SciWriteLabs #6: BMJ editor Fiona Godlee on the Wakefield-MMR fiasco, the problems with peer review, and research oversight boards

Yesterday, the British Medical Journal called for “a parliamentary inquiry into research which claimed that the MMR vaccine causes autism and bowel disease, following extraordinary new disclosures about what it calls the ‘elaborate fraud’ behind the work of Andrew Wakefield.” The BMJ call to action was ironically prompted by new data provided by one of Wakefield’s defenders, as the journal explains in a press release:

In May 2010, Wakefield, formerly a researcher at the Royal Free medical school in Hampstead, north London, was struck off the medical register over a raft of charges, including dishonesty in research published in the Lancet in 1998. And last January, the BMJ concluded that his claims linking MMR vaccine with autism and bowel disease were “an elaborate fraud.”

Now, the journal publishes further revelations about the research, removing any remaining credibility to the claim that Wakefield and his co-authors had discovered a new inflammatory bowel disease associated with MMR. Experts studying unpublished raw data submitted to the BMJ with a view to exonerating Wakefield say it provides no evidence of such disease and that almost entirely normal findings were misreported in the Lancet paper.

Published in February 1998, the paper claimed that 8 of 12 children with brain problems seen at the Royal Free hospital developed autism within days of MMR, and that 11 of the 12 had colitis. The paper triggered a decade-long storm of public anxiety, plummeting levels of vaccination, and the re-emergence of measles as an endemic disease in Britain and elsewhere.

This new information does nothing to exonerate Wakefield of fraud but nor does it reflect well on his 12 authors, says Godlee. “It is impossible to reconcile [the new data] with what was published in the Lancet. The paper talks of enterocolitis and a new bowel disease involving a putative “unique disease process.” How could two consultant histopathologists have reported healthy biopsies and then put their names to such a text?”

The BMJ has been at the forefront of investigating the MMR scare, and earlier this year Dr Godlee wrote to University College London reporting six more papers involving Wakefield which have aroused concerns. She believes that a continuing failure to get to the bottom of the vaccine scandal raises serious questions about the prevailing culture of our academic institutions and attitudes to the integrity of their output. Given the extent of involvement of senior personnel at the highest level, only an independent inquiry will be credible, she says.

Earlier today, Godlee spoke with me about her publication’s latest charges, as well as a number of issues relating to science writing and journalism. This is a lightly edited transcript of that chat.

SM: I want to start out with a question that has come up a lot in science writing circles over the past several months: What is the proper role for journalists when it comes to checking/vetting scientific work? I’ve spoken (and corresponded) with a number of scientists who have essentially said that peer review is the proper way to ensure new research is accurate and worthy of getting attention, and reporters should stick to informing the public about the results of those studies. The MMR-autism fiasco seems to put the lie to that notion: Here, Wakefield’s paper passed peer review and it was only when an investigative reporter named Brian Deer took up the case that the house of cards began to fall apart.

FG: Lot of important issues here. Did the peer review process fail in allowing Wakefield’s paper into the medical literature? Why does post-publication peer review tends to focus on scientific error rather than countenancing the prospect of fraud? What was the role of the mainstream media in giving Wakefield such a sympathetic hearing? All contributed to where we are now — not to mention the failure of the co-authors to fulfill their responsibilities.

SM: So do you think the peer review process failed in this case, or does the fact that the Wakefield paper was published in the first place highlight the intrinsic deficiencies of a system that’s designed to check data –which, as you point out, presumes that data is legit in the first place?

FG: Peer reviewers can only go on what they are sent – and what the Lancet‘s reviewers were sent was a falsified version of the children’s data, which they had no way of knowing. However, when peer review has succeeded in detecting fraud in the past, it has tended to be because the research looked “too good to be true.” I think the reviewers might have spotted this in the Wakefield case if they had been on the ball – the children almost all reported as having similar bowel pathology despite being (reportedly) a consecutive series; the high proportion of families (8 of 11) reportedly blaming the vaccine.

But hindsight is a wonderful thing. More open to criticism is the fact that the study itself was so poorly designed — relying on parental recall etc — especially considering that this is such an important topic for public health. It is this that should have kept it out of a high profile journal.

