Seth Mnookin responds to Andrew Wakefield on CNN

6 Jan

Seth Mnookin is the author of the upcoming (next week) book “The Panic Virus“. As someone who spent 2 years researching the issue of the vaccine/autism hypothesis, he was chosen to respond to Andrew Wakefield on CNN.

They note this in the story, but I will point it out again here: Andrew Wakefield would not appear together with Mr. Mnookin. This isn’t new. Last year the program “The Doctors” had a program with Jenny McCarthy, J.B. Handley, Dr. Jerry Kartzinel and others–where they only agreed to go on air if the there were no people with opposing views present.

http://i.cdn.turner.com/cnn/.element/apps/cvp/3.0/swf/cnn_416x234_embed.swf?context=embed&videoId=health/2011/01/06/ac.discussing.wakefield.cnn

Mr. Mnookin points out that Mr. Wakefield tried to frame the story as a single reporter (Brian Deer) “out to get him”.

He has framed this consistently as this one renegade journalist who’s out to get him. In fact, there was a British — the Medical Research Council, which licenses doctors in the U.K., spent two-and-a- half years looking into his work. It was the longest investigation they had ever done.

On the subject of Mr. Wakefield’s scientific credibility:

GUPTA: No, I think that — I think this is a pretty big deal, what’s happened today.

But, you know, he didn’t — he hasn’t had really credibility within the scientific world for some time. I mean, as you pointed out, he’s been stripped of his medical license. The paper has been retracted. His co-authors all essentially left the paper.

The problem is that Mr. Wakefield’s audience is not the scientific community. The damage he does is not within or to the science community. The damage is to public health and to the autism communities. I am hopeful that this paper in the BMJ will reduce what credibility Mr. Wakefield still has and the damage he is causing.

Mr. Mnookin has a blog post of his own on the BMJ article and editorial: The problems with the BMJ’s Wakefield-fraud story

Here is the transcript:

COOPER: Also joining us right now is Seth Mnookin, author of “Panic Virus.”

Andrew Wakefield would not go on the program with you.

SETH MNOOKIN, AUTHOR, “THE PANIC VIRUS: A TRUE STORY OF MEDICINE, SCIENCE, AND FEAR”: Right.

COOPER: He would only go on if Sanjay and I were — were asking the questions.

What do you make of what he said?

MNOOKIN: I find it — I find it upsetting and — and disturbing.

He has framed this consistently as this one renegade journalist who’s out to get him. In fact, there was a British — the Medical Research Council, which licenses doctors in the U.K., spent two-and-a- half years looking into his work. It was the longest investigation they had ever done.

And that was the group that stripped him of his right to practice medicine and — and said that he had displayed a callous disregard for children.

There have been dozens of studies.

COOPER: They said a callous disregard for children?

MNOOKIN: Callous disregard for children.

COOPER: That’s why — and that’s — in stripping him of his — of his license?

MNOOKIN: Well, the — the — there were several reasons they listed. The callous disregard had to do with performing unnecessary tests on children who had been brought to him to support this point, including spinal taps, invasive examinations, colonoscopies on very, very young children.

They also found that there was — his evidence couldn’t be backed up. His — his data couldn’t be backed up. So, for it to be portrayed by — by — by Andy Wakefield as this being one person out to get him, you know, I think what he’s banking on is that people won’t actually look and see — look and see what the reality of the situation is.

(CROSSTALK)

COOPER: When you read this report by — by Deer…

MNOOKIN: Right.

COOPER: And I don’t know this guy Deer at all, but, I mean, I have read his entire report. It’s — it’s — it’s pretty exhaustive.

MNOOKIN: Not only is it exhaustive, but, if you took out everything that Brian Deer had ever written, there would be exhaustive evidence that — that this was not trustworthy.

Dozens of researchers in dozens of countries have studied literally millions of children around the world. And this notion that there’s some sort of conspiracy between public health officials, doctors, journalists, drug companies, researchers around the world, you know, it — it would be the most brilliant conspiracy that had ever been hatched.

