their investment from their patients – the autism industry is a growing one after all!

But Buttar hasn’t forgotten his patients. Oh no.

Rashid Buttar: Caring and Sharing

While Dr. Buttar….is also one of those practitioners who receives a lot of complaints. In my opinion, Dr. Buttar’s latest chelation protocol is too invasive and risky. His rates are obscene, too.

(Autism-Mercury Yahoo Group)

Obscene rates? Surely not! Lets take a further look.

Dr. Buttar is asking for $800 for consultation fee (1 hr max) on his Dallas conference on June 16th-17th. I fell off my chair when I heard it.

(‘dingwendy’ CK2 yahoo Group)

We started with Dr. Buttar and $20,000 out-of-pocket expenses later (yes,in a little over a year!)…

(‘plumbrok’ CK2 Yahoo Group)

Wait, $20,000 _in a year??_ Thats…what….the same amount as _two_ years worth of legal fees when being investigated by North Carolina – guess Buttar was easily able to get that money back.

‘plumbrok’ continued:

..he had an unusually strict set-up, as Tracy put it, “My way or the highway” – every supplement had to be purchased through his office and at the time we saw him, he would not accept any substitutes.

Well of course! Only his products = only his profits. This is not a stupid man. However, for that $800 per hour I bet these people get _great_ service!

I do want you to become aware Dr. Buttar treats Cancer and Heart Disease patients. It is his Nurse Practioner that handles all the Autism children and Dr. Buttar reviews the files each week. Very rarely do patients get to see Dr. Buttar. I understand he is trying to see new patients the first time they are in the office, but there is no guarantee as he travels around the country lecturing on various topics and may not be around.

(‘punkinsmama1999’ CK2 Yahoo Group)

Yes, Dr Buttar does not see a lot of his autism patients more than once but oversees the protocol.

(‘Susan Fund’ CK2 Yahoo Group)

So it seems that your $800 per hour gets you an hour with Buttar’s nurse and that you probably won’t get to see Buttat himself above once. It also transpires that to be on his protocol you must buy _all_ supplements from him and him alone. Is his reputation suffering?

Is he really reversing Alzheimer’s? I find that Dr. Buttar talks a lot but produces little evidence.

(‘noaholiviaian’ CK2 Yahoo Group)

The crown seems to be slipping.

Im sorry, but I cant help but to think that with such an outrageous hourly rate, it is praying on parents who are desperately seeking the comforting assurance of a medical practitioner….I know that most parents would willing cut off their own right hand if it would help their kids… and Dr. Buttar knows that as well.

(‘rheaton_stormcast’ CK2 Yahoo Group)

As touched on above, Dr Buttar also treats cancer. I made mention of this in my first blog post about Buttar and discusses his biggest fan – Cajun Cowboy – who had this to say about Dr Buttar:

He (Dr Buttar) told me that most of his patients were much worse off than I and that God had Blessed me by giving me a wake up call and that he could enable my body to heal itself! Now that is the first time I have ever heard a Doctor say he could enable my body to heal cancer.

So I thought I’d drop in on Cajun Cowboy’s site to see how things were going. I was a little surprised by what I found:

All the information about Dr. Buttar is still on this site but I no longer am one of his patients and I do not recommend him to any one for any reason. If you go to him for treatment BEWARE, BEWARE and read Roger Mason’s books first and go to QuackWatch.org first!

Seems like Cajun Cowboy has had something of a change of heart.

Now as far as Dr. Buttar goes read what is said about almost every modality that he practices at QuackWatch.org. Now I new (sic) what was on this site and I new (sic) you have to take it with a grain of salt but for me, most of their opinions concerning Dr. Buttar’s treatment may be true! What I can say for sure is that they did not work for me after over $150,000.00 dollars and two years of treatment!

$150,000 worth of ‘treatment’ that appears to have done nothing at all. Cajun Cowboy sounds quite bitter about the whole thing. Why for $150,000, Buttar could afford to be pursued over 7 times over 14 years by the North Carolina medical authorities and _still_ make a $10,000 profit.

Rashid Buttar: Living The American Dream

Business and free enterprise are the American ideals. On a much smaller scale we could easily equate the level of success Rashid Buttar has had with say a company like…oh I don’t know…Enron. They were successful for quiet some time.

Rashid Buttar is making a very very good living out of his autism cottage industry and so far he’s managed to do it on the back of some fake respectability generated from meaningless board certifications, without publishing any studies (despite repeated promises to do so) into the efficacy of his treatments and by charging people who consider themselves as desperate a lot of money for receiving an ‘interesting’ level of personal service. Along the way he’s keeping his friends sweet by teaching them his methods and is also getting a good slice of money from them too.