SM:  I’d agree with you about the fact that the basic science was so shoddy in Wakefield’s study that it likely didn’t deserve to be published in the first place. The point I’ve made in the past is that the media should have known that the conclusions Wakefield was making in his press conference announcing his result wouldn’t be warranted by a 12-child case study even if the data had all checked out.

Once the Lancet piece was published, what could/should the mainstream media covering the story have done differently? Was it inevitable that once this story was out there it was going to take off the way that it did?

FG: I agree. And had the media ignored the study as they should have done, we might all have just carried on our merry way and Brian Deer would never have been put onto the case by his editor and the fraud would never have been uncovered. Essay question: does scientific fraud that has no impact on medicine, health care, science matter?

In terms of the media’s response – initially in the UK it was was quite sober, focussing on the lack of evidence of a link. For reasons I haven’t properly looked into, but Ben Goldacre will be able to give you more on, in about 2002 the mood changed. The UK’s Daily Mail has a journalist named Melanie Phillips, who took up Wakefield’s case, as did the satirical magazine Private Eye, publishing a special “expose” on vaccine safety and championing Wakefield. The BMJ pubslihed an article that talked about the problem of the media taking a “balanced” approach in such stories — setting Wakefield and the scientific consensus against each other as if there was equal weight on both sides. This is traditional legalistic approach but doesn’t work well for some stories in the media. Climate change is an example.

SM: I couldn’t agree with you more about the problems with two-handed reporting of one-handed issues — I wrote a lot about that in my book about the vaccine panics of the past decades. I also spent a fair amount of time looking into the initial 1998 coverage, and I’m probably less forgiving of those initial reports than you are. It was a situation where you had Wakefield making outrageous claims that virtually everyone else in the field said weren’t supported by his research — I’d argue that’s a case where the correct decision isn’t to put the story out there and essentially let the reader decide, it’s to not publish the story in the first place. But that’s a whole other issue…

One of the charges leveled against Lancet editor Richard Horton back in 1998 was that he published Wakefield’s piece despite some pre-publication misgivings that had been made because he wanted to stir up some attention for his publication. For people not involved in academic publishing, I think that might have seemed surprising. With this latest series, the BMJ has now been publishing new, fairly explosive charges about Wakefield paper for close to a year. In January, Paul Offit said that in some ways, Brian’s initial BMJ series was beside the point: Wakefield’s theories were already known to be incorrect. That’s a view I’m sympathetic to. At this point, it seems as if every new revelation or investigation only serves to bring the story back in to the public’s consciousness. Did you ever wonder whether this particular story has already gotten all of the attention it deserves?

FG: Yes, I’m very sympathetic to that view. However, I am in no doubt that the three articles we published in January did break new ground. Since they were published I have been invited to speak to a range of different groups around the world — clinicians, academics, research scientists — and I’ve been surprised by the extent to which what we published was, in their view, truely new and important. No longer was the resesrch in the Lancet, which had impacted so much of their professional activities, just poor science –  it was actually falsified.

I also thought it was important that we shed light on the failures at the institution and the journal to act properly when allegations of misconduct were [first] raised [by Brian Deer] in 2004. All too often such allegations are swept under the carpet, and that’s what happened in this case. But once we had published the series of articles and editorials in January and the BMJ had called for UCL to establish an independent enquiry, I thought that would be us done.

Then we were sent by Wakefield, via an intermediary, the original pathology grading sheets, and we had to decide what to do with them.

SM: I’m not disputing that they broke new ground at all — that’s clearly true. The pathology reports are interesting. In your editorial, you are quite forceful about what they show. Yesterday, Nature published a news story that used those same reports (supplied by David Lewis) and even quoted Ingvar Bjarnason, who wrote one of the commentaries in BMJ — but in Nature, he seems to be saying something quite different:

But [Bjarnason] says that the forms don’t clearly support charges that Wakefield deliberately misinterpreted the records. ‘The data are subjective. It’s different to say it’s deliberate falsification,’ he says.

I’m not sure if I have a specific question about that — it’s just interesting to me how differently the same information can be explained/described.