And — and — and Andrew Wakefield’s setting himself up as this one renegade or this band of renegades, you know, sort of fighting against this is — is, I think, laughable.

COOPER: Sanjay, does he have any credibility?

GUPTA: No, I think that — I think this is a pretty big deal, what’s happened today.

But, you know, he didn’t — he hasn’t had really credibility within the scientific world for some time. I mean, as you pointed out, he’s been stripped of his medical license. The paper has been retracted. His co-authors all essentially left the paper.

COOPER: But, you know, let me just say one thing. Because there — there is so much distrust of big pharmaceutical companies, there are going to be a lot of people watching this who say…

GUPTA: Well, that…

COOPER: … you know, we’re all in the pockets of big pharma, or, you know, that — that there is this conspiracy.

GUPTA: That’s what I was going to say. I don’t know that it’s going to change people who are still going to be very concerned about vaccines.

And the reality is that, if we had a great answer as to what causes autism, I think that would — that would change this debate altogether. But we don’t. So, you — it’s trying to prove a negative, obviously, an impossible thing to do.

But, in his case, I — I don’t think that it — while as big a deal as this is in science today, I don’t know how much this changes the debate overall, because his — his — his science has been discredited in the scientific community for some time.

COOPER: But — but, I mean, it’s understandable. Look, parents — look, we don’t know about — a lot about autism, and — and the numbers are growing. And that is — is of concern. And it’s understandable parents would latch on to anything.

But — but in terms of just facts, and we do — you know, I believe in facts a lot on this program — I mean, Seth, are there peer-reviewed scientific reports that — that indicate a link between…

MNOOKIN: No.

COOPER: … between vaccines and — and autism?

MNOOKIN: No. And not only is there not peer-reviewed work, this is probably the most studied public health issue involving children over the last 20 years.

COOPER: Would public health officials have an interest in — in hiding a link, if there was?

MNOOKIN: Public health officials, I think, would have an interest in keeping children safe.

Even if there — if there was a link and it was discovered, I think public health officials would — would have an interest in doing whatever they could to protect children. This notion that everyone’s trying to — to — to cover their butts and — because they have already been — been perpetrating this scam, is — to distrust the motives of that many people around the world, you know, you would need to assume that — that everything going on is in some ways out to get you.

I think Sanjay’s point about our not knowing what causes autism is really in some ways the crucial one, because it’s so frightening to parents. The numbers are rising. And here’s something that you can point to. And because it occurs at the same time, you always get vaccinated when you’re a child, and autism is diagnosed when you’re a child, so it’s easy to understand why patients would latch on to that as a connection.

But it has no more validity than — than if I said microwave popcorn causes autism. The numbers have gone up since we have started eating microwave popcorn. There’s just — there’s absolutely no evidence supporting a link.

COOPER: Do — do you agree with that?

GUPTA: Yes. I mean, and I think…

(CROSSTALK)

COOPER: And, as a parent, what do you tell other parents?

GUPTA: Well, I — I have three children. I got my kids vaccinated on schedule, on time. So, you know, I mean, that’s — I think the proof’s in the pudding in my case, because I had to make that decision.

But I think, also, you know, that I — you could get a sense of where the debate goes from here. Wakefield’s paper may be discredited, but we still don’t know. We give more vaccines now. We give them in different schedules. Could there be something new that’s possibly causing this uptick in autism?

And — and — and I think the question is going to remain out there, despite what’s happened today. You know, the smallpox vaccine, when it was given, it causes an immune response to the body. It was a — a really profound immune response, more powerful than all the vaccines that we give today, and yet the autism rates are higher now.

So, if it’s the vaccine itself, why wasn’t it happening when we gave these really, really powerful vaccines so many years ago?

COOPER: And, Seth, the report that is out today by this journalist Deer, it indicates that he had a financial — that Wakefield had a financial motive.

MNOOKIN: Right.

COOPER: What was the financial motive?

(CROSSTALK)

MNOOKIN: Well, there were a couple of things.

One, he had filed a patent application for an alternate measles vaccine several months before the paper came out, which he did not disclose at the time. It was precisely the vaccine that you would have wanted if you stopped using the three-in-one MMR vaccine. It was just for measles.