Wonder what things will be like a year from now?

Geier and Geier ‘Significantly Misrepresent’ Themselves

10 Jun

Kathleen has written part one of a multi-part look at some of the recent actions of those purveyors of Lupron, the Geier’s.

Seems that a new study of theirs; ‘A Clinical and Laboratory Evaluation of Methionine Cycle-Transsulfuration and Androgen Pathway Markers in Children with Autistic Disorders’ was accepted for publication in Hormone Research and published online prior to being published traditionally.

The interesting bit is the claim of institutional affiliation to Department of Biochemistry, George Washington University, Washington, D.C., USA.

Intruiged, Kathleen contacted Dr. Allen Goldstein, Chairman of the GWU Department of Biochemistry and Molecular Biology to ascertain exactly what the Geier’s affiliation to GWU was. His reply was a bombshell and a further mark against the Geier’s honesty and reliability:

He described the affiliation with the Department of Biochemistry in the Hormone Research article as “fallacious,” and stated that it conveyed a “significant misrepresentation” of Mr. Geier’s position in the field of biochemistry.

I urge you to go and read the rest of Kathleen’s investigation into the Geier’s. Its a compulsive read.

As I understand it, this is _far_ from the end of the matter. There will be further parts to this ongoing issue. Keep an eye on the Neurodiversity weblog.

Creatinine, Chelation and Lupron…Oh my!

6 Jun

A recent news segment on NBC in America covered Chelation therapy as a treatment for autism. The response was as predicted. The pro-cure/biomed side went into raptures. Everyone else winced. As a UK resident I have to say that (sorry America) this seems to be a furtherance of the dumbing down of science in the US that has led to both this sort of report appearing on a serious news show and the joke of creationism being taught in science classes.

Anyway, thankfully, these types of things are still viewed by most people (over there and over here) as marginal and not representative of the truth. However, that doesn’t negate the fact that there is a lot of experimentation going on by so called ‘scientists’ and by some parents. My favourite quote so far from some retorting to the Dateline segment is:

A treatment used prior to proof is called an experiment.

ACSH.

So what can be said to be poorly understood and yet still be used?

Lupron for Autism

I recently had an interaction with a number of people on an Autism Biomed board after they stated that Lupron was ‘working miracles in recovering my child’. At least one of these people was someone who had assured me about a year ago that chelation was ‘working miracles in recovering my child’. A part of me fully expects to hear that car battery acid is ‘working miracles in recovering my child’ from the same person a year from now. After that? Tongue of Toad? Eye of Newt?

It was clear that the ‘scientists’ advising these people had not informed them of basic facts about the condition that was allegedly affecting their kids autism. Neither of them had had their childrens hand and wrist radiographed which is the standard way of determining if a child is undergoing Precocious Puberty or not. Basically, If bone age is within 1 year of chronological age, puberty has not started. If bone age is advanced by 2 or more years, puberty likely has been present for a year or more or is progressing more rapidly.

The single most basic fact about Precocious Puberty is that it is immediately subdivided into Central Precocious Puberty (CPP) or Pseudo Precocious Puberty (PPP). It is vital to make this difference as the treatment is different in each division. The division can only be made by testing for premature activation of the hypothalamic-pituitary-gonadal axis. When I asked one of these people if the Geiers (yes, it was they) had subcategorised into CPP or PPP they did not know what I was talking about. They were entirely ignorant of these terms. It was clear neither of the two people I had spoken to had undergone this sub-categorisation.

They claimed it was ‘enough’ to ‘know’ that their children had excess testosterone. One of these children is female. This child’s parent was utterly ignorant of the fact that excess testosterone in females was not called ‘precocious puberty’ but indicative of ‘Androgen excess’. Lupron is not mentioned as a treatment for Androgen Excess.

One other interesting fact about increased testosterone is that in patients diagnosed with PPP, this can result from an excess of vitamins and other dietary supplements. Its common knowledge that this is a common part of DAN! and DAN! style treatment regimes. Yet again, the Geier’s patients parents were entirely unaware of this fact.

Sources

http://www.emedicine.com/ped/topic1882.htm
http://www.emedicine.com/PED/topic1881.htm
http://www.androgenexcesssociety.org/signs.html
http://www.healthatoz.com/healthatoz/Atoz/ency/sex_hormones_tests.jsp

The Role of Creatinine in Relation to Porphyrins and Chelation to Creatinine

I’m not going to go over this subject as well as Not Mercury recently did but I want to highlight a few key concepts from that paper that it seems the authors either missed or didn’t account for.