FG: I think we have been quite careful about what we said in relation to the children’s pathology. The conclusion that the data in the paper were fabricated is based on a whole raft of inconsistencies which together mean that, in no single child can the Lancet paper be reconciled with the health care records. This was also true for the bowel pathology reports. In January, we knew there were clear discrepancies between the routine hospital pathology reports — done by senior pathologist and co-author Susan Davies — and what was reported in the Lancet. We had no information that could shed light on how and why these changes had been made. A “research review” by fellow senior pathologist and co-author Anwar Dhillon was alleged to have found that the children had enterocolitis.

What we now know, as a result of the surfacing of the grading sheets, is that Anwar Dhillon found nothing of the sort. Almost all the children’s biopsies were normal or showing what amounts to physiological change. I agree with Bjarnason that we cannot know about intent. What we know is that the Lancet report is very far from an accurate report of the children’s biopsies. And it is not tenable that Wakefield simply transcribed Dhillon’s tick box that said “non-specific” for some of the biopsies and from this built the edifice that includes enterocolitis and a unique disease process for 11 out of the 12 children.

SM: Before we need to go, I want to get to some questions sent in by readers. Here’s one:

“Does research oversight, which the BMJ has called for, really work?  The US version has pretty mild sanctions (they list the people sanctioned).  Also, what about when people like those who put out the Pace University study go around the rules? There isn’t anyone to sanction them.  They don’t depend on grants, so it isn’t like they will lose their government funding.  No one wants to pursue that.  HHS, NYU, Pace — they just act like nothing happened.”

FG: In regards to research oversight – that’s a real challenge, I agree. Although the US system may be weak, at least there is one. In the UK we have nothing and, as I have been increasingly saying when asked about this, we should be ashamed about this. The Wakefield example is perhaps the most florid, but no doubt there are others — the evidence fronm the Committee of Publication Ethics suggests this — where institutions are failing to properly investigate allegations. We need at least some system that places the responsibility on institutions to investigate and publish their findings

SM: Two related questions that came in over the transom:
* Given the large number of examples of ethical lapses and dishonesty proved against Andrew Wakefield, how does one communicate to the public without it becoming a great deal of noise?
* Isn’t the Wakefield story over?  This last attempt to exonerate him was pretty weak.  Are we supposed to respond to every “newly discovered” document he pulls out of a drawer?

FG: On communication with the public — I agree, it’s a big challenge, especially in the age of the Internet. The medical and scientific establishment can’t possibly compete with the public, and parents of children with autism and people with autism are understandably passionate about this issue. I’m not sure what the answer is, but openness and humility will go a long way.

On whether this should all be done and dusted by now — if only that were true.

SM: I do want to make sure I ask one more question before we need to go. Has the BMJ looked into (or does it have any plans to look into) a 2002 paper that appeared in the BMJ publication Molecular Pathology titled “Potential viral pathogenic mechanism for new variant inflammatory bowel disease“? Wakefield and John Walker-Smith were both authors on that paper. It’s a study, since fairly convincingly discredited, that used PCR data to “prove” the measles virus was in children’s guts.

FG:
We have referred his to UCL, the institution where the research took place. This is the way journals are supposed to deal with potential misconduct. Once we hear back from them, we will take whatever action is appropriate

SM: Isn’t that kind of passing the buck, especially if you think the UCL has failed in other instances regarding Wakefield’s work? The fact that there’s a review that’s theoretically supposed to occur doesn’t mean that publications can’t also conduct their own reviews…right?

FG: Journals don’t have the resources or the aegis to investigate authors for misconduct. Arguably that’s where the Lancet went wrong in 2004. It should have stepped back (instead of almost running the investigation itself) and if the institution [where Wakefield had conducted his research] failed to do a proper job, it should have then kept badgering them until they did so. This is what we are now doing in relation to Wakefield’s other work.

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19 Responses to SciWriteLabs #6: BMJ editor Fiona Godlee on the Wakefield-MMR fiasco, the problems with peer review, and research oversight boards

  1. Barry says:

    The fact that so called ” Modern Medicine” see itself as a bastion of science is the biggest joke of all time. Health care should really be called di$ea$e care, because that’s all it really is.