So, that’s one very obvious thing. He also was — his work was being funded by a law firm that was involved in potential vaccine litigation. And a number of the children in this study were also involved with that law firm.

So, the — for — for him to say, you know, “I had no financial connection, and, to prove it, you should read my book,” you know, it — it’s — it’s sort of like saying, no, no, I swear I’m a good guy, and, to prove it, listen to me.

It — you know, it just doesn’t hold up.

COOPER: I read — I read in “Newsweek” this week in an article you wrote about kids who have died because they haven’t been vaccinated…

MNOOKIN: Yes.

COOPER: … died — died from things that they shouldn’t have died of. MNOOKIN: Yes.

COOPER: Whooping cough.

MNOOKIN: In 2010 alone, 10 infants died of whooping cough in California, which is astounding that that is happening today.

There are children that have died of Hib, diseases that I have always assumed were definitely in the past in this country. There was a measles epidemic several years ago in California, in San Diego, that cost $10 million to contain, and resulted in a quarantine of dozens of children.

That meant that those parents then had to find some way to take care of those kids, either not go to work or pay for day care. So, even when you have a case like with that measles epidemic, where it’s true that children didn’t die, you had one infant that was hospitalized for a serious amount of time, and dozens of families that had to pay an enormous amount of money because of this.

COOPER: This is maybe an unfair and an impossible question to answer, is, do you believe Wakefield believes what he’s saying?

MNOOKIN: I talked to him several times over the past several years. Mostly in the context of these conferences that he was referring to where he’s surrounded by people who adulate him.

I think that it’s certainly possible that, at this point, he’s been living in this for so long that he thinks it’s true. I have talked to other people involved in that community who have told me candidly that they wish the conversation could move on from that, because they understood that the science is not…

COOPER: Has the media played a role in perpetuating this? Because you see in a lot of TV shows, you know, on this subject, several sides represented. You have the people who believe the vaccines cause autism and the people who don’t. And it seems to give equal credence, you know.

Or you have a famous person, you know, like Jenny McCarthy, and nothing against her personally, but you know, who is going to get a lot of attention. Has that made the problem worse? Has that given the — this side more credence?

MNOOKIN: I think absolutely. And an example I use is there are people who believe the earth is flat. Most people obviously do not, but if you had one person who believed the earth is flat and one person who said, “No, it’s actually round,” and they were discussing the issue together, it would seem that the consensus was split 50/50.

So here you have a situation in which you have millions of doctors, public health officials, all coming down on one side, and then Andrew Wakefield and a very small number of people who are associated with him, a miniscule number of people, saying, “No, this is what’s actually going on.” But because we can’t present millions of points of view or millions of people, it ends up sounding — there’s this false equivalency. It ends up sounding on the one hand, on the other hand, when there really is only one hand in this case.

COOPER: Do you agree with that, there is only one hand in this?

GUPTA: Yes, and I mean, the one thing I would say with the earth, flat earth, round thing, is we know the answer to that now.

One of the things that again has made this discussion so difficult is that, at the end of the discussion, no matter how much you disagree with the other person, if they come back to you and say, “So what does cause it?” We still don’t have that great answer. It could be some environmental unknown with a genetic predisposition. Who knows? But that, in part, has made this difficult.

Also, you know, just as a parent, I can tell you, it’s so deeply personal. And that also, despite what’s happened today, I think many parents who are dealing with this right now are still believing this, despite all the evidence to the contrary.

COOPER: It’s a fascinating topic. I appreciate both you guys being here with your expertise. Thank you. Dr. Sanjay Gupta, Seth Mnookin.

Andrew Wakefield on CNN

6 Jan

http://i.cdn.turner.com/cnn/.element/apps/cvp/3.0/swf/cnn_416x234_embed.swf?context=embed&videoId=health/2011/01/05/ac.autism.wakefield.intv.cnn

Best bit? The journalist telling Wakefield to shut up about his book.