The paper’s essence is that it is significant the their are elevated levels of Porphyrins in autistic kids. However, they fail to account for the likelihood that this is a false elevation. The study attempts to measure the amount of porphyrins in the urine of their subjects. However, because collecting urine of a standard volume, content and dilution is next to impossible, its necessary to use a stable compound to express the porphyrins as a ratio of – which is where creatinine comes in. So, the paper claims that, relative to creatinine, porphyrins are high in autistic kids.

However, as Not Mercury also highlights, its fairly accepted amongst DAN! practitioners:

Creatinine is often found to be marginal in the urine of autistics, and low creatinine can skew urine analyte results to high levels. So, also take note of creatinine levels if the laboratory results include ratioing to creatinine.

PDF translated to HTML from ARI

And Andrew Wakefield’s colleague, Paul Shattock, also reports low creatinine in autistic kids (see source on Not Mercury blog entry). So why does that matter? Now, I’m no scientist so I was struggling to find a way to visualise this in my head and I came up with the bar chart below. The thin black line is an arbitrary ‘baseline’ (where the creatinine stops and the Porphs start) below which in purple is creatinine levels and above which is Porph levels. Now, in the autistic representation note how the decrease in creatinine has led the baseline measurement for Porph to falsely raise the amount of Porphs. In other words, relative to the baseline, there are not more Porphs as such, but less creatinine. I’m open to interpretation on this by the way – I don’t want it to be misleading.

There are also anecdotal reports of various chelators reducing creatinine further:

my son’s creatinine has come down to 11 by round 3. why is it going down?how can i bring it back to normal? i have been giving glycine to him also during rounds – every 3hrs dmsa+ala

Onibasu.

And:

Importantly, recent data suggest that oral NAC administration > transiently lowers creatinine levels.

PubMed

So here we seem to have a situation wherein autistic children are already noted to have low creatinine levels and that these levels could be even further reduced by the chelators used either in the study itself or by parents externally to the study and still the study authors claim it is significant to epxress Porphs _as a ratio_ of creatinine.

Autism One

Meanwhile, over in Chicago, Autism One has been in full force (or should that be farce?). I’m reliably informed that one of the big draws was David ‘crowd pleaser’ Kirby so I downloaded his slides to have a looksee.

Incredibly, it seems that David Kirby has magically ‘forgotten’ everything he conceded to blogger Citizen cain regarding the use of CDDS data. Lets remind ourselves of what Kirby told Citizen Cain:

…if the total number of 3-5 year olds in the California DDS system has not declined by 2007, that would deal a severe blow to the autism-thimerosal hypothesis. He [kirby] also conceded that total cases among 3-5 year olds, not changes in the rate of increase is the right measure….

And yet, here we have slides showing Kirby demonstrating the change in the rate of increase, something he has conceded is inaccurate as a measure. He also refers to the increase in cases as ‘new’ cases when its been demonstrated time and time again that these are _not new cases_ . All in all, this is simply more dishonesty from David Kirby.

Autism and autistic people deserve better than this hodge-podge of sloppiness and dishonesty.

MMR and Metal Studies – Empty Discussions

28 May

Two new (not sure what to call them) papers? Abstracts? Press releases? Came out this week concerning autism and vaccines. Also, one _actual_ study was released.

Study number one is entitled…well, actually, as far as I can tell, it doesn’t have a name yet. The first draft (which I saw in October last year) was called *Porphyrinuria in childhood autistic disorder*. The authors are Robert Nataf, MD Corinne Skorupka, MD, Alain Lam, BSc , Anthea Springbett, PhD, Lorene Amet, DPhil and Richard Lathe, DSc.

Richard Lathe is the heavy hitter in this bunch. He’s quoted in New Scientist as saying:

It’s highly likely that heavy metals are responsible for childhood autistic disorder in a majority of cases

New Scientist.

Strong words. However, as I said at the top of this piece, this study has not yet even been published yet. The only scientists who’ve read it are the scientists that performed the study. As far as I know, its not even been accepted for publication by Toxicology and Applied Pharmacology. I _do_ know it was submitted to The Lancet and I’m guessing as the authors moved on to Toxicology and Applied Pharmacology that it was rejected by The Lancet.

