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Autism

This doesn’t happen every day: A study author comments in a humble surgeon’s blog

Over the last couple of days, I’ve blogged a bit about a study by Paul Shattuck that shows how useless it is to try to use special education classification numbers as a means of proving the existence of an “autism epidemic.” Well, at the risk of driving at least one person away, I’m going to comment one last time on this study. (And the answer to that person’s question is that I’ll blog about this topic when there’s something going on that interests me enough to blog about it. He is perfectly free to ignore my posts on the topic if they annoy him so.)

In any case, Paul Shattuck himself showed up in the comments of this post.

Although I agree with most of what he said and am gratified for the tactical air support indicating that my conclusions about the attacks on him were correct, I do have to take a wee bit of issue with this one statement he made:

With respect to vaccines, I would describe myself as nonpartisan and open minded on the issue. The link has not been demonstrated in a way that I personally find compelling. But I do believe there is enough tantalizing evidence to keep examining the issue. Most notable to me was the mouse model study at Columbia showing the differential response to mercury exposure as a function of genetic manipulation.

In this one point, I’m afraid, I have to disagree with Dr. Shattuck rather strongly. There really is no longer any good evidence, tantalizing or otherwise, supporting a link between vaccines in autism, and the study he mentions is actually not a particularly convincing (or “tantalizing”) study at all. In addition, all the more recent studies (other than very shoddy studies done by advocates such as the Geiers) fail to support a link. Similarly, Wakefield’s work purporting to support a link between MMR and autism has been utterly discredited. The bottom line is that the “science” supposedly supporting a link between vaccines and autism is of uniformly very poor quality. I suppose that it is possible that there are a very small number of children who react differently to mercury with the result being autism (which larger epidemiological studies might miss), but there is no longer a scientifically viable case to be made that mercury is the cause of autism for even a significant minority of autistic children. (Perhaps Dr. Shattuck is aware of halfway decent studies that I am not aware of and would be kind enough to point me in their direction.) Certainly, it is not a “misdiagnosis for mercury poisoning,” as one advocacy group puts it, nor is there any scientific or clinical justification for treating it with chelation therapy.

That quibble aside, one thing that Dr. Shattuck said that rings absolutely true:

Concerns over autism prevalence have driven research funding to record levels at NIH and CDC over the past decade. If I was truly an unscrupulous researcher looking to boost my grant portfolio in any way possible then I would be better off trying to stoke concerns about an epidemic, rather than do the research I’ve undertaken. I’ve actually had colleagues from other universities nervously joke that if concern about autism fades then their research funding might dry up. So, the “unscrupulous researcher bends findings to boost financial self-interest” angle doesn’t hold up to scrutiny.

Indeed, it doesn’t. And, if he did research that supported the concept of an autism “epidemic,” he could get research money from various advocacy groups as well as the NIH or CDC. I have to tip my hat to him for being willint to take the risk that he is shooting himself in the foot (from a funding perspective) by publishing this data. I also have to admire his willingness to find what the blogosphere is saying about his study and then jump into the fray, and not just here. Dr. Shattuck has also made an appearance in the comments of Kev’s blog as well, where he has defends some aspects of the study that have been questioned. I don’t know of any other researcher who would dive into the trenches as Dr. Shattuck has, and I’m grateful that he’s willing to do that.

If I ever publish anything that causes that much controversy, I’ll have to try to do the same thing.

ADDENDUM: Before I finally move on to other topics at long last (for example, a couple of more posts in my Medicine and Evolution series), having apparently beaten this one to death over the last couple of days, I have to point out Mark CC’s comparison of Dr. Shattuck’s good math compared to the Geiers’ bad math and Skeptico’s comments on the study and how Shattuck is being attacked.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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