The National Autism Association tries and fails to defend Andrew Wakefield’s fraud

6 Jan

Of the groups pushing the vaccines-caused-an-epidemic-of-autism idea, the National Autism Association stands out. In a good way. They are the one group that actually has a non-vaccine segment to their agenda. They presented recently at the IACC on issues of safety. Unfortunately, they are stuck in the vaccine-causation debates of 10 years ago. Case in point: coincident with the lifting of the embargo on the BMJ’s pieces on Andrew Wakefield (e.g. How the case against the MMR vaccine was fixed) the NAA put out a statement defending Mr. Wakefield. (National Autism Association Says BMJ Article is Yet Another Attempt to Thwart Vaccine Safety Research)

As a part of this defense, they claim that Mr. Wakefield’s research has been replicated. The claim has been made before and upon scrutiny shown to be false. They use 5 references:

(1) Clinical Presentation and Histologic Findings at Ileocolonoscopy in Children with Autistic Spectrum Disorder and Chronic Gastrointestinal Symptoms, Arthur Krigsman, MD, et al, New York University School of Medicine, Autism Insights, 27 Jan 2010

(2) Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms. Gonzalez L, et al. ArchVenez Pueric Pediatr, 2005;69:19-25.

(3) Panenteric IBD-like disease in a patient with regressive autism shown for the first time by wireless capsulenteroscopy: Another piece in the jig-saw of the gut-brain syndrome? Balzola F, et al. American Journal of Gastroenterology. 2005. 100(4):979-981.

(4) Childhood autism and eosinophilic colitis. Chen B, Girgis S, El-Matary W.. Digestion. 2010;81:127-9. Epub 2010 Jan 9].

(5) Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report, Timothy Buie, MD, et al, Department of Pediatrics, Harvard Medical School Pediatrics, Vol. 125 Supplement January 2010

Taking a lead from Catherina at JustTheVax, who showed last year that the “replication” of Mr. Wakefield’s results was not independent nor a replication, I will take a look at the 4 papers which are purported to “confirm” and association between autism and bowel disease.

1) A paper by Arthur Krigsman in Autism Insights. Arthur Krigsman was one of Andrew Wakefield’s partners at Thoughtful House when he wrote this. Both have since left. Autism Insights is an online journal whose editors include Dr. Krigsman himself. At the time Dr. Krigsman’s paper was published, the editorial board also included Andrew Wakefield. (strangely, Mr. Wakefield is no longer listed on the editorial board). Hardly independent. Right now, Autism Insights has 18 editors. They also have 8 published papers. Yes, they have twice the number of editors as papers. One has to question if this is a real journal. The Krigsman paper was timed to come out to support Andrew Wakefield at a time when his press was quite poor. Not a replication.

2) Gonzalez, et al.. From JustTheVax:

Gonzales et al, number 2, has been published in “Arch Venez Pueric Pediatr” which stands for Archivos Venezolanos de Puericultura y Pediatría. It was a bit tricky to get my hands on the paper, especially since the citation was not quite right, but I did manage and was not surprised to find that indeed the authors cannot replicate Wakefield’s 1998 “findings” of a distinct autistic enterocolitis, although they do report a higher incidence of gastrointestinal problems in their autistic group.

3) Balzola, et al.. Again, from Catherina:

Balzola et al, number 3, is a case report of one adult autistic patient with inflammed bowel.

4) Chen, et al.. Here’s the abstract, which spells out a rare association in 2 children, with possible mechanisms that may connect the two.

BACKGROUND/AIMS: The significance of the association between many gastrointestinal pathologies and autism is yet to be discovered. The aim of this report is to highlight an association between autism and microscopic eosinophilic colitis in 2 children. The possible mechanisms that may connect these two conditions are discussed.

METHODS AND RESULTS: A rare association between autism and microscopic eosinophilic colitis in 2 children is reported through retrospective chart review. Common causes of secondary eosinophilic colitis were excluded.

CONCLUSION: This report suggests the possibility of either impaired intestinal barrier function or an aberrant immune system that predisposes autistic children to sensitization to environmental antigens. Large controlled studies are needed to examine this hypothesis.