    The REAL purpose of ALL vaccines is to generate diseases , for which pharmaceutical companies later cash in on with their life long “treatments” designed to treat (… hut never cure) them.

    That’s why there isn’t a single shred of scientific proof that any disease has ever been prevented by a vaccine (… remember, epidemiology IS NOT science). If you disagree, then by all means, try to prove me wrong.

    That”s why the work of REAL scientists like Andrew Wakefield is never challenged by the medical establishment. They resort instead to their only real option, which is to have his character assassinated by hack journalists like Brian Deer and Seth Mnookin, and/or utterly useless medical doctors like Fiona Godlee or Paul Profit.

    • Chris says:

      Oh, Barry, thank you so much for explaining it all so clearly. You obviously know much more than all of the Public Health service combined. You must have the answer to this question I keep asking, but I never seem to get one that involves real data. The following table is taken from a census document, can you please tell us (with proper documentation) why measles in 1970 was only 10% of what it was in 1960 in the USA?

      From http://www.census.gov/prod/99pubs/99statab/sec31.pdf
      Year…. Rate per 100000 of measles
      1912 . . . 310.0
      1920 . . . 480.5
      1925 . . . 194.3
      1930 . . . 340.8
      1935 . . . 584.6
      1940 . . . 220.7
      1945 . . . 110.2
      1950 . . . 210.1
      1955 . . . 337.9
      1960 . . . 245.4
      1965 . . . 135.1
      1970 . . . . 23.2
      1975 . . . . 11.3
      1980 . . . . . 5.9
      1985 . . . . . 1.2
      1990 . . . . .11.2
      1991 . . . . . .3.8
      1992 . . . . . .0.9
      1993 . . . . . .0.1

      • Barry says:

        Sure Chris, right after you show me what I asked you for first .

        Which is irrefutable scientific proof that any disease has ever been prevented by a vaccine.

        I won’t hold my breath.

        • Chris says:

          Oh, deer, the answer is in the census data I gave you. All you have to do is look. I don’t understand why if you know so much, why it is such a difficult question to answer.

          But if you insist:

          Impact of Vaccines Universally Recommended for Children—United States, 1900-1998

          Historical Comparisons of Morbidity and Mortality for Vaccine-Preventable Diseases in the United States

          I would also recommend you read the book Pox: An American History, pay close attention to what happened to Immanuel Pfeiffer.

          Even if you don’t like those papers, please do tell me why the rate of measles fell 90% between 1960 and 1970 in the USA. Your answer will provide me a guide as to what kind of data would satisfy you. Though, I do actually insist on real peer reviewed papers.

        • Chris says:

          Here are some more papers for you to mull over while you come up to the reason the rate of measles in the USA in 1970 was only 10% of what they were in 1960.

          You might want to also tell us why diseases tend to go away when there are vaccine programs, but come back when vaccines are dropped.

          Measles vaccine coverage and factors related to uncompleted vaccination among 18-month-old and 36-month-old children in Kyoto, Japan:

          According to an infectious disease surveillance (2000), total measles cases were estimated to be from 180,000 to 210,000, and total deaths were estimated to be 88.

          An office-based prospective study of deafness in mumps.
          Hashimoto H, Fujioka M, Kinumaki H; Kinki Ambulatory Pediatrics Study Group.
          Pediatr Infect Dis J. 2009 Mar;28(3):173-5.

          An outbreak of measles in Saitama City in 2007. What is the vaccination strategy to eliminate measles in Japan?
          Kaetsu A, Miyazaki M, Imatoh T, Matsumoto E, Sakamoto Y, Takano M, Une H.
          J Infect Chemother. 2008 Aug;14(4):291-5. Epub 2008 Aug 17.

          MMR-Vaccine and Regression in Autism Spectrum Disorders: Negative Results Presented from Japan.
          Uchiyama T et al.
          J Autism Dev Disord 2007; 37(2):210-7
          *Subjects: 904 children with autism spectrum disorder
          (Note: MMR was used in Japan only between 1989 and 1993.)