I can’t discuss the science as it may have changed since the first draft I have a copy of. In the absence of the science, we can’t really discuss much of any importance.

However, we can take a look ‘behind the curtain’ at some of those names can’t we?

_Lorène Amet_ is an Editor of Medical Veritas – a journal that PubMed does not, as far as I know, index. MV’s ‘mission statement’ includes:

MV…recognizes that medical modalities promoted by public health departments and authorities are often compromised by conflicts of interest with pharmaceutical companies and other political and personal agendas. These areas of detrimental influence include, but are not limited to, the following: vaccinations, pharmaceutical drugs, pregnancy, childbirth and child care practices, treatments for cancer, AIDS and other diseases, food additives, pesticides and herbicides, water fluoridation,d ental procedures, including amalgams, medical procedures and surgeries

Nothing like going in with a preconceived agenda eh? That’ll help with scientific objectivity.

Ms Amet’s colleagues from Medical Veritas include Mohammed Ali Al-Bayati, who doesn’t believe HIV leads to AIDS, as well as someone called Kenneth P. Soller, MD who I’m guessing is Kenneth P. S *t* oller, MD – our new friend who likes HBOT for autism and who tried to smear Paul Shattuck and Andrew ‘Wakers’ Wakefield.

Source – NB: there is at least one person who is now deceased listed on that page.

Here’s some snippets from Ms Amet’s CV:

In the process of setting up an Autism Treatment clinic with the charity Autism Treatment Trust (former Action Against Autism). Principal Scientist.

(UK version of Generation Rescue led by Bill Welsh)

Received DAN! (Defeat Autism Now) doctor accreditation, Dec., 2005. Initiated and organised with Action Against Autism a conference called Treating Autism, Edinburgh UK, October 14-15, 2005. Participated to two clinic days with Dr. McCandless and Dr. Usman (16 children with autism). October 16-17, 2005.

Well, I guess we should all be reassured at how impartial any study featuring a DAN! practitioner and Editor of Medical Veritas will be. I sincerely hope their study has moved on since the first draft.

The second study/paper/abstract/thingy does at least have an actual title. It’s title is: *PERSISTENT ILEAL MEASLES VIRUS IN A
LARGE COHORT OF REGRESSIVE AUTISTIC CHILDREN WITH ILEOCOLITIS AND LYMPHONODULAR HYPERPLASIA: REVISITATION OF AN EARLIER STUDY* which is a bit of a mouthful. It basically claims to substantiate Andrew Wakefields earlier findings with the MMR vaccine.

Yet again, however, despite this being reported in at least two mainstream newspapers, it should be noted that the actual study has not been published. It will be discussed at the upcoming IMFAR conference in Canada but no-one has seen the paper yet. The presentation could not even legitimately be referred to as an abstract yet.

The authors are: Steve Walker, Karin Hepner, Jeffrey Segal and Arthur Krigsman.

There appears to be a fund raiser for this study on the website of the NAA where Andrew Wakefield and Jeff Bradstreet (who apparently used to recommend exorcism for autistic kids) are listed as ‘consultants’.

Lets not forget that the NAA have made a big deal of ‘outing’ Paul Shattuck’s non-existent connection to Merck so I wonder if we’ll be seeing them play the ‘conflict of interest’ card in the case of this study? Doubtful I’d guess.

However, the big connection here is Thoughtful House, Andrew Wakefield’s project. Steve Walker, one of the authors listed above, is on the board alongside such scientific luminaries as, uh, Martie Maguire of the Dixie Chicks.

A keen eyed observer might also note that one of the other authors is a partner of Andrew Wakefield’s. This hardly instils a great deal of hope in the objectivity of this paper.

So there’s our two non-papers which we can’t really discuss the science of as none has been made available. However, that hasn’t stopped people from going ahead and reporting on them as if it were.

The third bit of news from the autism/vaccine issue is (gasp!) an _actual_ paper, which has been peer reviewed, submitted and accepted for publication in a decent journal. Its title is: *Is There a ‘Regressive Phenotype’ of Autism Spectrum Disorder Associated with the Measles-Mumps-Rubella Vaccine? A CPEA Study.*

And what does it say?

There was no evidence that onset of autistic symptoms or of regression was related to measles-mumps-rubella vaccination.

Of course, that story doesn’t get mentioned – its not as interesting as wild speculation.

The Shape Of An Elephant

17 May

Remember this old Bhuddist parable?