5) Bui, et al.. Here is the paragraph in that paper discussing Mr. Wakefield’s work:

In 1998, Wakefield et al. reported an association between ileocolitis and developmental regression in 12 children and coined the term “autistic enterocolitis.” From the same uncontrolled study they reported NLH of the ileum and colon as an abnormal finding in most children with ASDs. However, similar findings are known to be present in children with typical development, as well as children with food allergies and immunodeficiencies. The significance of these findings, therefore, is unclear. Wakefield et al. also proposed a causal relation between measles, mumps, and rubella (MMR) vaccination and autism, a suggestion that was later retracted by many of the original authors.

None of these papers is a replication of Mr. Wakefield’s work. And this is the best that the NAA can do to support Mr. Wakefield’s work, given 12 years of research since his paper in the Lancet. It also avoids the very clear problem with trying to “replicate” or “confirm” work that was fraudulent to begin with.

What is even more strange is that the NAA goes on in their piece to discuss the hypothesized link between autism and vaccines. Strange because Mr. Wakefield has been strenuously distancing himself from the impression that his paper “proved” a link between autism and vaccines.

Mr. Wakefield’s work was fraudulent. The BMJ says so in clearly and conclusively. It is time for some autism parent organizations to distance themselves from this man and his work. They are doing themselves and the autism communities as a whole any good by further association with him.

Current Trends In Autism Conference – April 29-30, 2011

6 Jan

I’ve written before here at LeftBrainRightBrain about the upcoming Current Trends in Autism Conference. At the time I first heard about it, I was hopefully optimistic that a good conference might be in the works. Autism parents are in great need of a real science based conference. The conference is being organized by the Lurie Family Autism Center LADDERS (“Learning and Developmental Disabilities Evaluation & Rehabilitation Services”).

The speaker list is now available, and I copy it below (go to their site if you want live links for each speaker):

Current List of Speakers
Margaret L. Bauman, MD
Director, TARF and LFAC/LADDERS/MGH; Associate Professor of Neurology, Harvard Medical School

Timothy Buie, MD
Pediatric Gastroenterologist, LFAC/LADDERS/MGH

Katarzyna Chawarska, PhD
Director, Toddler Developmental Disabilities Clinic, Yale School of Medicine

Ann Densmore, EdD CCC SLP/A
Founder, Child Talk; Author

Marie Duggan
Founder/President, Technology For Autism Now; AAC/AT Consultant, Boston Higashi School for Autism

Peter Gerhardt, EdD
Founding Chair, Scientific Council, OAR; Director of Education, Upper School, The McCarton School

Charles Henry, MD
Child Psychiatrist, LFAC/LADDERS/MGH

Dorothea Iannuzzi, LICSW, BCBA
Individual and Family Clinician, Milestones, Inc.

Michael A. Mancusi, LICSW, BCD
Vice President, Health Center Operations, East Boston Neighborhood Health Center

Marvin Natowicz, MD, PhD
The Cleveland Clinic, Autism and Metabolic Disorders

Jerry Newport
Autism Activist; International Speaker; Subject of the Feature Film Mozart and the Whale; Author

Carlos Pardo, MD
Associate Professor of Neurology and Pathology, The Johns Hopkins Hospital Department of Neurology

Mary Elizabeth Parker, PT, MSPT, PCS, NCS
Department of Physical Therapy, Texas State University, San Marcos

Stephen Shore, PhD
Assistant Professor of Education, Adelphi University; ASA Board of Directors; Author

Timothy Yu, MD
Department of Neurology, LFAC/LADDERS/MGH

Sheldon Wagner, PhD
Director, Behavioral Development and Educational Services, Inc.

Michael Weiss, PhD
Director of Applied Developmental Analysis (ADA) Therapy, LLC; Adjunct Faculty, Psychology, Fairfield University

Rosemary White, OTR/L
Director, Pediatric Physical & Occupational Therapy Services and Pacific Northwest Pediatric

Andy Zimmerman, MD
Pediatric Neurologist, LFAC/LADDERS/MGH

Additional speakers to be announced!

So far, one autistic adult is on the program, Jerry Newport. More autistic adults will be included as well.