          No effect of MMR withdrawal on the incidence of autism: a total population study.
          Honda H, Shimizu Y, Rutter M.
          J Child Psychol Psychiatry. 2005 Jun;46(6):572-9.

          Impact of anti-vaccine movements on pertussis control: the untold story

          Acellular pertussis vaccines in Japan: past, present and future.
          Watanabe M, Nagai M.
          Expert Rev Vaccines. 2005 Apr;4(2):173-84. Review.

          J Infect Dis. 2000 Feb;181 Suppl 1:S237-43. Review
          Epidemic diphtheria in the Newly Independent States of the Former Soviet Union: implications for diphtheria control in the United States.
          Golaz A, Hardy IR, Strebel P, Bisgard KM, Vitek C, Popovic T, Wharton M.
          .

          Pediatrics. 2009 Jun;123(6):1446-51.
          Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children.
          Glanz JM, McClure DL, Magid DJ, Daley MF, France EK, Salmon DA, Hambidge SJ.

          Am J Epidemiol. 2008 Dec 15;168(12):1389-96. Epub 2008 Oct 15.
          Geographic clustering of nonmedical exemptions to school immunization requirements and associations with geographic clustering of pertussis.
          Omer SB, Enger KS, Moulton LH, Halsey NA, Stokley S, Salmon DA.

          Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001
          Zhou F, Santoli J, Messonnier ML, Yusuf HR, Shefer A, Chu SY, Rodewald L, Harpaz R.
          Arch Pediatr Adolesc Med. 2005;159:1136-1144.

          An economic analysis of the current universal 2-dose measles-mumps-rubella vaccination program in the United States.
          Zhou F, Reef S, Massoudi M, Papania MJ, Yusuf HR, Bardenheier B, Zimmerman L, McCauley MM.
          J Infect Dis. 2004 May 1;189 Suppl 1:S131-45.

          Pediatric hospital admissions for measles. Lessons from the 1990 epidemic.
          Chavez GF, Ellis AA.
          West J Med. 1996 Jul-Aug;165(1-2):20-5.

          Measles epidemic from failure to immunize.
          Dales LG, Kizer KW, Rutherford GW, Pertowski CA, Waterman SH, Woodford G.
          West J Med. 1993 Oct;159(4):455-64.

          Impact of universal Haemophilus influenzae type b vaccination starting at 2 months of age in the United States: an economic analysis.
          Zhou F, Bisgard KM, Yusuf HR, Deuson RR, Bath SK, Murphy TV.
          Pediatrics. 2002 Oct;110(4):653-61.

          • Barry says:

            I asked you for science Chris… do you need some clarification on what constitutes science???

            Like I said earlier, there isn’t a single shred of scientific proof that any disease has ever been prevented by a vaccine .

            And so far, you’ve failed miserably in your attempts to even put a dent in that argument.

          • Chris says:

            So what kind of studies were you expecting? How are those deficit? Yes, I do need clarification of what constitutes science.

            Give me some good examples by showing us what caused the rate of measles to decline by 90% in the USA between 1960 and 1970.

            Since you obviously know more about science than me, I would like you to answer that question.

    • Matt Carey says:

      Barry,

      You’ve been able to spark the discussion you wanted, but in the end for almost all readers what you have done with this:

      The REAL purpose of ALL vaccines is to generate diseases , for which pharmaceutical companies later cash in on with their life long “treatments” designed to treat (… hut never cure) them.

      is show how far Andrew Wakefield has sunk. From a position of moderate prestige, to being the hero of the unscientific like yourself. From putting his gifts to some sort of valuable use, to being the favorite of UFO enthusiast radio shows and new world order podcasters.

      Mr. Wakefield could get some of his credibility back by distancing himself from people like yourself. Instead he seems to embrace any and all support, even though in doing so he gives support back to people with agendas even more damaging than his own.

  2. Barry says:

    Chris,

    One of the “studies” you provided is titled

    ” An economic analysis of the current universal 2-dose measles-mumps-rubella vaccination program in the United States.”

    While I think it pretty much defines what what vaccinating is really about…. do you really need me to explain how it in no way resembles science??