Five blind men of Savatthi are all describing an elephant. The problem is that one grabs the tail, the other a leg, the other the side, the other an ear and the fifth, the tusk. Each, remaining blindfolded, seeks to articulate the attributes of an elephant. The one who grabbed the tail insisted that the elephant was like a rope. The one who grabbed the leg was as certain that an elephant was not like a rope, but a tree. The one who was feeling the side of the elephant was convinced that an elephant was like a mud baked wall. The fourth blind man, feeling the ear, was shocked that the others could not understand that the elephant was like a banana leaf. The fifth denounced them all as he held to the tusk, insisting that an elephant was most like a brandished sword.

Every time I hear talk about the ‘autism epidemic’ I remember this parable.

The only way we can _definitively_ establish if thiomersal (or any other vaccine ingredient) causes autism is to take a hundred kids and do a double blind study involving injecting them with either an applicable amount of thiomersal containing vaccines or a control over an established time period.

Obviously, thats never going to happen. Firstly there are the obvious ethics of such a thing – with the prevailing beliefs about what autism is, no parent is going to risk ‘causing’ autism. Secondly there is the more practical reason that there aren’t really any thiomersal containing vaccines left in the West anymore – hence Burbacher’s need to get vaccines and then _add_ thiomersal to them. I suppose our ficticious study could do that but nobody really knows what confounders there may be in such an action. Burbacher certainly didn’t control for them.

So, what else can we do to try and establish if thiomersal (or whatever) can cause autism?

We can examine the symptoms of mercury poisoning (in the case of thiomersal) and see if there seems to be a relationship with autism. This is in essence what the Bernard et al paper tried to do. They concluded there _was_ a link but a closer examination of the paper shows that there is _not one_ common symptom between the diagnstic symptoms of mercury poisoning and the DSM(IV) diagnostic criteria for autism. This fact usually results in two counter-claims. Firstly that the DSM(IV) is not ‘up to the job’ of reflecting the current state of knowledge about autism. Secondly, that autism is such a novel form of mercury poisoning that autism is totally different from all other forms of mercury poisoning.

The first objection is essentially a call to retro-fit the DSM(IV) to fit one persons own beliefs about autism and thiomersal. This is pointless. The DSM criteria (which _are_ periodically adjusted) reflect the symptoms it requires to fulfil a diagnosis of ASD. This means the symptoms are common to _all_ autistic people. People have quoted gut issues, constipation and various other issues to me as ‘evidence’ of the damage resulting in autism, that thiomersal can do. Trouble is, none of the things that get quoted at me are common to all autistic people. These things may be comorbidities. If people have found ways to treat debilitating comorbidities then more power to them I say. I do exactly the same every time I administer a puff of a ventolin inhaler to my daughter. People then go on to say, well, maybe we should start sub-dividing autism into different ‘types’. However, we have no idea what prevalence these ‘sub-types’ might have. As far as we know they might only exist in statistically insignificant numbers that wouldn’t justify a sub-type categorisation. One of the biggest comorbidities is epilepsy. Should we create a sub-category of ‘epileptic autism’. Why? The underlying autism would be just the same. No – this is the very reason why secondary conditions are called comorbidities and not subtypes.

The second theory – that autism is so unique it doesn’t resemble any other form of mercury poisoning – is very hard to take seriously. Anorexia appears to be common across all types of mercury poisoning (its mentioned in Mad Hatters Disease, Pinks Disease and typical mercury poisoning) – why would it skip autism? Occams Razor applies here. The simplest explanation is one which requires no mangling/disappearing/ignoring of known facts – autism doesn’t really resemble mercury poisoning.

So whats next? Epidemiology. We’re left with looking at the numbers.

The ‘autism epidemic’ is central to the thiomersal hypothesis. The argument goes that as thiomersal useage increased both temporaly (vaccines were administered in shorter time frames) and in amount (maximum body burden in the US was 187.5 ug of Hg) that the number of autism diagnosis increased.

The main problem with the epidemic idea is that this chain of events is _far_ from established. The reason is mainly the quality of the underlying data.

There are three main US sources for prevalence data – the Dept of Education, VAERS and CDDS.

Many autism advocacy groups use the data collected by the US Department of Education (USDE) to show a rapidly increasing prevalence of autism. Closer examination of these data to follow each birth-year cohort reveals anomalies within the USDE data on autism. The USDE data show not only a rise in overall autism prevalence with time but also a significant and nearly linear rise in autism prevalence within a birth-year cohort as it ages, with significant numbers of new cases as late as 17 years of age. In addition, an unexpected reduction in the rise of autism prevalence occurs in most cohorts at 12 years of age, the age when most children would be entering middle school. These anomalies point to internal problems in the USDE data that make them *unsuitable for tracking autism prevalence*.