BMJ editorial: Wakefield’s article linking MMR vaccine and autism was fraudulent

6 Jan

In a recent post here on LeftBrainRightBrain we discussed the first in a series of articles by investigative journalist Brian Deer in the BMJ. There is also an editorial by the BMJ, “Wakefield’s article linking MMR vaccine and autism was fraudulent“. The Lancet’s retraction of the Wakefield paper was fairly mild, citing only that the patients were not consecutively referred and the study did not have ethical approval. The BMJ’s statement is much more clear, and with a reason. From the editorial:

The Lancet paper has of course been retracted, but for far narrower misconduct than is now apparent. The retraction statement cites the GMC’s findings that the patients were not consecutively referred and the study did not have ethical approval, leaving the door open for those who want to continue to believe that the science, flawed though it always was, still stands. We hope that declaring the paper a fraud will close that door for good.

Perhaps wishful thinking on their part, as there will always be people who believe Mr. Wakefield.

The BMJ goes further. They are calling for a review of other papers by Mr. Wakefield with the question of whether more retractions are warranted.

What of Wakefield’s other publications? In light of this new information their veracity must be questioned. Past experience tells us that research misconduct is rarely isolated behaviour. Over the years, the BMJ and its sister journals Gut and Archives of Disease in Childhood have published a number of articles, including letters and abstracts, by Wakefield and colleagues. We have written to the vice provost of UCL, John Tooke, who now has responsibility for Wakefield’s former institution, to ask for an investigation into all of his work to decide whether any more papers should be retracted.

This parent of an autistic child welcomes this move by the BMJ. I am grateful to the editors for their action.

BMJ press release: there is “no doubt” that it was Wakefield who perpetrated this fraud

6 Jan

Here is the press release for the series in the BMJ on Andrew Wakefield.

Today, the BMJ declares the 1998 Lancet paper that implied a link between the MMR vaccine and autism “an elaborate fraud.”

Dr Fiona Godlee, BMJ Editor in Chief says “the MMR scare was based not on bad science but on a deliberate fraud” and that such “clear evidence of falsification of data should now close the door on this damaging vaccine scare.”

She is struck by a comparison between researcher Andrew Wakefield’s fraud and Piltdown man, that great paleontological hoax that led people to believe for 40 years that the missing link between man and ape had been found.

She also questions the veracity of Wakefield’s other publications and calls for an investigation “to decide whether any others should be retracted.”

A series of three articles starting this week reveal the true extent of the scam behind the scare. The series is based on interviews, documents and data, collected during seven years of inquiries by award-winning investigative journalist Brian Deer.

Thanks to the recent publication of the General Medical Council’s six million word transcript, the BMJ was able to peer-review and check Deer’s findings and confirm extensive falsification in the Lancet paper.

In an editorial, Dr Godlee, together with deputy BMJ editor Jane Smith, and leading paediatrician and associate BMJ editor Harvey Marcovitch, conclude that there is “no doubt” that it was Wakefield who perpetrated this fraud. They say: “A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross.”

Yet he has repeatedly denied doing anything wrong at all, they add. “Instead, although now disgraced and stripped of his clinical and academic credentials, he continues to push his views. Meanwhile the damage to public health continues.”

“Science is based on trust,” concludes Dr Godlee. “Such a breach of trust is deeply shocking. And even though almost certainly rare on this scale, it raises important questions about how this could happen, what could have been done to uncover it earlier, what further inquiry is now needed, and what can be done to prevent something like this happening again.”

The BMJ will explore these and other questions over the next two weeks.

Brian Deer in the BMJ: How the case against the MMR vaccine was fixed

6 Jan

Brian Deer, the investigative journalist who broke the story of the misdeeds of Andrew Wakefield, has a new article in the BMJ, How the case against the MMR vaccine was fixed. The article is prefaced:

In the first part of a special BMJ series, Brian Deer exposes the bogus data behind claims that launched a worldwide scare over the measles, mumps, and rubella vaccine, and reveals how the appearance of a link with autism was manufactured at a London medical school

This article is damning enough, but as a series this may lay out clearly, in one place, the cases behind the multiple ethical breaches which cost Andrew Wakefield his license to practice medicine in the UK.