    What I asked for was irrefutable scientific proof that any disease has ever been prevented by a vaccine. And so far, you haven’t provided any.

    • Chris says:

      Okay, that is one study, and it showed less money was spent. What about the rest?

      Please use your superior knowledge of science to tell me why the rate of measles decreased by 90% between 1960 and 1970 in the USA. I provided the raw data in the form census data, Now prove to me with your science what caused the decline.

      By the way, what field of science do you work in?

  3. Chris says:

    It seems, Barry is at a loss for words now. Let me review his opening comment here:

    The REAL purpose of ALL vaccines is to generate diseases , for which pharmaceutical companies later cash in on with their life long “treatments” designed to treat (… hut never cure) them.

    He is arguing from blatant assertion. This is something that would have been documented. It is amazing that anyone thinks that treating diseases is cheaper than preventing them. It is the reason that I included the economic analyses in the list of studies.

    That’s why there isn’t a single shred of scientific proof that any disease has ever been prevented by a vaccine (… remember, epidemiology IS NOT science). If you disagree, then by all means, try to prove me wrong.

    In a spectacular example of Dunning-Kruger Syndrome, Barry as unilaterally decided an a whole branch of study is not science, and makes another argument from blatant assertion.

    Though, in truth, much of epidemiology does depend on mathematics. Sir Ronald Ross contributed to the use of mathematics in the study of disease/vector patterns. Something I appreciate since in my former life as an engineer I used statistical methods to predict dynamic structural failure. In the first few chapters of my Kreyszig Advanced Engineering Mathematics book there are even examples of equations used in epidemiology.

    He also demands that we prove him wrong, but has announced that he will not accept any evidence that is not science, yet he never actually defined what he considered “science.”

    When presented with the raw numbers of actual measles incidence that is contrary to his closed mind set, he refuses to even attempt to answer the question. He announces that his demands be met, even though he has already said he will only accept certain kinds of “science.”

    When answered with several studies from several countries using several methods that vaccines have reduced diseases, and that suspension of vaccination programs have caused diseases to return he returns with a beautiful example of Dunning-Kruger by asking if I needed a clarification of what constitutes science. Which I answered in the affirmative.

    To which he weakly responds that at least one paper was on economics. Except that paper basically debunked his first assertion that vaccines were largely ways for create future funds for pharmaceutical companies. And he has still not responded to the question about the declination of measles (or any other) disease in the USA.

    That”s why the work of REAL scientists like Andrew Wakefield is never challenged by the medical establishment. They resort instead to their only real option, which is to have his character assassinated by hack journalists like Brian Deer and Seth Mnookin, and/or utterly useless medical doctors like Fiona Godlee or Paul Profit.

    Ah, this is lovely. He declares that Wakefield is a real scientist, despite the fact that there is actual proof of fraud (and it was just a small case series!). And then goes to use “character assassination” on others, especially with the not-so-creative spelling of a name. This truly indicated I would never get a real answer out of Barry, but I did try to ask him politely (okay, there was some sarcasm).

    Dr. Mark Crislip, an infectious disease doctor, wrote recently about the phenomena that Barry represents in Random Flu Thoughts at ScienceBasedMedicine:

    There are two broad themes as to why people refuse the vaccine. One is straight from Bizarro World: there is a cabal of government, pharma, and doctors whose sole purpose in giving the vaccine is to line the pockets of big pharma and keep people ill. This is a delusional state so at odds with the reality to which I am accustomed, and evidently so common, I am surprised there is no DSM entry for the disorder and there are no clinical descriptions of the phenomena.

    • Seth Mnookin says:

      Hey, Barry and Chris,

      Thanks for engaging in what is certainly shaping up as a vigorous debate. It might make sense to curtail this particular back-and-forth here, as I think both of you have a) made your points and b) are unlikely to be persuaded by the other. I’m not going to cut off comments, but am worried that we’re inching closer to ad hominem attacks and further away from discussion.

      • Chris says:

        It is okay. I did sincerely want to know if he would answer my questions. I did try my best to answer his.

        Thanks.

      • Chris says:

        By the way, I did not use any ad hominem attacks, and actually, neither did Barry. There is a minor difference between “ad hominem attack” and insult … or the ever popular “poisoning of the well” gambit.