Source.

This is a shame but Jim Laidler is absolutely correct that we must use good, accurate data – USDE data clearly isn’t.

VAERS has massive problems. It allows anyone to enter any data at any time. I recently demonstrated this when I, a UK citizen, managed to submit a VAERS entry stating that a vaccine had turned my daughter into Wonder Woman. Clearly, this is not an acceptable source.

CDDS is the most contraversial. Rick Rollens has toally misintrpretted the data time after time. CDDS themselves state that their data should not be used for tracking autism prevalence. However, if it is insisted that we _do_ use CDDS data then we need to be clear about its use. Rick Rollens lumped all stats from all age groups together – quite obviously this results in meaningless data. As David Kirby conceeded:

…total cases among 3-5 year olds, not changes in the rate of increase is the right measure.

When one does isolate this cohort things are very different. In this cohort, nnot only are autism cases still rising, in the last quarter, the increase in the rate of increase is climbing.In other words, when one uses the correct group of cases to examine, data that David Kirby has referred to as ‘the Gold Standard’ for testing prevalence, shows that autism cases are still rising despite his statement in the New York Times in *2005* that:

Because autism is usually diagnosed sometime between a child’s third and fourth birthdays and thimerosal was largely removed from childhood vaccines in 2001, the incidence of autism should fall this year.

However, despite all this, we need to rememember that CDDS disclaimers appply to our interpretation of the data as well as Rollen’s or Kirby’s. However, ours are more accurate and at least are preformed on the right section of the data.

Make sure to read Joseph’s first comment in this thread which addresses another failing of this data I forgot to address.

So there are very large problems with the epidemiology as well. This is vexing and means, as Paul Shattuck recently concluded, that the true growth of autism cannot be realistically determined. So we’re left with the opinions and research of experts – people who study autism. What do they say?

Almost to a man they say that the idea of an epidemic is questionable. They state there may well have been a rise in _numbers_ but not necessarily a rise in _prevalence_. The distinction is important.

What they say is that improved tests and more recognition adds up to more diagnosis. This is simple common sense. If you know what you’re looking for, you’ll find more of it than you would if you _didn’t_ know what you were looking for.

What do we know that might support this opinion? Here are a few ideas from my neck of the woods.

In 2004, an ‘autism audit‘ was performed in Scotland. One of the questions the audit asked was how accurate they thought the prevalence rate estimates were for their area. 45% of authorities who responded made a point of noting that they felt diagnosis for adults was very underrepresented. For example, Perth and Kinross council stated

Figures for adults reflect the national findings that the numbers known to services/diagnosed represent a significant underestimate of those individuals likely to be affected. For example day centre managers locally consider a number of people to be on the spectrum who have had no formal diagnosis.

Also, in a New Scientist piece last year, the findings of the University of Nottingham were reported. The team reexamined data from the 1970’s which resulted in five diagnosis. Using modern diagnostic criteria, the team found 56 cases, a ten-fold increase.

Lastly, earlier this year, Health Minister Liam Byrne reported figures that demonstrated autism diagnoses for children have nearly doubled in 8 years from 3100 to 6170. Meanwhile adult diagnoses have nearly tripled in the same period from 1120 to 3000.

That seems to pretty firmly establish the idea of widescale underdiagnosis. What about misdiagnosis? From its very start as a categorised diagnosis, autism has been misdiagnosed. Kanner mentioned several of his patients were diagnosed with schizophrenia. However, as Shattuck _also_ concluded, its not possible to ascertain to what degree diagnostic substitution in the past has resulted in more cases now we know better.

A fascinating news article caught my eye this morning and led to this post. It seems that even _after_ we factor in more availability of diagnosis and better tests for it, most doctors still don’t screen for autism because a lot don’t know how.

The study of 255 Maryland and Delaware pediatricians found that 209 (82 percent) said they regularly screen their patients for general developmental delays, but only 20 (8 percent) of them said they regularly screen for ASD. Of the pediatricians who said they do not routinely screen for ASD, 62 percent said they didn’t do it because they weren’t familiar with the screening tools.

Source.

Remember that this is in a time when awareness and screening tools are better than they’ve ever been – if they’re like this now, just imagine how bad they must’ve been 10, 15 or 20 years ago.

Do you see a rope? A tree? A wall? A leaf? Maybe a sword? Or do you put these things together and percieve an elephant?

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