Some may ask “why?” There is so much information out there about Mr. Wakefield and his misdeeds. Do we really need it again? I would say yes. In this BMJ series we have the research (and other) ethical lapses laid out in a medical journal. No lengthy GMC transcripts. No news stories with false balance. No “Callous Disregard” book.

The full article is worth the read. Here is the summary from today’s article.

How the link was fixed

The Lancet paper was a case series of 12 child patients; it reported a proposed “new syndrome” of enterocolitis and regressive autism and associated this with MMR as an “apparent precipitating event.” But in fact:

• Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism

• Despite the paper claiming that all 12 children were “previously normal,” five had documented pre-existing developmental concerns

• Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination

• In nine cases, unremarkable colonic histopathology results—noting no or minimal fluctuations in inflammatory cell populations—were changed after a medical school “research review” to “non-specific colitis”

• The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations—all giving times to onset of problems in months—helped to create the appearance of a 14 day temporal link

• Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation

In multiple ways, the story of the Lancet article was crafted to support the conclusion Mr. Wakefield had–a conclusion he came to before starting on the research project.

Yes, before.

In his research proposal to the legal aid board, Mr. Wakefield made the following statement (quoted in Mr. Deer’s article):

““In contrast with the IBD cases [those set out in paragraph 2] which have a prima facie gastrointestinal pathology, children with enteritis/disintegrative disorder form part of a new syndrome. Nonetheless, the evidence is undeniably in favour of a specific vaccine induced pathology. ”

Mr. Deer presents a table comparing how the Lancet article reported the 12 children and how the records really show their cases. He compares regressive autism (only 1 patient’s records clearly show it), non-specific colitis (only 3 children showed it) and whether symptoms occured in the days following MMR (10 clearly did not, 2 are unclear). In all, none of the Lancet 12 children had all three features.

So that is the Lancet 12: the foundation of the vaccine scare. No case was free of misreporting or alteration. Taken together, NHS records cannot be reconciled with what was published, to such devastating effect, in the journal.

Mr. Deer opens his piece with a discussion he had with the father of child 11. Mr. 11 did not agree with the way his son was represented in the Lancet article. Mr. 11 states:

“Please let me know if Andrew W has his doctor’s license revoked,” wrote Mr 11, who is convinced that many vaccines and environmental pollutants may be responsible for childhood brain disorders. “His misrepresentation of my son in his research paper is inexcusable. His motives for this I may never know.”

We may never know the motives. In the end, I don’t care. It is the damage that this fraudulent research has caused to the autism communities and to public health that matter. Countless families have believed Mr. Wakefield, with parents blaming themselves for causing their child’s disability. As to public health, Mr. Wakefield is responsible for a drop in vaccine uptake in the UK, which led to disease and death.

Further reading on the subject can be found at Action For Autism with Wakefield and the MMR Autism Hoax

Paul Offit responds to Mark Blaxill

5 Jan

Over at Age of Autism today, financial whizz Mark Blaxill subjected Paul Offit’s finances to his usual searing intellect. I can’t quote from his post because its just to smart for me to understand!

Anyway, his conclusion has drawn the following response from Paul Offit in an email:

Just for the record: I no longer financially benefit from the sales of RotaTeq. My financial interests in that vaccine have been sold out by either The Wistar Institute, The Children’s Hospital of Philadelphia, or me. I will, however, continue to stand up for the science of vaccines because unfounded fears about vaccines have hurt children. That is why I do what I do and why I have always done it. And I will continue to closely follow the distribution of rotavirus vaccines because these vaccines have the potential to save as many as 2,000 children a day, which is why I joined the research team at Children’s Hospital.

Seems pretty clear to me 🙂

Quality of Life in Adolescents With Autism Spectrum Disorders: Reliability and Validity of Self-Reports

5 Jan

This is one of those papers I really wanted to read and report on, but I fear that I will not get the time to do an in-depth read for some time. But the subject is very interesting and I wanted to get this out before it drops off my radar.