        Neither of us said the argument was wrong because of who we are, but just decided to insult the persons and/or their positions. Barry did not say Mr. Mnookin was wrong because he was a journalist, but just decided to call him a “hack journalist.” To be clear, without any real evidence, I don’t believe you’ve hacked any phones like those who worked for the late “News of the World.” (attempt at humor)

        But even pointing that out makes me the scum of the internet: a pedant. For which, I am kind of sorry.

        But in my defense, I only really got fired up to explain to Barry why his comment was so full of fail after I listened to a podcast. It was Dr. Crislip’s Random Flu Shots Quackcast, which I listened to after delivering my son’s 24 hour holter monitor to the cardiac clinic.

        The last part is true, but only added to get sympathy votes. But, really, listen to Dr. Crislip. His delivery says it all.

        • Seth Mnookin says:

          Good point (inre: my use of “ad hominem”) — that was sloppy word choice on my part. I meant that I was worried we were on the verge of talking past each other and not to each other…

  4. Matt Carey says:

    It looks like the media attention to this latest set of articles in the BMJ is much lower than in January. Is it safe to say that the public for the most part has absorbed the idea that Andrew Wakefield was dishonest in the way he conducted and presented his research?

    There are still important questions to address from how this disaster occurred and how similar problems can be averted in the future. Ironic, isn’t it, that Mr. Wakefield did make it into the medical textbooks. Not for the ideas about autism causation he got from a group of parents, or his early work on Crohn’s, but as a textbook example of research fraud.

  5. Matt Carey says:

    One of Ms. Godee’s responses makes me wonder:

    “We have referred his to UCL, the institution where the research took place. This is the way journals are supposed to deal with potential misconduct.”

    Aside from the article in The Lancet, another Wakefield article has been retracted: “Enterocolitis in Children With Developmental Disorders”

    On 28 January 2010, the UK General Medical Council’s Fitness to Practice Panel raised concerns about a paper published in the Lancet by Dr Wakefi eld et al. (1). Th e main issues were that the patient sample collected was likely to be biased and that the statement in the paper, that the study had local ethics committee approval, was false. There was also the possibility of a serious conflict of interest in the interpretation of the data. Th e Lancet has now retracted this paper (1). Th is paper in the American Journal of Gastroenterology (AJG) (2) also includes the 12 patients in the original Lancet article and therefore we retract this AJG paper from the public record.

    That decision came quickly enough after the GMC hearing that it would seem that those editors did not wait for UCL to respond.

    Why must we wait for the Uhlmann paper to be retracted? The data presented at the Omnibus hearing by Steven Bustin was very clear that there were major methodological flaws in the the way the O’Leary laboratory performed the PCR.

    Also, the fact that Mr. Wakefield’s team quashed the results from Dr. Chadwick’s PCR analysis should on it’s own be grounds for retracting this paper.

    So, we have two questions: (1) What is taking UCL so long to respond? and (2) Why do we have to wait?

  6. Andrew says:

    “That”s why the work of REAL scientists like Andrew Wakefield is never challenged by the medical establishment. They resort instead to their only real option, which is to have his character assassinated by hack journalists like Brian Deer and Seth Mnookin, and/or utterly useless medical doctors like Fiona Godlee or Paul Profit.”

    Barry – If you really believed this crap, you wouldn’t bother to post here on Seth Mnookin’s blog, because the Seth Mnookin you claim to believe in would of course delete your “expose”. But you don’t really believe that Seth is a hack – you obviously recognize him as someone who is unafraid of criticism, and willing to engage in debate with even the most dishonest of critics. It’s rather shameful of you to exploit Seth’s openness to criticism with your baseless accusations, but understandable that you do – it’s the only weapon you’ve got in your endless war to pretend to yourself that you’re a fearless critic of the establishment. In your imagination, why did the big bad, diabolically evil and powerful medical establishment wait 12 years before “going after” Wakefield? Was he too unimportant to bother with?

  7. Pingback: It really is bizarro day: Andrew Wakefield sues Brian Deer, BMJ | The Panic Virus

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