Here’s the abstract:

Quality of Life in Adolescents With Autism Spectrum Disorders: Reliability and Validity of Self-Reports.

Shipman DL, Sheldrick RC, Perrin EC.

From the *Department of Pediatrics, Fallon Clinic, Worcester, MA; †Developmental-Behavioral Pediatrics Floating Hospital, Tufts Medical Center, Boston, MA.
Abstract

PURPOSE: This study examined the reliability and validity of self-reported quality of life (QoL) among adolescents with autism spectrum disorders (ASDs) but without mental retardation (IQ >70) using a validated QoL measure, Pediatric Quality of Life Inventory. Secondarily, the self-reported QoL of adolescents with ASDs was compared with published normative data.

METHODS: Thirty-nine adolescents with ASDs and their parents completed a QoL instrument and brief measures of psychosocial distress and self-esteem. A screening test of cognitive abilities was administered to adolescents; parents completed an assessment of behavioral and emotional symptoms and an assessment of the presence and extent of autistic social impairments.

RESULTS: Adolescent self-reports of QoL demonstrated internal reliability and concurrent validity. Self-reports on the Pediatric Quality of Life Inventory demonstrated moderate to large positive correlations with a measure of self-esteem and moderate to large negative correlations with measures of anxiety and mood. Concurrent validity with parent proxy reports fell within the range of expected values based on past studies of inter-rater reliability for QoL, with parents of adolescents reporting lower QoL when compared with adolescent reports. Adolescents reported QoL below the population mean for all domains.

CONCLUSIONS: Results of this study provide preliminary evidence that adolescents with ASDs are able to report on their own QoL in a valid and reliable manner. Based on our findings, the measurement of QoL may be useful for clinical care and research about adolescents with ASDs.

The idea here is excellent–ask the autistics themselves about their quality of life (QoL). The authors found that the adolescents were more accurate than their parents in describing their quality of life. Reported quality of life is lower than for the general population. QoL is higher for adolescents with higher self esteem and lower for “measures of anxiety and mood”. I don’t know if the authors can or tried to tackle the question of whether high self-esteem contributes to quality of life, or the other way around…or if it is a much more complex situation? The study is limited to autistics with IQ>70. The group is fairly small as well. Of course the big question–how to improve quality of life? What from this study can help in that regard, or in directing future studies.

The past is present (non autism related post)

5 Jan

Kev has recently discussed the book, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All. Besides discussing the dangers the movement poses in its current form, Dr. Offit puts the anti-vaccine movement into historical perspective.

Ever since there was vaccination, there was a resistance to the practice. One of the easiest hooks is to discuss the ingredients. In the case of the original vaccine (which used the cowpox virus to protect humans against smallpox), the target was clear: it comes from cows. One of the more famous images was a cartoon made by James Gillray, showing people growing cow parts after vaccination (click image to enlarge):

It’s so 19th century. Or, is it?

I wasn’t aware of this image (or didn’t remember it) before I read the book. I was taken aback by the similarity to recent imagery used to frighten people about the rotavirus vaccine. If you recall, fragments of a pig virus were found in one of the rotavirus vaccine brands. This was a time for a reasoned, serious discussion. Was there potential for these virus fragments to be harmful? (as it turns out, the virus does not infect humans. It is even found in the fecal matter of humans who have recently eaten pig products).

Here’s one image:

Yeah, kinda cute and funny. The text of the post has headings like “Rotavirus Vaccines Use Monkey, Cow, Pig Materials for Production” and, for some odd reason, “Using Cancer Cells to Produce Vaccines? ” What this has to do with pig virus fragments in rotavirus vaccine is beyond me. The post goes on to link to a video by Barbara Loe Fisher, who discusses “fatal pig viruses”. Fatal to infant pigs, yes. Fatal to humans, no. But, Ms. Fisher doesn’t make that distinction.

Here’s another image, this time from the Age of Autism blog:

There is room for a real vaccine safety movement. In fact, vaccine safety advocates have been successful in creating real change. Dr. Offit makes this clear in his book. But scaring people with these images isn’t helping anyone.

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